盐酸司维拉姆和低蛋白饮食对单侧输尿管结扎大鼠甲状旁腺细胞增生的影响  

Effects of sevelamer hydrochloride and low protein diet on proliferation of parathyroid cell in unilateral ureteral obstruction rats

作　　者：肖笑[1] 刘岩[1] 周道远[1] 覃丹平[1] 钟小仕[1] 

机构地区：[1]广州市红十字会医院肾脏内科,广州510220

出　　处：《肾脏病与透析肾移植杂志》2010年第4期333-337,共5页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：广州市科技局课题资助项目(2009J1C331);日本昭和大学奖学金资助项目

摘　　要：目的:研究不含钙铝的磷结合剂盐酸司维拉姆(sevelamer hydrochloride)对于单侧输尿管结扎(unilateral ureteral obstruction,UUO)大鼠的甲状旁腺增生及继发性甲状旁腺细胞增生的影响。方法:75只wistar UUO的大鼠随机分为普通饲料组(对照组)、盐酸司维拉姆组(SH组)和低蛋白饲料组(LP组)。0、3、7、14和28d每组各随机抽取五只大鼠,留取血标本和甲状旁腺组织标本,取血及组织标本前一天留取24h尿标本。结果:和对照组相比,SH组大鼠血磷水平、尿磷排泄及全段甲状旁腺(i-PTH)水平都显著降低(P<0.01)。实验第3天对照组大鼠的甲状旁腺细胞发生显著增生,并持续整个实验过程,SH组和LP组大鼠的甲状旁腺组织内增殖细胞核抗体阳性细胞的数量均显著低于对照组(P<0.05)。结论:盐酸司维拉姆和低蛋白饲料能有效地降低慢性肾功能不全大鼠的血磷水平,抑制甲状旁腺细胞的增生。Objective：To explore the effects of sevelamer hydrochloride and low protein diet on parathyroid cell proliferation in unilateral ureteral obstruction （UUO） rats. Methodology：Seventy-five rats with UUO were divided into three groups：control group received normal powder food （protein content 22% , containing 400 mg/100g of phosphorus, cont group ） , 5% sevelamer group received sevelamer plus control food （sevelamer content 5% ,SH group） , Low protein group received low protein food （protein content 6% , containing 350 mg/100g of phosphorus, LP group）. 5 rats of each group were sacrificed at day 0, 3, 7,14 and 28. Serum phosphorus, calcium, intact-PTH（i-PTH） , and 24-hour urinary phosphorus were assayed. Parathyroid tissues were removed to assess parathyroid cell proliferation. Results：The levels of serum phosphorus was decreased gradually in SH group from day 3 to the end of the study and showed significant lower level compared to cont group. The levels of urinary phosphorus excretion and serum intact-PTH were also significantly decreased in SH group compare to cont group. （ P 〈 0. 05 ）. Remarkable parathyroid cell proliferation has been observed from day 3 and continued during the whole study in eont group. The number of PCNA ＋ cells was significant lower in SH group than that in cont group at each time point of the study （ P 〈 0. 05 ）. LP group was showed the similar effect. Conclusion： The treatment of sevelamer hydrochloride can rapidly decrease serum phosphorus and markedly suppress parathyroid cell proliferation, it might prevent the development of secondary hyperparathyroidism in chronic renal failure.

关 键 词：盐酸司维拉姆 血清磷 甲状旁腺 肾功能衰竭 

分 类 号：R692.5[医药卫生—泌尿科学]