中药肾复舒合用阿托品对肾衰大鼠小肠黏膜VEGF和MVD的影响及其与尿素、肌酐清除的关系

目的 观察肾衰状态下用不同药物治疗小肠黏膜血管内皮生长因子（VEGF）的表达和微血管密度（MVD）分布与肠道清除尿素和肌酐的关系.方法 将5/6肾切除SD大鼠随机分为肾复舒治疗组,肾复舒＋阿托品治疗组和模型照组,并设假手术组为正常对照,连续灌药8周.检测各组用药前后血尿素氮（BUN）、血肌酐（Cr）、粪尿素氮及粪肌酐的浓度变化;并取大鼠小肠切片用免疫组化法检测小肠黏膜VEGF表达水平及MVD.用VEGF表达水平及MVD与血和粪尿素氮及肌酐作相关分析.结果 模型组与肾复舒治疗组、肾复舒＋阿托品治疗组小肠黏膜VEGF分别为（20.72±1.8） pu,（24.32±1.54） pu,（28.69±1.82） pu;MVD分别为（274.27±10.62）个/mm2、（332.71±10.96）个/mm2、（436.42±13.70）个/mm2,治疗组表达比对照组明显增强;两治疗组灌药后的血尿素氮及肌酐水平明显低于模型组,且肾复舒＋阿托品组下降更明显（P＜0.05）;小肠VEGF、MVD与血尿素氮呈负相关（P＜0.05）,与粪尿素氮、肌酐呈正相关（P＜0.01）.结论 肾复舒和阿托品能加强VEGF在小肠黏膜的表达,增加MVD,促进尿素氮及肌酐从肠道排出;降低BUN、血Cr浓度.两种药合用以上作用更为明显.

Comparison of the expressions of vascular endothelial growth factor and microvessel density in small intestine mucous membrane with urea and creatinine elimination in renal failure rat used Shenfushu and atropine treatment

Objective To investigate the relationship between that vascular endothelial growth factor （VEGF） expression and microvessel density （MVD） distribution were in the small intestine mucous membrane and that urea and creatinine were eliminated from intestine inrenal failure rat used Shenfushu and atropine treatment.Methods Sprague-Dawely （SD） rats with 5/6 kidney resection were randomly divided into Shenfushu treatment group,Shenfushu ＋ atropine treatment group,pathological control group,and sham operation group for the normal controls.Treatment groups were drenched for eight weeks.Before and after treatment,the concentration of blood urea nitrogen （BUN）,serum creatinine （Scr）,the fecal urea and fecal creatinine were detected; the expression levels of VEGF and MVD in the small intestinal were detected with small intestinal biopsy immunohistochemical method.The relationship between that expression of VEGF and MVD,and that concentration of BUN,Scr,the fecal urea,and fecal creatinine was analyzed.Results VEGF in the Shenfushu treatment group,Shenfushu ＋ atropine treatment group,and pathological control group was （20.72 ± 1.8） pu,（24.32 ± 1.54） pu,and （28.69 ± 1.82） pu,respectively; MVD was （274.27 ± 10.62）/mm2,（332.71 ± 10.96）/mm2,（436.42 ± 13.70）/mm2,respectively.Expressions of small intestinal VEGF and MVD in two treatment groups were increased significantly than the control group.The concentrations of BUN and Scr were significantly decreased with a negative correlation with the expressions of VEGF and MVD.The concentrations of fecal urea nitrogen and fecal creatinine were significantly increased with a positive correlation with the expressions of VEGF and MVD （P 〈0.05）.The concentrations of BUN and serum Cr in the Shenfushu ＋ atropine group were significantly changed more than Shenfushu group （P 〈 0.05）.Conclusions Shenshuaikang and atropine could enhance the expression of VEGF in the small intestinal mucosa,increase microvascular density,promote the elimination of urea nitrogen and creatinine from the intestinal tract to decrease the concentrations of BUN and Scr.Those effects were more obvious with two drugs in combination.