促红细胞生成素改善慢性肾功能衰竭血透患者红细胞质量

目的：探讨重组促红细胞生成素（ｒＨｕＥＰＯ）替代治疗慢性肾功能衰竭（ＣＲＦ）贫血患者的红细胞质量改变。方法：选择４３例ＣＲＦ维持性血透贫血患者，２４例应用ｒＨｕＥＰＯ治疗，１９例应用输血治疗，分别观察两组治疗前、后，血红蛋白（Ｈｂ）、血球压积（Ｈｃｔ）、脂质过氧化物（ＬＰＯ）、超氧化物歧化酶（ＳＯＤ）和Ｎａ＾＋－Ｋ＾＋－ＡＴＰａｓｅ活性变化以及分析Ｎａ＾＋－Ｋ＾＋ＴＡＰａｓｅ活性与ＬＰＯ，ＳＯＤ之     

促红细胞生成素对慢性肾性贫血患者红细胞免疫功能及NK细胞活性的影响

近来 ,我们应用重组人促红细胞生成素 (r Hu E-PO)治疗 1 8例慢性肾功能不全 (CRF)贫血患者 ,并对治疗前后的血红蛋白 (Hb)含量、红细胞 C3 b受体(C3 b R)花环率、红细胞免疫复合物 (IC)花环率及自然杀伤细胞 (NK)活性进行了检测 ,以观察 r Hu EPO对 CRF贫血的疗效 ,探讨 r Hu EPO对红细胞免疫功能及 NK细胞活性的影响。1　资料与方法 :1观察组 :CRF贫血患者 1 8例 ,男 1例、女 7例 ,年龄 1 6～ 5 4岁 ,病程 1～ 1 1年。原发病为慢性肾小球炎 1 2例 ,肾结石 2例 ,狼疮性肾炎、多囊肾、紫癜性肾炎、慢性肾盂炎各 1例。血尿素氮 …     

促红细胞生成素在急性肾功能衰竭治疗中的应用及机制

既往认为促红细胞生成素（erythropoietin，EPO）主要促进骨髓祖红细胞存活、增生和分化，重组人EPO主要应用于肾性贫血的治疗。近年研究表明除红细胞外，在脑、心血管和肾组织等多种脏器的内皮细胞、上皮细胞及其它细胞表面均有EPO及其受体表达。动物实验显示外源性EPO对多种神经系统损伤有保护作用，可以预防甚至逆转糖尿病大鼠神经病变，临床已成功应用于脑卒中的治疗。     

促红细胞生成素对慢性肾功能不全患者心功能的影响

目的观察促红细胞生成素（EPO）对慢性肾功能不全（CRF）患者心功能的影响,并探讨其机制。方法将60例CRF并贫血、心功能不全者分为两组,观察组采用EPO联合铁剂治疗,对照组仅予铁剂,均治疗6个月。结果治疗后观察组心功能显著改善（P〈0．05）,而对照组无明显变化。结论EPO联合铁剂治疗可改善CRF患者心脏功能。     

促红细胞生成素治疗成人慢性肾衰贫血的几点建议

促红细胞生成素治疗成人慢性肾衰贫血的几点建议尹广关键词促红细胞生成素慢性肾衰贫血，缺铁性治疗中图法分类号Ｒ９７３１９９５年加拿大学者Ｍｕｉｒｈｅａｄ〔１〕等人在总结已发表的２００余篇有关临床应用促红细胞生成素文献的基础上，就基因重组人促红细胞生成素（...     

促红细胞生成素治疗慢性肾衰贫血有关的补铁问题

促红细胞生成素治疗慢性肾衰贫血有关的补铁问题尹广龚德华关键词促红细胞生成素慢性肾衰血清铁中图法分类号Ｒ９７３促红细胞生成素（ｅｒｙｔｈｒｏｐｏｉｅｔｉｎ，ＥＰＯ）及铁都是正常红细胞生成过程中必不可少的要素。临床上在应用ＥＰＯ治疗慢性肾衰患者的贫血时，...     

重组人促红细胞生成素在慢性肾衰透析患儿的应用

重组人促红细胞生成素在慢性肾衰透析患儿的应用沈克勤关键词促红细胞生成素；慢性肾功能衰竭；血液透析；腹膜透析；儿童患有慢性肾功能衰竭（ＣＲＦ）的儿童多不可避免的出现正色素、正细胞、低增生性贫血，这种因肾脏病变造成的肾性贫血（ＲＡ）是红细胞生成减少、细胞...     

