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石淋清颗粒预防大鼠草酸钙肾结石形成的作用机制研究
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          靳潇潇 ,李卫胜,杨 雄,郑 聪,何文强(河南中医药大学第一附属医院泌尿外科二区,郑州 450003)
                *
          中图分类号  R965      文献标志码  A      文章编号  1001-0408(2022)23-2858-06
          DOI  10.6039/j.issn.1001-0408.2022.23.08


          摘   要  目的  探讨石淋清颗粒预防大鼠草酸钙肾结石形成的作用机制。方法  将60只大鼠随机分为空白组、模型组和石淋清颗
          粒低、中、高剂量组(6.5、13、26 g/kg)及去乙酰化酶3(SIRT3)抑制剂组(石淋清颗粒26 g/kg+SIRT3抑制剂25 mg/kg),每组10只。
          除空白组外,其余各组大鼠将饮水更换为 1% 乙二醇溶液,并每天灌胃 2% 氯化铵溶液 2 mL,连续 4 周,以复制肾结石大鼠模型。
          造模同时,给药组灌胃相应药物,空白组和模型组灌胃等体积生理盐水。测定大鼠24 h尿量、尿液pH值和尿液中Ca 、草酸(Ox)
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                                             2+
          含量及血清中肌酐(Cr)、血尿素氮(BUN)、Ca 含量;观察大鼠肾组织病理学形态、草酸钙肾结晶情况和超微结构;检测大鼠肾组
          织中丙二醛(MDA)、超氧化物歧化酶(SOD)、活性氧(ROS)、骨桥蛋白(OPN)水平;检测大鼠肾组织中 SIRT3、叉头框蛋白 O3a
         (FOXO3a)、SOD2 mRNA和蛋白的表达水平。结果  与空白组比较,模型组大鼠24 h尿量、尿液pH值、肾组织中SOD水平,以及
          SIRT3、FOXO3a、SOD2 mRNA和蛋白表达水平均显著降低(P<0.05或P<0.01);尿液中Ca 、Ox含量,血清中Cr、BUN、Ca 含量,
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          肾组织中ROS、MDA、OPN水平均显著升高(P<0.01);肾组织病理损伤严重,可见大量弥漫性分布的黑色结晶,肾小球基膜增厚,
          足突细胞和肾小管上皮细胞中的线粒体水肿。与模型组比较,石淋清颗粒各剂量组大鼠上述指标含量/水平(低剂量组血清中Ca                                         2+
          含量除外)均显著逆转(P<0.05或P<0.01),肾组织病理损伤、草酸钙肾结晶、肾小球足突细胞和肾小管上皮细胞中的线粒体损伤
          均明显改善;而SIRT3抑制剂组上述指标变化差异无统计学意义(P>0.05)。结论  石淋清颗粒可有效抑制大鼠草酸钙肾结石的
          形成,改善肾损伤,其作用机制可能与提高抗氧化作用和激活SIRT3/ FOXO3a信号通路有关。
          关键词  石淋清颗粒;草酸钙;肾结石;肾损伤;抗氧化;SIRT3/FOXO3a信号通路


          Study  on  the  mechanism  of  Shilinqing  granules  preventing  the  formation  of  calcium  oxalate  kidney  stones
          in rats
          JIN Xiaoxiao,LI Weisheng,YANG Xiong,ZHENG Cong,HE Wenqiang(Section Two,  Department  of  Urology,
          the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450003, China)

          ABSTRACT    OBJECTIVE  To  investigate  the  mechanism  of  Shilinqing  granules  preventing  the  formation  of  calcium  oxalate
          kidney  stones  in  rats.  METHODS  Sixty  rats  were  randomly  divided  into  blank  group,  model  group,  Shilingqing  granules  low-
          dose,  medium-dose  and  high-dose  groups (6.5,  13,  26  g/kg),  SIRT3  inhibitor  group (Shilingqing  granules  26  g/kg+SIRT3
          inhibitor  25  mg/kg),  with  10  rats  in  each  group.  Except  for  blank  group,  other  groups  were  given  1%  ethylene  glycol  solution
          instead of drinking water, and intragastrical administration of 2% ammonium chloride solution 2 mL, for 4 consecutive weeks, to
          induce kidney stones rat model; at the same time, administration groups were given relevant medicine intrgastrically, blank group
          and  model  group  were  given  constant  volume  of  normal  saline  intrgastrically. The  24  h  urine  volume,  urine  pH,  urine  contents  of
          Ca  and oxalic acid (Ox), serum contents of creatinine (Cr), blood urea nitrogen (BUN) and Ca  were all determined; the renal
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            2+
          histopathology, calcium oxalate crystallization and ultrastructure were observed; the levels of malondialdehyde (MDA), superoxide
          dismutase (SOD),  reactive  oxygen  species (ROS)  and  osteopontin (OPN)  in  renal  tissue  of  rats  were  determined;  mRNA  and
          protein  expressions  of  SIRT3,  FOXO3a,  and  SOD2  in  renal  tissue  of  rats  were  determined.  RESULTS  Compared  with  blank
          group,  24  h  urine  volume,  urine  pH,  SOD  level,  mRNA  and  protein  expressions  of  SIRT3,  FOXO3a  and  SOD2  in  renal  tissue
          were decreased significantly in model group (P<0.05 or P<0.01). The contents of urine Ca  and Ox, serum contents of Cr, BUN
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          and Ca and the levels of ROS, MDA and OPN in renal tissue were increased significantly (P<0.01). The pathological damage of
               2+
          renal  tissue  was  severe,  with  a  large  number  of  diffuse  black  crystals,  thickened  glomerular  basement  membrane,  and
          mitochondrial  edema  in  podocytes  and  renal  tubular  epithelial  cells.  Compared  with  model  group,  the  above  indexes (except  for
          serum  content  of  Ca   in  low-dose  group)  were  significantly  reversed  in  Shilinqing  granules  groups (P<0.05  or  P<0.01);
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                                                              pathological  renal  damage,  calcium  crystal,  mitochondrial
              Δ 基金项目 河南省科技发展计划项目(No.182102310059)             damage of glomerular podocyte and renal tubular epithelial cell
             *第一作者 硕士。研究方向:泌尿系结石临床诊疗与基础研究。                    were  significantly  improved;  there  was  no  statistical
          电话:0371-66232332。E-mail:904367580@qq.com
                                                              significance in the changes of above indexes in SIRT3 inhibitor
              # 通信作者 主任医师,教授,硕士生导师。研究方向:泌尿系结石
          防治与基础研究。E-mail:1936473056@qq.com                    group (P>0.05).  CONCLUSIONS  Shilinqing  granules  can


          · 2858 ·    China Pharmacy  2022 Vol. 33  No. 23                            中国药房  2022年第33卷第23期
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