苯那普利对2型糖尿病肾病的疗效观察

目的：观察血管紧张素转换酶抑制剂－苯那普利,对2型糖尿病肾病,降低血压、尿蛋白及延缓轻、中度慢性肾功能衰竭（CRF）进展的疗效。方法：根据内生肌酐清除率（Ccr）,将90例糖尿病患者分为无CRF组、轻度CRF、中度CRF组,每组病人再随机分为治疗组和对照组,治疗组加服苯那普利,剂量每天2．5－20mg,服用8周,对照组不用苯那普利。两组分别于治疗前、治疗后8周测血尿素氮（BUN）、血清肌酐（Scr)、Ccr、尿蛋白及24h动态血压。结果：治疗组的收缩压、舒张压、平均动脉压、尿蛋白、BUN、Scr下降,Ccr升高,均明显优于对照组。结论：苯那普利有良好的降低血压及尿蛋白,改善及延缓慢性肾功能衰竭进展的作用。     

芦沙坦治疗早期慢性肾功能衰竭30例分析

目的：探讨血管紧张素Ⅱ受体阻断剂芦沙坦对慢性肾功能衰竭的延缓作用。方法：30例轻、中度慢性肾功能衰竭患者血压及肾功能稳定后，给芦沙坦50mg/d，若2周后收缩压＞60mmHg，舒张压＞100mmHg，芦沙坦加至100mg/d，观察治疗前后2、4、8、12周血压（Bp），血肌酐（Scr)、血尿素氮（BuN）、肾小球滤过率（GFR）及24h尿蛋白定量（Upro)，肝功能，电解质。结果：治疗12周后，患者Bu,Upro，均有明显下降，GFR无下降，结论：芦沙坦能有效地降低血压，减少蛋白尿，保护肾功能，延缓轻，中度慢性肾功能衰的进展。     

阿魏酸钠与羟苯磺酸钙联合治疗慢性肾功能衰竭的临床疗效分析

目的观察阿魏酸钠与羟苯磺酸钙单独及联合应用对慢性肾功能衰竭(CRF)患者的临床疗效,以及长期应用的有效性与安全性。方法以106例慢性肾功能衰竭患者为研究对象,分为二组,每组53例:对照组(给予阿魏酸钠注射液)和联合用药组(给予羟苯磺酸钙和阿魏酸钠),疗程均为4周,观察两组患者治疗前后BUN、Scr、Ccr、尿蛋白和Hb的变化。结果两药单独应用和联合应用后CRF患者血BUN、Scr和尿蛋白明显下降,Ccr和Hb明显升高(P0.05),降低24h尿白蛋白排出(P0.05),联合治疗组改善肾功能损伤作用明显优于单独治疗组(P0.05)。结论羟苯磺酸钙、阿魏酸钠治疗慢性肾功能衰竭压均有较好的改善肾功能损害作用,两药联合应用具有协同作用,值得临床推广应用。     

氯沙坦在伴有高血压的慢性肾功能不全患者中的临床应用研究

目的 研究氯沙坦（ARB制剂）对伴有高血压的慢性肾功能不全患者在降低血压、减少蛋白尿和保护肾功能方面的疗效。方法 将32例停用其它降压药,改用氯沙坦（50－100mg/d),开始治疗时均用50mg/d,若两周后收缩压＞160mmHg或舒张压＞100mmHg,氯沙坦加至100mg/d,住院期间每天测血压2次,每周查Scr、血钾、24小时尿蛋白定量1次,门诊期间每周测血压2次,每2周查Scr、血钾、24小时尿蛋白定量1次,每月查肝功能1次。结果 氯沙坦对降低收缩压、舒张压都有明显的效果（P＜0．01）,且降压效果呈剂量依赖性。能明显降低24小时尿蛋白的排泄（P＜0．05）。对Scr 250-450 μmol/L病例,治疗前后Scr明显下降（P＜0．05）。结论 氯沙坦对伴有高血压的慢性肾功能不全患者,不但可以有效地降低血压,减少蛋白尿,还对肾功能有良好的保护作用。治疗过程未发现Scr上升和血钾升高。     