促红细胞生成素对尿毒症患者中性粒细胞功能的影响

目的　观察促红细胞生成素 ( EPO)对尿毒症患者中性粒细胞功能的影响。方法　分三组进行中性粒细胞墨汁吞噬试验、粘附试验和硝基兰四唑试验 ( NBT)。结果　三组吞噬率分别为 38 7%± 6 4%、 16 0 %± 5 1%和 2 1 9%± 6 3% ( P<0 0 5 ) ;粘附率分别为 67 6%±10 7%、 37 4%± 15 1%和 5 3 3%± 15 9% ( P<0 0 5 ) ;NBT阳性率分别为 4 3%± 2 7%、 3 6%± 2 9%和 5 8%± 4 5 % ( P>0 0 5 )。结论　尿毒症患者中性粒细胞功能受损 ,接受 EPO治疗后 ,其功能得到改善。     

Effects of Triiodothyronine Administration in Patients with Chronic Renal Failure

Clinically euthyroid patients with severe, chronic, non-thyroidal illnesses usually have decreased serum total and absolute free T₃ concentrations. Since T₃ is the metabolically more active of the two thyroid hormones, it has been suggested that these patients may be hypothyroid and thus may benefit from T₃ therapy. To test this hypothesis, five patients with chronic renal failure requiring maintenance haemodialysis were treated with 5 μg T₃ eight hourly, increasing at three weekly intervals to 10 μg eight hourly, 20 μg eight hourly and finally 30 μg eight hourly. The mean ± SD serum T₃ level did not change over the 12 week period (1–42± 0–17 vs. 141 ± 0–26 nmoll ^-1)whilst the mean serum T₄ and TSH levels fell from 87 0± 15 2 to 47 5± 18 8 nmol l^-1 and 19 ± 0–9 to 1 3± 1 6 mU 1^-1respectively. Only the change in T₄ levels was significant (P < 0005). A significant decrease in mean serum T₄ levels was apparent even after the treatment period with 5 μg T₃ eight hourly (87 0±15-2 vs. 51 2±15 7; P <0005). The mean fasting serum triglyceride level fell from 1 16 ± 0 74 to 0 94 ± 0 74 mmoll^-1(P <005) and the mean fasting serum cholesterol level fell from 6 06± 1 13 to 4 69± 1 10 mmoll^-1 (P < 005). There were no subjective improvements in any of the patients. From the marked changes in serum T₄ levels during the administration of T₃, it is concluded that, prior to treatment, the patients were biochemically euthyroid and not hypothyroid and thus did not require T₃ therapy.     

血红素氧合酶—1在慢性肾功能不全大鼠肾中的表达及其作用机制

目的 :探讨血红素氧合酶 1(HO 1)在慢性肾功能不全 (CRF)大鼠肾脏中的表达、活性变化以及对肾脏的作用 ,并探讨其作用机制。方法 :2 1只SD大鼠等分为 3组 :假手术组、CRF组和Hemin组。后 2组大鼠在相隔 1周的二次手术中接受肾 5 / 6切除术。第二次术后 8周检测各组血压、尿蛋白及其与尿肌肝比值、血清尿素氮、肌酐 ;观察肾组织病理改变。检测血清及肾组织中HO 1活性及促红细胞生成素 (EPO)含量 ;免疫组化方法检测HO 1在肾脏中的表达、分布。结果 :Hemin组血压、尿蛋白、血肌酐及尿素氮水平明显低于CRF组 (P <0 .0 5 ) ;肾小球系膜增生、间质炎性细胞浸润及纤维化程度明显减轻 (P <0 .0 5 ) ;免疫组化及HO 1活性检测显示 ,HO 1主要分布于肾小管上皮细胞内 ,在CRF大鼠肾脏中 ,HO 1表达及活性降低 ;Hemin组血清及肾组织EPO含量明显高于CRF组。结论 :HO 1通过上调血清及肾组织中EPO含量 ,从而延缓了肾脏病变     

Assessment of Osteodystrophy in Patients with Chronic Renal Failure

Abstract: Assessment of osteodystrophy in patients with chronic renal failure. D. J. Brown, J. K. Dawbom, D. P. Thomas and J. M. Xipell, Aust. N.Z.J. Med., 1982, 12, pp. 250–254.
Nine patients with chronic renal failure were followed for more than one year by serial bone biopsies which were assessed by quantitative histological techniques.¹Ail patients had evidence of bone disease; this progressed during the interbiopsy period in eight. Patients who had the most advanced histologic disease at initial biopsy showed the most progression in resorption and demineralisation, but with greater progression of hyperparathyroid bone disease than osteomalacia. The type of bone disease and its rate of progression could only be accurately assessed histologically. No predictive parameters of early bone disease were found from clinical history, biochemistry or radiology. Raised serum alkaline phosphatase occurred only in advanced hyperparathyroid bone disease. Minor radiological abnormalities in magnified views of the hands were indicative of histologically advanced asymptomatic hyperparathyroidism.     

