慢性血透不同平均时间尿素浓度患者血清胰岛素含量变化的研究

慢性血透不同平均时间尿素浓度患者血清胰岛素含量变化的研究方如美李国璋吴伟玲蒋仁晶贺丽艳慢性肾功能衰竭（ＣＲＦ）患者常伴有内分泌代谢异常。我们对１９例慢性血液透析（ＣＨＤ）不同平均时间尿素浓度（ＴＡＧｕｒｅａ）患者进行了血清胰岛素（Ｉｎｓ）及血糖的测定...     

慢性肾功能衰竭患者血清甲状腺激素变化的研究

通过对３６例ＣＲＦ７非透析患者甲状腺激素的水平及８例血透患者血透前后甲状腺激素的变化进行观察，并以３０例正常成年人甲状腺激素作对比分析，发现ＣＲＦ患者Ｔ３、Ｔ４、ｒＴ３、ＦＴ４、ＦＴ４／ＦＴ８均明显低于正常组（Ｐ＜０．０１）；ＣＲＦ非透析患者Ｔ３、ｒＴ３、ＦＴ３、ＦＴ４、ＦＴ４／ＦＴ３和Ｓｃｒ呈负相关；血透患者血透前后甲状腺激素无明显变化，结合文献探讨了ＣＲＦ患者继发性甲状腺机能低下症的机理。     

三七总皂甙对慢性肾衰患者自由基及红细胞膜流动性的作用

三七总皂甙对慢性肾衰患者自由基及红细胞膜流动性的作用蔡广研徐学明动物实验及临床观察表明，应用抗氧化剂或抗氧化酶类对改善肾功能、延缓肾功能衰竭方面有积极意义。三七总皂甙（ｐａｎａｘｎｏｔｏｇｉｎｓｅｎｇｓａｐｏｎｉｎｓ，ＰＮＳ）是从我国中草药三七中提取...     

慢性肾衰患者肾移植手术前后ET和CGRP的变化

内皮素（ＥＴ）和降钙基因相关肽（ＣＧＲＰ）是近几年发现的血管活性多肽。我们采用放射免疫分析法（ＲＩＡ）观察了２０例慢性肾功能衰竭行肾移植手术前后ＥＴ和ＣＧＲＰ及血压变化。资料与方法测定对象慢性肾功能衰竭行同种异体肾移植术２０例,男１４例,女６例,年龄...     

促红细胞生成素对慢性肾衰非透析患者肾功能的影响

本文综述了促红细胞生成素（ＥＰＯ）在慢性肾衰非透析患者中如何应用才能不损害残余肾功能的实验室及临床研究 。     

慢性肾衰代谢性酸中毒对蛋白代谢的影响

近年研究表明代谢性酸中毒是ＣＲＦ蛋白质营养不良的重要原因之一。其机制可能与代谢性酸中毒增加血浆皮质醇水平、促进氨基酸代谢紊乱、增高血浆ＰＴＨ水平、降低血浆ＩＧＦ－１水平及细胞内酸中毒等因素促进蛋白质分解有关。胞浆ＡＴＰ－Ｕｂ系统在代谢性酸中毒促进蛋白质分解方面可能起着重要作用。     

同种肾组织移植治疗慢性肾功能衰竭性贫血的实验研究

以Ｗｉｓｔａｒ雄性大鼠为受体，建立慢性肾功能衰竭动物模型，将鼠婴肾组织声多点植入受体双侧后肢皮下和筋膜下。结果表明，３０天后移植物的体积由１ｍｍ＾３增至４ｍｍ＾３大小，表面血管网丰富；光镜下见肾小球、肾小管结构正常。促红细胞生成素（ＥＰＯ）着色颗粒主要分布在肾小球区，移植组着色程度明显增高。血红蛋白和４促红细胞生成素随移植的时间延长而逐渐升高，实验结果提示，此方法有可能为治疗慢性肾功能衰竭性贫血提     

