复方丹参注射液加能量合剂治疗慢性肾功能衰竭

目的：探讨复方丹参注射液加能量合剂治疗慢性肾功能衰竭（ＣＲＦ）的疗效。方法：将４１例ＣＲＦ患者随机分为２组，治疗组２１例在对症治疗基础上加静滴复方丹参注射液及能量合剂治疗，对照组２０例采用一般对症及静滴葡萄糖、胰岛素治疗，治疗１个疗程后观察２组疗效。结果：治疗组总有效率为８５．７１％，对照组总有效率为３５．００％，治疗组明显优于对照组（Ｐ＜０．０１）。治疗组治疗后血尿素氮（ＢＵＮ）、血肌酐（ＳＣｒ）均下降，与治疗前比较均有显著性差异（Ｐ均＜０．０５）。对照组治疗后ＢＵＮ、ＳＣｒ与治疗前比较均无显著性差异（Ｐ均＞０．０５）。结论：复方丹参注射液加能量合剂可保护残余肾功能，延缓ＣＲＦ的发展，有较好的治疗前景     

慢性肾功能衰竭患者血清三碘甲状腺原氨酸、甲状腺素和促甲状腺激素含量的变化及临床意义

目的：探讨慢性肾功能衰竭（ＣＲＦ）患者血清三碘甲状腺原氨酸（Ｔ３）、甲状腺素（Ｔ４）和促甲状腺激素（ＴＳＨ）水平的变化及其临床意义。方法：采用放射免疫分析法测定６６例ＣＲＦ患者血清Ｔ３、Ｔ４和ＴＳＨ的含量，并与３０例正常人作对照分析。结果：ＣＲＦ患者失代偿期血清Ｔ３、Ｔ４水平随血尿素氮（ＢＵＮ）、肌酐（Ｃｒ）的升高而渐降低，与对照组比较均有显著性差异（Ｐ均＜０．０５）；ＴＳＨ与血ＢＵＮ和Ｃｒ的升高无关，治疗后Ｔ３、Ｔ４水平随病情好转而渐升高（Ｐ均＜０．０５）。结论：血清Ｔ３、Ｔ４水平可作为判断ＣＲＦ病情、观察药物疗效和预后的指标。     

茶多酚对慢性肾功能衰竭患者脂质过氧化损伤的影响

目的：探讨茶多酚在治疗慢性肾功能衰竭（ＣＲＦ）中抗脂质过氧化及改善肾功能的作用。方法：观察３１例ＣＲＦ患者（治疗组）用海南省茶多酚（ＴＰ）治疗前及治疗后３个月的红细胞超氧化物歧化酶（ＳＯＤ）、还原型谷胱甘肽（ＧＳＨ）、血浆丙二醛（ＭＤＡ）,血清总胆固醇（ＴＣ）、甘油三酯（ＴＧ）,血尿素氮（ＢＵＮ）和血肌酐（ＳＣｒ）含量变化。另以未经ＴＰ治疗的２０例ＣＲＦ患者为对照组,并与８９例健康成人的ＳＯＤ、ＧＳＨ和ＭＤＡ作比较。结果：治疗组及对照组ＣＲＦ患者ＳＯＤ活性明显低于健康成人（Ｐ均＜０．０１）,ＭＤＡ及ＧＳＨ高于健康成人（Ｐ均＜０．０５）;治疗后治疗组ＳＯＤ活性明显升高,ＭＤＡ、ＴＣ、ＴＧ、ＢＵＮ和ＳＣｒ均有降低,与对照组比较差异均显著（Ｐ均＜０．０５）。肾功能改善总有效率前者为６７．７４％,后者为３０．００％。结论：ＣＲＦ患者确实存在ＳＯＤ活性降低及脂质过氧化损伤,海南省茶多酚能有效对抗脂质过氧化,提高氧化酶ＳＯＤ活性,改善ＣＲＦ患者肾功能。     

