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1.
目的观察小剂量多巴胺对肾移植患者围术期β_2微球蛋白(β_2-MG)的影响。方法对40例肾移植术患者随机分为多巴胺组和对照组,各20例。术中分别以多巴胺和0.9%氯化钠微泵持续静推,速度为2μg/kg·min~(-1)。观察出尿时间、移植肾血管开放后1h总尿量、移植肾血管开放后6h总尿量;手术开始(T_1)、移植肾动脉开放前10min(T_2)、移植肾动脉开放后10min(T_3)、移植肾动脉开放后1h(T_4)、移植肾动脉开放后6h(T_5)等5个时间点的静脉血中β_2-MG结果。结果多巴胺组出尿时间显著快于对照组(P<0.05);多巴胺组移植肾动脉开放后1h总尿量、移植肾动脉开放后6h总尿量显著高于对照组(P均<0.01)。移植肾血管开放后10min、移植肾血管开放后1h、移植肾血管开放后6h的血中β_2-MG水平,与手术开始的血中β_2-MG水平对比并无变化(P>0.05)。而且移植肾血管开放后6h总尿量与静脉血中β_2-MG结果无直线相关关系(r=-0.0839,P>0.05)。结论术中使用多巴胺以2μg/kg·min~(-1)的速度微泵持续静推,对围术期(手术开始至移植肾血管开放后6h)血中β_2-MG水平并无影响。  相似文献   

2.
小剂量多巴胺在肾缺血-再灌注损伤中的抗损伤作用   总被引:1,自引:0,他引:1  
目的 探讨多巴胺在抗肾缺血-再灌注中损伤中的作用及其可能的作用机制.方法 选取体质量(2.1±0.2)kg的日本大耳白兔23只,随机分为生理盐水对照组(n=11)和多巴胺组(n=12),采用双盲法,通过夹闭家兔肾动脉的方式建立肾缺血模型,两组家兔在实验过程中分别持续静滴生理盐水或多巴胺1.5~2μg/(kg·min).分别于夹闭肾动脉前和缺血50 min再灌注30 min后取家兔肾静脉血,检测血肌酐(Scr)、血尿素氮(BUN)和丙二醛(MDA),并记录缺血再灌注前后的尿量.结果 两组血肌酐、血尿素氮和丙二醛在再灌注后较夹闭前均明显升高(P<0.05);再灌注30 min后对照组各指标升高更明显(P<0.05),而尿量无明显统计学差异(P>0.05).结论 小剂量多巴胺对肾缺血-再灌注损伤具有抗损伤保护作用,其作用机制可能与抗氧化作用有关.  相似文献   

3.
目的观察小剂量阿斯匹林对同种异基因移植受体大鼠慢性移植肾肾病的作用并探讨可能的作用机制。方法建立大鼠肾移植慢性排斥反应模型,移植受体大鼠随机分为2组(n=10),均自术前1d开始每日以环孢素A5mg/kg灌胃,治疗组每日给予阿斯匹林5mg/kg灌胃,对照组每日给予生理盐水2ml灌胃,术后8周采静脉血测定血清肌酐、尿素氮水平;处死动物取移植肾组织进行H-E染色及免疫组化染色(测定TGF-β1表达)。结果阿斯匹林治疗组大鼠血肌酐、尿素氮升高程度,组织病理损害及TGF-β1表达程度均较生理盐水对照组轻(P<0.05)。结论肾移植术后在常规抗排斥治疗基础上使用小剂量阿斯匹林对慢性移植肾肾病有治疗作用,其机制可能与致纤维化因子TGF-β1的表达减少有关。  相似文献   

4.
目的:观察氯胺酮抗肾移植术中脂质过氧化及对术后早期肾功能的影响。方法:选择26例肾移植患者分为两组,每组各13例。实验组于血管吻合开始后加氯胺酮0.2mg/kg静脉注射,对照组同时点加生理盐水2ml。分别于血管吻合开始前(T1)、动脉开放后5min(T2)、动脉开放后30min(T3)、动脉开放后60min(T4)取血测定丙二醛(MDA)、超氧化物歧化酶(SOD)。并记录术后第1天、第2天、第3天、第6天的肌酐和尿素氮值及尿量。结果:随动脉开放,MDA、SOD上升,T4最高。组间T2、T3、T4三个时间点MDA和SOD差异均有显著性(P〈0.05)。术后血肌酐、尿素氮和尿量:组间术后第6天差异有显著性(P〈0.05)。结论:亚麻醉剂量氯胺酮可通过抗肾移植术中脂质过氧化,改善肾移植术后早期肾功能。  相似文献   