生血肾灵对慢性肾衰竭大鼠肾小球硬化的影响

目的 :观察生血肾灵对慢性肾衰竭 (CRF)大鼠肾小球硬化和肾小球病理改变的影响。方法 :选用 2月龄Wistar雄性大鼠 ,分为正常对照组、模型对照组和治疗组。用 4/6肾大部切除术建立CRF模型。治疗组给予生血肾灵 ,连续 2个月。用免疫组化法测定肾小球内Ⅳ型胶原和纤维连接蛋白 (FN) ,根据染色程度做半定量分析。在光镜下根据肾小球的病理改变程度进行分级 ,做半定量分析。结果 :治疗组肾小球内Ⅳ型胶原和FN的沉积显著少于模型对照组 (P <0 .0 5 ) ,肾小球病理改变明显轻于模型对照组 (P <0 .0 1) ,血肌酐显著低于模型对照组 (P <0 .0 1)。结论 :生血肾灵能够抑制CRF大鼠肾小球内Ⅳ型胶原和FN的沉积 ,减缓肾小球的硬化和肾衰的发展     

Renal function in predialysis children with chronic renal failure treated with erythropoietin

To assess the effect of long-term administration of human recombinant erythropoietin (EPO) on renal function, 11 anemic children aged 1.4 – 17.2 years were followed for 10 – 61 (mean 31) months on treatment. During EPO therapy the mean hemoglobin rose from 8.1 to 11.1 g/dl at the last observation. The final maintenance dose ranged between 70 and 300 U/kg per week. The rate of deterioration of renal function was calculated by comparing the slope of the regression lines of reciprocal serum creatinine values (SCr) derived from a mean of 20 values per patient obtained over 8 – 50 (mean 29) months before and a mean of 24 SCR values during EPO therapy. The individual slopes improved after initiation of EPO therapy in all but 3 patients, but the mean change of slope (from –0.0521 to –0.0299) was not significant. The study suggests that in most children with predialysis chronic renal failure long-term administration of EPO is not associated with accelerated deterioration but rather with delayed deterioration of renal function. Received August 30, 1995; received in revised form November 16, 1995; accepted April 10, 1996     

慢性肾功能衰竭患者结核感染预防治疗的指征探讨

观察了８３０例慢性肾功能衰竭患者长期随访过程中结核感染的发生情况，以探讨这类患者预防性抗结核治疗的指征。由此提示，具有前三项中一项或一项以上因素的慢性肾衰患者应视为结核感染的高危人群而给予预防性抗结核治疗。     

维持性血液透析患者皮肤瘙痒情况的调查

目的 分析维持性血液透析患者皮肤瘙痒的部位、程度及治疗情况.方法 对我院血液净化中心63例维持性血液透析患者的皮肤瘙痒发生部位、以视觉模拟评分法评估瘙痒程度并调查其治疗情况.结果 63例维持性血液透析患者常见的瘙痒部位依次为背部、下肢、胸部、上肢、头颈部;轻度、中度、重度瘙痒分别为22例(34.9%)、25例(39.6%)、16例(25.4%);合并皮肤感染5例.63例患者中有40例患者接受血液灌流和(或)血液透析滤过治疗,经规律血液灌流和(或)血液透析滤过治疗后症状缓解.单纯行血液透析治疗的23例瘙痒患者中有14例去皮肤科就诊,经局部对症治疗效果不明显.结论 维持性血液透析患者皮肤瘙痒多为中、重度并可能发生皮肤感染.规律血液灌流和(或)血液透析滤过治疗能有效地缓解维持性血液透析患者皮肤瘙痒,而单纯局部对症治疗无效.     