大黄灌肠加口服开博通治疗小儿急性肾功能衰竭25例

目的：探讨大黄合剂保留灌肠加口服开博通对急性肾功能衰竭（ＡＲＦ）的治疗作用。方法：将４５例小儿ＡＲＦ患者分为２组，其中治疗组２５例采用西医综合治疗加用大黄合剂灌肠及口服开博通，对照组２０例只采用西医综合治疗。７天后观察２组患儿血尿素氮（ＢＵＮ）、血肌酐（Ｃｒ）和血压下降及尿量增加情况。结果：治疗组显效１５例，有效７例，总有效率８８．０％；对照组显效６例，有效９例，总有效率７５．０％。治疗组血ＢＵＮ、Ｃｒ、血压和尿量等各项指标的变化均明显优于对照组（Ｐ均＜０．０１）。结论：大黄灌肠加口服开博通能改善ＡＲＦ患儿的肾功能与临床症状，治疗ＡＲＦ有效。     

祛毒散合重组促红细胞生成素治疗慢性肾功能衰竭的临床观察

目的：探讨中药祛毒散合重组促红细胞生成素（ｒＨｕＥＰＯ）治疗慢性肾功能衰竭（ＣＲＦ）的疗效。方法：将９４例ＣＲＦ患者随机分为２组，治疗组４８例用祛毒散合ｒＨｕＥＰＯ治疗，对照组４６例只用祛毒散治疗，观察２组疗效。结果：２组患者的症状、体征均得到有效的改善，血肌酐和尿素氮降低。治疗组对食欲不振、面色萎黄、疲乏无力症状的改善优于对照组（Ｐ＜０．０５～０．０１）；治疗组血红蛋白和红细胞压积明显升高（Ｐ均＜０．０１），对照组无明显改变（Ｐ均＞０．０５）。治疗组２２．９％的患者血压较前升高。结论：祛毒散能改善ＣＲＦ患者的生活质量及肾功能，但不能纠正肾性贫血（ＲＡ）；与ｒＨｕＥＰＯ合用则能纠正ＲＡ，却又引起部分ＣＲＦ患者血压升高。     

L—精氨酸对实验性急性肾功能衰竭大鼠的治疗作用观察

目的：探讨Ｌ精氨酸（ＬＡｒｇ）对实验性急性肾功能衰竭（ＡＲＦ）大鼠的治疗作用。方法：ＳＤ大鼠随机分为３组，即蒸馏水组（Ｃ组）、顺铂组（ＣＰ组）和ＬＡｒｇ加顺铂组（Ａ组），静脉给药，观察一氧化氮（ＮＯ）合成底物ＬＡｒｇ对顺铂所致ＡＲＦ大鼠肾功能及肾组织形态学的影响。结果：①Ａ组用药后第４日、６日、８日和１０日的血肌酐（ＳＣｒ）及血尿素氮（ＢＵＮ）均显著低于同期ＣＰ组的ＳＣｒ和ＢＵＮ（Ｐ均＜０．０５）；②Ａ组肾组织形态学改变较ＣＰ组明显改善。结论：ＬＡｒｇ对实验性ＡＲＦ有明显保护作用，可能主要与其促使ＮＯ合成增加、改善肾血流动力学有关。     

慢性肾功能衰竭患者脂质过氧化物、超氧化物歧化酶及免疫功能状态的临床研究

目的：研究慢性肾功能衰竭（肾衰）患者氧自由基代谢和免疫功能状态的变化以及两者的关系。方法：测定８０例慢性肾衰患者和３０例正常人血清脂质过氧化物（ＬＰＯ）、超氧化物歧化酶（ＳＯＤ）、可溶性白细胞介素２受体（ＳＩＬ２Ｒ）和外周血Ｔ淋巴细胞亚群的水平并进行比较。结果：慢性肾衰患者血清ＬＰＯ、ＳＯＤ和ＳＩＬ２Ｒ水平较正常人明显升高（Ｐ均＜０．０１），外周血Ｔ淋巴细胞亚群ＣＤ＋３、ＣＤ＋４、ＣＤ＋８细胞及ＣＤ＋４／ＣＤ＋８比值则显著降低（Ｐ＜０．０５或Ｐ＜０．０１）。血清ＳＯＤ及ＳＩＬ２Ｒ水平与血肌酐（ＳＣｒ）呈显著正相关，与肾小球滤过率（ＧＦＲ）呈显著负相关；血清总ＳＯＤ、ＣｕＺｎＳＯＤ活性与ＳＩＬ２Ｒ水平呈显著正相关。结论：慢性肾衰患者存在氧自由基的蓄积，脂质过氧化反应的病理性亢进和超氧化物歧化酶代偿性增高及免疫功能异常的病理改变；血清ＳＯＤ、ＳＩＬ２Ｒ水平可作为肾功能损害的客观指标。     

