钙化生物瓣组织钙磷含量关系及钙化原因初探

钙化是造成生物瓣远期衰败和限制其临床应用范围的主要原因之一。对生物瓣钙化机制以及防止或延缓生物瓣钙化的研究，一直是瓣膜外科的热门课题。本文通过建立生物瓣钙化动物模型及钙化生物瓣组织钙磷含量关系的分析和组织学检查，发现在无交变应力及血液接触的情况下，仍可发生钙化。钙化组织中钙磷的增长速度基本相同，钙磷含量之间呈明显正相关，钙化处组织疏化，胶原断裂、肿胀、排列紊乱。这些结果说明，机械应力和血流接触并非     

32制剂内照射治疗难治性实体瘤的临床研究

目的 研究^32P胶体或微球治疗难治性实体瘤的疗效。方法 30例难治性实体瘤患者经动脉内介入，手术野直视或在CT引导下经皮注入瘤体内部，接受^32P胶体或微球（259～685MBq）治疗，通过γ照相机、X线平片及CT来观察抑瘤率、副作用及生存期。结果 瘤体内注射^32P制剂后肿瘤生长明显受到抑制。患者的平均生存期为33个月，抑瘤率为96．6％，完全抑制16例占53．3％，部分抑制13例占43．3％。其中1例右叶肝癌患者已带瘤生存至今94月。仅1例治疗无效，治疗后出现放射性肺显影、肝功能衰竭死亡。未出现其他明显副作用。病理检查结果表明，瘤体高度纤维化，内见坏死区，外层形成完整包膜。结论 ^32P胶体或微球是放射性核素治疗难治性实体瘤的理想药物。合理选择适应证和给药方法能进一步提高临床疗效。     

Muscle high-energy phosphates in central nervous system disorders. The phosphorus MRS experience

Phosphorus magnetic resonance spectroscopy (MRS) was used to study muscle phosphates metabolism in several brain disorders. Those with primary mitochondrial encephalomyopathies showed the typical pattern of impaired oxidative metabolism at rest and during recovery after exercise. In migraine, Parkinson's disease and alternating hemiplegia muscle MRS observations lend support to a possible mitochondrial dysfunction. Similar observations in multiple sclerosis are probably the result of secondary deconditioning. In post polio syndrome and in some of the hereditary ataxias, elevated intracellular inorganic phosphates may be the result of another, yet unknown, metabolic impairment. Thus, muscle phosphate metabolism may be altered in various central nervous system (CNS) disorders by different metabolic impairments. All these possibilities should be taken into account when evaluating MRS results in brain diseases.

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Sommario La risonanza magnetica spettroscopica del fosforo è usata per studiare il metabolismo dei fosfati del muscolo in molti disordini cerebrali. Le encefalomiopatie mitocondriali primitive evidenziano un pattern tipico di alterato metabolismo muscolare a riposo e durante il recupero dall'esercizio. Nelle cefalee, nella malattia di Parkinson e nell'emiplegia alternante le osservazioni di risonanza magnetica spettroscopica del muscolo supportano l'ipotesi di una possibile disfunzione mitocondriale in tali patologie. Simili risultati ottenuti in pazienti con sclerosi multipla sono probabilmente da mettere in relazione a un secondario decondizionamento muscolare. In pazienti con sindrome post poliomielitica e con alcune forme di atassia ereditaria, l'aumento del fosfato inorganico muscolare potrebbe essere dovuto ad un difetto metabolico ancora sconosciuto. In conclusione, in varie patologie del sistema nervoso centrale il metabolismo dei fosfati del muscolo scheletrico può essere alterato e tale alterazione può essere dovuta a differenti meccanismi patogenetici. Tutte le differenti possibilità dovrebbero essere prese in considerazione nel valutare i risultati della risonanza magnetica spettroscopica nelle malattie del sistema nervoso centrale.

     

32P液体球囊在血管内吸收剂量的研究

目的　研究32 P球囊在血管内的剂量分布。方法　用肌肉等效材料代替血管壁 ,采用热释光剂量学方法模拟测量靶血管轴向和径向吸收剂量率分布 ,并对相关影响因素 (球囊内压力 ,气泡 )进行了研究。结果　 3 0mm× 2 0mm 32 P球囊 ,活度为 92MBq时 ,血管表面平均吸收剂量率为0 48Gy min ,在径向 0 4mm处为 0 2 2Gy min。结论　血管壁表面剂量分布较均匀 ,径向剂量随距离迅速衰减 ,但存在诸多影响因素。     

Calcium homeostasis in prepubertal diabetic children

Summary Many authors have described abnormalities of calcium homeostasis in type I diabetes mellitus, but data in the literature are conflicting. Consequently we studied calcium, phosphorus and magnesium (in serum and urine), parathyroid hormone, calcitonin and 25-hydroxyvitamin D (25-OHD) levels in 21 prepubertal diabetic patients and in 21 sex- and age-matched controls. We did not find any significant difference of all the aforementioned parameters between diabetics and controls. Also the value of 25-OHD was similar in diabetic and healthy subjects (24.33 ± 6.04vs 22.09 ± 5.01 ng/ml). The results suggest that the principal parameters of calcium metabolism are normal in prepubertal diabetic children. Presented in part at the Annual Meeting of the European Society for Pediatric Research, Padova, Italy, 1987.     