Mortality trends in pediatric patients with chronic renal failure

Mortality trends were analyzed in 441 children and adolescents with chronic renal failure (CRF) observed over a 24-year period before and after institution of renal replacement therapy (RRT). A total of 93 patients died. Overall mortality rate (MR) per 100 patient years decreased from 6.6 in 1969–1978 to 2.5 in 1979–1988 and increased slightly to 2.9 in 1989–1992. The fall involved all four modes of treatment: conservative hemodialysis (HD), continuous peritoneal dialysis (CPD), and transplantation (TX). From 1979–1988 to 1989–1992 MR on conservative and on dialysis treatment changed only slightly and was similar on HD and CPD. An alarming rise in MR was noted after TX in 1989–1992, mainly due to malignant tumors. In 44 patients who died on conservative treatment, the reasons for non-acceptance for RRT were analyzed: in 22 multi-morbidity was the main reason, usually because of a congenital neurological disorder. Some patients died from advanced uremia or unexpected events after the decision to institute RRT. Our experience demonstrates a persistent mortality in pediatric patients with CRF, which in recent years is primarily ascribed to congenital multi-morbid conditions which make RRT unfeasible, infections on dialysis treatment, and malignancies after TX.     

腹腔镜引导下腹膜透析管置放术

目的　探讨腹腔镜引导下放置腹膜透析管的方法。　方法　选择 9例慢性肾功能衰竭患者 ,在腹腔镜引导将Tenckhoff腹膜透析管置入腹腔并经皮下隧道引出。　结果　所有病例腹膜透析管均放置成功。手术时间 10min～ 2 0min。均成功的进行了腹膜透析。患者术后 2～ 7天出院。　结论　腹腔镜引导放置腹膜透析管技术具有透析管定位准确 ,手术切口小 ,术后疼痛轻。优于常规开腹技术     

慢性肾功能衰竭患者血清粒系集落刺激因子水平观察

为了解血清粒系集落刺激因子（Ｇ－ＣＳＦ）的代谢途径，用自行建立ＥＬＩＳＡ法检测了６１例慢性肾功能衰竭（ＣＲＦ）患者及６０例健康对照者Ｇ－ＣＳＦ水平。结果表明８６．９ＣＲＦ患者血清Ｇ－ＣＳＦ水平明显升高，其原因可能是由于Ｇ－ＣＳＦ的排泄障碍，在体内堆积之敌。     

The effects of chronic renal failure on siblings

It is well recognised that chronic illness in children can have a significant effect upon siblings, but their viewpoints need to be sought if we are to change our practice. We conducted semi-structured interviews at home with 15 siblings (8 males) aged 8–12 years whose brother/sister were on chronic dialysis or had received or were waiting for a renal transplant. The interviews were analysed using a grounded theory approach. The children also completed the Spence Childrens Anxiety Scale (SCAS), which revealed no statistically significant evidence that they were exhibiting chronic clinical anxiety. Qualitative data indicated that siblings had a variety of concerns concerning their own health and that of their siblings and worried about the effects on family routine and separation from parents. The siblings felt more protective towards their chronically ill sibling and felt that they themselves needed to be more grown up. The study has implications for our clinical practice in that our psychosocial assessment of families needs to include an assessment of sibling needs and siblings should be involved when preparing patients for chronic renal failure treatment. The importance of maintaining family routines should be emphasised, as well as trying to involve siblings in unit activities.     

Children with chronic renal failure in Sweden 1978–1985

A survey of chronic renal failure (CRF) in Swedish children was carried out for the period 1978–1985, using age-related cut-off levels for creatinine concentrations corresponding approximately to a glomerular filtration rate of 30 ml/min per 1.73 m². The mean annual incidence of CRF was 6.9 and of terminal renal failure (TRF) 4.4/million children. The prevalence increased during the study period, for preterminal renal failure from 14.1 (1978) to 26.1 (1985) and for TRF from 12.4 to 16/million children. The main groups of primary renal disease were malformations (42%), hereditary disorders (27%), and glomerular diseases (14%), while pyelonephritis with vesico-ureteral reflux only made up 5%.