肾综合征出血热病毒结构蛋白致病作用的研究

为阐明肾综合征出血热（ＨＦＲＳ）发病机制，用免疫组化法检查了３０例患者ＨＦＲＳ病毒的膜蛋白（ＭＰ）、核蛋白（ＮＰ）在外周血单个核细胞（ＰＢＭＣ）中的表达情况，同时用放免等技术检测了血浆内皮素（ＥＴ）、Ｐ物质（ＳＰ）和肾功能相关指标。发现ＨＦＲＳ患者从４～５病日起至１３病日，ＰＢＭＣ中均有ＭＰ和ＮＰ表达，但随着病情的好转，其表达强度逐渐减弱。经染色鉴定ＭＰ与ＮＰ阳性细胞主要是单核细胞。入院时ＰＢＭＣ中ＭＰ和ＮＰ表达强度并不相同，ＭＰ的表达强度与血浆ＥＴ／ＳＰ比值、病情及肾脏损伤轻重呈平行关系。提示ＨＦＲＳ病毒能侵犯ＰＢＭＣ并在其中复制，表达病毒结构蛋白，而ＭＰ与ＨＦＲＳ病毒的致病作用相关；病程中血浆ＥＴ／ＳＰ比值升高是使肾损加重的重要因素。     

老年非杓型高血压病患者内皮素和降钙素基因相关肽含量变化及氨氯地平对其影响

目的探讨老年非杓型高血压病（ＥＨ）患者内皮素（ＥＴ）和降钙素基因相关肽（ＣＧＲＰ）含量变化及氨氯地平对其影响。方法观察氨氯地平治疗老年非杓型ＥＨ患者疗效及其治疗前后ＥＴ和ＣＧＲＰ含量变化。结果老年非杓型ＥＨ患者血浆ＥＴ水平明显高于老年杓型ＥＨ患者,而ＣＧＲＰ则明显降低;氨氯地平使老年非杓型ＥＨ患者白昼及夜间血压下降,治疗后老年非杓型ＥＨ患者血浆ＥＴ水平降低,而ＣＧＲＰ明显升高。结论ＥＴ及ＣＧＲＰ参与了老年非杓型ＥＨ的病理过程,氨氯地平是一种治疗老年非杓型ＥＨ患者有效药物,能纠正老年非杓型ＥＨ患者ＥＴ与ＣＧＲＰ之间的失衡。     

老年非杓型高血压病患者内皮素和降钙素基因相关肽含量变化及 …

目的 探讨老年非杓型高血压病（ＥＨ）患者内皮素（ＥＴ）和降钙素基因相关肽（ＣＧＲＰ）含量变化及氨氯地平对其影响。方法 观察氨氯地平治疗老年非杓型ＥＨ患者疗效及其治疗前后ＥＴ和ＣＧＲＰ含量变化。结果 老年非杓型ＥＨ患者血浆ＥＴ水平明显高于老年杓型ＥＨ患者,而ＣＧＲＰ则明显降低;氨氯地平使老年非杓型ＥＨ患者白昼及夜间血压下降,治疗后老年非杓型ＥＨ患者血浆ＥＴ水平降低,而ＣＧＲＰ明显升高。结论 ＥＴ及Ｃ     

高血压患者硝苯地平治疗前后血浆内皮素和降钙素基因相关肽的变化

目的观察硝苯地平降压治疗对血浆内皮素（ＥＴ）和降钙素基因相关肽（ＣＧＲＰ）水平的影响。方法３１例原发性高血压（ＥＨ）患者口服硝苯地平控释片４０ｍｇ／ｄ×１４，用放免法直接测定治疗前后的血浆ＥＴ和ＣＧＲＰ水平。结果ＥＨ患者血浆ＥＴ水平明显高于对照组（８５．６±２１．０ｖｓ４２．１±２０．３ｐｇ／ｍｌ，Ｐ＜０．００１）；ＣＧＲＰ水平明显低于对照组（２３．０±８．１ｖｓ５５．４±１７．８ｐｇ／ｍｌ，Ｐ＜０．００１）。舒张压与ＥＴ水平呈正相关（ｒ＝０．５３０２，Ｐ＜０．００５），ＥＴ与ＣＧＲＰ呈弱的负相关（ｒ＝０．３７０７，Ｐ＜０．００５）。治疗后，血压和ＥＴ水平明显下降（Ｐ均＜０．００１），ＣＧＲＰ水平显著增高（Ｐ＜０．００１）。结论硝苯地平是一种有效的降压药，它可通过调节ＥＨ时多种血管活性多肽之间的平衡关系，对器官保护具有重要作用     

