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1.
广西汉族IgA肾病临床病理和ACE基因多态性分析   总被引:1,自引:0,他引:1  
目的 :探讨广西汉族 Ig A肾病临床和病理与血管紧张素转化酶 I(ACE)基因插入 /缺失 (I/ D)多态性的相关情况。方法 :采用多聚酶链反应 (PCR)技术 ,对 95名广西地区汉族 Ig A肾病及 10 5名汉族正常对照组 ACE基因 I/ D多态性进行检测。结果 :Ig A肾病组 ACE基因分布频率与正常对照组比差异无统计学意义。Ig A肾病临床表现为高血压的 DD基因型发生频率高于其他基因型 ,差异有统计学意义 ;临床表现为反复血尿伴蛋白尿、孤立血尿、肾病综合征患者 ACE基因各基因型及等位基因无关联。 Ig A肾病病理分级 > 级及肾小管萎缩伴肾小管间质纤维化的 DD基因型发生频率高于其他基因型 ,差异有统计学意义 (P <0 .0 5 )。结论 :ACE基因不是广西 Ig A肾病易感基因 ;广西 Ig A肾病临床表现为高血压、肾脏病理分级及肾小管萎缩 +间质纤维化改变与 ACE基因 I/ D多态性有关联性。  相似文献   

2.
目的:研究广西籍IgA肾病(IgAN)临床病理表现及汉族和壮族IgAN的特点.方法:对57例IgAN患者的临床表现、实验室及组织学检查进行分析,并分别比较汉族组和壮族组的情况.结果:①广西籍IgAN临床表现以无症状性尿检异常最常见(43.9%),其次为慢性肾炎(35.1%)和肾病综合征(19.3%).IgAN的病理改变主要表现为Ⅲ级,蛋白尿<1 g/L的患者和中等量以上蛋白尿的患者病理表现不同,前者68.8%的患者表现为Ⅰ、Ⅱ级,后者64.3%的患者表现为Ⅳ、Ⅴ级.非肾病范围蛋白尿组的新月体形成多于肾病范围蛋白尿组(P<0.01).②壮族IgAN 临床表现多为慢性肾炎,而汉族IgAN临床表现多为无症状性尿检异常,两组间病理表现比较差异无统计学意义(P>0.05).结论:①广西籍IgAN临床表现最常见为无症状性尿检异常,病理改变主要表现为Ⅲ级,临床和病理有一定的联系.②汉族和壮族IgAN患者之间的临床和病理表现差别不大.  相似文献   

3.
目的探讨原发性IgA肾病患者临床表现与病理分级的关系,为临床诊疗及判断预后提供依据。方法对新疆医科大学第一附属医院肾病科经肾活检病理确诊为原发性IgA肾病的113例患者的年龄、血压、24h尿蛋白定量、肾小球滤过率、病理类型、临床表现及免疫复合物等进行回顾性分析。结果 113例IgA肾病患者中男女比例为1∶1.13,发病平均年龄为(34.08±11.15)岁,年龄在不同性别间差异有统计学意义(P<0.05)。病理分级越高,血尿素氮值越大,肾小球滤过率值随之降低,差异有统计学意义(P<0.05),收缩压、舒张压、24h尿蛋白定量在不同病理分级间、性别间差异无统计学意义。临床表现以无症状尿检异常型最常见,临床表现及免疫病理类型与病理分级间差异均无统计学意义。结论 IgA肾病好发于青壮年,临床表现多样化,病理分级越高,提示预后不良,早期行肾活检并行病理分级分析对IgA肾病指导治疗、判断预后有重要的临床意义。  相似文献   

