| ObjectiveThrough the animal experiment model of acute urinary tract obstruction, we showed the imaging features and pathological characteristics in their lung, combined with relevant laboratory examination, to analyze the reasons for relative lung features after acute urinary tract obstruction, and provide clinical data and diagnostic idea for doctors.MethodsSelected 30 New Zealand white rabbits who had normal lung after CT scans, and were randomly divided into control group, unilateral ureteral obstruction group (unilateral group) and bilateral ureteral obstruction group (bilateral group), after the first two days, chest high-resolution CT scan, serum creatinine (Cr), blood urea nitrogen (BUN) and atrial natriuretic peptide (ANP) were examined every 2 days till bilateral group animals were dead entirely. In the progress and after the end of the experiment, rabbits lung were taken for pathological examination.Results1 In unilateral group, there were negative pectoral features of rabbits in both CT and pathology. At the same time, the numbers of Cr,BUN and ANP between control group and unilatera were not statistically significant:(1) Chest CT showed the intensity of bilateral lung field could be steady and no abnormal density lesions, pulmonary markings could be well-distributed; no pleural thickening, pleural effusion and pericardial effusion in mediastinal window;(2) Biopsy showed two kinds of alveolar epithelial cells and capillaries within the alveolar septum in alveolar facets. Structure of lung tissue could be normal, alveolar septum were without edema, inflammatory cell infiltration and other performance;(3) In blood BUN, Cr and ANP, there were no statistically significant difference between unilateral group and control group after operation of 0d,2d, and 4d respectively (P> 0.05).2 The measure values of blood BUN, Cr, and ANP, with the features of CT and pathology in bilateral group were significant differences compared with the control group:(1) There were series of secondum CT features in the lungs about bilateral group, such as lung field blur, interstitial edema, alveolar pneumonedema, pericardial effusion and pleural effusion, etc.(2) Bilateral group animals pathology features in lung included alveolar septum thickening, alveolar epithelium rarefaction, pink-stained edema fluid in alveolar space and alveolar septum, vascular expansion and congestion, inflammatory cell infiltration, etc.(3) In blood BUN, Cr and ANP, there were some statistically significant difference between unilateral group and control group after operation of 2d, and 4d respectively (P< 0.05); there were no significantly different between them after operation of Od.(4) The overall trend of pectorl CT manifestations in bilateral group were that lung field were blur and later developed into an interstitial pulmonary edema, then alveolar pulmonary edema. Pleural effusion and pericardial effusion could appear with the lung manifestations or be seen alone after the various manifestations; a variety of lung performance had certain degree of consistency with the maximum frequency value of blood BUN and Cr.ConclusionThere were negative features about lungs in CT, pathology and chemical examination in unilateral group; but positive features in bilateral group, mainly pathogenesis included retention of sodium and water, increased volume of circulation, accumulation of a large number of toxins, and so on. While heart failure belonged to secondary changes.Accordingly, we can see that in clinical the patients with bilateral urinary tract obstruction and pulmonary changes should be first considered as the pulmonary edema, and diuretic and other related treatment could be used to observe treatment effect. In contrast, pulmonary edema was not the main etiopathogenisis for those patients with unilateral urinary tract obstruction with pulmonary changes. Doctors should comprehensively analyze the reason of disease combining with a of medical history and relevant examination. |
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