尿糖与尿微量白蛋白联合检验对糖尿病早期肾损伤的诊断价值研究

目的探讨尿糖与尿微量白蛋白联合检验对糖尿病早期肾损伤的诊断价值。方法将我院在2017年1月至2017年9月收治的57例糖尿病早期肾损伤患者作为观察组,选择同时期的健康体检者55例纳为对照组,对比分析两组的尿糖以及尿微量白蛋白的检测水平。结果观察组的尿糖阳性率以及尿微量白蛋白明显高于对照组,两组对比差异有统计学意义(P<0.05)。结论尿糖与尿微量白蛋白联合检验对糖尿病早期肾损伤有良好的诊断价值,值得临床推广。     

尿微量白蛋白与妊娠期高血压疾病早期肾损伤关系的研究

目的探讨尿微量白蛋白(尿mALB)与妊娠期高血压疾病患者早期肾损害的关系,评价临床诊断价值。方法采用免疫散射比浊法检测60例孕25～42周孕妇尿微量白蛋白(尿蛋白定性均为阴性),其中30例妊娠期高血压孕妇作为观察组,另30例正常孕妇为对照组。结果观察组尿微量白蛋白(26.01±7.28)mg/L,超过参考值阳性率60.00%。对照组尿微量白蛋白(8.17±2.98)mg/L,超过参考值阳性率10.00%。两组比较有统计学差异(P<0.05)。结论妊娠期高血压疾病早期肾损伤患者尿微量白蛋白明显升高,检测尿微量白蛋白可用于及早发现妊娠期高血压疾病的早期肾损伤,对及时干预,阻止病情发展有其重要的临床意义。     

妊娠期高血压疾病早期肾损伤与尿微量白蛋白关系的研究

目的 探讨尿微量白蛋白(尿mALB)与妊娠期高血压疾病患者早期肾损害的关系,评价临床诊断价值.方法 采用免疫散射比浊法检测70例孕25～ 42周孕妇尿微量白蛋白(尿蛋白定性均为阴性),其中35例妊娠期高血压孕妇作为观察组,另35例为我校进行健康体检的健康育龄妇女为对照组.结果 观察组尿微量白蛋白(26.01±7.28)mg/L,超过参考值阳性率60.00％.对照组尿微量白蛋白(8.17±2.98) mg/L,超过参考值阳性率10.00％.两组统计学差异均有统计学意义(P＜0.05).结论 妊娠期高血压疾病早期肾损伤患者尿微量白蛋白明显升高,检测尿微量白蛋白可用于及早发现妊娠期高血压疾病的早期肾损伤,对及时干预,阻止病情发展有其重要的临床意义.     

尿微量白蛋白／肌酐对诊断糖尿病早期肾损伤的临床意义

目的探讨尿微量白蛋白／肌酐检测在诊断糖尿病早期肾损伤中的临床意义。方法用快速免疫比浊法测定91例Ⅱ型糖尿病患者随机尿中微量白蛋白、肌酐,计算尿微量白蛋白／肌酐比值,并与40例健康体检者作对比。结果91例Ⅱ型糖尿病患者中尿微量白蛋白／肌酐比值大于参考值者54例,阳性率为59．34％,与对照纽有显著性差异（P〈0．001）,尿微量白蛋白／肌酐是诊断糖尿病早期肾损伤的敏感指标：尿微量白蛋白／肌酐阳性率与年龄、病程密切相关,年龄越大、病程越长,阳性率越高,与性别无关（P〉0．05）。结论尿微量白蛋白／肌酐是诊断早期糖尿病肾损伤的一项敏感指标,对诊断早期糖尿病肾损伤有重要的临床意义。     

