羟乙膦酸钠对实验性高钙尿症的防治作用及其机制

目的：观察骨吸收抑制剂羟乙膦酸钠对实验性高钙尿症的防治作用,并其可能机制。方法：建立大鼠实验性高钙尿症模型,观察羟乙膦酸钠治疗后２周和４周的尿钙,Ｃａ＾２＋／Ｃｒ,ＮＡＧ／Ｃｒ,以及肾和十二揸肠Ｃａ＾２＋－ＡＴＰ酶（钙泵）的变化。结果：２周时尿钙,Ｃａ＾２＋／Ｃｒ,血ＡＬＰ量有所升高,但４周时尿钙,Ｃａ＾２Ｃｒ,ＮＡＧ／Ｃｒ及血ＡＬＰ均显著下降（Ｐ〈０．０１）,２４小时尿一量与尿ＮＡＧ／Ｃｒ值呈正     

儿童特发性高钙尿症的流行病学和红细胞膜钙泵活性的研究

对青岛市１４１０名健康儿童随意早餐后２ｈ尿钙／肌酐（Ｃａ／Ｃｒ）比值和２４ｈ尿钙定量进行测定。提出以随意早餐后２ｈ尿Ｃａ／Ｃｒ比值≥０．２２，２４ｈ尿钙定量＞０．１ｍｍｏｌ／ｋｇ，作为本地区儿童高钙尿症诊断的标准；据此在本组被调查儿童中检出特发性高钙尿症（ＩＨ）３９例，发病率为２．７７％，无性别差异；钙负荷试验示ＩＨ以肠吸收型为主。同时发现肠吸收型ＩＨ病儿红细胞膜钙泵活性增高，而肾脏漏出型降低，与对照组比较Ｐ＜０．０１或０．０５，推测体内（尤其是小肠和肾小管上皮细胞）钙泵活性异常在ＩＨ发病机制中起重要作用。     

1410名健康儿童随意尿钙／肌酐比值测定及对高钙尿症的筛查价值

对青岛市区１４１０名２－１３岁健康儿童随意早餐后２－３ｈ尿标本的尿钙／肌酐比值（Ｃａ／Ｃｒ）进行检测，检测结果呈偏态分布，无年龄和性别差异，中位数为０．０９５，第９５百分位值０．２２，当尿Ｃａ／Ｃｒ比值〈０．２２时对高钙尿症筛查无假阴性，≥０．２２时应常规检测２４ｈ尿钙排泄量以确诊或排除钙尿症。结果提示，随意早餐后尿Ｃａ／Ｃｒ比值可做为高钙尿症的初筛试验。     

1410名健康儿童随意尿钙／肌酐比值测定及对高钙尿症的筛查价值

对青岛市区１４１０名２～１３岁健康儿童随意早餐后２～３ｈ尿标本的尿钙／肌酐比值（Ｃａ／Ｃｒ）进行检测，检测结果呈偏态分布，无年龄和性别差异，中位数为０．０９５，第９５百分位值０．２２．当尿Ｃａ／Ｃｒ比值＜０．２２时对高钙尿症筛查无假阴性，≥０．２２时应常规检测２４ｈ尿钙排泄量以确诊或排除高钙尿症。结果提示，随意早餐后尿Ｃａ／Ｃｒ比值可做为高钙尿症的初筛试验。     

儿童单纯性血尿和尿结石与特发性高钙尿症的关系

目的 探讨儿童单纯性血尿和尿地石与特发性高钙尿症的关系。方法 对５８例单纯性血尿患者进行２４小时尿钙定量,并测定午餐后２ｈ尿钙／尿肌酐比;确诊为特发性高钙尿症患儿作临床分型,以及ＩＶＰ,腹部平片,家族尿结石调查。结果 ５８例单纯性血尿中,发现１６例２４ｈ尿钙定量子大于０．１ｍｍｏｌ／ｋｇ,尿Ｃａ／Ｃｒ比值大于０．２;临床分型,１１例为肠吸收剂,５例为肾漏型;１６例中２例已有结石发生,５例有尿结石家     

