铁超负荷与肾间质纤维化的关系

发布时间：2018-02-22 12:38

本文关键词： 铁超负荷肾间质纤维化氧化性应激抗氧化剂　出处：《中国全科医学》2015年21期 　论文类型：期刊论文

【摘要】：目的探讨铁超负荷与肾间质纤维化(RIF)的关系。方法 2012年2月—2013年1月,选取同批清洁级健康Wister雄性大鼠84只,按体质量分层后随机分为假手术组、模型组、模型+右旋糖酐铁组(右旋糖酐铁500mg/kg)、模型+右旋糖酐铁+去铁敏组(右旋糖酐铁500 mg/kg+去铁敏150 mg·kg-1·d-1)、模型+右旋糖酐铁+N-乙酰半胱氨酸(NAC)组(右旋糖酐铁500 mg/kg+NAC 50 mg·kg-1·d-1)、模型+右旋糖酐铁+维生素E组(右旋糖酐铁500 mg/kg+维生素E 50 mg·kg-1·d-1),每组14只;根据术后观察时间的不同,将每组大鼠采用简单随机抽样法进行均分并分别于术后7 d及术后10 d进行观察。除假手术组外,其余5组均采用单侧输尿管结扎模型。术后第7、10天分别取大鼠左侧肾脏组织制成切片,进行苏木素-伊红(HE)染色、马松染色(Masson染色)及普鲁士兰染色于光镜下观察,比较各组RIF程度和阳性细胞数。结果 HE染色:模型组第7天肾间质有少量炎性细胞,肾小管上皮细胞变矮、肿胀、细胞核变长,出现颗粒和空泡变性;第10天肾间质炎性细胞浸润、充血,肾小管扩张,肾小管上皮细胞萎缩、坏死、部分脱失,基底膜出现断裂、溃解,肾间质出现轻度增宽,肾小球无明显病变。模型+右旋糖酐铁组病变较模型组明显,模型+右旋糖酐铁+去铁敏组、模型+右旋糖酐铁+NAC组、模型+右旋糖酐铁+维生素E组病变较模型组轻,假手术组未见明显变化。Masson染色:第7天模型组肾间质仅有少量胶原纤维,模型+右旋糖酐铁组可见大量胶原纤维增生;第10天模型组可见少量胶原纤维,模型+右旋糖酐铁组可见明显胶原纤维增生、肾间质增宽,扩张的肾小管基底膜旁胶原纤维增生,肾小球周围可见明显胶原纤维,肾小球中无胶原纤维增生,假手术组肾小管及肾间质无明显改变。6组大鼠第7天及第10天RIF程度比较,差异有统计学意义(P0.05);模型+右旋糖酐铁组RIF程度重于模型组,模型+右旋糖酐铁+去铁敏组、模型+右旋糖酐铁+NAC组、模型+右旋糖酐铁+维生素E组RIF程度轻于模型+右旋糖酐铁组(P0.05);各组第10天RIF程度重于第7天(P0.05)。普鲁士兰染色:第7天模型+右旋糖酐铁组肾小管及肾间质内可见较多蓝色颗粒,模型+右旋糖酐铁+维生素E组肾小管及肾间质可见少量蓝色颗粒,其余组未见蓝色颗粒;第10天各组均未见蓝色颗粒。第7天模型+右旋糖酐铁组阳性细胞数高于模型+右旋糖酐铁+维生素E组(t=5.85,P=0.000 1)。结论右旋糖酐铁会加重RIF,但去铁敏和抗氧化剂(NAC和维生素E)可减轻由于铁超负荷导致的RIF;铁超负荷加重RIF可能与其氧化应激的过程有关。
[Abstract]:Objective to investigate the relationship between iron overload and renal interstitial fibrosis. Methods from February 2012 to January 2013, 84 healthy male Wister rats were randomly divided into sham-operated group and model group. Model iron dextran group (500 mg / kg of iron dextran), model iron dextran group (500mg 路kg / kg iron dextran / kg iron desensitization 150mg 路kg-1 路d ~ (-1)), model iron dextran iron (N- acetylcysteine) group (500mg / kg NAC _ (50)). Mg 路kg-1 路d-1, model iron dextran vitamin E group (iron dextran 500 mg/kg vitamin E 50 mg 路kg-1 路d -1), 14 rats in each group; According to the time of postoperative observation, the rats in each group were divided equally by simple random sampling and observed on 7 and 10 days after operation respectively. The other five groups were treated with unilateral ureteral ligation model. The left kidney tissue of the rats was sectioned on the 7th day after operation and stained with hematoxylin eosin (HEH), Ma Song (Masson staining) and Prussian blue staining under light microscope. Results: on the 7th day, there were a few inflammatory cells in renal interstitial cells, tubule epithelial cells became shorter, swelling, nucleus became longer, granules and vacuolar degeneration appeared in the model group. On the 10th day, interstitial inflammatory cell infiltration, hyperemia, tubule dilatation, atrophy, necrosis, partial loss of renal tubule epithelial cells, rupture of basement membrane, collapse and slight widening of renal interstitial cells were observed. Model iron dextran group, model iron dextran group, model iron dextran group, model iron dextran group, model group of iron dextran group, model group of iron dextran vitamin E group, model group of iron dextran iron vitamin E, model group, model group, model group, model group, model group, model group, model group, model group, model group, model group. No significant changes were observed in sham-operated group. Masson staining: on the 7th day, there were only a small amount of collagen fibers in the renal interstitium of the model group, while a large number of collagen fibers were proliferated in the iron dextran group, and a small amount of collagen fibers were observed in the model group on the 10th day. In the model iron dextran group, the proliferation of collagen fibers, the widening of renal interstitium, the proliferation of collagen fibers around glomeruli, and the proliferation of collagen fibers in glomeruli were observed. There was no significant change in renal tubules and renal interstitium in sham-operated group (P 0.05), and the degree of RIF in model iron dextran group was more serious than that in model group, and the degree of RIF in model group was higher than that in model group, and there was no significant difference in the degree of RIF on day 7 and day 10 in sham operation group, and the degree of RIF in model group was more serious than that in model group. Model iron dextran NAC group, The degree of RIF in model iron dextran vitamin E group was lighter than that in model iron dextran group P0.05A, and the degree of RIF in each group on the 10th day was more serious than that in the 7th day. Prussian blue staining: model iron dextran iron group renal tubule and interstitial tissue on the 7th day. You can see more blue particles, A small amount of blue granules were observed in renal tubules and renal interstitium in the model iron dextran vitamin E group, but no blue granules were found in the other groups. On the 7th day, the number of positive cells in the iron dextran group was higher than that in the model iron and vitamin E group. Conclusion Iron dextran can aggravate RIFs, but iron desensitizer and antioxidants may increase the activity of NAC and NAC, and no blue granules can be found in each group on the 10th day, but the number of positive cells in the iron dextran group is higher than that in the iron vitamin E group of the model dextran iron group. Vitamin E) can alleviate the RIFs caused by iron overload, which may be related to the process of oxidative stress.
【作者单位】：天津市第四中心医院肾内科;天津医科大学总医院肾内科;哈尔滨医科大学附属第二医院肾内科;
【基金】：国家自然科学基金青年基金资助项目(30800259)
【分类号】：R692.5

【参考文献】