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1.
用卡托普利合并复方丹参治疗20例糖尿病肾病患者,治疗前血压为24.5±0.7/11.3±0.4kPa(184.2±5.3/84.8±3.0mmHg),治疗后为19.2±0.7/10.2±0.4kPa(144.0±5.5/76.5±3.0mmHg),P<0.01;血尿素氮治疗前后分别为8.53±0.78mmol/L和6.65±1.38mmol/L,P<0.01;血肌酐治疗前后分别为143.17±3.85μmol/L和120.21±4.51μmol/L,P<0.01;尿蛋白定量治疗前后分别为1.90±0.30g/24h和1.12±0.42g/24h,P<0.05。结果表明:二药合用确能降低血压,减少尿蛋白排出及改善肾功能,值得临床推广应用。  相似文献   

2.
目的:观察金水宝胶囊对慢性肾功能衰竭(CRF)患者红细胞免疫功能的影响。方法:选择36例CRF患者,停用对免疫功能有影响的药物,加用金水宝胶囊2粒,每日3次,并测定红细胞免疫功能及肾功能。并与20例健康人进行对照。结果:CRF患者存在红细胞免疫功能低下,经金水宝胶囊治疗后红细胞C3b受体花环率(RBCC3bR,7.84%±6.32%比10.17%±7.28%,P<0.05)和红细胞免疫复合物(RBCIC,3.65%±1.61%比2.93%±1.24%,P<0.01)明显下降,且能改善贫血〔Hb从(6.78±0.45)g/L上升至(7.86±0.22)g/L〕及肾功能〔BUN从(41.45±2.52)mmol/L降至(30.69±1.21)mmol/L,SCr从(612.71±104.23)μmol/L降至(510.45±98.36)μmol/L〕。结论:金水宝胶囊具有调节和保护CRF患者红细胞免疫功能的作用,并能改善肾性贫血及改善肾功能。  相似文献   

3.
目的:观察“军七虫草胶囊”治疗维持性血液透析(血透)患者的疗效。方法:分别测定25例病情稳定的维持性血透患者服用“军七虫草胶囊”前和用药1周后血尿素氮(BUN)、肌酐(Cr)及血K+、体重的上升值和血Ca2+的下降值各3次,以及用药前和用药1个月后的血白蛋白、血红蛋白值各1次,并进行对比分析。结果:透析间期的血BUN和Cr上升值用药前分别为16.3±4.2mmol/L和441.6±92.0μmol/L,用药后分别下降为12.9±5.4mmol/L和359.8±89.5μmol/L(P值均<0.05);体重上升值由用药前的1.90±0.50kg下降为1.50±0.35kg(P<0.01),血白蛋白则由30.7±4.5g/L上升为34.8±3.7g/L(P<0.05),血K+上升值和Ca2+下降值无明显变化。结论:“军七虫草胶囊”能使透析间期毒素上升水平减慢,明显改善透析患者的生存质量.且能使部分患者透析时间缩短,降低透析费用。  相似文献   

4.
人工虫草对慢性肾功能衰竭患者肾功能及免疫功能的影响   总被引:3,自引:0,他引:3  
目的:探讨人工虫草对慢性肾功能衰竭患者肾功能及免疫功能的影响。方法:53例慢性肾功能衰竭患者随机分为2组,治疗组29例给予人工虫草菌丝粉(金水宝胶囊)及常规西药对症治疗;对照组24例单用相同西药治疗。结果:53例慢性肾功能衰竭患者与健康人比较,单克隆抗体OKT3、OKT4及OKT8均明显降低(P均<0.01)。治疗组治疗后OKT8明显降低(0.14±0.09比0.24±0.10),OKT4/OKT8明显升高(1.97±0.54比1.02±0.48),P均<0.01;对体液免疫无影响。治疗组患者血红蛋白升高〔(78.50±0.53)g/L升至(87.20±0.44)g/L〕,血肌酐明显下降〔(478.5±196.4)μmol/L比(351.7±137.3)μmol/L〕,P均<0.05。结论:人工虫草具有调整慢性肾功能衰竭患者细胞免疫的作用,并能改善肾性贫血及肾功能。  相似文献   

