提高对抗中性白细胞胞浆自身抗体相关系统性小血管炎的认识

提高对抗中性白细胞胞浆自身抗体相关系统性小血管炎的认识谌贻璞王海燕系统性小血管炎系指主要累及微动脉、毛细血管及微静脉的坏死性血管炎，其中３个小血管炎与抗中性白细胞胞浆自身抗体（ＡＮＣＡ）密切相关，它们是：（１）显微镜下多血管炎（ｍｉｃｒｏｓｃｏｐ－ｉ...     

马兜铃酸-脱氧鸟苷酸加合物的合成及质谱分析

体外合成并应用多种质谱技术鉴定了马兜铃酸(aristolochic acid，AA)-脱氧鸟苷酸(2′-deoxyguanosine 5′-monophosphate，dGp)加合物。AA经酶活化或化学活化后与dGp反应，同时优化反应条件。应用液相色谱-串联质谱(LC-MS/MS)以及傅里叶变换离子回旋共振质谱(FT-ICRMS)精确质量数测定和同位素模式等检测技术对合成样品进行分析。在样品中分别检测到AA-dGp加合物准分子离子峰，子离子谱图提供了加合物结构信息。AA能在体外与dGp形成AA-dGp加合物，质谱分析方法可以快速、方便、准确分析与鉴定AA-dGp加合物。     

Inhibition of mesangial cell proliferation by antisense oligodeoxynucleotide targeting preproendothelin-1 mRNA in vitro

Ｏｂｊｅｃｔｉｖｅ　Ｔｏｉｎｖｅｓｔｉｇａｔｅｔｈｅｅｆｆｅｃｔｓｏｆｅｎｄｏｔｈｅｌｉｎ１（ＥＴ１）ｏｎｍｅｓａｎｇｉａｌｃｅｌｌｐｒｏｌｉｆｅｒａｔｉｏｎｉｎｖｉｔｒｏＭｅｔｈｏｄｓ　Ａｎｔｉｓｅｎｓｅｏｌｉｇｏｄｅｏｘｙｎｕｃｌｅｏｔｉｄｅ（ＡｓＯＤＮ）ａｎｄｉｔｓｃｏｎｔｒｏｌｓｅｑｕｅｎｃｅｓ,ｓｅｎｓｅ（ＳｅＯＤＮ）ａｎｄｍｉｓｍａｔｃｈ（ＭｉｓＯＤＮ）ｏｌｉｇｏｄｅｏｘｙｎｕｃｌｅｏｔｉｄｅｓ,ｔａｒｇｅｔｉｎｇｐｒｅｐｒｏｅｎｄｏｔｈｅｌｉｎ１（ｐｐＥＴ１）ｍＲＮ…     

第4例轻度蛋白尿一血尿一糖尿一夜尿增多(Ⅱ)

本例的病历摘要见本刊2001年第7期第442页 分析与讨论 本例患者肾小球及肾小管功能均已受损。CCr降至 0.83 ml/s以下，SCr超过177μmol/L，提示肾小球功能损伤已 达氮质血症期；出现肾性尿糖(血糖正常，尿糖阳性)，提示近 端肾小管回吸收功能受损；夜尿增多，出现低比重及低渗透 压尿(虽有尿糖干扰，测定值仍低)，提示远端肾小管浓缩功 能受损。此外，患者尿中还多次检出颗粒管型，故可肯定此 病系肾脏疾病。患者肾功能损害至少已有半年，而且B超显 示双肾缩小(右肾更明显)，说明此肾脏疾病已为慢性。血红 蛋白略低，提示已继发轻度肾性贫血。     

云南省西双版纳地区成人慢性肾脏病流行病学调查

目的 了解我国云南省西双版纳少数民族地区成人慢性肾脏病(CKD)患病率及危险因素.方法 对该地区20岁以上常住居民进行随机分层抽样,留取晨尿,分别采用尿白蛋白,肌酐比值方法检测白蛋白尿发生率(≥30 mg/g为阳性);干化学法结合尿离心后显微镜检查法检测血尿发生率(≥3红细胞/高倍视野为阳性);以中国人简化MDRD公式计算估计肾小球滤过率(eGFR)[低于60 ml·min-1·(1.73m2)-1者为eGFR异常].检测CKD相关危险因素指标.结果 符合入选条件的被调查者共5566例,白蛋白尿阳性率为8.06%;血尿阳性率为4.01%;eGFR低于60 ml·min-1(1.73 m2)-1者为2.89%;去除白蛋白尿、血尿及eGFR下降共同存在造成的重复.该地区CKD患病率为12.53%.性别、年龄、民族以及相关危险因素分层后比较结果与多因素Logistic回归分析结果一致,年龄增加、血压升高、空腹血糖升高及三酰甘油升高与白蛋白尿独立相关;年龄增加、收缩压升高与肾功能下降独立相关;年龄增加与血尿独立相关.结论 云南省西双版纳地区成人CKD患病率为12.53%,相关危险因素包括年龄增加、高血压、血糖及血脂异常.     

第一届肾素论坛会议纪要

自1898年Robert Tigerstedt教授第一次发现并命名"肾素"至今,针对肾素-血管紧张素系统(RAS)的研究已经有100余年了.时至今日,人们已经认识到,RAS在调节血压、维持水钠平衡及肾脏发育等方面起着重要的作用,并参与人体诸多病理生理过程.     