海昆肾喜胶囊联合丹参酮ⅡA磺酸钠治疗慢性肾功能衰竭的疗效观察

目的观察海昆肾喜胶囊与丹参酮IIA磺酸钠联合治疗慢性肾功能衰竭（CRF）的临床疗效。方法58名CRF患者,随机分为治疗组和对照组。在常规治疗基础上,治疗组采用海昆肾喜胶囊及丹参酮IIA磺酸钠联合治疗,而对照组仅予常规治疗,观察两组治疗前后患者尿素氮（BUN）、血肌酐（Scr）、内生肌酐清除率（Ccr）变化。结果治疗组治疗3周后BUN、Scr、Ccr的水平均明显下降,治疗前后差异具有统计学意义（P〈0.05）,而对照组治疗前后BUN、Scr、Ccr的水平则无明显变化,差异无显著性（ΔP〉0.05）。结论在常规治疗基础上,海昆肾喜胶囊联合丹参酮IIA磺酸钠治疗慢性肾功能衰竭的患者,可使患者BUN、Scr、Ccr的水平均明显下降,改善患者肾功能,延缓患者进入维持性血液透析,改善患者的生活质量。且治疗组治疗中无发生严重不良反应,是一种安全有效的治疗手段,值得临床推广应用。     

小剂量多巴胺联合前列地尔治疗慢性肾功能不全临床研究

目的观察小剂量多巴胺联合前列地尔（pG1）治疗肾功能不全（CRF）的疗效。方法将100例CRF患者随机分为治疗组50例和对照组50例。治疗组给予小剂量多巴胺联合前列地尔治疗;对照组丹参注射液,共同给予低蛋白饮食,控制血压纠正贫血及对症治疗。观察治疗前后血浆肌酐（Scr）,尿素（BUN）水平,内生肌酐清除率,24 h尿量,24 h尿蛋白定量等指标。结果治疗组慢性肾功能不全患者的血尿素、肌酐较对照组明显下降,尿量增加（P〈0.05）,Ccr较对照组明显升高,前列地尔差异有显著性（P〈0.0 5）,2组24 h尿蛋白定量均无明显变化。结论小剂量多巴胺联合前列地尔能有效延缓CRF进展。     

氯沙坦联合灯盏花素治疗慢性肾衰疗效观察

目的：观察氯沙坦、灯盏花素合用延缓慢性肾衰竭（CRF）进展的作用。方法：42例CRF患者分为治疗组和对照组。治疗组给予氯沙坦和灯盏花素;对照组服用钙离子拮抗剂等降压药。观察患者血压、尿蛋白定量、血尿素氮（BUN）、血肌酐（SCr）及内生肌酐清除率（Ccr）。观察期12～15个月。结果：两组治疗后血压均有下降;治疗组尿蛋白定量、BUN,SCr水平较对照组下降（P〈0．05,P〈0．01）,Ccr较对照组增加（P〈0．01）。结论：氯沙坦联合灯盏花素能有效延缓CRF进展。     

海昆肾喜胶囊对慢性肾功能衰竭患者肾功能指标的影响

目的:观察海昆肾喜胶囊对慢性肾功能衰竭(CRF)患者肾功能指标的影响.方法:采用随机数表将2017年1月至2018年6月在佳木斯骨科医院肾内科进行治疗的90例CRF患者展开研究,将其分为对照组与观察组,各45例.对照组采用复方丹参注射液治疗,观察组采用海昆肾喜胶囊治疗.对比两组临床疗效及肾功能指标[素氮(BUN)、血肌酐(Scr)、内生肌酐清除率(Ccr)、24h尿蛋白定量(24hpro)].结果:较对照组,观察组总有效率更高,差异有统计学意义(P<0.05);两组治疗后BUN、Scr、24hpro水平均下降,Ccr水平均上升,且与对照组相比,观察组治疗后的BUN、Scr、24hpro水平均较低,Ccr水平明显较高,差异有统计学意义(P<0.05).结论:CRF患者行海昆肾喜胶囊治疗效果明显,同时可以改善患者肾功能指标.     

