黄芪注射液对IgA肾病患者肾小管功能的影响

Effects of Astragalus Injection on Renal Tubular Function in Patients with IgA Nephropathy

目的探讨肾小管功能(尿视黄醇结合蛋白,urinary retinol binding protein,RBP及尿N-乙酰-β-D氨基葡萄糖苷酶N-acetyl-β-D-glucosaminidase,UNAG)与IgA肾病(IgA neplaropathy,IgAN)患者肾小管间质病理损害改变严重程度之间的关系,分析黄芪注射液对IgAN患者肾小管功能的影响。方法将67例IgAN患者随机分为黄芪组和对照组,均予潘生丁、洛汀新等口服,黄芪组加用黄芪注射液静脉滴注,观察两组患者治疗前后血、尿蛋白的变化,尿RBP及UNAG等肾小管功能指标。采用CMIAS2000多功能真彩色病理图像分析系统,进行测量肾小球的包曼氏囊、肾小管及血管面积总和与所采集图像的总皮质面积。结果尿RBP、NAG与肾间质病理改变相关。黄芪组治疗后尿蛋白明显下降,肾小管功能好转,血白蛋白明显上升,与对照组比较差异有显著性。结论肾小管间质病理损害程度与尿RBP密切相关;黄芪注射液治疗IgAN效果显著。

Objective To investigate the relationship between the renal tubular function and the severity of tubulo interstitial lesion and the effects of Astragalus Injection （AI） on renal tubular function in patients with IgA nephropathy （IgAN）. Methods Sixty-seven patients with IgAN were randomly divided into the control group and the astragalus group, both received dipyridamole and benazepril orally, while the astragalus group treated with AI by intravenous dripping additionally. The indices for renal tubular function, including protein in blood and urine, urinary retinol binding protein （RBP） and N-acetyl-^-D-glucosaminidase （UNAG）, were detected. Area of glomerular Bowman capsule, renal tubules, and capillary were measured with color magic image analysis system type CMIAS2000. Results Urinary RBP and UNAG were correlated with tubulointerstitial lesion. Urine protein concentration decreased, blood albumin increased remarkably and renal tubular function improved after treatment in the astragalus group, with the improvement significantly different to those in the control group respectively. Conclusion The severity of tubulointerstitial lesion was positively related to urinary RBP concentration, and astragalus injection has obvious effect on IgAN.