两种取石术治疗肾结石对患者血清NGAL，Cys-C及尿KIM-1水平的影响比较

摘要

Objective:To explore the flexible ureteroscope lithtripsy (FURL) and percutaneous nephrolithotomy (PCNL) two kind of surgery in the treatment of renal calculi with serum neutrophil gelatinase associated lipocalin (NGAL),cystatin C (Cys-C) and urine kidney injury molecule 1 (KIM-1) level effect. Method:From January 2013 to December 2014,176 cases of renal calculi in our hospital were selected as the research objects,they were divided into the control group of 85 cases and the experimental group of 91 cases according to the different surgical methods,the control group was treated with PCNL and the experimental group was treated with FURL,the changes of serum NGAL,Cys-C and urinary KIM-1 levels before and after operation in two groups were compared.Result:The serum levels of NGAL and urine KIM-1 in the experimental group were all decreased gradually after reaching the peak at 12 h after operation,and the serum level of Cys-C decreased gradually after reaching the peak at 24 h after operation.The serum levels of NGAL in the control group was decreased gradually after reaching the peak at 12 h after operation,while the serum levels of Cys-C and urine KIM-1 were gradually decreased after reaching the peak at 24 h after operation.Conclusion:Two kinds of surgical methods have a certain degree of impairment on renal function,but the damage is reversible.The damage of FURL to the glomerular is longer and the damage of PCNL to the renal tubular is longer.%目的：探讨输尿管软镜取石术与经皮肾镜取石术两种手术方式治疗肾结石对血清中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、胱抑素C（Cys-C）及尿肾脏损伤分子-1（KIM-1）水平的影响。方法：选取2013年1月-2014年12月本院收治的肾结石患者176例作为研究对象，根据手术方法的不同分为对照组85例和试验组91例，对照组行经皮肾镜取石术，试验组行输尿管软镜取石术，比较两组术前和术后各时间段血清NGAL、Cys-C及尿KIM-1水平的变化情况。结果：试验组血清NGAL和尿KIM-1均于术后12 h达到峰值后逐渐降低，血清Cys-C在术后24 h达到峰值后逐渐降低；对照组血清NGAL在术后12 h达到峰值后逐渐降低，而血清Cys-C及尿KIM-1均于术后24 h达到峰值后逐渐降低。结论：两种手术方式均对肾功能有一定程度的损害，但这些损害是可逆的，输尿管软镜碎石术对肾小球的损害持续时间较长，而经皮肾镜取石术对肾小管损伤的持续时间较长。