倍他乐克和达利全治疗慢性肾功能不全合并高血压的对比研究

目的:评价倍他乐克和达利全对慢性肾功能不全合并高血压的患者的治疗效果。方法:65例患者被随机分成两组,分别服用倍他乐克片(倍他乐克组)和达利全片(达利全组)比较治疗前及治疗8周后对血压及肾功能影响。结果:达利全组治疗后收缩压平均下降(31.2±4.8)mmHg,舒张压平均下降(11.3±3.8)mmHg,血肌酐浓度平均下降(54.8±9.2)μmol/L。倍他乐克组治疗后收缩压平均下降(30.4±6.3)mmHg,舒张压平均下降(9.2±5.1)mmHg,血肌酐浓度平均下降(8.9±2.8)μmol/L。结论:达利全对慢性肾功能不全合并高血压患者血压及肾功能均有良好效果,而且达利全比倍他乐克有更好的肾功能保护作用。     

尿毒清颗粒治疗慢性肾功能衰竭的临床研究

目的观察口服尿毒清颗粒治疗慢性肾功能衰竭（CRF）患者的临床疗效。方法将100例患者随机分为两组各50例,分别进行常规治疗和加服尿毒清颗粒进行治疗。结果加服尿毒清颗粒治疗后患者肾小球滤过率（Ccr）明显升高,血肌酐（Scr）和尿素氮（BUN）明显下降（P〈0.05）。常规治疗组患者Ccr明显下降,而Scr、BUN明显升高（P〈0.05）,差异有统计学意义（P〈0.05）。结论尿毒清颗粒对降低CRF患者Cr、BUN水平,改善患者临床症状有明显疗效。     

Vasopressin and the pathogenesis of chronic renal failure.

1. Partial (5/6) renal ablation was performed in Long Evans rats treated with vehicle or a vasopressin V1-receptor antagonist, in control Long Evans rats, and in homozygous Brattleboro rats which lack endogenous vasopressin. 2. In control and vasopressin-blocked Long Evans rats, 3 weeks following partial renal ablation, systolic blood pressure was 215 +/- 5 and 199 +/- 9 mmHg and, urinary protein excretion was 54 +/- 4 and 50 +/- 3 mg day-1, respectively. 3. The pressor response to exogenous vasopressin was significantly (P less than 0.05) reduced in rats treated with the V1-receptor antagonist (ED50 mmHg 5.0 +/- 1.6 vs. 0.09 +/- 0.01 micrograms kg-1). 4. In control Long Evans and in Brattleboro rats, 3 weeks following renal ablation, systolic blood pressure was 204 +/- 10 and 191 +/- 7 mmHg, and urinary protein excretion was 97 +/- 27 and 71 +/- 5 mg day-1, respectively. 5. Histological examination of the remaining kidney tissue demonstrated significant glomerular hyalinization following renal ablation but no differences between any of the groups. 6. The data indicate that neither vasopressin nor the urinary concentrating mechanism is likely to be involved in the hypertension and proteinuria associated with partial renal ablation.     

Short-term effects of atenolol and nifedipine on atrial natriuretic peptide, plasma renin activity, and plasma aldosterone in patients with essential hypertension.

The short-term effects of atenolol and nifedipine on plasma levels of atrial natriuretic peptide (ANP), plasma renin activity (PRA), and plasma aldosterone (PA) were studied in two groups of patients with uncomplicated essential hypertension. Urinary catecholamines, and sodium and potassium excretion were also studied. A group of 20 patients with hypertension, after a wash-out period of at least 10 days, was randomly subdivided into two protocol therapy subgroups. One group (six men and four women) received atenolol (100 mg/d), and the other group (six men and four women) received nifedipine (30 mg/d). Circulating plasma levels of ANP, PRA, and PA were determined by radioimmunoassay, and other variables were determined by routine laboratory techniques before therapy and at day 3 and day 7 after the treatment began. Arterial blood pressure and heart rate were monitored during the study. Both drugs reduced arterial blood pressure (P less than .001) significantly. The atenolol therapy decreased heart rate (P less than .001), increased plasma ANP levels and urinary catecholamine excretion, and decreased PRA and circulating PA levels. Nifedipine treatment did not modify plasma ANP values, whereas it increased PRA and PA circulating levels and urinary catecholamine excretion. No differences were shown for urinary volume, urinary sodium, and potassium excretions during the two different treatments. These findings suggest that the increased plasma ANP levels could contribute to the antihypertensive effects of the beta-adrenoreceptor blockers, by a reduction in PRA and PA levels and a vasodilatative effect.(ABSTRACT TRUNCATED AT 250 WORDS)     