5.
硬膜外麻醉用于同种异体肾移植术的管理   总被引:3,自引:0,他引:3  
目的 探讨同种异体肾移植手术患者应用硬膜外麻醉一点法围术期血流动力学的变化和麻醉管理方法。方法 观察 5 0例同种异体肾移植患者麻醉前 (T1)、肾动静脉血流开放前 (T2 )、血流开放后 10min(T3 )和手术结束时 (T4)各时点平均动脉压 (MAP)、中心静脉压 (CVP)和心率 (HR)的变化。结果 T2 、T3 和T1相比 ,MAP有显著降低 (P <0 .0 5 ) ,经扩容及小剂量多巴胺 (2~ 5 μg·kg-1·min-1)持续泵入 ,MAP波动小于麻醉前的 2 0 %。T3 与T1相比 ,CVP、HR显著升高 (P <0 .0 5 ) ;T2 、T4与T1比较无显著差异。结论 连续硬膜外麻醉用于同种异体肾移植术的过程中 ,阻滞平面易于调控 ,血流动力学波动较小 ,是肾移植术较为理想的麻醉方法  相似文献   

6.
目的:探讨全麻(GA)和腰-硬联合麻醉(CSEA)对肾移植术后患者肾功能的影响是否存在差异。方法:择期行肾移植手术的尿毒症患者80例,随机分为2组(GA组和CSEA组),每组40例。记录移植肾血流开放后24h内每组患者的总尿量和血肌酐下降百分比。结果:GA组开放后24h内尿量为(10320±3640)ml,血肌酐下降百分比为(40±13)%;CSEA组开放后24h内尿量为(9850±3470)ml,血肌酐下降百分比为(41±12)%。组间比较差异没有统计学意义(P>0.05)。结论:全麻和腰-硬联合麻醉2种麻醉方法对肾移植术后患者肾功能的影响无差别。  相似文献   

7.
硬膜外自控镇痛对同种异体肾移植术后肾功能的影响   总被引:1,自引:0,他引:1  
目的 观察硬膜外自控镇痛(PCEA)在同种异体肾移植患者术后镇痛效果及对移植肾功能恢复的影响.方法 同种异体肾移植手术病人80例,ASAⅡ~Ⅲ级,采用腰-硬联合麻醉完成手术,术后随机分为2组,每组40例).PECA组选择负荷剂量 持续剂量 PCA给药模式,镇痛药为0.75%罗哌卡因30mL,曲马多600mg,用生理盐水配置成150ml的混合液;对照组不给术后镇痛.两组分别于麻醉前、手术后24h、48h、72h抽取静脉血采用放射免疫法测定血内皮素及尿素氮、肌酐及尿酸,观察记录术后1h、4h、8h、12h、24h、48h、72h的心率、血压、SpO2、尿量及VAS评分.结果 PCEA组镇痛效果满意,副作用少.两组术前血压较高,自控镇痛组平均动脉压(MAP)术后迅速下降,术后72h接近正常(P<0.01);非自控镇痛组此变化不明显;组间比较差异显著(P<0.01),两组术后24h血浆内皮素、尿素氮、肌酐及尿素含量明显下降;手术后72h均达到各自的最低水平,但非自控镇痛组各时点测定值明显高于同时点自控镇痛组(P<0.01).结论 硬膜外自控镇痛有利于减轻同种异体肾移植术后疼痛刺激对生理功能的扰乱,有利于移植肾功能的恢复.  相似文献   

8.
为探讨前列腺素E1(PGE1)应用于肾移植患者的免疫抑制机制 ,及其对肾移植受者的影响 ,进行 :1 )基础实验 :选取正常人 1 6例及尿毒症患者 1 0例 ,取其外周血淋巴细胞 ,体外用植物血凝素 (PHA)刺激 ,检测PGE1对淋巴细胞增生的抑制能力。 2 )临床观察 :对 1 4例 (A组 )肾移植受者术后持续应用PGE12 0 μg/d ,与同期 1 1例 (B组 )未使用PGE1的肾移植受者相比 ,比较 2组术后血肌酐、尿素氮、血流变学以及 2组急性排斥反应的发生率。结果 :体外实验显示PGE1可以抑制PHA刺激的T淋巴细胞增生 ;术后 5dA组的尿量比B组明显增多 (P <0 .0 5 ) ;术后 1 4dA组的肌酐、尿素氮比B组明显减少 (P <0 .0 5 ) ;术后A组的血黏度、红细胞刚性指数、血小板聚集率等血流变学参数明显好于B组 (P <0 .0 5 ) ;术后A组的急性排斥反应发生率 (1 4.3 % )低于B组 (3 6.4% )。提示 :PGE1在体外可以抑制PHA刺激的T淋巴细胞增生 ,且呈剂量依赖关系 ;肾移植患者术后应用PGE1可以明显改善移植肾功能 ,对降低急性排斥反应的发生率可能有一定的作用  相似文献   

