近年血小板减少性紫癜文献分析

本文通过对1995-2003年有关血小板减少性紫癜文献年代分布、期刊分布、著者、文献主题词分布等方面进行统计分析,寻找其研究热点和发展趋势,为临床研究及治疗提供借鉴。     

Progressive tubulointerstitial nephritis and chronic cholestatic liver disease

We report the clinical and morphological features of a distinctive hepatorenal disorder in four patients and review the five similar patients in the literature. The main clinical characteristics were early onset of cholestatic liver disease and progressive tubulointerstitial nephritis leading to renal death in early childhood. Liver histology showed disturbed architecture with nodular and acinar formations and portal fibrosis and bile duct proliferation. Histological abnormalities in the kidney were severe interstitial fibrosis and tubular atrophy and dilatation, while the typical features of nephronophthisis were lacking. These clinical and morphological characteristics distinguish our patients from the majority described, as having nephronophthisis and congenital hepatic fibrosis or any other known syndrome with concomitant hepatorenel involvement. We suggest that the association of cholestatic liver disease and progressive tubulointerstitial nephritis represents a new syndrome.     

The rheumatic poison: a survey of some published investigations of the immunopathogenesis of Henoch-Schönlein purpura

Laboratory studies of the pathophysiology of Henoch-Schönlein purpura (HSP) have become more numerous in recent years with the recognition of the disease's links with the mucosal immune system in general and IgA nephropathy in particular. There are weak genetic associations with C4 null phenotypes and with HLA B35 and DR4. Studies of plasma proteins in HSP patients show an increased IgA concentration, activation of the alternative pathway of complement and consumption of factor XIII. High molecular weight (polymeric) IgA has been detected in affected individuals, which some investigators have called immune complexes. Many patients synthesise an IgA rheumatoid factor in the acute phase, but other autoantibodies are largely absent. In vitro studies of lymphocytes from HSP patients have demonstrated an increased number of IgA-bearing and secreting B-cells, with altered T-cell regulation of antibody synthesis. While these observations point to immune dysregulation — primarily of IgA production — as a consistent feature of acute HSP, there is as yet insufficient information available to allow a consistent theory of pathogenesis to be formulated.     

Excretion of epidermal growth factor-like material in acute Henoch-Schönlein purpura nephritis

In Henoch-Schönlein purpura nephritis (HSPN), glomeruli may develop cellular crescents composed of infiltrating monocytes and proliferating renal epithelia. In this study, we demonstrate that peripheral human monocytes can release an epidermal growth factor (EGF)-like substance detectable by a radioreceptor assay, which recognizes both EGF and transforming growth factor-alpha (TGF-alpha), but not with a radioimmunoassay, which recognizes only EGF. Furthermore, we report that urine from pediatric patients during the acute phase of HSPN contains a similar EGF-like species in addition to the endogenous EGF which is normally present. The EGF-like material was not present in urine from nine healthy children or from six children with acute post-streptococcal glomerulonephritis. The extent of crescent formation in our patients is uncertain, since renal biopsy was performed in only one case. However, we speculate that the urinary material resembling TGF-alpha which appears during the acute phase of HSPN may derive from monocytes infiltrating the kidney.     

复方丹参与维生素C合用治疗过敏性紫癜32例

[背景 ]探讨过敏性紫癜的治疗方法 .[病例报告 ]应用复方丹参与维生素C合用治疗过敏性紫癜 32例 ,并辅以对症治疗 .结果 ,32例中显效 2 7例 ,有效 5例 ,总有效率为 10 0 % .[讨论 ]应用复方丹参及维生素C合用治疗过敏性紫癜疗效满意     

慢性肾炎NK细胞活性的研究

目的　研究红细胞对慢性肾炎NK细胞活性的作用。方法　检测了 49例患者和 15例健康人NK细胞活性、红细胞C3b受体花环率 (RCR)、红细胞免疫复合物花环率 (RICR)及血红蛋白 (Hb)的含量。结果　慢性肾炎患者NK细胞活性、RCR水平显著低于正常对照 (P <0 .0 5、P <0 .0 1) ,RICR水平显著高于正常对照 (P <0 .0 1) ;慢性肾炎患者NK细胞活性与RCR、Hb呈正相关 ,与RICR呈负相关。结论　红细胞对慢性肾炎NK细胞活性有明显活化作用 ,作用机制与红细胞胞浆中的NK细胞增强因子及红细胞膜免疫功能有关     