5.
采用自血光量子疗法(血疗)加补阳还五汤加减及西药联合治疗缺血性中风268例(治疗组),并与单纯西药治疗134例(对照组)作对照观察,比较两组患者的临床疗效。两组所用西药相同,治疗20天,进行疗效评定。结果:总有效率治疗组96.3%,对照组86.6%,差异非常显著(P<0.01)。治疗组患者血胆固醇由治疗前的4.41±0.76mmol/L降至3.73±0.63mmol/L,甘油三酯由治疗前的1.71±0.35mmol/L降至1.49±0.21mmol/L,血糖由治疗前的7.20±1.28mmol/L降至5.90±1.30mmol/L,P均<0.01;总有效率治疗组为69.8%,对照组为43.6%,两组比较P<0.01。对照组胆固醇、甘油三酯、血糖水平治疗前后比较无显著性差异,P均>0.05。作者认为:中风发生后,如何迅速改善病灶及其周围组织的血氧供应,是使脑细胞功能恢复的关键。血疗能增加血氧饱和度,提高超氧化物歧化酶活性,减少自由基损伤;补阳还五汤加味能补气活血化瘀,通经活络;西药均能减轻脑水肿,改善脑循环。三者合用有利于急性期缺血性中风临床症状和体征的改善,从而提高了疗效  相似文献   

6.
目的:探讨抗心力衰竭(心衰)治疗中保护心肌能量代谢的意义。方法:将162例支气管肺炎并心衰患儿,随机分成治疗组与对照组各81例。对照组应用吸氧、镇静、抗感染及强心剂(西地兰饱和量法)和血管扩张剂治疗。治疗组在以上综合治疗的(1/5西地兰饱和量)基础上,应用大剂量丹参注射液和维生素C。丹参注射液每次5ml~10ml,维生素C200mg·kg-1/d~250mg·kg-1/d。结果:治疗组显效42例(51.9%),有效39例(48.1%),总有效率100.0%。对照组显效18例(22.2%),有效48例(59.3%),无效15例,总有效率81.5%,2组比较,P<0.01。2组呼吸频率、心率和肝肿大恢复正常的时间分别为(1.4±0.1)日比(5.1±0.4)日,(1.7±0.2)日比(4.6±0.3)日,(1.3±0.1)日比(7.6±0.7)日,2组疗效比较有极显著性差异(P均<0.001)。结论:清除氧自由基是纠正心肌能量不足的关键,也是抗心衰治疗的前提。丹参注射液与维生素C协同保护心肌能量代谢,可增加洋地黄制剂的疗效,避免其毒副作用。提示保护心肌的能量代谢是抗心衰治疗的关键  相似文献   

7.
依那普利治疗轻中度原发性高血压的临床疗效观察   总被引:3,自引:1,他引:3  
曾群英  张育君 《新医学》1996,27(6):293-295
本文将83例轻中度原发性高血压患者进行单盲分组对照试验。治疗组益压利42例,对照组怡那林41例。益压利组5~20mg/次,每日1次。6周后坐位BP由23.2±2.0/13.1±0.8降至19.8±1.2/11.6±0.7kPa,立位BP由23.0±1.9/13.0±0.8降至19.4±1.0/ll.5±0.7kPa,其降压临床显效率47.6%,总有效率90.5%。怡那林组5~20mg/次,每日1次,6周后坐位BP由23.3±2.0/13.1±0,8降至20.8±1.2/12.3±0.7kPa,立位BP由23.0±2.0/13.1±0.8降至20.6±1.0/12.2±0.7kPa,其显效率34.1%,总有效率82.9%。结果表明两组均有明显降压效果,但两组间临床总有效率无显著性差异(P>0.05)。而24小时ABP谷:峰(T/P)比值显示,益压利组SBP为81.7%,DBP为76.0%,优于怡那林组的50.8%及44.1%。  相似文献   

