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实验性诱导的尿道梗阻及宫内手术减压对兔肾脏发育和功能的影响。

Effect of experimentally induced urethral obstruction and surgical decompression in utero on renal development and function in rabbits.

作者信息

Gotoh H, Masuzaki H, Taguri H, Yoshimura S, Ishimaru T

机构信息

Department of Obstetrics and Gynecology, Nagasaki University School of Medicine, Japan.

出版信息

Early Hum Dev. 1998 Sep;52(2):111-23. doi: 10.1016/s0378-3782(98)00020-6.

Abstract

To investigate the effect of urethral obstruction during late fetal life on renal development and function, we developed a rabbit fetal model of obstructive nephropathy to examine the pathological and biochemical consequences of urethral obstruction and beneficial effects of early surgical decompression. Animals were divided into four groups, i.e., obstructed, early decompressed, late decompressed, and control. Fetal renal development was evaluated by histological examination and counting the number of glomeruli in the four groups. The number of renal glomeruli correlated with gestational age in the normal fetus (r = 0.90, P < 0.0001). Urethral ligation on gestational day 25 (full-term, 31 days) resulted in thinning of the renal cortex and significantly decreased the number of renal glomeruli. The concentration of urinary microalbumin was higher when urethral obstruction was maintained for 3 days than 1 day after urethral obstruction, although urinary beta2- microglobulin, Na, Cl, and osmotic pressure did not change during this period. Decompression of urethral obstruction 1 day after induction of urethral obstruction resulted in improvement in the severity glomerular hypoplasia compared with late decompression (P < 0.01). Our results suggest that the rabbit fetal model simulates fetal urethral obstruction in humans, and indicates that early surgical decompression may be effective in restoration of normal renal function.

摘要

为研究胎儿晚期尿道梗阻对肾脏发育及功能的影响,我们建立了兔胎儿梗阻性肾病模型,以检测尿道梗阻的病理和生化后果以及早期手术减压的有益作用。动物被分为四组,即梗阻组、早期减压组、晚期减压组和对照组。通过组织学检查和计数四组中肾小球的数量来评估胎儿肾脏发育情况。正常胎儿的肾小球数量与胎龄相关(r = 0.90,P < 0.0001)。在妊娠第25天(足月为31天)进行尿道结扎,导致肾皮质变薄,并显著减少了肾小球的数量。尿道梗阻维持3天时尿微量白蛋白浓度高于梗阻后1天,尽管在此期间尿β2-微球蛋白、钠、氯和渗透压没有变化。与晚期减压相比,尿道梗阻诱导后1天进行尿道减压可改善肾小球发育不全的严重程度(P < 0.01)。我们的结果表明,兔胎儿模型模拟了人类胎儿尿道梗阻情况,并表明早期手术减压可能对恢复正常肾功能有效。

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