单次尾静脉注射法阿霉素大鼠肾病模型的建立

目的建立阿霉素大鼠肾病模型,并观察模型的动态变化。方法 26只Wistar雄性大鼠随机分为模型组(13只)和空白组(13只),模型组单次尾静脉注射阿霉素6.2 mg/kg,空白组注射等容积生理盐水。检测连续10周12 h尿蛋白定量、终末血生化指标,光镜、电镜下观察各组大鼠肾脏病理改变。结果模型组12 h尿蛋白定量造模后1周与空白组差异有显著性(P0.01),第5周达到高峰;血总蛋白、白蛋白均低于空白组,甘油三酯、胆固醇、血尿素氮均高于空白组(均P0.05),血肌酐差异无显著性(P=0.64)。肾脏病理改变:第5周为微小病变型,第10周为局灶性节段性肾小球硬化。结论单次尾静脉注射6.2 mg/kg阿霉素,可以成功建立渐进性的大鼠肾病综合征模型。     

高热量高蛋白饮食诱导GK大鼠糖尿病肾病模型的建立

目的运用高热量高蛋白饮食诱导GK大鼠2型糖尿病肾病模型的建立,并探讨其可能的作用机制。方法 28周龄GK大鼠24只,随机分成对照组、模型组,每组各12只,模型组给予高热量高蛋白饮食,对照组给予正常饮食,共8周。于第0、4、8周观察24 h尿微量白蛋白、24 h尿蛋白、尿肌酐、尿微量白蛋白/尿肌酐比值水平;于第0、8周观察空腹血糖和血清肌酐、尿素氮、总胆固醇、甘油三脂、一氧化氮水平;实验结束时取双肾称重并计算肾肥大指数,取肾组织观察病理形态学变化,检测肾组织钠钾ATP酶活性。结果与对照组比,模型组大鼠24 h尿微量白蛋白、24 h尿蛋白、尿微量白蛋白/尿肌酐比值、空腹血糖、总胆固醇、甘油三脂、一氧化氮、肾肥大指数水平和肾组织钠钾ATP酶活性显著提高,模型组肾小球体积增大,系膜基质增生,基底膜增厚明显。结论运用高热量高蛋白饮食诱导GK大鼠可成功建立2型糖尿病肾病模型。血糖血脂的上升是糖尿病肾病形成的重要因素,同时钠钾ATP酶活性增强进一步损伤肾小管功能,一氧化氮升高促使肾小球高灌注、高滤过,也是加速GK大鼠肾病形成的原因。     

不同剂量阿霉素致大鼠局灶节段硬化肾病模型的建立比较

目的探讨不同剂量阿霉素对大鼠局灶节段硬化肾病模型的影响。方法左侧肾切除加尾静脉注射不同剂量阿霉素致大鼠肾脏局灶节段性硬化,观察不同剂量阿霉素对模型大鼠成活率、24 h尿蛋白定量、血清肌酐、尿素氮、肾脏病理的影响。结果不同阿霉素注射剂量组大鼠4周、8周成活率随着注射剂量的升高呈逐渐下降趋势,且4周、8周时阿霉素注射剂量4.5～6 mg/kg组模型大鼠成活率均低于50%;8周时成活率与注射剂量呈高度显著性负相关（r=0.9045,P〈0.01）。各阿霉素注射剂量组于1周出现尿蛋白明显升高（P〈0.01）、2周出现血清肌酐明显升高（P〈0.01）、4周出现血清尿素氮明显升高（P〈0.01）,并均呈进行性增高,2周时除3 mg/kg组外,其余各组血清尿素氮较正常组高（P〈0.01,P〈0.05）;8周时各注射剂量组大鼠24 h尿蛋白定量、血清肌酐、血清尿素氮与阿霉素注射剂量呈高度显著性正相关（r=0.942 9,P〈0.01;r=0.938 4,P〈0.01;r=0.956 8,P〈0.01）。各组大鼠肾脏病理均提示肾小球出现局灶节段硬化表现,且硬化程度随注射剂量的增加而呈加重趋势。结论阿霉素尾静脉注射剂量3 mg/kg模型组大鼠死亡率低,同时大鼠肾脏病理又能表现出符合人类肾小球局灶节段硬化的改变,是较为理想的造模剂量。     

