促红细胞生成素对血透患者ET-1、Ang-Ⅱ的影响

目的 :探讨血透患者用促红细胞生成素 (rHuEpo)后对血管活性介质内皮素 (ET - 1 )及血管紧张素Ⅱ(Ang-Ⅱ )的影响。方法 :收集 3年间规律血透尿毒症患者 80例 ,将其分为用rHuEPO(HDepo)组和不用rHuEPO(HD)组 ,应用放免法测定患者血浆中ET - 1、Ang -Ⅱ水平。结果 :尿毒症透析患者用rHuEpo治疗三个月后 ,血ET - 1、Ang -Ⅱ浓度增高。结论 :尿毒症透析患者经用rHuEpo治疗后血中ET - 1、Ang -Ⅱ水平升高 ,尿毒症血透患者用rHuEpo治疗后血压普遍升高 ,与ET - 1、Ang -Ⅱ水平升高有一定的关系。     

自发性高血压大鼠血浆一氧化氮浓度的变化

目的　观察自发性高血压大鼠 (SHR)血浆NO浓度的变化 ,探讨NO与高血压发生发展的关系。方法　颈总动脉插管测定大鼠血压 ,硝酸银还原法测定SHR血浆中NO的含量。结果　 (1)血压变化 :各时期WKY大鼠血压无显著性差异 ;高血压组大鼠血压随着月龄增加逐渐升高 ,均明显高于WKY大鼠 (P <0 0 1)。 (2 )血浆NO浓度的变化 :WKY大鼠血浆NO浓度各时期无显著性差异 ;高血压组大鼠血浆NO浓度在 3m、6m时间点明显高于WKY大鼠 ,但在 12m时间点却较WKY大鼠明显降低 (P<0 0 1) ,同组内与 3m、6m时间点比较亦显著减少 (P <0 0 1)。相关分析显示 ,在 3m、6m时间点高血压大鼠血浆NO浓度与血压之间呈正相关 (P <0 0 1) ,在 12m时间点与血压呈负相关 (P <0 0 1)。结论　随着高血压发生和发展 ,血浆NO升高 ,而在高血压后期 ,NO的变化不明显 ,这种变化可能与高血压的发生发展有关。     

不同透析膜对维持性血液透析血磷清除的比较研究

目的　了解不同种透析膜对维持性血液透析患者血磷的清除状况 .方法　维持性血液透析 (HD)患者分别使用血仿膜、聚砜膜、铜仿膜透析 ,比较透析前、透析 1小时、2小时、3小时、4小时的血磷浓度、血磷下降幅度、透出液中的磷 .结果　血仿膜透析组血磷浓度降幅较聚砜膜组、铜仿膜组大 (p <0 .0 5 ) . 3组血磷清除高峰出现在透析 1～ 2小时 ,其后血磷清除减少 ,透出液中磷于透析 2小时后减少 .结论　血仿膜较聚砜膜、铜仿膜清除血磷效果好 ,提高透析频率可以更有效地清除磷 ,而非延长透析时间     

尿毒症患者血液透析治疗对瘦素和神经肽Y水平的影响

研究尿毒症患者血液透析前后血浆瘦素和血清神经肽Y(NPY)的变化,探讨改善尿毒症营养不良的有效措施.本文尿毒症患者69例,分为3组:低通量纤维素膜透析组(A组)32例,低通量血仿膜F6透析组(B组)21例,F60高通量血滤器透析滤过并血液透析组(C组)16例.对照组18名.用RIA测定患者透析前、后及对照组血浆瘦素及血清NPY水平.结果三组瘦素与NPY水平透析前明显高于对照组(P＜0.01);透析后A、B组瘦素、NPY水平未降低,C组瘦素水平明显降低(P＜0.05),但NPY无显著变化.尿毒症患者存在高瘦素及NPY血症,二者无相关性,都不能通过单纯血液透析清除.利用高通量血滤器进行血液滤过有助于增加瘦素的清除率,改善患者营养状态.     

