Objective To investigate the mechanism of therapeutic effect of oxymatrine on renal fibrosis in chronic kidney disease(CKD). Methods Sixty-three CKD(stage 2-3)patients were selected and randomly divided into oxymatrine treatment(A)group(n=35)and control treatment(B)group(n=28). Group B treatment Methods are including protection of renal function,control blood pressure,lowering proteinuria, correction of acidosis and other symptomatic treatments. Group A treatment Methods are based on the above treatment,then additional use of oxymatrine 1.2 g in 250 mL of 5% glucose intravenously,once a day and continued 14 days. Indicators such as peripheral blood fibrosis and micro-inflammation were detected in CKD patients before and after treatment.Results After 14 days of treatment,sera fibrosis markers in patients of group A,such as hyaluronic acid(HA),typeⅢ procollagen(PⅢNP),typeⅣ collagen(Ⅳ-CA),laminin(LN)were significantly decreased than those before treatment(P<0.05)and also group B the same time period(P<0.05). Micro-inflammatory markers such as high-sensitivity C-reactive protein(hs-CRP),interleukin-1β(IL-1β),tumor necrosis factor-(TNF-)in patients of group A were also significantly lower than those before treatment (P<0.05),and had a more significant difference(P<0.05)compared with the same period in group B also.Conclusion The effect of oxymatrine anti-renal fibrosis is may be mediated by lowering the levels of serum HA,PⅢNP,Ⅳ-CA,LN and inhibition of micro-inflammation in CKD patients.%目的 探讨苦参素在慢性肾脏病(CKD)进展中抗肾脏纤维化的作用.方法 选取63例CKDII期或Ⅲ期患者,随机分成观察组35例、对照组28例.对照组采取保护肾功能、控制高血压、减少蛋白尿、纠正酸中毒等治疗措施.观察组在对照组基础上每天静脉滴注苦参素注射液1.2g,疗程14d.检测两组患者治疗14 d前后外周血纤维化及微炎症指标.结果 观察组治疗14d后血清中透明质酸(HA)、Ⅲ型前胶原(PⅢNP)、Ⅳ型胶原(Ⅳ-CA)、层粘连蛋白(LN)含量均低于治疗前(P<0.05),与同期对照组比较差异有统计学意义(P<0.05).观察组治疗14d后超敏C反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)等微炎症指标与治疗前比较显著降低(P<0.05),与同期对照组比较差异有统计学意义(P<0.05).结论 苦参素可能通过降低血清中HA、PⅢNP、Ⅳ-CA、LN水平及抑制微炎症因子表达来抗肾脏纤维化.
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