目的 探討魚膽汁對兔腎臟的影響及其機制。 方法 將實驗新西蘭大耳白兔隨機分為灌胃組（GP組，n=19）與靜脈注射組（VI組，n=15），根據體重分別按3 mL/kg、0.3 mL/kg的劑量通過灌胃或耳緣靜脈注射方式給予魚膽汁。采集魚膽汁處理前與處理后1～5 h的血標本，測定腎功能、酸堿平衡及電解質指標，記錄GP組每個采樣點前20 min尿量及魚膽汁處理前、處理后5 h的尿常規。魚膽汁處理后5 h處死動物取腎做病理學檢查。 結果 給予一定量魚膽汁后5 h內，兩組兔血肌酐（Scr）、尿素氮、K+呈升高趨勢（P均＜0.05），而血HCO3?濃度呈下降趨勢（P＜0.05），其中VI組兔Scr、血K+改變早于GP組。GP組記錄尿量明顯下降，尿pH值升高，蛋白定量試驗、隱血試驗結果均呈陽性。兩組兔腎組織病理檢查均顯示腎小球血管充盈，少量中性粒細胞浸潤；腎小管水腫及間質充血，部分有局灶性出血，腎間質損傷較腎小球更為嚴重。 結論 無論經由消化道還是血管給予實驗兔魚膽汁均可導致急性腎功能損傷，與魚膽汁造成急性腎實質損傷、特別是腎小管間質損傷有關。
Objective To assess the cost-utility study of renal transplantation compared with nemodialysis (HD) and peritoneal dialysis (PD). Methods A prospective study of end-stage renal disease patients was followed up for 3 months after renal replacement therapy. The study population included 196 patients (renal transplant [RT] n=63, hemodialysis [HD] n=82 and continious ambulatory peritoneal dialysis [CAPD] n=51) from 6 hospitals of Sichuan province. Health-related quality of life was assessed by using the WHOQOL-BRIEF questionnaire. Utility scores were obtained so as to conduct CUA (cost-utility analysis). Costs were collected from financial department and by patient interview. Results The utility values were 0.539 9± 0.013 for RT, 0.450 8± 0.014 for HD, 0.512 2±0.099 for CAPD, respectively. The mean direct cost of the first three months of renal transplant was significantly higher than dialysis (RT and CAPD). Over 3 months, the average cost per quality-adjusted life year (QALY) for patients after CAPD was lower than HD and RT. Compared to HD, incremental cost analysis showed that CAPD was more ecnomical than RT. Sensitive analysis showed that CAPD was more effective than RT when ΔQALY varied in the limit of 95% confidence interval. However, the cost-utility of RT vs HD and CAPD vs HD was varied with ΔQALY level. Conclusions Cost-utility analysis showed that CAPD was a more favorable cost-utility ratio when compared to RT at early stage RT vs HD and CAPD vs HD, but which cost-utility ratio is better, we can not draw a certain conclusion.