黄芪提取成分对体外冲击波碎石术致肾损伤的保护作用

目的 探讨黄芪中不同提取成分在体外冲击波碎石术（ESWL）致肾损伤中的保护作用及机制。方法 64只家兔随机分为：生理盐水对照组、黄芪总皂甙组、总黄酮组和总多糖组。分别测定ESWL前后血及肾组织匀浆中损伤相关因子内皮素（ET-1）、丙二醛（MDA）及保护相关因子一氧化氮（NO）含量,并观察肾脏组织形态及细胞超微结构的变化。结果ESWL后3个黄芪成分组血及肾组织匀浆ET-1、MDA的升高幅度均明显低于对照组（P〈0．05）,其中总皂甙与总黄酮作用尤为突出,总皂甙组ET-1与总黄酮组MDA,冲击前后无显著差异（P均〉0．05）;总皂甙组NO的下降幅显著低于同期对照组（P〈0．05）且24h后即恢复正常;总皂甙组与总黄酮组肾脏组织形态及细胞超微结构的损伤均明显轻于对照组,其中皂甙作用更加显著。结论 黄芪总皂甙与总黄酮,尤其总皂甙是黄芪抗冲击波肾损伤的主要效应成分。

The protective effects of three components isolated from Astragalus membranaceus on shock wave lithotripsy induced kidney injury in rabbit model

Objective Extracorporeal shock wave lithotripsy (ESWL) is has been shown to reduce renal parenchymal injury subject to application of shock wave lithotripsy in our pervious study. To investigate the protective action of three main components from Astragalus membranaceus, including total saponins of astragalus (TSA), total flavonoids of astragalus (TFA) total polysaccharide of astragalus (TPA) in alleviating shock wave induced kidney damage. Methods Sixty four male rabbits were randomly assigned to a control group or to 3 groups that were premedicated with TSA TFA and TPA respectively prior to application of ESWL. Each group of animals underwent shock wave lithotripsy (18 kV) to the right kidneys and received a total of 1500 shocks. Peripheral blood samples were collected to evaluate the levels of plasma endothelin-1 (ET-1), plasma nitric oxide (NO) and serum malondialdehyde (MDA) before and after shock wave treatment. The concentrations of these markers in the treated kidney tissues were also detected 3 days, 7 days and 14 days after application of ESWL. The changes of histopathology and cells ultrastructure were observed through light microscope and electron microscope. Untreated contralateral kidneys were evaluated as controls. Results In control serials the levels of ET-1 and MDA were elevated significantly while the level of NO was significantly decreased after application of shock wave lithotripsy( P <0.05). The comparison between the controls and premedicated groups demonstrated that all these three components especially TSA and TFA significantly inhibited shock wave induced increasing of ET-1 and MDA( P <0.05). TSA also significantly suppressed the decrease of NO and made the recovery time earlier compare to the results of controls ( P <0.05). However, TFA and TPA had almost no effects on the change of NO. ( P >0.05). The results in histopathology showed noticeably damage of glomerular and tubular epithelial cells in the treated kidneys in the controls. The histological alterations in the TPA group were similar to those of the controls. These alterations were significantly milder in the TSA and TFA particular the TSA group. Conclusion TFA and TSA, especially TSA seemed to play the key role in alleviating ESWL induced kidney damage.