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体外冲击波碎石术对肾结石病患者肾功能的影响。

Effects of extracorporeal shock wave lithotripsy on renal function in patients with kidney stone disease.

作者信息

Rutz-Danielczak A, Pupek-Musialik D, Raszeja-Wanic B

机构信息

Department of Hypertension, Karol Marcinkowski School of Medical Sciences, Poznań, Poland.

出版信息

Nephron. 1998;79(2):162-6. doi: 10.1159/000045019.

Abstract

The effects of extracorporeal shock wave lithotripsy on glomerular and tubular renal functions were determined by serum beta2-microglobulin (Sbeta2m) and urinary beta2-microglobulin (Ubeta2m) estimations in patients with nephrolithiasis. Unilateral treatment was performed in all patients. Urinary and serum creatinine levels were determined according to the method of Yatzidis. Sbeta2m and Ubeta2m were measured by radioimmunoassay the day before ESWL, on the day of ESWL, and then 1, 2, 5, 7, 8, 9, 14, and 28 days after treatment. Creatinine clearance, hourly urinary beta2m excretion (Ubeta2m/h), and tubular reabsorption of beta2m (TRbeta2m) were calculated. After lithotripsy, significant increases in Ubeta2m, Ubeta2m/h, and TRbeta2m were found (p < 0.001), whereas Sbeta2m, serum creatinine, and creatinine clearance values remained unchanged. Ubeta2m, Ubeta2m/h, and TRbeta2m reached their pretreatment values within 7-9 days after ESWL. We concluded that ESWL does not affect the glomerular filtration rate; however, it leads to a transient proximal tubular dysfunction.

摘要

通过测定肾结石患者的血清β2-微球蛋白(Sβ2m)和尿β2-微球蛋白(Uβ2m),来确定体外冲击波碎石术对肾小球和肾小管肾功能的影响。所有患者均接受单侧治疗。根据亚齐迪斯方法测定尿和血清肌酐水平。在体外冲击波碎石术前一天、体外冲击波碎石术当天,以及治疗后1、2、5、7、⑧、9、14和28天,通过放射免疫分析法测定Sβ2m和Uβ2m。计算肌酐清除率、每小时尿β2m排泄量(Uβ2m/h)和β2m的肾小管重吸收率(TRβ2m)。碎石术后,Uβ2m、Uβ2m/h和TRβ2m显著升高(p<0.001),而Sβ2m、血清肌酐和肌酐清除率值保持不变。Uβ2m、Uβ2m/h和TRβ2m在体外冲击波碎石术后7-9天内恢复到治疗前水平。我们得出结论,体外冲击波碎石术不影响肾小球滤过率;然而,它会导致短暂的近端肾小管功能障碍。

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