بررسی تغییرات ایجاد شده در آنزیم های کبدی پس از درمان سنگ های کلیوی به وسیله سنگ شکنی خارج اندامی با امواج ضربه ای (گزارش کوتاه)

Background and purpose: Extracorporeal shock wave lithotripsy changed the treatment of renal stones. Beacause the widespread usage of ESWL (extra Corporeal shock wave lithotripsy) in the treatment of the Urinary tract stones, the effects of these waves on the surrounding tissues are not compeletly understood and it is the origin of so many studies. Materials and methods: In this prospective study 250 patients suffering from renal and upper ureteral stones were selected. Serum levels of ALT(Alanine Aminotransferase), AST(AspartateAminotransferase), Alkaline Phosphatase were measured in all of the patients before treatment with ESWL and these measurements repeated after the treatment , then these findings were compared. ANOVA test was used for the quantitative variables. Results: Before the treatment no Significant differences found between groups. But we found a significant elevation in enzymes after the treatment in comparison with their serum levels before treatment. Rising in serum enzymes had a direct correlation with the number of shock waves that were used for treatment. Enzymatic levels in the patients with right renal stones raised more and for longer period than the left side. Conclusion: After the treatment of renal stones with ESWL, serum leveles of ALT, AST and ALP will increase. If we use these waves at the right side and specially when we use more waves, this rising will be more significant and persist for longer period. Thus when we want to use these waves in the right side we must consider the amount of these waves and the intervals of the treatment. We recommend that in the patients with elevated liver enzymes level, gastrointestinal evaluation before treatment is necessary.