Regional renal blood flow in hypertensive patients.

Renal blood flow measurements in three regions of each kidney were carried out in eighteen hypertensive patients using the radioactive Xenon-133 washout technique in conjunction with renal angiography. It was found that the regional differences were generally small but differences existed in four patients significant in spite of normal angiographic findings. The reduction in blood flow in the two kidneys was generally of the same degree which implies a uniform response to the elevated blood pressure.     

General, free and thrombocytic serotonin in the blood plasma of patients with hemorrhagic fever with renal syndrome

The study determined the content of free, total and thrombocytic serotonin in 26 patients suffering from hemorrhagic fever with renal syndrome (HFRS) varying in stage. Oligoanuria and polyuria periods of the disease were associated with a 5.5-fold increase in the level of free serotonin whereas the level of blood platelet serotonin reduced two-fold and more. The convalescence period was characterized by rapid recovery of free serotonin values, thrombocytic serotonin being still insufficient. Peak values of total serotonin were noted in the polyuric period.     

高血压合并慢性肾脏病患者的动态血压分析

目的 探讨原发性高血压合并慢性肾功能不全后动态血压的变化特点.方法 对28例单纯原发性高血压患者(A组)和25例合并慢性肾脏功能不全的高血压患者(B组)进行动态血压监测.结果 ①血压比较:24 h舒张压B组高于A组[(80.9±13.4)mm Hg比(70.3±15.6)mm Hg,P＜0.05)];B组夜间的收缩压与舒张压均高于A组[(160.2±17.8)mm Hg比(140.3±25.9)mm Hg和(82.6±16.1)姗Hg比(68.8±20.2)mm Hg,P＜0.01].②血压变异性比较:B组24 h收缩压变异性和舒张压变异性均高于A组[(13.5±3.9)mm Hg比(11.3±2.1)mm Hg和(9.2±1.2)mm Hg比(8.3±1.8)mm Hg,P＜0.05],B组夜间的收缩压与舒张压变异性均高于A组[(14.9±3.3)mm Hg比(9.3±2.1)mm Hg和(9.7±2.4)mm Hg比(8.0±2.2)mm Hg,P＜0.01)].③血压趋势比较:A组血压趋势以非勺型为多,占64.3%(18/28),反勺型占10.7%(3/28);而B组反勺型占48.0%(12/25),非勺型占40.0%(10/25).结论 肾性因素参与的高血压患者血压趋势紊乱,夜间血压及变异性明显增加,均可成为肾功能继续恶化和心脑血管事件发生的重要因素.     

A vasodepressor lipid resembling prostaglandin E2 (PGE2) in the renal venous blood of hypertensive patients

A method is described whereby (PG) prostaglandin-like compounds in blood may be measured by rat vasodepressor bioassay and tentatively identified by thin-layer chromatography and determination of absorption of ultraviolet light at 278 mmc by the compound formed during the treatment of the purified unknown with 2N KOH. Recovery rates are significantly improved by extracting homogenized whole blood rather than plasma, by performing the initial extraction in the cold, and by using L-ascorbic acid as a protective antioxidant. This method has been applied in the study of PGs in renal venous blood of 8 hypertensive patients. A vasodepressor lipid resembling PGE2 was found in blood from 1 renal vein in 5 of these in concentrations which ranged from 40-234 ng/milliliter. In each instance in which it was measurable, the vasodepressor lipid was found in the venous blood from the affected or more severely affected kidney as assessed by excretory urography, renal arteriography, isotope renography, renal venous renin-activity determination, and, in 4 instances, data from separated renal function studies. In 2 patients, the vasodepressor lipid was undetectable in blood from either renal vein. Both patients had previously had surgical repair of renal artery stenosis, and recent renal arteriography had shown both to have widely patent anastomases. In neither patient did renal venous renin-activity values lateralize. In another patient whose total investigation indicated severe bilateral renal dysfunction, the vasodepressor lipid was found in blood from both renal veins.     