重组促红细胞生成素治疗肾性贫血的疗效观察

观察７０例慢性肾功能衰竭合并肾性贫血患者,分别使用常规治疗方法,国产重组促红细胞生成素依普定和日本产利血宝治疗,并观察治疗前后血红蛋白、红细胞计数、红细胞压积、网织红细胞、白细胞及血小板计数变化及其并发症。     

Sleep-Disordered Breathing in Nondialyzed Patients with Chronic Renal Failure

The prevalence and significance of sleep-disordered breathing (SDB) in dialysis-independent chronic renal failure (CRF) remains unknown. We studied the presence of SDB in nondialyzed CRF patients. Diagnostic polysomnography was performed in consecutive stable nondialyzed CRF patients. Inclusion criteria were age ≤70 years, absence of systolic dysfunction or history of pulmonary edema, FEV₁ > 70% pr, absence of neurologic disease or hypothyroidism, and calculated creatinine clearance <40 ml/min. Thirty-five patients (19 male, 16 female) were studied. An apnea–hypopnea index (AHI) ≥5/h was present in 54.3% (almost exclusively obstructive events). AHI correlated with urea (r = 0.35, p = 0.037), age (r = 0.379, p = 0.025), and body mass index (BMI) (r = 0.351, p = 0.038), but not with creatinine clearance. AHI or SDB were unrelated to gender. In nondiabetics (n = 25), AHI correlated with urea (r = 0.608, p = 0.001) and creatinine clearance (r = −0.50, p = 0.012). Nondiabetics with severe CRF (calculated GFR < 15 ml/min/1.73 m²) had a significantly higher AHI compared with less severe CRF. Restless legs syndrome (RLS) was present in 37.1% and periodic limb movements in 28.6%. Daytime sleepiness was not associated with respiratory events, but was more common in patients with RLS. The prevalence of SDB and RLS is high in dialysis-independent CRF. SDB weakly correlates with indices of kidney function and this association becomes stronger in nondiabetics.     

Erythropoietin Levels in Patients with Sickle Cell Disease Do Not Correlate with Known Inducers of Erythropoietin

Previous studies have suggested that erythropoietin (Epo) levels may be inappropriately low in patients with sickle cell disease compared to the extent of the related anemia they demonstrate. Here, we evaluate Epo level vs. renal function, oxygenation, and markers of inflammation for patients treated for sickle cell disease at our institution. Blood was drawn from 54 patients with sickle cell disease during routine visits to the outpatient hematology office and analyzed for hemoglobin (Hb) level, Epo, markers of inflammation, oxygenation, and renal function. Erythropoietin levels were lower than expected for patients with sickle cell disease, compared to the degree of anemia demonstrated in these patients. In addition, a correlation between Hb level and Epo was not consistently observed. Higher Epo levels were seen in patients receiving hydroxyurea (HU), but no correlation with oxygenation, hemolysis, renal function, or inflammation was observed.     

Effect of Losartan on the Cardiac and Renal Function in Patients With Chronic Heart Failure

Objectives To explore the effect of losartan on cardiac and renal function in patients with chronic heart failure (CHF). Methods Sixty-five patients with CHF were divided into two groups using a randomized, control and single blind method: losartan group (n=30) and convention group (n=35), with a treatment course of 8 weeks for both groups. The concentrations of cystatin C (cys C) in serum, microamount albumin (MA) in urine were measured by immunoturbidimetry. The concentration of aquaporin-2(AQP-2)was determined by enzyme-linked-immunosorbent assay (ELISA) and the heart contractile function was measured by echocardiography before and after treatment respectively. Results Comparing with routine treatment group, left ventricular end-diastolic dimension (LVEDd) decreased significantly, while left ventricular ejection fraction(LVEF)and left ventricular fractional shortening (LVFS) increased significantly in losartan group. The levels of cys C in serum and MA, AQP-2 in urine were significantly lower in losartan group than in routine treatment group. Conclusion Losartan can improve cardiac and renal function in patients with CHF.