肝素防治局灶节段性肾小球硬化的实验研究

目的　观察肝素钙注射液防治局灶节段性肾小球硬化 (FSGS)的可能性。方法　 18只 Wistar大鼠随机分为正常对照组 (A组 )、肝素治疗组 (B组 )和模型组 (C组 )。采用小剂量分次阿霉素间羟胺高脂饲料法建立大鼠 FSGS模型 ,B组于实验第 2 9d予肝素钙注射液治疗。各组均测定 2 4 h尿蛋白、血生化指标及肾脏组织血流量 ,并在光镜和电镜下检查肾脏形态、肾小球硬化指数 (SI)及细胞外基质 (ECM)。结果　治疗后 2周 (实验 6周 )时肝素治疗组尿蛋白排泄量开始降低 ,实验 12周时肝素治疗组胆固醇升高的幅度低于模型组。肝素治疗组肾组织血流量明显增加。光镜检查显示 ,肝素治疗组 SI及 ECM/肾小球面积 (GA)均明显减低 ;电镜检查显示 ,肝素治疗组毛细血管腔通畅 ,基底膜改变及足突融合均较模型组明显减轻。结论　肝素对FSGS有一定的防治作用。

Experimental study on prevention and treatment of focal segmental glomerulosclerosis with heparin

Objective To observe the preventive and therapeutic feasibility of heparin calcium injection in rats with focal segmental glomerulosclerosis (FSGS). Methods Eighteen male Wistar rats were divided into three groups: normal control group (A, n=6), heparin-treated rats (B, n=6) and model group (C, n=6). Rat model of FSGS was constructed with low-dose adriamycin, metaraminol and high lipid feed method. Group B was treated with heparin. 24-hour urinary protein was measured at the 0, 2nd, 4th, 6th and 12th week. Serum total protein, albumin,cholesterol, blood urea nitrogen(BUN) and serum creatinine(SCr) were determined at 0, 2nd, 6th and 12th week. Renal cortex blood flow was performed at the 12th week . Renal pathology changes were evaluated at the 12th week as well. Results 24-hour urinary protein was decreased in heparin treatment group after 6th week. The serum cholesterol level in heparin treatment group was lower than that in model group at 12th week. Renal cortex blood flow was increased significantly in heparin -treated group. Glomerular sclerotic index (SI) and glomerular extracellular matrix (ECM)/glomerular area (GA) were decreased significantly in heparin treatment group . Electron microscopy revealed that there was no glomerular capillary cavities obstruction in heparin -treated group, basement membrane change and foot precesses fusion were markedly alleviated in comparison with model group. Conclusion Heparin may be play a valuable role in the prevention and treatment of FSGS.