髓过氧化物酶与大剂量顺铂所致小鼠肝功能变化关系的探讨

目的利用大剂量顺铂（Cisplatin,DDP）诱发小鼠急性肾功能衰竭的动物模型,了解大剂量DDP在引起肾损伤的同时对小鼠肝的毒性作用,探讨髓过氧化物酶（Peroxidase,MPO）与DDP所致小鼠肝功能变化的关系。方法 C57BL/6小鼠50只,雌雄各半,依体重随机分为DDP用药组和生理盐水（NS）对照组。15 mg/kg DDP单次腹腔内注射,等量NS对照。分别取对照组小鼠和DDP用药后6、12、24和48 h小鼠各10只,称重后乙醚麻醉,内眦静脉取血检测肝、肾功能;剖腹取肝、称重、计算肝系数,并取少量肝组织行HE染色、形态学观察;检测血浆和肝组织匀浆中MPO活性,统计学分析。结果大剂量DDP用药后48 h,小鼠出现急性肾功能衰竭。DDP用药后6 h血清谷丙转氨酶（ALT）含量达（91.0±11.3）IU/L,与对照组比较差异有统计学意义（P〈0.05）,随后血清ALT含量持续维持在高水平。DDP用药后各组小鼠肝系数明显升高,光镜下见肝细胞广泛变性水肿,肝小叶中可见点状坏死及炎细胞浸润。DDP用药后6 h,小鼠肝组织匀浆MPO含量显著升高,达（1.54±0.45）U/g,与对照组（0.58±0.28）U/g差异有统计学意义（P〈0.01）,随后MPO含量降至正常水平;DDP用药后小鼠外周血MPO含量缓慢增高,用药后48 h达（12.78±2.78）U/L,与对照组（8.06±1.89）U/L比较差异有统计学意义（P〈0.05）。结论大剂量DDP在诱发小鼠急性肾功能衰竭的同时还可引起小鼠急性肝细胞的破坏,其发生可能与肝组织内白细胞的激活及MPO的释放有关。     

大剂量顺铂所致大鼠急性肾衰过程中肠道细菌易位与肠内菌群比例变化的关系

目的研究大剂量顺铂(cisplatin,DDP)所致大鼠急性肾功能衰竭过程中肠道细菌易位与肠内菌群比例变化的关系。方法SD大鼠24只,雌雄各半,依体重随机分为DDP用药后24、48、72 h组和NS对照组,每组6只。10 mg/kg DDP单次腹腔内注射,等量生理盐水对照。随后观察并记录大鼠用药后的表现及体重变化情况;DDP用药后不同时间点分别取用药组大鼠和对照组大鼠,称重后内眦静脉取血,生化法检测血清尿素氮和肌酐的浓度;无菌条件下剖腹取回盲部淋巴结进行细菌培养;同时取十二指肠、空肠、回肠和结肠段内容物进行细菌涂片检查。结果大剂量DDP用药后6 h大鼠体重开始降低,用药48 h后出现腹泻症状并进行性加重。DDP用药后48 h大鼠出现血尿素氮、肌酐的比例显著升高,与对照组比较差异有非常显著性(P0.01)。DDP用药后24 h66%的大鼠回盲部淋巴结出现革兰阴性菌生长,用药后48 h革兰阴性菌生长的阳性率为83%,而对照组大鼠则无细菌生长。对照组大鼠十二指肠、空肠和回肠内主要以革兰阳性球菌为主,结肠内主要以革兰阴性杆菌和革兰阳性球菌为主。DDP用药后24 h,十二指肠、空肠、回肠和结肠内仍然以革兰阳性球菌为主;用药48 h后,空肠、回肠和结肠内革兰阴性杆菌所占比例逐渐增加。结论大剂量DDP可导致大鼠肠道细菌易位、空肠、回肠和结肠内菌群比例失衡,可能与大鼠内毒素血症及急性肾功能衰竭的发生、发展及恶化有关。     

