马兜铃酸对人脐静脉内皮细胞的作用

目的探讨马兜铃酸对人脐静脉内皮细胞（HUVEC）的作用。方法用马兜铃酸钠盐（AA-Na）干预体外培养原代HUVEC。用四唑盐比色法及乳酸脱氢酶释放法分别检测细胞增殖反应及细胞毒性作用。RT-PCR及酶联免疫吸附法分别检测转化生长因子β1 （TGF-β1）、纤溶酶原激活物抑制物1（PAI-1）及血小板反应蛋白1（TSP-1）的mRNA表达及上清液含量。结果10、20、40及80 mg/L浓度的AA-Na能显著抑制HUVEC增殖及有明显细胞毒效应（P〈0.01）。与对照组相比,5 mg/L的AA-Na显著上调了HUVEC的TGF-β1、PAI-1及TSP-1 mRNA和蛋白表达（P〈0.05）。结论AA-Na可上调HUVEC的TGF-β1、PAI-1及TSP-1表达,此作用可能在慢性马兜铃酸肾病小动脉管壁病变的发病中起一定作用。     

低蛋白饮食对环孢素A肾病大鼠肾间质纤维化的作用

Objective To investigate whether low-protein diet has protective effect on the progression of renal interstitial fibrosis in rats with cyclosporine A (CsA)-induced nephropathy. Methods Eighteen male Sprague-Dawley rats were randomly divided into three groups (6 rats in each group). The rats in control group (C group) received common diet; in model group (M group) low-salt diet; in intervention group (Ⅰ group) low-salt and low-protein diet. After diet adaptation period of one week, the rats in C group received subcutaneous injection of olive oil 1 mg/kg daily for 5 weeks, while M group and Ⅰ group subcutaneous injection of CsA (diluted into 25 g/L with olive oil) 1 ml/kg for 5 weeks. All the rats were sacrificed at the end of the 5th week. The food-intake and body weight were measured daily. The creatinine clearance (Ccr) was examined before rats were sacrificed. The semi-quantitative pathological analysis on kidney sections was performed. The mRNA and protein expression of transforming growth factor-β1 (TGF-βI) and type Ⅰ collagen (Col Ⅰ) in kidney tissue was determined with real time PCR and immunohistochemical staining, respectively. Results The food-intake and body weight of rats in M and I groups were significantly lower than those in C group (P<0.05). Compared with C group, the Ccr levels in M and Ⅰ groups were significantly reduced [(0.65±0.15) ml/min, (0.40+0.13) ml/min vs (1.55±0.29) ml/min, P<0.05], the relative fibrosis areas of kidney interstitium in M and I groups were significantly increased (3.60%±0.46%, 3.26%±0.75% vs 0.44%±0.24%, P<0.05), the mRNA and protein expression of TGF-β1 in M and I group was significantly up-regulated (by 2.6 and 3.1 times in mRNA and by 1.5 and 1.6 times in protein, respectively, P<0.05), and the mRNA and protein expression of Col Ⅰ in M and I groups was also significantly up-regulated (by 3.0 and 3.5 times in mRNA and by 2.3 and 2.1 times in protein, respectively, P<0.05). There were no significant differences between M and I groups in every parameters above-mentioned except the rat body weight and Ccr. Both the body weight and Ccr in Ⅰ group were significantly lower than those in M group (P<0.05). Compared with C group, the urine osmotic pressure in M group and in I group were deceased (for M group, P>0.05; for I group, P<0.05). Compared with C group, the serum cholesterol levels in M and I groups were significantly increased (P<0.05), and the serum phosphorus level in I group was significantly decreased (P<0.05). The levels of serum albumin and serum calcium of all three groups had no statistical differences (P>0.05). Conclusion Low-protein diet has no renoprutective effects on the rat model of cyclosporin A nephropathy, on the contrary, may induce body weight loss.     

用促红细胞生成素治疗肾性贫血必须合理补铁

应用基因重组人促红细胞生成素（rHuEPO）治疗慢性肾脏病贫血,在我国已有15年历史,但是,某些医师在应用rHuEPO治疗时,对合理补铁还认识不足或处理失当,故在此作一讨论.     

