中美科学家发现治疗糖尿病肾病新靶点

在美国糖尿病学会会刊《糖尿病》杂志11月号上,刊登了第三军医大学新桥医院与美国亚利桑那大学药学院等单位联合完成的一项研究成果。该研究在国际上首次证实,核相关因子2通路有望成为糖尿病肾病一个新的干预靶点,并率     

Oxidative stress and damage induced by abnormal free radical reactions and IgA nephropathy

Objective: To estimate the oxidative stress and oxidative damage induced by abnormal free radical reactions in IgA nephropathy (IgAN) patients' bodies. Methods: Seventy-two IgA N patients (IgANP) and 72 healthy adult volunteers (HAV) were enrolled in a random control study design, in which the levels of nitric oxide (NO) in plasma, lipoperoxide (LPO) in plasma and in erythrocytes, and vitamin C (VC), vitamin E (VE) and β-carotene (β-CAR) in plasma as well as the activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX) in erythrocytes were determined with spectrophotometric mothods. Results: Compared with the HAV group, the averages of NO in plasma, and LPO in plasma and in erythrocytes in the IgANP group were significantly increased (P＜0.0001), while those ofVC, VE and β-CAR in plasma as well as those of SOD, CAT and GPX in erythrocytes in the IgANP group were significantly decreased (P＜0.0001). Linear correlation analysis showed that with the increase of the values of NO, and LPO in plasma and in erythrocytes, and with the decrease of those ofVC, VE, β-CAR,SOD, CAT and GPX in the IgAN patients, the degree of histological damage of tubulointerstitial regions was increased gradually (P＜0.0001); and that with the prolongation of the duration of disease the values of NO, and LPO in plasma and erythrocytes were increased gradually, while those of VC, VE, β-CAR, SOD, CAT and GPX were decreased gradually (P＜0.005). The discriminatory correct rates of the above biochemical parameters reflecting oxidative damage of the IgAN patients were 73.8%-92.5%, and the correct rates for the HAV were 70.0%-91.3% when independent discriminant analysis was used; and the correct rate for the IgAN patients was increased to 98.8%, the correct rate for the HAV was increased to 100% when stepwise discriminant analysis was used. The above biochemical parameters' reliability coefficient (alpha) were used to estimate the oxidative damage of the IgAN patients as 0.8145, the standardized item alpha=0.9730, F=53273.5681, P＜0.0001. Conclusions: A series of free radical chain reactions caused serious pathological aggravation in the IgANP' bodies, thus resulting in oxidative damage in their bodies. In treating IgANP, therefore, it is necessary that suitable dose antioxidants should be supplemented to them so as to alleviate the oxidative damage in their bodies.     

通心络胶囊治疗肾病综合征预防血栓栓塞的临床研究

目的:观察通心络胶囊对肾病综合征患者凝血酶活性、纤维蛋白原的影响.方法:配对及肝素治疗对照研究.受试者均接受血常规、尿常规、24h尿蛋白定量、血浆肝功能、血脂、肾功能、凝血酶活性、纤维蛋白原浓度测定.结果:口服通心络胶囊可改善高凝状态,抑制凝血酶活性,降低纤维蛋白原浓度.结论:对于肾病综合征患者在有效控制蛋白尿的同时,加服通心络胶囊可有效抗凝,预防血栓、栓塞并发症出现.     

肾病综合征患儿院内感染分析

对医院84例肾病综合征患儿进行了院内感染调查,其中46例发生了院内感染,感染率为54.76％,分析院内感染的有关因素,提出肾病的院内感染率与小儿的年龄、性别、肾病的类型、血浆蛋白含量无关,而与住院天数、尿蛋白转阴时间、机体免疫状态、必要的预防措施有关,为减少院内感染,应建立严格的保护性隔离措施,对院内感染的治疗应严格选用适当抗生素及免疫调节剂。     

