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目的观察血糖波动对糖尿病大鼠肾脏病变及氧化应激的影响。方法 SD大鼠40只,随机分为4组:正常对照组(A组)、正常血糖波动组(B组)、糖尿病稳定性高血糖组(C组)和糖尿病血糖波动组(D组)。采用链脲佐菌素(STZ)60 mg/kg腹腔注射诱发糖尿病。血糖波动组每天错时腹部皮下注射胰岛素及灌葡萄糖造成血糖波动模型。实验9周后采血,检测空腹血糖(FBG)、肌酐(Cr)、尿素氮(SUN)、糖化血红蛋白(HbA1c)、24 h尿微量白蛋白含量,计算血糖水平标准差(SDBG)、最大血糖波动幅度(LAGE)、平均血糖水平(MBG),运用比色法检测血清中抗氧化酶的活性,包括总超氧化物歧化酶(TSOD)、谷胱甘肽过氧化物酶(GSH-Px)、过氧化氢酶(CAT)、丙二醛(MDA)的含量,通过光镜观察肾脏显微结构改变。结果 A组与B组间各指标无显著差异,C、D组与A、B组比:体重明显减轻;空腹血糖、血糖水平标准差、最大血糖波动幅度、平均血糖水平、肌酐、尿素氮、糖化血红蛋白、24h尿微量白蛋白明显升高;抗氧化物酶TSOD、GSH-Px、CAT活性明显下降,而MDA明显升高;组织形态学观察表明:肾小球体积增大、囊腔扩张破裂,肾小球细胞减少,炎细胞浸润,肾小管结构紊乱,D组比C组以上指标的变化更加明显。结论血糖波动能加重糖尿病大鼠肾脏病变及氧化应激反应,在糖尿病肾病发病机制中起到重要作用。
Objective To observe the effects of blood glucose fluctuation on renal lesions and oxidative stress in diabetic rats. Methods Forty SD rats were randomly divided into four groups: normal control group (A group), normal blood glucose fluctuation group (B group), stable diabetic hyperglycemia group (C group) and diabetes mellitus group (D group). Diabetes was induced by intraperitoneal injection of streptozotocin (STZ) 60 mg / kg. Blood glucose fluctuation group daily wrong subcutaneous injection of insulin and glucose into the abdomen caused by blood glucose fluctuations model. Nine weeks after the experiment, blood samples were taken for determination of fasting blood glucose (FBG), creatinine (Cr), blood urea nitrogen (SUN), glycosylated hemoglobin (HbA1c) and 24 h urine microalbumin. SDGG (LAGE) and mean blood glucose level (MBG). Serum anti-oxidative enzyme activities including total superoxide dismutase (TSOD), glutathione peroxidase (GSH-Px) Catalase (CAT) and malondialdehyde (MDA) in the kidney were detected by light microscopy. Results There was no significant difference between group A and group B. The ratio of group C and D to group A and group B was significantly lower than that of group A. The fasting blood glucose, standard deviation of blood glucose level, maximum blood glucose level, mean blood glucose level, creatinine, urea nitrogen, HbA1c, 24h urine microalbumin were significantly increased; the activity of antioxidant enzymes TSOD, GSH-Px, CAT decreased significantly, while MDA increased significantly; histological observation showed that the glomerular volume increased, the cystic dilatation and rupture , Glomerular cells decreased, infiltration of inflammatory cells, renal tubular disorder, D group more than the C group indicators more obvious changes. Conclusion The fluctuation of blood glucose aggravates the pathological changes of kidney and oxidative stress in diabetic rats and plays an important role in the pathogenesis of diabetic nephropathy.