Relevance. Urolithiasis is characterized by frequent early relapses, acquires a social character, because these patients are 30 to 45% of all urological patients.
Aim of the research. The carrying out pathophysiological analysis of changes in fibrinolytic activity of urine in the development of nephrolithiasis the presence of calculi with a size of 0.6–1.0 cm, upper, middle sections of the calyx and of the upper third of the ureter using extracorporeal shock wave lithotripsy apparatus, the “Duet Magna” lithotripter (Dyrex).
Materials and methods. The study included 40 patients with nephrolithiasis the presence of calculi with a size of 0.6–1.0 cm, upper middle sections of the calyx and of the upper third of the ureter, 10 patients constituted the control group. Fibrinolytic activity of urine in conditions of water stress 2% of body weight and urine collection for 2 h was carried out by determination of the lysis of azofibrine with the estimation of total (TFA), nonenzymatic (NFA) (incubation of the samples in the presence of a blocker of enzymatic fibrinolysis ε-aminocaproic acid) and calculation of enzymatic fibrinolytic activity (EFA) according to the formula: EFA = TFA – NFA.
Results of investigation. Under the terms of the survey statistically significant positive correlation in the control between the total enzymatic and non-enzymatic fibrinolytic activity of urine. In the presence of the concretion of the upper section of the renal colices revealed no significant correlations. In the presence of the concretion of the middle section of the renal colices has one correlation between the total and enzymatic fibrinolytic activity of urine. In the presence of concrement upper third of the ureter discovered similar correlations as in the control, and between the total and the total enzymatic and non-enzymatic fibrinolytic activity of urine.
Conclusions. There shown inhibition of the indicators of fibrinolytic activity of urine after sessions of shock wave lithotripsy apparatus “Duet Magna” kidney stones size of 0.6–1.0 cm in the upper third of the ureter, the upper and middle sections of the renal colices. Analysis of indicators of inhibition of fibrinolytic activity of urine and the results of correlation and regression analyses allowed us to establish the degree of increase dysfunction of the fibrinolytic activity of urine in the following sequence: the upper third of the ureter, middle and upper parts of the calyx.