川黄1号方对慢性肾脏病3期患者尿IL-18及Kim-1的影响  

Influence of “Chuanhuang Recipe No.1” on Urinary IL-18 and Kim-1 in Patients with Chronic Kidney Disease at Phase 3

作　　者：龚学忠[1] 徐欢[1] 王骞[1] 汤晓春 张长明[1] 王跃荣[3] 段亦汝 郑君丽[1] 汤志奇[1] 袁喆平[1] 

机构地区：[1]上海中医药大学附属市中医医院肾病科,上海200071 [2]江苏省启东市中医医院肾病科,江苏启东226200 [3]上海中医药大学附属市中医医院检验科,上海200071

出　　处：《上海中医药大学学报》2016年第6期14-18,共5页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81373614;81573936);上海市浦江人才计划资助项目(15PJD036);上海申康医院发展中心新兴前沿技术联合攻关项目(SHDC12015126)

摘　　要：目的:观察川黄1号方对慢性肾脏病(chronic kidney disease,CKD)3期患者尿液中急性肾损伤标志物白介素-18(IL-18)及肾损伤分子-1(Kim-1)的影响。方法:纳入66例CKD 3期患者,随机分为川黄1号方组(治疗组)及氯沙坦片组(对照组),每组各33例;同时随机纳入20例健康志愿者作为对照。两组患者除给予基础治疗外,治疗组予川黄1号方汤剂口服,对照组予氯沙坦片口服,治疗周期均为24周。比较两组患者治疗前后的血清肌酐(Scr)、尿素氮(BUN)、估算肾小球滤过率(e GFR,MDRD公式计算)、尿酸(UA)、尿IL-18、尿Kim-1、24 h尿蛋白定量(24 h U-pro)水平的变化,同时对比健康志愿者与CKD 3期患者尿IL-18、尿Kim-1的水平。结果:1与健康志愿者比较,CKD患者的尿IL-18、Kim-1水平均显著升高(P<0.01)。2治疗后,治疗组患者的e GFR明显升高(P<0.05),Scr、BUN水平明显降低(P<0.05,P<0.01),对照组患者的UA水平明显降低(P<0.05);且治疗组患者的e GFR、UA水平高于对照组(P<0.05),Scr、BUN水平低于对照组(P<0.05,P<0.01)。3治疗后,两组患者的24 h U-pro、尿IL-18、尿Kim-1水平较治疗前均明显降低(P<0.05,P<0.01),且对照组患者的24 h U-pro水平低于治疗组(P<0.05),治疗组患者的尿IL-18水平低于对照组(P<0.05)。结论:1急性肾损伤标志物尿IL-18、Kim-1可能有助于CKD肾损伤的早期发现及疗效判定;2川黄1号方能有效保护3期CKD患者的肾功能,具有较好的临床推广应用前景。Objective： To observe the influence of ＂Chuanhuang Recipe No. 1 ＂（ CHR） on the level of urinary interleukin-18（ IL-18） and kidney injury molecule-1（ Kim-1） in patients with chronic kidney disease（ CKD） at phase 3.Methods： Sixty-six patients with CKD at phase 3 were selected and randomly divided into the CHR group（ treatment group）and the losartan potassium group（ control group） with 33 cases in each group. Meanwhile,20 healthy volunteers were involved as control. All the patients were treated with the conventional medicine,and the patients in the treatment group were treated with CHR and the patients in the control group were treated with losartan tablet in addition,with a course of 24 weeks. The levels of serum creatinine（ Scr）,blood urea nitrogen（ BUN）,estimated glomerular filtration rate（ e GFR）,serum uric acid（ UA）,24 h urinary protein excretion（ 24 h U-pro）,urinary IL-18 and Kim-1 were detected and compared before and after treatment. Additionally,the levels of urinary IL-18 and Kim-1 were compared between the healthy volunteers and the patients with CKD at phase 3. Results： ①Compared with the healthy volunteers,the levels of urinary IL-18 and Kim-1 were obviously increased in patients with CKD（ P〈0. 01）. ②After treatment,the level of e GFR was increased in the treatment group（ P〈0. 05）,and the levels of Scr and BUN were obviously decreased（ P〈0. 05,P〈0. 01）; the level of UA was obviously decreased in the control group（ P〈0. 05）; and the levels of e GFR and UA in the treatment group were higher than those in the control group（ P〈0. 05）,and the levels of Scr and BUN in the treatment group were lower than those in the control group（ P〈0. 05,P〈0. 01）. ③After treatment,the levels of 24 h U-pro,urinary IL-18 and Kim-1 were significantly decreased in both groups（ P〈0. 05,P〈0. 01）,and the level of 24 h U-pro in the control group was lower than that in the treatment group（ P〈0. 05）,the level of urinary I

关 键 词：慢性肾脏病 川黄方 白介素-18 肾损伤分子-1 

分 类 号：R277.5[医药卫生—中医学]