老年人急性肾功能衰竭32例临床分析

急性肾功能衰竭(ARF)是一组由多种病因引起的临床综合征,表现为肾功能在数日或数周内迅速恶化,是临床危重疾病之一,随着年龄增长,尤其是老年人由于血管硬化,肾功能不同程度减退,更易发生ARF。为探讨其临床特点,本文对1999年至2003年我院收治的老年ARF病例作一回顾性分析,现报道如下。1对象和方法选择我院1999年至2003年住院的101例ARF病人。ARF的诊断标准为:在数小时至数天的短时间内肾小球滤过率较基础值降低50%或血清肌酐(SCr)较基础值上升50%或肾功能急剧减退到需要透析程度[1]。将其分为老年组和中青年组进行分析,老年组32例,男1…     

Protective Effect of Resveratrol,a Polyphenolic Phytoalexin on Glycerol-Induced Acute Renal Failure in Rat Kidney

Rhabdomyolysis-induced myoglobinuric acute renal failure (ARF) accounts for about 10% to 40% of all cases of ARF. Reactive oxygen intermediates have been demonstrated to play an etiologic role in myoglobinuric renal failure. This study was designed to investigate the effect of resveratrol, a polyphenolic phytoalexin in glycerol-induced ARF in rats. Seven groups of rats were employed in this study, group I served as control; group II was given 50% glycerol (8mL/kg, intramuscularly); groups III, IV, and V were given glycerol plus resveratrol (2mg/kg, 5mg/kg, and 10mg/kg p.o. route, respectively) 60 min prior to the glycerol injection; group VI received L-NAME (10mg/kg, i.p.) along with glycerol and resveratrol (5 mg/kg), group VII animals received L-NAME (10 mg/kg) 30 min prior to glycerol administration. Renal injury was assessed by measuring plasma creatinine, blood urea nitrogen, creatinine, and urea clearance. The oxidative stress was measured by renal malondialdehyde levels and reduced glutathione levels, and by enzymatic activity of catalase, glutathione reductase, and superoxide dismutase. Tissue and urine nitrite levels were measured as an index of total nitric oxide levels. Glycerol treatment resulted in a marked decrease in tissue and urine nitric oxide levels, renal oxidative stress, and significantly deranged the renal functions along with deterioration of renal morphology. Pretreatment of animals with resveratrol (5 and 10 mg/kg) 60 min prior to glycerol injection markedly attenuated the fall in nitric oxide levels, renal dysfunction, morphologic alterations, reduced elevated thiobarbituric acid reacting substances, and restored the depleted renal antioxidant enzymes. This protection afforded by resveratrol was significantly reversed by cotreatment of L-NAME along with resveratrol, clearly indicating that resveratrol exerts its protective effect through nitric oxide release along with the antioxidative effect in glycerol-induced ARF.     

急性砷化氢中毒31例临床分析

砷化氢（arsine，AsH3）为无色气体，具有大蒜样臭味，无明显刺激性，本品在工业上无直接用途，是某些工业生产过程中产生的废气，多见于冶金工业。AsH3是一种强烈的溶血性毒物，短时间内吸入高浓度AsH3可发生急性中毒。重度中毒主要表现为急性血管内溶血，造成多器官损害，特别是急性肾功能衰竭（ARF）最为常见。我科于1998年至2005年共收治急性AsH3中毒患者31例，报告如下。     

p14ARF、E2F-1与肺癌

p14ARF基因和核转录因子E2F-1在细胞周期调控,细胞凋亡和肿瘤发生中具有重要作用。近年来,有研究表明p14ARF在肺癌中的表达率低于正常组织,E2F-1的表达率高于正常组织。本文将就p14ARF、E2F-1与肺癌的关系进行综述。     

Dialysis and pediatric acute kidney injury: choice of renal support modality

Dialytic intervention for infants and children with acute kidney injury (AKI) can take many forms. Whether patients are treated by intermittent hemodialysis, peritoneal dialysis or continuous renal replacement therapy depends on specific patient characteristics. Modality choice is also determined by a variety of factors, including provider preference, available institutional resources, dialytic goals and the specific advantages or disadvantages of each modality. Our approach to AKI has benefited from the derivation and generally accepted defining criteria put forth by the Acute Dialysis Quality Initiative (ADQI) group. These are known as the risk, injury, failure, loss, and end-stage renal disease (RIFLE) criteria. A modified pediatrics RIFLE (pRIFLE) criteria has recently been validated. Common defining criteria will allow comparative investigation into therapeutic benefits of different dialytic interventions. While this is an extremely important development in our approach to AKI, several fundamental questions remain. Of these, arguably, the most important are “When and what type of dialytic modality should be used in the treatment of pediatric AKI?” This review will provide an overview of the limited data with the aim of providing objective guidelines regarding modality choice for pediatric AKI. Comparisons in terms of cost, availability, safety and target group will be reviewed.     

Acute renal failure as the presenting feature of leukaemic infiltration in chronic lymphocytic leukaemia

Chronic lymphocytic leukaemia (CLL) is a neoplastic condition of B cells which commonly affects the lymph nodes, liver, spleen and bone marrow. Leukaemic involvement of the kidney is also relatively common in CLL, but characteristically is not associated with renal impairment. Our report describes a patient who developed acute renal failure as the initial presenting feature of CLL. The renal failure was subsequently found to be due to direct leukaemic infiltration. Treatment with chlorambucil and prednisolone resulted in stabilisation of the renal function for approximately 1 year prior to the need for long-term haemodialysis. Leukaemic infiltration of kidney should always be considered when a patient with CLL presents with renal impairment, regardless of the clinical stage, as the renal failure often responds well to chemotherapy.     

血必净注射液治疗肾综合征出血热合并急性肾功能衰竭42例临床疗效观察

目的:观察血必净注射液治疗肾综合征出血热(HFRS)合并急性肾功能衰竭(ARF)的临床疗效。方法:将72例ARF患者随机分为治疗组(Ⅰ组,42例)和对照组(Ⅱ组,30例),Ⅰ组在西医综合治疗的基础上加用血必净注射液,Ⅱ组仅采用西医综合治疗。结果:Ⅰ组总有效率为95.24%,Ⅱ组为80.00%,2组比较具有显著性差异(P<0.05);Ⅰ组肾功能恢复正常时间显著短于Ⅱ组(P<0.05)。结论:血必净注射液治疗HFRS合并ARF具有良好疗效。     

阿昔洛韦致不良反应86例文献分析

目的：探讨阿昔洛韦所致不良反应（ADR）的一般规律和特点,为临床合理用药提供参考。方法：对1995-2009年国内医药学术期刊报道的86例阿昔洛韦致不良反应病例进行统计、分析。结果发生ADR的原疾患以单纯性疱疹和带状疱疹患者最多（65例,占75.58％）。静脉滴注（76侧,88.37％）ADR发生率明显高于口服和局部用药;ADR在≤24h发生例数最多（25例,29.07％）。急性肾功能衰竭（Acute renal failure,ARF）是其严重且高发的不良反应,有54例占62.79％,大部分是由于不合理用药所致,一般为非少尿型,停药并经积极对症治疗大多预后良好。结论：临床医生应严格掌握适应证,严格选取药物的用法、用量,使用疗程不宜过长。