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1.
目的:探讨血液灌流加血液透析对慢性肾衰患者血清中多胎类毒素:β2微球蛋白(β2-MG)、全段甲状旁腺素(iPTH)的清除作用,并与单纯血液透析清除β2-MGi、PTH的效果比较。方法:在28例慢性肾衰患者常规血液透析中增加一次血液透析加灌流治疗,在透析及透析加灌流前后分别检测其β2-MG、iPTH血清水平。结果:血液透析加灌流治疗后较治疗前血清β2-MG、iPTH水平明显降低(P<0.01),单纯血液透析前后血清β2-MG、iPTH水平没有明显改变(P>0.05)。结论:血液灌流加透析可以明显降低慢性肾衰患者血清中β2-MGi、PTH水平,从而改善透析患者的生活质量,减少血液透析相关并发症的发生。  相似文献   

2.
目的:探讨血液灌流(HP)串联血液透析(HD)对治疗尿毒症的疗效。方法:采用我院尿毒症患者20例,每例患者观察6个月,前3个月进行单纯HD为对照组,每周2-3次,每次4h;后3个月每周串联一次HP,进行HP-HD串联治疗为试验组,每周HP-HD串联治疗1次,HD的次数和时间与单纯HD同比相同。分别监测治疗前后血甲状旁腺激素(PTH)、BUN、Scr、RBC、WBC、Hb的变化。结果:与单纯HD相比,HP—HD联合组血PTH、BUN、Scr水平均显著降低,RBC、WBC、Hb显著升高。P﹤0.05,差异有统计学意义。结论:HP—HD联合组对尿毒症患者的疗效显著优于单纯HD组,可改善尿毒症患者的生活质量,提高生存率。  相似文献   

3.
目的：探讨超敏 C 反应蛋白（hs-CRP）与维持性血液透析（MHD）患者贫血、营养不良的关系。方法选择在我院血液透析中心治疗的 MHD 患者30例,依据血透前 hs-CRP 水平分为 hs-CRP 正常组和 hs-CRP 异常增高组,同时选取20例健康体检者为对照组。观察3个月,监测血液透析前后超敏 C 反应蛋白（hs-CRP）、血红蛋白（Hb）、血浆白蛋白（ALB）、血清尿素氮、血清肌酐（SCr）的变化;并记录促红细胞生成素（EPO）的用量。结果维持性血液透析患者超敏 C 反应蛋白水平比对照组升高（P〈0.01）;30例 MHD 患者中 hs-CRP 升高18例,正常12例,血透后 hs-CRP 水平较血透前升高（P〈0.05）。血液透析前 hs-CRP 正常组血红蛋白、血浆白蛋白均显著高于hs-CRP 增高组,而尿素氮、肌酐则较低（P〈0.05）;促红细胞生成素（Epo）周使用量与红细胞压积的比值（Epo/Hct）均显著低于 hs-CRP 升高组（P〈0.01）。结论部分MHD 患者存在 hs-CRP 升高,提示存在炎症状态,炎症状态可致 MHD 患者 EPO 使用量增加,提示炎症状态导致 MHD 患者对 EPO 低反应性; hs-CRP 水平升高,同贫血、营养不良事件发生独立相关。  相似文献   

4.
目的 :通过对 2 0例透析 2 0 6 0次维持性血液透析患者 ,采用F6 0滤过器进行高通量透析 (HPD) ,并与常规透析 (CHD)交替使用的方法 ,结果此法与单纯采用常规血液透析比较 :Bun、Cr、TG、CHOL尤其是β2 M的清除率均有明显下降 (P <0 0 5 ) ,而HDL却有明显上升 (P <0 0 5 ) ,结果表明 ,高通量透析可改善维持性血液透析患者的脂质代谢 ,对Bun、Cr等小分子的清除也优于CHD ,并能有效清除β2 M等中、大分子毒素 ,而无明显丢失血浆蛋白 (P <0 0 5 ) ,因此 ,HPD可预防血透患者的远期并发症 ,如肾性骨病 ,动脉硬化 ,并可改善食欲不振 ,便秘 ,高血压症状 ,提高透析的充分性  相似文献   