BMP-7 在子痫前期肾脏损伤中的表达及临床意义

目的：探究BMP-7 在子痫前期肾脏损伤中的表达及临床意义。方法：选取2012 年3 月到2013 年12 月我院妇产科收治的98 例子痫前期肾脏损伤患者作为研究对象,以30例健康孕妇为对照,分别采用ELISA 方法检测血液、尿液中BMP-7 蛋白、尿茁2微 球蛋白（beta2-MG）浓度,以苄索氯胺比浊法测定24 h尿蛋白定量。结果：①与对照组相比,子痫前期肾脏损伤患者尿液及血清 BMP-7 蛋白浓度显著降低(P<0.05);②随着病程进展,子痫前期组尿液血清BMP-7 蛋白浓度、尿白蛋白定量、beta2-MG 显著升高 (P<0.05);③子痫前期组尿液、血清BMP-7 蛋白浓度分别与尿白蛋白定量、beta2-MG 成正相关（P＜0.05）。结论：子痫前期肾脏损伤 患者血清BMP-7 蛋白水平显著降低,可用于评估子痫前期肾脏损伤进展,对临床具有指导意义。     

蝉蜕、僵蚕对大鼠系膜增生性肾炎作用的实验研究

目的:研究蝉蜕、僵蚕对大鼠系膜增生性肾小球肾炎(MsPGN)的治疗作用。方法:采用改良慢性血清病法制备的MsPGN模型,随机分为模型对照组、蝉蜕高剂量组、蝉蜕低剂量组、僵蚕高剂量组、僵蚕低剂量组,另设正常对照组。分别在用药5周、8周后检测大鼠24h尿蛋白;8周后处死大鼠,行血液生化指标检测和肾组织HE染色观察,免疫组化法检测TGF-β1的表达水平。结果:与模型对照组比较,用药5周后蝉蜕、僵蚕高剂量组显著降低大鼠24h蛋白尿(P<0.01);8周后各治疗组大鼠肾组织TGF-β1表达量,24h蛋白尿和血清胆固醇均显著下降,蝉蜕高、低剂量组血清白蛋白均有所升高,差异具有显著性意义(P<0.01)。肾组织形态学观察显示,蝉蜕、僵蚕高剂量组个别区域肾小球系膜细胞轻度增生,系膜区轻度增宽,管腔无挤压现象,较模型组明显改善。结论:蝉蜕、僵蚕均能有效降低MsPGN大鼠24h尿蛋白,改善脂质代谢,其作用机制可能与抑制TGF-β1的过度表达有关。     

D-半乳糖致亚急性衰老大鼠尿液排泄情况观察及其多尿机制探讨

目的观察D-半乳糖(D-gal)致亚急性衰老大鼠在尿液排泄方面的特点并探讨其多尿症状机制。方法在初筛合格的SD大鼠颈背部皮下注射浓度为5%的D-gal生理盐水溶液125mg/(kg·d)连续8周。观察动物在造模期间和停止造模后两周内24h总尿量及水负荷后排尿情况的变化;通过测定模型动物尿中K+、Na+、CL-浓度,血中ALD、ADH、ANP浓度及肾脏病理形态学观察,探讨模型动物24h总尿量增加的机制。结果与正常对照组相比较,模型组动物24h总尿量明显增加;水负荷后6h内排尿潜伏期明显缩短,排尿次数明显增多,但总尿量没有明显差异;模型动物尿中Na+、CL-浓度明显升高,K+浓度明显降低;血浆ALD、ADH含量显著降低,ANP含量显著增加,肾脏出现一系列硬化特征。结论 D-gal致亚急性衰老大鼠出现的总尿量增加和排尿次数增多的情况可能与其ADH、ALD、ANP合成与分泌异常及肾脏病理形态学改变有关。     

