【作者】 滕立霞；

【导师】 于俊生；

【作者基本信息】 青岛大学 ， 中西医结合临床， 2011， 硕士

【摘要】 目的观察升降散对大鼠系膜增生性肾小球肾炎的治疗作用,探讨升降散对系膜增生性肾小球肾炎大鼠肾组织CTGF、α-SMA表达的影响。方法将正常Wistar大鼠(50天龄)40只随机分为正常对照组、模型组、洛汀新组、升降散组。模型组与药物干预两组分别制备慢性系膜增生性肾小球肾炎模型。药物干预两组于造模第5周起,分别开始灌服洛汀新水溶液、升降散水煎液干预治疗,模型组和正常对照组每天给予等量自来水灌胃,大鼠自由进食、饮水。分别于实验前、4周末,12周末测定24小时尿蛋白定量；12周末分别处死各组大鼠并测定血生化中肌酐、尿素氮值,留取肾脏组织,观察各组肾脏病理变化,采用免疫组织化学法检测肾脏组织中CTGF、α-SMA表达。结果(1)正常对照组24小时尿蛋白定量、血尿素氮、肌酐均正常,模型组24小时尿蛋白定量较正常对照组升高(P<0.01),血肌酐、尿素氮升高(P<0.01),药物干预两组24小时尿蛋白定量与模型组相比均下降(P<0.05),药物干预两组尿素氮、肌酐与模型组比较均有下降,药物干预两组肌酐与模型组比较差异有显著统计学意义(P<0.01),洛汀新组尿素氮与模型组相比差异有统计学意义(P<0.05),升降散组与模型组相比差异无统计学意义(P>0.05)升降散组与洛汀新组相比,24小时尿蛋白定量、血尿素氮、肌酐三者差异均无统计学意义。(2)正常对照组肾小球大小结构无异常,无炎症细胞的浸润；模型组大鼠肾小球肥大,系膜内有少数炎症细胞浸润,系膜细胞与基质弥漫增生,肾小球系膜区、包曼囊及肾间质内肌成纤维细胞明显增多；升降散组部分肾小球系膜细胞与基质轻度增生,炎症细胞浸润不明显,肾小球系膜区、包曼囊及肾间质内肌成纤维细胞轻度增多；洛汀新组肾小球系膜细胞与基质增生不明显,系膜内炎症细胞浸润不明显,肾小球系膜区、包曼囊及肾间质内肌成纤维细胞轻微增多。(3)与对照组大鼠相比,模型组大鼠肾小球系膜区、肾间质CTGF阳性表达明显,差异有显著统计学意义(P<0.01),升降散组、洛汀新组相应区域CTGF呈弱阳性表达,差异有统计学意义(P<0.05),而升降散与洛汀新组比较差异无统计学意义(P>0.05))。与对照组大鼠相比,模型组大鼠肾小球系膜区、肾间质、包曼囊中α-SMA表达明显,差异有显著统计学意义(P<0.01)；升降散组及洛汀新组相应区域α-SMA表达较模型组明显减少,差异有统计学意义(P<0.05),而升降散与洛汀新组比较差异无统计学意义(P>0.05)。结论升降散能够降低慢性系膜增生性肾小球肾炎大鼠肾组织CTGF及α-SMA表达；减弱肾小球系膜区及肾间质中细胞与基质的增生,减轻肾纤维化的程度。更多还原

【Abstract】 Objective To observe the the rapeutic effects of Shengjiangsan on mesangial proliferative glomerulonephritis in rats and to investigate the influence of Shengjiangsan on experssion of CTGF, a-SMA in rats’kidney tissue of mesangial proliferative glomerulonephriti s.Methods 40 normal Wistar rats (50 days old) were randomly divided into contral group, model group, Shengjiangsan group and Lotensin group. The rats in last three groups were made as models of mesangial proliferative glomerulonephritis respectively from the fifth week. At the 12th week, all the rats were executed.The expressions of CTGF and a-SMA in kidney tissue was detected by immunohistochemistry.Results (1) The levels of 24 hours urine protein (UP), blood urea nitrogen (BUN), serum creatinine (Scr), were all normal in the contral group. In the model group, biochemistry indexes manifested increased UP of 24 hours (P<0.01), increased BUN and Scr levers (P<0.01).After treatment, the UP of 24 hours decreased in both Shengjiangsan and Lotensin group (P<0.05).The Drug intervention groups urea nitrogen, creatinine were decreased compared with model group, the difference between the model group and the Creatinine drug intervention groups is significant(P<0.01).the difference between the urea nitrogen of Lotensin group and the model’s is significantly(P<0.05). there is no significant difference between Shengjiangsan group and the model group(P>0.05).(2) There were no pathologic changes of glomerulus structure and no inflammatory celles infiltrate in contral group. The pathological manifestations of the model group were enlarged glomeruli, diffuse proliferation of mesangium, inflammatory cell infiltrate in mesangium region. There were mild proliferation in some glomeruli mesangium and its groundmass, but no inflammatory cell in Shengjiangsan group.There were no obviously proliferation in glomeruli mesangium and groundmass in Lotensin group, also no inflammatory cell. (3)The expressions of CTGF were sparing in contral group, however,there were apparent expressions in glomeruli mesangium,renal interstitium (p< 0.01), while the expressions of both Shengjiangsan and Lotensin groups were weakly positive without differences beween them(P>0.05). a-SMA in contral group was only expressed a little in cytoplasm of renal tubular epithelial cell, while there were manifest expressions in both glomerulus and renal interstitium in rats of model group with apparent differences beween them (p<0.01). They were more likely expressed in nucleolus(p< 0.05), but expressions in both Shengjiangsan and Lotensin groups were weaker without differences beween them (P>0.05).Conclusion Both Shengjiangsan and Lontins can decrease the expression of CTGF and a-SMA in kidney tissue,and relieve hyperplasy of intercapillary cells and ground substance.更多还原