超声测量肺循环阻力和体循环阻力比值

探讨超声测量肺循环阻力和体循环阻力比值（ＰＶＲ／ＳＶＲ）的方法。超声测量４３例先天性心脏病患儿左、右室射血前期（ＬＰＥＰ,ＲＰＥＰ）、射血期（ＬＥＴ,ＲＥＴ）和加速期（ＬＡＴ,ＲＡＴ）,同时测量主、肺动脉血流量（Ｑｓ,Ｑｐ）。进而计算ＲＰＥＰ：Ｑｐ、ＲＰＥＰ：ＥＴ：Ｑｐ、ＲＰＥＰ：ＡＴ：Ｑｐ、ＲＰＥＰ：Ｑｐ／ＬＰＥＰ：Ｑｓ、ＲＰＥＰ：ＥＴ：Ｑｐ／ＬＰＥＰ：ＥＴ：Ｑｓ和ＲＰＥＰ：ＡＴ：Ｑｐ／ＬＰＥＰ：ＡＴ：Ｑｓ。结果：超声测量ＲＰＥＰ：Ｑｐ、ＲＰＥＰ：ＥＴ：Ｑｐ和ＲＰＥＰ：ＡＴ：Ｑｐ与心导管测量的ＰＶＲ／ｍ２比较,ｒ分别为０．６６、０．６５和０．７５。超声测量ＲＰＥＰ：Ｑｐ／ＬＰＥＰ：Ｑｓ、ＲＰＥＰ：ＥＴ：Ｑｐ／ＬＰＥＰ：ＥＴ：Ｑｓ和ＰＲＥＰ：ＡＴ：Ｑｐ／ＬＰＥＰ：ＡＴ：Ｑｓ与心导管测量ＰＶＲ／ＳＶＲ比较,ｒ分别为０．７８、０．７８和０．８９。其中ＲＰＥＰ：ＡＴ：Ｑｐ／ＬＰＥＰ：ＡＴ：Ｑｓ与ＰＶＲ／ＳＶＲ相关最好。超声测量ＲＰＥＰ：ＡＴ：Ｑｐ／ＬＰＥＰ：ＡＴ：Ｑｓ能较准确地估测ＰＶＲ／ＳＶＲ。     

rIFN－a对胃癌细胞表皮生长因子受体表达的调节

用中性红吸收分析法和放射配体结合法分析基因重组干扰素－α（ｒＩＦＮ－α）对胃癌细胞（ＳＧＣ７９０１、ＫＡＴＯⅢ）增殖及其表皮生长因子受体（ＥＧＦ－Ｒ）表达的影响。结果显示ｒＩＦＮ－α可明显抑制ＳＧＣ７９０１细胞增殖，与作用时间、剂量相关，而对ＫＡＴＯⅢ增殖无明显抑制作用。采用氯胺Ｔ法自行标记表皮生长因子（ＥＧＦ），配体结合实验Ｓｃａｔｃｈａｒｄ分析结果ＳＧＣ７９０１、ＫＡＴＯⅢ均高表达单一亲和性的ＥＧＦ－Ｒ。ｒＩＦＮ－α降低ＳＧＣ７９０１细胞ＥＧＦ－Ｒ数量，与作用时间、剂量相关，ＥＧＦ－Ｒ亲和性无变化，而对ＫＡＴＯⅢ细胞ＥＧＦ－Ｒ的数量及亲和性均无明显影响。结果提示ｒＩＦＮ－α抑制胃癌细胞生长可能和其下调细胞ＥＧＦ－Ｒ相关。     

NIDDM患者心血管自主神经病变与红细胞山梨醇含量相关性及…

用Ｅｗｉｎｇ法和定量ＨＲＰＳ法同时测定９４级ＮＩＤＤＭ患者心血管自主神经病变（ＣＡＮＤ）程度，探讨其与红细胞山梨醇（ＲＢＣＳ）含量的关系。结果表明ＤＭ患者伴ＣＡＮＤ组的ＲＢＣＳ值显著高于无ＣＡＮＤ组，ＲＢＣＳ升高与ＣＡＮＤ严重程度，植物神经的改变，尤以副交感神经更易受影响，且与年龄、病程、ＦＢＧ、ＨｂＡ１Ｃ、血浆Ｆｇ、ＨＤＬ－Ｃ及亚类和血浆镁改变也显著相关；多元逐步回归分析显示ＲＢＣＳ是对ＣＡＮＤ     