阿霉素肾病大鼠表皮生长因子及其受体的表达

目的研究阿霉素肾病大鼠肾组织中表皮生长因子(EGF)及其受体EGFR的表达分布以及表达量与尿蛋白之间关系。方法选择第5天、14天、28天作为动态观察的时点,同期设立正常对照。采用荧光定量RT-PCR、免疫组织化学及计算机图像定量分析EGF mRNA以及EGF、EGFR蛋白在肾组织的表达,同时测定24 h尿蛋白定量。WT1和EGFR双重免疫组化确定EGFR在肾小球内确切细胞定位。结果阿霉素注射后第5天,EGFmRNA即较正常增高,28 d明显增高并高于5 d和14 d。正常对照组EGF阳性细胞主要分布于远曲小管和髓袢,阿霉素组EGF还在集合管和近曲小管上表达;EGF阳性表达范围和强度随尿蛋白增加而增加;EGFmRNA表达量以及EGF在肾小管中的表达强度与24 h尿蛋白量呈正相关。肾小管上皮细胞广泛表达EGFR,阿霉素组EGFR在小管表达均高于正常,但组间各时点差异无显著性;随尿蛋白增加EGFR在肾小球内表达逐渐增多。EGFR在肾小球和肾小管中的表达强度均与24 h尿蛋白量呈正相关。WT1和EGFR双重免疫组化显示阿霉素肾病组EGFR可在足突细胞上表达,正常组则无。结论阿霉素肾病大鼠的肾小球脏层上皮有EGFR的表达。EGF/EGFR可能参与了阿霉素肾病的发病过程以及蛋白尿的形成。     

阿霉素肾病小鼠的肾脏病理转变过程

目的观察不同时间点阿霉素肾病小鼠肾脏病理的转变过程。方法 48只雄性BALB/c小鼠,随机分成对照组和模型组,模型组经尾静脉一次性注射阿霉素10.5mg/kg,对照组给予等量的生理盐水。动态观察实验12周内小鼠24 h尿蛋白、血清生化指标、肾脏病理改变。结果模型小鼠蛋白尿于实验第2周出现,持续至第12周,第8周出现高峰(均P0.05);低蛋白血症、高脂血症分别于实验第4、8周出现,血肌酐于实验第12周明显高于正常组(均P0.05)。模型小鼠肾脏病理改变第4周表现为微小病变型;第8周病变较第4周加重,硬化不明显;第12周出现肾小球局灶节段性硬化、肾小球硬化指数(GSI)为(2.81±0.84)%,明显高于同一观测时间点对照组GSI(0.33±0.21)%(P0.01)。结论一次性尾静脉注射10.5 mg/kg阿霉素,能成功复制阿霉素肾病小鼠模型,该模型在早期表现为微小病变型肾病,晚期转变为局灶性节段性肾小球硬化。     

Podocin蛋白对肾小球足细胞的影响

目的：探讨肾小球足细胞裂隙膜蛋白podocin对足细胞形态及蛋白尿的影响.方法：32只体重160g～220g的雄性SD大鼠按阿霉素给药剂量随机分成小剂量组（3.0mg/Kg）、肾病剂量组（7.5mg/Kg）、超剂量组（10.0mg/Kg）、正常对照组.于给药第三周末处死大鼠,用氯化苄乙氧铵比浊法检测大鼠24h尿蛋白量,用免疫胶体金电镜检测大鼠肾小球蛋白podocin的表达和足细胞形态.结果：阿霉素组大鼠24h尿蛋白排泄量明显高于正常对照组,尤以肾病组最明显（P＜0.05）;正常对照组大鼠podocin分布在靠近肾小球基底膜（GBM）的足突基底部,主要定位于裂隙隔膜的胞质面,部分金颗粒也可发现于GBM稍远的足突细胞表面.肾病组肾小球足突广泛融合,免疫胶体金颗粒几乎见不到;超剂量组和小剂量组podocin分布在靠近肾小球基底膜（GBM）的足突基底部,免疫胶体金颗粒数明显少于正常对照组,有部分足突退缩.结论：（1）podocin表达减少或消失可能是导致肾小球足突细胞融合的关键因素（2）蛋白尿的发生与肾小球足细胞裂隙膜蛋白podocin的减少或缺失有关.     

