T细胞亚群与结缔组织疾病

T细胞亚群的研究,有助于揭示疾病过程中免疫凋节失常以及自身免疫性疾病的发病机理。本文报道72例结缔组织病中T细胞亚群测定的结果并对该类疾病的发病机制和治疗提出一些看法。本文对混合型结缔组织病(4例)、     

心肌纤维变性症酷似缩窄性心包炎(一例报告)

心肌纤维变性症系指心肌广泛为结缔组织所代替,以致心脏的正常功能受到影响,易于发生难以控制的心力衰竭的一种疾病。此病虽系少见,但近年来文献已屡有报导,很多学者特别指出它(包括非特异性心肌炎)和缩窄性心包炎的鉴别诊断问题。本文报导1例,在临床上亦被诊断为缩窄性心包炎,后经剖胸以及病理组织检查始赶实系非特异性心肌炎伴有心肌纤维变性,说明二者的鉴别确系十分困难。     

ALTERATION OF ZINC, COPPER AND MAGNESIUM IN SERUM OF UREMIC PATIENTS AND PERITONEAL DIALYSATE

In 11 uremic patients serum zinc, copper and magnesium were determined prior to and 3—6 months after starting intermittent peritoneal dialysis (IPD). The trace elements were measured by atomic absorption spectrophotometry. The concentrations of serum zinc and copper were raised significantly from the initial mean values of 9.36±2.498 μmol/L and 15.875±4.223 μmol/L prior to IPD to 12.102±2.514 μmol/L and 22.127 ±3.530 μmol/L respectively after IPD. While in normal controls serum zinc was 13.571±1.665 μmol/L and copper 15.830±4.113 μmol/L. Serum magnesium dropped from 2.127±0. 712 mmol/L to 1.921±0.378 mmol/L、but the change was not significant statistically; the value in normal controls was 1.300±0.128 mmol/L. When IPD had been well established and there was no sign of peritonitis, serum zinc, copper and magnesium were tested before and after the procedure of IPD in a single day at random, and at the same time the concentrations of these elements in the drained dialysate were also determined. The result showed that serum levels of zine, copper and magnesium remained unchanged before and after dialysis in a single day, however, those in the drained dialysate were raised from the initial values of 1.301±0.522 μmol/L, 0.9635±0.335 μmol/L and 1.168±0.411 mmol/L to 8.478±5.324 μmol/L, 5.715±1.868 μmol/L and 1.098±0.494 mmol/L.     

肝硬化腹水与肾脏的关系以及利尿剂的合理应用

肝硬化腹水治疗中,利尿剂的合理应用是以对腹水形成的病理生理和对利尿剂作用机理的充分认识为基础的。本文通过对肝硬化腹水形成与肾脏的关系的复习,提出肝硬化腹水中利尿剂的合理应用。一、腹水形成学说腹水形成主要有两种学说,一是传统途径,认为由于门脉高压,胶体渗透压降低和肝淋巴液漏出增多等综合因素引起腹水。由于循环血浆容量丧失,导致血管收缩,从而向肾小管发出潴盐信号,故尿钠潴留乃由于腹水形成导致血容量缩减,即血管充     

原发性慢性肾炎中T淋巴细胞及其亚群的改变

本文对50例原发性慢性肾炎T淋巴细胞及其亚群进行了初步研究。慢性肾炎的诊断根据1977年北戴河肾炎座谈会提出的“关于原发性肾小球疾病的临床分类初步方案。”属慢性肾炎肾病型27例,男性16例,女性11例,平均年龄29.9±12.1岁。属慢性肾炎普通型23例,男性11例,女性12例,平均年龄36.3±15.3岁。全组50例平均年龄32.8±13.9岁。多系住院病人,在未服皮质激素或用其他     

尿毒症高脂血症的治疗

尿毒症患者脂质代谢紊乱尿毒症的原发肾脏疾病虽不同,但发展到肾衰竭阶段,原有肾脏疾病对脂代谢似乎无多大影响,如慢性肾小球肾炎引起尿毒症患者的脂代谢变化与肾切除者相同,与多囊     

糖尿病昏迷小剂量胰岛素治疗的临床观察

本文报告20例酮症酸中毒性和2例高渗性非酮症性昏迷(简称非酮症性昏迷)用小剂量胰岛素治疗的结果,并作初步分析探讨。     

甲状旁腺激素与尿毒症

尿毒症病人表现全身各器官功能紊乱,呈现神经、消化、血液、循环、呼吸、泌尿等系统的多种症状和体征。这些症状和体征常被归咎于尿毒素。尿毒素究竟是什么?近几年来,由于使用现代化仪器,如气—液色谱、质谱法等,已从尿毒症血液分离到200多种代谢产物,其中100多种在尿毒症时特有或比正常值高。现认为主要是一些蛋白质的代谢产物,其中尤以胍类如甲基胍、胍基琥珀酸及一些未知结构的中分子物质的积聚尤为人们所注意,而尿素,肌酐、     

EFFECT OF LOW PROTEIN DIE'T ON WHOLE BODY NITROGEN METABOLISM IN PATIENTS WITH CHRONIC RENAL FAILURE

isN-glycine was administered orally as a tracer t0 3 patients with chronic renal failure (CRF) in the study of total body protein metabolism during the course of diet therapy. Five healthy subjects with matched age and sex served as controls. Patients on a diet providing l.2 g protein/kg/day had significantly low total nitrogen flux (Q), rates of total body pro- tein synthesis (S), catabolism (C) and S/Q, as com' pared with the controls. A reduction in daily protein intake t0 0.6 g/kg/day resulted in marked increase in all these parameters, approaching those of the con- trols. In normal subjects, low protein intake did not affect the total body protein turnover signfiicantly. The results suggest that the adaptive response to res- triction of protein intake is an efficient utilization of nitrogen entering the metabolic pool for anabolic purposes. This response becomes manifest and essen- tialin patients with CRF and forms the basis for low protein diet therapy.     

骨髓瘤肾病

骨髓瘤肾病是多发性骨髓瘤的严重并发症之一,其死亡率仅次于感染。多发性骨髓瘤中肾病发生率约66%,男略多于女,年龄多在50岁以上。骨髓瘤肾病可在确诊骨髓瘤前一段时间发生,因而易误诊为原发性肾病,应引起注意。一、骨髓瘤肾病的发生与下列因素有关:1.轻链的肾毒作用:骨髓瘤细胞可产生大量免疫球蛋白,其中轻链分子量小,能经肾小球滤过,进入肾小管内形成管型,阻塞管腔,从而降低GFR。此外轻链可直接损害肾脏,高等电点轻链易引起肾脏损害;轻链糖化作用和聚合作用也可损害肾脏;轻链还可促进Tamm-Horsfall 蛋白(THP)沉淀形成管型,且THP 外渗至肾间质与钙及其他蛋白形成钙蛋白复合物,直接损害肾实质。2.骨髓瘤细胞直接损害肾实质。3.骨髓瘤引起电解质代谢紊乱: