肾动脉硬化致肾血管性高血压的介入治疗

自 1995年 2月至 2 0 0 1年 12月我院采用介入治疗肾动脉硬化、肾血管性高血压 38例 ,现报告如下。材料与方法　本组 38例。男 2 7例 ,女 11例。年龄 5 8～ 76岁 ,平均 6 5岁。 38例均有高血压表现 ,其中 2 0例有原发性高血压病史 ,近期 (3～ 18个月 )血压明显升高 ,降压药物效果不好。收缩压 (2 12± 2 3)mmHg(1mmHg =0 .133kPa)。余 18例病程 2～ 4 8个月。收缩压 (2 0 8± 19)mmHg。动脉造影示单侧肾动脉受累 2 8例 ,双侧受累 10例。开口部病变 2 7段 ,中远端病变 2 1段。狭窄段长度 (16 .2±4 .8)mm ,狭窄远近端压力阶差 (5 2± 16 )m…     

高血压合并糖尿病患者动脉硬化无创检测的临床研究

目的通过无创检测评估高血压合并糖尿病患者动脉硬化的程度。方法应用无创式动脉硬化检测仪测量66例高血压合并糖尿病患者（观察组）和62例健康体检者（对照组）踝．臂指数（ABI）、脉搏波传导速度（PWV）、收缩压、舒张压、脉压（PP）,同时测定血脂、空腹血糖、糖化血红蛋白、高敏C反应蛋白（hs-CRP）和体重指数（BMI）,分析ABI、PWV的影响因素。结果观察组ABI（0．68±0．35）低于对照组（1．14±0．21）,PWV[（17．30±3．14）m／s]高于对照组[（11．30±0．86）m／s]（P〈0．01）。与ABI有关的重要危险因素是性别、空腹血糖、hs-CRP（P〈0．01）。PWV与年龄、收缩压和PP呈正相关（P〈0．01）,与BMI呈负相关（P〈0．05）。以PWV为应变量进行多元逐步回归分析,依次进入方程的变量为PP和BMI。结论应用无创式动脉硬化检测仪测量ABI、PWV能反映高血压合并糖尿病患者血管弹性的变化,了解动脉硬化的程度。     

高血压及高血压前期血清尿酸水平的变化及临床意义

目的：探讨高血压及高血压前期血清尿酸水平变化及临床意义。方法选择某社区常住居民412例为研究对象。根据血压情况分为血压正常组、高血压前期组、高血压组。检测和比较3组的血清尿酸水平。结果血压正常组尿酸水平为（236.3±61.4）μmol/L,高血压前期组（292.7±73.6）mol/L,高血压组（336.2±113.7）mol/L,3组间比较 P ＜0.01。血清尿酸水平为228～280μmol/L、281～344μmol/L 和≥345μmol/L 组收缩压和舒张压水平显著高于血清尿酸为＜228μmol/L 组（P ＜0.05或＜0.01）。回顾分析显示尿酸水平≥228μmol/L 是高血压及高血压前期的危险因素。结论血清尿酸水平与高血压及高血压前期具有相关性。     

胆红素、尿酸水平与下肢动脉硬化闭塞症相关性研究

目的探讨胆红素、尿酸水平与下肢动脉硬化闭塞症(ASO)的关系。方法对正常人群组(本院体检健康人群)、普通疾病组(静脉曲张,结节性甲状腺肿等)及住院的下肢ASO患者(ASO组)进行总胆红素、直接胆红素、间接胆红素及尿酸测定,每组各100例。结果下肢ASO组的总胆红素、直接胆红素、间接胆红素均较正常人群组、普通疾病组降低;而尿酸水平又明显高于正常人群组、普通疾病组(P0.05)。结论下肢ASO的发生与血清胆红素的水平呈负相关,与尿酸水平呈正相关,胆红素是动脉硬化的独立危险因素之一。     

探讨老年人骨质疏松与动脉硬化风险之间的关系

目的通过对老年人骨密度、T值与肱-踝脉搏波传导速度关系的分析,探讨老年人骨质疏松与动脉硬化的相关性。方法对97例老年高血压、冠心病患者采用双能X射线骨密度仪进行腰椎、股骨颈和前臂的骨密度测试,采用动脉硬化仪测定患者的肱-踝脉搏波传导速度(brachial-ankel pulse wave velocity,ba PWV),采用全自动生化仪测定患者的生化指标。根据T值将患者分为骨量正常组、骨量减少组和骨质疏松组,根据ba PWV将患者分为动脉硬化组和非动脉硬化组。结果骨量正常患者、骨量减少患者和骨质疏松患者的ba PWV依次增高,动脉硬化患者的BMD值和T值明显低于非动脉硬化患者,差异均有统计学意义(P0.05),动脉硬化患者与非动脉硬化患者之间、不同程度骨质疏松患者之间的性别分布、BMI、Ca、P、TC、TG、HDL-C、LDL-C、Apo A、Apo B比较差异无统计学意义(P0.05)。患者的T值、BMD分别与ba PWV呈负相关关系(r=-0.954、-0.923,P0.05)。结论老年人的骨质疏松和动脉硬化之间存在一定的作用关系。早期测定骨密度对骨质疏松的老年人群采取干预措施可能对老年人动脉硬化具有一定的防治效果。     

