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1.
雷公藤多甙在大鼠肾移植模型中的实验研究   总被引:9,自引:0,他引:9  
用显微外科技术建立大鼠肾移植模型(W→SD)。将大鼠分为四组:对照组仅给生理盐水,雷公藤多甙(T_Ⅱ)组给T_Ⅱ30mg·kg~(1)·d~(-1),CsA组给CsA15mg·kg~(-1)·d~(-1),CsA+T_Ⅱ组同时给CsA15mg·kg~(-1)·d~(-1)+T_Ⅱ30mg·kg~(-1)·d~(-1)。对照组大鼠肾移植后平均存活时间为7.3±2.2天,T_Ⅱ组平均存活时间为18.1±3.7天,两组存活时间有显著性差异(P<0.05)。T_Ⅱ+CsA组平均存活时间为34.6±5.2天,CsA组为26.1±4.6天。单纯用药的两组分别与联合用药组比较均有显著性差异(P<0.05)。T_Ⅱ30mg·kg~(-1)·d~(-1)对大鼠肝、肾、心脏及白细胞总数无影响,但显著抑制大鼠脾淋巴细胞的转化。T_Ⅱ也显著抑制大鼠外周血白细胞介素-2受体水平,但抑制能力不及CsA。  相似文献   

2.
肾移植术后应用雷公藤多甙的临床研究   总被引:6,自引:0,他引:6  
我院在动物实验的基础上,于1990年首次将中药雷公藤多甙(GTW)用于肾移植术后的病人,替代硫唑瞟呤(Aza),取得满意疗效。对照组(Azi+CsA+Pred)85例,实验组(GTw+CsA+Pred)87例。对照组平均肾功能恢复正常时间为18.17±1.16灭,移植肾脏1年及2年存活率为89.3±0.32%和87±0.31%;实验组平均肾功能恢复正常时间为10.19±0.18天(P<0.05),移植肾1年及2年存活率为96.1±0.22%(P<0.01)和90.4±0;59%(P<0.05)。实验组肝功能损伤及感染等的发生率亦明显低于对照组。  相似文献   

3.
骁悉与小剂量环孢素A在尸体肾移植中的联合应用   总被引:11,自引:0,他引:11  
为观察骁悉(MMF)与小剂量环孢素A(CsA)联合应用于尸体肾移植中的效果,将16例患者随机分为3组,MMF2.0g组(MMF用量为2.0g/d);MMF1.5g组(MMF用量为1.5g/d);硫唑嘌呤(Aza)组。3组患者均同时接受相似剂量的CsA和类固醇治疗。结果MMF2.0g组未发生急性排斥;MMF1.5g组1例(1/5)患者先后发生2次排斥;Aza组3例(3/5)患者各发生1次排斥。术后6个月MMF2.0g组患者血清肌酐值明显低于Aza组,其所用的CsA剂量低于Aza组。认为MMF无明显肝、肾毒性,每天2.0g口服,并与小剂量CsA和类固醇联合应用,临床疗效明显优于传统的三联疗法。  相似文献   

4.
CsA顺序用药对移植肾早期功能的影响   总被引:5,自引:0,他引:5  
1992年1月~1995年5月,分别对78例及32例肾移植患者术后立即应用ALG和OKT_3,随机选择80例术后立即应用CsA的患者为对照组,以了解CsA顺序用药对移植肾早期功能的影响。结果显示:ALG组和OKT_3组急性排斥反应(AR)发生率分别为11.5%和12.5%,CsA组为23.8%(P<0.05),急性肾小管坏死(ATN)ALG组和OKT_3组分别为5.1%和6.3%,CsA组为15.1%(P<0.05),移植肾功能3天正常率ALG组和OKT_3组分别为83.3%和68.8%,CsA组为57.5%(P<0.05)。证实CsA顺序用药可有效地预防AR和ATN的发生,促进移植肾功能的早期恢复。  相似文献   

5.
为了观察抗胸腺淋巴细胞蛋白(ATG)的免疫抑制效果,将肾移植术后单独应用环孢素A和术后早期小剂量应用ATG的各200例患者作了比较,结果CsA组发生急性排斥反应(AR)46例次(23%),逆转41例(89.1%);ATG发生AR33例(16.5%),逆转31例(93.9%)。肾功能在2-10天恢复正常的。CsA组为84例(42%),ATG组为159例(79.5);肾移植后合并感染,Cdisplay status  相似文献   

6.
为了观察抗胸腺淋巴细胞球蛋白(ATG)的免疫抑制效果,将肾移植术后单独应用环孢素A(CsA)和术后早期小剂量应用ATG的各200例患者作了比较,结果CsA组发生急性排斥反应(AR)46例次(23%),逆转41例(89.1%);ATG组发生AR33例(16.5%),逆转31例(93.9%)。肾功能在2~10天恢复正常的,CsA组为84例(42%),ATG组为159例(79.5%);肾移植后合并感染,CsA组36例,ATG组18例;CsA组摘肾8例,ATG组4例;CsA组死亡5例,ATG组3例。本组资料提示小剂量ATG的应用对延长肾移植后存活时间有重要意义  相似文献   

