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1.
目的分析血液透析滤过治疗维持性血液透析患者顽固性高血压的临床效果。方法选取2015年1月~2017年2月我院收治的维持性血液透析顽固性高血压患者46例,随机分为对照组与研究组,每组23例。对照组行常规血液透析治疗,研究组采用血液透析滤过方式,观察比较两组患者治疗前后的血压、血浆RA水平及AngII水平变化情况。结果治疗后,研究组的收缩压与舒张压均明显低于对照组(P0.05),血浆RA、AngII水平亦明显低于对照组(P0.05)。结论血液透析滤过治疗维持性血液透析患者顽固性高血压的效果显著,值得临床推广应用。 相似文献
2.
Batista MN Cuppari L de Fátima Campos Pedrosa L Almeida Md de Almeida JB de Medeiros AC Canziani ME 《Biological trace element research》2006,112(1):1-12
The aim of this study was to compare the nutritional status of zinc and copper in patients with and without diabetes submitted
to chronic hemodialysis. Thirty-three patients with type 2 diabetes (DM group), 30 nondiabetic patients (NDM group), and 20
healthy individuals (control group) were studied. Plasma, erythrocyte, and urinary zinc and plasma copper were obtained from
atomic absorption spectrophotometry and ceruloplasmin by immunonephelometry. The anthropometric parameters were similar among
the groups. Plasma zinc was lower and erythrocyte zinc was higher in the DM and NDM groups in relation to the control group.
No difference in urinary zinc was observed comparing the groups. Plasma copper was higher in the DM group when compared to
the NDM and control groups. Ceruloplasmin was similar in the three groups. Serum urea was a positive independent determinant
of plasma zinc concentrations. The determinants of erythrocyte zinc were MAMC midarm nuscle circumference and Kt/V dialysis
adequacy. The determinants of plasma copper concentration were serum creatinine and serum glucose. The results of this study
demonstrate an alteration in the distribution of zinc of patients with chronic kidney disease (CKD) independently of the presence
of DM. Also, the status of copper seems not to be influenced by CKD, but only by the metabolic derangements associated with
diabetes. 相似文献
3.
Bronisaw A. Zachara Andrzej Adamowicz Urszula Trafikowska Anna Trafikowska Jacek Manitius Edmund Nartowicz 《Journal of trace elements in medicine and biology》2001,15(4):201-208
Patients with chronic renal failure (CRF) often have reduced concentrations of selenium (Se) and lowered activities of glutathione peroxidase (GSH-Px) in blood components. The kidney is a major source of plasma GSH-Px. We measured Se and glutathione levels in blood components and red cell and plasma GSH-Px activities in 58 uremic patients on regular (3 times a week) hemodialysis (HD). The dialyzed patients were divided in 4 subgroups and were supplemented for 3 months with: 1) placebo (bakers yeast), 2) erythropoietin (EPO; 3 times a week with 2,000 U after each HD session), 3) Se-rich yeast (300 μg 3 times a week after each HD), and 4) Se-rich yeast plus EPO in doses as above. The results were compared with those for 25 healthy subjects. The Se concentrations and GSH-Px activities in the blood components of dialyzed uremic patients were significantly lower compared with the control group. Treatment of the HD patients with placebo and EPO only did not change the parameters studied. The treatment with Se as well as with Se and EPO caused an increase in Se levels and red cell GSH-Px activity. Plasma GSH-Px activity, however, increased only slowly or did not change after treatment with Se and with Se plus EPO. In the group treated with Se plus EPO the element concentration in blood components was higher compared with the group supplemented with Se alone. The weak or absence of response in plasma GSH-Px activity to Se supply indicates that the impaired kidney of uremic HD patients has reduced possibilities to synthesize this enzyme. 相似文献
4.
Daniel R. Mayer Walter Kosmus Helmut Pogglitsch David mayer Wolfgang Beyer 《Biological trace element research》1993,37(1):27-38
Serum arsenic concentrations of persons suffering from renal failure and undergoing hemodialysis treatment (n=85) and of healthy controls (n=25) were determined by hydride-generation AAS technique after microwave digestion. The results were evaluated by comparing
the values of both groups, considering physiological factors and individual data, as well as comorbid conditions of the hemodialysis
(HD) patients. Serum arsenic levels were diminished in the patient group compared with controls (mean values 8.5±1.8 ng/mL
vs 10.6±1.3 ng/mL). Furthermore, additional diseases within the hemodialysis group, particularly injuries of the central nervous
system (CNS), vascular diseases, and cancer, were correlated to occasionally markedly decreased serum arsenic concentrations.
