王薇;茹颖;宋红梅;连冬梅;
WANG Wei;RU Ying;SONG Hong-mei;LIAN Dong-mei;Department of Pediatrics,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

• 1:中国医学科学院北京协和医学院北京协和医院儿科

摘要(Abstract)：

目的探讨槐杞黄颗粒单独应用或与泼尼松联用对阿霉素肾病大鼠细胞免疫及体液免疫功能的影响以及对蛋白尿的作用。方法雄性SD大鼠50只,随机平均分为5组(n=10)。4组经尾静脉注射盐酸多柔比星(6.5 mg/kg)制作肾病模型,另一组注射生理盐水为正常对照组。2周后造模成功,每日灌胃治疗6周。给药剂量如下:正常对照组(A组)及肾病生理盐水组(B组)给予生理盐水2 ml;肾病泼尼松组(C组)给予泼尼松液2 mg/kg;肾病槐杞黄组(D组)给予槐杞黄颗粒液2 g/kg;肾病槐杞黄泼尼松联用组(E组)给予槐杞黄液2 g/kg及泼尼松液2 mg/kg。比较各组死亡率、体重变化趋势、24 h尿蛋白增长量,血清Ig A、Ig G、Ig M,以及淋巴细胞亚群CD3+T细胞、CD3+CD4+T细胞、CD3+CD8+T细胞、CD45RA+B细胞、CD161a+NK细胞比率的差异。结果所有大鼠均成功造模,24 h尿蛋白均值为(0.389±0.273)g/24 h。C、E组死亡率显著高于A、B组(P<0.05),C、D、E 3组之间差异无统计学意义。正常对照组体重持续增长,其余4组给药2周前体重呈增长趋势,之后呈下降趋势,4组之间差异无统计学意义。4组肾病大鼠给药6周后24 h尿蛋白量均增长,增长量分别为(0.313±0.266)、(0.404±0.235)、(0.120±0.628)、(0.480±0.229)g/24 h,差异无统计学意义。5组之间CD3+T细胞、CD3+CD4+T细胞、CD3+CD8+T细胞、CD45RA+B细胞、CD161a+NK细胞在全血中的比率差异均无统计学意义。B组的Ig A、Ig G及Ig M显著高于A组;C组的Ig A、Ig G及Ig M均显著低于B组;D组Ig A显著低于B组,Ig G显著低于A、B组,Ig M显著高于A、C组;E组Ig A、Ig G显著高于A、C、D组,Ig M显著高于A、C组(P均<0.05);各指标其他两组间比较差异均无统计学意义。结论极严重肾病大鼠体液免疫功能亢进,槐杞黄可发挥双向免疫调节作用,单用时可下调亢进的免疫功能,与泼尼松效果相近;与泼尼松联用时,可上调泼尼松对机体的免疫抑制作用,与泼尼松相拮抗。本研究未发现各种治疗对细胞免疫的影响及对尿蛋白增长量的作用。
Objective To investigate the effects of Huai Qi Huang granules administered alone or combined with predisone on humoral immunity,cellular immunity,and proteinuria of adriamycin nephrosis rats.Methods A total of 50 SD rats were randomly divided into 5 groups( all n = 10),in which 4 groups were injected with a single dose of 6. 5 mg / kg adriamycin into the caudal vein to establish nephrosis model,while the other group was injected with normal saline( NS) as normal control. Two weeks later,the nephrosis rat model was established successfully. The rats were treated by daily intragastric administration for 6 weeks: the normal control group( group A) and the nephrosis + NS group( group B) were treated with 2 ml NS; group C( nephrosis +predisone group),D( nephrosis + Huai Qi Huang group),and E( nephrosis + predisone + Huai Qi Huang group) were treated with 2 mg / kg prednisone,2 g / kg Huai Qi Huang granule solution,and 2 mg / kg prednisone plus 2 g / kg Huai Qi Huang granule solution,respectively. The 5 groups were compared in terms of death rate,weight changes trend,24-hour urinary protein increment,serum Ig A,Ig G and Ig M,and percentages of lymphocyte subsets of CD3+T cells,CD3+CD4+T cells,CD3+CD8+T cells,CD45RA+B cells,CD161a+NK cells. Results All nephrosis rats model were successfully made,with 24-hour urinary protein being( 0. 389 ±0. 273) g /24 h. The death rates of group C and group E were significantly higher than those of group A and group B( P < 0. 05),while no significant difference was found among group C,group D,and group E. The body weight of group A was sustainably growing; in contrast,the body weight of the other 4 groups grew in the 2 weeks before administration of treatment,but dropped thereafter,with no significant difference among the 4 groups. Six weeks after administration,24-hour urinary protein of the 4 nephrosis groups were all increased,by( 0. 313 ±0. 266),( 0. 404 ± 0. 235),( 0. 120 ± 0. 628),and( 0. 480 ± 0. 229) g /24 h,respectively,with no signficant difference in increment. There was no significant difference in the percentages of lymphocyte subsets( CD3+T cells,CD3+CD4+T cells,CD3+CD8+T cells,CD45RA+B cells,CD161a+NK cells) among the 5 groups.Ig A,Ig G,and Ig M were higher in group B than in group A; Ig A,Ig G,and Ig M in group C were lower than in group B; in group D,Ig A was lower than in group B,Ig G lower than in group A and group B,Ig M higher than in group A and group C; and in group E,Ig A and Ig G were higher than in group A,group C and group D,Ig M higher than in group A and group C; the differences were all of statistical significance( all P < 0. 05). In addition,there was no significant difference of Ig A,Ig G,or Ig M in the comparison between every other two groups.Conclusions Humoral immunity in severe nephrosis rats is hyperfunctional. Huai Qi Huang is a bidirectional immune modulator. It could down-regulate hyperactive humoral immunity when used alone,similar to the effect of prednisone. When combined with prednisone,it could antagonize the immunosuppression effect of prednisone on the body. No regulation effect of different treatments on cellular immunity or proteinuria was found in this study.

关键词(KeyWords)： 槐杞黄;阿霉素肾病大鼠;免疫调节;泼尼松;药物拮抗作用
Huai Qi Huang;adriamycin nephrosis rats;immunoregulation;prednisone;antagonism effect

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 王薇;茹颖;宋红梅;连冬梅;
WANG Wei;RU Ying;SONG Hong-mei;LIAN Dong-mei;Department of Pediatrics,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

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