谷氨酰胺对大剂量顺铂用药后大鼠肠道微生态影响的实验研究

目的 探讨谷氨酰胺( glutamine,Gln)对大剂量顺铂(cisplatin,DDP)用药后大鼠肠道菌群失衡及细菌易位和肠黏膜形态的影响.方法 SD大鼠30只,雌雄各半,依体重随机分为3组:DDP用药组、DDP与Gln联合用药组及生理盐水(NS)对照组,每组10只.10 mg/kg DDP单次腹腔内注射,等量NS腹腔内注射对照;DDP用药前3d开始,联合用药组大鼠Gln 1g/(kg·d)灌胃,等量水灌胃对照.DDP用药后48 h,各组大鼠麻醉后内眦静脉取血测血清尿素氮(BUN)、肌酐(CRE)含量;无菌条件下剖腹取回盲部淋巴结匀浆后细菌培养;取空肠、回肠和结肠段内容物细菌涂片检查肠内菌群比例的变化;取回肠黏膜组织检查形态学改变.结果 DDP用药后48 h,DDP用药组大鼠血BUN和CRE含量明显升高,出现急性肾功能衰竭;黏膜水肿明显、绒毛短缩部分破坏、隐窝变浅;各段肠管内革兰阴性杆菌所占比例较对照明显增高(P＜0.01);回盲部淋巴结革兰阴性菌阳性率为80％,而对照组大鼠回盲部淋巴结无细菌生长.DDP用药后48 h,联合用药组大鼠血BUN和CRE含量略低于DDP用药组大鼠,但仍明显高于对照组大鼠(P＜0.01);大鼠回肠黏膜水肿较DDP用药组大鼠明显减轻、绒毛破坏不明显;回肠内革兰阴性杆菌所占比例明显高于DDP用药组大鼠(P＜0.01),各段肠管内革兰阴性杆菌所占比例亦明显高于对照组大鼠(P＜0.01);回盲部淋巴结革兰阴性菌阳性率为30％,明显低于DDP用药组大鼠.结论 大剂量DDP在引起大鼠急性肾功能衰竭的同时,亦可导致大鼠肠黏膜损伤、肠道内菌群失衡,并出现肠源性细菌易位.Gln具有保护肠黏膜、减少肠源性细菌易位的功能,但对大剂量DDP所致肠道内菌群失衡及急性肾功能衰竭无明显防治作用.     

顺铂肾损伤机制的研究及进展

顺铂(cDDP)是临床化疗最常用的药物之一.它是一种广谱抗肿瘤药,对实体肿瘤的疗效尤为明显,其疗效与剂量成正比.     

顺铂诱导肾损伤过程中肾皮质脂质过氧化的变化

目的:探讨顺铂肾损伤过程中肾皮质脂质过氧化与肾小管结构改变的关系.方法:雌性Wistar大鼠随机分为生理盐水组、顺铂Ⅰ组、顺铂Ⅱ组、顺铂Ⅲ组,均为尾静脉注射给药,每天一次,连续五天.第六天取血测肌酐(Scr)、尿素氮(BUN)含量,取肾皮质测丙二醛(MDA)含量、超氧化物歧化酶(SOD)活性、谷胱甘肽过氧化物酶(GSH-Px)活性,同时进行肾小管上皮细胞碱性磷酸酶组织化学染色和组织病理学观察.结果:顺铂组Scr、BUN明显升高,肾皮质MDA含量升高,SOD与GSH-Px活性降低,与对照组相比均有显著差异(P＜0.05),且肾皮质SOD活性、GSH-Px活性与Scr、BUN含量呈明显负相关(P＜0.05),肾皮质MDA含量与Scr、BUN含量呈明显正相关(P＜0.05).酶组化显示肾小管上皮细胞碱性磷酸酶大量丢失,病理切片结果显示肾皮质部分肾小管上皮细胞变性、坏死.结论:顺铂引起肾皮质组织的破坏与肾皮质脂质过氧化增强有关,且随剂量增加肾皮质损伤加重.     