理血汤治疗慢性原发性血小板减少性紫癜的临床观察

目的 观察理血汤治疗慢性原发性血小板减少性紫癜（简称CITP）的临床疗效。方法 将CITP患随机分为理血汤治疗组（29例）和对照组（20例）。观察治疗前后外周血小板计数、血小板相关抗体、骨髓巨核细胞的变化。结果 治疗组和对照组的缓解率、显效率、总有效率分别为13.8%,24.1%.86.2%和5%,10%,60%。经统计学处理两组差异有非常显性（P＜0．01）,治疗组疗效明显优于对照组。停药后1个月治疗组外周血血小板计数仍明显高于对照组。结论 理血汤治疗CITP有较好疗效,具有很好的开发应用前景。     

肾炎灵冲剂对家兔慢性肾小球肾炎的作用

目的 :观察肾炎灵冲剂对家兔慢性肾小球肾炎的作用。方法 :用大鼠肾小球基底膜和弗氏佐剂 ,给家兔注射 ,复制出慢性肾小球肾炎模型。给肾炎灵冲剂 ,观察尿蛋白、血清尿素氮、肌酐、血清白蛋白、球蛋白及肾组织的病理学改变。结果 :肾炎灵冲剂可剂量依赖性地降低尿蛋白(P<0 .0 5)、血清尿素氮 (P<0 .0 5)、肌酐 (P<0 .0 5)的水平 ,提高血清白蛋白的水平 (P<0 .0 5) ,减轻肾小球病变。结论 :肾炎灵冲剂对家兔慢性肾小球肾炎具有保护作用     

Dysregulation of apoptosis: a possible mechanism leading to chronic progressive renal histological changes in lupus nephritis

Objective To evaluate apoptosis in lupus nephritis and the relationship between the existe nce of apoptotic cells in renal tissue and histopathological or clinical changes .Methods Apoptosis was detected by in situ nick-end labeling techniques (TUNEL) in renal biopsies from 25 patients with type Ⅳ lupus nephritis (LN), 12 patients with I gA nephropathy IgAN, 4 patients with idiopathic mesangioproliferative glomerulon ephritis (MsPGN) and 3 patients with acute poststreptococcal glomerulonephritis (APGN).Normal renal tissue obtained at nephrectomy for hypernephroma in 4 adul ts was used as control.Proliferating cells were identified by proliferating ce ll nuclear antigen (PCNA) in these patients. Results Compared to other proliferative glomerulo-nephritis and controls, the patients w ith lupus nephritis had less apoptotic cells, a higher ratio of PCNA+ cells/TdT+ cells (P/T) in renal tissues; and their P/T ratio in glomeruli and tubuloin terstitium correlated with the chronicity index, r=0.4983 (P=0.0132), r=0.8399 (P&lt;0.001), r=0.6614 (P=0.0033), respectively.P/T ratios in the glomerulus and tubule had a positive correlation with 24-hour uri nary protein, r=0.8554 (P&lt;0.001) and r=0.7134 (P=0.001); and a negative correlation with creatinine clearance (Ccr), r=-0.4880 (P=0 .0133) and r=-0.7229 (P=0.001), which in tubules positively corre lated with serum creatinine (Scr), r=0.4107 (P=0.0414).Conclusions Apoptosis is reduced in proliferative lupus nephritis.Intense proliferation wi thout a commensurate increase in apoptosis is a possible mechanism that leads to chronic progressive renal histopathological changes.     

ITP患者骨髓及血液检测指标与疗效关系的探讨

目的：为观察血小板表面相关抗体Ｇ（ＰａＩｇＧ）、外周血血小板计数（ＢＰＣ）、平均血小板容积（ＭＰＶ）、骨髓巨核细胞计数（ＭＫ）与产板型巨核细胞比例（ＰＰＭＫ）对特发性血小板减少性紫癜（ｉｄｉｏｐａｔｈｉｃ ｔｈｒｏｍｂｏｃｙｔｏｐｅｎｉｃｐｕｒｐｕｒａ,ＩＴＰ）患者疗效的预计价值。方法：采用Ｃｏｕｌｔｅｒ全自动血球分析仪及双抗体夹心ＥＬＩＳＡ法等,对７３例ＩＴＰ患者治疗前和治疗后的ＢＰＣ、ＭＰＶ、