周脂素在糖尿病肾病大鼠肾组织中的表达

目的观察大鼠糖尿病肾病(diabetic nephropathy,DN)模型的特点和尿LN对早期DN的诊断价值,探讨周脂素(perilipin,Plin)在DN大鼠肾脏中的表达情况。方法将14只SD雄性大鼠随机分为对照组(普通饲料)和糖尿病肾病模型组(高糖高脂饲料),对照组6只,模型组8只,饲养4周后模型组按照30mg/kg剂量注射1%链脲佐菌素(STZ),检测血糖≥16.7mmol/L,糖尿病模型制作成功,继续喂养6周,检测24h尿蛋白≥30mg/kg,糖尿病肾病模型制作成功。考马斯亮蓝检测24h尿蛋白、ELISA测尿层粘连蛋白,HE染色观察肾组织的病理变化,Real-time PCR及Western blot检测肾脏组织中perilipin表达情况。结果模型鼠24h尿蛋白≥30mg/kg,糖尿病肾病大鼠模型制作成功。和对照组大鼠相比,模型组的肾重/体重比明显增高(P<0.05),尿量、尿层粘连蛋白于5周出现升高、24h尿蛋白于6周时出现升高,且三项指标均随着时间不断增高。肾组织病理检查显示:肾小球肥大,基膜增生,微小血管瘤形成,肾小管管腔变形,上皮脱落、空泡样变,大量单核、淋巴等炎性细胞浸润,间质内胶原纤维增生。模型组大鼠肾组织Plin的mRNA及蛋白表达均明显的升高(P<0.05)。结论尿层粘连蛋白比24h尿蛋白升高得早,可作为早期糖尿病肾病的警示指标。Plin表达增高可能参与了糖尿病肾病肾病变过程,为进一步探讨糖尿病肾病的发病机制提供新的思路。     

Urinary excretion of glycosaminoglycans and albumin in experimental diabetes mellitus

Diabetes mellitus was induced in one group of rats by a single injection of streptozotocin. The glycemia, the body weight, and the blood systolic pressure were measured every week, and the 24 h urine volume and urinary excretions of creatinine, albumin and glycosaminoglycans were measured every 2 weeks. At the end of the experiment (12 weeks) the weight and the glycosaminoglycan composition of the kidneys were determined. All the diabetic animals were hyperglycemic, hypertense, and did not gain weight during all the experimental period. Albuminuria appeared from the second week on. Rat urine was shown to contain heparan sulfate, chondroitin sulfate, and dermatan sulfate, and the glycosaminoglycan excretion decreased in all diabetic animals. The onset of the change in glyco-samino-glycan excretion rate was a very early event, appearing in the second week after diabetes induction. The main glycosaminoglycan found in normal rat kidney was heparan sulfate and, in contrast to the urine, the total kidney glycosaminoglycans increased in diabetic kidney, due to chondroitin sulfate and dermatan sulfate accumulation. The heparan sulfate concentration (per tissue dry weight) did not change. Our results suggest that quantification of urinary glycosaminoglycans may be a useful tool for the early diagnosis of diabetic nephropathy.     

糖尿病大鼠肾皮质ICAM-1在缬沙坦作用后表达的变化研究

目的：利用血管紧张素I（IAngII）受体拮抗剂缬沙坦（Valsartan）阻断肾素-血管紧张素（RAS）观察其对糖尿病大鼠肾皮质细胞间粘附分子-1（ICAM-1）表达的影响。方法：成年雄性SD大鼠45只,任取其中30只腹腔注射链脲佐菌素制成糖尿病大鼠模型。将糖尿病大鼠随机分为糖尿病缬沙坦治疗组（A组,15只,缬沙坦10mg.kg-1/d灌胃）;糖尿病对照组（B组,15只）;其余15只为正常对照组（C组）。分别于实验第4、6周末各组任取7或8只测定大鼠血糖、平均动脉压、血肌酐、尿肌酐、尿白蛋白排泄率,用图像分析仪测量各组大鼠平均肾小球面积、平均肾小球体积。并于第6周末取各组大鼠肾皮质提取RNA,用逆转录-PCR（RT-PCR）方法对肾皮质ICAM-1mRNA表达进行半定量分析。结果：在第4周及第6周末,A组血糖、肌酐清除率、尿白蛋白排泄率显著低于同时期的B组,B组则较C组均有不同程度的升高（P〈0.01）,A、C组尿白蛋白排泄率始终无统计学差异,同时期三组平均动脉压无统计学差异（P〉0.05）。在4、6周,A、B组的肾小球平均面积、平均体积均明显高于同期的C组（P〈0.01）,但A组又低于同期的B组。RT-PCR半定量结果分析显示,B组ICAM-1 mRNA表达较A、C组显著增高（P〈0.01）,A组表达较C组为高（P〈0.01）,但仍较B组为低（P〈0.01）。结论：血管紧张素I（IAngII）受体拮抗剂缬沙坦能够减少糖尿病大鼠的尿白蛋白排泄,下调肾皮质ICAM-1mRNA表达,减轻肾脏肥大及延缓肾小球硬化,具有保护肾脏的作用。     

Increased glomerular atrial natriuretic peptide receptor affinity in experimental nephrotic syndrome.