强化治疗高血压疗效及随访

目的　评价原发性高血压患者常规和强化治疗的 3年远期预后 .方法　高血压病 10 0例分至对照组 (常规治疗组 )和强化治疗组各 5 0例 .强化组Ⅰ组 19例和Ⅱ组 3 1例 .结果　强化组收缩压、舒张压、总胆固醇等数值在治疗后 3年间降低 (p <0 .0 5 ) ;强化组和对照组之间血压、心率、血肌酐等数值低于对照组 (p <0 .0 1) ;终点事件发生率强化组明显低于对照组 .结论　各种降压药物在控制血压及减轻对靶器官远期损害方面均有一定益处 ,但强化治疗组优于对照组     

一种改良的尿毒症腹膜透析大鼠模型

 目的：研制一种改良的尿毒症大鼠腹膜透析模型。方法：采用二次手术法切除大鼠5/6肾脏建立尿毒症模型,造模后4周取尾静脉血测肌酐值,以达到正常血肌酐值2~3倍者为尿毒症大鼠模型;使用改良的硅胶腹透管置管制作腹膜透析大鼠模型,手术切口于背部,隧道出口于颈后两耳中点下方2~3 cm处。24只SD大鼠随机分为4组：A组(n=6),假手术组;B组(n=6),尿毒症组,不插管也不透析;C组(n=6),尿毒症插管组,插管但不透析;D组(n=6),尿毒症高糖透析组,4.25%葡萄糖透析液透析2周。D组大鼠停止透析24 h后各组行腹膜功能检查,测超滤量;透出液行白细胞计数;腹膜组织行HE染色,测量腹膜间皮至肌层厚度。结果：B、C、D组血肌酐值为A组的2~3倍,尿毒症大鼠模型制作成功;D组超滤量较A、B、C组显著减少（P<0.05）;B、C、D组透出液白细胞计数略高于A组（P<0.05）,但都未发现感染;HE染色显示D组腹膜间皮至肌层厚度较A、B和C组显著增加（P<0.05）,高糖透析液刺激腹膜组织呈现明显的慢性损伤病理特征。结论：我们通过改良的导管插入法建立了一个理想的尿毒症大鼠腹膜透析模型,该模型为研究腹膜透析功能保护奠定了实验基础。     

不同甲状腺疾病对血清IL-8、TNF的影响

目的 :研究不同甲状腺疾病患者 (甲亢 -Graves’病、甲减 -原发性甲减、亚甲炎 )及正常人对人体血清白介素 8、肿瘤坏死因子水平的影响。方法 :选初诊甲亢患者 95例 (男 4 1,女 5 4 ) ,甲减患者 5 3例 (男 2 3,女 30 ) ,正常对照 4 5例 (男 2 4 ,女 2 1) ,抽取静脉血测定血清白介素 8、肿瘤坏死因子水平。结果 :1 甲亢组 (Gra ves’病 )IL - 8浓度比对照组高 (F =2 93,p <0 0 1)。亚甲炎IL - 8浓度比对照组高 (F =3 4 0 ,p <0 0 0 5 )。甲减组中原发性甲减的IL - 8浓度比对照组高 (p <0 0 5 )。 2 甲亢组Graves’病TNF含量比正常对照高 (F =7 5 0 2 ,p<0 0 5 )。甲减组中原发性甲减的TNF含量比正常对照组高 (F =6 15 ,p <0 0 0 1)。 3 甲亢、甲减组患者中性别与IL - 8、TNF浓度无关 ,p >0 0 5 ,男女无差异。甲亢、甲减组患者年龄与IL - 8、TNF、T3、T4 、TSH无关。结论 :支持IL - 8和TNF参与多种自身免疫性疾病的免疫病理过程。包括Graves’甲亢 ,原发性甲减等。     

