高尿酸血症肾皮质损伤后的肾脏超声变化

Renal ultrasound changes after renal cortex injury in hyperuricemia

中文关键词: 高尿酸血症(HUA)  钠钾ATP酶(NKA)  超声

英文关键词: hyperuricemia  sodium-potassium ATPase  ultrasound

中文摘要:

      目的 研究高尿酸血症(hyperuricemia,HUA)肾皮质损伤的超声变化.方法 一共15 只雄性SD大鼠随机分为3 组(每组5 只),包括正常组(Cont组)、模型组(HUA组)和非布司他治疗组(HUA+Feb组,Feb 3 mg/kg·d).所有大鼠自由随意饮水和喂养普通饲料.HUA组大鼠用氧嗪酸(OA,750 mg/kg·d)灌胃8 周诱导成模.HUA+Feb组大鼠于第五周开始用非布司他灌胃4 周.8 周后检测血清尿素氮(BUN)、血肌酐(Scr)和血尿酸(Sua)水平.测定大鼠肾皮质组织中的钠钾ATP酶(NKA)活性和NKA α1 亚单位蛋白表达,并通过超声观察大鼠肾脏结构、检测皮质回声.计算肾/脾回声强度比(K/S).此外,临床上共招募在复旦大学附属华东医院接受肾脏B超检测的正常对照(n =44)和HUA受试者(n =46),并收集他们的基本临床信息并进行比较.结果 动物实验结果显示,与Cont组大鼠相比,HUA组的Sua水平升高(P＜0.05),NKA活性降低(P＜0.05).与HUA组相比,HUA+Feb组的Sua水平降低(P＜0.05),NKA活性和NKA α1 蛋白表达增加(P＜0.05).超声结果显示,HUA组的肾皮质回声高于Cont组(P＜0.05),非布司他治疗后 4周,HUA+Feb组大鼠肾皮质回声显著改善(P＜0.05),且K/S比值低于HUA组(P＜0.05).大鼠肾脏长度、宽度和肾实质厚度在各组间无明显差异(P＞0.05).临床数据显示,HUA患者表现为肾皮质回声增强,结晶增多以及结构欠清,部分伴有多发小囊灶形成.结论 HUA早期肾脏损伤的同时伴有肾脏皮质回声增强,因此超声可能用作非侵入性的影像工具,以评估早期HUA引起的肾脏损伤.

英文摘要:

      Objective To explore the ultrasound changes of renal cortex injury in hyperuricemia(HUA).Methods A total of 15 male SD rats were randomly divided into 3 groups(n =5 in each group),including normal group(Cont group),model group(HUA group)and febuxostat treatment group(HUA+Feb group,Feb 3 mg/kg·d).All rats were free to drink water and fed with regular feed.The rats in the HUA group were induced into models by gavage of oxazine acid(OA,750 mg/kg·d)for 8 weeks.The rats in the HUA+Feb group were given febuxostat by gavage for 4 weeks starting from the 5th week.After 8 weeks,the levels of serum urea nitrogen(BUN),blood creatinine(Scr)and blood uric acid(Sua)were detected.The activity of sodium-potassium ATPase(NKA)and the expression of NKA-α1 subunit protein in rat renal cortex were determined.The renal structure and cortical echogenicity were observed by ultrasound.The kidney/spleen echo-intensity ratio(K/S)was calculated.In addition,normal control subjects(n =44)and HUA patients(n =46)who received kidney ul-trasound examination in Huadong Hospital Affiliated to Fudan University were clinically recruited.Their basic clinical informa-tion was collected and compared.Results The results of animal experiments showed that compared with the Cont group,Sua level of the HUA group increased(P＜0.05),while NKA activity decreased(P＜0.05).Compared with the HUA group,Sua level of the HUA+Feb group decreased(P＜0.05),NKA activity and NKA-α1 protein expression increased(P＜0.05).The ultrasound results showed that the renal cortical echogenicity of the HUA group was higher than that of the Cont group(P＜0.05).After 4 weeks of treatment with febuxostat,the renal cortical echogenicity of the HUA+Feb group significantly improved(P＜0.05),and the K/S ratio was lower than that of the HUA group(P＜0.05).There were no significant differ-ences in renal length,width and renal parenchymal thickness among all groups(P＞0.05).The clinical data showed that HUA patients exhibited enhanced renal cortical echogenicity,increased crystallization and unclear structure,some of which were ac-companied by the formation of multiple small cystic lesions.Conclusion Early renal injury caused by HUA is accompanied by increased cortical echogenicity.Therefore,ultrasound may be used as a non-invasive imaging tool to evaluate renal injury caused by early HUA.