中国西北地区终末期肾病患者治疗方式的成本分析

目的评估针对终末期肾病患者的两种治疗方式——活体亲属肾移植和血液透析的成本费用并进行比较,确定一些直接影响移植费用的医疗因素及其治疗方式的效价比问题。方法回顾性分析了中国西北地区372例常规血液透析的患者和122例活体亲属肾移植患者资料,随访至少满3年。所有的数据囊括了血液透析、肾脏移植、供者摘取手术、免疫抑制剂等的相关费用以及随访期间产生的费用。结果在前3年期间,血液透析患者和肾移植患者每年平均的花费分别为13 713/31 027美元、13 502/11 038美元和13 382/10 285美元。在肾移植患者中,是否服用地尔硫卓、是否发生急性排斥反应及感染并发症同移植费用具有显著相关性。结论从第2年开始,肾移植相比透析治疗具有更优的效价比,意味着更有效率,花费更少;而肾移植术后第1年中,没有服用地尔硫卓、发生急性排斥反应及感染并发症的患者会花费更多。     

大鼠不同分离纯化方法对胰岛细胞丢失的影响

目的探讨提高大鼠胰岛细胞产量和纯度的最佳分离纯化方法。方法40只大鼠分为4组,每组10只。A组:Hanks液灌注 胶原酶V消化 Ficoll400梯度纯化;B组:组织剪碎研磨 筛网过滤;C组:胶原酶V灌注 Ficoll400梯度纯化;D组:胶原酶V灌注 筛网过滤。对用四种不同方法分离纯化的结果进行比较。结果完全随机设计的方差分析显示,A、B、C、D组收获量及纯度比较均有显著性差异(P<0.05);组间多重比较显示,A组收获量均高于B、D组(P<0.05),与C组比较差异无统计学意义(P>0.05);A组纯度与其他组比较均无显著性差异(P>0.05)。结论用胶原酶V或Hanks液灌注,Ficoll400梯度纯化法所收获胰岛细胞的产量和纯度较高,而且价格低廉,是一种较理想的胰岛细胞分离纯化方法。     

The effect of prostaglandin E1 on recovery of early renal graft functions after transplantation

Objective To investigate the effect of prostaglandin E: (PGE1) on recovery of early renal graft functions after transplantation. Methods One hundred and seven patients after renal transplantation were allocated in the treated group, and treated by conventional treatment with injection of 10 μg prostaglandin E1 additionally twice a day for 14 days. And eighty-eight patients who received conventional treatment alone after renal transplantation at the corresponding period were allocated in the control group. Indexes of the two groups, including incidence of delayed graft function and acute rejection reaction, volume of urine, serum certaintie (SCr), endogenous certainties clearance rate (CCr), the blood flow resistance in graft as well as blood viscosity (BV), and platelet aggregation rate (PAR), were determined. Results The urinary volume and endogenous certainties clearance rate of the treated group were significantly higher, but the level of SCr, incidence of renal function recovery retardation, BV, PAR and blood flow resistance in graft were significantly lower than these of the control group (P<0.05). The difference of incidence of acute rejection reaction between the two groups was insignificant (P>0.05). Conclusion Prostaglandin E1 can improve blood microcirculation and decrease the incidence of renal function recovery retardation. These effects are helpful for recovery of renal function after renal transplantation.