补肾排毒合剂治疗慢性肾衰竭营养不良60例临床观察

目的:观察补肾排毒合剂治疗慢性肾衰竭营养不良的疗效.方法:90例慢性肾衰竭营养不良患者随机分为治疗组60例和对照组30例,并设健康对照组30例.治疗组和对照组在综合治疗的基础上,治疗组加用补肾排毒合剂,对照组加用爱西特和百令胶囊.比较两组肾功能、营养状态和血浆瘦素、神经肽Y的变化.结果:治疗组治疗后BUN、Scr明显降低,与治疗前及对照组相比均有统计学差异(P<0.05).治疗组营养状态好转,与治疗前及对照组相比均有统计学差异(P<0.05).两组慢性肾衰竭营养不良患者治疗前Leptin、NPY水平均高于健康组(P<0.05),治疗后治疗组Leptin、NPY较治疗前下降,有统计学意义(P<0.05),但与对照组相比无统计学差异(P＞0.05).结论:补肾排毒合剂治疗慢性肾衰竭营养不良疗效明显,可降低BUN、Scr,改善营养不良状态.     

Changes in the levels of neuropeptide Y-LI in the external jugular vein in connection with vasoconstriction following subarachnoid haemorrhage in man

Summary NPY is a putative neurotransmitter mainly co-localized with noradrenaline in sympathetic fibers which innervate the cerebral vasculature. The origin of most of the perivascular NPY fibers seems to be in the superior cervical ganglion. To investigate involvement of Neuropeptide Y (NPY) mechanisms in subarachnoid haemorrhage (SAH), twenty patients with SAH were investigated. NPY-LI (-like immunoreactivity) levels in the external jugular vein were assessed using radioimmunoassay in blood samples collected postoperatively (or after SAH in non-surgical patients) on days 1, 2, 3, 5, 7 and 9. These levels were compared with the clinical course and blood flow velocity changes monitored with ultrasonic Doppler equipment from both middle cerebral arteries (MCA) and both internal carotid arteries (ICA).Compared to NPY-LI levels in 14 controls (mean 116±3 pmol/ l), increased levels (up to 253 pmol/l) and a close relationship between velocities and NPY-LI levels were found in a subpopulation of the SAH patients. When comparing the mean haemodynamic index (V MCA/ipsilateral V ICA) and mean NPY-LI levels in each of the 20 patients, a correlation of r=0.75, p=0.0001 was found. Increased NPY-LI were found (131±8 pmol/l) when simultaneous Doppler velocity recordings showed vasoconstriction (Haemodynamic index >5) compared with samples taken when the haemodynamic index was <5, p<0.05. When MCA velocity exceeded 120 cm/sec, increased levels were found (129±9 pmol/l) compared with the conditions when MCA velocity was less than 120 cm/sec (113±5 pmol/ l), p=0.06. The results indicate a possible NPY involvement in cerebral vasoconstriction after SAH.     

Chronic Administration of Glucocorticoids Directly Upregulates Prepro-Neuropeptide Y and Y1-Receptor mRNA Levels in the Arcuate Nucleus of the Rat

The complete sequence of the cDNA encoding the neuropeptide Y (NPY) Y₁-receptor has recently been deduced from a rat brain library, and the presence of messenger ribonucleic acid (mRNA) encoding Y₁-receptor protein has been demonstrated within the brain. Using quantitative in situ hybridization histochemistry, the content and distribution of Y₁receptor and preproNPY mRNAs have been investigated in the hypothalamic arcuate nucleus of adrenalectomized rats receiving glucocorticoid replacement therapy for 12 days by means of either high doses of dexamethasone in their drinking water or by subcutaneous corticosterone pellets. Basal metabolic parameters such as weight gain or loss, blood glucose and plasma insulin were monitored: Dexamethasone treatment induced weight loss and a state of hyperinsulinemia with normoglycemia, while corticosterone treated animals displayed metabolic parameters identical to sham ADX animals. Within the arcuate nucleus of glucocorticoid treated animals, levels of Y₁receptor and preproNPY mRNAs were increased. In contrast, adrenalectomy itself had no effect upon Y₁-receptor mRNA levels or preproNPY mRNA levels in the arcuate nucleus. These studies demonstrate that glucocorticoids exert a stimulatory action on levels of Y₁-receptor mRNA and preproNPY mRNA levels in the hypothalamic arcuate nucleus. This is the first evidence to suggest that the expression of a neuropeptide-receptor gene in the central nervous system may be directly sensitive to peripheral hormonal signals.     

