慢性肾小球肾炎病人白细胞糖皮质激素受体的变化

以氚标记的地塞米松(~3H-Dex)为配体,用一点分析法测定了23例慢性肾小球肾炎病人混合白细胞的糖皮质激素受体(GCR),平均为8825±2429位点/细胞((?)±SD)。与正常人5154±1635位点/细胞相比相差十分显著,P<0.01。其中16例并发尿毒症患者的GCR平均为9464±2571位点/细胞((?)±SD)。对这种变化的可能机制和临床意义进行了讨论。     

儿童急性肾小球肾炎的甲襞微循环变化

急 性肾小球肾炎是儿童常见病、多发病之一。人们对其高血压、水肿、尿少等症状较为重视 ,但对其微循环障碍研究较少。作者因之进行了甲襞微循环指标的动态观察和探讨并与正常儿童对照。1　资料与方法1.1　资料选用 1997年 1月～ 1999年 12月在我科确诊为急性肾小球肾炎的 42例住院患儿为观察样本 ,均符合 1981年肾病协作组“关于小儿肾小球疾病临床分类和治疗的建议”[1] 的诊断标准。其中男 2 4例、女 18例 ,年龄 4.5～ 13岁 ,平均年龄 8.2岁。入院时患儿均表现不同程度浮肿、高血压、血尿和蛋白尿 ,严重者出现抽搐及肾功能不全。血沉增快…     

急性肾小球肾炎尿IgG测定的临床研究

目的：探讨小儿急性肾小球肾炎（AGN）尿IgG测定的临床意义。方法：用免疫比浊法测定32例AGN患儿急性期和恢复期的尿IgG，比较两者尿IgG的阳性率。同时应用LOGISTIC多元回归分析急性期尿IgG与血尿、浮肿、高血压、BUN和年龄的相关关系。结果：急性期尿IgG阳性率为78％，比恢复期31％明显增高，χ^2=14.19,p＜0．005，急性期尿IgG与血尿、浮肿、高血压、BUN和年龄无相关关系。结论：AGN患儿尿IgG阳性反映肾小球滤过膜通透性明显增加，可考虑作为活动的指标之一，但与病情的轻重程度无关。     

肾小球肾炎与自身免疫

近年对有关肾小球肾炎相关自身抗原和相应的自身抗体方面有新的了解，尽管其病理作用尚未十分明确，但已部分证明可作为某些类型肾小球肾炎诊断、分型及病变活动程度或判断预后的参考。     

细胞因子与肾小球肾炎

肾小球细胞能产生许多细胞因子,随着分子生物学及细胞生物学技术的广泛应用,已发现这些细胞因子生成失控参与了肾小球疾病的发生、发展,引起肾小球结构和功能的损害。本文评述了几种主要细胞因子的生物学特性,并阐明其与肾小球肾炎的关系。     

急性肾小球肾炎护理分析

目的 探讨急性肾小球肾炎的临床护理方法以及临床效果.方法 对我科2007年3月至2010年7月所收治的73例急性肾小球肾炎患者的临床资料进行回顾性的分析总结.结果 73例患者在经过临床有效的治疗以及护理之后,有64例患者得到了痊愈出院,有8例患者以好转出院,1例患者出现了病情的反复性发作,经过临床合理有效的对症治疗,病情得到了有效的控制.患者的家属满意率较高.结论 临床及时正确的治疗以及合理的护理措施对于提高急性肾小球肾炎患者的临床治疗效果,降低疾病的复发率,最大限度的减少临床并发症的发生率以及提高患者的预后都有着十分重要的临床意义.     

急性肾小球肾炎不同病中TNF和sTNFR的变化

大量文献[1] 已经证明ＴＮＦ α在肾脏疾病中是一种重要的炎性因子 ,而ｓＴＮＦＲ通过竟争性结合ＴＮＦ可阻断ＴＮＦ与膜受体的结合 ,从而限制其生物学活性 ,对疾病的良性转归具有一定意义 ,本文探讨了儿童急性肾小球肾炎 (ＡＧＮ )中ＴＮＦ α及ｓＴＮＦＲ水平的变化。1　对象和方法1 1　临床观察对象　临床确诊的ＡＧＮ患儿 2 6例 ,急性发作期均在住院 2ｄ内静脉取血 ,恢复期 15例 ,于出院前取血 ,分离血清冻存待测。正常对照组 2 0例 ,年龄、性别与患者有可比性。1 2　测定方法　ＴＮＦ α采用ＲＩＡ法 ,单位ｎｇ/Ｌ ,试剂盒为北京北方所…     

