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目的:探讨糖尿病肾病患者血清胱抑素C、血肌酐和尿微量白蛋白水平的变化及意义。方法:选取糖尿病肾病患者60例,单纯糖尿病患者65例,正常对照组55例,分别检测其尿微量白蛋白、血肌酐、血清胱抑素。结果:正常对照组与单纯糖尿病组三者比较差异无显著性(P〉0.05);糖尿病肾病组与正常对照组及单纯糖尿病组比较尿微量白蛋白及胱抑素C差异显著(P〈0.01),血肌酐水平无明显差异(P〉0.05);糖尿病肾病组经辛伐他汀治疗1个月后,尿微量白蛋白、血清胱抑素C明显下降,与治疗前水平比较差异有显著性(P〈0.01)。结论:在糖尿病肾病早期肾功能损害中,CysC水平与尿微量白蛋白水有很好的相关性,是糖尿病肾病的敏感指标,且可以作为肾功能好转的指标。 相似文献
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目的 观察舒洛地特在老年心绞痛的临床疗效.方法 选择心绞痛患者100例,随机分为对照组和治疗组.治疗组在对照组的基础上增加舒洛地特,2 w后观察两组的临床疗效、心绞痛发作的频率以及时间心电图的疗效、C反应蛋白(CRP)、血浆纤维蛋白原(FIB)的变化.结果 治疗组与对照组比较治疗组中临床疗效、心电图的疗效有效率明显优于对照组(P<0.05)、心绞痛发作的频率以及时间明显下降(P<0.05);而血浆纤维蛋白原(FIB)、C反应蛋白(CRP)也明显低于对照组(P<0.01).结论 舒洛地特联合常规治疗在临床上能更有效地改善患者心绞痛症状. 相似文献
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目的比较新型钙通道阻滞剂贝尼地平与血管紧张素转换酶抑制剂培哚普利对老年高血压病伴蛋白尿患者肾脏保护作用的差别。方法将60例24h尿蛋白总量〈1g的老年高血压病患者,随机分为贝尼地平组(A组)与培哚普利组(B组),分别给予贝尼地平与培哚普利治疗12月,比较A、B两组治疗前后收缩压(SBP),舒张压(DBP),24h尿蛋白(Pro)、血清肌酐(Scr)、肾小球滤过率(GFR)的差别。结果①治疗前A、B两组SBP、DBP、Pro、Scr、GFR无显著性差异(P〉0.05);②A、B两组治疗后SBP、DBP、Scr较治疗前有显著下降,GFR均明显升高(P〈0.05);③治疗后AB两组间SBP、DBP、Scr、GFR无明显差异(P〉0.05)。结论贝尼地平与培哚普利比较,对老年高血压伴蛋白尿的患者,具有相似的肾脏保护作用。 相似文献
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目的:探讨老年慢性心力衰竭(CHF)患者内皮细胞结构和功能的变化,并观察培哚普利对其影响。方法:286例老年CHF患者随机分为2组,培哚普利治疗组(Pe组)及常规治疗组(sham组),测定2组患者治疗前后及正常对照组血液中循环内皮细胞(CEC)、一氧化氮(NO)和内皮素(ET)含量。结果:2组患者治疗后心功能均有明显改善(P〈0.05),Pe组改善更明显(P〈0.01)。CHF患者血中CEC和ET明显增加(P〈0.05),NO浓度明显下降(P〈0.05),它们的变化程度与心衰严重程度相一致。治疗后各指标均有明显的改善,CEC和ET明显下降(P〈0.05),NO浓度明显升高(P〈0.05),但Pe组改善更明显(P〈0.05)。结论:老年CHF患者内皮细胞的结构和功能明显受损,培哚普利能改善CHF患者内皮细胞的结构和功能,保护内皮细胞,同时明显改善老年CHF患者的心功能。 相似文献
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目的探讨贝那普利联合银杏达莫注射液治疗早期糖尿病肾病的临床疗效。方法40例早期糖尿病肾病患者随机分为两组,治疗组给予贝那普利(10mg,每日1次,口服)和银杏达莫注射液(20ml加入生理盐水250ml中,每日1次,缓慢静滴),对照组单用贝那普利(10mg,每日1次,口服),疗程4周,观察治疗前后24小时尿微量白蛋白(U-Alb)、肌酐(Scr)、胆固醇(TC)、甘油三酯(TG)、血液流变学变化。结果两组患者治疗后U-Alb明显降低(P〈0.05,P〈0.01),但Scr无明显变化(P〉0.05);治疗后U-Alb、TC、TG、全血黏度、血浆黏度、纤维蛋白原的下降治疗组较对照组明显,且差异有显著性(P〈0.05,P〈0.01)。结论贝那普利联合银杏达莫注射液治疗早期糖尿病肾病,不仅降低蛋白尿,还具有降血脂、降低血液黏度,纠正血液高凝状态的作用,在保护肾功能方面具有显著的临床疗效。两药合用在延缓DN进展方面能够发挥各自的优势,起到协同作用。 相似文献