Elevations of neuropeptide Y-like immunoreactivity and catecholamines in plasma on increased intracranial pressure in the pig

Graded increases of intracranial pressure (ICP) in anaesthetized pigs induced elevations of plasma levels of neuropeptide Y (NPY)-like immunoreactivity (LI) and catecholamines, simultaneously with hypertension and tachycardia. Plasma adrenaline (ADR) increased at a lower ICP-level than did the plasma levels of noradrenaline (NA) and NPY-LI. At the maximal ICP elevation, 22.9 kPa (172 mmHg), plasma NPY-LI was increased about 10-fold, from 48 +/- 8 pmol/l in the basal state, while NA and ADR concentrations increased more than 100-fold. At this maximal ICP-level the plasma levels of NPY-LI were correlated to the concentrations of both NA (r = 0.87, P less than 0.01) and ADR (r = 0.92, P less than 0.001). Plasma NPY-LI continued to increase to about 1000 pmol/l, 10 min after the maximal elevation of ICP was discontinued, while the catecholamines then had declined considerably. A slight cardiac release of NPY-LI was observed at the maximal elevation of ICP. The half-life of NPY-LI in plasma was about 6 min upon systemic infusion. At plasma levels similar to those obtained upon maximal ICP elevation, exogenous NPY caused slight vasoconstriction in the spleen and skeletal muscle, but had no effects on coronary blood flow or systemic blood pressure. This suggests that NPY mainly exerts local actions after release from nerve endings, while levels of circulating NPY in plasma must be very high to influence blood flow in some organs. It is concluded that elevation of ICP results in hypertension and tachycardia related to elevated plasma levels of NPY-LI and catecholamines.(ABSTRACT TRUNCATED AT 250 WORDS)     

电针“水沟”对脑缺血大鼠海马降钙素基因相关肽、神经肽Y含量的影响

目的:观察电针对局灶性脑缺血大鼠海马降钙素基因相关肽(CGRP)、神经肽Y(NPY)含量的影响,探讨电针水沟治疗缺血性脑血管疾病的作用机制。方法:将40只SD大鼠随机分为正常组、假手术组、模型组、电针组,每组10只。采用线栓法制作大鼠局灶性脑缺血模型。造模成功后即刻开始电针"水沟"穴,连续波,频率2 Hz,强度1 mA,治疗30 min,每天1次,连续治疗5 d。采用放射免疫法检测各组大鼠海马CGRP和NPY含量。结果:造模后大鼠海马CGRP含量明显下降,NPY含量明显升高(P<0.01);电针组CGRP含量较模型组显著升高,NPY含量明显降低(P<0.01)。结论:电针可通过调节海马神经肽含量,达到抗脑缺血损伤的作用。     

电针督脉经穴为主对血管性痴呆大鼠学习记忆及NPY的影响

目的：观察电针督脉经穴为主对拟血管性痴呆大鼠学习与记忆能力的改善作用，探讨其发生机理，寻找腧穴之间的协同或拮抗作用。方法：四血管阻断（4VO）法造模。以电针督脉经穴为主，观察各组大鼠行为学、脑中NPY浓度变化。结果：电针各组与模型组比较，水迷宫试验中寻找平台时间明显缩短；相同时间内跨越原平台及其余三象限相应平台处次数明显增加；脑组织中NPY浓度明显降低。各电针组之间比较，无显著差异。结论：电针可明显改善拟血管性痴呆（VD）大鼠学习与记忆能力。三种腧穴配伍处方在本实验中未见显著差异。     

Anorexia Induced by the Parasitic Nematode, Nippostrongylus brasiliensis: Effects on NPY and CRF Gene Expression in the Rat Hypothalamus

