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目的:探讨益气养血活血的中药复方——益肾缓衰口服液对肾大部切除(SNX)大鼠残肾内微血管重塑的影响。方法:雄性Wistar大鼠76只,随机分为4组。假手术组(n=16):假手术+自来水10ml·kg-1·d-1灌胃;模型组(n=20):5/6肾切除+自来水10ml·kg-1·d-1灌胃;缓衰口服液组(n=20):5/6肾切除+益肾缓衰口服液10ml·kg-1·d-1灌胃;氯沙坦钾组(n=20):5/6肾切除+氯沙坦钾40mg·kg-1·d-1灌胃。分别于术后2、4、8、12周取肾组织PAS染色观察病理改变;免疫组化SP法进行APP、FN和Col-Ⅳ染色,结合图像分析,评价肾小球微血管面积和肾间质微血管数动态变化及其与细胞外基质(ECM)成分(FN和Col-Ⅳ)表达的关系。结果:在大鼠SNX模型中,残余肾间质毛细血管数和肾小球毛细血管襻相对面积随时间呈逐渐下降趋势,肾小球的毛细血管襻相对面积与Col-Ⅳ、FN的表达水平呈负相关(r分别为-0.598和-0.601,P<0.001);缓衰口服液组和氯沙坦钾组其微血管丢失和ECM积聚程度较轻。结论:在SNX大鼠中,缓衰口服液与血管紧张素Ⅱ受体拮抗剂(氯沙坦钾)具有相似的减少肾内微血管丢失从而减轻肾小球硬化的作用。
OBJECTIVE: To investigate the effect of Yishenhuoxing Oral Liquid, a Chinese medicinal compound for replenishing qi and nourishing blood circulation, on microvascular remodeling in residual kidneys of rats undergoing major nephrectomy (SNX). Methods: Seventy-six male Wistar rats were randomly divided into 4 groups. Sham group (n=16): sham operation + tap water 10ml·kg-1·d-1 gavage; model group (n=20): 5/6 nephrectomy + tap water 10ml·kg-1·d-1 irrigation Stomach; Suifing oral liquid group (n=20): 5/6 nephrectomy + Yishen slow-decay oral liquid 10 ml·kg-1·d-1 gavage; Losartan potassium group (n=20): 5/ 6 nephrectomy + losartan potassium 40mg · kg-1 · d-1 gavage. Pathological changes of renal tissue were observed by PAS staining at 2, 4, 8 and 12 weeks postoperatively; APP, FN, and Col-IV staining were performed by immunohistochemical SP method. Combined with image analysis, glomerular microvascular area and renal interstitium were evaluated. Dynamic changes in microvessel density and its relationship with expression of extracellular matrix (ECM) components (FN and Col-IV). RESULTS: In the rat SNX model, the number of residual renal interstitial capillaries and the relative area of glomerular capillary loops gradually decreased with time. The relative area of glomerular capillary loops and the expression levels of Col-IV and FN were gradually decreased. There was a negative correlation (r = -0.598 and -0.601 respectively, P <0.001); the slow-slow oral solution group and losartan potassium group had less microvascular loss and ECM accumulation. CONCLUSIONS: In SNX rats, Chronic Acupuncture Oral Solution and angiotensin II receptor antagonist (Losartan Potassium) have a similar effect of reducing intrarenal microvascular loss and thus reducing glomerulosclerosis.