目的:探讨腹膜透析(PD)和血液透析(HD)对尿毒症患者肾功能及并发症的影响。方法:采用数表法,将96例接受透析治疗的尿毒症患者随机分为PD组和HD组,每组各48例。分别于治疗前、透析3个月后检测血清肌酐(SCr)、尿素氮(BUN)、超敏C-反应蛋白...目的:探讨腹膜透析(PD)和血液透析(HD)对尿毒症患者肾功能及并发症的影响。方法:采用数表法,将96例接受透析治疗的尿毒症患者随机分为PD组和HD组,每组各48例。分别于治疗前、透析3个月后检测血清肌酐(SCr)、尿素氮(BUN)、超敏C-反应蛋白((hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和降钙素原(PCT)等指标,统计两组并发症发生情况。结果:透析3个月后,两组患者的血清SCr、BUN、hs-CRP、IL-6、TNF-α和PCT水平均较透析前明显下降( P <0.05);两组患者SCr、BUN、IL-6、TNF-α和PCT水平与透析前比较,差异无统计学意义( P >0.05)。透析后,PD组患者的hs-CRP水平低于HD组,差异有统计学意义( P <0.05);PD组的感染发生率(16.67%)、低蛋白血症发生率(20.83%)分别高于HD组的4.17%、4.17%;PD组的高血压发生率(10.42%)、心律失常发生率(6.25%)和充血性心衰发生率(12.50%)明显低于HD组的29.17%、22.92%、35.42%,差异均有统计学意义( P <0.05)。结论: PD和HD均是保护尿毒症患者残余肾功能的有效透析模式,并发症方面也各有优势和不足,但PD对降低hs-CRP水平效果更为显著,可考虑作为尿毒症患者主要透析方式。展开更多
Objective To explore the effect of TGF-a1 on the mRNA and prot ei n expression of connective tissue growth factor (CTGF) in human peritoneal mesot helial cells (HPMCs) and the probable mechanism. Methods Greater oment...Objective To explore the effect of TGF-a1 on the mRNA and prot ei n expression of connective tissue growth factor (CTGF) in human peritoneal mesot helial cells (HPMCs) and the probable mechanism. Methods Greater omenta from hea lthy adults were used for primary culture of HPMCs. The third generation cells w ere stimulated by 5 ng/ml TGF-a1. Immunohistochemistry, Western blot, ELISA an d RT-PCR were employed to examine the follows:the mRNA and protein expression o f CTGF, the mRNA and protein expression of fibronectin (FN) and collagen type Ⅰ (ColⅠ), the protein expression of p-Smad2/3 and its migration in HPMCs. Result s (1)The mRNA expression of CTGF in the treatment groups increased obviously a s compared to the control group, and peaked at 48 h. (2)The protein expression of intracellular CTGF in the control group was very little, whereas it increase d markedly 24 h after TGF-a1 stimulation, and peaked at 48 h. The mRNA express ion of intracellular FN, and the protein expression of supernatent FN, as well a s the mRNA and protein expression of intracellular ColⅠin the treatment group u p-regulated significantly in a time dependent manner as compared to those in th e control group. (3)p-Smad2/3 in HPMCs hardly expressed in the control group( 3%p-Smad2/3-positive cells), and remarkably expressed 15 min after TGF-a1 s timulation(29%), peaked at 1 h (84%) and then decreased after 2 h(37%). Meanw hile, p-Smad2/3 mainly distributed in cytoplasm at 15 min, concentrated in cell nucleus and peri-nucleus at 1 h, and distributed in cytoplasm again at 2 h. Co nclusions TGF-a1 can induce the mRNA and protein expression of CTGF in the pro gression of human peritoneal fibrosis. The probably mechanism is that signaling through Smad pathway in HPMCs can be activated by TGF-a1 stimulation.展开更多
目的:探讨在维持性血液透析患者中采用实时超声引导留置永久性双腔导管的价值,并对其成功率、并发症进行临床分析.方法:2012年1月至2012年10月对我院共63例(男39例,女24例)维持性血液透析患者留置永久性双腔导管.在Logiq 5彩色多普勒超...目的:探讨在维持性血液透析患者中采用实时超声引导留置永久性双腔导管的价值,并对其成功率、并发症进行临床分析.方法:2012年1月至2012年10月对我院共63例(男39例,女24例)维持性血液透析患者留置永久性双腔导管.在Logiq 5彩色多普勒超声仪实时引导下,均经颈内静脉采用Seldinger技术加撕脱型扩张导管置管法植入永久性血液透析导管.分析记录穿刺次数、手术成功率、手术时间以及术后并发症的发生率.并将患者分为一般患者及高危患者两组进行对比,曾经有过颈内静脉临时置管或曾经有过置管困难情况或配合差、肥胖、衰弱、骨骼畸形及凝血功能异常者为高危患者.结果:全部患者采用实时超声引导经颈内静脉留置永久性导管成功率100％,其中高危患者20例(31.7％);有60例患者一次性置管成功(95.2％);穿刺次数1～3(1.23±0.21)次;3例患者出现术中即刻并发症(4.7％);在使用过程中导管感染3例(4.7％).手术时间高危组患者长于一般患者组[(30.6±0.11) min vs (19.1±0.09) min,P＜0.05];两组在穿刺次数,置管成功率、术中并发症方面的差异无统计学意义(P＞0.05);但高危组(4/20,20％)在长期使用导管过程更易因导管血栓形成而导致流量不佳.结论:采用超声引导下颈内静脉留置永久性双腔导管是一种安全、有效的血管通路技术,成功率高;不论在高危患者还是一般患者中都具有操作简单、并发症少的特点,值得在临床广泛推广.展开更多