Infections of the gastrointestinal nematode, Nippostrongylus brasiliensis, in the laboratory rat result in a characteristic biphasic anorexia which is followed by hyperphagia once the worm burden has been cleared. Despite the importance of parasite-induced anorexia, relatively little is known of the underlying mechanisms. We have investigated the involvement of the central appetite drive in this anorexia by studying the gene expression of two neuropeptides with opposing actions on energy balance, NPY and CRF. Gene expression was assessed by in situ hybridization at 2, 8 and 16 days post-infection (p.i.) in infected rats, in uninfected controls, and in a group with food intake restricted to match that taken voluntarily by the parasitized animals. The sampling intervals corresponded to each of the two phases of maximum anorexia and the period of compensatory hyperphagia. Surprisingly, we found that increases in NPY gene expression in the hypothalamic arcuate nucleus (ARC) accompany anorexia in rats infected with N. brasiliensis; there was a significant relationship between degree of anorexia and induction of NPY mRNA after 8 days of infection. Furthermore, ARC NPY mRNA levels in parasitized animals were similar to those in pair-fed individuals with food intake restricted to match the infected rats. The number of larvae used to establish the infection affected both the degree of anorexia and the level of NPY mRNA at 8 days p.i. in a dose-dependent manner. NPY gene expression remained elevated in infected rats during at least the initial stages of compensatory hyperphagia. This suggests that animals detect a state of energy deficit during the early stages of the infection, yet do not feed, but become hyperphagic coincident with worm loss. The failure of anorectic parasitized animals to feed in response to activation of the NPYergic system makes this a novel system in which to study the regulation of hypothalamic NPY by physiological challenge. There were no significant differences in CRF gene expression between the groups at any of the sampling intervals.     

Reciprocal interactions between α2-adrenoceptor agonist and neuropeptide Y binding sites in the nucleus tractus solitarius of the rat

Summary Interactions between a ₂-adrenoreceptor agonist and neuropeptide Y (NPY) binding sites have been studied in the rat medulla oblongata (MO) using biochemical binding techniques as well as quantitative autoradiography. Tritiated para-amino clonidine (³H-PAC; ₂-adrenoceptor agonist), idazoxan (³H-IDA; ₂-adrenoceptor antagonist) and iodinated neuropeptide Y (¹²⁵I-NPY) were used as radioligands. (1) Neuropeptide Y (NPY; 10^–8M) but not bovine pancreatic polypeptide (BPP) nor peptide YY (PYY 10nM) increased the K_D value of³H-PAC binding sites. However, intraventricular administration of a high dose of NPY (1.25nmol) did not change the³H-PAC binding characteristics in MO membrane preparations of these animals. (2) GTP 10^–4 lowered the affinity of³H-PAC binding. NPY (10 nM) had no additional effect, nor did NPYinfluence the GTP induced shift in potency of clonidine to displace³H-IDA from its binding sites. (3) In the autoradiographical experiments NPY (10nM) significantly reduced³H-PAC binding (2nM) in the nucleus tractus solitarius (NTS) area by 35%. (4) When clonidine, either given centrally in vivo (3.75nmol) or in vitro (10 nM) the binding of¹²⁵I-NPY was reduced (34 and 24%, respectively) in the NTS. When the monoamine receptors were irreversibly blocked in vivo by N-ethoxycarbonyl-2-ethoxy-1,2-dihydroquinoline (EEDQ, 10 g i.e. 24h)¹²⁵I-NPY (0.5 nM) binding was increased by 137% in the NTS. This effect of EEDQ was prevented by pretreatment with the ₂-adrenoreceptor antagonist idazoxan.These results provide support for a direct intramembrane interaction between the ₂-receptor and the NPY receptor within the NTS and may be of importance in central cardiovascular regulation.     

Receptor autoradiographical evidence for high densities of 125l-neuropeptide Y binding sites in the nucleus tractus solitarius of the normal male rat

By means of quantitative receptor autoradiography using ¹²⁵I-neuropeptide Y (¹²⁵I-NPY) as a radioligand, the distribution of ¹²⁵I-NPY binding sites has been evaluated in coronal sections at various rostrocaudal levels of the medulla oblongata of the male rat. High densities of neuropeptide Y (NPY) binding sites were demonstrated in the nucleus tractus solitarius (nTS), in the nucleus paratrigeminalis, in the area postrema, in the medial nuclei of the inferior olive and in the substantia gelatinosa of the caudal part of the spinal trigeminal nucleus. Low densities were present in the dorsal motor nucleus of the vagus (dmnX) and in the hypoglossal nucleus. Other regions of the medulla oblongata showed only a very low density or no specific binding of ¹²⁵I-NPY. These results indicate that the central cardiovascular actions of NPY at least in part may be mediated via an action in the nTS, in this way controlling the baroreceptor reflex activity. Neuropeptide Y mechanisms may also play a role in the regulation of other visceral afferents such as those involved in gastrointestinal control (dmnX) and of cerebellar function (inferior olive). Finally, the results indicate that a high density of NPY immunoreactive terminals in some regions of the medulla oblongata is associated with a low density of high affinity ¹²⁵I-neuropeptide Y binding sites and vice versa.