绝经期妇女尼尔雌醇替代治疗对骨代谢的影响

目的：探讨尼尔雌醇在雌激素替代治疗中对骨代谢的影响。方法：３０例绝经０．５ａ以上的妇女,口服尼尔雌醇２ｍｇ,每月２次,用ＣＨＡＬＬＥＮＧＥＲ全身双能Ｘ线骨密度仪测量骨密度及用ＡＬＣＹＯＮ－１６０生化分析仪检测雌二醇（Ｅ２）,骨碱性磷酸酶（ＡＫＩＰ）,２４ｈ尿钙（Ｃａ＾２＋）／肌苷（Ｃｒ）,羟脯氨酸（Ｈｙｐ）／Ｃｒ。结果 治疗３个月后腰椎正位的骨密度较治疗前增加０．２％,Ｃａ＾２＋／Ｃｒ及Ｈｙｐ／Ｃ     

青少年钙负荷的降压效应研究

对９６名１４～１７岁学生进行了２个月的钙干预试验。在实验前后进行体格指标、血清及尿电解质、血浆维生素Ｄ３、血小板内Ｃａ（２＋）及Ｍｇ（２＋）的测定。结果表明：青少年血压与皮脂厚度、脉率、血小板内Ｃａ（２＋）及尿Ｃａ（２＋）呈显著正相关关系（ｒ＝０．２７～０．３３，Ｐ＜０．０５）；血压下降与血浆维生素Ｄ３、肾排Ｎａ＋能力呈负相关关系（ｒ＝－０．４２～－０．４４．Ｐ＜０．０５）；血小板内Ｃａ（２＋）与舒张压下降，尿Ｎａ＋与有家族史组血压下降关系密切。提示钙负荷对青少年有显著的降压作用，但降压作用具有选择性。     

尿微量白蛋白／肌酐比值预测妊高征的临床研究

２４８例孕妇在妊娠２０～２４周时留晨尿，用放射免疫方法（ＲＩＡ）测定尿微量白蛋白（ＵＡｂ）生化自动分析仪测定尿肌酐，尿钙。尿白蛋白／肌酐比值（ＵＡｌｂ／Ｃｒ）≥１０（ｍｇ／ｇ）作为临界值，预测妊高征。其敏感性，特异性，阳性和阴性预测率分别为７７．８％，９７．０％，６６．７％和９８．２％，与尿钙／肌酐比值（ＵＣａ／Ｃｒ）红细胞压积（ＨＣＴ）孕中期平均动脉压（ＭＡＰ－２）等预测方法相比，各项指标均优于     

血清nCa^2＋含量在肾综合征出血热中的动态变化

目的 研究血清离子钙（ｎＣａ＾２＋）在肾综合征出血热（ＨＦＲＳ）中的变化规律及在发病中的作用。方法 用离子选择电极法检测了４６例ＨＦＲＳ患者不同病期血清ｎＣａ＾２＋含量,并将ｎＣａ＾２＋与血清尿素氮（ＢＵＮ）、肌酐（Ｃｒ）做相关分析。结果ＨＦＲＳ患者在低血压休克期和多尿期时血清ｎＣａ＾２＋含量降低（Ｐ〈０．０５）,以少尿期最为显著（Ｐ〈０．０１）。而且随病情加重,结果依次降低,危重型患者整个多尿     

染铅鼠海马神经原长时程增强过程中Ca^2＋浓度及PKC活性的…

为探讨中枢神经系统铅中毒的生化机制，以慢性染铅鼠为动物模型，用高叔刺激诱发海马区产生长时程增强后，以Ｆｕｒａ－２为Ｃａ＾２＋指示剂，测定海马神经元Ｃａ＾２＋浓度，以放射性［ｒ－＾３２Ｐ］－ＡＴＰ掺入外源性底物方法测定神经元胞浆及胞膜ＰＫＣ活性。结果：染铅组长时程增强过程中Ｃａ＾２＋浓度明显升高（２３６．４８±６１．８３ｎｍｏｌ／Ｌ，与对照组比较有统计学意义（Ｐ〈０．０００１）。ＰＫＣ活性亦升高（胞     

服镁后血镁钙及24小时尿钙和钙/肌酐比值变化

研究服镁后，血镁钙及24h尿钙和钙／肌酐比值变化及与妊高征发生的关系。方法：采用前瞻性随机双盲的方法，对治疗组52例（治疗1组24例和治疗2组28例）孕妇自孕28周起，连续服用葡萄糖酸镁，每日3g。结果：治疗组血钙明显高于对照组；治疗2组的尿钙和钙／肌酐明显高于对照2组，且妊高征发生率3．57％，明显低于对照2组（30．77％）；治疗组和对照组尿钙与钙／肌酐比值分别呈正相关关系。结论：服镁后，调节体内钙平衡，使妊高征发生率降低。     

The effect of low-dose estrogen and progestogen on menopausal symptoms and urinary excretion of calcium.