8.
目的:探讨脑出血患者血浆血小板α颗粒膜蛋白(GMP140)含量的变化和临床意义。方法:用放射免疫分析法测定90例脑出血患者和70例正常人血浆GMP140的含量。结果:脑出血患者血浆GMP140含量于发病1周内达高峰〔(26.54±7.21)μg/L〕,明显高于正常对照组〔(9.02±2.89)μg/L,P<0.01〕,以后逐渐下降,第3周末多数降为正常〔(9.65±3.40)μg/L〕。出血量>50ml组血浆GMP140含量〔(39.58±7.29)μg/L〕显著高于出血量<20ml组〔(15.35±3.90)μg/L,P<0.01〕;重型组血浆GMP140含量〔(32.18±6.81)μg/L〕明显高于轻型组〔(13.02±3.21)μg/L,P<0.01〕;恶化死亡组血浆GMP140含量〔(33.31±8.45)μg/L〕明显高于治愈组〔(14.65±5.34)μg/L,P<0.01〕。结论:测定脑出血患者血浆GMP140含量可作为临床上估计出血量、监测病情和判断预后的一个指标。  相似文献   

9.
目的:探讨肠系膜上动脉闭塞(SMAO)休克兔动脉血和门静脉血乳酸浓度的变化,以及小剂量多巴胺(5 μg·kg- 1·m in- 1)对其的影响。方法:20只新西兰家兔随机分成2组,均制成SMAO 休克模型,2组均按30 m l·kg- 1·h- 1输入0.9% NaCl;A组另给予多巴胺5 μg·kg- 1 ·m in- 1,B组作为对照组。分别观察血流动力学、动脉血和门静脉血乳酸浓度(ALT、PLT),以及腹腔组织氧供(SDO2)、氧耗(SVO2)和氧摄取率(SO2ER)的变化。结果:A组门静脉血流量指数(QpvⅠ)在休克模型复制后60、90 和120 分钟时明显高于B组(P< 0.05或P< 0.01);2 组ALT、PLT均明显升高,以休克后0 时为最高〔A 组分别为(6.5±1.1)m m ol/L和(6.9±1.4)m m ol/L;B组分别为(6.4±0.8)m m ol/L和(6.8±1.2)m m ol/L〕,但A 组在此后呈逐渐下降趋势,在120分钟时最低〔分别为(3.2±0.3)m m ol/L和(3.5±0.3)m m ol/L〕,而B组则呈持续高水平〔分别为(5.5±0.5)m m ol/L和(5.7±0.9)m m  相似文献   

10.
全血2,3—二磷酸甘油酸比色测定法   总被引:1,自引:0,他引:1  
本文介绍了用磷酸甘油酸变位酶测定2,3-二磷酸甘油酸的比色法。探讨了该法的最适反应条件,最适pH7.5% ̄7.6。线性范围可达6.0mmol/L。三份不同浓度标本批内CV1.1% ̄2.1%,批间CV2.5% ̄3.9%。60例南京地区健康成人2.3-二磷酸甘油酸含量为1.6 ̄2.7mmol/L,平均回收率94%,与Sigma试剂盒比较测定结果无显著性差异(P〉0.05),相关性良好,r=0.982。  相似文献   

