苦参素抗肾脏纤维化作用的临床观察.pdf

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1、浙江临床医学2015年5月第l7卷第5期·695·苦参素抗肾脏纤维化作用的临床观察李立范妮娜冯彬杨红丽房星星【摘要】目的探讨苦参素在慢性肾脏病(CKD)进展中抗肾脏纤维化的作用。方法选取63例cKDII期或Ⅲ期患者，随机分成观察组35例、对照组28例。对照组采取保护肾功能、控制高血压、减少蛋白尿、纠正酸中毒等治疗措施。观察组在对照组基础上每天静脉滴注苦参素注射液1．2g，疗f~14d。检测两组患者治疗14dgr后外周血纤维化及微炎症指标。结果观察组治疗14d2~Av-清中透明质酸(HA)、Ⅲ型前胶原(PⅢNP)、Ⅳ型胶原(1V—CA)、层

2、粘连蛋白(LN)含量均低于治疗前(P<0．05)，与同期对照组比较差异有统计学意义(P<0．05)。观察组治疗14d)~超敏c反应蛋白(hs—CRP)、白细胞介素．1p(IL一1p)、肿瘤坏死因子一d(TNF—)等微炎症指标与治疗前比较显著降低(P<0．05)．与同期对照组比较差异有统计学意义(P<0．05)。结论苦参素可能通过降低血清中HA、PllINP、IV—CA、LN水平及抑制微炎症因子表达来抗肾脏纤维化。【关键词】苦参素肾间质纤维化慢性肾脏病微炎症【Abstract】ObjectiveToinvestigatethemechani

3、smoftherapeuticefectofoxymatrineonrenalfibrosisinchronickidneydisease(CKD)．MethodsSixty—threeCKD(stage2-3)patientswereselectedandrandomlydividedintooxymatrinetreatment(A)group(n=35)andcontroltreatment(B)group(n=28)．GroupB~eatmentmethodsareincludingprotectionofrenalfunctio

4、n，controlbloodpressure，loweringproteinuria，correctionofacidosisandothersymptomatictreatmentsGroupAtreatmentmethodsarebasedontheabovetreatment．thenadditionaluseofoxymatrine1,2gin250mLof5％glucoseintravenously．onceadayandcontinued14days．Indicatorssuchasperipheralbloodfibrosi

5、sandmicro—inflammationweredetectedinCKDpatientsbeforeandaftertreatment．ResultsAfter14daysoftreatment，serafibrosismarkersinpatientsofgroupA，suchashyaluronicacid(HA)，typeIIprocollagen(PIIINP)，typeIVcollagen(IV—CA)，laminin(LN)weresignificantlydecreasedthanthosebeforetreatmen

6、t(P<0．05)andalsogroupBthesametimeperiod(P<0．05)．Micro—inflammatorymarkerssuchashigh—sensitivityC—reactiveprotein(hs—CRP)，interleukin一1B(IL·l／3)，tUlTIornecrosisfactor-(TNF·)inpatientsofgroupAwerealsosignificantlylowerthanthosebeforetreatment(P<0．05)，andhadamoresignificantd

7、iference(P<0．05)comparedwiththesanleperiodingroupBalso．ConclusionTheefectofoxymatrineanti—renalfibrosisismaybemediatedbyloweringthelevelsofserumHA，PmNP，IV—CA，LNandinhibitionofmicro—inflammationinCKDpatients．【Keywords】OxymatrineRenalinterstitialfibrosisChronickidneydisease

8、Micro·inflammation肾间质纤维化(renalinterstitialfibrosis，RIF)女l2例；平均年龄(47．64-15．4)岁。平均病程(19．7±14．2)是各种