The effects of low-dose estrogen and progestogen on menopausal symptoms were studied with Kuppermen score and urinary excretion of calcium as fasting morning urine Ca/Cr ratio in 69 perimenopausal women. The subjects were divided into 3 groups: amenorrhea less than 1 year (14 women); post menopause 1-3 years (19); and post menopause more than 3 years (36). Fasting urine Ca/Cr ratio in the post menopause 1-3 years group was 0.19 +/- 0.01, significantly higher than that (0.14-0.01) in the amenorrhea less than 1 year group and (0.11 +/- 0.006) the post menopause more than 3 years group. 18 women had 4 patterns of low-dose oral estrogen and progestogen: MPA 2 mg QOD, EE 5 micrograms QD, EE 5 micrograms QOD, and EE 5 micrograms and MPA 2 mg QOD. Each pattern was used in turn for 3 weeks, and discontinued for 2 weeks, then the next pattern started and so on. EE 5 micrograms and MPA 2 mg QOD alternately gave the best results both in improving symptoms and lowering urine Ca/Cr ratio. Seven women given intermittent large dose, namely, EE 50 micrograms every 10 days or premarin 2.5 mg every 7 days had symptoms relieved but inconsistent decrease of urine Ca/Cr ratio.

     

夏枯草提取物抑制大鼠肾草酸钙结石形成作用的研究

目的 研究夏枯草提取物对大鼠肾草酸钙结石的作用及机制. 方法 将40只雄性Wistar大鼠随机分为4组:对照组、模型组、夏枯草提取物低剂量(50 g/L)和高剂量(100 g/L)实验组.实验4周后处死动物,将各组大鼠肾脏标本制成组织切片,H-E染色,观察大鼠肾组织病理学改变;检测大鼠血清尿素氮(BUN)、血清肌酐(Cr)、磷(P)和Ca2+的含量,检测24 h尿液中Ca2+和草酸(Ox)的含量;运用荧光定量PCR和Western-blot检测大鼠肾内TRPV5 mRNA和蛋白的表达,并进行统计学分析. 结果 与对照组比较,模型组大鼠肾呈现草酸钙结石病理改变,不同浓度的夏枯草提取物作用后,可明显改善其病理变化.模型组血清BUN,Cr,Ca2+和P含量明显升高,经不同浓度的夏枯草提取物作用后,实验组BUN及Cr含量明显低于模型组(P＜0.05),但实验组和模型组Ca2+及P含量比较无显著性差异;模型组尿液Ca2+,Ox含量较对照组明显升高,经不同浓度的夏枯草提取物作用后,可降低实验组Ca2+含量,且成药物剂量依赖性(P＜0.05),但对Ox的含量无显著性作用;模型组肾内TRPV5mRNA和蛋白的表达明显降低,经不同浓度的夏枯草水提取物作用后,实验组TRPV5 mRNA和蛋白的表达逆转,且具有统计学意义(P＜0.05). 结论 夏枯草对大鼠肾草酸钙结石具有防治作用;可能是通过上调大鼠肾脏尿钙调控信号TRPV5的表达,降低血清中BUN、Cr含量及尿液中Ca2+的含量.     

补肾壮骨冲剂治疗绝经后骨质疏松症2年疗效观察

目的：客观评价补肾壮骨冲剂治疗绝经后骨质疏松症的疗效。方法：将175例绝经后骨质疏松症患者随机分成两组，分别应用补肾壮骨冲剂、密钙息治疗2年。另设67例作为空白对照组。治疗后观察其疼痛缓解情况并测定前臂骨密度，血清钙、磷和碱性磷酸酶等骨代谢生化指标，进行综合疗效分析。结果：补肾壮骨冲剂组、密钙息组的总有效率分别为87．51％和89．66％，两组间无明显差异（P＞0．05）；两组与空白对照组（总有效率为32．84％）比较有明显差异（P＜0．05）。结论：补肾壮骨冲剂与密钙息治疗绝经后骨质疏松症疗效相仿，而补肾壮骨冲剂有价格低廉、副作用少、服用方便等优势，值得推广应用。     