慢性高原心脏病患者血浆心钠素和肾素系统的变化及其作用

对１９例代偿期慢性高原心脏病（ＨＡＣＣ）患者、２９例长期移居高原健康成人（对照组）用放免法测定了血浆肾素活性（ＰＲＡ）、血管紧张素Ⅱ（ＡＴⅡ）、醛固酮（ＡＬＤ）和心钠素（ＡＮＦ）含量，发现ＨＡＣＣ患者肾素系统（ＲＡＳ）被激活，ＰＲＡ、ＡＴⅡ和ＡＮＦ含量均明显增高（Ｐ＜０．０５～０．０１），提示ＲＡＳ活性增强在ＨＡＣＣ的形成和发展中起重要作用，ＡＮＦ浓度增高则对其损害起缓解作用。     

不同病型,病期HFRS患者特异性抗体水平测定及其临床意义

用捕获ＥＬＩＳＡ方法检测了６０例（１２０份）肾综合征出血热患者（ＨＦＲＳ）血清特异性ＩｇＡ、Ｉｇ－Ｅ、ＩｇＭ、ＩｇＧ抗体。发现４种抗体几何平均滴度均随病期进展逐渐升高，且早期（发热及休克少尿期）与后期（多尿恢复期）间有差异性。ＨＦＲＳ－ＩｇＭ、ＩｇＥ、ＩｇＧ抗体水平的差异在早期（特别是发热期）尤为显著（Ｐ＜０．０５）。结果显示，ＨＦＲＳ－ＩｇＭ确属早期较可靠诊断指标；ＨＦＲＳ－ＩｇＧ、ＩｇＥ抗体水平与病情严重度相关。ＨＦＲＳ－ＩｇＡ抗体可能是一种保护性抗体。     

病毒胸苷激酶基因治疗人胃癌的实验研究

为观察单纯疱疹病毒脱氧胸苷激酶（ＨＳＶ－ＴＫ）／丙氧鸟苷（ＧＣＶ）基因治疗系统对胃癌细胞的杀伤作用，将ＨＳＶ－ＴＫｃＤＮＡ定向克隆入逆转录病毒载体ｐＤＯＲ－ｎｅｏ中，用ＬＩＰＯＦＥＣＴＡＭＩＮＥ法将该ＨＳＶ－ＴＫ基因转染胃癌细胞系ＳＧＣ－７９０１，测定阳性转染细胞（ＳＧＣ－７９０１／ＴＫ）在体内外对ＧＣＶ的敏感性。结果示ＧＣＶ在体外对ＳＧＣ－７９０１／ＴＫ细胞有明显的杀伤作用，其作用呈现剂量和时间依赖性特点，且同时表现出对周围亲代ＳＧＣ－７９０１细胞的杀伤效应（旁观者效应）。体内实验表明ＧＣＶ可抑制ＨＳＶ－ＴＫ阳性胃癌细胞的生长，使已形成的肿瘤逐渐消失。提示逆转录病毒载体介导的ＨＳＶ－ＴＫ基因转移胃癌细胞，配合以ＧＣＶ治疗，是胃癌基因治疗的又一途径。     

降钙素基因相关肽和内皮素在充血性心力衰竭中的作用

采用同位素放射免疫法同时检测30例充血性心力衰竭（CHF）患者的血浆降钙素基因相关肽（CGRP）和内皮素（ET）浓度，求出ET／CGRP比值，并与30例健康人对照，结果显示CHF患者血浆CGRP和ET浓度以及ET／CGRP比值较对照组明显增高（P＜0．05和P＜0．01）。提示在CHF时血浆CGRP和ET浓度均增高，且失去ET和CGRP的正常平衡，这对CHF的防治可能具有重要意义。     

老年高血压病合并急性脑梗塞时血浆降钙素基因相关肽和内皮素的变化

目的　探讨老年高血压病 (EH)合并急性脑梗死 (ACI)患者血浆降钙素基因相关肽(CGRP)和内皮素 (ET)的变化。方法　用放射免疫学方法测定 6 0例老年EH +ACI患者血浆CGRP和ET浓度 ,求出ET/CGRP比值 ,并与 31例正常老年人对照。结果　EH +ACI患者血浆ET浓度以及ET/CGRP比值较对照组明显增高(P <0 0 5 ) ;而CGRP浓度较对照组明显降低(P <0 0 5 )。结论　老年高血压病合并急性脑梗死时血浆CGRP浓度明显降低 ,而ET明显升高 ,且失去了CGRP和ET的正常平衡 ,这对高血压病合并急性脑梗死的防治可能具有重要意义     

