【摘要】：目的：通過觀察原發(fā)性腎病綜合征(Primary Nephrotic Syndrome,PNS)患兒中藥腎康靈干預(yù)治療前后血清趨化因子CXCL16和金屬蛋白酶ADAM10的水平變化,從分子生物學(xué)水平闡明趨化因子CXCL16和金屬蛋白酶ADAM10與PNS的相關(guān)性及中藥腎康靈干預(yù)治療的作用機(jī)理,進(jìn)一步完善PNS的發(fā)病機(jī)制和中藥腎康靈干預(yù)治療的作用機(jī)制,為提高小兒PNS的臨床療效及中藥新藥研創(chuàng)奠定基礎(chǔ)。 方法：選取門診和病房PNS患兒40例,采用簡單隨機(jī)法將病例分為中西醫(yī)結(jié)合治療組20例(簡稱治療組,A組)和西藥治療對(duì)照組20例(簡稱對(duì)照組,B組),另選取體檢中心健康兒童6例作為健康對(duì)照組(簡稱正常組,C組)。對(duì)照組予以單純西藥治療,治療組在對(duì)照組的治療基礎(chǔ)上加用中藥腎康靈沖劑。應(yīng)用酶聯(lián)免疫吸附法(ELISA)檢測(cè)兩組治療前后的血清趨化因子CXCL16和金屬蛋白酶ADAM10水平,同時(shí)檢測(cè)血清白蛋白、血脂(膽固醇、甘油三酯)和尿蛋白定量,觀察治療前后檢測(cè)指標(biāo)的變化,應(yīng)用SPSS13.0統(tǒng)計(jì)軟件對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)處理。 結(jié)果：①A、B兩組治療前血清CXCL16、ADAM10水平比正常組明顯升高。治療后A、B兩組的血清CXCL16、ADAM10比治療前明顯下降(P均0.01),且A組的血清CXCL16水平明顯低于B組(P0.05)。②A、B兩組治療后的血膽固醇、甘油三酯和尿蛋白定量均明顯低于治療前(P0.01和P0.05),血清白蛋白顯著上升(P0.01和P0.05)。治療后A、B兩組相比,A組在降低血膽固醇、甘油三酯和升高血清白蛋白方面優(yōu)于B組(P0.01和P0.05)。 結(jié)論：PNS患兒存在著血清CXCL16、ADAM10異常升高的表現(xiàn),說明血清CXCL16、 ADAM10參與了PNS的發(fā)病機(jī)制：CXCL16、ADAM10作為吞噬腎臟損傷關(guān)鍵因子ox-LDL的重要成分,能促進(jìn)腎臟炎癥因子的粘附、聚集。中藥腎康靈沖劑治療小兒PNS能顯著降低血清CXCL16、ADAM10的水平,降低異常升高的尿蛋白、血脂,升高血白蛋白,從而改善患兒病情,這可能與清除吞噬ox-LDL的血清CXCL16而發(fā)揮整體作用有關(guān)。
[Abstract]:Objective: to observe the changes of serum chemokine CXCL16 and metalloproteinase ADAM10 in children with primary nephrotic syndrome (PNS) before and after intervention with Shenkangling. To elucidate the correlation between CXCL16 and ADAM10 and PNS and the mechanism of Shenkangling intervention therapy from the molecular biological level, and to improve the pathogenesis of PNS and the mechanism of Shenkangling intervention therapy. To improve the clinical efficacy of children with PNS and to establish a foundation for the development of new Chinese medicine. Methods: 40 children with PNS in outpatients and wards were selected. The patients were randomly divided into two groups: the treatment group (group A) and the control group (group B). 6 healthy children in the physical examination center were selected as the healthy control group. (referred to as normal group C). The control group was treated with simple western medicine, and the treatment group was treated with Shenkangling granule on the basis of the treatment in the control group. The levels of serum chemokine CXCL16 and metalloproteinase ADAM10 were measured by enzyme-linked immunosorbent assay (Elisa) before and after treatment. Serum albumin, serum lipid (cholesterol, triglyceride) and urine protein were measured. The changes of the indexes before and after treatment were observed. SPSS 13.0 statistical software was used to process the data. Results the serum CXCL16 ADAM10 level in the two groups was significantly higher than that in the normal group before treatment. After treatment, the serum CXCL16ADAM10 of AXCL16ADAM10 in group A was significantly lower than that before treatment (P0.01), and the level of serum CXCL16 in group A was significantly lower than that in group B (P0.05). Triglyceride and urine protein were significantly lower than before treatment (P0.01 and P0.05), serum albumin significantly increased (P0.01 and P0.05). After treatment, group A was superior to group B in lowering serum cholesterol, triglyceride and raising serum albumin (P0.01 and P0.05). Conclusion there is abnormal increase of serum CXCL16ADAM10 in children with PNS, which suggests that serum CXCL16 and ADAM10 are involved in the pathogenesis of PNS: CXCL16ADAM10 is an important component of ox-LDL, which can promote the adhesion and aggregation of renal inflammatory factors. Shenkangling granule could significantly reduce the level of serum CXCL16ADAM10, decrease the abnormal increase of urinary protein, blood lipid and serum albumin, thus improve the condition of children, which may be related to the clearance of ox-LDL serum CXCL16 and play a whole role.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R272

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