肾性骨营养不良的有关细胞机制

肾性骨营养不良是肾衰竭时出现的复杂骨代谢异常症候群 ,是多因素致成的骨重塑紊乱。当病人肾小球滤过率 (ＧＦＲ)减少 5 0 %时 ,约半数患者会出现骨组织学异常 ;而血液透析开始时 ,则几乎所有患者均有骨组织学异常表现。肾性骨营养不良的骨重塑紊乱可表现为重塑位点、效力及重塑周期各时相的异常 ,骨活检组织学检查对该病诊断、分型、判断疾病严重程度及指导治疗都非常重要。1　肾性骨营养不良分类依据病理生理特点可将肾性骨营养不良分为两个主要类型 :高转化骨病及低转化骨病。高转化骨病的病理组织学表现为纤维性骨炎 (ｏｓｔｅｉｔｉｓ…     

低蛋白饮食对环孢素A肾病大鼠肾间质纤维化的作用

Objective To investigate whether low-protein diet has protective effect on the progression of renal interstitial fibrosis in rats with cyclosporine A (CsA)-induced nephropathy. Methods Eighteen male Sprague-Dawley rats were randomly divided into three groups (6 rats in each group). The rats in control group (C group) received common diet; in model group (M group) low-salt diet; in intervention group (Ⅰ group) low-salt and low-protein diet. After diet adaptation period of one week, the rats in C group received subcutaneous injection of olive oil 1 mg/kg daily for 5 weeks, while M group and Ⅰ group subcutaneous injection of CsA (diluted into 25 g/L with olive oil) 1 ml/kg for 5 weeks. All the rats were sacrificed at the end of the 5th week. The food-intake and body weight were measured daily. The creatinine clearance (Ccr) was examined before rats were sacrificed. The semi-quantitative pathological analysis on kidney sections was performed. The mRNA and protein expression of transforming growth factor-β1 (TGF-βI) and type Ⅰ collagen (Col Ⅰ) in kidney tissue was determined with real time PCR and immunohistochemical staining, respectively. Results The food-intake and body weight of rats in M and I groups were significantly lower than those in C group (P<0.05). Compared with C group, the Ccr levels in M and Ⅰ groups were significantly reduced [(0.65±0.15) ml/min, (0.40+0.13) ml/min vs (1.55±0.29) ml/min, P<0.05], the relative fibrosis areas of kidney interstitium in M and I groups were significantly increased (3.60%±0.46%, 3.26%±0.75% vs 0.44%±0.24%, P<0.05), the mRNA and protein expression of TGF-β1 in M and I group was significantly up-regulated (by 2.6 and 3.1 times in mRNA and by 1.5 and 1.6 times in protein, respectively, P<0.05), and the mRNA and protein expression of Col Ⅰ in M and I groups was also significantly up-regulated (by 3.0 and 3.5 times in mRNA and by 2.3 and 2.1 times in protein, respectively, P<0.05). There were no significant differences between M and I groups in every parameters above-mentioned except the rat body weight and Ccr. Both the body weight and Ccr in Ⅰ group were significantly lower than those in M group (P<0.05). Compared with C group, the urine osmotic pressure in M group and in I group were deceased (for M group, P>0.05; for I group, P<0.05). Compared with C group, the serum cholesterol levels in M and I groups were significantly increased (P<0.05), and the serum phosphorus level in I group was significantly decreased (P<0.05). The levels of serum albumin and serum calcium of all three groups had no statistical differences (P>0.05). Conclusion Low-protein diet has no renoprutective effects on the rat model of cyclosporin A nephropathy, on the contrary, may induce body weight loss.     

肾康注射液对慢性马兜铃酸肾病模型大鼠肾间质纤维化的拮抗作用

目的 研究肾康注射液对慢性马兜铃酸肾病 (CAAN) 模型大鼠肾间质纤维化的拮抗效应。方法 雄性 SD 大鼠随机分为对照组、模型组和干预组，每组6只。于 0、1、4、8、12 周末分别检测体质量、尿糖、24 h 尿蛋白定量和肌酐清除率 (Ccr)；第12周末处死大鼠留取肾组织，行 Masson 染色观察肾间质纤维化程度；并用逆转录实时定量聚合酶链反应和免疫组织化学方法检测肾组织中转化生长因子-β₁ (TGF-β₁)、结缔组织生长因子 (CTGF)、纤溶酶原激活物抑制物-1 (PAI-1)、金属蛋白酶组织抑制物-1 (TIMP-1) 和Ⅰ型胶原 (Col I) mRNA 及蛋白表达。结果 与对照组比较，模型组和干预组大鼠体质量明显减轻 (P＜0.01)，但干预组大鼠体质量明显高于模型组，12周末时存在显著差异 (P＜0.05)。与对照组相比，模型组大鼠 24 h 尿蛋白定量显著上升 (P＜0.01)，Ccr 显著下降 (P＜0.01)；12 周时肾间质纤维化面积显著增加 (P＜0.01)；肾组织内上述各检测指标的 mRNA 及蛋白表达均显著上调 (P＜0.01)。与模型组相比，干预组大鼠各时间点 Ccr 均显著升高 (P＜0.01)；第12周时 24 h 尿蛋白定量及肾间质纤维化面积均显著降低 (P＜0.05、0.01)；上述高表达的 mRNA 及蛋白指标均被显著抑制 (P＜0.05)。结论 肾康注射液可能通过抑制肾组织促细胞外基质 (ECM) 合成因子 (TFG-β₁、CTGF) 及抗 ECM 降解因子 (TIMP-1、PAI-1) 生成，而改善 CAAN 的肾间质纤维化及肾功能。     

肾脏病临床撷萃(3)

IgA肾病诊断中的几个问题肾小球疾病常可作出3种诊断,即临床诊断、病理诊断及免疫病理诊断。IgA肾病是免疫病理诊断。自从80年代初国内开始报道此病以来,它已渐被人