Intrarenal hemodynamics and blood pressure in hypertensive patients with renal artery anomalies

AIM: To determine characteristics of a clinical course, 24-h profile of arterial pressure (AP), of renal hemodynamics, involvement of target organs in patients with arterial hypertension (AH) of the third degree and anomalies of renal arteries. MATERIAL AND METHODS: 24-h monitoring of AP, echocardiography, measurement of microalbuminuria, renal hemodynamic were made in 15 patients (9 female, 6 male) having resistant AH of the third degree and different anomalies of renal arteries (mean age 45.3 +/- 1.9 years). The control group consisted of patients with essential AH stage III (mean age 45.3 +/- 1.8 years). The groups were comparable by sex, age, duration of AH. RESULTS: The patients of the study group had a significantly lower pulsatility index in the renal artery and interlobular level and resistance index at the segmental and interlobular level of the RA on the side of the anomaly. There was a significantly higher minimal diastolic blood flow velocity in the segmental level of RA on the side of the anomaly. Renal scintigraphy revealed a decreased index of radiopharmaceutical accumulation. A positive correlation was found between the pulsatility index, resistance at a segment RA level and variability, an increase of morning diastolic blood pressure. The groups had significant differences neither by 24-h AP indices nor by severity of target organ lesion. CONCLUSION: Patients with RA anomalies have specific renal hemodynamics determining renal hypoperfusion on the side of the anomaly which may be involved in development of resistance to hypotensive therapy.     

Characteristics of lipid profile in blood plasma of patients with metabolic syndrome and manifest disorder of carbohydrate metabolism

AIM: To study specific features of lipid plasm profile in patients with metabolic syndrome (MS) and manifest disorder of carbohydrate metabolism (CM) as well as their relationships with clinical symptoms of MS. MATERIALS AND METHODS: Contents of lipids and apolipoproteins of plasm was measured on an empty stomach in 30 patients (18 females and 12 males) with MS and manifest disorder of CM (diabetes mellitus type 2 at the stage of good and satisfactory compensation of CM without terminal complications). RESULTS: The patients were found to have a subnormal level of HDLP cholesterol, high levels of total cholesterol, LDLP cholesterol and LP alpha. Hypertriglyceridemia occurred only in 31.4% patients (TG < 200 mg/dl). Mean TG level was 173.69 +/- 21.52 mg/dl. TG and diastolic arterial pressure, fasting glycemia and waist circumference significantly correlated. If the WC/TC was 1.0 and higher, the antiatherogenic plasm factor--HDLP cholesterol--significantly lowered. Positive correlation existed between TG and total cholesterol, LDLP cholesterol, apoB, LDLP cholesterol/HDLP cholesterol, apoB/apoA1, while negative correlation was seen between TG and HDLP cholesterol levels. Patients with hypertriglyceridemia had significantly higher levels of total cholesterol, LDLP cholesterol, apoB, apoB/apoA1. CONCLUSION: Plasm levels of TG most significantly reflect severity of basic clinical manifestations of MS: abdominal obesity, arterial hypertension, CM compensation. The presence of hypertriglyceridemia in MS patients can be considered as an indicator of high atherogenic potential of plasm.     

Analysis of lipid plasma spectrum and basic parameters of red cell membranes in patients with metabolic syndrome and ischemic heart disease

Specific features of lipid plasma spectrum and principal parameters of red cell membranes are characterized in patients with metabolic syndrome (MS) and chronic stable ischemic heart disease (IHD). 109 patients with metabolic syndrome (diabetes mellitus type 2, arterial hypertension, abdominal obesity and dyslipidemia) were divided into 2 groups: with and without IHD. MS patients with IHD had marked defects of lipid metabolism with hypercholesterolemia, high levels of triglycerides, LDLP cholesterol, low level of HDLP cholesterol. Lipid plasma spectrum in MS patients with IHD vs those without coronary atherosclerosis was characterized by a significantly lower level of apo A1. In red cell membranes these patients had lower fractions of esterified cholesterol combined with high intensity of lipid peroxidation.     

