尿毒症不宁腿患者静息态脑功能磁共振局部一致性研究

目的采用静息态功能磁共振成像评价尿毒症不宁腿(uremic restless legs syndrome,URLS)患者脑部自发神经活动的改变,并进行相关性分析,为URLS神经机制的探索提供客观依据。方法对26例URLS患者和25例健康志愿者(对照组)进行静息态功能磁共振扫描,对患者组进行临床资料收集,计算两组的大脑局部一致性(ReHo)改变,并进行统计学分析。结果与对照组比较,患者组存在情绪心理的异常,而且患者组双侧辅助运动区、双侧丘脑、左侧岛叶、左侧海马ReHo值较对照组均增高(P均<0.05),前扣带回、双侧中央后回、右侧杏仁核ReHo值较对照组均减低(P均<0.05);患者组RLS严重程度评分与透析龄(r=0.57,P=0.002)、甲状旁腺激素(r=0.419,P=0.033)、BAI(r=0.528,P=0.006)、BDI(r=0.567,P=0.003)呈正相关。结论 URLS患者症状严重程度与透析龄、甲状旁腺激素、焦虑、抑郁等因素相关;URLS患者感觉运动脑区神经元活动一致性存在异常,这种异常对解释维持性透析患者出现不宁腿症状提供了客观的影像学诊断依据。     

尿毒症及肾病综合征患者血清蛋白电泳的变化

本文对50例尿毒症患者血清进行聚丙酰胺凝胶电泳,结果表明其α~-脂蛋白、部分α_1~-和α_2~-球蛋白明显下降,触珠蛋白、β-脂蛋白明显上升。同时对50例肾病综合征患者血清进行上述电泳,结果表明其白蛋白、部分α_1~-和α_2~-球蛋白明显下降,部分β_2-球蛋白及β-脂蛋白明显上升。对上述变化的机理及临床意义也进行了探讨。     

高危尿毒症患者肾移植术后早期全血环孢素A浓度的监测及临床意义

探讨不同高危患者术后应用 Cs A免疫抑制治疗的特点 ,摸索高危患者肾移植术后的早期临床监测及处理。方法　应用荧光偏振免疫法 ( FPIA)对 30例高危尿毒症患者肾移植术后早期的全血环孢素 A( Cs A)浓度进行动态监测。结果　高危尿毒症患者肾移植术后早期的全血 Cs A浓度明显高于对照组 ,术后早期急性排斥反应的发生率低 ,但是容易发生 Cs A的肝脏及胰腺的毒副作用。结论　早期动态监测全血 Cs A浓度有助于预防和减轻 Cs A的毒副作用 ,维持有效的免疫抑制治疗     

尿毒症apoE基因敲除小鼠主动脉动脉粥样硬化的病变特征

目的 观察尿毒症apoE-/-小鼠主动脉粥样硬化(As)病变特征及MMP-9的表达.方法 以apoE-/-小鼠为研究对象,通过2步外科手术法建立尿毒症模型,对照组行假手术.造模后检测肾功能,判断造模是否成功.造模后10周,检测血清MMP-9浓度;主动脉根部切片油红O染色计算斑块相对面积,天狼星红染色计算斑块内胶原含量,α-肌动蛋白、MAC3免疫组化染色检测斑块内SMC及巨噬细胞的含量;RT-PCR法检测主动脉MMP-9 mRNA的表达.结果 造模后肾功能检测显示造模成功.尿毒症组与对照组相比:主动脉根部As斑块相对面积提高、斑块内胶原含量减少、SMC成分减少、巨噬细胞含量增加,血清MMP-9浓度及主动脉MMP-9 mRNA的表达提高.结论 尿毒症apoE-/-小鼠主动脉加速发展的As伴随着斑块的稳定性降低.     

当心“憋”出来的“致命病”

憋尿:当心尿毒症当膀胱的存储空间达到一定极限时,便会被憋爆,造成严重后果;如果尿液过多,超过膀胱的储量,便会向输尿管回流,时间长了可能会导致尿毒症,膀胱的括约肌也会因此变得松弛。所以,人们一旦有了尿意,一定要及时排出体外。     

Establishment of a uremic apolipoprotein E knockout mouse model to explore the mechanism of uremic atherosclerosis

Objective To establish a uremic apoE-/- mouse model to observe serum biochemical parameters and features of aortic root atherosclerosis (AS) in the model. Methods A uremic model was induced surgically in apoE-/- mice: electrocautery of the right kidney at 8 weeks of age and nephrectomy (NX) of the left one 2 weeks later. Control mice were sham-operated. Two weeks after NX, renal functions were detected in the uremic and control mice to evaluate the efficiency of the model. After 10 weeks of NX, blood samples were taken to determine serum biochemical parameters, and aortic root was collected for frozen sections to investigate the lesion features of AS. Results Two weeks after NX, renal functions declined significantly in the uremic mice compared with the control ones, and remained stable 8 weeks later either in males or in females. Ten weeks after NX, serum levels of TCH, TG and LDL-C were dramatically higher in the uremic mice than in the controls, whereas no differences in serum HDL-C or glucose concentration were found between the two groups. Aortic root plaque relative area increased significantly in the uremic mice compared with the controls either in males or in females; more-over, the lesion area was larger in female mice than in male ones. Conclusion We established a uremic apoE-/- mouse model successfully, and this model is characterized by accelerated atherogenesis which is associated with an increase in serum lipid profile. This experimental model can be a useful tool to study the pathogenesis and therapeutic strategies of uremic AS.     

美德 公德 道德

一位六十多岁的老母亲患了尿毒症，她三十多岁当经理的儿子，为了挽救母亲的生命，不顾亲人的劝阻，瞒着母亲把自己的一个肾脏捐给母亲，使母亲的生命得以延续。这是《感动中国》节目报道的一个真实事迹。这位当经理的儿子的行为，体现的是家庭美德。     

西安地区尿毒症患者血清、透析液及饮用水铝含量的检测

应用原子吸收光谱法检测了西安地区５２例尿毒症患者血清铝水平，非透析组为（１．２０±０．６０）μｍｏｌ／Ｌ，血液透析（ＨＤ）和腹膜透析（ＣＡＰＤ）组分别为（１．８１±０．６５）μｍｏｌ／Ｌ和（１．４７±０．７７）μｍｏｌ／Ｌ；与对照组（０．４９±０．１６）μｍｏｌ／Ｌ比较，３组均显著升高（Ｐ＜０．０１）。非透析患者血清铝与肌酐水平之间，透析患者血清铝与透析时间之间均无显著相关。腹膜透析液之铝含量在安全范围。讨论了尿毒症铝中毒的原因、诊断及其防治。     

尿毒症病人心率变异检测

借助心率变异检测，评估尿毒症病人自主神经功能的改变。应用ＤＥＬ ＭＡＲ－３６３Ｈｏｌｔｅｒ监测系统，分别对尿毒症组，高血压病组，冠心病组，正常对照组受试者连续检测２４ｈ，计算机自动分析２４ｈ总的Ｒ－Ｒ间期标准差。结果尿毒症组，高血压病组和冠心病组ＳＤＲＲ值均显著低于正常对照组，且尿毒症组ＳＤＲＲ值显著低于高血压病组和冠心病组。