环丙氟哌酸在犬胆汁、血中药代动力学的研究

为了有效治疗胆道感染的病人，提供合理选择抗生素的理论依据，我们检测了犬经口给予环丙氟哌酸后在胆汁及血中的药代动力学变化规律。结果表明犬经口给予0．25克环丙氟哌酸后，胆汁中浓度能较快上升，0．91h达峰值时间；峰值浓度为(Cmax)为11．8μg／ml，仅略低于血中的峰值浓度(14．36μg／m1)；半衰期(T1／2β)较长为7．66h．是血中半衰期(T1／2β)3．31h的2倍；清除率(CL)是30ml／min；表观分布容积为19．88L。由于经口给予环丙氟哌酸后，药物在胆汁中含量较高，半衰期长，所以，急、慢性胆道感染时该药是较为理想的口服抗生素之一。     

环丙氟哌酸在犬胆汁、血中药代动力学的研究

为了有效治疗胆道感染的病人,提供合理选择抗生素的理论依据,我们检测了犬经口给予环丙氟哌酸后在胆汁及血中的药代动力学变化规律。结果表明犬经口给予0.25克环丙氟哌酸后,胆汁中浓度能较快上升,0.91h达峰值时间;峰值浓度为(Cmax)为11.8μg/ml,仅略低于血中的峰值浓度(14.36μg/ml);半衰期(T1/2β)较长为7.66h,是血中半衰期(T1/2β)3.31h的2倍;清除率(CL)是30ml/min;表观分布容积为19.88L。由于经口给予环丙氟哌酸后,药物在胆汁中含量较高,半衰期长,所以,急、慢性胆道感染时该药是较为理想的口服抗生素之一。     

老年心力衰竭病人地高辛药代动力学研究

目的研究老年心力衰竭（心衰）病人地高辛（ＤＧ）药代动力学变化规律及影响因素。方法用ＲＩＡ法测定ＤＧ血药浓度。用Ｂａｙｅｓｉａｎ一点法拟合ＤＧ个体药代动力学参数及给药方案。结果肌酐清除率（ＣＣｒ）５０．９±１６．４ｍｌ·ｍｉｎ－１／１．７３ｍ２，地高辛清除率（ＣＤＧ）６６．１±２３．４ｍｌ·ｋｇ－１／ｈ，分布容积（Ｖｄ）６．５１±０．９３Ｌ／ｋｇ，半衰期（Ｔ１／２）７７．９±２５．６ｈ，消除速度常数（Ｋ）０．００９９±０．００３３ｈ－１。年龄老化以及肾功能和心功能对地高辛药代动力学均有显著影响（Ｐ＜０．０５）。结论老年心衰病人的个体药代动力学参数波动范围大，个体差异更为突出，临床应在血药浓度监测的基础上实行最佳个体化给药。     

临床常用铜离子螯合剂药代动力学和不良反应研究进展

铜离子螯合剂能与铜离子发生螯合作用进而清除人体内过多的铜,临床常用于治疗威尔逊疾病。目前,国内对该类药物药代动力学的相关报道较少,且铜离子螯合剂在治疗过程中常出现不同类型、程度不一的不良反应。本文主要介绍这类药物的药代动力学和不良反应研究资料,为临床合理用药提供参考。     

索他洛尔的临床药代动力学

索他洛尔兼有Ⅱ类、Ⅲ类抗心律失常药物的特性，本文介绍了索他洛尔在体内的吸收、生物利用用度、分布、消除、药物的相互作用、血药浓度与效应的关系，在特殊人群的体内过程。     

二氢奎尼丁抗心律失常临床药代动力学研究

缓释剂长效盐酸二氢奎尼丁（赛利科）在欧美等国已广泛应用于抗心律失常治疗中,我国从１９８８年起应用于临床,但国人的药代动力学研究鲜为报道。为此我们对其进行了初步研究,现报道如下。２９例住院心律失常患者为受试者,其中频发室性早搏伴短阵室性心动过速９例,频...     