同型半胱氨酸与老年人心脑血管病变关系的研究

目的　比较血清同型半胱氨酸 (HCY)、叶酸、维生素B12 等与原发性高血压、冠心病、脑卒中病变的关系 ,探讨其血浓度在预测老年人心、脑血管病变中的意义 .方法　对 2 2 4例患原发性高血压、冠心病、脑卒中患者和 10 6例健康体检正常的对照组应用荧光偏振法 (FPIA)分析血清HCY和用微粒子酶免疫分析 (MEIA)测定血清叶酸、VitB12 水平并比较各组间差异 .结果　心肌梗死组、脑溢血和脑梗死患者的血清HCY水平显著高于正常对照组 (p <0 .0 1) ,而叶酸浓度则明显低于正常对照组 (p<0 .0 1) .VitB12 含量仅在脑梗死组中低于正常对照组 .单纯原发性高血压组和心绞痛组的血清HCY和叶酸的含量与正常对照组比较无差异 .在冠心病、脑卒患者中血清HCY浓度与血清叶酸浓度呈负相关 (r=- 0 .6 0 8,p<0 .0 1;r=- 0 .6 87,p<0 .0 1) .结论　在老年人群中血清HCY浓度增高与低叶酸水平是冠心病、脑血管疾病的一个重要危险因素 .用荧光偏振 (FPIA)法检测血清HCY浓度可作为评价和预测心、脑血管疾病的一个敏感可信的指标     

高通量透析对慢性肾病患者生物活性物质的影响

目的血清肌酐(Scr)、血管紧张素Ⅱ(Ang Ⅱ)、内皮素-1(ET-1)和一氧化氮(NO)水平升高是慢性肾病的主要标志。机体淋巴细胞和血管内皮细胞均可通过分泌上述活性分子,参与慢性肾病的发病过程。本实验通过观察高通量透析(HFHD)对维持性血液透析(MHD)患者血管活性物质的影响,从而探讨HFHD改善MHD患者体内这些生物活性物质分泌的作用,为临床治疗提供理论依据及新思路,也为进一步研究机体免疫系统参与慢性肾病的发生机制奠定基础。方法将MHD患者20例随机分为低通量血液透析(LFHD)组和高通量血液透析(HFHD)组各10例。选取尿毒症非透析患者20例,另选取20例正常健康体检者作为健康对照组。HFHD组改用可重复使用高通量透析器Polyflux17R,LFHD组继续采用可重复使用透析器Polyflux8LR。分别检测HFHD组及LFHD组患者单次治疗前后及3个月透析前检测的Scr、Ang Ⅱ、ET-1和NO;另抽取尿毒症非透析组和健康对照组各20例的清晨空腹肘静脉血标本同时检验。NO测定用硝酸还原酶法,ET-1、Ang Ⅱ检测均采用放免法。Cr的测定采用常规生化法。透析组患者同时监测血压变化。结果两组患者单次透析后HFHD组Ang Ⅱ、ET-1水平较LFHD组显著降低(P<0.05)。治疗3个月后,HFHD组患者NO、ET-1、平均动脉压与治疗前显著下降(P<0.05)。结论高通量血液透析可以提高上述生物活性物质的清除,使MHD患者高血压得到改善;本实验结果为将来进一步研究淋巴细胞和内皮细胞参与慢性肾病发病的机制提供临床实验依据。     

血管活性物质测定在心血管疾病中的意义

目的 :检测原发性高血压 (EH)和冠心病 (CHD)患者血中CNP、NO、CGRP、ET的含量 ,探讨其与内皮细胞功能的关系及临床意义。方法 :EH组 30例、CHD组 33例、正常对照组 30例 ,均为男性。CNP、CGRP、ET采用放射免疫分析法测定 ,NO采用生化比色镉还原法测定。结果 :EH和CHD组分别与对照组比较CNP、ET含量明显增高 (CNP :P <0 .0 1,ET :P <0 .0 5 ) ,NO、CGRP则明显降低 (P <0 .0 1) ;相关分析表明 :两组患者CNP与CGRP之间具有显著负相关性 (EH组r=0 .5 6 7,P <0 .0 1、CHD组r =0 .42 8,P <0 .0 5 )。结论 :检测EH和CHD血中CNP、NO、CGRP、ET含量变化 ,为研究EH ,CHD与内皮细胞功能关系、发病机理等提供了有价值的实验室依据。     

大鼠心肌缺血预适应中cAMP含量变化观察

目的 :研究心肌缺血预适应时 ,腺苷酸环化酶 (AC)及cAMP变化及意义。方法 :选择SD大鼠 ,随机分成预适应组 (IP组 ) ,缺血 /再灌注组 (I/R组 )及假手术组 (CON组 ) ,手术套管法造成左冠脉主干缺血及再灌注。损伤后取心脏用TTC法测梗塞面积 ,取血清测心肌酶改变 ,测AC活性变化 ,放免测cAMP水平。结果 :IP组较I/R组心梗面积明显缩小 (p <0 0 0 1) ,心肌酶CK、CK—MB、LDH明显降低 (p <0 0 0 1)。IP组较I/R组AC活性增高 (p<0 0 5 ) ,cAMP含量增加 (p<0 0 0 1)。结论 :心肌缺血预适应保护心脏 ,缩小梗塞面积 ,减少心肌酶漏出 ,cAMP可能在预适应保护作用中起重要作用。     