联合应用氯沙坦或贝那普利强化降压治疗高血压并2型糖尿病肾病的疗效观察

目的研究在基础治疗上联合氯沙坦或贝那普利治疗高血压并糖尿病肾病临床疗效。方法98例高血压并糖尿病患者随机分成氯沙坦组、贝那普利组,治疗12月,观察期间每3月检测一次24h尿蛋白定量、肾功能及血钾。基础治疗均使用胰岛素和(或)口服降糖药,严格控制血糖、血压低于130/80mmHg范围。结果治疗12月两组患者血压、尿微量蛋白、血尿酸及血肌酐均明显下降,差异有显著性意义(P<0.05)。所有病例均未发生高钾血症和肾功能恶化。结论联合氯沙坦或贝那普利治疗高血压并2型糖尿病肾病明显降低血压、尿微量蛋白和尿酸,具有相同的抗血压和肾脏保护作用。     

Double-blind placebo-controlled trial of terazosin effect on blood pressure and urinary output of dopamine in hypertensive patients.

In a parallel, double-blind study, 12 untreated hypertensive patients received terazosin (2-4 mg/day for 4 weeks), and 12 received placebo during the same period. Systolic and diastolic blood pressure decreased significantly in the terazosin group, from 150 +/- 5.0 mmHg systolic and 99.6 +/- 2.0 diastolic before treatment, to 134.0 +/- 7.0 systolic and 85.6 +/- 3.0 mmHg diastolic at week 4 of treatment. No significant blood pressure changes occurred in the placebo group. Blood pressure decrease showed a positive correlation (r = .62 and r = .52 for systolic and diastolic blood pressure, respectively) with the patient's age (P less than .05). Total plasma cholesterol decreased 18% in the terazosin group (P less than .05) and 9% in the placebo group (P greater than .05). Urinary dopamine excretion decreased significantly from 692.8 +/- 180.0 to 330.5 +/- 52.0 micrograms/24 hours in the terazosin group (P less than .05) and showed a nonsignificant increase in the placebo group. Compared with 22 age- and sex-matched healthy volunteers, urinary dopamine excretion in the hypertensive group before treatment was not statistically different (779.3 +/- 83.1 micrograms/24 hours). Dopamine excretion was higher in untreated hypertensive men and in male healthy volunteers compared with women. The decrease of urinary dopamine excretion observed under terazosin treatment could be due to a decrease of kidney dopamine synthesis or release induced by blood pressure reduction, or secondarily to the blockade of kidney alpha 1-receptors, modulating dopamine excretion. No significant changes were observed in urinary excretion of noradrenaline and adrenaline.     

The effect of nifedipine GITS on renal function in hypertensive patients with renal insufficiency

Twelve hypertensive patients with moderately severe renal dysfunction were entered into a protocol to assess the blood pressure and renal effects of the sustained release calcium antagonist, nifedipine GITS (30-180 mg/d given once a day) administered for 5 weeks. Nifedipine GITS monotherapy effectively lowered blood pressure in 50% of the patients. Glomerular filtration rate and effective renal plasma flow were increased 18% and 20%, respectively. The filtration fraction and urinary protein excretion remained unchanged. Changes that were observed in renal function were independent of the blood pressure responses of the patients; there was no correlation between the systemic and renal effect of nifedipine GITS monotherapy. Patients who had a poor systemic blood pressure response exhibited an increase in glomerular filtration rate (+11%) but had a decrease in effective renal plasma flow (-6%); patients who achieved a goal blood pressure response showed increases in both glomerular filtration rate (+35%) and effective renal plasma flow (+40%). These results show that nifedipine GITS monotherapy has the potential to improve renal function abnormalities that are encountered in hypertensive patients with renal disease; the improvement in renal function may be independent of their effect on systemic blood pressure.     

银杏注射液治疗儿童原发性肾病综合征的临床观察

目的观察银杏注射液对儿童原发性肾病综合征(PNS)的疗效。方法46例PNS患儿随机分成观察组26例,对照组20例,观察组在常规激素治疗的基础上加用银杏注射液治疗,对照组以常规激素治疗,其它治疗2组相同。分别测定2组治疗前后的血液流变学的变化、24h尿蛋白、血清白蛋白(ALB)、血2-微球蛋白(2-MG)、尿素氮(BUN)、血肌酐(SCr)、平均动脉血压(MAP)及总胆固醇(TC)、三酰甘油(TG)、免疫球蛋白IgA、IgG、IgM、补体C3等指标。结果观察组与对照组相比能使血黏度改善(P<0.05);24h尿蛋白、BUN、血2-MG、TC、MAP等明显降低(P<0.05);尿蛋白转阴时间明显缩短(P<0.05),IgA、IgG、C3水平明显升高(P<0.05)。结论银杏注射液具有降低血液黏滞度,改善微循环,降低血压,减少尿白蛋白,缩短尿蛋白转阴时间,保护肾功能等作用,对儿童PNS有治疗作用。     

