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目的探讨延肾胶囊延缓残进行性损伤的量效关系。方法Wistar大鼠120只,随机分为6组,A组为假手术对照组;B组为5/6肾切除;C,D和E分别为5/6肾切除+低、中、高剂量延肾胶囊;F组为5/6肾切除+肾衰宁。术后A和B两组给予等容积生理盐水灌胃。定量喂养,自由饮水。于术后15,90天测定血尿素氮(BUN)、血肝酐(SCr)、血红素(Hb),肾组织光镜及其形态计量、电镜,每组每时相点观察10只大鼠。结果术后B组BUN和SCr显著高于A组,Hb显著低于A组;C,D和E组BUN和SCr也有所升高,但显著低于B组,随着延肾胶囊剂量增加,BUN和SCr逐渐降低;F组的BUN和SCr低于B组,高于E组。术后B组,光镜下可见肾小球系膜细胞增生,肾小球系膜区增宽,肾小球硬化和肾间质纤维化,术后时间越长病变越重,形态计量示硬化肾小球比率和病变肾小管肾间质比率显著高于A组,C,D和E组硬化肾小球比率和病变肾小管肾间质比率逐渐降低;F组硬化肾小球比率和病变肾上管间质比率低于B组,但高于D和F两组。电镜观察,B组术后肾小球系膜细胞增生,未见明显系膜细胞凋亡,C,D和E组可见增生的系膜细胞凋亡,A组无明显异常发现。结论延肾胶囊能显著降低血BUN,SCr,抵制残肾纤维化,延缓慢性肾衰的进程,呈剂量依赖性,其效果优于肾衰宁;延肾胶囊促进增生的系膜细胞凋亡可能是其抑制残肾纤维化
Objective To investigate the dose-effect relationship of Yanshen capsules in delaying residual damage. Methods One hundred and twenty Wistar rats were randomly divided into 6 groups. Group A was sham-operated control group; Group B was 5/6 nephrectomy; C, D and E were 5/6 nephrectomy + low, medium and high doses respectively. Kidney capsules; group F was 5/6 nephrectomized + renal failure. Postoperative A and B groups were given equal volume of normal saline. Quantitative feeding, free drinking water. Blood urea nitrogen (BUN), serum hepatic anhydride (SCr), hemoglobin (Hb) were measured at 15, 90 days after operation. Renal tissue light microscopy, morphometrics, and electron microscopy were performed. Ten rats at each time point were observed. . Results BUN and SCr in group B were significantly higher than those in group A, and Hb was significantly lower than that in group A. BUN and SCr in group C, D, and E also increased, but were significantly lower than those in group B. With increasing dose of Yanshen capsule, BUN and SCr gradually decreased; BUN and SCr in group F were lower than group B and higher than group E. In group B, glomerular mesangial cell proliferation, glomerular mesangial area broadening, glomerular sclerosis and renal interstitial fibrosis were observed under light microscope. The longer the operation, the heavier the lesion, and the morphometric measurement showed sclerosis. The glomerular ratio and the ratio of diseased renal tubular interstitium were significantly higher than those in group A. The ratio of sclerosing glomerulus and the ratio of diseased renal tubular interstitial in the C, D, and E groups gradually decreased; the sclerosing glomerular ratio and lesional nephropathy in the F group. The ratio of the upper tubulointerstitium was lower than that of the B group, but higher than that of the D and F groups. Electron microscopy observations showed that there was no proliferative mesangial cell apoptosis in group B after proliferative mesangial cell proliferation. Mesangial cell apoptosis was observed in groups C, D, and E. There was no obvious abnormality in group A. Conclusion Yanshen Capsule can significantly reduce blood BUN and SCr, resist the fibrosis of residual kidney, and delay the progression of chronic renal failure in a dose-dependent manner. The effect of Yanshen Capsule is better than Renshaoning; Yanshen Capsule may promote the proliferation of mesangial cells. It inhibits fibrosis of residual kidney