姜黄素抑制脂多糖刺激的系膜细胞增殖及其白细胞介素1β和巨噬细胞趋化蛋白1基因的表达

目的　观察姜黄素对系膜细胞增殖以及对系膜细胞基质蛋白分泌的影响 ,并进一步探索姜黄素对系膜细胞白细胞介素 (IL 1β)和巨噬细胞趋化蛋白 (MCP 1)基因表达的改变。 方法　采用不同浓度姜黄素处理体外培养的人肾小球系膜细胞后 ,分别收集上清液及细胞 ,应用ELISA的方法测定上清液中胶原Ⅳ和Ⅲ的蛋白分泌量 ,MTT法测定系膜细胞活性 (吸光度值 ) ,RT PCR的方法测定系膜细胞IL 1β和MCP 1基因的相对表达量 ,以未加LPS及姜黄素和仅加LPS不加姜黄素作为对照组。结果　当姜黄素浓度大于或等于 6 2 5 μmol/L时 ,系膜细胞增殖明显受到抑制 (P <0 0 1) ,且表现为浓度依赖性。在基础状态下 ,系膜细胞分泌一定量的胶原Ⅳ和Ⅲ [(10± 9 13)ng/ml和 (2 9 5± 0 5 8)ng/ml],亦有MCP 1mRNA表达 [(42 1± 14 98) % ],但IL 1βmRNA几乎不表达 ;经LPS刺激后其胶原Ⅳ和Ⅲ分泌增加 [(138 75± 2 3 2 3)ng/ml和 (38 2 5± 5 38)ng/ml],同时IL 1β和MCP 1基因表达上调 [分别为 (16 91± 1 6 8) %和 (76 6± 6 5 9) % ],而姜黄素浓度为 4 μmol/L时即能明显抑制LPS刺激的系膜细胞胶原Ⅳ和Ⅲ的蛋白分泌 (P <0 0 5 ) ,且在高浓度时作用更为明显 ;同时姜黄素还能消除LPS上调系膜细胞IL 1β和MCP 1基因表达的作用 (P <     

Glomerular filtration rate in children with solid tumors: normative values and a new method for estimation

Many chemotherapy regimens used in children are nephrotoxic. Accurate dosing of these medications requires that some estimation of glomerular filtration rate (GFR) be performed prior to initiating chemotherapy. However, few studies evaluating normal GFR in children exist. The authors report normal values for GFR for children with nonhematogenous malignancies using a highly accurate method of directly measuring GFR and an equation for estimating absolute GFR in these children. Children with nonhematogenous malignancies with no evidence of renal involvement or prior use of nephrotoxic agents had their GFR measured using an iothalamate infusion methodology. A total of 111 children (males and females) with a mean age = 7.95 years (range 2.8 months-19.5 years) were included in the study. GFR adjusted for body surface area (mL/min/1.73 m(2)) increases in the first 2 years of life and then plateaus at a level comparable to adult values. GFR adjusted for body surface area for males >2 years = 131.3 +/- 22.5, females = 126.8 +/- 24.4 mL/min/1.73 m(2) (p value not significant). Absolute GFR in mL/min can be easily estimated by a simple formula (r(2) =.97) based on the child's weight and serum creatinine: GFR (mL/min) = k sqrt[ ( (agemos+ 6)* wt) / Cr serum ] where agemos is age in months, wt is weight in kg, and k = 1.05 for males and 0.95 for females. The accurate measurement of GFR remains vitally important in the safe and effective treatment of pediatric solid tumors. This study provides a set of normal GFR values for these children and an equation for easy estimate of absolute GFR.     

白细胞介素—13对肾小球系膜细胞增殖的影响

目的 :观察白细胞介素 - 1 3(IL - 1 3)对肾小球系膜细胞增殖的影响。方法 :应用流式细胞仪检测加入不同浓度 IL - 1 3作用后对肾小球系膜细胞 DNA含量的变化。结果 :各实验组的 DNA合成前期 (G1期 )细胞数增加 ,而合成期 (S期 )细胞数降低 ,各实验组与对照组比较 ,差异均有显著性 (P<0 .0 1 )。结论 :IL - 1 3具有抑制肾小球系膜细胞增殖作用     

