肾小球硬化中肾小管间质细胞表型转化及肾疏宁的干预作用  

Phenotypic Changes of Renal Tubulointerstitial Cells in Rats Glomerulosclerosis and Effect of Shenshuning Mixture

作　　者：张丽芬[1] 黄文政[2] 朱小棣[3] 曹式丽[2] 王耀光[2] 陈御麟[2] 

机构地区：[1]北京中医药大学东直门医院肾病内分泌科,北京100700 [2]天津中医学院第一附属医院肾内科,天津300193 [3]天津中医学院第一附属医院病理科,天津300193

出　　处：《中国中西医结合肾病杂志》2005年第1期13-16,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：天津市自然科学基金资助项目 (No .0 2 3 6115 11)

摘　　要：目的 :探讨肾小球硬化大鼠肾小管上皮细胞及间质成纤维细胞的表型转化情况及中药复方肾疏宁的作用。方法 :SD大鼠随机分为假手术组、模型组、模型组 +肾疏宁治疗组、模型组 +苯那普利治疗组。采用单侧肾切除并阿霉素尾静脉注射的方法建立大鼠肾小球硬化模型 ,8周末光镜及透射电镜观察肾组织病理 ,免疫组织化学染色法观察大鼠肾小管上皮细胞及间质成纤维细胞α -平滑肌肌动蛋白 (alphasmoothmuscleactin ,α -SMA)和转化生长因子 - β1(transforminggrowthfactorβ1,TGF - β1)表达情况 ,用计算机病理图像分析软件检测肾小管间质α -SMA和TGF - β1染色阳性相对面积 ,和肾间质纤维化相对面积。同时观察肾疏宁对肾小球硬化大鼠体重、尿蛋白、血总蛋白、白蛋白、尿素氮、肌酐的影响。结果 :假手术组大鼠肾小管间质α -SMA少量表达 ,TGF - β1微量表达 ,肾小球硬化模型组大鼠肾小管间质α-SMA明显阳性表达 (P <0 .0 1) ,TGF - β1显著阳性表达 (P <0 .0 1) ,肾小管间距加宽 ,肾间质纤维化和大量淋巴细胞和单核细胞浸润 ,血白蛋白、总蛋白明显降低 (P <0 .0 1) ,尿蛋白、血尿素氮、肌酐明显升高(P <0 .0 1) ,肾疏宁治疗组和苯那普利治疗组 2 4h尿蛋白排泄量、血尿素氮、肌酐明显降低 (P <0 .0 1) 。Objective:To explore whether there is phenotypic changes of renal tubulointerstitial cells in glomerulosclerosis rats and study the effect of Shenshuning mixture on it.Methods:Sprague-Dawley rats were randomly divided into 4 groups, sham operation group, glomerulosclerosis model group, glomerulosclerosis treated with Shenshuning group and glomerulosclerosis treated with benazepril group. Glomerulosclerosis model rats were induced by unilateral nephrectomy(Nx)and Doxorubicin injection. At the end of 8 weeks, Morphological expression and ultrastructure changes were observed by lightscope and electronlicroscopy. Immunohistochemical stain to explore the expression of α-smooth muscle actin(α-SMA)and transforming growth factor-β 1(TGF-β 1) in tubulointerstitial cells, and the relative positive area of α-SMA, TGF-β 1,and interstitial fibrosis area were analyzed using compute-assisted image analysis software, while examined weight, 24 hour proteinuria,plasma albumin, total serum proteim and renal function.Results:There was littleα-SMA expression,trace TGF-β 1 positive was found in the sham operation groups'tubulointerestitial, but prominent α-SMA and TGF-β 1 positive staining in tubulointersititial cells of model group(P<0.01), intersititialfibrosis and abundance lymphocyte and monocyte soakage, marked with deduce of albumin, total serum proteim(P<0.01)and increase of 24 hours proteinuria excretion, blood urine nitrogen and creatinine(P<0.01).The 24 hours proteinuria excretion,blood urea nitrogen and creatinine was remarkably reduced after treated with Shenshuning mixture and benazepril(P<0.01), also with the lessened of the α-SMA positive area, TGF-β 1 area and interstitial area(P<0.01). The relatively analysis show significant corelation of α-SMA and TGF-β 1 factors(r=0.637,P<0.01). Conclusion:The expression of α-SMA in tubulointerstitial cells in glomerulosclerosis rats is pronounced, indicate that phenotypic changes of tubulointerstitial cells involvement in the pathogenesis of glome

关 键 词：肾小球硬化 肾小管间质细胞 肾疏宁 干预作用 

分 类 号：R692.6[医药卫生—泌尿科学]