肾衰康对慢性肾衰竭尿中细胞外基质成分的影响

The Effects of Shenshuaikang on the ECM in Chronic Renal Patients

目的 :探讨中药对细胞外基质 ( ECM)成分积聚的抑制作用及其延缓慢性肾衰竭进展和改善肾功能的作用。方法 :对 60例慢性肾衰竭 2期患者随机分为肾衰康治疗组 (治疗组 )及苯那普利治疗组 (对照组 ) ,每组 30例 ,观察治疗前后尿液中 ECM成分及肾功能改变。结果 :两组治疗前尿中 ECM成分均显著高于健康人 ( P<0 .0 1 ;P<0 .0 5 ) ;治疗后尿中 型胶原 ( C- )、层粘蛋白 ( LN)、纤维连接蛋白 ( FN)及 型前胶原 ( PC- )均比治疗前显著降低 ( P<0 .0 1 ;P<0 .0 5 ) ;治疗组同时有尿液中组织纤溶酶原激活物 ( t- PA)活性比治疗前有明显增高 ( P<0 .0 1 ) ;对照组治疗后 t- PA反比治疗前更低 ( P<0 .0 5 ) ,t- PA抑制物 ( PAI- 1 )比治疗前增高 ( P<0 .0 5 ) ;治疗组治疗后血尿素氮 ( BUN)及肌酐 ( Scr)均比治疗前明显降低 ( P<0 .0 5、P<0 .0 1 )、内生肌酐清除率 ( Ccr)上升 ( P<0 .0 5 )。结论 :肾衰康有抑制 ECM成分积聚和促进其降解作用 ,从而延缓慢性肾衰进展和改善肾功能。

Objective: To explore the effects of Shenshuaikang (SSK) treatment on the accumulation of extra cellular matrix (ECM) in chronic renal failure patients. Methods:60 cases of chronic renal failure patients call in the second stage were randomly assigned to be SSK treated group (30 cases) and benazepril treated control group (30 cases). The blood urea nitrogen (BUN), Serum creatinine (Scr) and the clearance of creatinine (Ccr) were determined. The urine type Ⅲ precollagen (Pe-Ⅲ), type Ⅳ collagen (C-Ⅳ), Laminin (LN), fibronectin (FN), tissue-type plasminogen activator (t-PA) and activatov inhibitor (PAI-1) were evaluated.Results: The renal function was improved as evidenced by the decreased BUN (P<0.05) and Scr (P<0.01) and increased Ccr (P<0.05). The ECM components in SSK pre-treated group were significantly higher than those in healthy people (P<0.01 or P<0.05). After treatment the ECM components and PAI-1 decreased, compared with those in the respective pre-treated group (P<0.01 or P<0.05), whereas the t-PA rose (P<0.01). Conclusion:SSK therapy has the effect on inhibiting the accumulations of ECM, which contribute to prevent the development of chronic renal failure.