尿糖与尿微量白蛋白联合检验对糖尿病早期肾损伤的诊断价值研究

目的研究尿糖与尿微量白蛋白联合检验对糖尿病早期肾损伤的诊断价值。方法将本院2017年1月至2017年12月接受的1100例糖尿病患者作为研究对象,并将其设置为观察组,选取同时期在我院接受健康体检的300名健康人群作为参照对象设置为对照组,观察两组尿糖、尿微量白蛋白检验结果。结果观察组尿痛、微量白蛋白指标检验结果均明显高于对照组(P <0.05);观察尿糖与尿微量白蛋白检测阳性率分别为85.18%和71.91%,观察组阳性率均为0。结论尿糖与尿微量白蛋白指标联合检测能够有效提高糖尿病早期肾损伤诊断的准确性,为医师临床诊断和治疗提供了重要的数据支撑。     

尿微量白蛋白检测在早期肾损伤的诊断价值

目的探讨尿微量白蛋白的测定对早期肾损伤的诊断价值。方法选取2009年2月至2010年1月来确诊糖尿病、高血压（观察组）患者100例,检测尿微量白蛋白;同时检测100例健康成年人（对照组）的尿微量白蛋白水平,进行比较分析。结果观察组患者的m-Alb检测值和阳性率均明显高于对照组,两组阳性率比较差异有统计学意义（P〈0.05）。结论尿微量蛋白的检测是发现早期肾损伤最敏感、最可靠的诊断指标,对于肾病的预防及早期治疗都起了积极作用。     

尿微量白蛋白检测对糖尿病早期肾损害的临床分析

目的对尿微量白蛋白检测对糖尿病早期肾损害临床进行分析。方法选自我院自2004年5月至2007年3月期间内分泌科室收治的糖尿病患者100例,以上患者均符合WHO对糖尿病诊断标准,另选取期间正常人群50例,以上两组的年龄、性别、病情等均无统计学意义,具有可比性。收集以上两组患者早晨的第一次尿,分为两管,每管5mL,其中一管取完后立即作尿常规检查,再取另一管做离心处理,转速是3000r/min,时间10min后取上清液进行尿微量白蛋白检测,此过程要严格按照规程执行,采用免疫比浊法进行测定。结果正常组的尿微量白蛋白平均值为(16.3±8.9)mg/L,患者组的尿微量白蛋白平均值为(248.3±105.9)mg/L,出现异常患者有56例,占56%。结论对糖尿病患者进行尿微量白蛋白检测对早期肾损害是有重要的临床意义的,对其预防、早期诊断和治疗也具有重要意义,因此值得在临床上高度重视。     

药物干预高血压早期肾脏损害的观察

目的:通过降压治疗观察原发性高血压病人尿微量白蛋白尿(MAU)的改变,从而探讨降压治疗对肾脏早期损伤的延缓作用。方法:1～2级原发性高血压病人63人,无明显的肾功能不全等相关因素。降压的同时观测MAU的变化1年。结果:治疗后1年的MAU含量呈显著的有意义降低(P<0.01)结论:MAU是早期肾损害的敏感指标。用培哚普利和缬沙坦降压治疗对改善MAU有益,而二者在降低MAU方面没有明显的差异。     

Comparison of speciated arsenic levels in the liver and brain of mice between arsenate and arsenite exposure at the early life

The aim of this study was to compare the risk from exposure to arsenate (iAs^V) or arsenite (iAs^III) at the early life. Mother mice were exposed to equimolar dose of iAs^V and iAs^III via drinking water during gestation and lactation. Their offspring continually drank the same water after weaning. Levels of speciated arsenic in both liver and brain were analyzed by hydride generation of volatile arsines and atomic absorption spectrophotometry (HG‐AAS). In the liver, inorganic arsenic (iAs) levels significantly increased from postnatal day (PND) 15, and those on PND 35 were significantly higher than on PND 15 and 21 in iAs^III exposed mice, but iAs levels did not significantly differ until PND 35 in iAs^V exposed mice; Furthermore, all speciated arsenic levels on PND 35 and dimethylarsinic acid (DMA) levels on PND 1 were significantly higher in iAs^III exposed mice than those in iAs^V exposed mice. In the brain, iAs levels increased significantly on PND 21, but those declined sharply on PND 35 in either iAs^III or iAs^V exposed mice, however the mean difference between the two exposure groups was not significant; whereas DMA levels in iAs^III exposed mice were significantly higher than those in iAs^V exposed mice on both PND 1 and 35. In conclusion, findings from this study suggested that iAs^III was preferentially accumulated into liver, and expected to result in more efficient methylation capacity than iAs^V; either iAs^V or iAs^III might be accumulated in the brain readily, when immature blood brain barrier can not limit it into brain. Hence, exposure to either iAs^V or iAs^III at the early life may increase the risk of iAs exposure in the brain. © 2012 Wiley Periodicals, Inc. Environ Toxicol 29: 797–803, 2014.     