NF-κB、p53和bax在顺铂所致肾损伤中的作用

目的探讨NF-κB抑制剂吡咯烷二硫代氨基甲酸盐(PDTC)和顺铂治疗对Lewis肺癌小鼠肾脏组织中p53和bax表达的影响。方法给小鼠皮下接种Lewis肺癌细胞用顺铂和/或PDTC治疗,15 d后处死小鼠。取肾脏并制成切片,应用免疫组织化学技术检测p53和bax蛋白的表达。结果对照组和PDTC组小鼠肾脏未检测到p53和bax表达;顺铂治疗小鼠肾小管上皮细胞表达p53和bax;合用PDTC治疗组小鼠p53和表达水平较单用顺铂治疗组明显减低。结论合用PDTC下调顺铂诱导的p53和bax表达上调,减少肾细胞凋亡。     

PPAR-γ激动剂吡格列酮对大剂量顺铂所致小鼠肠道微生态失调的影响

利用大剂量顺铂（DDP）诱导小鼠急性肾功能衰竭模型,研究吡格列酮对DDP所致小鼠肠道微生态的影响及其机制。

昆明种小鼠,依性别、体重随机分组：DDP组、DDP+吡格列酮组、对照组,每组10只。每日观察小鼠的体重、记录粪便数量等,并进行粪便涂片检查。DDP用药后3 d,分别取各组小鼠称重后乙醚麻醉,内眦静脉取血;分别取空肠、回肠末段、升结肠上段内容物进行细菌涂片检查。生化法检测血清尿素氮（BUN）、尿酸（UA）、丙二醛（MDA）的水平,并对数据进行统计学分析。

DDP用药后3 d,小鼠回肠、结肠内G⁺菌与G⁻菌比值均显著低于对照组小鼠。吡格列酮可明显增加DDP用药后小鼠回肠、结肠内G⁺菌与G⁻菌比值。DDP组小鼠外周血BUN、UA和MDA水平明显高于对照组小鼠,差异具有统计学意义;DDP+吡格列酮组小鼠其水平明显低于DDP组小鼠。

大剂量DDP可导致小鼠肠内菌群比例失衡;吡格列酮可能通过抑制小鼠体内氧化应激、进而减轻DDP所致的小鼠肾损伤和肠内菌群失衡。

     

三七总皂苷联合顺铂对胃癌大鼠肾损伤的改善作用及机制分析

摘要 目的：探讨三七总皂苷联合顺铂对胃癌大鼠肾损伤的改善作用并分析潜在机制。方法：选择60只健康SD雄性大鼠分为对照组、胃癌模型组、顺铂组及三七总皂苷组,各15只。除对照组外,其余组大鼠采用皮下接种胃癌BGC823细胞悬液法建立胃癌模型。建模成功后,给予对照组和胃癌模型组大鼠生理盐水腹腔注射和灌胃,给予顺铂组大鼠腹腔注射25 mg/kg顺铂注射液并灌胃生理盐水,给予三七总皂苷组大鼠腹腔注射25 mg/kg顺铂注射液并灌胃30 mg/kg三七总皂苷。分别于建模成功时、药物处理28 d时采用酶联免疫吸附法检测血清肌酐（SCr）、尿素氮（BUN）和尿液β-N-乙酰氨基葡萄糖苷酶（NAG）、肾损伤分子1（KIM-1）水平。处死大鼠后取肾脏,分别测定肾脏组织匀浆中超氧化物歧化酶（SOD）、丙二醛（MDA）、过氧化氢酶（CAT）、谷胱甘肽（GSH）水平,制备肾脏组织石蜡切片并行苏木精-伊红染色后观察大鼠肾组织的病理学变化。采用TUNEL染色法检测肾脏组织细胞凋亡情况,采用Western Blotting法检测肾脏组织中LC3、HIF-1α和Beclin1 蛋白表达情况。结果：顺铂组和三七总皂苷组大鼠血清SCr、BUN和尿液NAG、KIM-1水平均显著高于对照组和模型组（P<0.05）,三七总皂苷组大鼠血清SCr、BUN和尿液NAG、KIM-1水平显著高于顺铂组（P<0.05）。三七总皂苷组大鼠肾脏组织SOD、GSH水平显著低于模型组但显著高于顺铂组,MDA显著高于模型组但显著低于顺铂组（P＜0.05）,CAT与模型组无显著差异（P＜0.05）,但显著高于顺铂组（P>0.05）。顺铂组大鼠肾小管明显扩张、管腔狭窄,基底层上皮细胞水肿、坏死并形成空泡,肾小管。三七总皂苷组大鼠肾脏病理学改变程度显著轻于顺铂组。顺铂组和三七总皂苷组大鼠肾脏组织细胞凋亡指数显著增加,三七总皂苷组大鼠肾脏组织细胞凋亡指数显著低于顺铂组（P＜0.05）。顺铂组大鼠肾脏组织中LC3、HIF-1α和Beclin1蛋白水平均显著高于模型组,但显著低于三七总皂苷组（P＜0.05）。结论：三七总皂苷可能通过减轻过氧自由基和过氧化水平、增强线粒体自噬水平减少肾组织细胞凋亡,减轻顺铂引起的胃癌大鼠肾损伤。     