老年人动脉硬化与骨质疏松关系的初步研究

目的 探讨老年患者动脉硬化与骨质疏松的关系。方法对106例老年患者进行超声波颈动脉内中膜厚度(IMT)检测及双能X线吸收法(DEXA)骨密度(BMD)测定,并对界值上下两组患者临床数据及骨密度进行比较。另外,所有患者再分为骨质疏松组与非骨质疏松组,比较两组的IMT结果。结果 IMT≥0.8 mm组的松质骨T值明显降低(P<0.01),有斑块组BMD未明显低于无斑块组,骨质疏松组与非骨质疏松组比较,IMT无明显升高,骨密度与年龄及IMT。呈负相关(P<0.01)。结论 老年人动脉硬化可能与骨质疏松有关,但是颈动脉超声检查IMT不能作为很好反映动脉硬化与骨质疏松关系的指标。二者的明确因果关系有待于进一步研究。     

动脉硬化闭塞症与内皮素、一氧化氮的关系

目的 探讨内皮素（ＥＴ）、一氧化氮（ＮＯ）在动脉硬化闭塞症（ＡＳＯ）形成和发展听 作用及ＥＴ、一氧化氮合酶（ＮＯＳ）基因表达同ＡＳＯ的关系。方法 收集４０例ＡＳＯ病人、１２０处病变血管和３０例正常血管,根据病理学检查分为ＡＳＯ早期、中期、晚期和正常血管４组。利用放射免疫测定法和Ｇｒｉｓｓｅ方法检测ＡＳＯ病脸的血浆ＥＴ和ＮＯ水平,利用逆转录－聚合酶链反应（ＲＴ－ＰＣＲ）技术检测４组血管ＥＴｍＲＮＡＴ     

内皮素、一氧化氮及其基因表达与动脉硬化闭塞症的关系

为从分子生物学水平探讨内皮素（ｅｎｄｏｔｈｅｌｉｎｓ，ＥＴ）、一氧化氮（ｎｉｔｉｃｏｘｉｄｅ，Ｎ０）在动脉硬化闭塞症（ａｔｈｅｒｏｓｃｌｅｒｏｓｉｓｏｂｌｉｔｅｒａｎｓ，ＡＳＯ）形成和发展中的地位，我们选择２０例截肢或接受转流手术的ＡＳＯ患者，检测其...     

内皮素,一氧化氮与动脉硬化闭塞症相互关系的探讨

目的：探讨内皮素、一氧化氮在动脉粥样硬化闭塞症的发病学地位及其临床意义。方法：选择49例动脉硬化闭塞症患者，利用放射免疫测定法和亚硝酸盐比色法于中西医结合治疗过程中测定血浆内皮素和一氧化氮的水平。结果：所有患者均存在高内皮素血症和低一氧化氮血症，并于中西医结合有效治疗后恢复正常水平。结论：内皮素、一氧化氮同动脉粥样硬化闭塞症的发生、发展密切相关，血浆内皮素、一氧化氮的检测有助于了解疾病进程、有助于中西医结合治疗疗效观察。     

急性脑梗死患者CRP、UA与颈动脉斑块的相关性分析

目的探讨脑梗死患者CRP、UA与颈动脉斑块的相关性。方法选择84例2013年1月-2014年1月期间住院的急性脑梗死患者。所有患者均行颈动脉彩超检查及血清CRP、UA检查。结果有斑块组CRP、UA水平高于无斑块组,两组比较有统计学差异（P〈0.05）。不稳定斑块组CRP、UA水平高于稳定斑块组,两者有统计学差异（P〈0.05）。结论血清CRP、UA是脑梗死颈动脉粥样硬化斑块发生发展的危险因素。     

Relationship between serum uric acid level and vascular injury markers in hemodialysis patients

Purpose

It has been reported that hyperuricemia causes vascular endothelial injury. Most hemodialysis patients present with hyperuricemia and also with vascular injury, resulting in cardiovascular diseases (CVD). However, the association of serum uric acid (sUA) with vascular injury markers in hemodialysis patients remains unclear. This study aimed to investigate this and discuss the mechanism by which uric acid causes vascular injury.