肝硬化患者血浆降钙素基因相关肽及内皮素-1水平的变化

目的 探讨肝硬化患者血浆降钙素基因相关肽（ＣＧＲＰ）及内皮素－１（ＥＴ－１）水平的变化,了解此二者之间及它们与肝硬化门脉高压形成及局长和肝功能损伤的关系。方法 用放免法检测２４例正常人和６１例肝硬化患者血浆ＣＧＲＰ和ＥＴ－１水平。结果 肝硬化组血浆ＣＧＲＰ及ＥＴ－１水平显著高于对照组,且在肝功能分级中,呈现ＣｈｉｌｄＣ〉Ｃｈｉｌｄ Ｂ〉ＣｈｉｌｄＡ的规律。组间分析表明肝硬化患者食管静脉曲张伴大中量     

内皮素、降钙素基因相关肽在肾性高血压大鼠的动态变化

目的观察2、4、6周肾性高血压(RH)大鼠血浆及主动脉组织中内皮素(endothelin,ET)及降钙素基因相关肽(calcitoningene-relatedpeptide,CGRP)的动态变化,探讨其在RH发病中的作用。方法用颈动脉直接插管法测定大鼠血压的变化。用放射免疫测定技术测定ET、CGRP水平。结果RH组大鼠术后2周血压即已升高,4、6周时显著升高。各时期RH组大鼠血浆中CGRP含量明显低于同期对照组,而主动脉组织中CGRP含量显著高于同期对照组;血浆及主动脉组织中ET含量均显著高于同期对照组。结论RH时,血管内皮细胞功能紊乱,缩血管物质ET生成异常增多;组织中CGRP的释放减少和循环血中其含量不足均与RH发病有关。     

慢性肺心病降钙素基因相关肽内皮素心钠素的表达及其临床意义

目的 :探讨降钙素基因相关肽 (CGRP)内皮素 (ET)心钠素 (ANP)在慢性阻塞性肺疾病肺心病病理生理过程所起的作用、临床意义及其相互关系。方法 :应用放射免疫方法测定单纯慢性支气管炎(A组 ) 2 1例 ,慢性支气管炎并阻塞性肺气肿 (B组 ) 2 7例 ,慢性支气管炎、阻塞性肺气肿并肺心病 (PHD)(C组 ) 3 2例及健康对照组 (D组 ) 2 4例CGRP、ET及ANP水平 ,同步测定动脉血气及第一秒用力呼气容积占预计值的百分比数 (FEV1 %P)。结果 :1 各指标变化 ( 1)CGRPB、C组急性期、稳定期均低于对照组 ,且急性期均低于稳定期 ;C组各期相应的低于B组 ,A组急性期、稳定期与对照组无明显差异 ;( 2 )ETA组急性期及B、C组急性期、稳定期均高于对照组 ,各自组急性期均高于稳定期 ,除A组稳定期降至正常外 ,B、C组稳定期均高于对照组 ,且C组各期相应的高于B组 ;( 3 )ANPB组急性期及C组急性期、稳定期均高于对照组 ,C组急性期明显高于B组急性期 ,B、C组急性期明显高于各自稳定期。 2 直线相关分析结果 :CGRP与PaO2 呈非常显著正相关 (P <0 0 1) ,与PaCO2 、ANP呈显著负相关 (P <0 0 5 ) ,与ET呈非常显著负相关 (P <0 0 1) ;ET与ANP非常显著正相关 (P <0 0 1) ,与PaCO2 正相关 (P <0 0 5 ) ,与PaO2 、FEV1 %P非常显著负相关 (P     

Effects of prolonged infusion of human alpha calcitonin gene-related peptide on hemodynamics, renal blood flow and hormone levels in congestive heart failure

We have previously demonstrated that short-term infusion of calcitonin gene-related peptide (CGRP) has beneficial effects in congestive heart failure. The effects of prolonged infusion of CGRP on hemodynamic functions, plasma hormones and renal blood flow were studied in 9 patients with congestive heart failure (New York Heart Association class III or IV, ejection fraction less than 35%). Hemodynamic variables were measured at 30-minute intervals for 8 hours during CGRP infusion (8 ng/kg/min) and for 2 hours after discontinuation. CGRP caused a decrease in right atrial (28%, p less than 0.05), pulmonary artery (22%, p less than 0.02), pulmonary artery wedge (37%, p less than 0.001) and systemic arterial (18%, p less than 0.05) pressures. Systemic vascular resistance decreased more than pulmonary vascular resistance. Cardiac output (72%, p less than 0.001) and stroke volume (60%, p less than 0.02) increased. Heart rate did not change. There was no evidence of tolerance throughout the infusion. The hemodynamic effects were lost within 30 minutes of stopping CGRP. Renal blood flow (34%, p less than 0.01) and glomerular filtration rate (43%, p less than 0.01) increased. Atrial natriuretic peptide decreased (p less than 0.05), while plasma cortisol (p less than 0.02) increased. Plasma epinephrine, norepinephrine, renin activity, aldosterone and growth hormone were unchanged. It is concluded that in patients with severe congestive heart failure, CGRP has sustained beneficial effects on hemodynamic functions and has no adverse effects on hormones. Unlike many other vasodilators, CGRP also increases renal blood flow and glomerular filtration.     