5.
目的：观察通心络胶囊对原发肾病综合征（PNS）患者蛋白尿、低白蛋白血症、高脂血症、高血粘度的改善，探讨其对患者血管内皮功能的影响。方法：40例PNS患者．随机分为常规治疗组和通心络组（常规治疗＋通心络胶囊3次／d，每次四粒），观察治疗前后24h尿蛋白定量、血浆白蛋白、血脂、血粘度、血清一氧化氮（NO）、内皮素（ET）的变化。结果：与治疗前相比，治疗后两组患者24h尿蛋白定量、血脂、血粘度、内皮素（ET）水平均下降，血清一氧化氮（NO）、血浆白蛋白水平均升高，但通心络治疗组24h尿蛋白定量、血脂、血粘度、内皮素（ET）水平显著下降（P〈0．05），并可显著升高血清NO、血浆白蛋白水平（P〈0．05）。结论：PNS患者在规律口服强的松的同时加用通心络胶囊，可促进毛细血管内皮细胞的恢复，减少尿蛋白排出．改善血液粘稠度、降低血脂，提高临床疗效。  相似文献   

6.
目的研究氟伐他汀对不稳定型心绞痛患者血清白介素-18（IL-18）和肿瘤坏死因子α（TNFα）的影响。方法选择2006年9月至2007年7月79例不稳定型心绞痛患者,入院后随机分为2组：氟伐他汀干预组42例：常规药物治疗基础上加用氟伐他汀40mg／d;对照组37例：常规药物治疗。分别于药物治疗前、药物治疗后2周采集静脉血,测定血清IL-18和TNFα的浓度。结果药物治疗后,对照组（P〈0．05）及氟伐他汀干预组（P〈0．01）血清IL-18和TNF＆浓度均明显降低;氟伐他汀干预组血清IL-18（P〈0．01）和TNFα（P〈0．01）浓度明显低于同期对照组。结论氟伐他汀可明显降低不稳定型心绞痛患者血清IL-18和TNFα浓度。  相似文献   

7.
<正> 血液透析是治疗急慢性肾衰的有效方法,一经确诊的患者,在条件适合的情况下应尽早进行血透,而透析前后血清生化指标的变化是临床观察透析效果、合理调整透析间隔,以提高成活率的关键。为此,我们观察了39例肾衰患者血透前后血清钾(K)、钠(Na)、氯(Cl)、钙(Ca)、磷(P)、尿素氮(BUN)、肌酐(Cr)和二氧化碳结合力(CO_2CP)等八项生化指  相似文献   

8.
目的：探讨在监测血清脑钠肽水平下,短期使用注射用重组人脑利钠肽治疗急性心力衰竭或慢性心力衰竭急性发作的临床效果。方法：48例急性心力衰竭患者根据是否使用注射用重组人脑利钠肽分为常规组和注射用重组人脑利钠肽组,对比两组治疗的临床效果和超声心动图情况,并监测BNP水平。结果：治疗7d后,注射用重组人脑利钠肽组临床有效率明显好于常规组（81．7％vs61．6％,P〈0．05）,左室射血分数明显高于常规组（51±6）％vs（46±5）％,（P〈0．01）,且血清脑钠肽水平明显降低（498±209）pg／mL vs（642±318）pg／mL,（P〈0．01）,血清脑钠肽下降水平和左室射血分数提高水平差异有统计学意义（P〈0．05）,有效者治疗后左室射血分数提高及血清脑钠肽下降均强于无效者（P〈0．01）。结论：在血清脑钠肽指导下短期应用注射用重组人脑利钠肽有助于改善急性心力衰竭患者的临床症状和心功能。  相似文献   

9.
目的：观察中西医结合治疗激素依赖型肾病综合征的疗效。方法：将53例患者随机分为治疗组30例,对照组23例。对照组给予激素及细胞毒药物常规治疗。治疗组在对照组的基础上加用补脾益肾、活血化瘀中药加减。观察两组24h尿蛋白定量,尿FDP及血清白蛋白变化。结果：治疗组疗效优于单纯用西药的对照组（P〈0．05）,且两组治疗后24h尿蛋白、尿FDP,血清白蛋白指标差异均有显著性（P〈0．001）。治疗组治疗前后血、尿生化指标差异均有显著性（P〈0．001）。结论：采用中西医结合治疗激素依赖型肾病综合征,其多项生化指标及疗效要明显优于单纯西药治疗,并且能够明显改善西药治疗的副作用,值得在临床上推广使用。  相似文献   

