改良保肾方Ⅱ号治疗糖尿病肾病临床观察

目的：观察改良保肾方Ⅱ号对糖尿病肾病患者的临床疗效。方法：将79例2型糖尿病肾病患者分为治疗组和对照组,两组病人均予基础治疗即：控制饮食、血糖、血压、血脂。在此基础上,治疗组加用改良保肾方Ⅱ号中药汤剂,两组疗程均为3个月。观察两组治疗前后中医证候评分、尿蛋白定量、肾小球滤过率、糖化血红蛋白及血脂等指标变化。结果：治疗组总有效率87.50%,对照组总有效率61.54%,两组比较差异有统计学意义（P〈0.05）。两组治疗后中医证候评分、24h尿蛋白定量较治疗前均有下降（P〈0.05）,但治疗组明显优于对照组（P〈0.05）。两组治疗前后肾小球滤过率无明显差异（P〉0.05）。两组治疗后糖化血红蛋白、总胆固醇、甘油三酯均较治疗前有显著改善（P〈0.05）,但组间比较无明显差异（P〉0.05）。结论：改良保肾方Ⅱ号能够明显降低糖尿病肾病患者的尿蛋白,改善临床症状,治疗糖尿病肾病具有显著疗效。     

高尿酸血症肾病模型大鼠TGF-β1、TNF-α变化及中药的调节作用

目的：观察高尿酸肾病模型大鼠血尿酸、肾脏组织病理学及肾组织中的TGF-β1、TNF-α的变化及中药复方对TGF-β1、TNF-α表达的调节作用。方法：采用高嘌呤饲料加腺嘌呤灌胃制作高尿酸血症肾病大鼠模型,并分组处理,中药治疗组用中药煎剂,别嘌呤醇治疗组用别嘌呤醇溶液,模型对照组及正常对照组给予蒸馏水灌胃,用药持续4周。观察血尿酸、肾脏组织病理学及肾组织中的TGF-β1、TNF-α的变化。同时,观察中药复方对上述各项指标的调节作用。结果：高尿酸血症肾病大鼠肾组织TGF-β1、TNF-α表达明显上调,且中药复方能调节其表达。结论：高尿酸血症肾病大鼠肾组织TGF-β1、TNF-α表达明显上调;中药有调节高尿酸血症肾病大鼠肾组织中TGF-β1、TNF-α表达的作用。     

肾病合剂对阿霉素肾病大鼠肝组织白蛋白基因 表达影响的实验研究

目的探讨肾病合剂对阿霉素肾病大鼠肝组织白蛋白基因表达的作用。方法建立阿霉素肾病大鼠模型,采用Northern杂交及Dot-blot定量分析,观察肝组织白蛋白mRNA的表达水平。结果肾病合剂组大鼠肝组织白蛋白mRNA表达均明显高于模型组及正常组(P＜0.05)。结论肾病合剂可上调阿霉素肾病大鼠肝组织白蛋白mRNA的表达水平,促进白蛋白合成。     

静脉水化联合碱化预防高危患者对比剂诱发肾病的作用

目的探讨静脉水化联合碱化治疗预防高危患者对比剂诱发肾病的临床效果。方法选择行经皮冠状动脉介入诊疗,对比剂肾病发生风险评分系统评分≥11分的患者80例,治疗组40例,给予0.9%氯化钠溶液1mL·kg-1·h-1的静脉注射12h,联合30mL碳酸氢钠快速静脉注射;对照组40例,仅给予0.9%氯化钠溶液1mL·kg-1·h-1静脉注射12h的水化治疗,比较两组治疗后生化检验结果和对比剂诱发肾病发生率。结果治疗组介入治疗后尿pH值及肾小球率过滤比对照组高,血清肌酐浓度比对照组低,差异有统计学意义[7.11±0.72vs.5.46±0.61,P0.05;37.91%±7.48%vs.30.11%±7.54%,P0.05;(1.40±0.19)mg/Lvs.(1.69±0.22)mg/L,P0.05]。治疗组对比剂诱发肾病发生2例,占5%(2/40),对照组发生8例,占20%(8/40),两者比较,差异有统计学意义(P0.05)。结论静脉水化联合碱化治疗可更有效地防止高危患者经皮冠状动脉介入治疗后对比剂诱发肾病的发生。     

