梗阻性肾间质纤维化大鼠血流变及微循环研究_药学论文.docVIP

梗阻性肾间质纤维化大鼠血流变及微循环研究_药学论文 梗阻性肾间质纤维化大鼠血流变及微循环研究_药学论文 作者：吕小燕，孙学刚，刘强，吕志平 【摘要】 目的观察单侧输尿管梗阻(UUO)致大鼠肾间质纤维化的血液流变学及微循环的变化特点，从络病角度探讨肾间质纤维化的中医病机。方法 建立单侧输尿管梗阻致大鼠肾间质纤维化模型，观察肾间质纤维化大鼠全血粘度150/s切变率、30/s切变率、5/s切变率、1/s切变率、红细胞压积、舌下及耳廓的脉络变化，同时检测肾纤维化指标、血清肌酐及尿素氮。结果肾间质纤维化模型组的全血粘度150/s切变率、30/s切变率、5/s切变率、1/s切变率、红细胞压积、透明质酸酶(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、IV型胶原(C IV)、血清肌酐(SCr)、尿素氮(BUN)与假手术组相比显著升高;且肾纤维化指标(HA、LN、 PCⅢ、C IV)与全血粘度的各个切变率及红细胞压积呈显著正相关。结论肾间质纤维化大鼠血流变及微循环的变化特点一定程度上反应了肾间质纤维化“络脉瘀组”的中医病机，为抗肾间质纤维化“活血通络”的治疗提供初步依据。 【关键词】 肾间质纤维化; 血液流变学; 全血粘度; 红细胞压积 　　Abstract：ObjectiveTo observe the changes of blood rheology and microcirculation in renal interstitial fibrosis and unilateral ureteral obstruction (UUO) . MethodsRat fibrosis models was established by unilateral ureteral obstruction. Hematocrit and blood viscosity at shear rate in 150/s, 30/s, 5/s, 1/s, renal fibrosis serum markers, serum creatinine and blood urea nitrogen were detected respectively in sham operation and model group; microcirculation microscope was used to observe the thread of hypoglottis and auricle in rats. ResultsThe indexes of hematocrit, blood viscosity at different shear rate, hyaluronic acid (HA), laminin (LN), procolagen type Ⅲ (PCⅢ), collagen typeⅣ (CⅣ), serum creatinine (SCr) and blood urea nitrogen (BUN) were increased significantly after fibrosis appeared, and there had positive correlation between blood viscosity at different shear rate, hematocrit and serum concentration of the fibrosis markers(HA，LN， PCⅢ，C IV). ConclusionThe tendency of blood rheological and microcirculation changes hint the pathogenesis of renal interstitial fibrosis including “blood- stasis blocking collaterals”. This may be one of the causes about using “promoting blood circulation to remove meridian obstruction” method to treat renal interstitial fibrosis. 　　Key words：Renal interstitial fibrosis; Hemorheology; Blood viscosity; Hematocrit 　　肾间质纤维化(RIF)是各种慢性肾脏疾病进展到终末期肾功能衰竭共有的病理改变[1]，隶属于络病学说中“肾络病”的范畴，其形成的病理过程与络病学说中的“久病入络”相一致[2,3]。近来有关学者认为，血流变及微循环的异常变化是