| Objective:Establish partial unilateral ureteral obstruction model with WZS minipigs with partial ureteral ligation. To determine the role of Doppler Ultrasonography in the diagnosis of unilateral obstruction and the prediction of renal function.To evaluate99mTc-DTPA renal dynamic imaging in the diagnosis of the renal function in partial unilateral obstructive pigs, so as to analyze the predictive value of GFR、ERPF for the functional restoration, and to provide reference for clinical treatment.Methods:Fifteen pigs aged from10to12months were involved in the study. The maximum anteroposterior dimension (APD) of renal pelvis, renal cortical thickness (RCT), peak systolic velocity (PSV), end-diastolic velocity (EDV) of the arteries, the resistance index (RI), glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured preoperatively in all pigs as normal controls. Nine of them were randomly selected to perform the obstructive operation, and the other six were performed sham-operation. All these parameters were measured1,2,4weeks after obstruction and1,2,4weeks after the relief of obstruction in obstructed pigs, but only1week after operation in sham-operated pigs. The delta-RI (changes of RI) and RI ratio were also calculated. Compare these results with normal controls to get to elucidate their changing rules.Results:There were no statistical differences between preoperative and postoperative values in all parameters in the sham-operation group. The value of APD was increased significantly after partial obstruction compared with normal controls (P<0.01), while RCT decreased significantly after partial obstruction (P<0.01). Only one week after the relief of the obstruction, APD decreased notably and showed no significant difference compared with normal controls.No significant changes in RCT were found after the obstruction was removed but it indeed had increased slightly.The peak systolic velocity (PSV) and End diastolic velocity (EDV) of renal artery and intra-renal artery decreased significantly after obstruction compared with normal controls (P<0.01), while RI of renal artery and intra-renal artery increased notably after obstruction (P<0.01). Not until four weeks after relief of the obstruction, RI recovered to the level of normal controls (P>0.05). But the recovery of PSV and EDV were not remarkable even4weeks after relief of the obstruction (P>0.05). If we set RI≥0.7, ARI≥0.1, RIR≥1.10as the criterion for obstruction, the diagnostic accuracy of RI in renal artery was0,18.5%,62.9%respectively and0,14.8%,25.9%in intra-renal arteries respectively.GFR decreased gradually after partial unilateral ureteral obstruction compared with normal controls(P<0.01), and there was a greater extent of decrease(23.2%) in the early stage.It increased gradually after the relief of the obstruction,but still showed a significant difference compared with the controls(P<0.01). ERPF had showed the same tendency with GFR. Total GFR and ERPF had no statistical differences compared with the controls, it means that the right kidney had a good compensation.Conclusion:1. Partial unilateral ureteral obstruction model can be successfully established with WZS minipigs through partial ureteral ligation.2.Renal blood flow was significantly slowed down after partial unilateral ureteral obstruction and renal haemodynamic changes could reflect the functional status of kidney. The resistive index (RI) is not reliable parameter for diagnosising ureteral obstruction, comparison of RI with the contralateral is beneficial for the diagnosis of the ureteral obstruction.3. GFR and ERPF had a greater extent of decrease in the early stage after partial unilateral ureteral obstruction, it increased gradually after relief of the obstruction. The function can be well restored after relief of obstruction even the GFR or ERPF of the obstructed kidney dropped to about50%, but wheather it could come to a complete recovery or not still needs further study.19Figures,20Tables,52References... |
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