测定尿红细胞平均体积和分布曲线鉴别血尿来源的临床价值

目的观察尿红细胞平均体积（ＭＣＶ）和尿红细胞分布曲线鉴别血尿来源和性质。方法用ＣＯＵＬＴＥＲ－ＪＴ全自动血球计数仪检测４０例肾小球性血尿、４０例非肾小球性血尿ＭＣＶ和分布曲线。结果肾小球肾炎ＭＣＶ为６１±１４ｆｌ,非肾小球肾炎ＭＣＶ为８９±１８ｆｌ,以ＭＣＶ＜８０ｆｌ鉴别为肾小球性血尿,敏感性和特异性分别为９７．５％和８８．２％。分布曲线的特点不同,峰值差异很大。结论测定尿ＭＣＶ及分布曲线对鉴别血尿来源和性质有重要意义。     

Urethral hemangioma: Laser treatment

Urethral hemangioma is a rare cause of hematuria for which variousmodalities of treatment have been used. We report a young patient, whopresented with hematuria and in whom urethrocystoscopy showed multiplehemangiomas in penile urethra. These were fulgurated successfully withNd-YAG laser. This revised version was published online in August 2006 with corrections to the Cover Date.     

中医药治疗血尿的临床体会

针对肾脏疾病血尿病程长、症情复杂、兼症多和易反复等特点，结合医案介绍了沈庆法教授运用中医药治疗血尿的临床经验和用药体会。     

Hematuria duration does not predict kidney function at 1 year in ANCA-associated glomerulonephritis

Objectives

Hematuria is considered a marker of active renal disease in ANCA-associated glomerulonephritis (ANCA-GN) with induction immunosuppression often continued until hematuria has resolved. We aim to determine whether longer hematuria duration is associated with lower estimated glomerular filtration rate (eGFR) at 1 year.

Methods

We conducted a retrospective study of 55 patients with biopsy-proven ANCA-GN. Linear regression models were constructed to determine predictors of eGFR at 1 year. The primary exposure was hematuria (>5 rbc/hpf) duration, defined as <90 days vs. ≥90 days following renal biopsy. Covariates included age, gender, ANCA type, baseline eGFR, and baseline proteinuria.

Results

Mean age at diagnosis was 58 years (53% male, 80% Caucasian, 38% PR3-ANCA, and 45% MPO-ANCA). At baseline, all patients had hematuria, 95% had proteinuria, and mean serum creatinine was 3.1 [standard deviation (SD) = 2.3] mg/dL. Overall, 93% were treated with steroids in combination with either cyclophosphamide or rituximab. Mean hematuria duration was 92 (SD = 77) days with 34 (62%) patients having hematuria resolution within 90 days. Older age and lower baseline eGFR were associated with lower eGFR at 1 year (p = 0.03 and p < 0.001, respectively). Hematuria resolution (<90 days vs. ≥90 days) was not predictive of eGFR at 1 year (p = 0.93).

Conclusions

In ANCA-GN, hematuria duration does not predict eGFR at 1 year. Our findings provide support that among individuals who are otherwise considered to be in clinical remission, the persistence of hematuria should not delay transition from induction to maintenance immunosuppression.     

Choriocarcinome gestationnel révélé par une métastase rénale

Gestational choriocarcinoma (GC) belongs to a group of gestational trophoblastic tumors. This rare tumor has a great metastatic potential and thus requires an early and adapted treatment. Herein We report a case of GC in a 35-year-old patient who presents with hematuria from a renal metastasis. Clinical improvement was noted after nephrectomy and chemotherapy. This observation underlines the importance of the dosage of the beta-HCG and the polymorphic clinical presentation of gestational choriocarcinoma.     

肾炎清片对无症状性血尿患者IL-6和VEGF水平的影响

目的 探讨肾炎清片对无症状性血尿患者IL-6和VEGF水平的影响.方法 将76例临床诊断为无症状性血尿患者随机分为治疗组和对照组各38例,对照分析肾炎清片治疗前和治疗后无症状血尿患者的IL-6和VEGF的水平.结果 肾炎清片治疗组无症状性血尿患者的IL-6和VEGF的水平较对照组明显降低,结果显示组间的差异具有统计学意义(P＜0.05).结论 肾炎清片能够改变无症状性血尿患者IL-6和VEGF的水平,可能对无症状性血尿患者血尿症状的改善具有一定的作用.     

1200名白族成年人体检单次尿液和肾功能检查结果分析及临床意义

目的:通过分析健康体检人群的检查结果,了解云南白族成年人尿检和肾功能检查异常的情况,为中国西南地区慢性肾脏病(chronic kidney disease,CKD)防治提供流行病学依据.方法:回顾性收集并分析2019年1月至12月于云南省大理白族自治州剑川县人民医院体检中心进行常规体检的白族成年人群的尿常规及肾功能检查...     

三叶人字草对IgA肾病模型大鼠的治疗作用

目的 研究三叶人字草对IgA肾病模型大鼠的治疗作用.方法 取SD大鼠60只.适应性喂养3 d后.随机分为6组,分别为空白对照组、模型对照组、雷公藤多苷组((0.0165 g/kg))和三叶人字草高、中、低剂量组(16.0,8.0,4.0 g/kg),每组10只.除空白对照组之外,其余各组均采用联合应用脂多糖牛血清白蛋白(BSA)、脂多糖(LPS)和四氯化碳(CCl_4)的方法制备实验性IgA肾病大鼠模型,造模成功后,连续灌胃给药5周.测定各组大鼠24 h尿蛋白和尿常规,取血检测血清总蛋白(TP)、血清白蛋白(ALB)、谷草转氨酶(AST)和谷丙转氨酶(ALT)的含量;取肾组织进行HE染色,光镜下观察大鼠肾组织的病理变化情况.结果 三叶人字草水煎液能够明显地减轻IgA肾病大鼠蛋白尿和血尿的状况,对各肝功能指标TP、ALB、AST、ALT无明显影响,可明显地减轻IgA肾痛引起的大鼠肾脏病理组织学变化.结论 三叶人字草对IgA肾病模型大鼠具有一定的治疗作用.