复肾口服液对阿霉素肾病大鼠肾脏形态的影响

目的：观察复肾口服液对阿霉素肾病大鼠肾脏的形态学影响。方法：采用尾静脉一次性注射阿霉素（ADR）复制肾病综合征模型。用光学显微镜、电子显微镜观察肾小球毛细血管、上皮细胞、基底膜及肾小管的病理形态学改变。结果：复肾口服液能使阿霉素肾病大鼠蛋白尿显著降低，肾小管管腔内的蛋白管型明显减少，肾小球淤血及上皮细胞和基底膜的损伤程度明显减轻，肾小球上皮细胞足突融合明显改善。结论：复肾口服液可促进肾病大鼠肾小球上皮细胞的修复及滤过膜功能的恢复，但存在着量效依赖关系。     

The treatment of relapsing primary nephrotic syndrome in children

Objective: To explore better therapy and reduce the rate of re-relapse of primary nephritic syndrome in children who had been treated with corticosteroids but relapsed. Methods: Eighty relapsers were enrolled from Jan. 1994 to Apr. 2000, who were randomly divided into two groups. The treatment group (n=39) had been treated with tripterysium glucosides for three months, with the control group (n=41) members were treated with cyclophosphmide (CTX) by intermission intravenous pulse, with total dose of CTX not being more than 150 mg/kg. Prednisone, meanwhile, was given to both groups. The total treatment period of prednisone was prolonged by 12-18 months. Results: After following up for 3-7 years, the re-relapse rates of both groups were observed. The re-relapse rate of the treatment group was 28.2% to 29.3% in the CTX-controlled group. The re-relapse rates between two groups were almost similar, and with no observed significant difference (P>0.05). The side effect of tripterysium glucosides was less than that of CTX. Conclusion: For the treatment of relapsing nephritic syndrome in children, the combination of tripterysium glucosides and prolonged corticosteroid therapy is as effective as the regimen of CTX plus prolonged use of prednisone.     

糖尿病,我们需要应对

近年来,随着生活水平的提高、饮食结构的改变、日趋紧张的生活节奏以及少动多坐的生活方式等诸多因素的影响,糖尿病发病率增长迅速,成为继肿瘤、心血管疾病之后第三大严重威胁人类健康的慢性疾病。我国的糖尿病知识普及率低,诊断治疗率更低。据世界卫生组织预计,未来50年内,糖尿病将是中国一个严重的公共卫生问题。发现     

脉血康对原发性肾病综合征血脂及血液流变学的影响

目的:探讨脉血康对原发性肾病综合征(PNS)患者血脂和血液流变特性的影响。方法:对PNS患者60例随机分组,一组为对照组,另一组为治疗组。治疗组除加用脉血康制剂外,两组其他治疗措施完全相同。对所有患者在治疗前、缓解期进行24小时尿蛋白,血BUN、Scr测定,并观察患者治疗前后血浆脂蛋白,血液流变学,肾功及24小时尿蛋白的变化。结果:治疗组缓解原发性肾病综合征患者高凝状态,高血脂症,减少尿蛋白的丢失明显高于对照组(P<0.01)。     

再论依那普利对糖尿病肾病血流动力学及尿白蛋白排泄的影响

糖尿病肾病是糖尿病常见而又难治的慢性并发症。其治疗的关键在于早期发现,Mogensen认为微量白蛋白尿(尿白蛋白排泄率为20～200μg·min~(-1)或30～300mg/24hr)有预测糖尿病患者出现临床蛋白尿的作用,微量白蛋白阶段称为早期或稳性期糖尿病肾病。在此阶段若严格治疗可防止或延缓糖尿病肾病的发生,国外不少研究证明血管紧张素转换酶抑制剂可降低糖尿病肾病的尿白蛋白排泄率,保护肾功能,延缓甚至阻止向临床期进展,而且可明显减缓临床期糖尿病肾病的肾功能恶化。依那普利(Enalapril)是第二代血管紧张素转换酶的抑制剂,本实验以其对早期及临床期糖尿病肾病进行治疗,观察其对肾血流动力学及其尿白蛋白的影响。