It was concluded that arsenic homeostasis is disturbed by HD treatment and certain additional diseases. Desirable arsenic
concentrations in the body seem to be reasonable. This consideration results in the conclusion that arsenic could play an
essential role in human health. Thus, reference arsenic concentrations in different human tissues and body fluids should be
established in order to recognize not only arsenic intoxication, but also arsenic deficiency. Perhaps arsenic deficiency contributes
to the increased death risk of HD patients, and therefore, arsenic supplementations for patients with extremely low serum
arsenic concentrations should be taken into account. 相似文献
5.
Marie J. Richard Veronique Ducros Michel Rorêt Josiane Arnaud Charles Coudray Michèle Fusselier Alain Favier 《Biological trace element research》1993,39(2-3):149-159
In six chronic dialyzed uremic patients, an intravenous sodium selenite (Se 50 μg during 5 wk and then 100 μg) and zinc gluconate
(Zn 5 mg) supplementation was performed during 20 wk at each dialysis session three times weekly. Before supplementation,
plasma Se and Zn, plasma and erythrocytes (RBC) antioxidant metalloenzymes glutathione peroxidase (GPX), and superoxide dismutase
(SOD) were significantly decreased, whereas lipid peroxidation (as thiobarbituric acid reactants TBARs) was increased. To
obtain a significative change in plasma selenium, we had to use an Se dose of 100 μg/dialysis session. Then, treatment-increased
plasma Se (from 0.58 ±0.09 to 0.89±0.16 μmol/L) led to a repletion of RBC-GPX (from 29.6±6 to 43±5.8 U/g Hb) and increased
plasma GPX levels (from 62±13 to 151±43 U/L). Plasma Zn and RBC-SOD did not vary significantly. The change of TBARs was not
observed between wk 1 and 4. They decreased significantly between wk 4 (4.80±0.21μmol/L) and wk 20 (4.16±0.26 μmol/L). We
noted a low correlation between TBARs and plasma GPX. A strong correlation was observed between Se and plasma GPX. The reversal
of Se deficiencies should reduce oxidative damage observed in these patients. 相似文献
6.
摘要 目的:探讨不同血液净化方法对维持性血液透析(MHD)尿毒症动脉粥样硬化患者血清microRNA-144和microRNA-155水平的影响及其临床意义。方法:选取2019年6月~2020年6月川北医学院附属医院收治的98例MHD尿毒症动脉粥样硬化患者为研究组,另选取98例同期本院体检健康的志愿者为健康对照组,比较两组血清microRNA-144和microRNA-155、血清炎症因子[白细胞介素-6(IL-6)、单核细胞趋化蛋白-1(MCP-1)、超敏C反应蛋白(hs-CRP)]水平。采用Pearson分析法分析血清microRNA-144、microRNA-155水平与MHD尿毒症动脉粥样硬化患者内膜中层厚度(IMT)值、斑块面积及血清炎症因子的相关性。采用多因素Logistic回归分析MHD尿毒症动脉粥样硬化患者IMT增厚的影响因素。将研究组按随机数字表法分为血液透析滤过组和血液灌流组,各49例。血液透析滤过组给予血液透析滤过联合血液透析治疗,血液灌流组给予血液灌流联合血液透析治疗。比较两组血清microRNA-144和microRNA-155、血清炎症因子水平、IMT值和斑块面积。结果:研究组血清microRNA-144、microRNA-155、IL-6、MCP-1、hs-CRP水平明显高于健康对照组(P<0.05);Pearson相关性结果显示,血清microRNA-144、microRNA-155均与MHD尿毒症动脉粥样硬化患者IMT值、斑块面积及IL-6、MCP-1、hs-CRP均呈正相关(P<0.05);多因素Logistic回归分析结果显示,血清microRNA-144、microRNA-155、IL-6、MCP-1、hs-CRP水平均是导致MHD尿毒症动脉粥样硬化患者IMT增厚的危险因素(P<0.05)。治疗后,血液灌流组血清microRNA-144和microRNA-155水平均明显低于血液透析滤过组(P<0.05),IL-6、MCP-1、hs-CRP水平均明显低于血液透析滤过组(P<0.05),IMT值和斑块面积均明显低于血液透析滤过组(P<0.05)。结论:血清microRNA-144、microRNA-155水平与IMT值、斑块面积及IL-6、MCP-1、hs-CRP水平呈正相关,均是MHD尿毒症动脉粥样硬化患者IMT增厚的危险因素。血液灌流联合血液透析治疗可减轻机体炎症反应,延缓动脉粥样硬化进程,可能与下调患者血清microRNA-144、microRNA-155水平有关。 相似文献
7.
