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目的:研究当归补血汤(Danggui Buxue Tang,DBT)对腹膜透析相关性大鼠腹膜功能衰竭的影响,并探讨相关的作用机制。方法:SD大鼠ip 4.25%高糖透析液100 m L·kg~(-1),连续40 d,在第8,10,12天ip大肠埃希菌脂多糖5 mg·kg~(-1),建立腹膜功能衰竭大鼠模型;造模大鼠随机分为4组,每组10只,分别为模型组,贝那普利组(2.1 mg·kg~(-1)),DBD高、低剂量组(12,6 g·kg~(-1)),另设正常组,各组大鼠造模的同时ig给药;实验期间观察各大鼠活动状态,第40天末次ip透析液2 h后进行腹膜平衡实验,计算超滤量(UF),检测血清肌酐(P_(Cr))和尿素氮(P_(UN)),腹透液中肌酐(D_(Cr)),尿素氮(D_(UN)),葡萄糖(D_(Glu))及4.25%透析液中的葡萄糖(D_(0Glu)),计算腹膜转运功能参数(D_(Cr)/P_(Cr),D_(UN)/P_(UN),D_(Glu)/D_(0Glu)),取大鼠壁层腹膜采用苏木素-伊红(HE)观察组织形态变化,并用免疫组化法检测转化生长因子-β_1(TGF-β_1)蛋白的表达。结果:与正常组比较,模型组大鼠P_(Cr)和P_(UN)均显著升高(P<0.01),D_(Cr)和D_(Glu)显著降低,D_(UN)显著升高(P<0.01),UF,D_(Cr)/P_(Cr),D_(UN)/P_(UN)及D_(Glu)/D_(0Glu)均显著降低(P<0.01),腹膜间皮细胞受损明显,腹膜TGF-β_1表达增高(P<0.01);与模型组比较,DBT高、低剂量组P_(Cr)和P_(UN)均显著降低(P<0.05),D_(Glu)显著升高(P<0.01),DBT低剂量组D_(UN)显著升高(P<0.05),DBT高剂量组大鼠UF显著升高(P<0.05),DBT高、低剂量组D_(Cr)/P_(Cr),D_(UN)/P_(UN)及D_(Glu)/D_(0Glu)均显著升高(P<0.01);DBT高、低剂量组大鼠腹膜组织形态明显改善,且TGF-β_1表达显著降低(P<0.05,P<0.01)。结论:DBT能抑制腹膜透析相关性大鼠腹膜功能衰竭,保护腹膜结构。
Objective: To study the effect of Danggui Buxue Tang (DBT) on peritoneal dialysis-related rat peritoneal failure and to explore the related mechanism. Methods: Sprague Dawley rats were randomly divided into 4 groups: control group (ip), LPS (40 mg / kg) ) Rats were divided into 4 groups (10 rats in each group): model group, benazepril group (2.1 mg · kg -1), high DBD, Low dose group (12,6 g · kg ~ (-1)), another normal group, the same time, each group of rats model ig administration; during the experiment observed the activity of rats, the last 40 days ip dialysis fluid After 2 hours, the peritoneal balance test was performed to calculate the ultrafiltration volume (UF) and the levels of serum creatinine (P_ (Cr)) and urea nitrogen (P_ (UN)), peritoneal dialysis fluid creatinine (Cr), urea nitrogen D_ (UN), glucose (D_ (Glu)) and glucose (D_ (0Glu)) in 4.25% dialysate were measured to calculate the peritoneal transport parameters (Cr / Cr and D_U / P_ (HE), and the expression of transforming growth factor-β 1 (TGF-β 1) in the peritoneum was detected by immunohistochemistry. Protein expression. Results: Compared with the normal group, the P_ (Cr) and P_ (UN) in the model group were significantly increased (P <0.01), the Cr and D_ (Glu) significantly decreased, while the D_ (UN) (P <0.01), UF, Cr / Cr, D_UU and P_ (Glu) / D_ (0Glu) were significantly decreased (P <0.01). Peritoneal mesothelial cells Compared with model group, P_ (Cr) and P_ (UN) in DBT high and low dose groups were significantly decreased (P <0.05), D_ (Glu) increased significantly (P <0.05). DBF high dose group had significantly increased UF (P <0.05), DBT high dose group and low dose group (Cr) D, Cr, D_UU and D_Glu / D_Glu were significantly increased (P <0.01). The morphology of peritoneum in DBT high and low dose groups was significantly improved, and TGF-β 1 expression was significantly lower (P <0.05, P <0.01). Conclusion: DBT can inhibit peritoneal dialysis-related rat peritoneal failure and protect peritoneal structure.