血液透析对慢性肾衰血清红细胞生成素浓度无影响

用酶联免疫吸附分析测定了１５列慢性肾功能衰竭（ＣＲＦ）患者血透前、后血清促红细胞生成素（ＥＰＯ）浓度的变化。结果发现血透前慢性肾衰竭患者血清ＥＰＯ浓度在“正常范围”，透析后尽管贫血有所改善，但血清ＥＰＯ浓度无明显变化，与贫血改善无关。血透不影响ＣＲＦ血清ＥＰＯ浓度，血透对ＣＲＦ贫血的改善可能与透析清除某种红细胞生成抑制物质有关。     

血清红细胞生成素测定的临床意义

采用放射免疫分析法测定９２例血液和肝肾疾病患者的血清红细胞生成素（ＥＰＯ），结果显示，在缺铁性贫血，急性淋巴细胞生白血病，肝硬化伴有消化道出血的情况上，其ＥＰＯ的浓度显著增高。８０％的慢性肾功能不全伴有肾性贫血患者血清ＥＰＯ浓度下降；急淋缓解期和肝硬化患者血清ＥＰＯ浓度正常。提示：测定血清ＥＰＯ浓度对上述疾病的诊断、疗效观察和随访具有较高的临床价值。     

脑梗死患者血浆内皮素与一氧化氮浓度的动态观察

目的探讨脑梗死发病后血浆内皮素（ＥＴ）及一氧化氮（ＮＯ）动态变化及与脑梗死的关系。方法采用放射免疫测定法及比色法对 ３８例急性期脑梗死患者在发病后 ６ｈ内、 ６ｈ后、 ２４ｈ、３ｄ、５ｄ、７ｄ连续测定其血浆ＥＴ、ＮＯ浓度。结果脑梗死发病６ｈ后至７ｄ前血浆ＥＴ、ＮＯ均显著高于正常对照组（Ｐ<０．０５～０．０１）,两者浓度均在发病６ｈ后始增高（Ｐ<０ ．０５）,２４ｈ达高峰（Ｐ<０．０１）,持续３ｄ后始下降,７ｄ后接近于正常（Ｐ＞０．０５）,两者呈显著正相关性（Ｐ<０．０１）。有高血压、糖尿病史者其血浆ＥＴ、ＮＯ浓度明显高于无两病史者（Ｐ<０．０５～０．０１）、结论ＥＴ和ＮＯ是致脑梗死发展的重要因素,ＥＴ、ＮＯ的动态变化为临床有效治疗脑梗死及选择治疗时机有指导意义。     

血小板活化因子对嗜酸性粒细胞的活化作用

用多粘菌素Ｂ注射，造成豚鼠腹腔渗出液中嗜酸性粒细胞（Ｅｏｓ）增多，分离出其中的Ｅｏｓ，测定血小板活化因子（ＰＡＦ）对Ｅｏｓ过氧化物酶（ＥＰＯ）活性、Ｅｏｓ沉淀密度和存活时间的作用。结果表明：ＰＡＦ能增强ＥＰＯ活性，诱导Ｅｏｓ脱颗粒，其最大作用浓度分别为１０＾－７ｍｏｌ／Ｌ和１０＾－６ｍｏｌ／Ｌ。淋巴细胞培养上清液能显著增强ＰＡＦ的脱颗粒作用。１０＾－６ｍｏｌ／Ｌ ＰＡＦ还能使１５．９％的正常密度Ｅ     

新生儿HIE血清SOD活性和MDA浓度变化及临床意义

目的：探讨缺氧缺血性脑病（ＨＩＥ）新生儿血清超氧化物歧化酶（ＳＯＤ）活性和丙二醛（ＭＤＡ）浓度的变化及临床意义。方法：采用化学比色法分别测定２０例ＨＩＥ新生儿和２０例正常新生儿血清ＳＯＤ活性和ＭＤＡ浓度。结果：新生儿ＨＩＥ急性期血清ＳＯＤ活性明显低于恢复期及对照组（Ｐ均〈０．０１）,有非常显著差异,ＨＩＥ急性期血清ＭＤＡ浓度明显高于恢复期及对照组（Ｐ均〈０．０１）,有非常显著差异。ＨＩＥ急性期血清     