急性肾小球肾炎尿IgG测定的临床研究

目的探讨小儿急性肾小球肾炎(AGN)尿IgG测定的临床意义. 方法用免疫比浊法测定 32例 AGN患儿急性期和恢复期的尿IgG,比较两者尿IgG的阳性率.同时应用LOGISTIC多元回归分析急性期尿IgG与血尿、浮肿、高血压、BUN和年龄的相关关系. 结果急性期尿IgG阳性率为78%,比恢复期31%明显增高,χ2=14.19,p<0.005,急性期尿IgG与血尿、浮肿、高血压、BUN和年龄无相关关系. 结论 AGN患儿尿IgG阳性反映肾小球滤过膜通透性明显增加,可考虑作为活动的指标之一,但与病情的轻重程度无关.     

粘附分子与肾小球肾炎

粘附分子是一类介导细胞与细胞、细胞与基质相互作用的糖蛋白分子，在各种实验性肾炎模型，ＩＣＡＭ－１和ＶＣＡＭ－１表达增强，应用抗ＩＣＡＭ－１和ＶＣＡＭ－１单克隆抗体，可减少炎性细胞的浸润，抑制白细胞与肾实质细胞的粘附、阻止蛋白尿的发展。另外，在系膜增殖性肾炎，细胞外基质增加的同时，整合素表达增强，提示肾炎的系膜细胞增殖、细胞外基质增加与整合素相关。     

细胞粘附分子与肾小球肾炎

细胞粘附分子与肾小球肾炎周同，宋长玲，董德长（上海第二医科大学瑞金医院上海２０００２５）肾小球肾炎（下称肾炎）的发生、发展机制中，已知与许多因素有关。最近，细胞粘附分子（Ａｄｈｅ－ｓｉｎｏＭｏｌｅｃｕｌｅｓ，ＡＭｓ）及其细胞与细胞、细胞与细胞外基质（...     

儿童肾病综合征体液免疫,急性期蛋白及尿液蛋白成分变化

测定肾病综合征（ＮＳ）患儿２０种血清蛋白成分的含量及其它３项指标，并测定尿液中总蛋白（ＴＰ）及１１种不同分子量蛋白质的含量变化。与正常儿童比较，ＮＳ患儿血清Ｃ５、Ｃ１＾－ＩＮＨ、ＩｇＭ、ＨＰ、α２Ｍ含量均极显著升高，Ｐｇ含量显著升高，Ｃ１ｑ、ＩｇＧ、ＡＬｂ、Ｔｆ含量极显著降低，ＣＩＣ浓度极显著升高而ＣＨ５０活性显著降低，ＥＳＲ极显著升高。表明ＮＳ时有抗原刺激机体介导体液免疫应答，并存在抗体生成异常     

PARTICIPATION OF MONOCYTES IN GLOMERULONEPHRITIS IN ACUTE SERUM SICKNESS OF RABBIT

Acute serum sickness In the rabbit was studied with special reference to the role of monocytes in the Inflammatory process in the glomerulus. It was revealed that macrophages were the major factor in producing glomerular hyperceliularity In acute serum sickness. Proliferation of intrinsic glomerular cells or accumulation of polymorphonuclear leukocytes (PMNs) was minimal. Ultrastructural characteristics of these phagocytic cells were described. Macrophages engulfed various inflammatory products such as fibrin and cell debri in the glomerular capillary. Colloidal carbon administered at the active inflammatory stage was found to be mostly engulfed by macrophages, little by mesangial cells, and was not seen In endothelial or epithelial cells and PMNs. The selective ingestion of the carbon particles by these macrophages made it possible to differentiate them from glomerular cells. This in turn indicated that the macrophages were derived from neither endothelial nor mesangial cells and that they were of blood monocytic origin. It was suggested that monocytic cells participated in glomerular Inflammation but they, on the other hand, contributed to the repair of glomerular Injuries through their active role for phagocytosis.     

CLONING OF THE MOUSE FIBRONECTIN V-REGION AND VARIATION OF ITS SPLICING PATTERN IN EXPERIMENTAL IMMUNE COMPLEX GLOMERULONEPHRITIS