Toxicity of chlorpyrifos to the early life history stages of eastern rainbowfish Melanotaenia splendida splendida (Peters 1866) in tropical Australia

Various life history stages of the eastern rainbowfish Melanotaenia splendida splendida were exposed to the organophosphorus insecticide chlorpyrifos at different temperatures and under different exposure regimes. Chlorpyrifos was found to be highly toxic to all stages of M. s. splendida and became significantly more toxic to embryonic and larval fish as the temperature of the exposure increased. The toxicity of chlorpyrifos was found to be different for each of the various life history stages tested, with the LC50 values increasing from 0.02 mg chlorpyrifos L(-1), for eggs and sperm exposed prior to fertilization, to 2.02 mg chlorpyrifos L(-1), for eggs exposed after fertilization and hardening of the chorion. Sublethal early life stage (ELS) tests revealed that larval length and otolith perimeter were the most sensitive indicators of stress, with significant differences from the controls at chlorpyrifos concentrations as low as 0.006 mg L(-1).     

早期康复训练在急性脑卒中患者生存质量改善中的价值探讨

目的：探讨早期康复训练在急性脑卒中患者生存质量改善中的价值。方法：将我院内科2015年1月—2015年9月收治的56例急性脑卒中患者随机分为研究组和对照组,两组患者均给予神经内科常规护理和健康知识教育,研究组由社区志愿者或家属给予康复训练。6个月后,观察比较患者的疗效、Barthel指数、MMSE评分。结果：研究组治疗总有效率为82.14%,高于对照组的57.14%,差异有统计学意义（P＜0.05）;两组治疗前的Barthel指数和MMSE评分差异均无统计学意义（P＞0.05）;治疗6个月后,研究组Barthel指数高于治疗前和对照组（P＜0.05）。MMSE评分低于治疗前和对照组（P＜0.05）;对照组MMSE评分低于治疗前（P＜0.05）。结论：早期康复训练在急性脑卒中患者生存质量改善中的价值较高,能够提高患者临床疗效,改善患者Barthel指数、MESSS评分。     

替米沙坦对原发性高血压患者血尿酸和微量白蛋白尿的影响

目的:观察替米沙坦对轻中度原发性高血压患者血尿酸代谢及尿白蛋白排泄的影响。方法:88例轻中度高血压患者,随机分为2组,其中治疗组44例,用替米沙坦40mg.d-1口服;对照组44例,用非洛地平缓释片5mg.d-1口服;治疗前测24h动态血压(ABPM)、空腹血尿酸水平、24h尿白蛋白排泄量及其他相应检查。2组患者用药2周末测血压,如坐位血压收缩压≥140mmHg和/或舒张压≥90mmHg者则剂量加倍,以后每周定时、定点测血压一次。治疗12周后重复治疗前各项检查。结果:治疗2周末2组患者血压均明显下降,4周后血压趋于稳定,与治疗前比较,有统计学差异(P<0.01)。治疗12周末治疗组治疗后与治疗前比较,血尿酸水平明显下降(P<0.01);与对照组治疗后比较,差异有统计学意义(P<0.01)。治疗组治疗后尿白蛋白排泄量较治疗前明显下降(P<0.01);与对照组治疗后比较,差异有统计学意义(P<0.01)。结论:替米沙坦不仅能有效降低血压,而且能有效降低患者血尿酸水平,减少尿白蛋白的排泄。     