红细胞生成素的临床研究进展

自１９８５年人促红细胞生成素（ｅｒｙｔｈｒｏｐｏｉｅｔｉｎ,ＥＰＯ）基因及其ｃＤＮＡ被成功地克隆以来,利用基因工程大批量生产重组人促红细胞生成素（Ｈｕｍａｎ ｒｅ－ｃｏｍｂｉｎａｎｔ ｅｒｙｔｈｒｏｐｏｉｅｔｉｎ, ｈｒＥＰＯ）并应用于临床治疗多种类型的贫血,ＥＰＯ的基础和应用研究方兴未艾,取得了令人瞩目的成就。１ＥＰＯ的生物学特性 人类ＥＰＯ基因位于７号染色体长臂２２区,ＥＰＯ分子量３４ｋＤ,按碳水化合物表达量的不同,将人类自然的 ＥＰＯ分为两种形式： ａ型含３１％碳水化合物,β型含 ２４％碳水化合…     

分泌性中耳炎中耳积液和血清中sIL－2R水平的初步研究

应用酶联免疫吸附法（ＥＬＩＳＡ）对３０例正常人血清（对照组）和６０例分泌性中耳炎患者（ＳＯＭ组）中耳积液和血清中可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）进行了检测。结果示ＳＯＭ组血清ｓＩＬ－２Ｒ水平明显高于对照组，ＭＥＦ中其含量明显高于血清；鼻咽癌组血清及ＭＥＦ中ｓＩＬ－２Ｒ水平明显高于─般ＳＯＭ组；粘液组高浆液组；慢性组高于急性组（均Ｐ＜０．０１）。提示：血清及ＭＥＦ中ｓＩＬ－２Ｒ水平的测定有助于对ＳＯＭ患者免疫状态的评估；ＭＥＦ中ｓＩＬ－２Ｒ可能主要由局部中耳粘膜产生；ＭＥＰ中高浓度的ｓＩＬ－２Ｒ存在可能是ＳＯＭ迁延不愈的─个原因。     

糖尿病时血清一氧化氮的变化及其与微血管病变的关系

目的：研究糖尿病时一氧化氮（ＮＯ）的变化及其与肾脏病变和神经病变的关系。方法：采用硝酸还原酶法对５３例Ⅱ型糖尿病和３２例对照组的血清ＮＯ水平进行了检测。结果：糖尿病患者血清ＮＯ浓度显著高于对照组（Ｐ＜０．０１）;有微血管病变（有肾脏病变和／或神经病变）组的血清ＮＯ明显高于无微血管病变组（Ｐ＜０．０１）;尿蛋白排泄（ＵＡＥ）增高组血清ＮＯ高于ＵＡＥ正常组（Ｐ＜０．０５）。结论：糖尿病时血清ＮＯ浓度增高;高ＮＯ水平引起肾小球高滤过的同时对肾小球入球小动脉的扩张比对出球小动脉的扩张更明显,可使肾小球滤过率增加,蛋白尿排出增加;过量ＮＯ的产生具有神经毒性,可耗竭神经元内的能量储存,使神经元死亡。以上结果均参与糖尿病肾病和神经病变的发生。     

抗MPO抗体的ELISA检测和应用

本文应用Ｍａｔｈｅｓｏｎ方法从人白细胞中提取髓过氧化物酶ＭＰＯ，建立ＥＬＩＳＡ法检测６３份血清标本中抗ＭＰＯ抗体，同时与间接免疫荧光法（ＩＩＦ）作比较，结果是：１９例结节性多动脉炎（ＰＡＮ）患者中６例抗ＭＰＯ抗体阳性（３２％），较ＩＩＦ法阳性率提高（１９例中１例），而２２例正常人及２２例其他肾脏病患者血清均为阴性。提示ＥＬＩＳＡ法既可从分子水平鉴定系统性血管炎致病的特异性抗体，又是系统性血管炎敏感的诊断方法。     