Increased mRNA and protein expression of extracellular matrix (ECM) components, including fibronectin, occurs during the development of glomerulonephritis and glomerulosclerosis in immunologically mediated kidney diseases. However, in addition to these quantitative changes in ECM expression, qualitative changes in these molecules may contribute to malformations in the composition of the glomerular matrix. These qualitative changes may include alterations in the splicing pattern of the V-region of fibronectin, since this region plays a role in its accumulation. The splicing patterns of this region have been studied in chronic graft-versus-host disease (GvHD) in mice, a model of lupus nephritis, and in chronic serum sickness (CSS) in rats, a model of immune complex nephritis. Cloning of the mouse fibronectin V-region from kidney tissue revealed 96·1 per cent homology with the corresponding domain in rat fibronectin. PCR (polymerase chain reaction) analysis of RNA from isolated glomeruli revealed three isoforms of this region in both mouse and rat fibronectin, namely inclusion or exclusion of the whole region, or exclusion of only the CS1 domain. In both models, increased exclusion of the V-region was observed early in the disease. However, in GvHD the splicing pattern returned to normal, whereas in CSS the shift persisted during the course of the experiment. Differentiated expression of fibronectin isoforms may exert an important effect on the structure and biological function of the glomerulus and may thus play a role in the development of glomerulonephritis and glomerulosclerosis.     

IMMUNE COMPLEX-MEDIATED GLOMERULONEPHRITIS AND INTERSTITIAL PNEUMONIA SIMULATING GOODPASTURE'S SYNDROME

An autopsy case of what was clinically considered to be Goodpasture's syndrome was Investigated. The lung had hemorrhagic interstitial pneumonia, showing granular patterns of IgG and C3 along the alveoli by the immunofluo-rescent method and electron-dense subepithelial deposits by electron microscopy. The kidney had crescentic and segmental necrotizing glomerulonephritis associated with membranous nephropathy. Uneven, continuous patterns of immunofluorescent IgG and C3 along the GBM were noted. Electron microscopy showed numerous subepithelial deposits, and immunoelectron microscopy revealed that IgG was not present in the GBM itself but present in the subepithelial deposits. Anti-GBM antibody activity was not detected in the serum or the kidney eluate. It was suggested that renal and pulmonary lesions occurred through the same mechanism and in association with immune deposits. We propose that there is a disease having immune complex-mediated renal and pulmonary lesions which clinically resembles the conventional Goodpasture's syndrome.     

转铁蛋白对肾病综合征患者血浆免疫抑制活性的影响

本文研究了人转铁蛋白(Tf)对27例单纯性肾病,2例急性肾衰患者血浆淋转抑制作用的影响。结果是活动期肾病中激素效应组 5/8例患者血浆的抑制活性能被 Tf逆转,但在激素非效应组和急性肾衰患者则无逆转作用。Tf对缓解期患者及对照组血浆抑制活性无影响。在激素效应组及缓解期肾病患者,血浆Tf浓度与血浆抑制活性间有明显相关。本文提示Tf 缺乏是部分肾病患者血浆对正常人淋转抑制活性的原因之一,但对患者实际免疫功能的影响尚有待进一步研究。     

急性心肌梗塞病人高频心电图分析及动态观察的临床意义

本文对２８例急性心肌梗塞病人及２０例正常人做了高频心电图检查。并对１２人做了３－４周的动态观察。结果表明：急性心肌梗塞患者高频成分明显增多，有并发症者高频成分增加更明显，动态观察显示，急性心肌梗塞患者第２周高频成分减少，第３－４周高频成分又稍增加，反映了急性心肌梗塞的病情变化。     

脑卒中患者急性期康复过程中神经功能和脑电生理的变化

目的:观察卒中患者急性期康复过程中功能恢复与脑电生理变化的关系。方法:将62例脑卒中患者于治疗前及治疗后的不同时间段内评价其功能及脑电慢波变化情况。结果:脑电地形图中δ波功率值变化与NIHSS得分变化相关,虽然脑电慢波功率变化过程与NIHSS得分变化过程不完全相同,但总趋势是相同的。结论:脑电生理的慢波变化反映了卒中后功能变化的情况,可以作为卒中患者功能恢复的预测和评价指标。     

肺瘤坏死因子和神经肽Y与急性心肌梗塞的关系

动态测定76例临床明确诊断的急性心肌梗塞患者和15例正常对照组肿瘤坏死因子和血浆神经肽Y的水平。结果显示,正常对照组NPY为93.3±10.6ng/L,急性心肌梗塞组在发病后1天NPY异常升高,为160.2±26.3ng/L,发病后第7天为121.3±24.7ng/L,均高于正常对照组(p<0.05);与NPY不同,正常对照组的TNF为0.97±0.38μg/L,在急性心肌梗塞发病后第1天升高至2.48±0.89μg/L(p<0.01),但发病后第3天降至1.12±0.37μg/L,已接近正常(p>0.05)。提示,TNF在急性心肌梗塞的发生中有重要作用,但与患者预后无直接关系;而血浆神经肽Y的水平不仅与急性心肌梗塞患者的发生有关,而且在急性心肌梗塞的病程和预后中有重要价值。