维持血液透析患者血清钙、磷、甲状旁腺激素水平及高通量滤器干预观察

目的 改善慢性肾衰竭尿毒症维持血液透析患者钙、磷、甲状旁腺代谢紊乱.方法 对解放军第451医院原有82例患者改用高通量滤器透析治疗3个月后,对照钙、磷、甲状旁腺素（iPTH）水平.所有患者B超检测甲状旁腺,并进一步分为增生、非增生2组对比此效果.结果 高通量滤器透析患者血钙升高（t=-4.786,P＜0.05）,血磷、甲状旁腺素水平降低（t=2.341,P＜0.05,iPTH=2.937,P＜0.05）,甲状旁腺增生组效果更为明显（Ca∶ t=-3.583/-3.207,P=0.001/0.003;P：t=1.74/1.619,P=0.089/0.113,iPTH∶ t=2.408/1.830,P=0.001/0.074）. 结论 高通量滤器透析改善了尿毒症维持血液透析患者钙、磷、甲状旁腺代谢紊乱.     

妊娠期糖尿病患者骨代谢变化的研究及治疗方案的选择

目的探讨妊娠期糖尿病(GDM)患者骨代谢的变化及适宜的治疗方案。方法选择104例孕妇,包括GDM患者52例,正常对照52例。GDM患者随机为A、B两组,自孕中期(24~26周)开始,A组服用1片碳酸钙D3,B组服用2片碳酸钙D3,直至分娩。比较GDM与对照组血钙、尿钙、血磷代谢变化及治疗前后钙磷代谢和碱性磷酸酶(ALP)及25(OH)D变化。结果治疗前,GDM组24 h尿钙水平显著高于对照组(P0.001),血钙水平略高于对照组,但无统计学差异(P0.05)。GDM患者产后血钙与对照组水平接近,血磷水平则基本无明显变化。A、B两种方案血钙水平治疗后均降低,无统计学差异,两组血ALP和25(OH)D水平治疗后均显著增高,其中B方案治疗后血ALP水平较A方法低(P0.05)。B方案治疗的患者24尿钙水平显著降低(P=0.002)。结论妊娠中晚期尿钙丢失增加,应及时补充钙剂。GDM患者尿钙丢失更多,采取B方案可增加对钙剂的补充,更适合GDM患者。     

Hypophosphatemia accompanying blastic crisis in a patient with malignant lymphoma

Summary A patient with malignant lymphoma showed severe hypophosphatemia during a blastic crisix. x-Ray microprobe analysis of the cells at this stage revealed a high phosphorus content. Following treatment and a decline in the white cell count the serum phosphorus increased, whereas the cellular phosphorus decreased. The potential prognostic value of serum and cellular phosphorus determinations during the course of malignant disorders of the hematopoietic system is discussed.     

Graves病治疗前及治疗中血清游离钙与血,尿钙磷代谢异常

46例Graves病患者治疗前血清游离钙(Ca~( ))、磷(P)、碱性磷酸酶(AKP)及24小时尿钙(Ca)、P、羟脯氨酸(Hyp)排量水平都显著高于正常对照组。经治疗2—3个月甲亢病情控制后,血Ca~( )、P及24小时尿Ca、P亦随之恢复正常,但血AKP与24小时尿Hyp仍高于对照组。高钙血症比率在血Ca、校正钙与Ca~( )测定中分别为11.2％、16.3％与30.0％。前臂骨密度呈现骨量减少和腰椎相示骨质疏松者分别为29.0％和13.3％。本文对Graves病患者的钙、磷和骨代谢改变及其发生作了初步讨论。     

Graves病患者一次静脉注射葡萄糖酸钙及EDTA后血浆PTH、钙、磷的动态变化

作者观察了正常人及Graves病患者静脉注射葡萄糖酸钙、EDTA后血浆PTH、钙、磷的变化。静注葡萄糖酸钙、EDTA后,正常人组血清钙迅速上升或下降,血浆PTH亦随之下降或升高;Graves病组血钙亦迅速上升或下降,而血PTH无明显动态变化。血钙与PTH无明显相关性。提示Graves病患者在血钙的平衡调节中,PTH以外的因素起主要作用,并认为甲状旁腺功能有缺陷。