厄贝沙坦联合降糖保肾方治疗早期糖尿病肾病大鼠的实验研究  

Experimental Study of the Combination Therapy of Irbesartan and Chinese Medicinal Formulae on the Renal Oxidative Stress and Ultramicroscopic Structure in Early Diabetic Nephropathy Rats

作　　者：谢辉[1] 刘长波[1] 黄霖[1] 肖洁[1] 汪华林[1] 

机构地区：[1]广州医学院第一附属医院肾内科,广州510120

出　　处：《中国中西医结合肾病杂志》2009年第5期392-395,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：广州市卫生局基金资助项目(No.2004A057)

摘　　要：目的:探讨中西医结合对早期糖尿病肾病大鼠肾脏氧化应激与超微结构变化的影响。方法:用链脲佐菌素(STZ)诱导糖尿病肾病大鼠模型,将SD大鼠随机分成5组,每组10只:正常对照组(C组)、糖尿病肾病组(D组)、厄贝沙坦组(X组)、降糖保肾方组(Z组)和中西医结合组(L组)。5周末检测5组大鼠血糖(BG)、糖化血红蛋白(HbAlc)、总胆固醇(TC)、三酰甘油(TG)、血尿素氮(BUN)、肌酐(Scr)、肌酐清除率(Ccr)、肾重/体重(S/T)、尿白蛋白排泄率(UAER)等指标的变化以及肾皮质总超氧化物歧化酶(TSOD)、过氧化氢酶(CAT)的活性、丙二醛(MDA)的水平;利用透射电子显微镜观察肾脏足细胞超微病理结构。结果:D组与C组比较,BG、HbAlc、TC、TG、S/T明显升高;BUN、Scr水平差异无统计学意义,但Ccr显著下降;抗氧化酶中,TSOD、CAT活性明显下降,MDA水平明显升高;UAER增高,足细胞足突严重融合。中药或西药单药治疗组上述指标改善,尤其中西医结合治疗组上述指标改善显著,明显优于各单药治疗组。结论:早期糖尿病肾病大鼠肾脏即存在氧化应激增加及足细胞的损害,厄贝沙坦联合中药方剂降糖保肾方对糖尿病肾脏的保护作用优于单种给药治疗,其机制部分与其对糖尿病肾组织氧化应激增加、足细胞损伤与协同抑制作用有关。Objective：To explore the effects of the combination of Irbesartan and Chinese medicinal formulae ＂jiang tang bao shen fang＂ on the renal oxidative stress and ultramicroscopic structure in early diabetic nephropathy rats. Methods： Diabetic nephropathy rats were induced by streptozocin（STZ）, the experimental rats were randomly divided into control, diabetes, diabetes treated with Irbesartan, diabetes treated with traditional Chinese medicine, and diabetes treated with combined lrbesartan and traditional Chinese medicine. Blood glucose（BG）, HbAlc, blood cholesterol（TC）, trigalloylglycerol（TG）, blood ureanitrogen（BUN）, serum creatinine（Scr）, kidney weight/body weight（S/T）, urinary albumin excretion rate （UAER） were measured after 5 weeks. The activities of antioxidant enzymes in renal cortex, including total superoxide dismutase（TSOD）, catalase （CAT）, and maleiedialdehyde （MDA） were measured by chromatometry, and the podocyte ultrastructure was observed by transmission electronic microscopy. Resuits; Compared with the group C, the levels of BG, HbA1c ,TC,TG,UAER and S/T in group D increased significantly, and creatinine clearance rates（Ccr） decreased obviously. The activities of TSOD and CAT decreased significantly, and the level of MDA increased notably in group D. Meantime, the projections of podocyte were fused, which destroyed the structure of the protective screen in group D.When Irbesartan and Chinese medicinal formulae were used together, all the laboratory indicators improved remarkable than monotherapies. Conclusion：The increasing of oxidative stress and podocyte injury were existed in early diabetic nephropathy rats. The combination therapy of irbesartan and traditional Chinese medicine confers superiority over monotherapies on the changes of oxidative stress and ultramicroscopic structure in early diabetic nephropathy rats. The mechanism may be related to the synergism of the two medicines in the treatment of diabetic nephropathy.

关 键 词：早期糖尿病肾病 厄贝沙坦 降糖保肾方 氧化应激 足细胞 动物实验 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]