Comparison of histopathological characteristics of allograft biopsy between responder and non-responder to antiproteinuric effect of angiotensin-converting enzyme inhibitor (ACEI)

Abstract:  Angiotensin-converting enzyme inhibitor (ACEI) has become recognized as agents that have renoprotective effects in the treatment of progressive renal diseases including post-transplant kidneys. Previously we demonstrated the safety and effectiveness of ACEI treatment on the hypertensive proteinuric post-transplant patients ( N  = 10) who had been followed up for 12 months. However, not all patients show good response in urinary protein reduction. We aimed to analyse the histopathological factor(s) affecting the responsiveness of proteinuria to ACEI treatment. Fourteen post-transplant patients with proteinuria who were treated with ACEI and underwent allograft biopsy were analysed. Eight patients showed 50% or more reduction in proteinuria (responder). The other 6 patients showed less (< 50%) reduction in proteinuria (non-responder). There was no difference in clinical characteristics (BP, renal function, donor age, recipient body mass index), dietary sodium or protein intake, and diuretic use between the two groups. As a histopathological characteristic, glomerular size in responder group was significantly larger than that in non-responder group. This suggests that the large glomerular size at least partly contributes to the responsiveness in urinary protein reduction to ACEI treatment in kidney allograft recipients with proteinuria.     

清燥救肺汤加减治疗依那普利所致咳嗽临床研究

目的 :观察清燥救肺汤加减治疗依那普利所致咳嗽疗效。方法 :设清燥救肺汤组与复方甘草片组对照观察疗效及对血压的影响。结果 :与对照组比较 ,疗效有显著差异 ,P <0 .0 1;血压有明显改善 ,P <0 .0 5。结论 :清燥救肺汤用于治疗依那普利所致咳嗽疗效肯定。     

冠心病患者内皮素前列环素白细胞白介素-2的变化及悦宁定的干预作用

通过对４５ 例冠心病（ＣＨＤ）患者外周血循环内皮素（ＥＴ）、前列环素（ＰＧＩ２）代谢产物６－酮类固醇－前列腺素Ｆ１ａ（６－ｋｅｔｏ－ＰＧＦ１ａ）和白细胞（Ｗ ＢＣ）、嗜中性粒细胞（ＰＭＮ）、白细胞介素－２（ＩＬ－２）的测定,以了解ＣＨＤ 患者内皮细胞（ＥＣ）的损伤及功能变化,并悦宁定（ｅｎａｌａｐｒｉｌ）治疗组与对照组比较。结果显示：ＣＨＤ 患者ＥＴ、ＷＢＣ、ＰＭＮ 明显高于正常;６－ｋｅｔｏ－ＰＧＦ１ａ则明显低于正常;ＩＬ－２在急性心肌梗塞（ＡＭＩ）早期明显低于正常,均与病情严重程度相一致。通过ｅｎａｌａｐｒｉｌ治疗后,上述指标明显改善,提示：ｅｎａｌａｐｒｉｌ对ＣＨＤ 患者ＶＥＣ损伤有较好的保护和治疗作用     

ACEI药理性预适应的心脏保护作用及机制

 目的阐述血管紧张素转换酶抑制剂(angiotensin converting enzyme inhibitor，ACEI)药理性预适应的心脏保护作用及机制。方法参阅相关文献，加以综合、分析和归纳。结果与结论 ACEI通过保存缓激肽产生缩小心肌梗死范围、抗心律失常、改善心功能和能量代谢等作用。     

血管紧张素转换酶抑制剂的临床应用进展

就近年来血管紧张素转换酶抑制剂(ACEI)在临床应用、不良反应、费用-效益分析方面的进展进行了综述，并进行讨论，表明ACEI具有广泛的应用。     

2000年～2002年杭州地区18家医院血管紧张素转换酶抑制剂应用分析

目的 :分析杭州地区血管紧张素转换酶抑制剂 (ACEI)的用药现状和趋势。方法 :调查杭州地区 18家医院 2 0 0 0年～ 2 0 0 2年ACEI的用药数据 ,采用金额排序法进行分析。结果 :2 0 0 0年～ 2 0 0 2年杭州地区ACEI的用药金额 2 0 0 0、2 0 0 1、2 0 0 2年分别为115 6 2 4万元、10 5 7 90万元、10 74 5 6万元 ,其中 2 0 0 1年较 2 0 0 0年下降 9 30 % ,2 0 0 2年较 2 0 0 1年增长 1 5 5 %。结论 :ACEI是一类很有发展潜力的药物     

心力衰竭药物治疗的抉择

本文结合有关心力衰竭药物治疗的最新文献,重点介绍了目前已作为标准治疗的四类药物的药理作用和临床应用;其次,还简介了四类尚未作为标准治疗的药物.     

Attenuation of diabetic nephropathy by Chaihuang-Yishen granule through anti-inflammatory mechanism in streptozotocin-induced rat model of diabetics

Ethnopharmacological relevance

Traditional Chinese medical herbs have been used in China for a long time to treat different diseases. Based on traditional Chinese medicine (TCM) principle, Chaihuang-Yishen granule (CHYS) was developed and has been employed clinically to treat chronic kidney disease including diabetic nephropathy (DN). The present study was designed to investigate its mechanism of action in treatment of DN.

Materials and methods

Diabetic rats were established by having a right uninephrectomy plus a single intraperitoneal injection of STZ. Rats were divided into four groups of sham, diabetes, diabetes with CHYS and diabetes with fosinopril. CHYS and fosinopril were given to rats by gavage for 20 weeks. Samples from blood, urine and kidney were collected for biochemical, histological, immunohistochemical and molecular analyses.

Results

Rats treated with CHYS showed reduced 24 h urinary protein excretion, decreased serum TC and TG levels, but CHYS treatment did not affect blood glucose level. Glomerular mesangial expansion and tubulointerstitial fibrosis in diabetic rats were significantly alleviated by CHYS treatment. Moreover, CHYS administration markedly reduced mRNA levels of NF-κB p65 and TGF-β1, as well as decreased protein levels of NF-κB p65, MCP-1, TNF-α and TGF-β1 in the kidney of diabetic rats.

Conclusions

CHYS ameliorates renal injury in diabetic rats through reduction of inflammatory cytokines and their intracellular signaling.     

杭州地区18家医院ACE抑制剂用药情况分析

目的: 分析杭州地区血管紧张素转换酶(ACE)抑制剂的用药现状和趋势.方法: 调查杭州地区18家医院 2000～2002年ACE抑制剂的用药数据,采用金额排序法进行分析.结果: 2000～2002年杭州地区ACE抑制剂的用药金额 2000,2001,2002年分别为 1156.24,1057.90,1074.56万元,其中2001年较2000年下降 9.30%,2002年较2001年增长1.55%.结论: ACE抑制剂是一类很有发展潜力的药物.     

卡托普利治疗急性冠脉综合征合并心房颤动的临床疗效

目的:探讨转换酶抑制剂(ACEI)卡托普利在急性冠脉综合征(ACS)合并心房颤动(房颤)治疗中的作用。方法:选择我院1998年1月至2004年1月期间收住的急性冠脉综合征合并心房颤动患者126例,分为ACEI治疗组(82例)和对照组(44例),随访2年,评价两组的治疗效果。结果:ACEI治疗组房颤再发率、转为永久性房颤的发生率及缺血相关事件均明显低于对照组,P(0.05。结论:ACEI类药物早期、长期应用于ACS,对治疗ACS合并房颤是有效的。