The growth response in fish chronic and early life stage toxicity tests: A critical review

Toxicity data from 25 years of fish life cycle chronic, partial chronic and early life stage tests are examined to determine the utility of the standard fish chronic toxicity endpoints, in particular the growth response, to chemical hazard evaluations. The 173 tests include exposure to metals, pesticides, unclassified organics, inorganic compounds, detergent chemicals and complex effluents. Fry survival was significantly reduced in 57% of all tests at the lowest effect concentration. Fry growth was reduced in 36% and egg hatching in 19% of the tests. Only 60% of the tests include exposure of adult organisms. Reproduction was reduced in 30% of these tests. Adult survival (13%) and growth (5%) were seldom reduced at the lowest effect concentration. Fry survival and growth were very often correlated as equally sensitive. Fry growth was the single most sensitive response in only 14% of the tests reported. In the absence of the growth response data for these 20 chemicals/effluents, the fry survival data would have provided MATC values within a factor of 2 to 7 ($\text{x}\text{?3}$). The conclusion is that, as presently derived, the growth response could be deleted from routine applications of the fish early life stage test. The net result would be a significant reduction in the duration and cost of screening tests with no appreciable impact on estimating MATCs for chemical hazard assessments. Possible explanations for the insensitivity of the standard growth response, alternatives, and other relevant observations of this data base are discussed.     

A structured review of the relationship between microalbuminuria and cardiovascular events in patients with diabetes mellitus and hypertension

STUDY OBJECTIVE: To quantify the relative risk of cardiovascular events associated with microalbuminuria in patients with both diabetes mellitus and hypertension. DESIGN: A structured literature search from January 1990-December 2002 using MEDLINE, IPA, and CINAHL. MEASUREMENTS AND MAIN RESULTS: We identified original studies that reported the presence or absence of microalbuminuria and estimates of risk associated with cardiovascular events in patients with both diabetes and hypertension. Abstracted information consisted of study design, patient demographics and risk factors, treatment regimens, and outcome variables. Point estimates and confidence intervals for relative risk were calculated from available data. Of 651 citations identified and reviewed based on title and abstract, 72 were selected for full review. Seven met the inclusion criteria. Because of lack of homogeneity among studies, the results were not conducive to pooling. Cardiovascular end points associated with the presence of microalbuminuria in these studies were all-cause mortality, cardiovascular mortality, and composite cardiovascular morbidity. The relative risk of cardiovascular end points associated with the presence of microalbuminuria ranged from 1.6 (95% confidence interval [CI] 1.2-2.2) to 7.9 (95% CI 2.5-25.3). CONCLUSION: From the limited information available, the risk of cardiovascular events and mortality is estimated to be 2-8 times higher when microalbuminuria is present in patients with diabetes and hypertension. Point estimates in relative risk of cardiovascular morbidity and mortality in patients with diabetes and hypertension were generally higher compared with studies estimating risk in those with only diabetes. Studies that examine the relationship between microalbuminuria (scaled as a continuous or ordinal variable) and cardiovascular events are necessary to clarify potential benefits of pharmacotherapies that reduce levels of urinary albumin.     

生命早期肠道菌群失调与后期过敏性疾病发病风险的研究

目的 探索生命早期肠道菌群失调是否增加后期过敏性疾病的发病风险。方法 建立生命早期肠道菌群失调小鼠模型后对其多次重复腹腔注射过敏原OVA(ovalbumin,卵清蛋白),观察其特异性免疫学指标血清IgE水平的变化。结果 OVA干预前,3组小鼠血清IgE水平差异无统计学意义(P>0.05);第29天、第36天和第43天时,抗生素高剂量组血清IgE水平均显著高于对照组,且差异均有统计学意义(P<0.05);到第43天时,抗生素低剂量组血清IgE水平也显著高于对照(P<0.05)。结论 多次腹腔注射OVA致敏可使生命早期肠道菌群失调小鼠血清IgE水平显著升高,且生命早期抗生素致菌群失调引起的菌群结构的变化可能持续至生命后期,对后期机体免疫功能的发育产生持久的影响。提示生命早期肠道菌群失调可能是导致过敏性疾病发病风险增加的危险因素。     