实验性急性肝衰竭大鼠血清中TNF-α的来源及水平变化

目的研究D-氨基半乳糖／内毒素所致大鼠急性肝衰竭模型中血清内TNF-α的来源及不同时间点的水平变化。方法取30只Wistar大鼠腹腔内注射D-氨基半乳糖／内毒素诱导大鼠急性肝衰竭模型（AHF组,n=30）,于建模3h、6h、12h、24h、48h、72h各取5只动物检测其血清丙氨酸转氨酶（ALT）与肝组织的病理形态学变化;采用ELISA检测不同时间点动物血清中TNF-α水平的变化;通过免疫组化法检测不同时间点动物肝、肺组织内TNF-α的表达。另取30只Wistar大鼠腹腔内注射等量生理盐水为正常对照（N组,n=30）。结果AHF组各时间点血清ALT的增高与N组相比有统计学差异（P〈0．05）,肝脏内炎细胞浸润、坏死明显;AHF组与N组相比血清内TNF-α的增高在3h（P〈0．01）、6h（P〈0．05）有统计学差异;AHF组肺组织与N组相比TNF-α的表达在3h、6h、12h（均为P〈0．01）有统计学差异。结论本实验成功建立了大鼠AHF模型;TNF-α在此模型的早期阶段起重要作用;肺脏可能是血清内TNF-α的主要来源之一。     

牛磺胆酸钠在大鼠急性胰腺炎模型中的半数致死量(LD50)研究

目的:通过使用不同浓度的牛磺胆酸钠(TC)建立急性胰腺炎(AP)模型,观察相应的死亡率,进而计算其半数致死量。方法:使用不同浓度的TC(0%(wt/vl)、1%、2%、3%、4%、5%、9%)观察AP造模72小时后各组的死亡率。同时分析TC浓度与组织病理评分、血清淀粉酶和外周血细胞变化的相关性。结果:TC的半数致死量为3.409%。并且,TC的浓度与组织病理评分、血清淀粉酶和外周血细胞变化密切相关。结论:TC所致AP造模的最佳剂量为3.409%。     

Fetal kidney stem cells ameliorate cisplatin induced acute renal failure and promote renal angiogenesis

AIM: To investigate whether fetal kidney stem cells (fKSC) ameliorate cisplatin induced acute renal failure (ARF) in rats and promote renal angiogenesis.METHODS: The fKSC were isolated from rat fetuses of gestation day 16 and expanded in vitro up to 3^rd passage. They were characterized for the expression of mesenchymal and renal progenitor markers by flow cytometry and immunocytochemistry, respectively. The in vitro differentiation of fKSC towards epithelial lineage was evaluated by the treatment with specific induction medium and their angiogenic potential by matrigel induced tube formation assay. To study the effect of fKSC in ARF, fKSC labeled with PKH26 were infused in rats with cisplatin induced ARF and, the blood and renal tissues of the rats were collected at different time points. Blood biochemical parameters were studied to evaluate renal function. Renal tissues were evaluated for renal architecture, renal cell proliferation and angiogenesis by immunohistochemistry, renal cell apoptosis by terminal deoxynucleotidyl transferase nick-end labeling assay and early expression of angiogenic molecules viz. vascular endothelial growth factor (VEGF), hypoxia-inducible factor (HIF)-1α and endothelial nitric oxide synthase (eNOS) by western blot.RESULTS: The fKSC expressed mesenchymal markers viz. CD29, CD44, CD73, CD90 and CD105 as well as renal progenitor markers viz. Wt1, Pax2 and Six2. They exhibited a potential to form CD31 and Von Willebrand factor expressing capillary-like structures and could be differentiated into cytokeratin (CK)18 and CK19 positive epithelial cells. Administration of fKSC in rats with ARF as compared to administration of saline alone, resulted in a significant improvement in renal function and histology on day 3 (2.33 ± 0.33 vs 3.50 ± 0.34, P < 0.05) and on day 7 (0.83 ± 0.16 vs 2.00 ± 0.25, P < 0.05). The infused PKH26 labeled fKSC were observed to engraft in damaged renal tubules and showed increased proliferation and reduced apoptosis (P < 0.05) of renal cells. The kidneys of fKSC as compared to saline treated rats had a higher capillary density on day 3 [13.30 ± 1.54 vs 7.10 ± 1.29, capillaries/high-power fields (HPF), P < 0.05], and on day 7 (21.10 ± 1.46 vs 15.00 ± 1.30, capillaries/HPF, P < 0.05). In addition, kidneys of fKSC treated rats had an up-regulation of angiogenic proteins hypoxia-inducible factor-1α, VEGF and eNOS on day 3 (P < 0.05).CONCLUSION: Our study shows that fKSC ameliorate cisplatin induced ARF in rats and promote renal angiogenesis, which may be an important therapeutic mechanism of these stem cells in the disease.     