急性心肌梗塞、急性脑梗塞及糖尿病患者红细胞变形能力的研究

目的：探讨急性心肌梗塞（ＡＭＩ）、急性脑梗塞（ＡＣＩ）及糖尿病（ＤＭ）患者的发病与血液流变学中红细胞变形能力（ＲＣＤ）的变化关系。方法：采用德国ＦＭ４红细胞过滤仪，检测ＡＭＩ、ＡＣＩ及ＤＭ患者的ＲＣＤ。结果：ＡＭＩ、ＡＣＩ及ＤＭ３组患者的ＲＣＤ的最小余量明显高于对照组（Ｐ均＜０．０１），斜明显低于对照组。ＡＭＩ发病２４小时内的ＲＣＤ最小余量明显高于治疗２周后的ＲＣＤ的最小余量（Ｐ＜０．０１）。ＡＭＩ组ＲＣＤ最小余量与５．７５ｓ－１切变率的粘度呈正相关（ｒ＝０．３５０，Ｐ＜０．０５），与２３０ｓ－１切变率的粘度呈明显正相关（ｒ＝０．５６２，Ｐ＜０．００１）。结论：直接检测ＲＣＤ的变化，对估测活动期心脑血管病及糖尿病微血管病变的轻重及治疗效果有一定的意义。     

复方丹参注射液加能量合剂治疗慢性肾功能衰竭

目的：探讨复方丹参注射液加能量合剂治疗慢性肾功能衰竭（ＣＲＦ）的疗效。方法：将４１例ＣＲＦ患者随机分为２组，治疗组２１例在地症治疗基础上加静滴复方丹参注射液及能量合剂治疗，对照组２０例采用一般对症及静滴葡萄糖、胰岛素治疗，治疗１个疗程后观察２组疗效。结果：治疗组总有效率为８５．７１％，对照组总有效率为３５．００％，治疗组明显优于对照组（Ｐ〈０．０１）。治疗组治疗后血尿素氮（ＢＵＮ）、血肌酐（ＳＣｒ     

光量子血氧疗法治疗急性呼吸窘迫综合征的临床疗效观察

目的：研究用光量子血氧疗法治疗急性呼吸窘迫综合征（ＡＲＤＳ）的临床疗效。方法：早期ＡＲＤＳ患者６０例,随机分为对照组（３０例）、治疗组（３０例）,对照组采用常规综合治疗,治疗组在综合治疗的基础上加用光量子血氧疗法。观察２组血液流变性、肺动脉压（ＰＡＰ）、氧合指数（ＰａＯ２／ＦｉＯ２）和红细胞Ｃ３ｂ受体花环率（ＲＣ３ｂＲＲ）及其免疫复合物花环率（ＲＩＣＲ）的变化和治愈率。结果：治疗组较对照组血液流变     