肿瘤坏死因子介导内皮素所致人肾小球系膜细胞增殖的研究

内皮素（endothelin，ET）不但是强烈缩血管多肽，而且还是一个强有力促有丝分裂因子，能够刺激肾小球系膜细胞增殖[1]，但机理仍欠清楚。为探讨内皮素致系膜细胞由肿瘤坏死因子α（TNFα）介导的可能性，我们利用细胞培养、放射免疫及分子杂交等技术进行了本实验。一、材料和方法1．实验对象：第2－3代亚培养人肾小球系膜细胞（humanmesangialbell，HMC）。2．TNFu测定：分试验组和对照组，试验组加10－’mol／L人ET－l，孵育8。12和24h后收集上清，放射免疫法测定’FNFa蛋白浓度。3Northern杂交：实验分5组，第1组仅加含2．5％FC…     

造影剂肾病的临床病理表现及防治

近年来,随着血管造影和介入治疗的推广,造影剂肾病（RCN）发病率日益上升,已是当今医源性急性肾衰竭的第3位病因.我们仅就其发病机制、表现及防治作一简介.     

慢性肾功能衰竭的二级预防 肾小管高代谢状态及可能的防治策略

慢性肾功能衰竭（Ｃｈｒｏｎｉｃｒｅｎａｌｆａｉｌｕｒｅ，ＣＲＦ）是各种慢性肾脏病进展到晚期的结局，由于肾小球滤过率显著下降，导致机体代谢产物潴留，水、电解质及酸碱平衡紊乱。统计资料表明，原、继发性肾小球疾病是导致ＣＲＦ的最常见病因，传统观点认为此时ＣＲＦ的发生系由严重肾小球病变引起，但是，近年来越来越多的学者认为肾小管—间质病变也同样具有重要作用。肾小管与间质约占肾脏容量的８０％，肾小管—间质病变能通过多种机制促进ＣＲＦ发生。本文拟就肾小管高代谢状态在ＣＲＦ发生中的作用及其可能防治策略作一简介。…     

要提高对原发性小血管炎肾损害的认识

１　引　言显微镜下多血管炎（ＭＰＡ）及韦格纳肉芽肿（ＷＧ）是常引起严重肾损害的原发性小血管炎，西方国家发病率很高，国内于１９９３年初见报道后，近年确诊例数已愈来愈多，提示本病在我国也不少。但是，至今不少医生对本病认识仍不足，误、漏诊仍不少，故有进一步提高对该病认识的必要。２　临床表现ＭＰＡ及ＷＧ好发于中、老年，男性多见。病初患者多有全身症状，如发热（低热或高热）、体重下降，贫血、皮肤紫癜、肌肉痛、关节痛及周围神经炎等，这些症状虽非本病特异，但对提示本病很有意义。肾脏最易受累，病人呈现肾炎综合征（…     

过氧化酶体增殖体激活受体γ及其配体与肾脏疾病的关系

过氧化酶体增殖体激活受体γ(PPARγ)作为一种核转录因子,能与其特异性配体结合、激活,进而在转录水平上调控多种基因表达。PPARγ广泛存在于肾组织中,它具有调节系膜细胞增殖和阻止转分化、抑制成纤维细胞增殖和巨噬细胞浸润、抑制炎症介质和血管活性物质合成以及减少细胞外基质蓄积等作用,已证实能在糖尿病肾病、5／6肾切除、狼疮性肾炎和急性缺血-再灌注肾衰竭等模型防治中发挥重要作用。     

充分水化对对比剂肾病的预防作用——倾向评分配比分析北大核心CSCD

目的用倾向评分配比分析探讨充分水化对冠状动脉造影术(CA)或经皮冠状动脉介入治疗术(PCI)所致对比剂肾病(CIN)的预防作用。方法以2010年首都医科大学附属北京安贞医院3993例行CA或PCI的患者为研究对象,并以是否按照2006年"国际对比剂肾病专家共识"建议的方案进行了水化处理将上述患者分为充分水化(48例)和未行水化(共3945例)两类,而后应用倾向评分匹配法从未行水化患者中筛选出与充分水化患者匹配的等数量(48例)患者,构成了本研究的充分水化组及未水化组(各48例)。观察并比较了这两组患者的术后CIN发生率、院内不良事件发生率及全因死亡率。结果未水化组的CIN发病率为16.7%(8/48例),充分水化组为0,两组比较差异具有统计学意义(P=0.006);未水化组的院内不良事件发生率为2.1%,充分水化组为0,但两组间差异尚无统计学意义(P=1.000);两组均无死亡病例。结论充分水化处理可有效预防CIN发生。