原发性高血压病伴房颤患者血浆ET和BNP的含量变化

目的 :探讨原发性高血压伴房颤患者血浆ET、BNP的含量变化。方法 :应用IRMA法测定 4 8例原发性高血压病伴房颤患者和 82例原发性高血压病无房颤患者血浆ET、BNP含量 ,并以 5 6例健康人作对照。结果 :原发性高血压病伴房颤组血浆ET、BNP含量均非常显著高于正常人组 (p <0 0 0 1)。结论 :深入研究原发性高血压病患者血浆ET、BNP的含量变化 ,对预防和治疗原发性高血压心脏病将有重要的临床意义。     

Vascular calcifications under maintenance hemodialysis

Summary In a cross-sectional study X-rays of the forefoot and the pelvis of 101 adult dialysis patients were taken. Vascular calcifications (forefoot) were observed in 20 patients. The incidence was higher in patients who had been started on dialysis several years ago. However, in a longitudinal prospective study de novo appearance of vascular calcifications was observed only in 1 out of 50 dialysed patients, although hyperparathyreoidism and moderate hyperphosphatemia persisted. Vascular calcifications were seen only once in 138 uremic children (56 uremic children without dialysis; 82 uremic children on maintenance hemodialysis). However at autopsy visceral calcifications of the lung were found in three (out of 11) children who did not have vascular calcifications on X-rays.With the support of the Deutsche Forschungsgemeinschaft     

血透患者血浆中选择素P水平的变化

采用双抗体夹心法（ELISA）,定量测定20例慢性肾功能不全维持性血透患者（HD）透析过程中血浆选择素P水平的动态变化。结果显示:HD组血浆选择素P水平在透析前与正常对照组无明显差异（P>0.05）,而透析后5min选择素P即显著升高,并随透析过程逐渐升高（P<0.01～0.001）。同时观察到透析后白细胞计数下降、提示血透过程中血小板被激活,血小板与白细胞粘附的增加。     

Role of nitric oxide in haemodialysis hypotension

To investigate the possible involvement of nitric oxide (NO) in haemodialysis hypotension, we measured plasma concentrations of nitrate anion (NO3-), a metabolite of NO, in 114 patients undergoing maintenance haemodialysis. Mean plasma NO3- concentrations before dialysis were greater in subjects with lower blood pressure (155 +/- 16 micromol L-1) than in those with middle (117 +/- 8 micromol L-1) or higher blood pressure (105 +/- 12 micromol L-1) before dialysis. Further, mean plasma NO3- concentrations before dialysis were greater in subjects with lower blood pressure (186 +/- 13 micromol L-1) than in those with middle (112 +/- 7 micromol L-1) or higher blood pressure (64 +/- 11 micromol L-1) after dialysis. Plasma NO3- concentrations before dialysis were inversely correlated with mean blood pressure before dialysis (r=0.318, P=0.0006), and showed a strong inverse correlation with mean blood pressure after dialysis (r=0.608, P=0.0001). In the selected participants who had equal range of mean blood pressure before dialysis, mean plasma NO3- concentrations were greater in subjects with severe hypotension during dialysis (180 +/- 14 micromol L-1) than in those with mild hypotension (99 +/- 11 micromol L-1) or without hypotension (53 +/- 12 micromol L-1); plasma NO3- concentrations before dialysis were inversely correlated with changes in mean blood pressure during dialysis and mean blood pressure after dialysis. Results indicate that enhanced NO production may be involved in acute hypotension during dialysis, and suggest the possible involvement of NO in the pathogenesis of chronic hypotension associated with maintenance haemodialysis.     