Use of angiotensin-converting enzyme inhibitors in chronic kidney insufficiency

AIM: To study effects of ACE inhibitors in patients with diffuse renal diseases at the stage of chronic renal failure (CRF). MATERIAL AND METHODS: Acute changes in renal filtration and in renal hemodynamics in response to 100-200 mg captopril were studied in 7 patients with CRF and 6 patients with intact renal function. Effects of long-term ACE inhibitors were retrospectively studied in 50 patients with CRF (27 men, 23 women, mean age 46.0 +/- 1.9 years, 7 patients were over 60 years old). Sixteen patients were selected from this group who were followed up for a long time. They were examined for CRF progression rate when given conventional antihypertensive treatment and after treatment with ACE inhibitors. RESULTS: Acute response to ACE inhibitors was the following: SCF fell by 18.4% on the average by the end on therapy week 1; by the end of week 3 renal hemodynamics showed stability, SCF returned to normal, effective renal plasm flow rose by 16.9%, serum potassium rose significantly after 7 days of treatment but did not reach 6 mmol/l. Effects of long-term ACE inhibitor in CRF: the treatment was discontinued after 30-60 days in 12 of 50 patients because of high creatinine (> 20%); in 38 patients ACE inhibitor had a pronounced antihypertensive and antiproteinuric action for 2-3 years, creatinine growth inhibited. Progression of CRF became slow. CONCLUSION: ACE-inhibitors in CRF had a nephroprotective effect but blood creatinine levels should be controlled especially within the first 1-2 months of treatment.     

Erythropoietin drugs in patients with chronic renal failure at the stage of conservative treatment. Effectiveness and side effects

AIM: To assess activity and safety of erythropoietin (EP) drugs in conservative chronic renal failure (CRF). MATERIAL AND METHODS: The antianemic effect of EP drugs, central and cardiac hemodynamics were studied in 28 CRF patients (mean blood creatinine 5.27 mg%) with renal anemia. In addition, arterial pressure was automatically measured within 24 hours and the CRF progression rate was assessed. RESULTS: Low-dose EP drugs injected subcutaneously rapidly produced antianemic and cardioprotective effects and may improve residual renal function. CONCLUSION: Pathogenetically grounded and safe for patients with conservative CRF is a combination of low-dose subcutaneous EP drugs with hypotensive drugs (calcium antagonists, ACE inhibitors), loop diuretics and low-protein diet.     

Characteristics of peripheral and peritoneal white blood cells in children with chronic renal failure, dialyzed or not.

OBJECTIVE: To explore further the mechanisms leading to immune deficiency in chronic renal failure and the role of dialysis treatment in these mechanisms. DESIGN: Cross-sectional and longitudinal analysis. PATIENTS: We studied 39 children treated with peritoneal dialysis (PD), 23 children treated with hemodialysis (HD), 33 children not yet dialyzed [chronic renal failure (CRF)], and 27 healthy children. Peritoneal cells were also obtained from PD children for analysis. METHODS: White blood cells (WBCs) were isolated from blood and peritoneal dialysis effluent by centrifugation. The number of CD2+, CD4+, and CD8+ T cells, B cells, and natural killer cells were measured by flow cytometry. RESULTS: The total peripheral blood lymphocyte count was lower in PD children (2.6 x 10(9)/L), HD children (2.1 x 10(9)/L), and CRF children (2.0 x 10(9)/L) compared with healthy children (3.1 x 10(9)/L, p < 0.05). The B lymphocyte count was also lower in PD children (0.34 x 10(9)/L), HD children (0.22 x 10(9)/L), and CRF children (0.33 x 10(9)/L) compared with healthy children (0.52 x 10(9)/L, p < 0.01). Numbers of CD4+ T cells were not different, but numbers of CD8+ T cells were lower in PD children (0.56 x 10(9)/L), HD children (0.63 x 10(9)/L), and CRF children (0.53 x 10(9)/L) compared with healthy children (0.77 x 10(9)/L, p < 0.05). The count of natural killer cells was lower in PD children (0.21 x 10(9)/L), HD children (0.17 x 10(9)/L), and CRF children (0.18 x 10(9)/L) compared with healthy children (0.50 x 10(9)/L, p < 0.0001). The CD4/CD8 ratio of lymphocytes in peritoneal effluent was 0.8 versus 1.9 in peripheral blood (p < 0.001). The CD2/CD19 ratio was not different. The cell subsets remained stable during the first year of PD treatment. The CD2/CD19 ratio in peritoneal effluent was higher in children with a peritonitis incidence > or = 1 per year. CONCLUSIONS: The reduced numbers of B lymphocytes, CD8+ T cells, and natural killer cells found in CRF children, dialyzed or not, may favor the frequent occurrence of infections.     

