霉酚酸酯对微小病变肾病治疗作用研究  

Effects of Mycophenolate Mofetil on Minimal Change Nephrotic Syndrom.

作　　者：郑东辉[1] 邢昌赢[2] 陈菊花[1] 金跃[1] 任胜利[1] 

机构地区：[1]江苏省淮安市第二人民医院徐州医学院附属淮安医院,223002 [2]南京医科大学第一附属医院肾脏科

出　　处：《医学研究杂志》2006年第9期13-16,共4页Journal of Medical Research

基　　金：江苏省卫生厅135工程重点人才基金项目(135-034)

摘　　要：目的以阿霉素肾病大鼠建立微小病变肾病模型,以霉酚酸酯(MMF)进行干预,检测nephrin的表达,研究霉酚酸酯对微小病变肾病的治疗作用及其机制。方法SD大鼠18只,分为肾病模型组、MMF治疗组、对照组。模型组、治疗组大鼠尾静脉一次性注入阿霉素7.5mg/kg,治疗组大鼠于注药次日开始使用MMF20mg/(kg·d)灌胃。对照组大鼠尾静脉一次性注入等量生理盐水。每组于第28天各取大鼠6只,检测尿蛋白、血生化指标;并用免疫组化、Westernblot方法,检测肾组织内nephrin蛋白水平。结果肾病组尿蛋白第28天达高峰;血清清蛋白明显降低(P<0.01);治疗组第28天尿蛋白、血清甘油三酯、胆固醇较肾病组减少(P<0.01),血清清蛋白较肾病组增加(P<0.01)。免疫组化、Westernblot结果提示肾病组较对照组第28天nephrin蛋白表达升高(P<0.01);治疗组第28天nephrin蛋白表达较肾病组下调(P<0.01)。结论阿霉素诱发的微小病变肾病发生与nephrin表达异常有关,霉酚酸酯可以减少蛋白尿,延缓微小病变型大鼠肾损伤,其作用与影响nephrin的表达有关。Objective To detecte the changes of nephrin in adriamycin nephropathy rats, study the effects of mycophenolate mofetil on minimal change nephrotic syndrome, investigate its possible mechanism. Methods 18 SD rats were randomly divided into three groups： control group（ CG, n=6）, adriamycin model group（AG, n=6）, MMF treated group（TG, n =6）. Rats in MG and TG were given adriamycin 7.5mg/kg through vena caudalis. At the same time, an equal volume of normal saline was given to the rats in CG by the same method. The rats in TG received MMF 20mg/（ kg·d） by daily gastric garage from the second day. Urinary protein excretion of each rat were measured at the day before adriamycin injection, and the 14th day and the 28th day after adriamycin injection. Six rats of each group were killed at the 28th day. Serum urea nitrogen, creatinine, cholesterol, triglyeeride and albumin were measured at the end of the study. Immunohistochemistry and western blot were used to examine the expression of nephrin. Results The urinary protein excretion of AG at 28th day was the highest. Serum albumin decreased markedly at the 14th day（p 〈 0.01 ） , Cholesterol and triglyceride increased significantly at the 14th day. Proteinuria, serum cholesterol and triglyceride of the rats in TG were lower than those of the rats in AG at the 28th day. Serum albumin level were higher than those of AG（p 〈 0.01 ）. The results of Immunohistochemistry and western blot indicated the expression of nephrin of AG rats increased at 28th day compared to those in CG（p 〈 0.01 ） , the expression of nephrin of TG rats are lower than those of AG rats（p 〈 0.01 ）. Conclusions MMF can ameliorate the kidney injury of minimal change disease, it may be related to limit the changes of nephrin protein.

关 键 词：霉酚酸酯 阿霉素肾病 微小病变肾病 足细胞 

分 类 号：R277.52[医药卫生—中医学]