Octreotide in liver cirrhosis: a salvage for variceal bleeding can be a gunshot for kidneys.

BACKGROUND: The renal effects of octreotide, used for bleeding esophageal varices in cirrhosis, are controversial. METHODS: Fourteen cirrhotic patients (Child-Pugh; A/B/C: 1/12/1) were enrolled. Plasma nitrite and endothelin (ET) levels, urinary nitrite output, free water clearance (FWC) and fractional excretion of filtered sodium (FENa) were measured and renal Doppler ultrasound was carried out. Octreotide was infused at a rate of 0.75 microg/kg/h for 3 h after a bolus of 0.75 microg/kg body weight. All the parameters were reevaluated during octreotide administration while the patients acted as their own controls. RESULTS: Octreotide induced significant reductions in urinary nitrite, FENa and FWC. Plasma ET levels increased (baseline: 6.7 pg/ml, octreotide: 8.4 pg/ml), whereas the plasma nitrite level did not change significantly after octreotide infusion. Overall, no significant change in renal resistive index (RRI) could be demonstrated on Doppler after octreotide administration. However, patients with elevated baseline RRI values had significantly more deterioration in FWC and FENa compared with patients with normal RRI in response to octreotide. CONCLUSION: A marked decrease in FENa, FWC and urinary nitrite output, together with a significant increase in plasma ET level in response to octreotide, may indicate renal dysfunction in cirrhotic patients. This deleterious renal effect of octreotide may be more enhanced in patients with elevated baseline RRI.     

血浆降钙素基因相关肽和内皮素改变在不稳定性心绞痛中的意义

应用放射免疫法测定40例不稳定性心绞痛(UA),25例稳定性心绞痛(SA)和26例正常人血浆降钙素基因相关肽(CGRP)及内皮素(ET)浓度,结果:UA患者心绞痛发作时CGRP、ET均明显高于SA发作时及正常对照组,但CGRP/ET比值显著降低,且恶化型>初发型>自发型,UA缓解时升高的CGRP、ET均显著下降,提示CGRP、ET变化对UA的发生具有重要的影响,并与其病变程度相关.     

Renal effects of atrial natriuretic peptide during dopamine infusion

To study whether the renal effects of atrial natriuretic peptide (ANP) are different from those of dopamine, we compared the effects of dopamine and dopamine plus ANP on renal circulation. Dopamine was infused at 1 microgram/kg/min for 120 min into 7 patients with essential hypertension (EH) and 5 normotensive subjects (NT). After 40 min of dopamine infusion, ANP infusion at 25 ng/kg/min was added to dopamine for 40 min. Before, during and after the infusion, renal function and nephrogenous cGMP were determined. Dopamine did not influence blood pressure, but increased urinary Na excretion (UNaV) by 100% in EH and NT. Addition of ANP further increased UNaV by 90%, but increases in UNaV were greater in EH than in NT. Renal blood flow was increased only by dopamine, while glomerular filtration rate (GFR) was increased by both dopamine (+8%) and dopamine plus ANP (+7%) as a whole, resulting in a significant increase in filtration fraction by the addition of ANP. Plasma and urinary cGMP and nephrogenous cGMP were elevated only during ANP infusion. These results suggest that the effects of ANP and dopamine on both GFR and UNaV were additive. However, in contrast with dopamine, ANP increased efferent resistance and nephrogenous cGMP, suggesting that the renal effects of ANP are different from those of dopamine.     

系统性红斑狼疮活动期血浆降钙素基因相关肽及内皮素-1含量变化

目的：为了探讨肽－降钙素基因相关肽和内上素－１在ＳＬＥ活动期中的作用。方法；采用放射免疫分析法测定了３４例系统性红斑狼疮病人和２０例健康人血浆ＥＴ－１，ＣＧＲＰ水平。结果；有抗ｄｓ－ＤＮＡ抗体升高和补体Ｃ３，Ｃ４下降的ＳＬＥ组，ＥＴ－１水平升高，ＣＧＲＰ水平降低。『