H型高血压患者血压晨峰现象与早期肾功能损害的关系

目的 探讨具有晨峰现象的H型高血压与早期肾功损害关系.方法 选择已确诊H型高血压[同型半胱氨酸(Hcy)≥10 μmol·L-1]者共210例,对这些患者行24 h动态血压监测(ABPM),根据监测结果将患者分为晨峰组(108例)和非晨峰组(102例),检测各组受试者血清胱抑素C水平以及尿β2-微球蛋白的含量,同时检测一般生化指标.结果 晨峰组24 h平均收缩压[(155.7±14.6) mmHg]、白昼平均收缩压[(160.4±15.5) mmHg]、夜间平均收缩压[(147.7 ±16.5) mmHg]、收缩压晨峰[(35.4±7.2) mmHg]、尿β2-微球蛋白[(1.11±0.31) mg·L-1]及血清半胱氨酸蛋白酶抑制剂C[(1.86±1.04) mg·L-1]均高于非晨峰组(P＜0.05).结论 H型高血压患者中具有血压晨峰者较非血压晨峰者更易出现早期肾功能损害.     

Treatment with atenolol prevents progression of microalbuminuria in type I diabetic patients.

Nine patients with Type I diabetes mellitus, diastolic blood pressure of 90 to 100 mmHg and persistent microalbuminuria of greater than or equal to 30 micrograms/min were treated with 50 to 100 mg atenolol daily for 3 years in an uncontrolled pilot study to assess the effect of long-term reduction of blood pressure on microalbuminuria. Treatment with atenolol prevented progression of microalbuminuria with a median (range) urinary albumin excretion rate before treatment of 74 (33 to 196) micrograms/min and 50 (5 to 123) micrograms/min after 3 years of therapy (p less than 0.05). Blood pressure was significantly reduced from 156 (121 to 187) mmHg systolic and 95 (90 to 100) mmHg diastolic before treatment to 143 (112 to 168) mmHg systolic (p less than 0.04) and 82 (66 to 84) mmHg diastolic (p less than 0.0003) at 3 years. Measurements of renal function and diabetic control remained unchanged throughout the study period. These results suggest that early and prolonged use of antihypertensive therapy is beneficial in slowing down progression of microalbuminuria.     

贝那普利对原发性高血压病人肾功能的影响

目的 :研究贝那普利对高血压病人尿微量清蛋白及肾功能的作用。方法 :42例高血压病人 [男性 2 9例 ,女性 13例 ;年龄 ( 49±s 4)a ;病程 ( 3.8±0 .7)a]应用贝那普利 10mg ,po ,qd× 6wk ;治疗前后检测比较病人的血压、尿微量清蛋白、肾功能等各项指标。结果 :贝那普利治疗 6wk后 ,病人血压及尿微量清蛋白降低有非常显著意义 (P <0 .0 1) ;血浆肾素活性增加有非常显著意义 (P <0 .0 1) ;其他肾功能指标无明显影响。结论 :贝那普利可在有效降低血压的同时 ,对尿微量清蛋白有减低作用 ,并提示对肾有保护作用     

糖尿病肾病与踝臂指数的相关性研究

目的分析研究踝臂指数对糖尿病肾病发病率的相关性研究。方法选择2009年8月～2011年8月就诊于内分泌科的糖尿病患者200例,其中100例经尿微量白蛋白排泄量确诊为糖尿病肾病(观察组),另100例为糖尿病无肾病组(对照组),测定两组患者24h尿蛋白定量、尿mALB、肾功能及血钾、血糖、血压、ABI,统计分析ABI与糖尿病肾病的相关性。结果观察组和对照组在24h尿蛋白定量、尿mALB、收缩压、舒张压、血钾上均有显著性差异,ABI同24h尿蛋白定量呈直线相关关系,其Pearson相关系数r=-0.99。结论通过本试验,证实其与ABI的相关性。可以考虑用ABI联合24h尿蛋白作为糖尿病是否并发肾病的评估指标。