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目的 探讨中药益生注射液对大鼠慢性移植肾肾病(CAN)的防治效果。方法 分别采用封闭群雄性SD大鼠和Wistar大鼠作为供、受者进行原位肾移植,术中强化缺血再灌注损伤,建立CAN加快动物模型。将成模大鼠随机分为4个组,A组术后仅给予环孢素A(CsA)10 mg·kg-1·d-1治疗10 d;B、C组除接受CsA治疗外,还分别给予益生注射液4 mg/kg、8 mg/kg;D组除接受CsA治疗外,还给予霉酚酸酯(MMF)10 mg/kg。观察各组术后4、8及12周时的血肌酐水平、移植肾形态学变化及移植肾组织中转化生长因子β1(TGF β1)的表达。结果 术后4周起,A组的血肌酐水平明显高于其它三组(P<0.05);C组第12周时的血肌酐水平高于D组(P<0.05)。除A组术后12周出现TGF β1 表达下调外,各组术后TGF β1 的表达均呈上升趋势,A组4周和8 周时的表达最强;C组和D组的TGF β1 表达较弱。术后8周A组出现明显的CAN病理改变,而C组和D组出现明显血管内膜增生的时间明显晚于A组,且程度较轻。结论 中药益生注射液具有与霉酚酸酯类似的能够延缓慢性移植肾肾病进程的作用。
Objective To investigate the preventive and therapeutic effects of Yisheng Injection of Chinese herbs on chronic allograft nephropathy (CAN) in rats. Methods Orthotopic kidney transplantation was performed using closed male SD rats and Wistar rats as donors and recipients. Ischemia-reperfusion injury was performed during the operation, and a CAN accelerated animal model was established. The model rats were randomly divided into 4 groups. In group A, only 10 mg·kg-1·d-1 of cyclosporine A (CsA) was given for 10 days after treatment. In group B and C, in addition to CsA treatment, Probiotics were given at 4 mg/kg and 8 mg/kg; in group D, in addition to CsA treatment, mycophenolate mofetil (MMF) was also given at 10 mg/kg. The serum creatinine levels, morphological changes of transplanted kidneys and the expression of transforming growth factor-β1 (TGF-β1) in transplanted kidneys were observed at 4, 8 and 12 weeks after operation. Results The serum creatinine level in group A was significantly higher than that in the other three groups at 4 weeks after operation (P<0.05). The serum creatinine level in group C was higher at week 12 than in group D (P<0.05). Except for the down-regulation of TGFβ1 expression at 12 weeks after operation in group A, the expression of TGFβ1 in all groups showed an upward trend. The expression of TGFβ1 in group A and group D was higher than that in group A and at week 8; weak. At 8 weeks postoperatively, there was a significant CAN pathological change in group A, while the time of significant intimal hyperplasia in group C and group D was significantly later than in group A, and to a lesser extent. Conclusion The Chinese herbal medicine Yisheng injection has the similar effect to that of mycophenolate mofetil that can delay the progress of renal allograft.