ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2015, Vol. 7 ›› Issue (2): 112-115.doi: 10.3969/j.issn.1674-3865.2015.02.005

• 临床论著 • 上一篇    下一篇

肾康灵干预小儿原发性肾病综合征的CXCL16、解聚素金属蛋白酶10变化

郑健，艾斯，杨帆，邱彩霞，卢小露   

  1. 350122 福州，福建中医药大学（郑健）；福建中医药大学研究生院（杨帆，邱彩霞，卢小露）；350004 福州，福建中医药大学附属人民医院儿科（艾斯）；350004 福州，福建省中西医结合肾脏病重点实验室（郑健，艾斯）
  • 出版日期:2015-04-25 发布日期:2018-11-19
  • 作者简介:郑健（1958-），男，教授、主任医师。研究方向：小儿肾病的诊断与治疗，Email：13705056837@126.com。
  • 基金资助:
    福建省科技计划项目资助（2008KJB09）

The changed of CXCL16 and ADAM10 in children with primary nephrotic syndrome interfered by Shenkangling decoction

ZHENG Jian，AI Si，YANG Fan，et al   

  1. Fujian University of Traditional Chinese Medicine,Fuzhou 350122，China.
  • Online:2015-04-25 Published:2018-11-19

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摘要：
目的:通过观察原发性肾病综合征(PNS)患儿中药肾康灵干预治疗前后血清趋化因子CXCL16和解聚素金属蛋白酶（ADAM10）水平的变化。
方法：将60例PNS患儿随机分为中西医结合组和西药对照组各30例。另同期选取健康儿童30例作为正常对照组。西药对照组予以单纯西药治疗，中西医结合组在西药对照组治疗基础上加用中药清解肾康灵煎剂，检测两组治疗前后的血清CXCL16和ADAM10水平，同时检测血清白蛋白、胆固醇和尿蛋白定量，观察治疗前后检测指标的变化。
结果：（1）治疗前中西医结合组和西药对照组的CXCL16、ADAM10水平明显高于正常对照组，差异有统计学意义（P<0.01）；中西医结合组和西药对照组的CXCL16、ADAM10水平比较差异无统计学意义（P>0.05）。治疗3个月后中西医结合组和西药对照组的CXCL16、ADAM10水平高于正常对照组，差异有统计学意义（P<0.01）；中西医结合组的CXCL16、ADAM10水平明显低于西药对照组，差异有统计学意义（P<0.01）。中西医结合组和西药对照组治疗3个月后血清CXCL16、ADAM10水平均明显低于治疗前，差异有统计学意义（P<0.01），说明两组病情均有改善但未痊愈，中西医结合组较西药对照组改善更明显。（2）与治疗前比较，两组血清胆固醇和尿蛋白定量均显著降低，血清白蛋白明显升高，差异有统计学意义（P<0.05）。与西药对照组比较，中西医结合组血清胆固醇明显降低，血清白蛋白明显升高，差异有统计学意义（P<0.05），24 h尿蛋白定量两组比较差异无统计学意义（P>0.05）。
结论：CXCL16、ADAM10参与了小儿PNS的发病机制，中药肾康灵干预治疗能显著降低血清PNS患儿的CXCL16、ADAM10水平，降低尿蛋白、血胆固醇，升高血白蛋白，从而改善患儿病情，这可能与清除吞噬oxLDL的血清CXCL16而发挥整体作用有关。

关键词: 原发性肾病综合征, 趋化因子, 解聚素金属蛋白酶, 肾康灵, 儿童

Abstract:


Objective：To observe the levels of CXCL16,a disintegrin and metalloprotease 10(ADAM10) in children with primary nephrotic syndrome(PNS) before and after intervention of traditional Chinese medicine Shenkangling,and to clarify the mechanism of PNS and the action of Shenkangling by molecular biology.
Methods：PNS children were randomly divided into the Shenkangling + western medicine group(n=30) and the western medicine group(n=30),and healthy children as normal control group were selected in the examination center(n=30).Serum CXCL16,ADAM10 were detected by ELISA in children with PNS before and after treatment, and at the same time, serum albumin(ALB), cholesterol(CH) and 24hour urinary protein excretion efficacy evaluation were detected.
Results：In PNS children urinary protein excretion was elevated, serum ALB reduced,CH increased,CXCL16 and ADAM10 content increased(P<0.01).Compared to western medicine group, in Shenkangling + western medicine group CH and serum CXCL16 and ADAM10 content was reduced, serum ALB increased more significantly(P<0.01 or P<0.05).Both in Shenkangling + western medicine group and in western medicine group urine protein was decreased, but there was no difference between them.
Conclusion：CXCL16 and ADAM10 are involved in the pathogenesis of PNS,and traditional Chinese medicine Shenkangling can significantly reduce the levels of serum CXCL16 and ADAM10,reduce the urine protein and CH and elevate ALB, thus improving symptoms in children, which may be related to removal of serum CXCL16 by clearing up oxLDL.

Key words: primary nephrotic syndrome, CXCL16, disintegrin and metalloprotease, Shenkangling, children