10.
目的：观察红花对特发性水肿患者血液流变学的影响，探讨其治疗机制。方法：特发性水肿患者52例（水肿组），应用红花注射液进行治疗；健康女性30例作为对照。在治疗前后，测定血液流变学各项指标的变化。结果：治疗前，特发性水肿患者表现为血液流变性异常，治疗后全血粘度、血浆粘度明显降低（P〈0．05）。结论：红花对特发性水肿有较好的治疗作用，其机制与改善血液流变性异常有关。  相似文献   

11.
目的探讨血浆总同型半胱氨酸（tHCY）含量在肝硬化疾病的临床价值。方法测定并分析47例肝硬化患者及55例健康者血浆tHCY含量,以及肝硬化患者血清丙氨酸转氨酶（ALT）、门冬氨酸转氨酶（AST）、总胆红素（TBIL）、胆碱酯酶（CHE）、白蛋白（ALB）、前白蛋白（PALB）、葡萄糖（GLU）、尿素氮（BUN）、肌酐（Cr）含量、血浆中20种氨基酸水平。结果肝硬化患者血浆tHCY水平（12.98±3.73μmol/L）与正常对照组（10.29±1.96）μmol/L相比有所升高,差异有统计学意义,肝硬化Child-pugh C级患者中HCY水平明显升高（14.96±4.74μmol/L）,与对照组、肝硬化Child-pugh A级患者、肝硬化Child-pugh B级患者相比差异具有统计学意义。tHCY变化与血清ALT、AST、ALB、TBIL、PALB、BUN、Cr、BCAA/AAA无相关性,而与氨基酸分析中蛋氨酸（MET）成正相关,且具有统计学意义。结论 HCY可作为评价肝硬化病情严重程度的一项新的生化指标。  相似文献   

12.
目的:研究慢性肾功能衰竭患者血浆脂蛋白(a)与纤溶活性的关系.方法:应用酶联免疫吸附法分别测定58例慢性肾功能衰竭患者及51名健康对照者的血浆脂蛋白(a)浓度,并以底物显色法测定其组织型纤溶酶原激活剂(tPA)及其抑制物(PAI)活性.结果:慢性肾功能衰竭患者血浆脂蛋白(a)浓度和PAI活性明显升高,tPA活性明显降低;脂蛋白(a)浓度与血浆尿素氮水平、PAI活性均呈正相关;脂蛋白(a)浓度与tPA活性呈负相关.结论:肾功能对血浆脂蛋白(a)浓度起一定的调节作用,脂蛋白(a)水平的升高与纤溶活性低下有关.  相似文献   

13.
目的 :观察复肾方配合血液透析治疗慢性肾功能衰竭的临床疗效。方法 :通过随机对照法将 4 8例进行维持性血透的慢性肾衰患者分为两组 :治疗组 (复肾方加血透组 ) 2 8例 ,对照组 (单纯血透组 ) 2 0例 ,观察两组治疗前后尿毒症的临床表现、肾功能、机体营养状况、血脂、血磷和电解质等各项指标 ,并进行治疗后两组血透充分性比较。结果 :复肾方能明显地改善临床症状 ,而且能提高内生肌酐的清除率 ,更有效地降低血尿素氮BUN和血肌酐SCr,并能提高血清蛋白和血红蛋白、血红细胞数 ,治疗后血透充分性高于对照组 ,并能降低血磷 ,在一定程度上防治血透患者的血脂代谢紊乱。结论 :复肾方切合慢性肾衰及维持性血透患者的基本病机 ,组方合理 ,具有提高血透充分性 ,更好地改善临床症状和肾功能 ,改善患者机体营养状况和生活质量 ,降低血透副反应的作用。  相似文献   

