目的 探索使用活血化瘀药川芎嗪保护家兔ESWL后肾功能的效果。方法 以家兔(20只, 2~3 kg)为研究对象, 随机分为实验组10只(20%川芎嗪4 ml/kg, 肌注)和对照组10只, 以硫喷妥钠50 mg/kg麻醉, 切除右肾, 左肾门处放置一银夹后制成结石动物模型, 饲养两周, 行ESWL治疗, 测定ESWL前、后第1、3、5天家兔血中Cr、Bun、NO;并在第3、7天分别处死其中各3只, 取肾组织观察形态和结构。结果 用药组ESWL后血中Cr、Bun、NO升高不明显而非用药组中Cr、Bun、NO明显升高(P<0.05);光镜和电镜的组织结构显示, 用药组的组织损伤轻于未用药组。结论 川芎嗪能改善肾血流, 增加肾内前列腺素的合成, 减少血管紧张素, 促进氧自由基的清除, 对ESWL导致的急性肾功能损伤有保护作用。

Objective Explore the effect of tetramethylpyrazine on protecting rabbit’s renal function after ESWL.Methods Rabbits (20,2~3 kg) were randomly divided into the experimental group (10 rabbits,20% tetramethylpyrazine,4 ml/kg,IM) and the control group (10 rabbits).We used thiopental sodium 50 mg/kg to anesthetize rabbits,then resected the right kidney and placed a silver clip on the left renal hilum to obtain nephrolithiasis animal models.ESWL was performed after 2 weeks.We measured serum creatinine,urea nitrogen and nitric oxide 1,3,5 days before and after ESWL,and executed 3 rabbits each time from each group on day 3 and 7 after ESWL.We observed the morphology and structure of the renal tissue.Results The experimental group shows no obvious elavation of serum Cr Bun NO after ESWL while the control group has a significantly increased serum Cr,Bun,NO (P<0.05); Light and Electron microscopy shows a lower tissue damage in the experimental group than in the control group.Conclusion Tetramethylpyrazine can improve renal blood flow,increase prostaglandin synthesis in kidney,reduce angiotensin and promote scavenging oxygen free radicals.Hence Tetramethylpyrazine thas a protective effect on the acute renal injury caused by ESWL.