体外衝撃波の腎機能への影響 - 圧電式結石破砕装置THERASONICでの経験 -

Abstract

圧電式結石破砕装置セラソニックを用いて治療を行った尿路結石症34例について, 術後1ヵ月目まで観察した.1)尿中NAG活性, 尿中BMG濃度は, 腎結石症例において治療直後に有意な上昇を示したが, 尿管結石症例ではいずれも有意な変化は示さなかった.2)血中BMG濃度, 内因性クレアチニンクリアランスは治療前後で有意な変化を示さなかった.3)腎結石症例での治療直後の尿中NAG活性, BMG濃度と衝撃波の総数, 発射頻度, 出力との間には有意な関係はなかった

Seventeen patients with renal stones and 17 patients with ureteral stones were treated using the newly developed piezoelectric shock wave lithotripter, THERASONIC. To determine the effect of shock wave on renal function, urinary N-acetyl-beta-D-glucosaminidase (NAG) activity, urinary beta 2 microglobulin (BMG) concentration, serum BMG concentration and creatinine clearance (Ccr) were measured. Urinary NAG activity and urinary BMG concentration in renal stone patients were significantly elevated immediately after the treatment and returned to the pretreatment value within 24 hours. Neither serum BMG nor Ccr showed significant change in any of the patients. Therefore, we conclude that the renal tubular damage, which is transient and subtle, is the effect of shock wave lithotripsy using THERASONIC machine.