肾后性急性肾衰诊治临床探讨

目的分析60例肾后性急性肾功能衰竭患者的诊治。方法对60例肾后性急性肾功能衰竭患者的诊治效果进行回顾性分析。结果解除梗阻后,22例患者肾功能恢复正常,38例未完全恢复正常,其中19例行维持性血液透析。结论影象学检查是明确诊断的主要方法,梗阻程度和时间是影响肾功能恢复的关键因素。     

Effects of oxygen free radical scavengers on uranium-induced acute renal failure in rats

Study was made to determine whether oxygen free radicals mediate uranium-induced acute renal failure (ARF). Superoxide dismutase (SOD), a superoxide anion scavenger, did not prevent uranium acetate (UA) (5 mg/kg, i.v.)-induced renal injury 48 h after injection. In contrast, dimethylthiourea (DMTU), a hydroxyl radical scavenger, significantly attenuated UA-induced rise in serum creatinine concentration (1.11 ± 0.05 (DMTU) vs. 1.40 ± 0.06 mg/dl (control), p < .05), and tubular necrosis. Dimethyl sulfoxide (DMSO), a hydroxyl radical scavenger, decreased UA-induced tubular damage. UA injection caused no increase in renal cortical malondialdehyde (MDA) content. DMTU and DMSO did not modify intrarenal MDA content. UA administration brought about significant increase in plasma renin activity but not in renal cortical renin content. Treatment with DMTU and DMSO had no effect on plasma renin activity or intrarenal renin content. It follows from these findings that DMTU and DMSO may attenuate UA-induced renal injury. Such a protective effect would not be mediated through modulation of lipid peroxidation or renin activity.     

Ang Ⅱ拮抗剂对慢性肾衰大鼠肾血流量和肾内氧耗的影响

目的观察血管紧张素II(AngⅡ)拮抗剂对5/6(ablation/infarction,A/I)肾切除诱导慢性肾衰竭(CRF)大鼠肾功能、肾血流量及肾内氧耗的影响。方法制备5/6(A/I)肾切除诱导慢性肾衰大鼠模型,设正常组(A组,n=14只),模型组(B组,n=14只),AngⅡ拮抗剂治疗组(氯沙坦钾联合福辛普利钠)(C组,n=14只)。给予相应干预,疗程60 d。分别测量尾动脉收缩压(SBP)、舒张压(DBP),检测大鼠尾静脉血清肌酐(Scr)、尿素氮(BUN)、血红蛋白(Hb),计算内生肌酐清除率(Ccr)。干预60 d后,检测肾血流量(RBF)、腹主动脉和肾静脉血气(AABG and RVBG),左肾静脉压(RVpO2),计算残余肾内氧耗(QO2/TNa)及观察残肾组织病理变化。结果 (1)造模后与A组比较,B、C两组的Scr、BUN和尾动脉SBP、DBP显著增加(P0.01),Ccr、Hb显著降低(P0.01),提示造模成功。(2)干预后与B组比较,C组的Scr、尾动脉SBP、DBP、QO2/TNa明显下降(P0.01),BUN降低(P0.05),Hb、Ccr、RVpO2显著升高(P0.01),RBF升高(P0.05)。(3)残肾组织病理形态学变化显示,C组的肾组织病理变化明显减轻,优于B组。结论 AngⅡ拮抗剂可以增加慢性肾衰大鼠肾血流量,降低肾内氧耗,改善肾功能及减轻肾组织病理变化,其肾脏保护作用机制可能与其调节细胞能量代谢,改善肾内氧耗有关。     

