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Effect of vasico-amniotic shunt for fetal obstructive uropathy in lambs

血管羊膜分流术治疗羔羊胎儿梗阻性尿路病的效果

基本信息

批准号：
18591959
负责人：
KITAGAWA Hiroaki
金额：
$ 2.55万
依托单位：
St.Marianna University School of Medicine
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2006
资助国家：
日本
起止时间：
2006 至 2007
项目状态：
已结题

项目摘要

Purpose : The long term outcome for children after antenatal intervention for obstructive uropathies is disappointing. We reported that renal dysplastic changes are well established 3 weeks after obstruction in a fetal lamb model. We used this model to explore renal development and bladder function after fetal intervention.Methods: We created an obstructive uropathy in fetal lambs at 60 days gestation by ligating the urethra and urachus. A vesicostomy (female) or urethrostomy (male) were performed 21 days later. The fetuses were sacrificed at term(145 days) and bladder volume and compliance were measured. The urinary tract was processed for histological examination.Results: Twenty two fetuses were shunted. Nine miscarried or were still-born. Thirteen survived and eleven had a successful shunt with a small bladder (8±5ml) compared to controls (71±19ml), p<0.05. Shunted bladders had poor compliance. Histologically, they had thickened submucosal connective tissue with hypertrophied muscle. Histology of the renal tissue demonstrated relatively well-preserved renal architecture with reduced nephron mass (oligonephronia) in two lambs and multycystic dysplastic change (MCDK) in three. Six (55%) had normal nephrogenesis.Conclusions : In our model, shunt operations after obstructive uropathy fail to preserve bladder function. Shunting ameliorated the development of cystic dysplasia but half of the lambs had oligonephronia or MCDK. Thiese might develop renal failure later in life.

目的：针对梗阻性尿路病进行产前干预后的儿童的长期结果令人失望。我们报告说，在胎儿羔羊模型中，梗阻后 3 周，肾脏发育不良的变化已经确定。我们使用该模型来探索胎儿干预后的肾脏发育和膀胱功能。方法：我们通过结扎尿道和尿尿管，在妊娠 60 天的羔羊身上建立了阻塞性尿路病模型。 21 天后进行膀胱造口术（女性）或尿道造口术（男性）。足月（145天）处死胎儿并测量膀胱体积和顺应性。对泌尿道进行组织学检查。结果：22个胎儿被分流。九人流产或死产。与对照组 (71±19ml) 相比，13 名患者幸存，11 名患者成功分流，膀胱较小 (8±5ml)，p<0.05。分流膀胱的顺应性较差。组织学上，它们的粘膜下结缔组织增厚，肌肉肥大。肾组织的组织学显示，两只羔羊的肾脏结构保存相对完好，肾单位质量减少（少肾），三只羔羊出现多囊性发育不良改变（MCDK）。六名（55%）肾发生正常。结论：在我们的模型中，梗阻性尿路病后的分流手术未能保留膀胱功能。分流改善了囊性发育不良的发展，但一半的羔羊患有少肾病或 MCDK。 Thiese 可能会在以后的生活中出现肾功能衰竭。

项目成果

期刊论文数量（0）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

The effect of pressure valve shunt tube for fetal obstructive uropathy.

压力阀分流管治疗胎儿梗阻性尿路病的效果

DOI：
发表时间：
2006
期刊：
影响因子：
0
作者：
Hideki Nagae;Hiroaki Kitagawa;Kevin C.Pringle;Junki Koike.
通讯作者：
Junki Koike.

Expression of CD10 in normal and obstructive uropathy kidneys in the fetal lamb

CD10 在正常和梗阻性尿病肾中胎羔的表达

DOI：
发表时间：
2007
期刊：
影响因子：
0
作者：
Junki Koike;et. al.
通讯作者：
et. al.

Is a vesicoamuniotic shunt intrinsically bad? Shunting a normal fetal bladder.

膀胱羊膜分流本质上是不好的吗？

DOI：
发表时间：
2007
期刊：
J Pediatr Surg 42
影响因子：
0
作者：
Hiroaki Kitagawa;Kevin C. Pringle;Junki Koike;Hideki Nagae;Jane Zuccollo;Takeshi Aoba;Yasuji Seki;Chiai Nagae;Mamoru Tadokoro.
通讯作者：
Mamoru Tadokoro.

Pressure-limited vesico-amniotic shunt tube for fetal obstructive uropathy

限压膀胱羊膜分流管治疗胎儿梗阻性尿路病