尿微量白蛋白测定的生物学变异研究

目的：研究尿微量白蛋白（以下简称Ｕ－ｍＡｌｂ）排出量与性别、年龄、运动、饮食、昼夜节律等生物学因素间的关系。方法：对受试正常人群，用免疫比浊法检测Ｕ－ｍＡｌｂ；用饱和苦味酸法检测尿Ｃｒ，计算出Ｕ－ｍＡｌｂ比值（ｍｇ／ｇ Ｃｒ）结果，并进行对比试验。结果：８０１例正常人Ｕ－ｍＡｌｂ排出量呈正偏态分布，Ｕ－ｍＡｌｂ参考值上限，６￣１２岁；男３１．５ｍｇ／ｇ Ｃｒ，ｍｇ／ｇ Ｃｒ；１３￣４０岁：男２４．     

The Expression and Implication of TRPV5,Calbindin-D28k and NCX1 in Idiopathic Hypercalciuria

The expression of calcium epithelium TRPV5, alcium binding protein Calbindin-D28k and Na＋/Ca2＋ exchanger NCX1 was detected in renal distal convoluted tubule, and their effects on urine calcium reabsorption and the possible pathogenic mechanism in idiopathic hypercalciuria （IH） were investigated. Genetic hypercalciuric stone-forming （GHS） rats were chosen as animal models to study urine calcium reabsorption and IH. The cognate female and male rats that had maximal urine calcium were matched to breed next generation. Twelve GHS rats and 12 normal control （NC） SD rats were selected. Western blot and real time quantitative PCR were used to detect the protein and gene expression of TRPV5, Calbindin-D28k and NCX1 respectively. The expression levels of TRPV5 protein and mRNA in GHS rats were significantly lower than in NC rats （P〈0.05）. Western blot revealed that the expression levels of Calbindin-D28k in GHS rats and NC rats were 0.49±0.02 and 0.20±0.01 respectively, with the difference being significant between them （P〈0.05）. By using real time quantitative PCR, it was found that there was no significant difference in Calbindin-28k mRNA expression levels between GHS rats and NC rats （P〉0.05）. There was no significant differ- ence in the NCX1 expression between GHS rats and NC rats （P〉0.05）. It was suggested that TRPV5 and Calbindin-D28k might play an important role in urine calcium reabsorption and IH, but they dif- ferently contributed to the pathogenesis： The down-regulation of TRPV5 decreases urine calcium reabsorption, directly leading to loss of the urine calcium and resulting in hypercalciuria, and the increased Calbindin-D28k expression could relieve, neutralize and decrease intracellular Ca2＋ concentration to maintain calcium balance. NCX1 is not the key protein in urine calcium reabsorption.     

Clinical biochemical observation on the treatment of postmenopausal osteoporosis with Gusong II

Objective: To assess the effect of Gusong II in treating postmenopausal osteoporosis and try to reveal its mechanism.Methods: Thirty-five women, 49 to 62 years old, with 5.6 years menopause, were treated as the subjects and followed-up for 6 months, 12 months or 24 months. The course of treatment ranged from 6 months to 25 months with an average of 14 months. Some related biochemical parameters, such as serum estradiol (E₂), testosterone (T), the ratio of fasting urinary calcium to creatinine (Ca/Cr), the ratio of 24h urinary calcium to creatinine (24h Ca/Cr), 24h urinary E₂, and 24h urinary hydroxyproline (HOP) were measured before and after treatment.Results: After 6~9 months or 1~2 years of treatment, the levels of serum E₂ and 24h urinary E₂ were raised significantly, while the levels of serum T and urinary Ca/Cr fell evidently after one or two year’s treatment. The levels of serum E₂ and 24h urinary E₂ were significantly correlated with the levels of fasting urinary Ca/Cr, 24h urinary Ca/Cr, serum T, and 24h urinary HOP respectively.Conclusions: Gusong-II can elevate the serum E₂ levels of postmenopausal women, reduce the discharge of urinary calcium and HOP, and inhibit bone resorption. The rise of the serum E₂ level might be correlated with the conversion of T to E₂.