依那普利和限食对肥胖相关肾病大鼠足细胞损伤的干预作用  

Protective effect of Enalapril and weight reduction on podocyte lesions of obesity-related glomerulopathy rats

作　　者：张强[1] 武明虎[1] 张晓东[1] 

机构地区：[1]山西医科大学第一医院肾内科,山西太原030001

出　　处：《中国医师杂志》2008年第7期879-881,共3页Journal of Chinese Physician

摘　　要：目的观察肥胖相关肾病（ORG）大鼠肾小球足细胞WT1表达，探讨依那普利和限食对ORG肾脏保护机制。方法高脂饲料喂养Wistar大鼠24周建立ORG模型后，分为对照组（A）、模型组（B）、依那普利治疗组（C）、限食组（D）、限食加依那普利组（E）继续饲喂8周，观察24h尿白蛋白（24hUA1b）、肾组织形态学及超微结构，免疫组化检测足细胞WT1表达（足细胞密度）。结果B组足细胞数和密度显著低于A组（P〈0．01），24hUA1b和肾小球硬化显著高于A组（P〈0．01）；C、D、E治疗组足细胞数和密度明显高于B组（P〈0．05，P〈0．01），24hUA1b和肾小球硬化较B组明显降低（P〈0．01），且E组联合疗效明显优于单个治疗组。结论ORG足细胞改变与蛋白尿程度和肾损伤呈一定相关性。依那普利加限食能明显抑制ORG足细胞WT1表达，减少尿蛋白，减轻肾损伤。Objective To investigate the expression of WT1 in podocyte of obesity-related glomerulopathy （ORG） rats and the mechanism of enalapril and weight reduction-induced renal protection. Methods After the ORG model was established by high lipid forage for 24 weeks, the rats were divided into control rats （ group A）, ORG rats （ group B）, enalapril-treated ORG rats （ group C）, ORG rats with weight reduction （group D） and enalapril -treated ORG rats with weight reduction （group E）. At the 8th week, 24 hour urine albumen （24hUAlb） was assayed, and the pathological changes of kidney were detected by optics microscopy and transmission electronic microscopy. Immunohistochemistry was used to detect the expression of WT1, a marker of podocyte injury. Results In ORG rats, podocyte number and density were declined remarkably compared with group A （ respectively, P 〈0.01 ）, and 24 hour UAlb and obvious kidney damage were sig- nificantly higher than those of group A （ respectively, P 〈0. 01 ）. After treatment, podocyte number and density in group （ C, D, E） were significantly increased compared with group B （respectively, P 〈 0. 05, P 〈 0. 01 ）. Meanwhile, 24hour UAlb was reduced and kidney damage was alleviated （respectively, P 〈0. 01 ）, and therapeutic alliance effect in group E outweighed than that in group C and D. Conclusion Changes of podocyte in ORG correlated with degree of proteinuria and renal function impairment. Enalapril and weight reduction can re- strain the expression of WT1 in ORG, which can reduce proteinuria and lessen kidney damage.

关 键 词：依那普利 膳食 肥胖症 肾疾病 WT1蛋白质类 

分 类 号：R96[医药卫生—药理学]