简介:上尿路中的Cajal样细胞(CLC)具有产生协调的自发动作电位的能力,并被认为有助于将尿液从肾盂推进到输尿管。这篇综述的目的是描述与肾盂输尿管连接部梗阻(UPJO)相关的CLC密度和分布的变化。材料和方法:本系统综述包括比较UPJO患者和健康对照者上尿路中CLC的密度和分布的研究。我们搜索了在线电子数据库OvidMEDLINE,Scopus,PubMed和Cochrane对2020年10月31日之前发表的研究进行了评论。进行了荟萃分析,以比较患有肾盂输尿管交界处(UPJ)的患者和匹配的对照组的CLC密度。结果:我们纳入了20项和7项定性和定量综合研究,分别。大多数(55%)CLC位于上尿路的肌肉层之间。在健康受试者和患有UPJO的患者中,随着年龄的增长,UPJ中的CLC密度逐渐增加。汇总分析显示,与对照组相比,UPJO患者UPJ的CLC密度显着降低(SMD=-3.00,95%CI=-3.89至-2.11,p<0.01)。结论:UPJO患者UPJ处CLC密度的降低表明CLC在UPJO的发病机理中的作用。由于年龄与CLC密度呈正相关,在进行病例对照研究比较CLC密度和分布时,必须仔细匹配年龄。协议注册号:CRD42020219882。
Introduction: Cajal like cells (CLCs) in the upper urinary tract have an ability to generate coordinated spontaneous action potentials and are hypothesized to help propel urine from renal pelvis into the ureter. The objective of this
review was to describe the variations in the density and distribution of CLCs associated with ureteropelvic junction obstruction (UPJO). Materials and Methods: Studies comparing the density and distribution of CLCs in the human upper urinary tract in patients with UPJO and healthy controls were included in this systematic
review. We searched online electronic databases; Ovid MEDLINE, Scopus, PubMed and Cochrane reviews for the studies published before October 31, 2020. A meta-analysis was conducted to compare the density of CLCs at the ureteropelvic junction (UPJ) in patients with UPJO and matched controls. Results: We included 20 and seven studies in the qualitative and quantitative synthesis, respectively. In majority (55%) CLCs were located between the muscle layers of the upper urinary tract. The CLC density in the UPJ gradually increased with aging in both healthy subjects and patients with UPJO. The pooled analysis revealed that the density of CLCs at the UPJ was significantly low in patients with UPJO compared to the controls (SMD = -3.00, 95% CI = -3.89 to -2.11, p < 0.01). Conclusions: The reduction in CLC density at the UPJ in patients with UPJO suggests a contribution from CLCs in the pathogenesis of UPJO. Since age positively correlates with CLC density, it is imperative to carefully match age when conducting case control studies comparing the CLC density and distribution. Protocol Registration Number: CRD42020219882.