Redox status and lipid peroxidation in alcoholic hypertensive patients and alcoholic hypertensive patients with diabetes

Background: Free radical-mediated oxidative stress has been implicated in the progression of alcoholic hypertension and diabetic hypertension. Methods: The lipid peroxides and antioxidant status of plasma and erythrocytes were investigated in alcoholic hypertensive patients and alcoholic hypertensive patients with diabetes and compared with normal subjects. Results: A significant increase is observed in the levels of glucose, lipid peroxidation (P<0.05) in the alcoholic hypertensive patients with/without diabetes and the increase was significantly higher in alcoholic hypertensive patients with diabetes. The activities of erythrocyte antioxidant enzymes such as superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and reduced glutathione (GSH) and plasma concentrations of GSH, vitamin C, vitamin E and β-carotene decreased significantly and the level of ceruloplasmin increased in alcoholic hypertensive patients with/without diabetes when compared to normal subjects. Plasma GSH and vitamin E levels exhibited a further decrease in alcoholic hypertensive patients with diabetes. Conclusions: An enhanced lipid peroxidation is observed in alcoholic hypertensive patients with diabetes and a more pronounced decrease in the levels of plasma GSH and vitamin E among antioxidants.     

Oligopeptides in blood plasma of healthy humans and of patients with nephrotic syndrome

The isolation and separation of oligopeptides from blood plasma is the subject of this investigation. The method given is based on column chromatography on Sephadex G-25 and QAE-Sephadex A-25 gels and on DEAE-cellulose for cupric complexes.     

连续性血液净化对全身炎性反应综合征合并急性肾衰患者血浆炎性介质水平的影响

目的　应用连续静静脉血液滤过 (CVVH)技术 ,探讨其对全身炎性反应综合征 (SIRS)合并急性肾衰 (ARF)患者体内促炎与抗炎细胞因子水平的影响。方法　 16例SIRS合并ARF患者经右侧股静脉插管留置单针双腔导管 ,使用DiapactCRRT机行高容量连续静脉—静脉血液滤过 (HV -CVVH)模式治疗。治疗上除连续性血液净化 (CBP)外 ,主要包括原发病的处理和重要脏器或系统功能的支持或维护。于CVVH治疗前和治疗后 2、4、6h以及停止CVVH后 6h ,分别抽取静脉血检测血液电解质、肾功能和有关细胞因子 ,动脉血做血气分析 ,其中采用ELISA法测定有关细胞因子。结果　 16例患者CVVH后血清BUN、Scr、K+ 均逐渐地呈明显下降趋势 (P均 <0 0 5或 0 0 1) ,血浆TNF -α、IL - 1β、IL - 2、IL - 2R以及IL - 8水平均逐渐降低 ,血浆IL - 6、IL - 4、IL - 10水平在CBP治疗前后均无统计学差异 (P均 >0 0 5 )。结论　CBP能清除SIRS合并ARF患者血浆多种致炎细胞因子 ,并可改善血液生化指标。     

Basal and stimulated plasma antidiuretic activity of patients with hemorrhagic fever with renal syndrome

A basal value of antidiuretic activity (ADA) of the plasma was determined in 79 HFRS patients and stimulated activity using the insulin tolerance test in 24 persons. A decrease in the plasma ADA was observed in the acute period of disease. The insulin tolerance test did not cause a statistically significant increment of the plasma ADA in the HFRS patients.     

高血压患者血脂情况分析

目的观察血脂水平与高血压的关系。方法以男女各60例高血压患者为高血压组,以男女各60例血压正常者为对照组,检测血中总胆固醇（TC）、甘油三酯（TG）,高密度脂蛋白胆固醇（HDL）、低密度脂蛋白胆固醇（LDL）水平,进行组间比较。结果高血压组的TC、TG、LDL水平都明显高于对照组（P〈0．01）,HDL水平则低于对照组（P〈0．05）。结论相比血压正常者,高血压患者TC、TG、LDL水平增加,HDL水平降低。