目的 探討參附強心丸對心腎綜合征模型大鼠心、腎、腦組織中腎素原受體（PRR）/水通道蛋白（AQP2）表達的相互影響，為其治療心腎綜合征提供可能的作用機制。方法 采用腹主動脈縮窄合并腎臟急性缺血再灌注的方法建立心腎綜合征大鼠模型，除假手術(shù)組外，于術(shù)后8周將模型大鼠隨機分為4組：模型組、、柄區(qū)肽10 mg/kg組、參附強心丸13.2 g生藥/kg和6.6 g生藥/kg組。檢測血清中肌酐（Cr）、尿素氮（BUN）和總?cè)饧谞钕僭彼幔═3）、總甲狀腺激素（T4）、甲狀腺刺激激素（TSH）；并計算心室指數(shù)和左腎指數(shù)；采用免疫熒光檢測心、腎及下丘腦中PRR、AQP2蛋白的表達。結(jié)果 與模型組比較，參附強心丸13.2 g/kg組的Cr、BUN水平均明顯降低（P<0.01），T3水平增加顯著（P<0.01），大鼠全心指數(shù)、心室指數(shù)均顯著減?。?i>P<0.01），心室肌、腎臟PRR表達明顯增強。結(jié)論 參附強心丸不僅能改善心肌和腎臟功能，還可升高甲狀腺系統(tǒng)的激素分泌水平，從而延緩心腎衰竭終末端病變進程，并證實了該藥調(diào)控PRR與AQP2在下丘腦中同位點的共表達特點，對心腎綜合征治療機制研究具有的重要意義。

Objective To investigate the effect of Shenfu Qiangxin Pills in regulating the expression of renin proreceptor (PRR) and water channel protein (AQP2) in rats with cardiorenal syndrome, so as to provide a basis for further elucidation of the mechanism. Methods Rat model of cardiorenal syndrome was induced by abdominal aortic coarctation with acute renal ischemia reperfusion. After operation, except the sham operation group, the rats with cardiorenal syndrome were randomly divided into four groups:model group, Shenfu Qiangxin Pills 13.2 and 6.6 g crude drug/kg groups, and handle region peptide 10 mg/kg group. Cr, BUN, T3, T4, and TSH in serum were detected. The ventricular index and left kidney index were calculated. The expressions of PRR and AQP2 proteins in heart, kidney, and hypothalamus were detected by immunofluorescence. Results Compared with the model group, Cr and BUN levels in the Shenfu Qiangxin Pills 13.2 g/kg group were significantly decreased (P<0.01), but T3 level was significantly increased (P<0.01). Compared with the model group, the ventricular index and left kidney index in the Shenfu Qiangxin Pills 13.2 g/kg group were significantly decreased (P<0.01). And PRR expression in ventricular muscle and kidney in the Shenfu Qiangxin Pills 13.2 g/kg group were significantly increased compared with the model group. Conclusion Shenfu Qiangxin Pills can not only improve cardiac and renal function, it also increases hormone levels in the thyroid system. It delayed the progression of end-terminal lesions in heart and kidney failure, and confirmed the co-expression of PRR and AQP2 in the hypothalamus, which has important significance for the study of the therapeutic mechanism of cardiorenal syndrome.

R285.5

天津市衛(wèi)生健康委中醫(yī)中西醫(yī)結(jié)合科研課題（2017078）