Methods

We enrolled 48 Japanese maintenance hemodialysis patients without any history of CVD. The association between sUA level and three vascular injury markers (reactive hyperemia index [RHI], ankle–brachial index [ABI], and cardio ankle vascular index [CAVI]) was investigated by linear- and logistic regression analyses.

Results

The median natural logarithm RHI (LnRHI) was 0.36. Linear regression analysis revealed a significant positive correlation between sUA level and LnRHI (β?=?0.42, p?=?0.001) in all patients. Moreover, a significant, strongly positive correlation was observed between sUA and LnRHI in patients who were treated with xanthine oxidase inhibitors (XOIs) (β?=?0.75, p?=?0.001). Further, the linear analysis showed a significant negative correlation between sUA level and CAVI in patients who were treated with XOIs (β?=?? 0.52, p?=?0.049). sUA level was not significantly associated with ABI abnormality.

Conclusions

It is possible that a high level of sUA is significantly associated with better vascular endothelial function and condition of vascular tone in hemodialysis patients who were treated with XOIs. The findings suggest a significant paradox between sUA level and vascular endothelial function in hemodialysis patients; however, the opposite has been reported in patients without hemodialysis.

     

特发性膜性肾病患者血尿酸与肾小管萎缩的关系

目的:探讨特发性膜性肾病(IMN)患者的血尿酸水平与肾小管萎缩的关系。方法:选取2010年1月至2017年12月本院收治的200例IMN患者,按是否合并肾小管萎缩分为肾小管萎缩组和非肾小管萎缩组。采用logistic回归分析影响IMN患者肾小管萎缩的相关因素。受试者工作特征(ROC)曲线分析血尿酸对诊断IMN患者肾小管...     

Relationship between serum adiopocyte fatty acid binding protein and atherosclerosis in chronic kidney disease

Objective To investigate the expression of serum adiopocyte fatty acid binding protein(A-FABP) in chronic kidney disease (CKD) and the role that A-FABP plays in CKD with atherosclerosis. Methods A total of 138 patients with CKD and 20 health control volunteers (HC) were involved in this study. The levels of serum A-FABP, free fatty acid (FFA), interleukin- 6 (IL-6), monocyte chemotactic protein 1(MCP-1) were measured by enzyme-linked immunosorbent assay(ELISA). Inteima-media thickness of common carotid artery was measured by color doppler ultrasound.Results According to the progression of glomerular filtration rate(GFR), the patients with CKD were divided into three groups: group CKD1-2[eGFR≥ 60 ml·min-1·(1.73 m2)-1], group CKD 3-4[60 ml·min-1·(1.73 m2)-1 > eGFR ≥ 15 ml·min-1·(1.73 m2)-1], group CKD5[eGFR ＜ 15 ml·min-1·(1.73 m2)-1].The levels of serum A-FABP were relatively higher in CKD than that in HC group(P＜0.05), and that in the group CKD5 were the most highest (P＜0.01). The level of serum FFA in group CKD 1-2 was relatively higher than that in group HC (P＜0.05), and FFA had a rising trend with decreased eGFR. The level of serum A-FABP was positively correlated with the levels of serum FFA (r＝0.825, P＜0.01), and also positively correlated with IL-6 (r＝0.569, P＜0.01), MCP-1(r＝0.657, P＜0.01) in CKD by Pearson correlation analysis. The levels of A-FABP in 56 patients of CKD with vascular atherosclerosis were significantly higher than that in 82 patients without vascular atherosclerosis (P＜0.01). Conclusion Serum A-FABP maybe play an important role in the progression of vascular atherosclerosis in CKD.     

Relationship between diabetic polyneuropathy,serum visfatin,and oxidative stress biomarkers

