疏血通对早期糖尿病肾病的治疗作用

目的观察疏血通对糖尿病肾病(DN)的治疗作用。方法选择早期DN病人62例随机分为疏血通治疗纽和对照组,对照组行饮食控制及应用胰岛素或糖适平控制血糖。治疗组在上述治疗基础上加疏血通治疗共4周。观察两组治疗前后血糖、血常规、血生化、肝功能、肾小球滤过率(GFR)、尿清蛋白排泄率(UAER)及治疗过程中出现的副作用。结果治疗前两组病人GFR,UAER相近,治疗后两组病人GFR,UAFAt明显改善(3.051-5.126,P<0.05),而治疗组上述指标改善优于对照组(t=2.105,2.864,P<0.05),疏血通治疗过程中无明显的副作用发生。结论疏血通对早期糖尿病肾病有明显疗效,值得推广应用。     

前列腺素与糖尿病肾病关系的探讨

用放免法测定糖尿病肾病２６例、单纯糖尿病２４例和同年龄的健康对照者２５例血浆的血栓素Ｂ２（ＴＸＢ２）、６－酮前列腺素Ｆ１α（６－ｋ－ＰＧＦ１α）及空腹血糖（ＦＳＧ）、基础胰岛素（ＩＦ）、血肌酐（ＳＣｒ）水平。结果显示，糖尿病肾病组ＴＸＢ２明显高于对照组，６－ｋ－ＰＧＦ１α明显下降，ＳＣｒ与－ｋ－ＰＧＦ１α呈负相关，与ＴＸＢ２呈正相关，ＴＸＢ２／６－ｋ－ＰＧＦ１α与空腹血糖呈正相关，与内源胰岛素释放无关。     

Approved indications of lipo-PGE1 in Japan

For its peripheral vascular dilating effect and platelet agglutination inhibitory activity, prostaglandin E₁ is used in the treatment of diseases which are likely to cause peripheral circulatory failure or thrombus. In Japan, lipo-PGE₁, which was developed to give it a target-directed nature by modifying the conventional PGE₁, has been used and found to be useful in clinical practice. In this report, we attempt to describe the clinical benefits of lipo-PGE₁ focusing on the diseases which have been approved for its indications.     

Treatment of diabetic polyneuropathy with the neurotrophic peptide ORG 2766

The efficacy of the neurotrophic peptide ORG 2766 in diabetic patients with polyneuropathy was evaluated in a double-blind, placebo-controlled, multicentre trial. One hundred and twenty four patients were randomised in five groups to receive 0.1, 0.4, 2 or 5 mg ORG 2766 or placebo, once daily, administered subcutaneously 52 weeks. Thermal discrimination thresholds (TDT) and vibration perception thresholds (VPT), motor and sensory nerve conduction velocity, Hoffmann reflex, heart rate variation during deep breathing and heart rate response after standing up, neurological examination score and neuropathic symptom score were determined at baseline and after 17, 34 and 52 weeks of treatment. Of the nerve function indices studied, at week 52 the TDT_warmth of the hand in the ORG 2766 0.1, 0.4 and 5 mg groups and the TDT_cold of the foot in the ORG 2766 0.1 and 0.4 mg groups significantly improved compared with placebo. Further significant improvement as compared with placebo was observed in the paraesthesia score at week 34 and week 52 in the ORG 2766 2 mg group. Only at week 34 had both the heartbeat variation during deep breathing and the VPT of the foot in the ORG 2766 0.1 mg group improved significantly, compared with placebo. No further statistically significant differences were observed at time for the other measures. No adverse reactions were observed. The only recorded drug-induced side effect was pain at the injection site. Taking all measures of efficacy into account, the statistically significant results observed did not show consistency within each measure. Therefore, it is concluded that ORG 2766, in contrast to earlier reports, is not effective in treating diabetic polyneuropathy.     