盐酸班布特罗片剂和口服液临床及药代动力学研究

盐酸班布特罗是新型长效β2受体激动剂,它是特布他林的前体药,其药理作用可持续24ｈ。本组报告该药临床应用多中心研究及药代动力学的测定结果。一、对象和方法1.对象:选择轻、中度支气管哮喘患者254例,男141例,女113例,年龄18～65岁,平均(37.28±11.32)岁。1秒钟用力呼气容积(ＦＥＶ1)占用力肺活量比值(ＦＥＶ1%)为50%～80%。吸入喘康速可逆试验ＦＥＶ1或最大呼气流量(ＰＥＦ)≥15%。心、肝、肾功能正常,无活动性肺结核和甲亢。入选前2周无明显呼吸道感染。2方法:本组对照试验采用计算机随机数字分组法,将患者随机分为3组,Ａ组:100例,分为…     

肟类药物在有机磷农药中毒病人中的药代动力学变化

肟类药物在有机磷农药中毒病人中的药代动力学变化李立君，赵德禄国外治疗急性有机磷农药中毒常用重活化剂有氯磷定（ＰＡＭ的氯盐）、Ｐ＿２Ｓ（ＰＡＭ的甲磺酸盐）、双复磷等肟类药物，动物实验发现，肟类药物在健康动物和有机磷化合物中毒动物体内的药代动力学有显著差...     

口服碘油在缺碘大鼠体内的药代动力学研究

本文采用药代动力学方法研究缺碘大鼠口服大、小剂量碘油制剂后的药物变化规律。以尿药排泄速率法计算出药代参数。结果表明药物排泄速率曲线符合二房室开放模型曲线;主要药代参数 t_(1/2)。为3.3～3.7天,t_(1/28)为55.9～72.2天;尿药排泄量占给药剂量的5.91～14.95%。该药药代动力学特点为口服吸收迅速、分布广泛、消除缓慢,肾外途径排泄较多。另外,两种不同厂家生产的碘油制剂在消除方面略有差异。     

慢性肾功能衰竭接受替代治疗病人并发结核病

为了解慢性肾功能衰竭治疗中并发结核情况，对我院近５年收治的９７８例慢性肾功能衰竭接受替代治疗的病人进行了分析，其中４０例并发结核病，发生率为４．１％，为一般人群的１０倍。结核病６８％发生于透析或肾移植术后１年之内。其中肺外结核占８２．５％，淋巴结核是最常见的表现类型。慢性肾功能衰竭并发结核病的诊断仍有一定困难，结核菌素皮试在这类病人的阳性率仅６．４％。检测血清抗结核菌纯蛋白衍生物抗体（ＰＰＤ－ＩｇＧ）是一个有价值的辅助诊断方法，本组活动性结核８５％（３４／４０）呈阳性反应。并发浆膜腔或泌尿系结核的病人，检测渗出液或尿的抗ＰＰＤ－ＩｇＧ，或以聚合酶链反应（ＰＣＲ）检测结核菌ＤＮＡ有助于诊断。     

EFFECTS OF NAPROXEN ON RENAL FUNCTION IN OLDER PATIENTS WITH MILD TO MODERATE RENAL DYSFUNCTION

We have evaluated 45 elderly patients with both musculoskeletalproblems and mild to moderate renal dysfunction. We treatedthese patients with a non-steroidal anti-inflammatory drug (NSAID)for 2 weeks. The serum creatinine, urinary creatinine clearanceand blood pressure were monitored before and after therapy.In some patients serum levels of throm boxane B₂ (TxB₂) andthe urinary prostaglandins E₂ (PGE₂) and I₂ (prostacyclin) measuredas 6-keto-PGF_I     

