Weichert-Jacobsen K, Scheidt M, Külkens C, Loch T
Department of Urology, Kiel Medical School, Christian-Albrechts University, Germany.
Urol Res. 1997;25(4):257-62. doi: 10.1007/BF00942095.
Urinary loss of the tubular marker enzyme N-acetyl-beta-D-glucosaminidase (NAG) immediately following extracorporeal lithotripsy suggests corresponding morphological changes in the kidney. To date, the morphological correlate of the enzymuria remains unclear. In this animal study with Wistar rats acute morphological changes in the tubulus cells beneath isolated tubulus necrosis were demonstrated. The mechanically induced lesions of the cell organelles included fragmentation of the lysosomes and severe alterations of the cell membrane. The tubulus damage was quantified. With the help of histochemical NAG staining and electron microscopic observations, a significant correlation between number and intensity of shock waves and tubular damage was found. The intracellular lesions described here are at least part of the morphological basis of shock-wave-induced enzymuria. The results show that enzymatic changes in urine reflect visible renal damage.
体外冲击波碎石术后立即出现肾小管标志物酶N - 乙酰 - β - D - 氨基葡萄糖苷酶（NAG）的尿中丢失，提示肾脏相应的形态学改变。迄今为止，酶尿的形态学关联仍不清楚。在这项针对Wistar大鼠的动物研究中，证实了在孤立的肾小管坏死下方的肾小管细胞存在急性形态学变化。细胞器的机械性损伤包括溶酶体破碎和细胞膜的严重改变。对肾小管损伤进行了量化。借助组织化学NAG染色和电子显微镜观察，发现冲击波的数量和强度与肾小管损伤之间存在显著相关性。这里描述的细胞内损伤至少是冲击波诱导酶尿的部分形态学基础。结果表明，尿液中的酶变化反映了可见的肾脏损伤。
