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目的:探讨输尿管梗阻及再通大鼠肾间质纤维化发生和恢复过程中单核-巨噬细胞相关因子的动态表达。方法将48只SD大鼠随机分成梗阻和再通两个实验部分,梗阻部分分为假手术组( sham,n=6)、单侧输尿管梗阻(UUO)3d(n=6)、UUO 7d(n=6)和UUO 14d(n=6);再通部分分为双侧输尿管梗阻(RBUO)0d(n=6)、RBUO后再通3d(n=6)、RBUO后再通7d(n=6)和RBUO 后再通14d(n=6)。术后3、7和14 d后处死取其肾脏组织。采用HE和Masson染色观察肾组织病理改变和间质纤维化程度;免疫组织化学染色检测肾组织内单核细胞趋化蛋白-1(MCP-1)、巨噬细胞克隆刺激因子(M-CSF)和活化巨噬细胞标志物CD68的表达水平;Real-time PCR检测MCP-1和M-CSF mRNA表达水平;ELISA测定TGF-β1含量。结果与Sham大鼠相比,UUO大鼠随着梗阻时间延长,纤维化程度加剧。同时TGF-β1水平明显升高。输尿管再通后,纤维化程度随时间延长明显减轻,且TGF-β1水平明显下调。 UUO大鼠肾组织中, MCP-1和M-CSF mRNA 和表达蛋白随梗阻时间延长而增加;梗阻再通后, MCP-1和M-CSF mRNA和蛋白表达随再通时间延长持续下降。 MCP-1和M-CSF在UUO或再通大鼠肾组织中的表达与CD68呈现一致性变化趋势。结论输尿管梗阻后,M-CSF和MCP-1的动态表达反映单核-巨噬细胞的活化和聚集状态,这可能是间质纤维化发生十分重要的炎症基础。而输尿管再通可抑制活化和趋化的单核-巨噬细胞,控制炎症反应,缓解肾间质纤维化。“,”Objective To investigate the expression of monocyte-macrophage-related factors and interstitial fibrosis in kidney tissues of rats with ureter obstruction and recanalization .Methods Forty-eight male Spragur-Dawley rats were divided randomly into the obstructive group:sham (n=6), unilateral ureteral obstruction(UUO)3 days (n=6), UUO 7 days (n=6), and UUO 14 days (n=6) and recanalization group:bilateral ureteral obstruction(RBUO)0 day (n=6), 3 days after RBUO (n=6), 7 days after RBUO (n=6), and 14 days after RBUO (n=6).The kidneys were excised on day 3, 7, and 14, and the deposition of collagen fibers in kidney was detected with HE and Masson staining . Immunohistochemical analysis was performed to evaluate the protein expressions of monocyte chemoattractant protein -1 (MCP-1), macrophage colony-stimulating factor (M-CSF) and activated-macrophage marker CD68.Real-time PCR was used to detect the mRNA expressions of MCP-1 and M-CSF.TGF-β1 levels were determined by ELISA .Results Fibrosis observed with HE and Masson staining was obviously increased in kidney tissue of UUO rats , and aggravated as timeprolonged, but alleviated in rats with recanalization .TGF-β1 levels were increased obviously in the UUO group , but decreased in rats with recanalization compared with those in BUO rats .In UUO rats, mRNA and protein expression levels of MCP-1 and M-CSF were increased .MCP-1 and M-CSF expression was gradually decreased in rats with recanalization compared with those in BUO rats .The dynamic change in expression of MCP-1 and M-CSF in both UUO rats and recanalization rats was consistent with the change in expression of CD 68. Conclusion Dynamic change in expression of MCP-1 and M-CSF in kidney tissues reflects change of activated and accumulated monocyte -macrophages , which may be one of the major mechanisms contributing to fibrosis induced by ureter obstruction .Renal fibrosis is alleviated by down-regulated expression of monocyte-macrophages factors with recanalization operation .