| Objective:①To establish an ideal and repeatable animal model of partialunilateral ureter obstruction(PUUO).②To evaluate the clinical significance of urinaryN-acetyl-β-D-glucosaminidase(NAG), Retinoid-binding-protein(RBP), Albumin(Alb)and renal dynamic imaging in degree of kidney damage caused by unilateral ureteralobstruction.③To investigate the degree of hydronephrosis, the change of renal function,and the development of tubulointerstitial fibrosis caused by PUUO.Methods：Fifty male New Zealand white rabbits were randomly allocated intosham operation group（control group）of 10 rabbits，only the left ureter was isolateddirectly before the abdomen was closed; Surgical approach chose a longitudinalincision on the back side under the costal arch about 2 cm away from the spine.The leftureters of 40 New Zealand white rabbits of surgery group were separated out ,thenplace a 1 mm diameter polyethylene plastic pipe around the ureter fixing the pipe bysilk thread. Surgery group was divided into A, B, C, D four groups randomly assigned10,and after surgery in 1, 2, 4, 8 weeks renal dynamic imaging were detected.Thencollect urine of left renal pelvis to test Alb, NAG, RBP, Cr. After eight weeks thecontrol group tested each index and get the renal dynamic imaging examination, theresults using the image analysis system for half quantitative analysis.Experimentalresults mean in x±s , the comparisons among each group is using the single factoranalysis of variance by software SPSS 16.0, P < 0.05 for with a statistical significance.After renal dynamic imaging examination and urine specimen collection, killed theanimals , Removing the damaged renals ,and make pathological microsection byusing HE,Masson dyeing, monitoring of renal cell apoptosis and fibrosis stage.Result: NAG level in the urine of the renal pelvis of A, B, C, D group isobviously high compared with the control group (P < 0.05).Along with the increaseof the time of the obstruction ,the NAG level is group A < B < C <D, and all are statistically significant (P < 0.05). Alb, RBP level in left renal pelvis of A group is nochange(P>0.05),and it increased obviously in group B,C,D(P<0.05). Alb, RBP aftercorrection of endogenous creatinine, the RBP/Cr of group A compared with the controlgroup is obvious difference (P < 0.05), Alb/Cr is no difference (P > 0.05). Agroup ,GFR level has no difference with the control group (P > 0.05), but B, C, Dgroup have significant difference (P < 0.05), and with the obstruction time passingGFR levels drop progressively. HE, Masson dyeing show: the control group: renalorganization structure form normal; Group A :part of the kidney tubules become mildexpansion, and epithelial cell is swelling; Group B :distal tubule and manifolds bacomefar more expansion than groupA, renal tubular epithelial cells appear more emptybubble degeneration, tubulointerstitial appear inflammatory cells infiltration, glomerulicell become swelling and denaturation; group C :Part of renal tubular is atrophy andlumen collapse, a large number of inflammatory cells infiltrate the kidney, renalinterstitial become wide, matrix components increase, fibrous tissue hyperplasia, partglomeruli appear atrophy; Group D: renal tubular fibrosis become more evidently,most of the renal tubular structure damage and disappear, atrophy of the glomerular isincreased.Conclusion:①Partial obstruction of the left ureter is created by cheng’way andthe method is simple.the obstruction was easy to remove and the degree can becontrolled.The animal modle completely conforming the requirements of study withvery good repeatability is a kind of ideal of ureteral obstruction of the reversibility.The operation way through back of the animal is simple and have little effect on theexperimental animal gut.The operation method is feasible with the high survival rate .②NAG/Cr, RBP/Cr of the renal pelvis urine is increasing obviously in the early timeof the obstruction when the GFR has not changed. It shows that at the beginning of theobstructive nephropathy the renal tubule damage first and NAG、RBP/Cr can evaluatethe damage degree of the real function, especially at the early stage of hydronephrosiswhen the GFR has no change. Urinary Alb/Cr can evaluate the damage degree of theglomeruli having good correlation with GFR.③At the early time of the ureteral obstruction,kidney become edema and the size become larger; the renal pelvis andureter is expansion obvious 2 week after the surgery; 4 weeks later the renal cortexbegan to become thinner, and more thinner after, Microscopically, in early time renaltubule expand, the epithelial cells become flat, interstitial fibrosis appear significantly;8 weeks later renal tubule atrophy and the structure is not clear.At the 2 weeks after obstruction, tubulointerstitium appears fibrinogendeposition, and the longer time obstruction cause renal fibrosis more heavier,renaltubule atrophy more visibly, After ureteral obstruction the function of glomerularfiltration and urine concentration damaged gradually. With the internal pressure ofrenal pelvis increasing, the renal tubule atrophy ,and renal fibrosis ,the function ofkidney become damaged. |
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