Potential mechanism of fibronectin deposits in acute renal failure induced by mercuric chloride

Many glomerular diseases are associated with changes in the expression and distribution in the components of extracellular matrix. A remarkable feature in acute renal failure induced by mercuric chloride in rats was large fibronectin (Fn) deposits in kidneys 1 h post-HgCl₂ injection (5 mg/kg body wt., s.c.). Our study examined some mechanisms as potential explanation of the early Fn deposits in mercuric chloride induced acute renal failure. Total tissue mRNA of livers and kidneys of control and treated rats were used in Northern blot to determine whether accumulation of Fn in kidney is associated with increases in the expression of this protein in the kidney and/or in the liver. Analysis of Fn levels by Western blot were also performed. Northern blot did not show significant difference between control and treated rats, while the abundance of polymerized-Fn in kidney tissue was increased 1 h and 5 h post HgCl₂ injection.HgCl₂ influence on Fn folding was studied in vitro to detect possible conformational changes that could altered its normal pattern of matrix assembly and/or binding to different ligands. In this context HgCl₂ binding to Fn was measured following native thryptophan fluorescence of Fn in the presence of HgCl₂ (0.5–250 mM). Binding parameters for the HgCl₂–Fn complex formation were Kd = (1.6 ± 0.2) 10^–4 M; n = 1 ± 0.3, indicating a low apparent affinity and one type binding site. Thermal denaturation of Fn showed, between 30–60°C, a soft reversible conformational change, while between 75–80°C a highly and irreversible transition is produced suggesting a modification of the tertiary structure. HgCl₂ abolished this transition. The kinetic of thermal unfolding of Fn was also measured and the effects observed due to HgCl₂ presence reinforced the previous data. Finally, the effect of HgCl₂ on Fn binding to denatured collagen (gelatin) was also measured as an index of the effect of this cation on biological properties of Fn. Fn binds gelatin strongest in the presence of HgCl₂.Our results suggest that higher Fn deposits in kidney treated rats seems not to be associated to augmented mRNA-Fn neither in kidney nor in liver. On the other hand, increased levels of polymerized Fn abundance was observed in kidney tissue from mercury-treated rats. We also describe that HgCl₂ promotes, in vitro, conformational changes on Fn structure, inducing its denaturation and increasing its binding to gelatin, all events that could be related to the Fn deposits in renal tissues of HgCl₂-treated rats, and could be expected in other situations that promoted interstitial fibrosis, not associated to overexpression of matrix-proteins.     

广东虫草对腺嘌呤诱导的慢性肾衰竭大鼠的治疗作用

广东虫草Cordyceps guangdongensis是广东省微生物研究所近年发现并成功驯化的独有新品种,前期研究发现其具有抗氧化、抗疲劳、延缓衰老等药理作用,但其对慢性肾衰竭的治疗作用还未见报道。实验采用饲喂腺嘌呤诱导大鼠慢性肾衰竭（CRF）模型,观察比较了阴性对照组、阳性对照组、广东虫草子实体低、中、高剂量组CRF模型大鼠及正常健康大鼠对照组的血尿素氮、肌酐、24h尿量、尿蛋白量,以及肾组织病理变化。结果表明广东虫草子实体组能显著降低CRF大鼠血尿素氮和肌酐,能促进机体生成白蛋白和总蛋白,改善肾功能衰竭大鼠的临床症状及肾脏水肿、变大和病变程度。由此证明广东虫草子实体对大鼠的慢性肾衰竭有明显的治疗作用。