α-酮酸配伍低蛋白饮食对长期腹膜透析患者营养状况及残余肾功能影响的临床研究

目的前瞻性观察α-酮酸配伍低蛋白饮食对长期持续性不卧床腹膜透析（CAPD）患者营养状况及残余肾功能（RRF）的影响。方法随访CAPD患者78例共1年，随机分为α-酮酸配伍低蛋白饮食组（酮酸组，31例）、低蛋白组（26例）、常规蛋白组（21例）。检测营养指标包括：血清白蛋白（Alb）、前白蛋白（PA）、转铁蛋白（TRF）、视黄醇结合蛋白（RBP）、胆固醇（TC）、甘油三酯（TG）、血浆瘦素（Leptin）、肱三头肌处皮褶厚度（TSF），上臂肌围（MAMC）和体重指数（BMI）等．计算RRF、KT/V、肌酐清除率（Ccr）．并监测血清氨基酸谱变化。结果与低蛋白组相比，酮酸组、常规蛋白组的营养指标升高，尤以PA、RBP、TRF、Scr升高明显（P〈0．01）；而酮酸组与常规蛋白组相比，BMI、TSF、MAMC、Alb、TC及TG有升高趋势，但差别无统计学意义（P〉0．05）；酮酸组缬氨酸（Val）、亮氩酸（Leu）、异亮氨酸（lle）水平均高于低蛋白组及常规蛋白组（P〈0．01及〈0．05）；与常规蛋白组相比，酬酸组与低蛋白组KT/V、Ccr、尿莆均升高P〈0．05），而酮酸组与常规蛋白组的水钠潴留发生率无统计学意义（P〉0．05）。结论α-酮酸配伍低蛋白饮食有缓解尿毒症CAPD患者营养不良的作用，可有效保护RRF，并能显著提高血浆支链氨皋酸（BCAA）水平。     

慢性肾功能衰竭患者肾活检的临床意义

目的：对慢性肾功能衰竭（ＣＲＦ）患者肾活检的临床意义进行评价。方法：对２２２例临床诊断为ＣＲＦ,ＳＣｒ〉１７８μｍｏｌ／Ｌ（２ｍｇ／ｄｌ）的口才行肾活检术,分析其病理类型、标本合格率、穿刺成功率、并发症发生率及并发症的危险因素。根据肾穿后有无并发症,将患者分为并发症且和无并发症组两组,对并发症影响因素进行统计学分析。结果：肾活检后能明确诊断者占８９．１％,其中ＩｇＡ肾病、血管炎、慢性间质性肾炎、狼     

老年糖尿病患者的肾功能观察

目的调查老年糖尿病患者的肾功能情况。方法调查了195例糖尿病患者和18例健康人的肾小球滤过率。分8个组对肾功能进行多方面的对比研究:健康老年组、健康成年组,两个年龄层的糖尿患者各自按蛋白尿量分为正常白蛋白尿组、微量白蛋白尿组、临床白蛋白尿组,核素法99mTc-DTPA测定GFR,同时进行血生化检查。结果和成年组相比,相应的老年患者的GFR明显降低。另外,大多数老年患者同时患有多重可能影响肾功能的疾病,如高血压、动脉粥样硬化等。老年患者中伴有这些疾病的百分比明显高于成年组。(98.2%vs44.5%,P<0.01)。结论导致老年糖尿病患者肾功能损害的原因不仅限于糖尿病本身,而且还包括诸如年龄、高血压、动脉粥样硬化等多重因素。     

SELF-MEASURED SYSTOLIC BLOOD PRESSURE IN THE MORNING IS A STRONG INDICATOR OF DECLINE OF RENAL FUNCTION IN HYPERTENSIVE PATIENTS WITH NON-DIABETIC CHRONIC RENAL INSUFFICIENCY

