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目的:研究不含钙铝的磷结合剂盐酸司维拉姆(sevelamer hydrochloride)对于单侧输尿管结扎(unilateral ureteral obstruction,UUO)大鼠的甲状旁腺增生及继发性甲状旁腺细胞增生的影响。方法:75只wistar UUO的大鼠随机分为普通饲料组(对照组)、盐酸司维拉姆组(SH组)和低蛋白饲料组(LP组)。0、3、7、14和28d每组各随机抽取五只大鼠,留取血标本和甲状旁腺组织标本,取血及组织标本前一天留取24h尿标本。结果:和对照组相比,SH组大鼠血磷水平、尿磷排泄及全段甲状旁腺(i-PTH)水平都显著降低(P<0.01)。实验第3天对照组大鼠的甲状旁腺细胞发生显著增生,并持续整个实验过程,SH组和LP组大鼠的甲状旁腺组织内增殖细胞核抗体阳性细胞的数量均显著低于对照组(P<0.05)。结论:盐酸司维拉姆和低蛋白饲料能有效地降低慢性肾功能不全大鼠的血磷水平,抑制甲状旁腺细胞的增生。
OBJECTIVE: To study the effect of non-calcium phosphate-based phosphate binding agent sevelamer hydrochloride on parathyroid hyperplasia and secondary hyperparathyroidism in unilateral ureteral obstruction (UUO) rats. Methods: Seventy - five wistar UUO rats were randomly divided into normal feed group (control group), sevelamin hydrochloride group (SH group) and low protein diet group (LP group). Five rats were randomly selected from each group on days 0, 3, 7, 14 and 28d. Blood samples and parathyroid tissue samples were collected. 24 hours urine samples were collected on the day before blood and tissue samples were taken. Results: Compared with the control group, the levels of phosphorus, urinary excretion of urine and parathyroid hormone (i-PTH) in SH group were significantly decreased (P <0.01). On the 3rd day of the experiment, the parathyroid cells of the control group were significantly proliferated and continued throughout the experiment. The numbers of proliferating cell nuclear antigen positive cells in the parathyroid tissue in SH and LP groups were significantly lower than those in the control group (P <0.05). Conclusion: Sevelamine hydrochloride and low protein feed can effectively reduce the level of serum phosphorus and inhibit the proliferation of parathyroid cells in rats with chronic renal failure.