文摘目的:探讨腹膜透析(PD)和血液透析(HD)对尿毒症患者肾功能及并发症的影响。方法:采用数表法,将96例接受透析治疗的尿毒症患者随机分为PD组和HD组,每组各48例。分别于治疗前、透析3个月后检测血清肌酐(SCr)、尿素氮(BUN)、超敏C-反应蛋白((hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和降钙素原(PCT)等指标,统计两组并发症发生情况。结果:透析3个月后,两组患者的血清SCr、BUN、hs-CRP、IL-6、TNF-α和PCT水平均较透析前明显下降( P <0.05);两组患者SCr、BUN、IL-6、TNF-α和PCT水平与透析前比较,差异无统计学意义( P >0.05)。透析后,PD组患者的hs-CRP水平低于HD组,差异有统计学意义( P <0.05);PD组的感染发生率(16.67%)、低蛋白血症发生率(20.83%)分别高于HD组的4.17%、4.17%;PD组的高血压发生率(10.42%)、心律失常发生率(6.25%)和充血性心衰发生率(12.50%)明显低于HD组的29.17%、22.92%、35.42%,差异均有统计学意义( P <0.05)。结论: PD和HD均是保护尿毒症患者残余肾功能的有效透析模式,并发症方面也各有优势和不足,但PD对降低hs-CRP水平效果更为显著,可考虑作为尿毒症患者主要透析方式。
文摘Objective To explore the effect of TGF-a1 on the mRNA and prot ei n expression of connective tissue growth factor (CTGF) in human peritoneal mesot helial cells (HPMCs) and the probable mechanism. Methods Greater omenta from hea lthy adults were used for primary culture of HPMCs. The third generation cells w ere stimulated by 5 ng/ml TGF-a1. Immunohistochemistry, Western blot, ELISA an d RT-PCR were employed to examine the follows:the mRNA and protein expression o f CTGF, the mRNA and protein expression of fibronectin (FN) and collagen type Ⅰ (ColⅠ), the protein expression of p-Smad2/3 and its migration in HPMCs. Result s (1)The mRNA expression of CTGF in the treatment groups increased obviously a s compared to the control group, and peaked at 48 h. (2)The protein expression of intracellular CTGF in the control group was very little, whereas it increase d markedly 24 h after TGF-a1 stimulation, and peaked at 48 h. The mRNA express ion of intracellular FN, and the protein expression of supernatent FN, as well a s the mRNA and protein expression of intracellular ColⅠin the treatment group u p-regulated significantly in a time dependent manner as compared to those in th e control group. (3)p-Smad2/3 in HPMCs hardly expressed in the control group( 3%p-Smad2/3-positive cells), and remarkably expressed 15 min after TGF-a1 s timulation(29%), peaked at 1 h (84%) and then decreased after 2 h(37%). Meanw hile, p-Smad2/3 mainly distributed in cytoplasm at 15 min, concentrated in cell nucleus and peri-nucleus at 1 h, and distributed in cytoplasm again at 2 h. Co nclusions TGF-a1 can induce the mRNA and protein expression of CTGF in the pro gression of human peritoneal fibrosis. The probably mechanism is that signaling through Smad pathway in HPMCs can be activated by TGF-a1 stimulation.
文摘目的:探讨在维持性血液透析患者中采用实时超声引导留置永久性双腔导管的价值,并对其成功率、并发症进行临床分析.方法:2012年1月至2012年10月对我院共63例(男39例,女24例)维持性血液透析患者留置永久性双腔导管.在Logiq 5彩色多普勒超声仪实时引导下,均经颈内静脉采用Seldinger技术加撕脱型扩张导管置管法植入永久性血液透析导管.分析记录穿刺次数、手术成功率、手术时间以及术后并发症的发生率.并将患者分为一般患者及高危患者两组进行对比,曾经有过颈内静脉临时置管或曾经有过置管困难情况或配合差、肥胖、衰弱、骨骼畸形及凝血功能异常者为高危患者.结果:全部患者采用实时超声引导经颈内静脉留置永久性导管成功率100％,其中高危患者20例(31.7％);有60例患者一次性置管成功(95.2％);穿刺次数1～3(1.23±0.21)次;3例患者出现术中即刻并发症(4.7％);在使用过程中导管感染3例(4.7％).手术时间高危组患者长于一般患者组[(30.6±0.11) min vs (19.1±0.09) min,P＜0.05];两组在穿刺次数,置管成功率、术中并发症方面的差异无统计学意义(P＞0.05);但高危组(4/20,20％)在长期使用导管过程更易因导管血栓形成而导致流量不佳.结论:采用超声引导下颈内静脉留置永久性双腔导管是一种安全、有效的血管通路技术,成功率高;不论在高危患者还是一般患者中都具有操作简单、并发症少的特点,值得在临床广泛推广.