三种肾小球滤过率估算方程的适用性比较

目的：评价三种肾小球滤过率估算方程在南京地区慢性肾脏病(CKD)人群中的适用性。方法回顾性分析2010年1月至2015年1月在江苏省中医院肾内科住院的168例符合条件患者的临床资料,以99 mTc-DTPA肾动态显像法所测肾小球滤过率(GFR)为参考标准,以rGFR表示;分别用EPI-Scr、EPI-CysC、EPI-scr-cysc方程估算患者GFR,以eGFR表示。分别从偏倚、10%及30%的准确性(P10及P30)、精确度、95%一致性及相关性等方面对方程的适用性进行评估。结果在绝对偏倚方面,三种方程间比较差异均有统计学意义(P<0.01);EPI-Scr的绝对偏倚明显大于EPI-CysC及EPI-scr-cysc,差异均有统计学意义(P<0.0167),但EPI-CysC及EPI-scr-cysc间比较差异无统计学意义(P>0.0167)。在偏倚百分比方面,三种方程间比较差异均有统计学意义(P<0.01);EPI-Scr的偏倚百分比明显大于EPI-CysC及EPI-scr-cysc,差异均有统计学意义(P<0.0167);但EPI-CysC及EPI-scr-cysc间比较差异无统计学意义(P>0.0167)。一致性限度由小到大分别为EPI-scr-cysc (67.8)、EPI-CysC (68.8)及EPI-Scr (80.6)。与rGFR的Spearman相关系数由大到小分别为EPI-CysC(r=0.774)、EPI-scr-cysc(r=0.769)及EPI-Scr(r=0.559)。P10方面三者间比较差异无统计学意义(P>0.05)。P30方面,三者间比较差异有统计学意义(P<0.01);EPI-Scr的准确性小于EPI-CysC及EPI-scr-cysc,差异均有统计学意义(P<0.0167);但EPI-CysC及EPI-scr-cysc间比较差异无统计学意义(P>0.0167)。EPI-scr-cysc及EPI-CysC与EPI-Scr相比,精确度得到了提高,标准误差分别为17.27、17.55、23.39。结论对于南京地区CKD患者来说,EPI-CysC与EPI-scr-cysc方程适用性更佳,但仍需进一步改良并开发更合适的方程以更好服务于临床。     

正常或轻度肾功能受损社区居民肾小球滤过率与动脉硬化的相关性

目的横断面调查正常或轻度受损社区居民估测的肾小球滤过率（eGFR）及传统心血管危险因素与脉搏波速度（PWV）的关系。方法北京4个社区入选2285名18-96岁居民,平均年龄51±16岁,用问卷调查方法采集病史,自动示波测量仪检测PWV,同期化验血脂、肌酐、尿酸、血糖等指标,简化的MDRD公式估测肾小球滤过率（eGFR）。结果随着eGFR的下降,年龄、脉压、肌酐、餐后2h血糖、颈股PWV（cfPWV）均显著增高（P〈0.001）,但颈桡PWV（crPWV）组间比较无统计学意义（P=0.672）。整体人群中,cfPWV（r=-0.353,P〈0.001）、颈踝PWV（caPWV,r=-0.167,P〈0.001）与eGFR呈显著负相关,而crPWV与eGFR无相关关系（r=-0.033,P=0.115）;经校正性别、年龄和收缩压后,仅cfPWV与eGFR呈微弱负相关（r=-0.047,P=0.026）。逐步回归显示,eGFR降低是女性cfPWV增高的独立危险因素（R2=0.495,P〈0.001）,而男性eGFR对cfPWV无显著影响。结论肾小球滤过率降低是女性肾功能正常或轻度减退人群动脉僵硬度增加的独立危险因素,主要引起中心动脉僵硬度的增加,与外周动脉硬化无明显关系。     

糖尿病患者肾小球滤过率测定的临床意义

目的：观察糖尿病不同时期的肾小球滤过率（ＧＦＲ），方法：用￣(９９ｍ)ｃ－ＤＴＰＡ测定３０例正常人、２０例初发Ⅰ型糖尿病和１３９例Ⅱ型糖尿病者的ＧＦＲ，并检测尿白蛋白排泄率（ｕＡＥＲ）。结果：初发Ⅰ型糖尿病（ＪＦＲ（１２３±８．６ｍｌ／ｍｉｎ）高于正常组（１０６±７．２ｍｌ／ｍｉｎ）．Ｐ＜０．０１；Ⅱ型糖尿病随ｕＡＥＲ增加，ＧＦＲ逐渐下降，二者呈负相关（ｒ＝０．９１，Ｐ＜０．０１）。结论：糖尿病早期存在肾小球高滤过，并用ＧＦＲ和ｕＡＥＲ检测对早期发现和治疗糖尿病肾病有重要意义。     

