黄蜀葵花对阿霉素肾病大鼠足细胞的保护作用

Protective effect of Sunset Abelmoschus on podocyte injury in adriamycin-induced nephropathyrats

目的探讨黄蜀葵花（黄葵）治疗阿霉素肾病大鼠的疗效及其对足细胞病变的影响。方法雄性SD大鼠50只，按随机数字法分为假手术组（n=10）、模型组（n=10）、黄葵低剂量组（0．5g·kg^-1·d^-1，n=10）、黄葵中剂量组（1．0g·kg^-1·d^-1，n=10）和黄葵高剂量组（2．0g·kg^-1·d^-1，n=10）。采用单侧肾切除联合两次阿霉素（ADR）注射法，制备阿霉素肾病大鼠模型。黄葵各组于右肾摘除术当天起给予相应剂量黄葵溶液灌胃。分别在术前、术后2、4、6、8周末检测大鼠尿蛋白、尿N-乙酰葡萄糖氨基转移酶（NAG）、血清白蛋白、Scr和血脂。第8周末宰杀大鼠，取肾组织行光镜和电镜检查，并观察肾组织nephrin的分布。结果与模型组比较，黄葵各组在各时间点的尿蛋白量和尿NAG水平均降低，以高剂量组最显著（P〈0．01）；且血浆白蛋白增加，血脂紊乱改善，差异均有统计学意义（P〈0．05）。模型组及黄葵各治疗组Scr自第4周起较假手术组明显升高；第8周末，黄葵高剂量组Scr低于模型组（P〈0．05）。黄葵各组肾小球球性硬化和节段硬化比例均低于模型组，肾小管间质损害改善，且以高剂量组最显著。与模型组比较，黄葵各组足细胞的足突损伤减轻，足突融合程度和范围均有所改善，以高剂量组最显著。黄葵各组肾组织nephrin表达较模型组增加。结论黄葵能减少阿霉素肾病大鼠的蛋白尿，减轻肾组织损伤和慢性化，其机制可能与改善足细胞病变有关。

Objective To explore the effect of Sunset Abelmoschus on podocyte injury in adriamycin-induced nephropathy rats. Methods Fifty male SD rats were randomly divided into five groups： sham operation group （n=10）, model group （n=10）, Sunset Abelmoschus low dose group （0.5 g·kg^-1·d^-1,n=10）, middle dose group （1.0g·kg^-1·d^-1,n=10） and high dose group （2.0 ·kg^-1·d^-1,n=10）. Unilateral nephrectomy combined repeated adriamycin injection were performed to establish adriamycin- induced nephropathy models. The rats were administered with the corresponding dose of Sunset Abelmoschns during the experiment period. Urinary protein, urinary N-acetyl glucose aminotransferase （NAG）, serum albumin, serum creatinine and blood lipid were measured before operation and 2, 4, 6, 8 weeks after operation. The rats were sacrificed on week 8 for the renal histological examination, including light microscope and electron microscope. Expression of nephrin was examined by immunofluorescence assays. Results As compared to model group, urinary protein and NAG significantly decreases in Sunset Abelmoschns groups in each time point, especially in high dose group （P〈0.01）, meanwhile the serum albumin increased and the disturbance of lipid metabolism was improved in Sunset Abelmoschns groups （P〈0.05）. Compared with sham group, Scr increased significantly in model group and Sunset Abelmosehus groups at the 4th week. At the 8th week, Set in high dose group was lower than that in model group （P〈0.05）, and the ratio of glomerular globe sclerosis and segmental sclerosis, tubulointerstitial damage reduced in Sunset Abelmoschns groups, especially in high dose group. The podocyte damage and the extent of foot process fusion were improved in SunsetAbelmoschus groups compared with model group. Expression of nephrin increased in Sunset Abelmoschus groups than that in model group. Conclusion Sunset Abelmoschus can ameliorate proteinuria and renal tissue damage of adriamycin-induced nephropathy rats, whose mechanism may be associated with the improvement of podocyte injury.