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糖皮质激素预防逆行性肾盂肾炎大鼠肾脏纤维化的作用及其机制的初步探讨 被引量:3

Suppression of renal scarring by glucocorticoid combined with antibiotic in rats with ascending pyelonephritis
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摘要 目的 探讨糖皮质激素有否预防或减轻肾盂肾炎大鼠肾脏纤维化的作用。方法 雌性成年SD大鼠随机分为对照组和实验组:(1)正常对照组:未经任何处理;(2)实验组:建立逆行性肾盂肾炎模型,按治疗的不同分为4组:①早期治疗组;②延迟治疗组;③延迟加激素组;④未治疗组。所有实验对象在接种细菌前和接种细菌后分别检测血清肌酐、血尿素氮、尿渗透浓度、尿蛋白/肌酐比值、尿NAG酶及β2-m,膀胱穿刺取尿行细菌培养。接种细菌后12周处死大鼠取肾行大体标本、肾组织切片普通光镜检查、肾组织免疫组织化学检测胶原蛋白Ⅲ(COⅢ)和纤连蛋白(FN)在肾脏的表达。结果 早期治疗组无肉眼肾疤痕形成,肾小球未见明显异常,肾小管形态基本正常。延迟治疗组有明显肾疤痕形成,明显的间质纤维化、小管萎缩,尿渗透浓度在接种细菌后第8周开始下降,NAG酶在接种细菌后12周开始升高。延迟加激素组仅见轻度疤痕,疤痕外组织基本正常,与未治疗组和延迟治疗组比较差异有显著性意义。结论 糖皮质激素联合抗生素治疗可预防和减轻实验性肾盂肾炎间质纤维化。 Objective To investigate whether glucocorticoid can suppress the renal scarring or fibrosis and its possible mechanism in rats with ascending pyelonephritis. Methods Female adults Sprague-Dawley rats were randomized to divide into two groups: (1) Normal controls, (2) Ascending pyelonephritis animals. The pyelonephritis animals were divided into four subgroups; (1) Early antibiotic treatment group; (2) Delayed antibiotic treatment group; (3) Delayed treatment combined with methylprednisolone group; (4) untreated group. Parameters, including Scr, BUN, urinary osmotic concentration, urinary NAG enzyme, urinary B2-m, urine protein/creatinine ratio and urinary bacteria culture etc, were examined before and after the formation of pyelonephritis models. Rats were sacrificed at the 12th week. Kidneys were moved and examined macroscopically and microscopically. Expression of COIII and FN was studied by immunohistochemlogical stain. Results No scarring was observed, and no noticeable abnormalitis were found in glomeruli, tubules or interstitium of early antibiotic treatment rats. Gross scarring were presented, and irregular parenchymal scars, marked interstitial fibrosis, tubular atrophy, focal segmental glomerulosclerosis and global sclerosis could be seen in delayed antibiotic treatment rats. In rats of delayed treatment combined with glucocorticoids, histological changes and functional lesions ameliorated significantly as compared with those in delayed treatment and untreated rats. Conclusion Glucocorticoids (methylprednisolone) added to antibiotic therapy can decrease or inhibit renal scarring, interstitial fibrosis and tubular atrophy resulting from ascending pyelonephritis in rats even when the treatment is delayed.
出处 《中华肾脏病杂志》 CAS CSCD 北大核心 2002年第2期95-99,共5页 Chinese Journal of Nephrology
基金 广东省科学委员会重点攻关课题(99M04906G)
关键词 肾盂肾炎 糖皮质激素类 肾纤维化 疾病预防 作用机制 大鼠 Pyelonephritis Glucocortiooids Renal flbrosis
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