14.
A novel adsorber, polyvinylidene fluoride matrix immobilized with L-serine ligand (PVDF-Ser), was developed in the present study to evaluate its safety and therapeutic efficacy in septic pigs by extracorporeal hemoperfusion. Endotoxin adsorption efficiency (EAE) of the adsorber was firstly measured in vitro. The biocompatibility and hemodynamic changes during extracorporeal circulation were then evaluated. One half of 16 pigs receiving lipopolysaccharide (Escherichia coli O111:B4, 5 μg/kg) intravenously in 1 h were consecutively treated by hemoperfusion with the new adsorber for 2 h. The changes of circulating endotoxin and certain cytokines and respiratory function were analyzed. The 72 h-survival rate was assessed eventually. EAE reached 46.3% (100 EU/ml in 80 ml calf serum) after 2 h- circulation. No deleterious effect was observed within the process. The plasma endotoxin, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) levels were decreased during the hemoperfusion. Arterial oxygenation was also improved during and after the process. Furthermore, the survival time was significantly extended (>72 h vs. 47.5 h for median survival time). The novel product PVDF-Ser could adsorb endotoxin with high safety and efficacy. Early use of extracorporeal hemoperfusion with the new adsorber could reduce the levels of circulating endotoxin, IL-6, and TNF-α, besides improve respiratory function and consequent 72 h-survival rate of the septic pigs. Endotoxin removal strategy with blood purification using the new adsorber renders a potential promising future in sepsis therapy.  相似文献   

15.
Objective:To investigate the effect of enalapril on plasma homocysteine(Hcy) levels and the association of methylenetetrahydrofolate reductase(MTHFR) C677T polymorphism with the changes of Hcy levels in response to enalapril among patients with essential hypertension.Methods:A total of 130 patients with mild-to-moderate essential hypertension were enrolled and enalapril was orally administered at a dose of 10 mg/d for eight weeks.Plasma Hcy levels were measured by denaturing high-performance liquid chromatography(DHPLC) at baseline and after eight weeks of treatment.Genotyping of MTHFR C677T polymorphism was performed by TaqMan probe technique.Results:Compared with baseline,plasma Hcy levels did not change significantly after eight weeks(P=0.81).Stratified by baseline Hcy levels,a significant increase in plasma Hcy levels(P=0.02) among those with Hcy 10 μmol/L was observed,in contrast to no significant changes in plasma Hcy levels(P=0.54) among those with Hcy ≥10 μmol/L.No significant association was observed between MTHFR C677T polymorphism and changes in Hcy levels in response to enalapril.Conclusions:Enalapril may cause an increase in plasma Hcy levels among the hypertensives with low baseline Hcy levels.There was no significant association between MTHFR C677T genotypes and changes in Hcy levels in response to enalapril among subjects with essential hypertension.  相似文献   

16.
The majority of patients with chronic kidney disease (CKD) are undergoing maintenance hemodialyisis. Hemodialysis is a process of removing metabolic waste, other poisons, and excess fluids from the blood and replacing essential blood constituents through a dialysis machine. With hemodialysis causing stress not only to physical status but also to psychological functioning and well-being, the individual will have to strive to cope with it. Coping involves cognitive and/or behavioral efforts exerted by the individual to be able to master, reduce, or tolerate the demands of a situation. Different coping strategies are being utilized by individuals such as thinking positively, having a positive outlook, and positively comparing self to others in similar situations. These techniques are what is referred to as optimistic coping. The study aims to capture the essences or languages of coping according to a select group of Filipino elderly patients with lived hemodialysis experiences. A total of 13 respondents, selected through purposive sampling, were provided with a two-part questionnaire. The first part is the robotfoto, which provides the cartographic sketch of the subjects. The second part is the semistructured interview, with an aide memoir. This is intended to surface the subjects' lived experience relative to hemodialysis experience coping mechanisms and the meaning of coping to them. Data gathered were transcribed and analyzed via cool and warm analyses. A repertory grid was constructed where significant statements were categorized and thematised revealing the languages of coping according to elderly patients with lived hemodialysis experience. Through interviews, the study yielded three themes that reveal the language of coping for Filipino geriatric patients undergoing hemodialyis. These themes consist of (a) coping as scaffolding: or the power to hold on, (b) coping as sailing: or the power to let go, and (c) coping as sanguinity: or the power to see the difference. Coping was defined as an ability (will power, acceptance, positive thinking) that people possess to keep up with certain stressful events, thereby making life more tolerable.  相似文献   