HEPES诱导增强细胞病变中和试验在肾综合征出血？…

依据羟乙基哌嗪乙烷磺酸（ＨＥＰＥＳ）能诱导增强肾综合征出血热病毒感染的Ｖｅｒｏ－Ｅ６细胞产生细胞融合病变，并可被特异性抗体所中和抑制的特性，建立了微量细胞病变中和试验方法。应用该方法对１１株肾综合征出血热病毒分离株进行分型。结果７株可鉴定为ＨＴＮ型，４株为ＳＥＯ型。另对７个地区８２份出血热病人血清进行分型。结果，西安、四川、沈阳、湖南、浙江的血清鉴定为ＨＴＮ型；山西、山东、福建的血清定为ＳＥＯ型。     

How the Duration Period of Erythropoietin Treatment Influences the Oxidative Status of Hemodialysis Patients

Background: End-stage renal disease is a state of enhanced oxidative stress (OS) and hemodialysis (HD) and renal anemia further augment this disbalance. Anemia correction with erythropoietin (EPO) may improve oxidative status. However, there is no evidence of time dependent effects of EPO therapy on redox status of HD patients.Objective: The aim of this study was to evaluate whether the duration of EPO treatment may affect OS parameters in uremic patients.Patients and methods: 104 HD patients and 29 healthy volunteers were included. Patients were divided into 3 groups according to the duration of EPO treatment. Forth group consisted of HD patients without EPO treatment. Plasma and erythrocyte malondialdehyde (MDA, MDA_rbc), reactive carbonyl groups (RCG), plasma sulfhydryl (-SH) groups and total antioxidative capacity (TAC) levels were evaluated.Results: HD patients both with and without EPO treatment, showed a significant increase in all oxidative parameters without significance between EPO treated and -untreated group. The decrease in MDA and MDA_rbc levels coincided with the duration of EPO treatment. A negative correlation was observed between the duration of EPO treatment and serum MDA (r=˗0.309, p=0.003). Increasing periods of EPO treatment were associated with decrease in RCG, without significance between EPO groups. Increase in TAC accompanied increasing durations of EPO treatment, with EPO treatment for more than 24 months causing the most striking changes (p<0.05). There were no significant differences in ˗SH levels between EPO subgroups.Conclusion: Our results suggest that long term administration of EPO attenuated the lipid peroxidation process and restored the levels of antioxidants.     

Reliability and significance of increased creatine kinase MB isoenzyme in the serum of uremic patients

The authors quantified creatine kinase MB (CK-MB) isoenzyme activity and mass in the serum of 81 uremic and 20 nonuremic (control) patients who had no clinical or electrocardiographic evidence of acute myocardial infarction. CK-MB was quantified by three methods: electrophoresis, the QuiCK-MB (International Immunoassay Labs), and the Tandem-E CK-MB (Hybritech, Inc.). The authors then followed all uremic patients for subsequent hospitalization for cardiac disease. Median CK-MB was increased in the serum of the uremic patients as compared with the control patients by all methods. Most uremic patients had CK-MB in serum above the median CK-MB of the control group. Seventeen (21%) uremic patients had CK-MB in serum elevated above the reference range by at least one method. All control patients had CK-MB in the serum within the reference range. Twelve of 81 (15%) uremic patients have subsequently developed acute myocardial infarction (six patients; four died) or angina pectoris (six patients; one died). Eleven patients were specifically hospitalized for cardiac symptoms. One patient had acute myocardial infarction three weeks after renal transplant. With the use of the chi-square test and 2 X 2 contingency tables, patients with CK-MB in serum above 5 U/L by electrophoresis (chi 2 = 5.47; P less than 0.05) or at least 2.9 EU/L by the QuiCK-MB (chi 2 = 6.56; P less than 0.01) appeared to be at increased risk of subsequent hospitalization. The authors conclude that a slight increase of CK-MB in serum is found in most uremic patients. However, CK-MB elevated above reference range in the serum of uremic patients without clinical or electrocardiographic evidence of acute myocardial infarction is not common. When found, elevated CK-MB isoenzyme appears to be associated with an increased risk of subsequent cardiac disease. Therefore, quantification of CK-MB in the serum of uremic patients is more reliable than is implied in the literature.     