Atrial natriuretic peptide (ANP) is a cardiac hormone with natriuretic and diuretic effects. To better define the ANP hormonal system in the nephrotic syndrome, a condition associated with renal sodium retention, we undertook a study of glomerular ANP receptors in rats with puromycin aminonucleoside-induced nephrotic syndrome and in pair-fed controls. Nephrotic rats had significantly decreased serum albumin and total protein and significantly increased serum cholesterol, triglycerides and 24 hour urinary protein excretion. Plasma level of atrial natriuretic peptide was similar in both groups of rats. Competition binding inhibition studies in isolated glomeruli demonstrated one binding site in both groups of rats. The density of ANP binding sites in isolated glomeruli was similar in nephrotic and pair-fed rats while the binding affinity was increased significantly in the nephrotic rats. This is the first study to demonstrate alterations in renal ANP receptors in the nephrotic syndrome. Further studies will be necessary to determine whether alterations in glomerular ANP receptors contribute to renal sodium retention in the nephrotic syndrome.     

成人原发肾病综合征患者血尿酸与血脂代谢的关系

目的:研究成人原发肾病综合征(PNS)患者高尿酸血症的患病率及其与血脂代谢的关系。方法:将109例成人PNS患者根据其尿酸水平分为高尿酸血症组与血尿酸正常组,检测患者的血脂、血清脂蛋白、ALB及24小时尿蛋白定量,分析成人PNS患者高尿酸血症的患病率,比较高尿酸血症组与血尿酸正常组PNS患者的一般情况及血脂水平,并分析PNS患者血尿酸水平的相关因素。结果:成人PNS患者高尿酸血症的发病率为24.77%;高尿酸血症组患者TG及24小时尿蛋白定量水平明显高于血尿酸正常组(P0.01),两组患者TC、LDL-C、HDL-C、Apo AI及Apo B比较差异无统计学意义(P0.05);成人PNS患者血尿酸水平与TG及24小时尿蛋白定量水平呈正相关(r=0.350,P=0.001;r=0.533,P=0.014),与TC、LDL-C、HDL-C及ALB无明显相关性(P0.05)。结论:成人PNS患者高尿酸血症的发生率较高,高尿酸血症患者具有更高的TG及尿蛋白水平,且成人PNS患者血尿酸水平与TG及24小时尿蛋白定量具有相关性,应高度重视成人PNS患者的血尿酸水平。     

Increased secretion of brain natriuretic peptide and atrial natriuretic peptide, but not sufficient to induce natriuresis in rats with nephrotic syndrome.

The levels of immunoreactive brain natriuretic peptide (ir-BNP) and immunoreactive atrial natriuretic peptide (ir-ANP) were evaluated by radioimmunoassay in both the atrium, ventricle and plasma of adriamycin-induced nephrotic rats and control rats. There was no difference in right and left atrial concentrations of ir-BNP, however, a higher right atrial concentration of ir-ANP was observed in nephrotic rats than in controls (p less than 0.01). The ventricular ir-BNP and ir-ANP were increased in nephrotic rats compared to controls (BNP: p less than 0.001, ANP: p less than 0.001). Cardiac BNPs were composed of pro-BNP (gamma-BNP) and its C-terminal 45-amino-acid peptide (BNP-45). The ratio of BNP-45/gamma-BNP in nephrotic rats was higher than that of controls in both atria and in the ventricle. Plasma ir-BNP and ir-ANP were significantly higher in nephrotic rats than in controls (BNP: p less than 0.001, ANP: p less than 0.001), and each level was negatively correlated with urinary sodium excretion in nephrotic rats (BNP: r = -0.84, p less than 0.001, ANP: r = -0.88, p less than 0.001). These results suggest that production and secretion of both BNP and ANP are concomitantly stimulated by a decreased renal ability to eliminate sodium and water, but this secretion is insufficient to induce effective natriuresis in nephrotic rats.     