目的:探讨丹参多酚酸盐对维持性血液透析患者残余肾功能与钙磷代谢的影响.方法:2014年1月-2019年5月选择在本院肾内科就诊的终末期肾病患者72例,根据随机数字表法分为观察组与对照组各36例.所有患者都给予维持性血液透析治疗,在此基础上观察组给予丹参多酚酸盐治疗,持续3个月,记录残余肾功能与钙磷代谢变化情况.结果:治... 相似文献
8.
Trace elements and lipid peroxidation in 26 patients with chronic renal failure treated with hemodialysis and 25 healthy subjects
were observed. Both plasma and erythrocyte trace elements and plasma malon dialdehyde (MDA) were examined immediately before
and after hemodialysis. Increased levels of plasma Cu, MDA, and erythrocyte Pb, Mn, Zn, and a significantly decreased plasma
Se, Zn and erythrocyte Se were found in patients before hemodialysis. After a single hemodialysis, erythrocyte Mn, Cu, Zn,
and plasma Cu, Al, and MDA were significantly increased whereas both plasma and erythrocyte Se were lower in patients than
in healthy subjects. The level of MDA was not significantly changed during the single hemodialysis. Both plasma and erythrocyte
Zn levels and plasma Cu and Al were significantly higher after hemodialysis than before hemodialysis. In conclusion, levels
of trace elements are altered by hemodialysis, which may increase patient susceptibility to lipid peroxidation in uremia. 相似文献
9.
目的:探讨老年维持性血液透析(MHD)患者血清脂联素(adiponectin,ADPN)水平与其心脑血管事件发生风险及其预后的关系。方法:采用酶联免疫吸附实验(ELISA)检测76例老年MHD患者血清ADPN水平,以5 mg/L为界,以5 mg/L为低ADPN组,≥5 mg/L为高ADPN组。随访观察两组心脑血管事件的发生情况及预后。采用Cox回归分析血清ADPN水平和心脑血管事件对老年MHD患者的预后影响。结果:76例老年MHD患者的血清ADPN水平为(11.10±10.68)mg/L,其中低ADPN组患者有33例,高ADPN组患者有43例。与低ADPN组相比,高ADPN组患者的心脑血管事件发生率明显下降,而生存时间明显延长(P0.05)。Cox回归分析显示低ADPN水平和发生心脑血管事件是老年MHD患者生存时间的危险因素(P0.05)。结论:血清ADPN水平可作为老年MHD患者心脑血管事件的预测指标,并与患者的预后相关,有较好的临床应用价值。 相似文献
10.
目的:探讨糖尿病肾病(diabtic nephropgthy,DN)与非糖尿病肾病(non-DN)维持性血液透析患者(maintenance hemodialysis,MHD)血钙、血磷、甲状旁腺激素(intact parathyroid hormone,iPTH)水平的差异;分析其血钙、血磷、iPTH和糖化血红蛋白(glycosylated hemoglobin,HbA1c)水平的相关性。方法:选择沈阳军区总医院血液透析中心收治的148例MHD患者,分为糖尿病组(58例)和非糖尿病组(90例),比较两组间血钙、血磷、甲状旁腺激素水平的差异,并分析其血钙、血磷、iPTH、HbA1c水平的相关性。结果:糖尿病组iPTH、血磷水平均明显低于非糖尿病组(P〈0.05),两组血钙水平比较无明显差异。在非DN组中,iPTH与血钙水平呈显著负相关(r=-0.320,P=0.036),iPTH与血磷水平呈明显正相关(r=0.426,P=0.005)。在DN组中,iPTH与血钙、血磷无显著相关性,而iPTH与HbA1C水平呈显著负相关(r=-0.732,P=0.007)。结论:糖尿病肾病血液透析患者的iPTH水平和血磷水平明显低于非糖尿病肾病血液透析患者,HbA1c可能抑制iPTH的分泌。 相似文献