Untoward effects of chronic dual renin-angiotensin system blockade: influence of previous chronic renal failure

Dual blockade of the renin-angiotensin system (RAS) has increased antiproteinuric effects and so a higher incidence of secondary effects can be expected when this kind of treatment is administered. The aim of this study was to assess the safety of dual blockade of RAS. Seventy-five (54 men and 21 women) patients has been treated in our unit with dual RAS blockade due to proteinuria higher than 1 g/24 h. Mean age was 57.1 +/- 14.0 years. Fifty-three patients had chronic renal failure (CRF) at baseline. Analytical data of 6 months visit and last follow-up visit were recorded. A small reduction of systolic blood pressure and diastolic blood pressure was observed in both treatment groups throughout the study. Neither the CRF patients nor those with normal renal function showed any reduction in mean plasma haemoglobin levels, but differences between groups were significant at the second and third visits (anova). No change was detected in haematocrit. Mean K+ significantly increase at the second visit in the CRF group (from 4.80 +/- 0.64 to 5.23 +/- 0.81 mmol/l, p < 0.001, Student's t-test). There were no changes in normal kidney function group (4.58 +/- 0.37 vs. 4.63 +/- 0.44). At baseline plasmatic creatinine was higher in the CRF group (2.09 +/- 0.60 0.20 mg/dl vs. 0.99 +/- 0.20 mg/dl, p < 0.001, Student's t-test) and creatinine clearance was lower (48.6 +/- 20.7 ml/min vs. 107.0 +/- 0.30 ml/min, p < 0.001, Student's t-test). There was a small increase in creatinine along the follow-up when compared with the normal renal function group (p < 0.001, anova). Conversely, creatinine clearance remain unchanged in the normal renal function group, and there was a decrease in creatinine in CRF patients (p < 0.001). Dual RAS blockade seems to be safe in renal patients even when mild to moderate renal failure is present. Severe hyperkalaemia is uncommon. Small increments in plasmatic creatinine can be seen but they are hardly dangerous. Combined treatment does not significantly influence erythropoiesis.     

Heart remodeling in patients with predialysis phase of chronic renal failure

AIM: To investigate remodeling of the heart in patients with predialysis phase of chronic renal failure (CRF). MATERIAL AND METHODS: Patients with predialysis phase of CRF (n = 61; serum creatinine 412.4 +/- 242.69 mumol/l), essential hypertension (EH) (n = 35) and healthy volunteers (n = 20) were assessed with echocardiography. The patients were not significantly different by the level of systolic and diastolic blood pressure, age and gender. RESULTS: Left ventricular mass index (LVMI) was increased in 53(86.9%) patients with CRF. LVMI was not different in patients with CRF and EH (189.9 +/- 71.35 vs. 165.0 +/- 41.83 g/m2; p = 0.3). Relative wall thickness was similar in patients with serum creatinine < 200 mumol/l and patients with more elevated serum creatinine (57.2 +/- 10.33 vs 58.31 +/- 13.33; p = 0.9). The ejection fraction lower than 50% was detected in 14(22.9%) patients with CRF. Multivariate regression analysis showed that LVMI was independently related to systolic blood pressure (p = 0.004) and level of hemoglobin (p = 0.004). Diastolic dysfunction (early and atrial peak filling velocities ratio < 1.0) was detected in 13(50%) from 26 investigated patients with CRF. The independent influence of hemoglobin on isovolumic relaxation time (p = 0.04) and early and atrial peak filling velocities ratio (p = 0.02) are shown. CONCLUSION: In patients with predialysis phase of CRF left ventricular hypertrophy (LVH) is extremely common including patients with mildly elevated serum creatinine. The treatment of patients with renal pathology and normal function must include measures not only to correct renal process but also to prevent development of LVH.     