4.
目的 了解小儿 Ig A肾病 ( Ig A nephropathy,Ig AN)临床、病理及与预后的关系。方法 对肾活检病理诊断为 Ig AN的 3 0例病例进行临床与病理分析。结果 小儿 Ig AN临床表现以单纯肉眼血尿最常见 ,其与血尿伴蛋白尿者免疫复合物沉积均多为 Ig A+Ig G型 ,但前者临床及病理改变相对轻于后者。肾病综合征 ( NS)的临床及病理改变最重 ,易合并肾功能不全、高血压 ,以 Ig A+Ig G+Ig M型的免疫复合物沉积为主。结论 小儿 Ig AN预后与临床及病理分级有关 ,单纯肉眼血尿预后较好 ,NS、病理改变有肾小球硬化及免疫复合物沉积为 Ig A+Ig G+Ig M型者预后不良。  相似文献   

5.
目的探讨并分析张家口地区肾活检患者的流行病学特点,为提高肾病的诊断和防治能力提供参考。方法对张家口地区463例肾活检患者的临床资料进行回顾性分析。观察肾活检患者的疾病分类,病理类型与性别、年龄分布特点的关系。结果原发性肾小球肾炎患者371例(80.13%)、继发性肾小球肾炎患者84例(18.14%)、遗传性肾病患者3例(0.65%)、小管间质性疾病患者5例(1.08%),原发性肾小球肾炎患者显著多于其他组患者,差异有统计学意义(P0.05)。其中,原发性肾小球肾炎患者男性和女性各占60.11%、39.89%,男性患者显著多于女性(P0.05);继发性肾小球肾炎患者男性和女性各占32.14%、67.86%,男性患者显著少于女性,差异有统计学意义(P0.05)。Ig A肾病是原发性肾小球肾炎的多发病理类型,占比为50.13%,显著高于其他病理类型,差异有统计学意义(P0.05)。狼疮性肾炎是继发性肾小球疾病的多发病理类型,占30.95%,显著高于其他病理类型,差异有统计学意义(P0.05)。19~40岁组是原发性和继发性肾小球疾病的高发人群,发病显著高于其他年龄组人数,差异有统计学意义(P0.05)。遗传性肾病和小管间质性疾病的年龄分布特点不明显。结论张家口地区肾病的关键流行特点为:青壮年是肾病的高发人群,Ig A肾病是出现最多的病理类型。应加强对青壮年Ig A肾病的诊断,并制定有效的防治措施。  相似文献   

6.
51例IgA肾病临床与病理分析   总被引:1,自引:0,他引:1  
Ig A肾病是以肾小球系膜区有颗粒状 Ig A沉积为特征的一类肾小球疾病 ,是我国最常见的原发性肾小球疾病之一 ,其临床表现多种多样 ,疾病的自然病程变化很大 ,预后相差甚远。现将本院收治的 5 1例 Ig A肾病的临床和病理结果报告如下。1 资料和方法1.1 一般资料 :本院 1993年 5月至 1997年 12月共作肾活检 16 2例 ,诊断为原发性肾小球疾病 142例 ,其中 5 1例经临床和病理证实为 Ig A肾病。1.2 方法 :肾组织行常规光镜病理及免疫酶标检查 ,肾小球病变采用 1982年 WHO病理组织分类法 ,免疫酶标分为 4型 :Ig A型、Ig A+ Ig G型、Ig A+…  相似文献   

7.
目的探讨IgA肾病患者临床表现、病理特点及其相关性。方法对我院收治的153例IgA肾病患者相关资料进行综合性回顾性分析,入选患者均进行过肾活检病理确诊为IgA肾病,分析IgA肾病临床表现、病理类型等。结果 40例患者为有诱因发病,其中22例上呼吸道感染、3例妊娠、7例疲劳、4例肠道感染,1例由于海鲜引起过敏,1例腰部扭伤,2例手术原因;Ι级病理患者中6例为蛋白尿联合血尿型,Ⅱ级病理中7例单纯血尿型,10例蛋白尿联合血尿型;Ⅲ级病理中,20例蛋白尿联合血尿型;Ⅳ级病理中27例蛋白尿联合血尿型;Ⅴ级病理中5例单纯血尿型,5例蛋白尿联合血尿型;免疫复合IgA中有12例,占7.8%,IgA+Ig M占13.7%;IgA+C3占17.0%;IgA+Ig G+Ig M占5.2%;IgA+Ig G+C3占7.2%;IgA+Ig M+C3占32.7%;IgA+Ig G+Ig M+C3占17%。结论 IgA肾病在感染诱因下发病率较高,患者发病后临床表现以蛋白尿联合血尿型为主;同时,肾衰竭型比例出现上升趋势,且患者治疗预后不佳,临床上应该根据患者病理结果进行积极有效治疗,降低肾衰竭发生率。  相似文献   

