阿托伐他汀与螺内酯对腹膜纤维化的作用研究

目的探讨腹膜纤维化的药物防治措施。方法50只Wister雄性大鼠随机分成5组,每组10只。A组为对照组,每日腹腔内注入0.9%生理盐水20ml。B、C、D、E组腹腔内每日注入20ml4.25%百特透析液,并于试验第7,14,21,28天分别加入乳酸盐红霉素6.25万IU;C组螺内酯100mg/（Kg·d）灌胃;D组阿托伐他汀20mg/（Kg·d）灌胃;E组两药合用。于第1、第30天测定腹膜透析液中的转化生长因子（TGF-β1）,30天后收集大鼠腹膜作常规病理（HE染色.Masson染色）,行腹膜平衡试验（PET）,免疫组化检测eNOS表达和血管生成情况。结果C、D、E组的腹膜纤维化程度比B组轻（P〈0.05）;TGF-β1）浓度明显下降（P〈0.05）;各组腹膜间皮细胞均有eNOS表达,B、C、D、E组均有新生毛细血管表达,C、D、E组较B组表达下调（P〈0.05）。结论阿托伐他汀及螺内酯能有效的防治腹膜纤维化进程。

Effect of Atorvastatin and Spironolactorne on peritoneal fibrosis

Objective To investigate the prevention and treatment of peritoneal fibrosis in long-term peritoneal dialysis patients. Methods We randomly and equally divided 50 Wistar male rats into 5 groups. Rats in group A were intraperitoneally infected with 0.9% normal saline daily as control group. Rats in groups B, C, D and E were intraperitoneally injected with 4.25% Batter dialysate 20ml daily, and infected with Erythromycin lactobionate 62,500 units on the 7th, 14th, 21st and 28th days of the treatment; Additionally, rats in group C were given Spironolactone 100mg/kg daily by gastric gavage, those in group D Atrovastatin 20 mg/kg daily by gastric gavage, and those in group E Spironolactone 100mg/kg daily as well as Atrovastatin 20 mg/kg daily by gastric gavage. TGF β 1 in the peritoneal fluid was measured on the 1st and 30th days of the treatment. Rats were sacrificed on the 30th day of the treatment. Pathological change of peritoneal membrane, 2-hour peritoneal equilibration test （PET）, eNOS expression and angiogenesis by immunohistochemistry in peritoneal membrane were examined in these rats. Results Thickness of peritoneal membrane was less in groups C, D and E than in group B （P〈0.05）, so did the eNOS expression （P 〈 0.05） and the angiogenesis in peritoneal membrane. TGF-β1 was significantly higher in group B, than in groups C, D and E （P 〈 0.05）. Conclusion Both Spironolactone and Atorvastatin are useful for the prevention and treatment of peritoneal fibrosis.