四妙丸对高尿酸血症肾病患者肾功能及NLRP3炎症小体活化的影响

Effects of Simiao Pill on Renal Function and NLRP3 Inflammasome Activation in Patients with Hyperuricemia Nephropathy

目的:观察四妙丸对高尿酸血症肾病患者血尿酸水平、肾功能及NLRP3炎症小体活化的影响。方法:选择60例高尿酸血症肾病患者,随机分为非布司他组、四妙丸组和综合治疗组(非布司他+四妙丸),监测每组患者血尿酸、血肌酐水平,同时利用实时荧光定量PCR法检测NLRP3、ASC、caspase-1等炎症小体活化指标。结果:(1)血尿酸水平方面,非布司他组、综合治疗组2月时与0月相比即差异有统计学意义(424.3±38.99 vs 460.45±56.37,412.65±42.27 vs 486.0±67.19,P<0.05);四妙丸组3月时与0月比较差异有统计学意义(410.55±47.65 vs 454.75±70.79,P<0.05);3月时,综合治疗组与四妙丸组比较下降明显(382.55±33.34 vs 410.55±47.65,P<0.05)。(2)血肌酐水平方面,综合治疗组2月时与0月比较即明显降低(244.35±74.03 vs 304.65±87.21,P<0.05);四妙丸组3月时与0月比较显著下降(225.60±74.12 vs 281.55±101.36,P<0.05);3月时组间比较差异无统计学意义;(3)NLRP3炎症小体活化方面,非布司他组、四妙丸组和综合治疗组在NLRP3、ASC、caspase1水平上3月时与0月比较均下降明显(P<0.05);3月时,与非布司他组相比,四妙丸组、综合治疗组在NLRP3水平(0.55±0.07 vs 0.75±0.01,0.47±0.03 vs 0.75±0.01,P<0.05)、caspase-1水平(0.49±0.05 vs 0.68±0.08,0.42±0.01 vs 0.68±0.08,P<0.05)降低明显,综合治疗组ASC水平显著降低(0.42±0.03 vs 0.70±0.02,P<0.05)。结论:四妙丸能够通过降低血尿酸水平及抑制NLRP3炎症小体的活化对高尿酸血症肾病患者产生肾脏保护作用。

Objective:To observe the effects of Simiao Pill on serum uric acid level,renal function and NLRP3 inflammasome activation in patients with hyperuricemia nephropathy.Methods:60 patients with hyperuricemia nephropathy were randomly divided into febuxostat group,Simiao pill group and comprehensive treatment group(febuxostat+Simiao pill).The level of serum uric acid and serum creatinine in each group were monitored every month.NLRP3,ASC and caspase-1 which present activation of NLRP3 were detected by real-time PCR.Results:(1)The serum uric acid level in febuxostat group and comprehensive treatment group was significantly different between 2 month and 0 month(424.3±38.99 vs 460.45±56.37,412.65±42.27 vs 486.0±67.19,P<0.05).Serum uric acid in Simiao Pill group decreased significantly until 3 month(410.55±47.65 vs 454.75±70.79,P<0.05).At 3 month,the level of serum uric acid in comprehensive treatment group was lower compared with the Simiao pill group(382.55±33.34 vs 410.55±47.65,P<0.05).(2)The serum creatinine level in comprehensive treatment group at 2 month was much lower than 0 month(244.35±74.03 vs 304.65±87.21,P<0.05).Compared with 0 month,serum creatinine level in Simiao pill group significantly decreased at 3 month(225.60±74.12 vs 281.55±101.36,P<0.05).There was no obvious difference between these three groups at 3 month.(3)The level of NLRP3,ASC and caspase-1 in febuxostat group,Simiaowan group and comprehensive treatment group decreased significantly at 3 month compared with 0 month(P<0.05).At 3 month,the level of NLRP3(0.55±0.07 vs 0.75±0.01,0.47±0.03 vs 0.75±0.01,P<0.05)and caspase-1(0.49±0.05 vs 0.68±0.08,0.42±0.01 vs 0.68±0.08,P<0.05)in Simiaon Pill group and comprehensive treatment group was much lower than febuxostat group.Compared with febuxostat group,the ASC level in comprehensive treatment group was significantly decreased(0.42±0.03 vs 0.70±0.02,P<0.05).Conclusion:Simiao Pill can protect renal function in patients with hyperuricemia nephropathy by reducing serum uric acid level and inhibiting activation of NLRP3 inflammasome.