促红细胞生成素对急性肾损伤大鼠肾小管细胞凋亡和p-MAPKAPK-2表达的影响

目的:探讨促红细胞生成素(EPO)对急性肾损伤大鼠肾小管细胞凋亡和MAPKAPK-2水平的影响.方法:30只SD雄性大鼠分为假手术组、模型组、EPO治疗组,假手术组仅分离肾被膜后逐层关闭腹腔;模型组采用缺血再灌注法建立急性肾损伤模型;EPO治疗组为急性肾损伤大鼠腹腔注射EPO 50 U/kg,每周3次,共6周,其余大鼠...     

Erythropoietin improves long-term outcomes in patients with acute kidney injury after coronary artery bypass grafting

Previous studies reported the beneficial effect of erythropoietin (EPO) in acute injuries. We followed patients with and without acute kidney injury (AKI) after coronary artery bypass grafting (CABG) and evaluated the effect of EPO on long-term outcome. We also assessed the efficacy of urinary neutrophil gelatinase-associated lipocalin (uNGAL) as a predictive marker of AKI. Seventy-one patients scheduled for elective CABG were randomly given either 300 U/kg of EPO or saline before CABG. The primary outcome was AKI, and the secondary outcome was the all-cause-mortality and composite of all-cause-mortality and end stage renal disease (ESRD). Twenty-one patients had AKI, 14 (66.7%) in the placebo group and 7 (33.3%) in the EPO group (P = 0.05). Also, uNGAL was higher in the patients with AKI than in those without AKI at baseline, 2, 4, 24, and 72 hr after CABG (P = 0.011). Among patients with AKI, 2-week creatinine (Cr) was not different from baseline Cr in the EPO group, but 2-week Cr was significantly higher than baseline Cr in the placebo group (P = 0.009). All-cause-mortality (P = 0.022) and the composite of all-cause-mortality and ESRD (P = 0.003) were reduced by EPO. EPO reduces all-cause-mortality and ESRD in patients with AKI, largely due to the beneficial effect of EPO on recovery after AKI.     

T lymphocyte subsets and NK cell cytotoxicity in chronic hemodialysis patients. The effect of recombinant human erythropoietin (rHu-EPO) treatment.

We investigated subpopulations of T lymphocytes, NK cell number and cytotoxic activity in 14 chronic uremic patients on regular hemodialysis treatment. We observed a significantly decreased absolute lymphocyte number and percentage of CD3 cells. Relative numbers of CD16 cells were significantly elevated, but NK cell cytotoxic activity was within a normal range. Nine patients with chronic renal anemia on maintenance hemodialysis were enrolled in rHu-EPO treatment trial. The treatment was continued till the hematocrit level reached 30%. Each of the patients had corrected anemia and well-being. After 12 weeks of the treatment we observed in these patients decreases in CD3, CD4, CD8 and CD16 cell numbers and elevation of CD4/CD8 ratio. Cytotoxic activity of NK cells did not change significantly. Presented results indicate that chronic hemodialysis patients have significantly diminished lymphocyte number. rHu EPO treatment affects the T lymphocyte subsets inducing a deep decrease of CD8 and CD16 cell percentage leading to normalisation of the CD4/CD8 ratio.     

