血管紧张素转换酶抑制剂延缓慢性肾衰大鼠肾功能恶化进程的研究

目的:研究ACEI对慢性肾功能衰竭大鼠肾小球硬化进程的延缓作用.方法:将动物分为正常对照组(N组)、慢性肾衰疾病组(D组)、苯那普利早期治疗组(ET组)及晚期治疗组(LT组).检测各组大鼠的BUN、Cr、TP/24h和MAP水平以及肾小球平均截面积和平均体积,并用光镜和电镜观察肾脏的病理学改变.结果:ET组大鼠BUN、Cr、TP/24h以及肾小球平均截面积和平均体积均显著低于D组和LT组;LT组仅前三项指标水平较D组明显下降.病理学检查D组可见肾小球体积增大,呈局灶截段性硬化,系膜增生,间质纤维化:ET组肾脏病理损伤明显减轻,;LT组肾脏病理损伤轻微减轻,较D组有所下降,但差异无显著性.结论:早期给予苯那普利治疗能有效延缓慢性肾衰肾小球硬化的进程,而晚期苯那普利治疗虽能一定程度地改善肾功能和蛋白尿,但对慢性肾衰肾小球硬化的进程并无明显延缓作用.

Effects of Early and Late ACEI Treatment on the Progression of Chronic Renal Failure

Objective: To explore the effects of early and late ACEI treatment on the development and progression of glomerulosclerosis in chronic renai failure. Methods: Experimental chronic renai failure was induced by uninephrectomy with intravenous adriamycin injection. The following groups of rats were studied: normai control group (N group), chronic renai failure group (D group), early benazepril treatment group (ET group) and late benazepril treatment group (LT group). Plasma nitrogen and creatinine, urinary protein excretion and mean arterial pressure(MAP) as well as the glomerulosclerosis profile of the average areas(AG) and volumes(VG) of glomeruli were measured. Results: Plasma nitrogen and creatinine Ievels, urinary protein excretion, MAP and the AG and VG of ET group were significantiy lower than those of Dgroup and LT group (p<0.05).There was no significant difference in MAP.AG and VG between LT group and D group although plasma nitrogen and creatinine levels, urinary protein excretion of LT group were lower than those of D group (p<0.05).Conclusion: This study showed that early benazepril treatment could prevent the development and progression of glomerulosclerosis in chronic renai failure rats, however, late benazepril treatment had not significantly attenuated the progression of glomerulosclerosis though the renai function had been improved in chronic renai failure.