肾病及尿崩症患者尿渗透压检测的临床意义

目的探讨肾病及尿崩症患者尿渗透压与血渗透压比值的临床意义。方法采用BS-88冰点渗透压检测仪对56例肾病、尿崩症患者及20例健康人分别进行血浆和尿液渗透压测定并计算尿/血渗比,对测定结果进行比较、分析。结果各疾病组与健康人的尿渗透压及尿/血比差异有显著性(P<0.01)。结论尿/血渗比值是反映肾脏功能的一个重要指标,对患者的疗效和预后均具有重要的提示意义。     

223例IgA肾病气阴两虚证患者证候特征分析

目的通过对临床试验数据的挖掘，探讨kA肾病气阴两虚证的证候特点。方法对临床试验数据进行频数分析和因子分析。结果（1）IgA肾病气阴两虚证主要临床症状依次为腰膝酸痛、身倦乏力、咽干咽痛、手足心热、易感冒、畏寒、目干涩、头晕目眩、自汗、纳差、大便干结、盗汗。舌象以舌质红或偏红或边尖红最多，说明内热较多见；舌质淡红其次，说明气虚阴虚并重的患者亦不少见。（2）因子分析研究得出3个共因子，其中F1所包括的症状与气阴两虚偏阴虚证相似，病位偏于肝、脾、肾，且F1的特征根值最高，说明气阴两虚偏阴虚证的比率最大；F2所包括的症状与气阴两虚并重证相似，病位多在脾、肾；F3所包括的症状与气阴两虚偏气虚证相似，病位多在肺、脾。结论IgA肾病气阴两虚证的证候特征以气阴两虚偏阴虚证和气阴两虚并重证常见。     

柴胡对四种不同肾病模型的作用研究

本文综述了用于柴胡作用研究的几种常用肾病模型（大鼠抗肾小球基底膜肾炎模型、Heymann肾炎模型、系膜增殖性肾炎模型和嘌呤霉素氨基核苷肾病模型）的造模方法、病理特征和病变机制；总结了柴胡皂苷治疗肾炎作用及其机制的研究状况，为进一步开展柴胡治疗肾炎的作用研究提供依据。     

Inhibitory Effect of Potassium Citrate on Rat Renal Tumors Induced by N-Ethyl-N-hydroxyethylnitrosamine Followed by Potassium Dibasic Phosphate

Potassium dibasic phosphate (PDP) was administered at a concentration of 10% by weight in basal diet to unilaterally nephrectomized Wistar rats previously given 1000 ppm N-ethyl-N-hydroxyethyl-nitrosamine (EHEN) in the diet for 2 weeks. To study the effect of alkalinization on renal mineralization, some animals concomitantly received 5% potassium citrate (PC). Feeding PDP alone promoted adenomatous hyperplasias, which were regarded as preneoplastic lesions, as well as renal cell tumors in EHEN-initiated rats, whereas the addition of PC to PDP diets reduced the promoting effect. Histopathology, serum biochemistry and urinalysis indicated retardation of renal calcium crystallization by PC. Two other phosphate salts, sodium phosphate (SP) and calcium phosphate (CP), were also administered. SP showed a slight promoting effect on adenomatous hyperplasias and a 2-fold increase in the yield of renal cell tumors, while CP induced a clear reduction of both lesions, over EHEN alone. The promoting effects of both PDP and SP and the inhibitory effect of PC were somewhat correlated to 5-bromo-2'-deoxyuridine labeling indices, the degree of nephropathy, and mineralization in the kidney. Immunohistochemically, the nephropathy induced by phosphate salts was not linked to α_zu-globulin. A pathogenesis for renal carcinogenesis is suggested in which nephropathy associated with mineralization enhances the development of renal cell tumors.     

Inherited multicentric osteolysis with carpal-tarsal localisation mimicking juvenile idiopathic arthritis

Five patients with multicentric carpal-tarsal osteolysis are presented: a mother and her three children with an autosomal dominant mode of inheritance and one of the children with nephropathy, the fifth a sporadic case also with renal involvement. The main findings common to these five patients are symptoms and signs simulating arthritis of the wrists and/or ankles starting at a young age and mimicking juvenile idiopathic arthritis. Early signs of osteolysis and shortening of the carpus or tarsus are radiological characteristic. The disease may be associated with a peculiar face, but most importantly with nephropathy. The pathogenesis is still unknown. Conclusion: recognition of this disease and differentiation from juvenile idiopathic arthritis is important to avoid unnecessary investigations and treatment. Follow-up of renal function is indicated.Abbreviations JCA juvenile chronic arthritis - JIA juvenile idiopathic arthritis - MCTO multicentric carpal-tarsal osteolysis