17.
罗倩  孙风 《宜春学院学报》2021,(3):82-84,125
目的:分析预见性护理是否减少了血液透析患者低血压和不良情绪的影响。方法:以我院2019年1月-2020年1月100例尿毒症血液透析患者为研究对象,采用随机法分为两组。对照组给予常规护理,实验组实施预见性护理。每组患者在实验前、后采用评分的方式调查得出其焦虑评分、护理满意度评分;实验结束后,由责任护士对患者的治疗依从性进行评分,并观察两组别并发症(低血压)的出现例数。最后,将得到的数据采用SPSS17.0软件进行对比分析。结果:实验组有效降低了透析患者的不良情绪、焦虑程度以及低血压的发生率(P<0.05);同时,实验组也有效提高了透析患者的护理工作满意度及治疗依从性(P<0.05),维护了患者良好的心态和医患关系。结论:预见性护理能够有效减少血液透析患者在治疗所受不良情绪和低血压的影响,提升了血液透析患者的治疗依从性和治疗效果。  相似文献   

18.
用免疫组织化学PAP法观察33例人阑尾肌层胃动素(MTL)样免疫反应(-IR)神经,阑尾炎组25例(单纯组7例;慢性组6例;化脓组7例;坏疽组5例),对照组8例;用放免技术测定25例阑尾炎患者与5例对照组患者血浆和阑尾组织MTL浓度。结果:各组阑尾肌层中均有MTL-IR神经分布,环肌层较多。各阑尾炎组神经丛及神经细胞数密度均较对照组减少(P<0.05,P<0.01),坏疽组MTL-IR神经丛较慢性组减少(P<0.05)。阑尾炎患者血浆及阑尾组织MTL浓度均较对照组升高(P<0.05)。本研究结果提示:MTL可能参与了阑尾炎的调理过程。  相似文献   

19.

Objective  

To report on three patients with paraquat (PQ) intoxication surviving after combined therapy with hemoperfusion (HP), cyclophosphamide (CTX), and glucocorticoid.  相似文献   

20.
Objective: To test the influence of homocysteine on the production and activation of matrix metalloproteinase-2 (MMP-2) and tissue inhibitors of matrix metalloproteinase-2 (TIMP-2) and on cell migration of cultured rat vascular smooth muscle cells (VSMCs). Also, to explore whether rosuvastatin can alter the abnormal secretion and activation of MMP-2 and TIMP-2 and migration of VSMCs induced by homocysteine. Methods: Rat VSMCs were incubated with different concentrations of homocysteine (50–5 000 μmol/L). Western blotting and gelatin zymography were used to investigate the expressions and activities of MMP-2 and TIMP-2 in VSMCs in culture medium when induced with homocysteine for 24, 48, and 72 h. Transwell chambers were employed to test the migratory ability of VSMCs when incubated with homocysteine for 48 h. Different concentrations of rosuvastatin (10−9–10−5 mol/L) were added when VSMCs were induced with 1 000 μmol/L homocysteine. The expressions and activities of MMP-2 and TIMP-2 were examined after incubating for 24, 48, and 72 h, and the migration of VSMCs was also examined after incubating for 48 h. Results: Homocysteine (50–1 000 μmol/L) increased the production and activation of MMP-2 and expression of TIMP-2 in a dose-dependent manner. However, when incubated with 5 000 μmol/L homocysteine, the expression of MMP-2 was up-regulated, but its activity was down-regulated. Increased homocysteine-induced production and activation of MMP-2 were reduced by rosuvastatin in a dose-dependent manner whereas secretion of TIMP-2 was not significantly altered by rosuvastatin. Homocysteine (50–5 000 μmol/L) stimulated the migration of VSMCs in a dose-dependent manner, but this effect was eliminated by rosuvastatin. Conclusions: Homocysteine (50–1 000 μmol/L) significantly increased the production and activation of MMP-2, the expression of TIMP-2, and the migration of VSMCs in a dose-dependent manner. Additional extracellular rosuvastatin can decrease the excessive expression and activation of MMP-2 and abnormal migration of VSMCs induced by homocysteine.  相似文献   

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