8.
Ig A肾病 ( Ig AN)是原发性肾小球肾炎中最常见的一种 ,其临床和病理改变呈多样性 ,预后也各不相同。结合临床上存在许多继发性 Ig A肾病的情况 ,推测可能有不同的致病因素参与了 Ig A肾病的发病。近年来乙型肝炎病毒 ( HBV)感染与Ig A肾病的关系引起了国内外学者的关注 ,笔者就 Ig A肾病与乙型肝炎病毒相关性研究的进展综述如下。1 乙型肝炎病毒与 Ig A肾病是否具有相关性HBV感染与 Ig A肾病发病的关系目前尚有争论。 1 987年 Lai等 [1~ 3]首次在 Ig A肾病患者的肾切片中发现了 HBV抗原 ,并主要定位于系膜区 ,因此认为 HBV…  相似文献   

9.
目的对Ig A肾病进行病理学分型及其临床指标之间的关系进行探讨和分析,并观察转化生长因子β1和Smad7蛋白的不同表达,旨在对发病机制等因素进行探讨。方法选取该院收治的100例原发性Ig A肾病患者,收集并研究患者临床资料,参照Ig A肾病分型对所有患者的肾活检标本进行评分并比较各病理及分型见常见指标的差异。通过使用免疫荧光双套染法并结合激光共聚焦显微镜检测Ig A免疫复合物在不同肾病肾小球的沉积量,比较并分析其相关因素。此外,采用化学二步法检测转化生长因子β1和Smad7蛋白的表达,并比较不同表达情况与肾小球沉积量的关系。结果 Ig A肾病肾组织除E0/1外,其余临床指标之间差异有统计学意义(P〈0.05);血清Ig A浓度组间差异无统计学意义(P〉0.05),肾组织Ig A沉积量差异有统计学意义(P〈0.05);转化生长因子β1和Smad7蛋白表达差异有统计学意义(P〈0.05)。结论 Ig A肾病病理可以反映病变指标;血清浓度高低并不一定能决定Ig A肾病是否发作,但沉积的Ig A复合物可能过量聚积造成肾小球硬化;转化生长因子β1和Smad7蛋白很可能是过量聚积的重要原因并造成肾小球硬化。  相似文献   

10.
目的探讨Ig A肾病伴贫血患者的临床病理特点。方法收集202例经肾活检明确诊断原发性Ig A肾病患者的临床病理资料。根据是否贫血分为两组,其中A组(贫血组)33例,B组(非贫血组)169例,比较两组临床和病理方面的差异。结果与B组比较,A组的Scr、BUN、24h-Upro明显增高,RBC、Hb、Alb下降,肾小球硬化、新月体形成及血管壁增厚的数目增多,差异具有统计学意义(P<0.05)。肾组织病理学参照Lee氏分级比较,贫血组病理Lee氏分级较重(P<0.05)。Spearman相关分析结果提示,Hb与小球硬化/肾小球总数、新月体/肾小球总数呈负相关,Scr、24h-Upro与小球硬化/肾小球总数、新月体/肾小球总数呈正相关。多因素Logistic回归分析表明女性、Scr、24h-Upro、新月体病变是是Ig AN合并贫血患者的独立危险因素。结论 Ig AN伴有贫血患者的临床病理改变重于Ig A肾病不伴有贫血的患者,即贫血可加重Ig A肾病患者的临床病理损伤。  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.
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   

13.
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   

14.
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   

15.
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   

16.
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   

17.
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   

18.
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   

19.
FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…  相似文献   

20.
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   

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