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目的探讨血清胱抑素C(Cys-C)浓度在2型糖尿病肾病早期诊断中的临床意义,为临床提供反映肾小球滤过功能的敏感的肾小球滤过率(GFR)标志物。方法测定97例本院门诊和住院2型糖尿病患者与60名健康体检者血清胱抑素C(Cys-C)、尿素(UREA)、肌酐(CRE)水平比较分析。结果2型糖尿病无糖尿病肾病(DN)组与对照组比较无统计学意义(P〉0.05);在DN三组中,血清Cys-C浓度升高,Ⅲ期DN组〉无DN组(P〈0.05),Ⅳ期DN组〉Ⅲ期DN组(P〈0.01),Ⅴ期DN组〉Ⅳ期DN组(P〈0.01)。血清尿素和血清肌酐浓度,无DN组、Ⅲ期DN组与对照组比较无统计学意义(P〉0.05),Ⅳ、Ⅴ期DN组血清尿素、血清肌酐浓度水平显著升高,有统计学意义(P〈0.01)。结论胱抑素C是能反映肾小球滤过率的理想标志物,比尿素、肌酐敏感,是糖尿病肾病早期评价的理想指标。 相似文献
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目的:观察口服福辛普利联合阿魏酸钠静脉点滴对糖尿病肾病的疗效。方法:将67例糖尿病肾病患者随机分为两组。在常规治疗的基础上治疗组予口服福辛普利10 mg/次,1次/d,并予阿魏酸钠0.3加生理盐水250 mL静脉点滴,1次/d,而对照组只予口服福辛普利10 mg/次,1次/d,两组疗程均为4周。并分别检测治疗前后尿白蛋白、血肌酐、尿素氮。结果:两组治疗后尿蛋白与同组治疗前相比均有明显下降(P〈0.01),而治疗组治疗后尿蛋白与对照组治疗后相比下降更明显(P〈0.05),两组肾功能治疗后略有改善,组内及组间治疗前后比较无显著性差异(P〉0.05)。结论:福辛普利联合阿魏酸钠治疗糖尿病肾病可有效减少白蛋白尿,稳定肾功能,延缓糖尿病肾病进展。 相似文献
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目的探讨舒洛地特治疗2型糖尿病肾病尿微量白蛋白的疗效。方法 41例糖尿病肾病微量白蛋白尿期患者(200μg/min≤UAER〈200μg/min)被随机分为两组,A组(18例)为常规治疗,B组(23例)为常规+舒洛地特(600LSU,iv,qd)治疗,疗程均为4周。结果治疗4周后,B组UAER降低(41.7±0.4)%明显高于A组(5.1±0.2)%。B组治疗前后以及两组治疗后UAER比较,均有统计学差异(P〈0.001)。而A组治疗前后无统计学差异(P〉0.05)。结论常规治疗基础上加用舒洛地特4周治疗可有效降低2型糖尿病肾病微量白蛋白尿期患者尿微量白蛋白。 相似文献
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目的:观察糖皮质激素联合贝那普利在IgA肾病治疗中的价值。方法:选取Ign肾病42例,随机分为观察组(泼尼松+贝那普利)22例和对照组(贝那普利)20例。治疗6个月后对比分析两组的临床疗效,并记录两组治疗前后尿蛋白、血肌酐(SCr)和血尿素氮(BUN)的变化。结果:观察组的总显效率77.3%显著高于对照组的55.0%(P〈0.05);观察组治疗后24h尿蛋白定量、SCr、BUN水平均显著低于对照组(P〈0.05);两组治疗期间不良反应发生率差异不显著(P〉0.05)。结论:糖皮质激素联合贝那普利治疗kA肾病,效果优于单独应用贝那普利。 相似文献
