动员自体骨髓干细胞对大鼠急性肾小管坏死的治疗

目的：观察粒细胞集落刺激因子联合干细胞因子动员骨髓干细胞的作用、骨髓干细胞是否具有向损伤肾组织归巢的能力及其在肾脏组织中的分布,初步探讨粒细胞集落刺激因子联合干细胞因子是否具有促进急性肾小管坏死修复的作用。方法：160只8～10周龄雄性SD大鼠随机分为4组：对照组,模型组、G-CSF＋SCF治疗组、G-CSF＋SCF对照组,检测：（1）外周血白细胞总数及单个核细胞中CD34＋细胞百分比的变化;（2）尿NAG酶检测;（3）肾脏组织病理学改变;（4）肾组织CD34＋细胞表达变化。结果：（1）G-CSF＋SCF治疗组和G-CSF＋SCF对照组外周血中白细胞数、CD34＋细胞百分比于第5天达高峰,与对照组、模型组相比,差异有统计学意义（P〈0.05）,以后逐渐下降;相应地,G-CSF＋SCF治疗组肾组织内CD34＋细胞较对照组、模型组也明显增多（P〈0.05）。（2）手术后第5、10、17天,G-CSF＋SCF治疗组尿NAG酶、肾脏病理学改变均明显好于模型组（P〈0.05）。第24天G-CSF＋SCF治疗组尿NAG酶、肾脏病理学改变基本恢复正常,而模型组仍异常。第31天各组间尿NAG酶、肾脏病理学改变其差异无统计学意义。结论：（1）粒细胞集落刺激因子和干细胞因子联合应用对缺血再灌注损伤诱发急性肾小管坏死大鼠的骨髓干细胞有显著的动员作用。（2）骨髓干细胞能在损伤的肾小管归巢和定居,并可能参与损伤肾组织的修复。（3）粒细胞集落刺激因子和干细胞因子联合应用能在一定程度上加速急性肾小管坏死后肾功能的修复。

Treatment of Acute Tubular Necrosis in Rats with Mobilizing Autologous Bone Marrow Stem Cells

Objective:This research is to investigate the mobilization of granulocyte-colony stimulating factor(G-CSF) with stem cell factor(SCF) to bone marrow stem cells,whether bone marrow stem cells have the ability of homing to the injured renal tissue and the distribution of the stem cells in the kidney.At last to investigate whether G-CSF with SCF can accelerate the repair of the acute tubular necrosis.Methods:160 male Sprague-Dawley(SD) rats were randomly divided into four groups,control group,model group,G-CSF+SCF treatment group and G-CSF +SCF control group.G-CSF+SCF treatment group and G-CSF +SCF control group were injected with G-CSF 50 mg/kg and SCF 200 mg/kg via hypodermic per day for 5 days.Several items were measured at 5,10,17,24 and 31day:(1)The numbers of WBC in peripheral blood and the percentage of CD34+ cells in mononuclear cell in venous blood.(2)The expression of CD34+ cells of renal.(3)NAG.(4)Histological changes.Results:(1)At day 5,the numbers of WBC and the percentage of CD34+ cells of rats from G-CSF+SCF treatment and G-CSF +SCF control group were the highest in peripheral blood.They were conspicuous higher than those of rats from control and model group(P<0.05).They gradually descended from 5 day.Corresponding,the percentage of CD34+ cells in renal tissue from G-CSF+SCF treatment group were conspicuous higher than those of rats from blank control and model group(P<0.05).(2)At day 5,10 and 17,urinary NAG and pathological changes of rats from G-CSF+SCF treatment group were conspicuous lower than those of rats from model group(P<0.05).Those rats from G-CSF+SCF treatment group recovered normal nearly at day 24,but those rats from model group were abnormal yet.There was no significantly difference at day 31.Conclusion:(1)Granulocyte-colony stimulating factor plus stem cell factor have conspicuous mobilization to bone marrow stem cells of the rats who have acute tubular necrosis through renal ischemic-reperfusion injury.(2)Mobilized bone marrow stem cells can home and settle down at injured tubular.It will repair the injury of renal tissues.(3)Granulocyte-colony stimulating factor plus stem cell factor can accelerate the repair of renal function after acute tubular necrosis to some extent.