7.
为探讨梗阻性黄疸患者败血症的发生机理,研究了37例梗阻性黄疸(A组)和90例胆囊结石(B组)患者的胆道内压力、门静脉血流速度与白细胞介素-2(IL-2)、可溶性白细胞介素-2受体(sIL-2R)及T淋巴细胞亚群的关系。A组又分为急诊手术组(A1)、择期手术组(A2)、>60岁组(A3)和<60岁组(A4)4个亚组。结果显示:A及A1~4各组术前CD3+、CD4+、CD8+值均显著低于术后10天值(P<0.05或P<0.01),sIL-2R显著高于术后10天值(P<0.01)。A1组术前sIL-2R极显著高于A及A2~4组(P<0.01)。相关分析显示胆道内压力与IL-2、CD3+、CD4+及CD8+呈负相关,与sIL-2R呈正相关(P<0.01),门静脉血流速度与IL-2呈正相关(P<0.01)。由此表明梗阻性黄疸感染与宿主细胞免疫功能降低密切相关。  相似文献   

8.
环孢素A及硫唑嘌呤对大鼠肝毒性的对比研究   总被引:4,自引:0,他引:4  
给Wistar大鼠分别胃饲环孢素A(CsA)50mg·kg~(-1)·d~(-1),硫唑嘌呤(Aza)10mg·kg~(-1)·d~(-1),CsA30mg·kg~(-1)·d~(-1)加Aza5mg·kg~(-1)·d~(-1)及橄榄油2周,检测肝功能指标,血清丙二醛(MDA),全血谷胱甘肽(GSH)含量及肝组织病理学变化。结果Aza组血清ALT、TBil、MDA升高以及肝组织损害最明显,CsA组血清TP、ALb降低、AKP升高较Aza组及合并用药组更明显。结果表明CsA与Aza导致肝损害的机理不同,Aza肝毒性大于CsA,且为剂量依赖性。  相似文献   

9.
CsA顺序用药对肾移植长期存活的影响   总被引:2,自引:0,他引:2  
目的:探讨CsA顺序用药对肾移植长期存活的影响。方法:随机选择32例肾移植患者术后立即应用OKT3,并以同期56例术后立即应用CsA的患者为对照。结果:OKT3组及CsA组急性排斥反应(AR)发生率分别为34.4%和64.3%(P〈0.01),难治性排斥反应发生率OKT3组为9.1%,CsA组为30.6%(P〈0.05)。术后首次AR发生时间,CsA组为13.1±1.3d,OKT3组为22.5±3  相似文献   

10.
抗胸腺淋巴细胞球蛋白预防肾移植后排斥反应的临床研究   总被引:2,自引:0,他引:2  
本实验分别给予100例肾移植术后患者预防性应用抗胸腺淋巴细胞球蛋白(ATG)和100例肾移植术后常规应用环孢素A(CsA)组进行了持续三个月的临床研究。结果表明:应用ATG组肾功能恢复快(3 ̄10天,CsA组7 ̄15天);急性排斥率低(ATG组18%,CsA为47%);肾中毒ATG组无,而CsA组15例(P〈0.001),有显著差别;肝中毒及感染发生率无显著差别(P〉0.05)。在应用ATG过程中  相似文献   

11.
Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI2) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI2), TXB2 (stabile metabolite of thromboxane A2) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI2 release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB2 (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI2 release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A2, presumably contributing to hemodynamic stability within 30 min after MT.  相似文献   

12.
Don Dame 《Artificial organs》1996,20(5):613-617
Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.  相似文献   

13.
Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H2O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg−1 followed by 0.15 mg · kg−1 · h−1, n=8) or verapamil (0.1 mg · kg−1 followed by 0.3 mg · kg−1 · h−1, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.  相似文献   

14.
Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.  相似文献   

15.
Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.  相似文献   

16.
Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.  相似文献   

17.
Abstract Immunoadsorption (1A) therapy with tryptophan (TR-350) or phenylalanine (PH-350) adsorbents has been used to reduce the concentration of serum antibodies in human lymphocyte antigen (HLA)-immunized patients. Other forms of plasma purification have been reported to reduce the level of fibrinogen, which affects the blood properties. In this study we investigated the effects of IA therapy using both adsorbents on plasma fibrinogen and immunoglobulins G and M in 13 patients (8 patients were treated with TR-350, and 5 patients were treated with PH-350). During each session 1 plasma volume (2.8 ± 0.4 L of plasma) was processed through the immunocolumn and then returned to the patient together with the blood cells. Compared with the pretreatment values, the plasma fibrinogen, IgG, and IgM concentrations were significantly reduced after IA therapy (p < 0.01 for TR-350; p < 0.04 for PH-350). There was a positive correlation between the degree of reduction of plasma proteins and the number of IA treatments given. A nonpara-metric test (Wilcoxon's signed-rank test or the Mann-Whitney test) was used for statistical analysis. We conclude from our study that IA therapy effectively lowers the plasma levels of fibrinogen, IgG, and IgM and thus can be considered a valuable alternative to other blood purification methods.  相似文献   

18.
Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.  相似文献   

19.
Abstract: Photopheresis is a technique in which peripheral blood mononuclear cells, in the presence of a photoacti-vatable compound, are exposed extracorporeally to ultraviolet A light and reinfused, inducing a host autoregula-tory immune response. Experimental work and ongoing clinical studies are helping to define the role of this novel, safe, and non-toxic immunomodulating technology in the field of transplantation.  相似文献   

20.
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