The differential release of eosinophil granule proteins. Studies on patients with acute bacterial and viral infections

Background: Harlier in vitro studies have suggested that the eosinophil may release its granule proteins selectively depending on the stimulus to which the cell is exposed. Objective: The object of the present study was to study the question of selective release in vivo by means of serum measurements of the two eosinophil granule proteins eosinophil cationic protein (ECP) and eosinophil peroxidase (EPO) in acute infections. Methods: Fourty-six subjects with acute infections were studied before treatment, 20 with bacterial infections and 26 with viral infections. Serum ECP, EPO and MPO were measured by specific RIA. Results: In acute bacterial infections ECP, but not EPO. was significantly raised in serum (P < 0.0001) compared with non-infected healthy subjects. In acute bacterial infections ECP was significantly correlated to the levels of the neutrophil marker myeloperoxidase (MPO) (r_s= 0.96, P < 0.0001) but not to EPO. In acute viral infections neither ECP nor EPO were on average raised. However, almost 20% the patients had elevated levels of both proteins. In the viral infections the serum-levels of ECP and EPO were correlated (r_s= 0.63, P < 0.001), but no correlation was found with MPO Conclusion: It is concluded that eosinophils are activated during acute bacterial infections and that this activation results in the preferential mobilisation of ECP. The simultaneous assay of the two eosinophil proteins, ECP and EPO. may give new insight into the role of the eosinophil in disease.     

Plasma erythropoietin concentration in lung cancer patients

The goal of this study was to evaluate serum level of EPO in 32 men with lung cancer (Squamous cell lung cancer N = 11, Adenocarcinoma N = 10, Small cell lung cancer N = 11) in relation to the degree of anemia, stage of disease and the regimen of anticancer therapy. The control group consisted of 29 men, among whom were 15 patients with posthemorrhagic anemia. Blood samples were withdrawn for assessment of blood count, serum concentration of EPO, iron, total iron binding capacity (TIBC) and ferritin. The assessment of all parameters was repeated after 3 months of therapy: RESULTS: Patients suffering from lung cancer were characterized by a lower hemoglobin level and higher level of EPO as compared with the control group. A significant negative correlation was found between hemoglobin level and EPO serum concentration in all groups of patients and in the control group. The strongest correlation was observed in the control group t = -0.812. In each group of patients the serum level of EPO increased after treatment; although a significant increase was found only in surgically treated patients and patients after chemotherapy. After treatment the correlation between hemoglobin and EPO became stronger especially in the group of patients with small cell lung cancer. CONCLUSIONS: 1. Patients with lung cancer are characterized by inappropriately low serum EPO levels when related to the degree of anemia, 2. The suppressive effect of lung cancer on EPO secretion depends on the histological type of the cancer (with the exception of small cell lung cancer). 3. The increase of EPO level after treatment seems to be caused not only by a decrease of hemoglobin concentration, but also by reduction of the tumor mass.     

Acute hepatitis C in Brazil: results of a national survey

The incidence of acute hepatitis C has decreased in the world. However, new cases are still reported. The objective of this study was to obtain data of acute hepatitis C in Brazil and to identify risk factors of transmission, diagnostic criteria, clinical presentation, evolution, and treatment. A questionnaire was sent to all members of the Brazilian Society of Hepatology. Sixteen centers participated with a total of 170 cases between 2000 and 2008. Among them, 37 had chronic renal failure on hemodialysis and were evaluated separately. The main diagnostic criterion in non‐uremic patients was ALT (alanine aminotransferase) elevation associated with risk factors. In patients with chronic renal failure, anti‐hepatitis C virus (HCV) seroconversion was the most frequent criterion. Among the 133 non‐uremic patients the main risk factors were hospital procedures, whereas in hemodialysis patients, dialysis was the single risk factor in 95% of the cases. Jaundice was more frequent in non‐uremic patients (82% vs. 13%; P < 0.001) and ALT levels were higher in these individuals (P < 0.001). Spontaneous clearance was more frequent in non‐uremic patients (51% vs. 3%; P < 0.001). Sixty‐five patients were treated: 39 non‐uremic patients and 26 on dialysis. Sustained virological response rates were 60% for non‐uremic and 58% for uremic patients (P = 0.98). There was no association of these rates with the study variables. These findings show that cases of acute hepatitis C are still occurring and have been related predominantly to hospital procedures. Measures to prevent nosocomial transmission should be adopted rigorously and followed to minimize this important source of infection observed in this survey. J. Med. Virol. 83:1738–1743, 2011. © 2011 Wiley‐Liss, Inc.