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目的 观察灯盏花素、黄芪联合贝那普利对早期糖尿病肾病(DN)患者尿蛋白的影响.方法 将92例早期DN患者随机分为A、B两组,A组为对照组,单用贝那普利 B组为治疗组,灯盏花素、黄芪、贝那普利联合应用.疗程均为4 w,观察治疗前后24 h尿蛋白定量、尿白蛋白排泄率(UAER)、血β2微球蛋白(β2-MG)、血肌酐(SCr)、空腹血糖.结果 A、B组治疗后24 h尿蛋白定量、UAER、血β2-MG均下降,B组下降更明显(P〈0.01).结论 灯盏花素、黄芪联合贝那普利治疗早期DN,可明显地减少DN患者尿蛋白,对肾脏具有明显的保护作用,可延缓DN的发生和发展. 相似文献
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湿润烧伤膏与手术联合治疗褥疮的护理 总被引:2,自引:0,他引:2
目的 :减少溃疡期褥疮的术前准备时间 ,缩短褥疮的总病程。方法 :将 1996年 5月至 2 0 0 2年 5月收住院的 4 2例溃疡期褥疮病人按随机原则分为 2组 ,2 1例术前用湿润烧伤膏纱换药处理 ,为A组 (试验组 ) ;2 1例用庆大霉素紫草油纱布换药处理 ,为B组 (对照组 )。 2组病例的年龄、性别、发病原因、病灶部位、病灶范围等经统计学处理 ,无显著性差别 ,有可比性。两组病人均换药至创面新鲜行皮瓣转移手术 ;比较两组平均术前换药时间 ,及换药 +手术的总住院日。术前术后两组患者均运用护理程序施行整体护理。结果 :A组术前平均换药时间为 8 4 9± 2 2 3天 ,B组为 15 6 0± 6 70天 ;A组平均治愈时间为 2 0 5 0± 4 81天 ,B组为 35 31± 7 70天。结论 :湿润烧伤膏换药与庆大霉素紫草油纱布换药比较 ,前者可明显缩短褥疮手术的术前准备时间及病人的总住院天数。 相似文献
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1995年 1月~ 1 998年 2月 ,我们采用多虑平、雷尼替丁治疗消化性溃疡 (PU) ,并与雷尼替丁为对照组进行治疗观察 ,疗效满意 ,现总结报告如下。1 临床资料1 1 一般资料 本组 81例PU均因上腹痛、返酸、腹胀及食欲不振等症状 ,经胃镜诊断为溃疡活动期患者。病程 2个月~ 5a,平均 1 7a。伴有焦虑、抑郁及夜眠欠佳等症者59例。随机分为 2组 :治疗组 4 1例 ,男 3 8例 ,女 3例 ;年龄 1 8~ 3 6岁 ,平均 2 4岁。其中胃溃疡 1 1例 ,十二指肠球部溃疡 3 0例。对照组 4 0例 ,男 3 7例 ,女 3例 ;年龄 1 9~ 3 5岁 ,平均 2 4 5岁 ;胃溃疡 1 2… 相似文献
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The effect of chemotherapy on subjects with primary amyloidosis (AL-amyloidosis) were studied with MRI in five patients. The MRI was performed every 3–5 months for 23–60 months, and the T1 and T2 relaxation times were determined in liver and subcutaneous fat. In the patients as a whole T1 was significantly prolonged (P < 0.05), whereas T2 was within normal range. On follow-up with repeated MRI increasing T1 values could be measured in progressive disease (one patient) whereas decreasing T1 values seemed to parallel clinical improvements in four patients. The effect of different treatment schedules in AL-amyloidosis may be evaluated with MRI and the amount of amyloid deposits may be quantified.