高尿酸合并高血压对肾功能影响的分析

目的 探讨高血压、高尿酸血症（HUA）对肾功能损害的作用.方法 回顾分析2000年12月至2002年12月1 209例体检者（1 164例）及肾脏病患者（45例）的临床资料,测定指标有血压、身高、体重、肾功能、肝功能及肾小球滤过率（GFR）,其中血压、血尿酸水平均正常者832例（正常对照组）、单纯高血压者134例（高血压组）、单纯HUA者185例（HUA组）、高血压合并HUA者58例（高血压＋ HUA组）,分析各组间GFR水平的差异.结果 ①HUA者的高血压率为23.9％（58/243）,血尿酸水平正常者的高血压率为13.9％ （134/966）,两者差异有统计学意义（x^2=14.52,P =0.000）.②高血压＋HUA组GFR最低,HUA、高血压组GFR水平依次递增,分别为（69.1±30.5）、（82.8±25.3）和（90.1±21.7）ml·min^-1·（1.73 m^2）^-1,正常对照组为（94.9±20.5）ml·min·^-1·（1.73 m^2）^-1.③logistic回归分析显示,影响GFR的危险因素依次是血尿酸水平、收缩压和年龄.（521例体检者5年后,HUA组（66例）、高血压＋HUA组（52例）的GFR水平显著下降,正常对照组（238例）、高血压组（165例）、HUA组和高血压＋HUA组分别为[（90.6±17.1）、（85.6±17.6）、（62.1 ±8.2）和（49.3±9.8）ml·min-·（1.73 m^2）-],影响GFR长期因素是血尿酸水平和年龄（x^2值分别为81.10和12.18,均P=0.000）.结论 HUA、高血压是影响肾功能的重要因素,高血尿酸较高血压作用明显.高血压合并HUA对肾功能的损害最显著.     

慢性非糖尿病肾病患者血清胱抑素C的检测及临床分析

目的探讨血清胱抑素C（CysC）在慢性非糖尿病肾病2～4期患者中的水平及与其他肾功能评价指标的相关性。方法对129例慢性非糖尿病肾病患者和35例健康体检者（对照组）进行CysC和其他肾功能指标检测。结果慢性非糖尿病肾病2～4期患者的估计肾小球滤过率（eGFR）、肌酐（SCr）、C反应蛋白、尿素氮和CysC指标与对照组相比,差异均有统计学意义（P〈0.05）。与对照组相比,慢性肾病2～4期患者的红细胞压积、纤维蛋白原的差异有统计学意义（P〈0.05）。直线相关回归分析显示,CysC与SCr呈显著正相关（r=0.802,P〈0.01）;CysC与尿素氮呈显著正相关（r=0.796,P〈0.01）;CysC与eGFR呈显著负相关（r=-0.812,P〈0.01）。慢性肾病不同分期患者中,随着eGFR的减少,CysC水平逐渐增加。结论血清CysC检测是评估慢性肾病患者肾小球滤过功能较理想的指标。     

Increased blood pressure but normal renal function in adult women born preterm

It has been suggested that children born small for gestational age may develop hypertension and renal dysfunction in adulthood due to impaired fetal kidney development. Very little information on this issue is available on children born preterm. The objective of this study was to investigate the relationship between birth weight, blood pressure, and kidney function in adult subjects who were born preterm or born small for gestational age (SGA). Study design: Subjects (n=50), all women born between 1966 and 1974, were evaluated at a mean age of 26±1.9 years. They were allocated to three groups: (1) born before gestational week 32 (n=15), (2) born full term with birth weight <2600 g (n=18) (SGA), and (3) controls, born full term with appropriate birth weight (n=17). Casual blood pressure, ambulatory 24-h blood pressure (ABPM), glomerular filtration rate (GFR), renal plasma flow (ERPF) and urinary albumin excretion were determined. Results: Preterms had significantly higher casual systolic and mean arterial blood pressure levels compared to controls (123±13 vs 110±7 mmHg, P<0.01, and 87±9 vs 79±6 mmHg, P<0.005, respectively). ABPM was not significantly different between the groups. When the number of systolic recordings >130 mmHg/subject during ABPM was calculated, the preterms had significantly more recordings above this value (P<0.05) as well as a significantly increased area under the curve >130 mmHg and >140 mmHg systolic (P<0.05) compared to the controls. SGA subjects were not significantly different from controls. There were no significant differences in GFR, ERPF or urinary albumin excretion between the three groups. Conclusion: Women born preterm seem to have a disturbance in blood pressure regulation in adulthood, a finding that is not observed for those born small for gestational age. Kidney function in early adulthood seems to be normal in subjects born preterm or small for gestational age. Received: 29 December 1999 / Revised: 13 June 2000 / Accepted: 15 June 2000