CAJ | 학술논문

目的：探讨全反式维甲酸(ATRA)在腹膜透析中的抗腹膜纤维化作用。方法选择40只雄性SD大鼠，编号后随机分为对照组(腹腔注射生理盐水10 mL/d+与药物等体积的磷酸盐缓冲液稀释的二甲亚砜)、模型组(腹腔注射4.25%的腹透液10 mL/d+与药物等体积的磷酸盐缓冲液稀释的二甲亚砜)、实验1组(腹腔注射4.25%的腹透液10 mL/d+ATRA 2 mg/kg)、实验2组(腹腔注射4.25%的腹透液10 mL/d+ATRA 5 mg/kg)，每组各10只；四组大鼠正常喂养4周后检测腹膜功能，并采用免疫组化法检测大鼠腹膜纤维化相关细胞因子的变化情况。结果实验第4周，模型组和实验1组的腹膜功能指标超滤量、透析液尿素浓度/血浆尿素浓度、初始腹透液葡萄糖浓度/透出液葡萄糖浓度测定值较对照组均有不同程度的下降(P<0.05)，实验2组与对照组比较，差异无统计学意义(P>0.05)。与对照组比较，模型组、实验1组、实验2组的脏层腹膜组织中转化生长因子-β1(TGF-β1)、结缔组织生长因子(CTGF)、α平滑肌肌动蛋白(α-SMA)免疫组化检测结果均发生显著的变化(P<0.05)，实验1组、实验2组较模型组的表达水平更低(P<0.05)。模型组、实验1组、实验2组肝细胞生长因子(HGF)、骨形态发生蛋白-7(BMP-7)、白细胞介素-6(IL-6)、血管内皮生长因子(VEGF)表达水平较对照组均显著升高(P<0.05)；实验1组、实验2组的HGF、BMP-7、IL-6、VEGF表达水平显著低于模型组(P<0.05)。结论 ATRA在腹膜透析中可以通过调节TGF-β1、CTGF、α-SMA等细胞因子的表达达到抗腹膜纤维化的目的。
목적：탐토전반식유갑산(ATRA)재복막투석중적항복막섬유화작용。방법선택40지웅성SD대서，편호후수궤분위대조조(복강주사생리염수10 mL/d+여약물등체적적린산염완충액희석적이갑아풍)、모형조(복강주사4.25%적복투액10 mL/d+여약물등체적적린산염완충액희석적이갑아풍)、실험1조(복강주사4.25%적복투액10 mL/d+ATRA 2 mg/kg)、실험2조(복강주사4.25%적복투액10 mL/d+ATRA 5 mg/kg)，매조각10지；사조대서정상위양4주후검측복막공능，병채용면역조화법검측대서복막섬유화상관세포인자적변화정황。결과실험제4주，모형조화실험1조적복막공능지표초려량、투석액뇨소농도/혈장뇨소농도、초시복투액포도당농도/투출액포도당농도측정치교대조조균유불동정도적하강(P<0.05)，실험2조여대조조비교，차이무통계학의의(P>0.05)。여대조조비교，모형조、실험1조、실험2조적장층복막조직중전화생장인자-β1(TGF-β1)、결체조직생장인자(CTGF)、α평활기기동단백(α-SMA)면역조화검측결과균발생현저적변화(P<0.05)，실험1조、실험2조교모형조적표체수평경저(P<0.05)。모형조、실험1조、실험2조간세포생장인자(HGF)、골형태발생단백-7(BMP-7)、백세포개소-6(IL-6)、혈관내피생장인자(VEGF)표체수평교대조조균현저승고(P<0.05)；실험1조、실험2조적HGF、BMP-7、IL-6、VEGF표체수평현저저우모형조(P<0.05)。결론 ATRA재복막투석중가이통과조절TGF-β1、CTGF、α-SMA등세포인자적표체체도항복막섬유화적목적。
Objective To investigate the effects of all trans retinoic acid (ATRA) in anti peritoneal fibrosis of peritoneal dialysis. Methods Forty healthy male SD rats were selected, after numbered they were randomly divided into control group (intraperitoneal injection 10 mL/d normal saline+phosphate buffer diluting dimethyl sulfoxide with same volume as medicines), model group (intraperitoneal injection 4.25% peritoneal dialysis fluid 10 mL/d + phosphate buffer dilut-ing dimethyl sulfoxide with same volume as medicines), experiment group 1 (intraperitoneal injection 4.25%peritoneal dial-ysis fluid+ATRA 2 mg/kg), experiment group 2 (intraperitoneal injection 4.25%peritoneal dialysis fluid 10 mL/d+A-TRA 5 mg/kg), with 10 rats in each group; peritoneal membrane function of rats in four groups after 4 week were de-tected, changes of peritoneal fibrosis related cytokines in rats was detected by immunohistochemical method. Results In the fourth week, compared with the control group, peritoneal function indexes of UF, D/Purea, D1/D0 in model group and experiment group 1 declined (P< 0.05), those in experiment group 2 had no statistically significant difference (P>0.05). Compared with the control group, TGF-β1, CTGF,α-SMA expression of visceral peritoneum tissues in model group, experiment group 1 and experiment group 2 occured significantly changes (P<0.05), these in experiment group 1 and ex-periment group 2 were lower than those in model group (P<0.05). Compared with the control group, the expression of HGF, BMP-7, IL-6, VEGF in model group, experiment group 1 and experiment group 2 increased (P<0.05), these in exper-iment group 1 and experiment group 2 were lower than those in model group (P< 0.05). Conclusion ATRA can anti peritoneal fibrosis by adjusting the expression TGF-β1, CTGF,α-SMA and other cytokines.