肾复康Ⅵ号方对阿霉素肾病大鼠模型肾小球电荷屏障的影响

Experimental research on Shenfukang Ⅵ decoction and glomerulus electrostatic barrier in adriamycin nephropathy rats model

目的通过观察肾复康Ⅵ号方联合泼尼松对阿霉素肾病大鼠模型疗效及肾小球电荷屏障影响,探讨肾复康Ⅵ号方治疗阿霉素肾病大鼠模型的机制。方法将大鼠随机分为五组:正常组、模型组、中药组、泼尼松组、结合组。除正常组外,给予尾静脉注射阿霉素建立肾病大鼠模型,并对应给予药物干预。每周测定各组大鼠24h尿蛋白定量,给药4周后检测各组大鼠血清白蛋白、肾脏组织病理变化及足细胞特异性蛋白足盂蛋白(PCX)、硫酸乙酰肝素蛋白多糖(HSPG)、乙酰肝素酶(HPA)的表达水平。结果每周模型组的24 h尿蛋白定量比正常组均明显增高(P<0.05);药物干预组的24 h尿蛋白定量与模型组比较均降低(P<0.05);光镜下模型组肾组织内可见系膜细胞及基质轻度增生,肾小管内可见蛋白管型,肾间质严重水肿。各治疗组肾组织病变程度与模型组比较明显减轻。模型组PCX在肾小球基底膜上表达断裂不连续,HPA在肾小球内皮及上皮细胞大量表达;与模型组比较,各药物干预组的肾组织PCX表达增多(P<0.05),HSPG表达无明显变化(P>0.05),HPA表达减少(P<0.05)。结论肾复康Ⅵ号方能够降低24 h尿蛋白定量,减轻肾脏病理改变,其机制可能与降低HPA表达水平,上调PCX蛋白的表达水平有关。

Objective To observe the effect of Shenfukang VI decoction combined with prednisone on adriamycin nephropathy model rats and their glomerular electrostatic barrier,to investigate the mechanism of action of Shenfukang Ⅵ in adriamycin nephropathy. Methods Rats were randomly divided into a normal group,a model group,a Chinese medicine group,a prednisone group,and a combination group. Except for the normal group,adriamycin was injected into the tail vein to establish an adriamycin nephropathy model,and the other groups were given the corresponding drugs. The 24-h urinary protein level of each group was determined every week. Four weeks after administration,serum albumin,renal pathological changes,and PCX,HSPG,and HPA protein expression levels were determined. Results Compared with thatin the normal group,the 24-h urinary protein level increased in the model group（ P〈0. 05）. Compared with that in the model group,the 24-h urinary protein level was decreased in the drug intervention group（ P〈0. 05）. In addition,optical microscopy revealed mild hyperplasia in the membrane cells and stroma,the protein tube type was found in the renal tubules,and renal interstitial edema was severe in the model group. The degree of pathological change in renal tissue was significantly reduced in each treatment group. The expression of PCX on GBM was not continuous and the expression of HPA on glomerular endothelium and epithelial cells was high in the model group. Compared with that in the model group,the expression of PCX in renal tissue was increased（ P〈0. 05）,the expression of HSPG showed no significant difference（ P〈0. 05）,and the expression of HPA was decreased（ P〈0. 05） in the other treatment groups. Conclusions Shenfukang Ⅵ decoction can improve the general condition of rats and reduce the 24-h urinary protein level. This decoction can also reduce the severity of kidney disease. This may be related to lowering the expression level of HPA and raising the expression level of PCX protein to improve the glomerular electrostatic barrier.