11.
狼疮肾炎尿毒症治疗中两种透析法的疗效比较   总被引:3,自引:0,他引:3  
目的:探讨在腹膜透析(腹透)或血液透析(血透)辅助治疗下激素和细胞毒性药物(环磷酰胺)对狼疮肾炎(LN)尿毒症的逆转作用。方法:观察LN尿毒症患者腹透组(37例)与血透组(15例)在透析治疗尿毒症症状消失后,予以相同剂量和用法的泼尼松与环磷酰胺治疗的疗效,并进行比较。结果:腹透组37例中,31例(83.8%)成功脱离了透析,6例(16.2%)无效,但可以减少每周透析次数;而血透组15例中仅4例(26.7%)脱离了透析,11例(73.3%)无效,其中1例可以减少每周透析次数,10例仍需继续作维持性血透。2组疗效有极显著性差异(P<0.01)。结论:LN尿毒症应尽可能选择腹透作辅助治疗。  相似文献   

12.
目的:探讨过敏性紫癜(HSP)患儿微循环与T细胞亚群的改变及中西医结合治疗的疗效。方法:对40例HSP患儿进行甲襞微循环与T细胞亚群变化的观测;随机分为清热凉血、活血化瘀加激素治疗组(20例)和激素治疗对照组(20例),对比2组疗效,另设24例正常儿童T细胞亚群对照观察。结果:HSP患儿CD+3、CD+4百分率及CD+4/CD+8比值均低于正常对照组(P均<0.01)。治疗组治愈率较治疗对照组明显升高分别为100%与90%,P<0.01;皮疹复发率(15%)和紫癜肾炎发生率(15%)均显著低于治疗对照组(50%和55%),P均<0.05。结论:HSP存在甲襞微循环与T细胞亚群异常改变;用清热凉血、活血化瘀中药加激素联合治疗较单纯激素治疗更为有效、安全。  相似文献   

13.
目的 探讨狼疮性肾炎(lupus nephritis,LN)患者在尿毒症阶段行肾脏替代治疗的特点。方法 收集上海交通大学医学院附属仁济医院肾脏科近年LN患者尿毒症阶段的临床资料,包括完整的病史、病情演变、临床症状、实验室检查等随访资料,总结分析LN患者行肾脏替代治疗(renal replacement therapy,RRT)的特点。结果 入选规律性肾脏替代治疗的LN患者共23例,8例男性(35%),15例女性(65%)。其中10例(43.5%)首选血液透析(HD),13例(56.5%)首选腹膜透析(PD)。随访时间为6~211个月。随访中有4例患者死亡,2例(50%)死于心血管疾病(cardiovasculardisease,CVD),5年生存率为85.0%。皿患者中有4例(40%)在开始透析治疗后一年内肾功能部分恢复。PD患者中有2例(15.0%)在透析第一年后残肾Kt/V有上升。HD患者中有2例(20.0%)因心房纤颤、腕管综合征和瘘管功能不良改为PD。PD患者中有5例(38.5%)因腹水感染而改为HD。透析后第一年有14例(60.996)发生感染,有6例(21.6%)发生肾外狼疮活动。结论 进入肾脏替代治疗的LN患者的预后较好。部分患者在开始透析一年内肾功能可有不同程度恢复,CVD是LN终末期肾衰竭患者的主要死因。  相似文献   

14.
目的:观察中西医结合治疗小儿难治性肾病综合征的临床疗效。方法:治疗组40例患儿采用泼尼松、肝素及中药相结合治疗;对照组36例只用与治疗组相同西药治疗;检测患儿治疗前后尿蛋白,血胆固醇、尿素氮及血、尿中纤维蛋白降解产物(FDP)含量变化。结果:2组治疗后各项检测指标显著降低,治疗组尿蛋白、血尿素氮较对照组降低有极显著性差异(P均<0.001)。2组近期疗效比较,治疗组、对照组完全缓解率分别为85.0%和83.3%,无显著性差异(χ2=2.17,P>0.05);远期疗效显示,治疗组、对照组复发率分别为15.4%和41.2%,有显著性差异(χ2=6.53,P<0.05)。结论:中西医结合治疗小儿难治性肾病综合征疗效显著,有助于消除肾病本身及长期激素治疗加重的血液高凝状态,增强病情稳定性,减少复发。  相似文献   