C3 Deposition in IgA Nephropathy in Children and Adolescents

The aim of this study was to assess the significance of C3 deposition in IgA nephropathy in children and adolescents. One hundred and two patients aged 5–21 years (57 male and 45 female) were studied. The findings of C3 deposition were classified into 8 groups by immunofluorescent (IF) pattern and intensity as follows: group MC3+ (N = 12): mesangiocapillary pattern and 3+ in intensity; group MC2+ (N = 13): mesangiocapillary and 2+; group MC1 + (N = 4): mesangiocapillary and 1 +; group M3+ (N = 11): mesangial and 3+; group M2+ (N = 24): mesangial and 2+; group M1 + (N=18): mesangial 1 +; group S (N = 12): only segmentally positive; and group N (N = 8): negative. Histological changes were scored semiquantitatively as an activity index (cellular proliferation, necrosis, interstitial cell infiltration, and cellular crescents) and a chronicity index (mesangial sclerosis, segmental and global glomerular sclerosis, fibrous crescents, adhesion and tubulo-interstitial change). IF findings were scored semiquantitatively and laboratory findings were also studied. The following results were obtained: 1) The scores of total activity index in MC groups were higher than in the M, S or N groups, and the greater the degree of C3 deposition, the higher the score; 2) Such result was not evident in the chronicity index; 3) High IF scores of IgG and IgM were found in the MC3+ and MC2+ groups; 4) Hematuria was more severe in MC3+ and MC2+ than in other groups, and proteinuria was more prominent in the MC than other groups. Thus the degree of C3 deposition was parallel with histological activity and urinary findings.     

Pattern of renal dysfunction in analgesic nephropathy--comparison with glomerulonephritis.

Comprehensive renal function tests were performed in 84 patients with analgesic nephropathy, 33 glomerulonephritis patients matched for creatinine clearance, and 30 control subjects. A system of 1-day renal function tests including urine microscopy, creatinine clearance, phenolsulphonphthalein excretion, urine concentration and acidification, and electrolyte excretion, was used. Patients with analgesic nephropathy were found to have significant sterile pyuria and haematuria, even those with mild renal insufficiency, significantly reduced concentrating ability and a distal acidifying defect, and a tendency to impaired sodium conservation. These function defects are consistent with the primary lesion of renal papillary necrosis in analgesic nephropathy; the detection of these defects have implications in patient management.     

IgA肾病大鼠血清IgA-纤维连接蛋白的检测及意义

目的 检测IgA肾病大鼠血清IgA-纤维连接蛋白水平，探讨其在IgA肾小球系膜沉积中的作用。方法 肝叶切除后，尾静脉注射脂多糖，制作IgA肾病大鼠模型。应用ELISA法检测血清IgA-纤维连接蛋白聚合物水平，半定量法对系膜IgA免疫荧光强度评分，二者作相关性分析。结果 IgA肾病时，血清IgA-纤维连接蛋白聚合物水平升高，并与系膜IgA沉积呈正相关。结论 IgA肾病时，血清IgA-纤维连接蛋白聚合物水平是升高的，且可能是导致IgA系膜沉积的原因之一。     

补体对免疫沉淀的抑制作用与小儿肾脏疾病的关系

以辣根过氧化物酶（PO）和抗-PO作为免疫沉淀中的抗原和抗体，用光电比色法，对78例小儿肾脏疾病血清补体对免疫沉淀的抑制作用（IIPC）进行了研究，并同时检测补体成分C3、C4。结果，正常对照IIPCOD值为0．505±0．085，急性肾小球肾炎（0．137±0．108）显著降低（P＜0．001）；慢性肾小球肾炎（0．470±0．053）改变不明显（P＞0．05）；肾病综合征（0．401±0．038）明显低下（P＜0．05）。IIPC低下的发生率依次为急性肾小球肾炎（83％）、肾病综合征（43％）、慢性肾小球肾炎（32％）。表明小儿肾小球疾病时IIPC大多降低并与疾病的活动性有关。因此认为IIPC低下在肾脏病的发生和发展中起一定作用。