泰淋方对慢性逆行性肾盂肾炎大鼠肾皮质瘢痕的影响

Effects of "Tailin Decoction" on renal scarring suppression in chronic pyelonephrits rats

目的探讨泰淋方对慢性逆行性肾盂肾炎(CPN)肾皮质瘢痕产生的干预作用及其机制。方法将雄性SD大鼠随机分为正常组、模型组、左旋氧氟沙星对照组、泰淋方治疗组。建立逆行性CPN大鼠模型,分别予相应的药物干预。动态观察肾小管功能、肾功能、24h尿蛋白定量,以及造模侧肾脏的皮质瘢痕、病理形态学变化,并应用RT-PCR检测肾组织转化生长因子-β1(TGF-β1)mRNA的表达。结果①第30、60天各组尿N-乙酰-β-D-氨基葡萄糖苷酶/尿肌酐(NAG/Cr)无明显差异,而第90天模型组尿NAG/Cr显著升高,与两药物干预组相比差异有统计学意义(P<0.01);实验期间各组肾功能、24h尿蛋白无明显差异。②模型组肾皮质二级及以上瘢痕明显,大部分造模侧肾脏发生明显固缩、对侧代偿性增大,镜下见明显肾间质纤维化和小球周围纤维化;药物干预组瘢痕发生率显著减少(P(0.05),总体病变减轻。③模型组造模侧肾组织TGF-β1mRNA表达明显增加,而药物干预组明显回落。结论泰淋方能部分抑制细菌逆行感染导致的肾皮质瘢痕发生,并有效保护肾小管功能。

Objective To explore the effects of ＂Tailin Decoction＂ in suppressing renal scarring in chronic pyelonephfits（CPN）. Methods Experimental CPN model was produced in male SD rats. All rats were randomly divided into four groups, including normal group, model group, Levofloxacin Lactate treatment group, and Decoction treatment group. Urinary N-aeetyl-beta -D- glocosamidase （NAG） was detected, as well as serum ereatinine （Scr）, blood urea nitrogen （BUN）, and 24 hour quantitative examination of urinary protein at 30 d, 60 d, and 90 d separately. After sacrificing the rats, renal scarring and pathological changes were observed. Transforming growth factor-beta 1 （ TGF-betal ） mRNA of kidney was examined with RT-PCR method in the end. Results （1）Urinary NAG/Cr significantly increased at 90 d in model group （P 〈0.01 vs normal group）, and two treatment groups inhibited such increase （P 〈0.01 vs model group）. （2） Results of Scr, BUN, and 24 hour quantitative examination of urinary protein in all groups didn＇ t show any difference during the whole period. Two treatment groups decreased severe renal scarring （ grades 2 and 3 ） compared with model group （ P 〈0.05 ）. （3） Compared with normal group, a significant increase was observed in model group in TGF- betal mRNA level of kidney （P 〈0.01 ） ; meanwhile, two treatment groups reversed such increase （ P 〈0.01 vs model group）. Conclusion ＂Tailin Decoction＂ is partially effective to avoid renal scarring and decrease tubular lesion in CPN, and improve renal function.