来氟米特对糖尿病大鼠血清高敏C反应蛋白及肾脏病理的影响  

Effect of Leflunomide on Serum High Sensitive C-reactive Protein and Glomerular Pathological Changes in Diabetic Rat

作　　者：常保超[1] 陈卫东 

机构地区：[1]蚌埠医学院第一附属医院肾病科,蚌埠233000

出　　处：《中国中西医结合肾病杂志》2008年第9期775-778,I0003,共5页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：安徽省教育厅自然科学基金资助项目(No2005kj290)

摘　　要：目的:探讨糖尿病大鼠血清中高敏C反应蛋白(Hs-CRP)的变化和肾小球病理改变,观察来氟米特治疗后对Hs-CRP的变化和肾小球病理改变的影响。方法:将50只SD大鼠随机分为正常对照组(C组)、糖尿病对照组(DM组)和来氟米特干预组(LEF组)。链脲佐菌素(STZ)诱导糖尿病大鼠模型,来氟米特对LEF组进行治疗性灌胃。12周后留取尿液测量24h尿蛋白定量(24h U-TP)、留取血标本测血糖(Glu)、血清肌酐(Scr)、尿素氮(BUN)、Hs-CRP;肾脏标本测肾脏重量,部分肾组织行HE和PAS染色,在光镜下观察肾小球组织形态学的改变;显微图像摄影系统采图后应用Image J医学图像分析系统,测量肾小球平均面积及肾小球平均体积。结果:12周末DM组大鼠与C组大鼠比较,DM组大鼠体重(BW)增长缓慢或体重明显下降,LEF治疗组大鼠体重增长缓慢,但较DM组体重增加,肾重指数(KI)、GLU、Scr、BUN、Hs-CRP及24h U-TP均有统计学差异(P<0.01)。LEF组大鼠与C组大鼠比较GLU、KI、Scr、BUN、Hs-CRP、24h U-TP虽然仍明显增高(P<0.05或P<0.01),除GLU外其余指标与DM组相比明显降低,有统计学差异(P<0.01或P<0.05),相关分析显示Hs-CRP与24h U-TP(r=0.838,P<0.01)、Scr(r=0.732,P<0.01)、BUN(r=0.772,P<0.01),KI(r=0.869,P<0.01),提示Hs-CRP与Scr、BUN、KI及24h U-TP呈显著正相关,图像分析显示糖尿病大鼠肾小球平均面积及平均体积较对照组明显增大,LEF组较DM组明显减轻。结论:血清Hs-CRP的水平与糖尿病大鼠肾脏损害的严重程度一致,来氟米特可以通过减低血清Hs-CRP的水平,降低炎症反应,减轻糖尿病大鼠肾脏损害。Objective： To investigate the serum high sensitive C- reactive protein （Hs- CRP） and glomerualr patological changes and effects of leflunomide on Hs - CRP and glomerualr pathological changes in diabetic rat. Methods： Fifty Sprague - Dawlay （SD） rats were randomly divided into normal control group （group C）, diabetes mellitus control group （group DM） and leflunomide treated diabetes mellitus group （group LEF）. Diabetes mellitus were induced by streptozocin （STZ）, and group LEF were treated with leflunomide through intragastric administration. After 12 weeks,24 hours urine protein （24 h U-TP）,blcv,t glucose （GLU）, serum creatinine （Scr）, blood urea nitrogen （BUN） and Hs - CRP were measured. The kidney hypertrohy index （KI） were alto measured; partial nephridial tissue were observed HE and PAS staining; mean glomerular area （MGA） and mean glomerular volume （MGV） were determined. Results：Compared with those in group C, GLU, KI, Scr,BUN and 24 h U- TP were significantly in- creased in DM group and LEF group（ P〈 0.01 or P 〈 0.05）. There were significant differences in K1, Scr, BUN and 24h U- TP between groups DM and group LEF （ P 〈 0.01 or P 〈 0.05 ）. Correlation analysis showed that the change of Hs CRP was positively correlated with KI, Scr, BUN and 24 h U TP. MGA and MGV were significantly increased in DM group compared with those in group C; pathological changes in group LEF were improved compared to those in group DM. Conclusion： The serum levels of Hs- CRP are corresponded with the degree of diabetic nephrpathy. Leflunomide can reduce renal damage of diabetic rat through decreasing serum Hs - CRP and relieving inflammation reaction.

关 键 词：糖尿病肾病 高敏C反应蛋白 来氟米特 

分 类 号：R692.9[医药卫生—泌尿科学]