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医学免费论文:祛风通络方对阿霉素肾病大鼠肾小球基底膜阴离子位点的影响
【摘要】 目的 观察祛风通络方对阿霉素肾病大鼠肾小球基底膜(GBM)上阴离子位点(AS)的影响。方法 尾静脉注射阿霉素建立阿霉素肾病(AN)大鼠模型，并随机分为A(空白组)、B(模型组)、C(祛风通络方组)、D(激素+祛风通络方组)、E(激素组)、F(苯那普利组)组，并给予相应干预;第3、7周留取肾皮质，以醋酸铀和柠檬酸铅双重染色法，透射电镜观察GBM的超微结构;以PEI示踪染色电镜观察GBM上AS的分布变化。结果 ①3周时与A组相比，模型组大鼠24h尿蛋白显著升高(P<0.01)，血清ALB明显下降(P<0.01)，血清TG和TCH明显升高(P<0.01);②3周时透射电镜示模型组大鼠肾小球足突呈部分或弥漫性融合，GBM上AS明显减少;③7周时与B组相比，C、E组超微结构明显改善，AS分布呈连续点线状分布，平均AS表达量增强(P<0.01)。结论 祛风通络方可通过改善GBM上AS的表达与分布而修复肾小球电荷屏障。
【关键词】 阿霉素肾病;蛋白尿;阴离子位点;祛风通络方医.学全.在.线网站www.lindalemus.com
Effects of Qufengtongluo Recipe on anionic site in glomerular basement membrane in adriamycin-induced nephropathy ratsREN Yan-yun, SUN Wan-sen, ZHAO Yan-long, MA Qiao-ya, WANG ZhuDepartment of Traditional and Western Medicine, the Second Affiliated Hospital,dical School of Xian Jiaotong University, Xian 710004, ChinaABSTRACT: Objective To investigate the expression of anionic site in adriamycin-induced nephropathy (AN) rats, and to further explore the effects of Qufengtongluo Recipe on charge barrier in glomerulus in AN rats. Methods Adriamycin nephropathy was induced by a single tail intravenous injection of adriamycin. Totally 80 rats were randomly divided into normal control group and nephropathy model group. Three weeks later, the nephropathy model was established, and 50 AN rats were randomly divided into five groups: nephropathy model group (B, n=10), Qufeng group (C, n=10), prednisone and Qufeng group (D, n=10), prednisone group (E, n=10) and benazepri group (F, n=10), and they were treated respectively. With treatment being given respectively, renal tissue samples in each group were collected at week 3 and 7, respectively. The ultrastructure and expression of anionic site were examined by electron microscope observation. Results ① After adriamycin injection, a significant increase of the 24-hour urinary protein was observed at week 3 (P<0.01). In AN rats, serum albumin was decreased (P<0.01) while serum TCH and TG were increased (P<0.01). ② In AN rats the diffuse fusion and effacement of foot processes and decrease of anionic sites in GBM were observed at week 3. ③ At week 7, the average intensity of AS dramatically increased in C and E groups (P<0.01) compared with that in nephropathy model group. Conclusion The abnormal expression of AS is the important mechanism that leads to the occurrence and development of proteinuria in AN rats. It is possible that Qufengtongluo Recipe has effects on nephrotic syndrome through altering the charge barrier in GBM in glomerulus.
KEY WORDS: adriamycin nephropathy; proteinuria; anionic site; Qufengtongluo Recipe
肾性蛋白尿的发生由肾小球滤过膜的机械屏障和电荷屏障损伤所致，肾小球毛细血管壁的电荷选择性通透性的变化是其发生的主要原因。肾小球基底膜(glomerular basement membrane, GBM)通过表面丰富的阴离子电荷和网络样小孔径筛网结构发挥电荷屏障和孔径屏障的功能。GBM上阴离子位点(anionic sites, AS)的变化可以有效反应肾小球滤过膜电荷屏障的功能状态。祛风通络方是在“风伏肾络”[1]的病机理论指导下组成的中药复方，用于肾病临床多年，效果可靠。本研究通过PEI示踪法观察祛风通络方对阿霉素肾病(adriamycin nephropathy, AN)大鼠GBM超微结构和AS的表达的影响，为祛风通络方的临床应用提供新的理论依据。