15.
目的:观察中西医结合治疗老年慢性肾功能衰竭的临床疗效。方法:将60例老年慢性肾功能衰竭患者随机分为中西医结合治疗组(30例)和对照组(30例)。中西医结合治疗组给予低蛋白饮食,应用必需氨基酸,口服百令胶囊和中药汤剂;对照组则采用低蛋白饮食,口服包醛氧化淀粉。观察治疗前后2组患者症状变化及血肌酐(SCr)和肌酐清除率(CCr)变化。结果:中西医结合治疗组总有效率80%,对照组总有效率60%,2组疗效比较有显著性差异(P<0.05)。2组治疗后SCr均下降,且中西医结合治疗组治疗前后比较有显著性差异(P<0.05);CCr均升高,中西医结合治疗组治疗前后比较有显著性差异(P<0.01);对照组治疗前后SCr、CCr均无显著性差异。结论:中西医结合治疗老年慢性肾功能衰竭有较好的临床疗效。  相似文献   

16.
17.
血液透析急性低血压患者的中西医结合治疗效果观察   总被引:2,自引:1,他引:1  
目的:观察中西医结合治疗血液透析急性低血压的临床疗效。方法:160例次血液透析低血压患者随机分成西药治疗组和中西药治疗组。西药治疗组以常规处理(如停止超滤脱水、降低血流量等)加静注50%葡萄糖,中西药治疗组在西药治疗组的基础上加静注参麦注射液;分别观察即刻及治疗3、6、9、12分钟各时间点的血压及症状积分变化。结果:中西药治疗组临床症状及血压的改善均明显优于西药治疗组(P<0.05或P<0.01)。结论:对血液透析急性低血压的治疗,中西医结合方法优于传统西药治疗方法。  相似文献   

18.
Dyslipidemia in peritoneal dialysis--relation to dialytic variables.   总被引:4,自引:0,他引:4  
OBJECTIVE: To investigate whether the specific lipoprotein (LP) abnormalities of peritoneal dialysis (PD) are associated with functional variables of this mode of dialysis. DESIGN: A survey of the LP profile in relation to peritoneal dialysis capacity (PDC) variables.The LP profile was compared to that of a group of age- and sex-matched controls. SETTING: The Peritoneal Dialysis Unit at Sahlgrenska University Hospital in Gothenburg, Sweden. PATIENTS: Twenty-two nondiabetic PD patients (5 women, 17 men) who had been on PD for at least 6 months. MAIN OUTCOME MEASURES: The LP profile included plasma lipids, apolipoproteins (Apo), and individual ApoA- and ApoB-containing LP. The PDC measurement determined peritoneal glucose uptake, protein losses, effective peritoneal surface area, and total weekly creatinine clearance. RESULTS: The patients had been on PD for 6 to 48 months (mean 15.3 months) and had a total weekly creatinine clearance of 69.7+/-13.3 L/1.73 m2 body surface area, an average peritoneal glucose uptake corresponding to 446+/-162 kcal/24 hour, and a protein loss of 8.1+/-2.5 g/24 hr. The patients had significantly higher total cholesterol (7.1 mmol/L),VLDL-cholesterol (1.0 mmol/L), LDL-cholesterol (4.7 mmol/L), and triglyceride levels (2.5 mmol/L); whereas the HDL-cholesterol level (1.2 mmol/L) was significantly lower than in controls. The PD patients had increased levels of ApoB-containing LPs, both of the cholesterol-rich LP-B and of the triglyceride-rich LP-B complex, reflected in higher plasma concentrations of ApoB, ApoC-III, and ApoE. Furthermore, they had significantly lower levels of LP-A-I:A-II, as well as of ApoA-I and ApoA-II. The LP-A-I:A-II and ApoA-II levels correlated inversely with the duration of PD treatment (r = 0.54, p < 0.01 and r = 0.52, p < 0.05, respectively).The ApoA-II level was inversely correlated with the peritoneal surface area (r = 0.53, p < 0.05). There were no other correlations between LP variables and PDC variables, nor did any of the LP variables correlate with peritoneal glucose uptake or protein losses. CONCLUSION: The proatherogenic lipoprotein profile of patients on PD is characterized by increased concentrations of cholesterol-rich and triglyceride-rich ApoB-containing LPs. While the duration of treatment appears to have some influence on the development of this type of dyslipidemia, the pathophysiological links to the dialysis mode must be further explored.  相似文献   

