肾血安对iga肾病大鼠凝血纤溶系统pai-1及肾组织病理改变的影响-effect of shenxuean on pai - 1 and renal histopathology in iga nephropathy rats.docxVIP

摘要目的：1、观察纤溶酶原激活物抑制物（PAI-1）在IgA肾病（IgAN）中的作用，从而揭示IgAN的发病及进展机理；2、通过观察肾血安对IgAN大鼠肾组织中PAI-1的表达、血尿生化指标及肾脏病理改变的影响来探讨安肾血安治疗IgAN的分子机理，以筛选出治疗IgAN的有效方药。方法：将60只SD大鼠随机分为正常对照组、IgAN模型组、肾血安治疗组及复方肾炎片治疗组，每组16只（正常组12只），采用口服异种蛋白同时加皮下注射四氯化碳、蓖麻油及尾静脉注射脂多糖的方法造模，分别在造模第4、8、12周测定尿沉渣、尿蛋白，12周后测定高凝状态指标，镜下观察肾脏组织病理改变及用免疫组化染色定性定量评价肾组织PAI－1蛋白表达。结果：模型组大鼠尿沉渣检查可见较多变形红细胞；尿蛋白显著增加；血生化检查呈高凝状态；肾组织PAI－1表达增高；肾小球系膜细胞及基质增多。各治疗组肾组织PAI－1表达呈不同程度的下降；肾脏病理改变减轻；尿蛋白及高凝状态相对改善；以肾血安组尤为显著。结论：1、肾小球内PAI-1表达上调是导致IgAN肾脏损伤的机理之一；2、肾血安可明显减轻IgAN大鼠血尿，减少尿蛋白并缓解其高凝状态；3、肾血安对IgAN大鼠PAI-1的影响呈明显量效关系；4、肾血安对IgAN大鼠肾脏病理改变的影响呈明显量效关系；5、本虚标实是IgAN的基本病机，益气活血、凉血止血是治疗IgAN的基本治法之一。关键词：肾血安；IgA肾病；纤溶酶原激活物抑制物；肾脏病理变化；TheinfluenceofShenxueanonCoagulation-fibrinolysissystemPAI-1andrenalpathologicalchangeinIgANratsAbstractObjectives:Observetheeffectsofplasminogenactivatorinhibitor(PAI-1)inIgAnephropathy(IgAN)toshedlightsonthepathogenesisanddevelopmentofIgAnephropathy.DiscussthemolecularmechanismofShenxueaninthetreatmentofIgANthroughobservingtheeffectsofShenxueanontheexpressionofPAI-1,biochemicalindicesofbloodandurine,andrenalpathologicalchangesinIgANratkidneys,soastoselecttheeffectiveprescriptionsforIgAN.Method:Put60SDratsintofivegroupsrandomly,with12inthenormalcontrolgroup,and18eachintheIgANmodelgroup,theShenxueantreatmentgroup,andtheFufangShenyanPiantreatmentgroup.Establishmodelviaoraladministrationofxenoprotein,subcutaneousinjectionofcarbontetrachlorideandcastoroil,andinjectionofLPSbycaudalvein.Fourweeksafterthemodelisestablished,measureurinesedimentsandurineproteins.Dothesamemeasurementintheeighthandtwelfthweekrespectively.Measurethehypercoagulationindicesafterthetwelfthweek.ObserverenalpathologicalchangeunderthemicroscopeandevaluatetheexpressionofPAI-1proteinbothinqualitativeandquantitativetermsthroughimmunohistochemic-Alstaining.Results:Modelrats,urinedregchecksvisiblemoredeformationredbloodcells;Significantlyincreasedurinaryprotein;Bloodbiochemicaltestwashighpour-pointstate;KidneytissuesPAI-1expressheighten;Mesangialcellsandmatrixincrease.Thetreatmentgro