9.
目的:观察体外循环期间持续输注多巴胺对患者肝静脉血流动力学的影响?方法:选择20例择期行冠状动脉旁路移植术(CABG)患者,随机分成多巴胺组和对照组,多巴胺组在体外循环开始时泵注2 μg/(kg?min)多巴胺,分别于全麻诱导后(T0)?体外循环开始后5 min(T1)?体外循环后30 min(T2)及体外循环停机后30 min(T3),记录血流动力学变化(心率?血压等)及肝静脉血流相关指标(肝静脉直径?流速等)?比较术前与术后第1天肝肾功能的变化?结果:两组体外循环后血压均下降,多巴胺组停机后心率较对照组增快(P < 0.05);多巴胺组体外循环期间肝静脉血流量较术前有所上升(P < 0.05),但与对照组比较差异无统计学意义?与对照组相比,多巴胺组肌酐及尿素氮下降?结论:持续泵注2 μg/(kg?min)小剂量泵注多巴胺可能增加肝静脉血流,但仍需进一步研究合适的多巴胺剂量使其达到更好的临床效果?  相似文献   

10.
目的:探讨围体外循环(CPB)期应用小剂量多巴胺对肾脏功能的影响.方法:选取48例无肾脏疾病行CPB心内直视手术的病人,将其随机分成两组,两组均采用静-吸全麻外,A组术始即以小剂量多巴胺持续泵注,余处理与B组相同.观察术前、术毕及术后24小时两组患者血尿素氮(BUN)、血肌酐(Cr)、尿蛋白及尿量等肾功能指标,了解肾损害情况.结果:应用小剂量多巴胺组与对照组的BUN、Cr、尿蛋白在术前、术毕及术后24小时比较差异均无统计学意义,而两组患者的尿量术毕及术后24小时差异有统计学意义,应用多巴胺组的尿量较对照组明显增加.结论:围体外循环期应用小剂量多巴胺对肾脏功能无保护作用.  相似文献   

11.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

12.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

13.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

14.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

15.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

16.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

17.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

18.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

19.
Objective To measure Derpl and Blot5 allergen levels in asthmatics' homes in Hongkong.Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derpl and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.Results The levels of Derpl allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g)and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derpl and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P< 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 =0 μg/g of dust as compared with Derpl in bed and on the floor (4.3% and 14.5% respectively, P< 0.05).Conclusions Derpl and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.  相似文献   

20.
ANTI-PROLIFERATION EFFECT OF ORIDONIN ON HL-60 CELLS AND ITS MECHANISM   总被引:4,自引:0,他引:4  
Objcetive To investigate the anti-proliferation effect of oridonin on leukemic HL-60 cells and its mechanism. Methods HL-60 cells in vitro in culture medium were given different concentrations of oridonin. The inhibitory rate of cells were measured by microculture tetrazolium (MTT) assay, cell apoptotic rate was detected by flow cytometry (FCM), morphology of cell apoptosis was observed by hoechst 33258 fluorescence staining, and the activity of telomerase was detected using telomere repeat amplification protocol (TRAP) PCR-ELISA before and after apoptosis occurred. Results Oridonin could decrease telomerase activity, inhibit growth of HL-60 cells, and cause apoptosis significantly. The suppression was both in time- and dose-dependent manner. Marked morphological changes of cell apoptosis including condensation of chromatin and nuclear fragmentation were observed clearly by hoechst 33258 fluorescence staining especially after cells were treated 48-60 hours by oridonin. Conclusions Oridonin has apparent anti-proliferation and apoptotic effects on HL-60 cells in vitro, decreasing telomerase activity of HL-60 cells may be one of its most important mechanisms. These results will provide strong laboratory evidence of oridonin for clinical treatment of acute leukemia.  相似文献   

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