19.
OBJECTIVE: It is unknown whether a given level of urea clearance by the native kidneys provides better or similar control of uremia than the same level of urea clearance by continuous peritoneal dialysis (PD). More insight into possible differences between renal and peritoneal urea clearances is warranted. Therefore, we investigated the relationship between Kt/V(urea) and protein equivalent of total nitrogen appearance normalized to body weight (nPNA), the relationship between urea clearance and creatinine appearance, and other nutritional parameters in PD patients without residual renal function, and in predialysis end-stage renal disease patients. PATIENTS: All patients participated in the Netherlands Cooperative Study on the Adequacy of Dialysis. This is a prospective cohort study of incident dialysis patients, in whom regular assessments of renal function are done. A group of 75 PD patients was identified at the first follow-up assessment in which their urine production was less than 100 mL/day. These patients were considered the anuric group. This group was compared with a control group of 97 predialysis patients studied 0-4 weeks before the start of dialysis treatment. RESULTS: Linear relationships were present between Kt/V(urea) and nPNA, in both the predialysis patients and the anuric PD patients. A significant difference was present between the slopes of the two regression lines (0.40 vs 0.18, p = 0.007). When Kt/V(urea) exceeded 1.3/week, a given level of Kt/V(urea) was associated with a higher nPNA in predialysis than in anuric PD patients. Similar relationships were found between Kt(urea) and PNA. Kt(urea) was also significantly related to urine or dialysate creatinine appearance. A significant difference existed between the slopes of the regression lines in the two groups of patients (p < 0.001). A weekly Kt(urea) of 70 L was associated with a urine creatinine appearance of 11.0 mmol/day and a dialysate creatinine appearance of 8.4 mmol/day. Nutritional status measured with creatinine appearance and Subjective Global Assessment was better in the predialysis population, despite much lower values for Kt/V(urea) in these patients. CONCLUSIONS: The relationship between Kt/V(urea) and nPNA in anuric PD patients is different from that in a predialysis population. It follows from our results that, when Kt/V(urea) is above 1.3/week, a given level of Kt/V(urea) is associated with a higher nPNA in predialysis than in anuric PD patients.This challenges the concept of equivalency between renal and peritoneal Kt/V(urea) with respect to control of uremic morbidity.  相似文献   

20.
目的对31例糖尿病肾病腹膜透析病人进行自我管理教育,旨在提高病人自我管理能力,从而改善血糖及容量状况。方法对31例接受规律腹膜透析>3个月的糖尿病肾病患者进行6个月的自我管理教育及密切的追踪随访,于干预前后分别评估患者血糖控制、容量控制状况。结果经过6个月的自我管理教育,患者自我管理能力明显提高,糖化血红蛋白由6.68%下降至6.35%,总排钠由3.48 g/d下降至2.58 g/d,平均血清钠离子浓度由137.64 mmol/L下降至136.14 mmol/L,体重由61.67 kg下降至59.89 kg,E/I由1.25下降至1.15。经配对t检验,差异有统计学意义(P<0.05)。同时,病人的总液体清除量没有增加,血压控制率由35.5%上升到51.6%(χ2值10.542,P<0.01)。结论自我管理教育,可以提高糖尿病肾病腹膜透析病人的依从性及病人的自我管理能力。  相似文献   

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