BACKGROUND Diabetic polyneuropathy is a very common complication of diabetes. Numerous studies are available in terms of pathogenesis. But examination methods with low reliability are still not standardized and generally time consuming. Highsensitive, easy-to-access methods are expected. Biochemical markers are one of the subjects of research. We aimed to discover a potential biomarker that can be used for this purpose in patients with diabetes who have not yet developed symptoms of neuropathy.AIM To determine the place and availability of visfatin and thiol-disulfide homeostasis in this disorder.METHODS A total of 392 patients with type 2 diabetes mellitus were included in the study. The polyneuropathy clinical signs were evaluated with the Subjective Peripheral Neuropathy Screen Questionnaire and Michigan Neuropathy Screening Instrument questionnaire and examination. The biochemical parameters, oxidative stress markers, visfatin, and thiol-disulfide homeostasis were analyzed and correlated with each other and clinical signs.RESULTS Subjective Peripheral Neuropathy Screen Questionnaire and Michigan Neuropathy Screening Instrument questionnaire with examination scores were correlated with each other and diabetes duration(P 0.005). Neuropathy related symptoms were present in 20.7% of the patients, but neuropathy related findings were observed in 43.9% of the patients. Serum glucose, glycated hemoglobin, and visfatin were positively correlated with each other. Also, these parameters were positively correlated with the total oxidative stress index. Total and native thiol was positively correlated with total antioxidant status and negatively with oxidant status. Inversely thiol-disulfide positively correlated with higher glucose and oxidant status and negatively with total antioxidant status(P 0.005). There was no correlation between visfatin and thiol-disulphide(P = 0.092, r = 0.086). However, a significant negative correlation was observed between visfatin and total with native thiol(P 0.005, r =-0.338),(P 0.005, r =-0.448).CONCLUSION Diagnosis of neuropathy is one of the issues studied in patients with diabetes. Visfatin and thiol-disulfide balance were analyzed for the first time in this study with inspiring results.     

The Relationship between Oxidative Stress,Inflammation, and Atherosclerosis in Renal Transplant and End-Stage Renal Disease Patients

Objectives: Cardiovascular risk is increased in the early stages of chronic kidney disease (CKD) and is also found to be ongoing in renal transplant (Rtx) patients. As a sign of atherosclerosis, increased carotid intima–media thickness (CIMT) has been widely accepted as a strong predictor of cardiovascular disease (CVD) and mortality in the end-stage renal disease (ESRD) patients. Ischemia-modified albumin (IMA), pentraxin-3 (PTX-3), and neutrophil-to-lymphocyte ratio (NLR) were introduced as oxidative stress and inflammatory biomarkers in ESRD. The role of Rtx in terms of atherogenesis, oxidative stress, and inflammation is still unclear. We aimed to investigate the relationship between IMA, PTX-3, NLR, and CIMT in Rtx patients without overt CVD and to compare these results with those obtained from healthy subjects and ESRD patients receiving hemodialysis (HD) and peritoneal dialysis (PD). Design and methods: Cross-sectional analysis in which CIMT measurements, NLR, and serum PTX-3 and IMA levels were assessed in 18 Rtx patients (10 females; mean age: 40.0 ± 13.3 years), 16 PD patients (7 females; 40.2 ± 12.9 years), 14 HD patients (8 females; 46.6 ± 10.7 years), and 19 healthy subjects (9 females; 36.9 ± 8.9 years). Results: IMA, PTX-3, and high-sensitive C-reactive protein (hs-CRP) levels, NLR, and CIMT of Rtx patients were found to be significantly higher compared with healthy subjects (?p = 0.04, p < 0.0001, p < 0.005, p = 0.005, and p = 0.005, respectively). IMA level was positively correlated with hs-CRP and PTX-3 levels, NLR, and CIMT when all participants were included (r = 0.338, p = 0.005; r = 0.485, p < 0.0001; r = 0.304, p = 0.013; and r = 0.499, p < 0.0001, respectively). Conclusion: There has been ongoing inflammation, oxidative stress, and atherosclerosis in Rtx patients.     

波动性高血压与中膜板层变化的动物实验

目的　为了验证和完善关于波动性血压可引起主动脉中膜板层分离 ,从而导致Stan fordB型夹层动脉瘤的假说。方法　通过犬的动物模型设计 ,同时加大血压的波动性和应用悬吊法来加大应力对主动脉弓与主动脉降段交界处的作用。结果　在施加血流动力学应力作用影响后 ,主动脉弓与主动脉降段交界处中膜可较明显地形成 3个板层区。结论　用本实验方法 ,验证了波动性高血压可以造成主动脉弓与主动脉降段交界处中膜板层的分离破坏。在一定角度上解释了StanfordB型胸主动脉夹层动脉瘤形成和发展趋势。     

肝脏微循环调节与门静脉高压症

慢性肝脏疾病终末期的共同变化常常先是肝硬化的出现,继而是门静脉高压的形成。门脉高压的形成一方面是由于肝内肝内血管阻力增高,另一方面是由于扩血管物质的合成增多。近年来的研究发现,肝脏微循环不仅是物质交换的场所,在生理、病理情况下一氧化氮(NO)、一氧化碳(CO)及内皮素(ET)等血管活性物质也参与了肝脏微循环的调节。虽然它们的确切作用部位还有待进一步研究,但主要通过肝窦及肝窦前二个环节起作用这一点已被证实。1　肝脏微循环肝脏的微血管系统是指肝内直径小于300um的血管,包括门脉小支、肝小动脉、肝窦、中央小静脉和淋巴管…