几种天然产物对高尿酸血症大鼠血清尿酸水平的影响初探

目的:探讨几种天然产物对高尿酸血症大鼠血清尿酸水平及尿酸排泄的影响.方法:对wistar大鼠灌胃氧嗪酸钾和酵母膏,制作高尿酸血症大鼠动物模型.灌胃给药褐藻糖胶、柠檬酸钾和东哥阿里提取物,2周后采血并进行代谢实验,检测血清尿酸、尿素氮,24小时尿液体积、pH值、尿酸浓度及总量,分析三种活性物质对机体尿酸水平、尿酸排泄、肾脏功能的影响.结果:三种物质均可显著降低高尿酸血症模型大鼠的血清尿酸水平,其中东哥阿里提取物组的24小时排泄尿酸总量较模型组显著降低,褐藻糖胶对实验大鼠的血清尿素氮水平升高有抑制作用.结论:三种活性物质对高尿酸血症大鼠血清尿酸浓度有降低作用,其中褐藻糖胶对肾脏功能有保护作用,从而保证尿酸的顺利排泄,而东哥阿里在降低血尿酸水平的同时,24小时尿液中排泄的尿酸总量也显著低于模型对照组,其机制可能与抑制尿酸生成有关.     

Glomerular function in spontaneously diabetic rats.

This study was undertaken to determine whether hyperfiltration exists at the single nephron level and whether albumin excretion is increased early in the course of diabetes in Biobreeding rats. Diabetic rats were studied at 8-12 weeks after the onset of diabetes. Control animals were age-matched, diabetes-resistant rats. Urinary and tubular fluid albumin concentrations were measured by polyacrylamide gel electrophoresis. Clearance and micropuncture techniques were used to determine whole kidney and single nephron glomerular filtration rate, renal blood flow, and glomerular capillary pressure. The urinary albumin excretion rate (1.3 +/- 0.1 mg/24 hr) and the tubular fluid albumin concentration (4.7 +/- 0.7 mg/dl) in the diabetic group were significantly elevated when compared with urinary albumin excretion (0.9 +/- 0.1 mg/24 hr) and tubular fluid albumin concentration (2.5 +/- 0.5 mg/dl) in the control group. There were no significant differences in glomerular hemodynamics (whole kidney or single nephron glomerular filtration rate or glomerular capillary pressure) between diabetic and control rats. The kidney weight and kidney weight to body weight ratio were significantly higher in diabetic rats when compared with control rats. Early diabetes in Biobreeding rats is characterized by mild albuminuria and increased kidney size, but not glomerular hyperfiltration.     

Urinary and plasma calcium changes in endurance trained volunteers during exposure to acute and rigorous bed rest conditions

The purpose of the present study was to evaluate the effect of acute (abrupt restriction of muscular activity) and rigorous bed-rest conditions on urinary and plasma calcium changes in endurance trained volunteers. The studies were performed on 30 long distance runners ages 23–25 who had a peak oxygen uptake of 66.0 mL/min/kg and had run 14.0 km/d on the average prior to their participation in the study. The volunteers were divided into three groups: The volunteers in the first group were under normal ambulatory conditions (control subjects), the second group was subjected to an acute bed-rest regime (acute bedrested subjects), and the third group was submitted to a rigorous bed-rest regime (rigorous bedrested subjects). The second and third groups of volunteers were kept under a rigorous bed rest regime for 7 d. During the pre-bed-rest period and during the actual bed-rest periods (acute and rigorous bed-rest periods), urinary excretion of calcium and plasma calcium and parathyroid hormone (PTH) concentrations were determined. During the 1st d of acute and rigorous bed-rest periods, urinary excretion and plasma concentration of calcium increased significantly (P≤0.05), while plasma parathyroid hormone content decreased significantly (P≤0.05). On the 3rd d of the experimental period, urinary excretion and plasma calcium concentration decreased somewhat, during the 7th d, calcium in urine and plasma increased further, while parathyroid hormone content in plasma increased somewhat on the 3rd d and decreased again on the 7th d of the experimental period. The changes were more pronounced in the volunteers who were subjected to acute bed-rest conditions than in the volunteers who were submitted to rigorous bed-rest conditions. It was concluded that exposure to acute bed-rest conditions induces significantly greater urinary and serum calcium changes than rigorous bed-rest conditions in endurance trained volunteers.