中国中西医结合杂志2012，Vol.32Issue(2)：183-187,5.
益肾降浊冲剂对慢性肾脏病3、4期患者骨代谢的影响及与免疫指标的关系
Effects of Yishen Jiangzhuo Granule on the Bone Metabolism of Patients with Stage 3 -4 Chronic KidneyDisease and Its Correlation with the Immune Indices
摘要
Abstract
Objective To explore the changes of bone gla protein (BGP) and tartrate resistant acid phosphatase (TRACP) in patients with stage 3-4 chronic kidney disease (CKD) before and after treatment, to study their correlation with interleukin-17 (IL-17) and regulatory T cells (Treg), and the effects of Yishen Jiang-zhuo Granule (YJG) on the bone metabolism. Methods Fifty-three patients with stage 3-4 CKD were randomly assigned to the treatment group and the control group using random digit table. The following parameters in blood were detected: Treg (CD4+CD25+CD127lo) using trichrism fluorescent labeling by flow cytometry; levels of TRACP, BGP, and IL-17 by double antibody sandwich ELISA. The hemoglobin (HGB) content was detected u-sing Beckman-Coulter hemoanalysis. The urinary contents of creatinine (Ucr) were determined using reversed HPLC. The blood contents of calcium (Ca), phosphate (P), blood urea nitrogen (BUN), serum creatinine (SCr), and plasma albumin (ALB) were determined using automatic biochemical analyzer. Then the calcium-phosphate (Ca xP) product was calculated on the basis of blood contents of Ca and P. The clearance rate of endogenous creatinine (CCr) was calculated on the basis of blood BUN and SCr contents. Results (1) There was no obvious change in CD4+CD25 + CD127lo in the two groups before and after treatment (P>0. 05). Compared with before treatment in the same group, there were statistical difference in the levels of CD4 + and TRACP in the two groups, as well as the IL-17 level in the control group (P<0. 01, P<0. 05). But compared with the healthy group, statistical difference was shown in each index (except CD4+) ( P < 0. 01). Compared with the control group after treatment, there was no statistical difference in each index of the treatment group after treatment (P> 0. 05). Compared with before treatment in the same group, the levels of Hb, ALB, and CCr increased (P < 0. 05, P <0. 01), and the SCr level decreased in the two groups after treatment (P <0. 05). Compared with the control group after treatment, the SCr level decreased and the CCr level increased more obviously in the treatment group (P<0. 05). There was no correlation among the levels of IL-17, TRACP, BGP, and Treg between before and after treatment in the two groups. Conclusions YJG could improve the kidney function and delay the progression of micro-inflammation of stage 3-4 CKD patients. It could not improve the level of CD4+CD25+ CD127lo. It also showed no effects on bone metabolism. The CD4+T cells were differentiated to Th17 cells in stage 3 -4 CKD patients. Their immunity was in a state of anergy but continually activated. The inflammatory factors in patients with stage 3-4 CKD play important roles in inducing the activation of osteoclasts.关键词
慢性肾脏病/调节性T细胞/白细胞介素-17/抗酒石酸酸性磷酸酶/骨钙素Key words
chronic kidney disease/ regulatory T cell/ interleukin-17/ tartrate resistant acid phosphatase/osteocalcin引用本文复制引用
郑京,文丹,翁苓,陈彩凤,郑雪敏,黄璐..益肾降浊冲剂对慢性肾脏病3、4期患者骨代谢的影响及与免疫指标的关系[J].中国中西医结合杂志,2012,32(2):183-187,5.基金项目
陈可冀中西医结合发展基金(No.CKJ2008068) （No.CKJ2008068）
福建省卫生厅基金资助项目(No.WZZSb0911) （No.WZZSb0911）
福建省教委基金资助项目(No.JA08116) （No.JA08116）
