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目的:通过对破损皮肤模型大鼠连续给予朱红膏4周和停药4周各相关指标的检测,探讨其对汞蓄积和肾组织形态的影响,为临床安全用药提供科学依据。方法:将大鼠随机分成4组:破损皮肤对照组、朱红膏低、中、高剂量组。于连续给药4周和停药4周后,分别测定尿汞、血汞、肾汞、β-N-乙酰氨基葡萄糖苷酶(NAG)、β2-微球蛋白(β2-MG)、血清尿素氮(BUN)、肌酐(SCr)、尿蛋白(PRO)和尿液pH,计算肾脏系数,进行肾脏组织形态学观察。结果:连续给药4周,3个剂量组大鼠尿汞、血汞和肾汞含量与对照组比较显著升高(P<0.01),且存在量毒关系。停药4周,3个剂量组大鼠尿汞和血汞含量均恢复正常,肾汞含量仍明显升高(P<0.01)。高剂量组大鼠NAG显著升高。停药4周,不同剂量组与对照组比较没有差异。结论:对破损皮肤大鼠长期大剂量使用朱红膏会出现汞蓄积,有可能造成肾组织损伤,临床使用朱红膏应积极监测患者体内的汞含量和肾功能指标。
OBJECTIVE: To explore the effects of various factors on the accumulation of mercury and the morphological changes of renal tissue in rats with damaged skin, and to provide a scientific basis for clinical safe medication. Methods: The rats were randomly divided into 4 groups: the control group of damaged skin, low, medium and high dose of Zhu Hong paste. After continuous administration for 4 weeks and withdrawal for 4 weeks, urinary mercury, blood mercury, renal mercury, β-N-acetylglucosaminidase (NAG), β2-microglobulin Nitric oxide (BUN), creatinine (SCr), urinary protein (PRO) and urine pH were measured to calculate the renal coefficient. Morphological changes of kidney were observed. Results: Compared with the control group, the contents of urinary mercury, blood mercury and renal mercury in the three dose groups were significantly increased (P <0.01) after 4 weeks of continuous administration, and there was a dose-related relationship. Four weeks after drug withdrawal, urinary mercury and blood mercury levels returned to normal in three dose groups, but mercury levels in kidney were still significantly increased (P <0.01). High-dose group rats NAG was significantly higher. Four weeks withdrawal, there was no difference between the different dose groups and the control group. CONCLUSION: Mercury accumulation may occur in the skin of rats with damaged skin over a long period of high dosage, which may cause renal tissue damage. Clinical application of rhubarb cream should actively monitor the mercury content and renal function of patients.