目的:观察补肾活血汤对阿霉素肾病大鼠肾脏病变的干预作用并探讨其机制。方法:SD大鼠行单侧肾切术后随机分为对照组、模型组及中药治疗组。采用单侧肾切除加阿霉素注射建立慢性肾衰模型。用药8周后观察各组大鼠血生化、24h尿蛋白定量的变化,PAS、Masson染色评估肾小球及肾小管病变情况,免疫组化观察肾脏nephrin及α-平滑肌肌动蛋白(α-SMA)的表达。结果:与对照组相比,模型组大鼠血尿素氮(BUN)、肌酐(Scr)、24h尿蛋白量、肾小球及肾小管病变积分均显著升高(P〈0.01)。与对照组相比,免疫组化发现模型组中肾小球nephrin的表达明显减弱,肾组织中α-SMA显著增强(P〈0.01)。与模型组比较,治疗组BUN、Scr、24h尿蛋白水平及肾小球、肾小管病变积分降低;肾小球nephrin的表达上调,肾组织中α-SMA的表达下调(P〈0.05)。结论:补肾活血汤可以延缓阿霉素大鼠慢性肾病进展,其机制可能与抑制nephrin在肾小球的丢失,下调间质α-SMA的表达有关。
Objective:To investigate the protective effect and its possible mechanism of Bushen Huoxue Decoction on renal glomerulosclerosis in the adriamycin(ADR)-induced nephropathy rats.Methods:SD rats with unilateral nephrectomy were randomly divided into three groups:control group,model group and Bushen Huoxue Decoction group.The glomerulosclerosis rat model was established by adriamycin injection and unilateral nephropathy.Renal PAS and Masson staining were used to assess the severity of glomerulosclerosis after the rats were treated for 8 weeks.Additionally,24-hour urinary protein excretion and renal function were detected.Expression of nephrin and α-SMA were examined by immunohistochemistry.Results:Compared with the control group,the values of BUN,Scr and 24-hour urinary protein excretion were significantly increased in model group rats,accordingly,more severe glomerular and tubular lesions presented in their kidneys(P〈0.01).Compared with the control group,renal expression of nephrin in model group rats was significantly reduced,while the expression of α-SMA was significantly enhanced(P〈0.01).Bushen Huoxue Decoction treatment significantly decreased the level of BUN,Scr,24-hour urinary protein excretion and renal lesions,up-regulated glomerular expression of nephrin and down-regulated renal expression of α-SMA as well(P〈0.05).Conclusion:Bushen Huoxue Decoction could slow down the progression of chronic renal failure in adriamycin-induced nephropathy rats.Its mechanism may be due to the inhibiting the loss of glomerular nephrin and renal expression of α-SMA.