安体舒通对大鼠慢性环孢素A肾毒性的保护作用

目的:观察醛固酮拮抗剂--安体舒通对慢性环孢素A(CsA)肾毒性发生及发展的影响.方法:健康雄性SD大鼠,低盐饮食1周后随机分为对照组(n=12)、模型组(CsA皮下注射,n=12)和治疗组(CsA皮下注射+安体舒通灌胃,n=12).于实验35d时处死大鼠,检测大鼠肌酐清除率(Cer)、血醛崮酮水平,Masson染色观察肾脏病理,免疫组化检测肾组织转化生长因子-β1,(TGF-β1)的表达.结果:与对照组相比,模型组大鼠体重明显下降(P<0.01),给予安体舒通后大鼠体重下降减慢(P<0.05);与对照组比较,模型组、治疗组大鼠Ccr均下降(P<0.05),但治疗组较模型组下降缓慢(P<0.05);与对照组比较,模型组、治疗组大鼠血醛固酮水平均明显升高(P<0.05),但治疗组与模型组相比.无显著性差异;与对照组相比,模型组大鼠肾脏出现明显间质纤维化(P<0.05),治疗组较模型组明显减轻(P<0.05);与对照组相比,模型组肾组织TGF-β1表达增强(P<0.05),治疗组较模型组明显减弱(P<0.05).结论:醛崮酮参与慢性CsA肾毒性的发生及发展,安体舒通可抑制慢性CsA肾毒性肾组织中TGF-β1的表达,进而抑制CsA诱导的肾间质纤维化.     

内皮抑素在大鼠腹膜的表达及其与腹膜血管新生的关系

Objective To investigate the expression of endostatin (ES) in rat peritoneum and its association with peritoneal neoangiogensis. Methods Thirty-two male SD rats were randomly divided into 4 groups: normal control rats (C group), renal failure without PD rats (non-PD group), rats dialyzed with 1.5% PD solution (1.5% PD group) and 4.25% PD solution (4.25% PD group). After regular PD for 28 days, mRNA and protein expression of ES in peritoneal tissues of each group were detected by RT-PCR and immunohistochemistry respectively. Microvessel density (MVD) of peritoneal tissue was assessed using immunohistochemistry with CD34 monoclonal antibody. Results ES mRNA was expressed in each group, 0.47±0.05 in C group, 0.45±0.04 in non-PD group, 0.46±0.04 in 1.5%PD group, 0.47±0.03 in 4.25%PD group, and no significant differences were found among groups. Score of ES protein expression was O in C group, 2 in non-PD group, 4 in 1.5%PD group, and 9 in 4.25%PD group. MVD was 3.13±1.13 in C group, 5.13±1.14 in non-PD group, 9.00±1.51 in 1.5%PD group, 10.75±1.83 in 4.25%PD group, and significant differences were found among groups. Conclusion Uremia circumstance and non-physiological compatibility peritoneal dialysate can increase ES protein expression and MVD, which may participate in and have effects on the course of peritoneal neoangiogensis.     

医联体分级共管模式对血液透析患者移植物内瘘通畅的影响

目的探讨医联体分级共管模式对移植物内瘘(arteriovenous graft, AVG)通畅率的影响, 为进一步优化AVG管理提供依据。方法该研究为回顾性队列研究, 分析郑州大学第一附属医院2018年1月1日至2021年12月31日建立AVG患者的临床及随访资料, 根据是否加入分级共管模式分为医联体组和非医联体组, 比较两组AVG通畅率及临床事件发生率。结果该研究共纳入328例次AVG, 来自151个血液透析中心, 其中医联体组189例次(57.6%), 来自72个中心, 非医联体组139例次(42.4%), 来自79个中心。患者年龄(55.57±11.80)岁, 男性130例次(39.6%), 合并糖尿病126例次(38.4%)。该队列AVG随访15.5(9.5, 26.2)个月, 其中医联体组随访15.4(9.8, 25.2)个月, 非医联体组随访15.5(9.2, 27.3)个月。医联体组通路血栓/闭塞的发生率(0.328次/患者年)、移植物夹层发生率(0.007次/患者年)、移植物感染发生率(0.030次/患者年)及导管使用率(0.043次/患者年)均低于非医联体组(0.58...     