While blood pressure is a recognized major determinant of renal function deterioration, the role of self blood pressure measurement (BPM) in predicting the loss of renal function in hypertensive patients with chronic renal insufficiency (CRI) has not been adequately addressed. One hundred and thirteen patients (F/M: 46/67; 56±1 years) with CRI (mean serum creatinine: 1.87±0.08; range: 1.4 to 3.5?mg/dl; average urinary protein excretion: 1.2±0.2?g/24?hrs.) were followed for 3 years. The record of renal biopsy revealed that 74 patients had IgA nephropathy, 16 had chronic glomerulonephritis, and 6 had membranous nephropathy, while 17, unbiopsied patients had underlying renal disease of unknown origin. Self BPM were made at regular intervals throughout the course of the study. All recorded blood pressures were included in a stepwise multiple regression analysis in which the decline in GFR per year was the dependent variable. Patients were primarily treated with a combination of amlodipine (5 to 20?mg daily), a calcium antagonist, and benazepril(2.5 to 5?mg daily), an ACE inhibitor in an effort to reduce their blood pressure at the office to <130/85?mmHg. The simple correlation between blood pressures (i.e., office, home morning and home evening) and the decline in GFR were all statistically significant. The correlation coefficients of determination for this model were as follows: r=0.64 for home morning SBP; 0.43 for office SBP; 0.39 for office DBP; and 0.38 for home morning DBP. The level of urinary protein excretion did not correlate with the decline in GFR. These data suggest that self BPM improves prognostic ability in hypertensive patients with CRI.     

肾脏病患者的骨代谢改变

目的：观察不同肾功能状态时慢性肾脏病患者的骨代谢状况。方法：采用酶联免疫法和放射免疫法检测６０名不同肾功能状态的慢性肾脏病患者和４５名正常人的骨吸收指标－－尿脱氧吡啶酚（ＤＰＤ）、尿钙／肌酐（Ｃａ／Ｃｒ）比值、因 段甲状旁腺素（Ｍ－ＰＴＨ）和骨形成指标－－血骨钙素（ＢＧＰ）、生磷酸酶（ＡＬＰ）。同时以双能Ｘ线吸收法（ＤＥＸＡ）检测腰椎（Ｌ２－４）、股骨颈、ＷＡＲＤＳ三角和股骨粗隆部位的骨密度。结果     

INSIDIOUS LOSS OF RENAL FUNCTION IN PATIENTS WITH ANTICARDIOLIPIN ANTIBODIES AND ABSENCE OF OVERT NEPHRITIS

Circulating anticardiolipin antibodies are associated with recurrentthrombosis, fetal loss and thrombocytopenia. We have identifiedfour patients with SLE or lupus-like disease who have high circulatinglevels of ACLA, repeated thrombosis and evidence of renal disease.Their clinical signs and symptoms of lupus activity were minimal,yet all had renal insufficiency with GFR 50 ml/min or less despiteno history nor evidence of overt nephritis (proteinuriat<0.5g/day and no haematuria). Renal biopsy specimens showed focalischaemic lesions with no evidence of active lupus nephritis.We describe a new lesion of renal ischaemia secondary to non-inflammatoryvascular pathology associated with circulating ACLA. KEY WORDS: Anticardiolipin antibody, Lupus nephritis, SLE, Renal dysfunction     

IS 1,25-DIHYDROXY-CHOLECALCIFEROL HARMFUL TO RENAL FUNCTION IN PATIENTS WITH CHRONIC RENAL FAILURE?

Seventeen undialysed adult patients with chronic renal failure took part in a controlled study of the effects of 1,25(OH)₂D₃ and D₃. After a 6-month observation period the patients were allocated at random to two groups for 6 months of treatment with either 1,25(OH)₂D₃ (mean dose 0·5 μg daily) or D₃ (dose 100 μg daily). Treatment was then discontinued and the patients were studied for a further 6 months. Serum iPTH was decreased in both groups but most markedly in the 1,25(OH)₂D₃ group in which the iPTH values became normal. Serum creatinine increased during treatment in both groups. In the group receiving 1,25(OH)₂D₃ this was coupled to an increase in serum calcium within the normal range. Our data demonstrate that 1,25(OH)₂D₃ treatment in patients with chronic renal failure leads to a further reduction in renal function, which may be partially reversible. Physicians should therefore be reluctant to give vitamin D analogues to patients with chronic renal failure unless they have severe symptomatic renal osteodystrophy.