肺癌患者化疗前后SIL-2R和TNF检测的临床意义

目的 :探讨了 4 0例肺癌患者化疗前后血清中SIL - 2R和TNF含量的变化。方法 :应用放免法和酶免法检测 4 0例肺癌患者血清中SIL - 2R和TNF含量并与 35名正常人作比较。结果 :肺癌患者在化疗前血清中SIL - 2R和TNF含量显著地高于正常人组 (p <0 0 1 ) ,化疗后明显下降 (p <0 0 5 )。 结论 :血清中SIL- 2R和TNF水平可作为肺癌患者免疫功能监测指标之一 ,并可作为疗效判断参考     

Glutathione and nitrite in induced sputum from patients with stable and acute asthma compared with controls.

BACKGROUND: Oxidative stress is believed to play an important role in the pathogenesis of asthma. Determining the reduced glutathione (GSH) and nitric oxide (NO) contents of the airway is useful when investigating oxidative stress in the lung. OBJECTIVE: To explore antioxidant defenses by measuring sputum GSH levels and to evaluate oxidant stress by measuring sputum nitrite (NO2-) levels in asthma patients. METHODS: Sputum GSH, NO2-, cell counts, and plasma NO2- contents were evaluated in 11 patients with stable asthma, 10 patients with acute asthma attacks, and 11 controls. RESULTS: The highest GSH content in sputum samples was in stable asthma patients compared with the other groups (P < .001), and patients with exacerbations of asthma had a greater GSH content than controls (P < .001). Mean sputum NO2- content was significantly lower in controls than in acute (P = .001) and stable (P < .001) asthma patients. There was no significant difference in sputum NO2- contents between acute and stable asthma patients, although there was a trend toward higher levels in acute asthma patients (P = .38). CONCLUSIONS: Sputum induction can be used to obtain bronchial secretions for the evaluation of GSH and NO2- contents. Oxidative stress is chronic and probably less severe in patients with stable asthma. Glutathione and NO2- may serve as markers for determining the extent of the oxidative processes in asthma, which is characterized by chronic airway inflammation.     

Dimethylarginines in chronic renal failure

BACKGROUND: Nitric oxide (NO) is a potent chemical mediator involved in many functions. In vivo production of NO is thought to be regulated by endogenous analogues of L-arginine: asymmetric dimethylarginine (ADMA). AIM: To examine the effect of renal function and dialysis on the serum concentrations of ADMA and symmetric dimethylarginine (SDMA). METHODS: Blood samples were obtained from nine healthy subjects, patients with renal failure before (n = 17) and after haemodialysis (n = 9), nine patients on chronic ambulatory peritoneal dialysis (CAPD), and 13 patients with chronic renal failure on conservative treatment. Serum samples were extracted using a solid phase cation exchange column and the extracts were analysed by high performance liquid chromatography (HPLC). RESULTS: Serum concentrations of ADMA in patients with renal failure (mean, 1.04 micromol/litre; SD, 0.17) were significantly higher than those of controls (mean, 0.61 micromol/litre; SD, 0.13). Haemodialysis significantly decreased the serum concentration by 36% (before dialysis: mean 0.99 (SD, 0.25) micromol/litre; after dialysis: mean, 0.63 (SD, 0.15) micromol/litre). Serum SDMA concentrations were higher in patients with renal failure, and haemodialysis decreased the concentration by 60%. There was no difference in serum arginine concentrations between the groups. CONCLUSION: Serum concentrations of ADMA are increased in renal failure and haemodialysis reduces the concentration.     

急性脑梗死患者血清NSE与GST的测定及其临床意义

目的：研究急性脑梗死患者血清神经元特异性烯醇化酶(NSE)和谷肮甘肽—S—转移酶(GST)的变化及其临床意义。方法：应用免疫放射分析(IRMA)法测定血清NSE含量和应用酶联免疫反应(ELISA)法测定血清GST含量。结果：脑梗死患者发病3天内血清NSE含量高于对照组和2周时(p＜0．01)，血清GST含量低于对照组和2周时(p＜0．01)。血清NSE含量与神经功能缺损程度呈正相关(p＜0．001)，与血清GST含量呈负相关(p＜0．05)，也与梗死灶体积有关(p＜0．001)。结论：急性脑梗死患者早期血清NSE和GST的水平变化与脑梗死的临床表现关系密切。