营养治疗在血液透析中应用

16例尿毒症血透患者分成三组。第一组6例常规维持血透,自由进食;第二组5例低蛋白饮食,蛋白量为0.6g·kg~(-1)/a,第三组5例极低蛋白饮食,蛋白量为0.3～0.4g·kg~(-1)/d,供给必需氨基酸或酮酸。二、三组每周血透1次,所有患者均观察6个月。结果示三组患者营养状态相似,氮平衡、总体氮流量、蛋白合成速度均有改善,二和三组患者血磷明显降低,血钙明显升高,其Ccr下降率明显慢于一组,提示血透联合低蛋白饮食或(和)加必需氨基酸可以减少血透次数,能保护残存肾单位功能。     

原发性慢性肾炎中T淋巴细胞及其亚群的改变

本文对50例原发性慢性肾炎T淋巴细胞及其亚群进行了初步研究。慢性肾炎的诊断根据1977年北戴河肾炎座谈会提出的“关于原发性肾小球疾病的临床分类初步方案。”属慢性肾炎肾病型27例,男性16例,女性11例,平均年龄29.9±12.1岁。属慢性肾炎普通型23例,男性11例,女性12例,平均年龄36.3±15.3岁。全组50例平均年龄32.8±13.9岁。多系住院病人,在未服皮质激素或用其他     

EFFECT OF LOW PROTEIN DIE'T ON WHOLE BODY NITROGEN METABOLISM IN PATIENTS WITH CHRONIC RENAL FAILURE

isN-glycine was administered orally as a tracer t0 3 patients with chronic renal failure (CRF) in the study of total body protein metabolism during the course of diet therapy. Five healthy subjects with matched age and sex served as controls. Patients on a diet providing l.2 g protein/kg/day had significantly low total nitrogen flux (Q), rates of total body pro- tein synthesis (S), catabolism (C) and S/Q, as com' pared with the controls. A reduction in daily protein intake t0 0.6 g/kg/day resulted in marked increase in all these parameters, approaching those of the con- trols. In normal subjects, low protein intake did not affect the total body protein turnover signfiicantly. The results suggest that the adaptive response to res- triction of protein intake is an efficient utilization of nitrogen entering the metabolic pool for anabolic purposes. This response becomes manifest and essen- tialin patients with CRF and forms the basis for low protein diet therapy.     

ALTERATION OF ZINC, COPPER AND MAGNESIUM IN SERUM OF UREMIC PATIENTS AND PERITONEAL DIALYSATE

In 11 uremic patients serum zinc, copper and magnesium were determined prior to and 3—6 months after starting intermittent peritoneal dialysis (IPD). The trace elements were measured by atomic absorption spectrophotometry. The concentrations of serum zinc and copper were raised significantly from the initial mean values of 9.36±2.498 μmol/L and 15.875±4.223 μmol/L prior to IPD to 12.102±2.514 μmol/L and 22.127 ±3.530 μmol/L respectively after IPD. While in normal controls serum zinc was 13.571±1.665 μmol/L and copper 15.830±4.113 μmol/L. Serum magnesium dropped from 2.127±0. 712 mmol/L to 1.921±0.378 mmol/L、but the change was not significant statistically; the value in normal controls was 1.300±0.128 mmol/L. When IPD had been well established and there was no sign of peritonitis, serum zinc, copper and magnesium were tested before and after the procedure of IPD in a single day at random, and at the same time the concentrations of these elements in the drained dialysate were also determined. The result showed that serum levels of zine, copper and magnesium remained unchanged before and after dialysis in a single day, however, those in the drained dialysate were raised from the initial values of 1.301±0.522 μmol/L, 0.9635±0.335 μmol/L and 1.168±0.411 mmol/L to 8.478±5.324 μmol/L, 5.715±1.868 μmol/L and 1.098±0.494 mmol/L.     

氯沙坦降压疗效及对尿酸和蛋白尿的影响

目的探讨高血压治疗中氯沙坦对血压、蛋白尿和尿酸的影响.方法观察30例高血压患者服用氯沙坦(50mg/d)治疗8周后血压、尿蛋白、血尿酸及肌酐的变化. 结果氯沙坦治疗8周后,血压明显下降,从161.66±17.52/97.42±6.70mmHg降至137.33±14.81/87.30±8.53mmHg(1mmHg=0.133kPa,P＜0.001);尿酸从457.76±108.77μmol/L降至405.91±90.11μmol/L(P＜0.001);蛋白尿从2210.26±1969.8mg/24h降至1895±2447.97mg/24h(P＜0.001);血肌酐变化不显著(P＞0.05).结论氯沙坦对高血压患者具有良好的降压作用,同时兼有降尿酸、降尿蛋白的作用.     

报道一例表现为急性胰腺炎的系统性红斑狼疮

目的介绍一例以急性胰腺炎为主要表现的系统性红斑狼疮（SLE），探究SLE中急性胰腺炎的发病机理及其治疗方法。方法参考国内外大量文献，采用中等剂量的甲基强的松龙冲击治疗。结并本例患者经确诊为此急性胰腺炎为表现的SLE，用激素治疗后取得了满意的效果。结哈SLE中急性胰腺炎的发生可能与SLE所致的小血管炎有关，中等剂量的甲基强的松龙治疗可能通过抑制免疫反应，减轻小血管炎从而缓解疾病。     

肾脏病患者尿液中SIgA的含量的观察

用放射免疫(双抗体-PEG法)测定109例正常人和85例各种类型肾脏病患者尿液中SIgA含量。表明慢性肾炎普通型、慢性肾炎肾病型活动期和慢性肾炎所引起的慢性肾功能不全均较正常对照组明显增高。慢性肾炎肾病型好转期尿 SIgA与正常对照组无显著差异,但较活动期明显减少。高分子和混合蛋白尿患者尿 SIgA较中分子和低分子蛋白尿患者明显增加。肾病患者24小时尿蛋白排出量与尿 SIgA呈正相关,而与血清 IgA无相关性。文中讨论了非感染性肾脏疾病时尿 SIgA增高的可能原因。     

PATTERN OF SERUM TRYPTOPHAN IN CHRONIC RENAL FAILURE

Data on serum total (Trp) and free (fTrp) and bound (bTrp) tryptophan concentrations in patients with chronic renal failure were analysed. The results revealed marked decrease of serum Trp and bTrp, increase of fTrp concentrations and negative correlation between serum creatinine and bTrp/albumin ratio. The mechanism leading to these alterations is not clear. Increased serum fTrp concentration may play a role in causing uremic syndrome.     

肾病综合征患者低IgG血症原因的探讨

对本组肾病综合征患者,在活动期、缓解期和停药后所测IgG的平均值均明显低于正常对照组(P<0.01);而IgM较正常对照均明显增高(P<0.01)。与正常对照组比较,活动期和停药后,Tt百分率和绝对数在活动期无差异,停药后显著增加(分别为P<0.01、P<0.05);Tγ百分率和绝对数除活动期Tγ绝对数无差异外,其余均有非常显著增高(P<0.01);而Tμ百分率和绝对数,除停药后Tμ绝对数无差异外,余均明显降低;Tμ/Tγ活动期和停药后均有非常显著降低(P<0.01)。慢性肾炎肾病型患者低IgG血症可能由于Tμ细胞数量不足或其功能低下有关。     

健康老年人尿中N-乙酰-β-D氨基葡萄糖苷酶的测定

近十年尿酶测定已作为诊断肾脏病变的一种简便方法,广泛应用于临床。对判断肾脏疾病的预后及疗效有一定帮助。为了明