Correspondence to: K.-Å. Thuomas 相似文献
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Flavio Forrer Helena Uusij?rvi Daniel Storch Helmut R Maecke Jan Mueller-Brand 《Journal of nuclear medicine》2005,46(8):1310-1316
Therapy with [(90)Y-DOTA(0), Tyr(3)]-octreotide (DOTATOC, where DOTA = tetraazacyclododecane tetraacetic acid and TOC = D-Phe-c(Cys-Tyr-D-Trp-Lys-Thr-Cys)-Thr(ol)) is established for the treatment of metastatic neuroendocrine tumors. Nevertheless, many patients experience disease relapse, and further treatment may cause renal failure. Trials with (177)Lu-labeled somatostatin analogs showed less nephrotoxicity. We initiated a prospective study with (177)Lu-DOTATOC in patients with relapsed neuroendocrine tumors after (90)Y-DOTATOC treatment. METHODS: Twenty-seven patients, pretreated with (90)Y-DOTATOC, were included. The mean time between the last treatment with (90)Y-DOTATOC and (177)Lu-DOTATOC was 15.4 +/- 7.8 mo (SD). All patients were injected with 7,400 MBq of (177)Lu-DOTATOC. Restaging was performed after 8-12 wk. Hematotoxicity or renal toxicity of World Health Organization grade 1 or 2 was not an exclusion criterion. RESULTS: Creatinine levels increased significantly, from 66 +/- 14 micromol/L to 100 +/- 44 micromol/L (P < 0.0001), after (90)Y-DOTATOC therapy. The mean hemoglobin level dropped from 131 +/- 14 to 117 +/- 13 g/L (P < 0.0001) after (90)Y-DOTATOC therapy. (177)Lu-DOTATOC therapy was well tolerated. No serious adverse events occurred. The mean absorbed doses were 413 +/- 159 mGy for the whole body, 3.1 +/- 1.5 Gy for the kidneys, and 61 +/- 5 mGy for the red marrow. After restaging, we found a partial remission in 2 patients, a minor response in 5 patients, stable disease in 12 patients, and progressive disease in 8 patients. Mean hemoglobin and creatinine levels did not change significantly. CONCLUSION: (177)Lu-DOTATOC therapy in patients with relapse after (90)Y-DOTATOC treatment is feasible, safe, and efficacious. No serious adverse events occurred. 相似文献
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Cardiac complications are well known after aneurysmal subarachnoid hemorrhage. Electrocardiographic changes occur in 50% to 100% of such cases. Arrhythmias, left ventricular dysfunction, and frank myocardial infarction are infrequently observed. Myocardial infarction must be differentiated from neurogenic stunned myocardium, which is a reversible condition. From 1996 to 2001, 105 patients with aneurysmal subarachnoid hemorrhage underwent endovascular treatment at the University of Michigan. Of these, four patients with no history of cardiac disease experienced cardiac failure related to neurogenic stunned myocardium. All had signs of left ventricular dysfunction, electrocardiographic changes, and elevated cardiac enzymes. Three had pulmonary edema at presentation. All were diagnosed with myocardial infarction. One underwent coronary angiography, which was normal. All were considered poor surgical candidates and underwent endovascular treatment of the aneurysms. Three of four patients developed symptomatic vasospasm, and two required balloon angioplasty. Three patients achieved good outcomes. The eldest died from severe vasospasm that was unresponsive to angioplasty. Reversible cardiac failure associated with subarachnoid hemorrhage may be due the neurogenic stunned myocardium. Frequent symptomatic vasospasm occurs, possibly related to poor cardiac output and the inability to optimize hyperdynamic hypervolemic therapy, particularly with compromised volume status. These patients can be treated with endovascular therapy of the aneurysms and balloon angioplasty as needed. With aggressive management, patients can recover from these reversible cardiac complications. 相似文献