中草药复杂方剂对慢性肾功能不全进展的影响

目的 探讨复杂配方的中草药制剂时对慢性功能不全进展的影响。方法 回顾性分析44例服中草药患者和49例未服过中草药患者病程初期、病程3个月时的血尿素氮(BUN)、血肌酐(Scr)水平变化;将两组患者同期的SUN、Scr水平进行对比。并将两组患者发现BUN、Scr开始升高至发展到Scr>600umol/L的时间进行对比。结果 两组患者病程3个月时的BUN、Scr水平均较病程初期明显升高(P相似文献   

中药加高渗腹透液灌肠治疗尿毒症疗效观察

目的：评价中药加高渗腹透液及单纯高渗腹透液灌肠治疗慢性肾功能衰竭（ＣＲＦ）尿毒症期患者的疗效。方法：６１例患者随机分为２组。治疗组用中药加４．２５％Ｂ５１８５高渗腹透液灌肠，对照组单纯应用４．２５％Ｂ５１８５高渗腹透液灌肠，每次３００ｍｌ，每日２次，每次保留２小时以上。结果：治疗组总有效率８８．５７％，对照组总有效率８０．７７％，２组比较无显著性差异（Ｐ＞０．０５）。２组治疗后血尿素氮、肌酐和肌酐清除率均有明显改善（Ｐ均＜０．０５）。结论：中药加高渗腹透液灌肠或单纯高渗腹透液灌肠，均为治疗ＣＲＦ尿毒症期的有效药物。此方法操作简便，患者痛苦小，费用低，能明显提高患者的生活质量，延长存活时间，是一种值得研究的治疗方法。     

结肠透析配合尿毒清颗粒保留灌肠治疗慢性肾功能衰竭的疗效

目的:观察结肠透析配合尿毒清颗粒保留灌肠治疗慢性肾功能衰竭(CRF)的临床疗效.方法:将80例CRF患者随机分为观察组与对照组各40例.两组常规治疗相同,对照组采用尿毒清颗粒直接保留灌肠;观察组先行结肠透析,之后以尿毒清颗粒保留灌肠.观察两组治疗前后临床症状和血肌酐(Scr)、血尿素氮(BUN)及血清β2-微球蛋白(β2-MG)指标的变化.结果:两组治疗后临床症状体征、Scr、BUN、β2-MG较治疗前均有不同程度的改善(P＜ 0.01或P＜0.05),观察组改善优于对照组(P＜0.01),两组总有效率比较差异有显著性(P＜0.01).结论:尿毒清灌肠治疗CRF有一定疗效,而结肠透析配合尿毒清颗粒保留灌肠治疗CRF疗效更为显著.     

三七总皂苷对慢性肾衰竭患者尿白蛋白的影响

目的 观察三七总皂苷治疗慢性肾衰竭(CRF)的临床疗效. 方法 将60例CRF(非尿毒症期)患者按入院顺序1:1随机分为观察组和对照组,每组30例.观察组在一般对症治疗基础上给予三七总皂苷提取物血栓通0.45 g,每日1次;对照组给予百令胶囊1.0 g,每日3次;两组均治疗2个月.观察治疗前后两组肾功能、血红蛋白、24 h尿蛋白定量、甲状旁腺素(PTH)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)的变化. 结果 两组患者治疗后血肌酐(SCr)、内生肌酐清除率(CCr)、尿素氮(BUN)、血尿酸(UA)、血红蛋白、24 h尿蛋白定量均较治疗前有不同程度改善,以观察组CCr、BUN、血红蛋白、24 h尿蛋白定量变化更为明显[CCr(ml/s):0.36±0.13比0.34±0.12,BUN(mmol/L):15.66±9.05比20.32±8.30,血红蛋白(g/L):101.2±9.4比95.4±8.7,24 h尿蛋白定量(mg):1 040±450比2 360±390,均P<0.05];而两组治疗后PTH、NAG中仅对照组NAG(U/L)较治疗前明显下降(18.2±9.8比28.9±12.0,P<0.05). 结论 三七总皂苷是治疗CRF(非尿毒症期)的有效药物,具有改善肾功能、减少尿蛋白等作用.