ATR12181降压疫苗降低自发性高血压大鼠的尿微量白蛋白作用

目的:研究血管紧张素Ⅱ受体I型(AT1)胞外的肽段ATR12181主动免疫自发性高血压大鼠(SHR)后是否降低尿微量白蛋白。方法:根据大鼠AT1受体胞外肽段氨基酸序列设计合成的多肽片段ATR12181作为抗原主动免疫SHR和WISTAR大鼠,SHR用药组给予氯沙坦(10mg·kg-1.d-1)灌胃治疗,动态监测血清抗体滴度及收缩压,以ELISA法检测尿微量白蛋白,RT-PCR法检测肾脏组织中AT1R、c-fos、c-jun基因表达。结果:ATR12181免疫SHR后产生高滴度抗体并降低血压,20周末收缩压为(145±8)mmHg(1mmHg=0.133kPa),低于SHR对照组(197mmHg±8mmHg,P<0.05),与氯沙坦组相近(139mmHg±17mmHg,P>0.05);WISTAR大鼠免疫后产生高滴度抗体,血压正常(116mmHg±6mmHg)。ATR12181主动免疫组SHR尿微量白蛋白降低,肾脏AT1R、c-fos、c-jun基因表达下调,与氯沙坦组变化相近(P>0.05),低于SHR对照组(P<0.05)。WISTAR大鼠免疫组与正常对照组相比无改变。结论:用AT1胞外肽段ATR12181主动免疫SHR可产生高滴度抗体,降低血压和尿微量白蛋白。正常大鼠免疫后可产生高滴度抗体,但对机体无影响。     

高血压病患者尿微量白蛋白与氧化应激、血管内皮功能的相关性研究

目的探讨高血压病患者尿微量白蛋白与氧化应激、血管内皮功能关系。方法根据尿微量白蛋白量将86例高血压病患者分为尿微量白蛋白阳性组（≥30mg/24h）组（MA组,n=47）、尿微量白蛋白正常组（〈30mg/24h）组（NMA组,n=39）。抽血化验血清超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）的活性及氧化低密度脂蛋白抗体（OLAb）滴度,并用彩色多普勒测量肱动脉内皮功能（Flow-MD）,留取24h尿测量微量白蛋白。结果与NMA组比较,MA组的血清SOD、GSH-PX的活性下降、氧化低密度脂蛋白抗体（OLAb）滴度明显升高,并伴有肱动脉内皮功能损害增加（P〈0.01）。结论与尿微量白蛋白阴性的高血压病患者相比,高血压病伴有尿微量白蛋白阳性患者有较严重内皮功能损害和较高水平氧化应激状态,提示氧化应激和血管内皮功能异常在高血压早期肾损害可能起重要作用。     

社区老年原发性高血压患者尿微量清蛋白与动脉粥样硬化状况分析

目的探讨社区老年原发性高血压患者微量清蛋白尿(MA)与动脉粥样硬化间的关系。方法测定社区112例老年原发性高血压患者(根据血压水平分3组)的MA和颈动脉内膜-中层厚度(IMT)值,并设立健康对照组作对照。结果老年原发性高血压组的尿MA及颈动脉IMT水平均高于健康对照组(P<0.01),并且随着血压升高,MA和IMT有增高趋势;MA水平与颈动脉IMT值呈正相关:r=0.52,P<0.01。结论老年原发性高血压患者MA与动脉粥样硬化相关,MA可作为动脉粥样硬化的预测因子之一。