螺内酯对2型糖尿病大鼠肾脏紧张素转换酶2和细胞间黏附分子表达的影响

目的观察螺内酯对T2DM大鼠肾脏紧张素转换酶2（ACE2）和细胞间黏附分子（ICAM-1）表达的影响，以探讨其对糖尿病肾脏病变的保护作用。方法用高脂高糖饲料喂养大鼠2个月后，腹腔注射30mg／kg STZ制备糖尿病大鼠模型，分为正常对照（NC）组、糖尿病（DM）组、螺内酯治疗（R）组，检测第16周FBG、Cr、24hUAER、肾重／体重（×10^-3）；并用免疫组化和RT-PCR的方法检测16周后大鼠肾脏ACE2和ICAM-1表达的改变。结果第16周末DM、R组各项比较，差异无统计学意义（P〉0．05），但均高于NC组（P均〈0．01）；R组ACE2水平高于DM组（P〈0．01），ICAM-1水平低于DM组（P〈0．05）。结论螺内酯通过增加肾脏组织ACE2的表达、降低ICAM-1的表达而发挥保护肾脏的作用。

Effect of spironolactone on the expressions of ACE2 and ICAM-1 in the kidney of T2DM rats

Objective To observe the effect of spironolactone on the expressions of angiotensin- converting enzyme 2 （ACE2） and intercellular adhesion molecular-1 （ICAM-1） in the kidney of T2DM rats and to discuss its protection against diabetic nephropathy. Methods The rat models of T2DM were established by peritoneal injection of streptozotocin （STZ） 30 mg/kg after feeding high-sugar and high-fat diet for two months. The rats were assigned to normal control （NC） group, diabetic rat （DM） group, and spironolactone treatment （R） group. At the end of 16th week, blood glucose （BG）, creatinine （Cr）, 24- hour urine albumin excretion rate （UAER）, and kidney weight/body weight （× 10^-3） were detected. The expressions of ACE2 and ICAM-1 were measured with immunohistochemical method after 16 weeks. Results At the end of the 16th week, the fasting blood glucose level （FBG） in the DM group was similar to that of the R group （P〈0. 05）, but it was significantly higher in the DM group and NC group than in the NC group （P〈0.01） ; the expression of ACE2 was significantly higher in the R group than in the DM group （P〈0. 01）, while the expression of ICAM-1 was significantly lower in the R group than in the DM group （P〈0. 05）. Conclusion Spironolactone plays a protective role on the kidneys by up-regulating ACE2 and down-regulating ICAM-1 expressions.