内皮抑素在大鼠腹膜的表达及其与腹膜血管新生的关系

Objective To investigate the expression of endostatin (ES) in rat peritoneum and its association with peritoneal neoangiogensis. Methods Thirty-two male SD rats were randomly divided into 4 groups: normal control rats (C group), renal failure without PD rats (non-PD group), rats dialyzed with 1.5% PD solution (1.5% PD group) and 4.25% PD solution (4.25% PD group). After regular PD for 28 days, mRNA and protein expression of ES in peritoneal tissues of each group were detected by RT-PCR and immunohistochemistry respectively. Microvessel density (MVD) of peritoneal tissue was assessed using immunohistochemistry with CD34 monoclonal antibody. Results ES mRNA was expressed in each group, 0.47±0.05 in C group, 0.45±0.04 in non-PD group, 0.46±0.04 in 1.5%PD group, 0.47±0.03 in 4.25%PD group, and no significant differences were found among groups. Score of ES protein expression was O in C group, 2 in non-PD group, 4 in 1.5%PD group, and 9 in 4.25%PD group. MVD was 3.13±1.13 in C group, 5.13±1.14 in non-PD group, 9.00±1.51 in 1.5%PD group, 10.75±1.83 in 4.25%PD group, and significant differences were found among groups. Conclusion Uremia circumstance and non-physiological compatibility peritoneal dialysate can increase ES protein expression and MVD, which may participate in and have effects on the course of peritoneal neoangiogensis.     

小量蛋白尿原发性IgA肾病患者预后影响因素分析

IgA肾病(IgAN)的预后存在明显的异质性[1].小量蛋白尿是IgAN的常见临床表现,一般认为其肾脏预后相对较好,但临床中不乏小量蛋白尿而肾功能持续进展者,故对于此人群预后的分析十分重要.本研究回顾性分析了163例小量蛋白尿原发性IgAN患者的预后,探讨该人群肾功能丧失的危险因素.     

水通道蛋白与腹膜超滤

近年来研究发现水通道蛋白（aquaponn，AQP）可介导自由水被动跨生物膜转运，在维持细胞内外环境的稳定平衡中具有特殊作用。现已发现13种AQP分子AQP0—12（11，12又称超AQP），分布于腹膜组织的AQP主要有两种（AQP1，AQP3），其中AQP1被认为是腹膜转运“三孔”模型中的超小孔，在腹膜跨细胞水转运中起重要作用，近年来对AQP3的研究提示它可能也在腹膜液体转运中起到重要作用，研究AQP在腹膜超滤中的作用及可能调节机制，对认识腹膜UFF的机制具有重要意义。     

正念减压疗法对AAVF术后老年维持性血液透析患者负面情绪及应对方式的影响

目的 探讨正念减压疗法（MB-SR）对自体动静脉内瘘（AAVF）术后老年维持性血液透析患者血管功能、负面情绪及应对方式的影响。方法 选取我科2018年7月～2020年10月期间收治的123例AAVF术后老年维持性血液透析患者作为研究对象。采用随机数字表法分为观察组和对照组。两组患者均给予内瘘局部热敷、握拳与放松训练、远红外线照射及常规护理干预。对照组61例患者增加知识教育模式,观察组62例患者增加MB-SR疗法。观察两组患者干预前后动静脉内瘘血管功能、负面情绪评分以及疾病应对方式评分和动静脉内瘘相关并发症发生情况。结果 干预后,观察组患者动静脉内瘘血管内径、血管壁厚度、血流量均大于对照组（P<0.05）;观察组汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）评分小于对照组（P<0.05）;观察组患者屈服评分小于对照组,面对、回避评分均大于对照组（P<0.05）;观察组患者并发症发生率明显小于对照组（P<0.05）。结论 MB-SR治疗能够增强AAVF术后老年维持性血液透析患者血管功能,改善患者焦虑抑郁情绪及应对疾病的方式,并发症减少,值得临床推广应用。