Excretion of inhibitors of calcification in urine Part II. Findings in patients with chronic renal failure.

By means of a semiquantitative method incorporating the rachitic rat cartilage technique, the total urinary inhibitory activity with respect to calcification was compared in 11 control subjects and 20 patients with renal failure. The patients had significantly lower mean values of inhibiting units per day than did the control subjects. Both groups showed a significant positive correlation between the number of inhibiting units per day and urine volume. When urine volume was taken into account in the comparison, the numbers of inhibiting units for patients continued to be lower than the numbers for controls. These findings are consistent with the hypothesis that the increase of inhibitory activity observed in uremic serum is secondary to a decrease in excretion of the responsible factor (or factors) in the urine, and that the factor (or factors) in serum responsible for the inhibition are identical to those in the urine.     

Idiopathic calcium nephrolithiasis. 1. Differences in urine crystalloids,urine saturation with brushite and urine inhibitors of calcification between persons with and persons without recurrent kidney stone formation.

The propensity of urine to promote calcium stone formation was compared in 64 patients with recurrent idiopathic calcium nephrolithiasis and 30 healthy individuals without such a history. The rates of excretion of urine crystalloids, the urine saturation with brushite (CaHPO4-2H2O), the ability of the urine to calcify collagen in vitro, and the concentration of urine inhibitors of collagen calcification were measured. The patients had a reduced urine citrate excretion rate in addition to an increased urine calcium excretion rate, while the rates for urine magnesium, phosphate, uric acid and oxalate were not significantly different in the two groups of subjects. The urine concentration of magnesium, phosphate and uric acid was decreased in the patients because of the higher urine volume. The urine creatinine excretion rate correlated with the rates of excretion of urine calcium, magnesium, phosphate, uric acid and oxalate in both groups, which suggested that increased lean body mass, possibly associated with greater food intake, may be an important determinant of crystalloid excretion. The urine of the patients was significantly more saturated with brushite than the urine of the control subjects and resulted in greater collagen calcification when incubated in vitro. The urine concentration of inhibitors of collagen calcification, however, was not significantly different in the two groups. Thus, the urine of patients with recurrent idiopathic calcium nephrolithiasis is more highly saturated with brushite, largely as a result of an increased urine calcium excretion rate, and contains a lower concentration of magnesium and citrate, substances that tend to prevent the precipitation and growth of crystals in urine.     

The Diagnostic Evaluation of Risk Factors for Urinary Tract Stones: An Analysis of Care Patterns in Five Hospitals

Medical records of hospitalized primary urolithiasis patients in five Connecticut hospitals were studied to determine the aggressiveness of the diagnostic search for metabolic and other renal stone risk factors. A total of 924 patients over three years were analyzed. Routine serum, urine, and X-ray tests were generally performed according to accepted criteria. However, medical histories were generally inadequate, and 24-hour urine studies for calcium and uric acid were performed on less than half of the patients for whom they were indicated. Neither the complexity of the stone problem nor the stone event number appeared to influence the intensity of the diagnostic search in any important way. Other deficiencies included the lack of followup of abnormal test findings and the lack of treatment of problems discovered. The diagnostic approach in each hospital was stable over time.     

几种天然产物对高尿酸血症大鼠血清尿酸水平的影响初探

目的:探讨几种天然产物对高尿酸血症大鼠血清尿酸水平及尿酸排泄的影响.方法:对wistar大鼠灌胃氧嗪酸钾和酵母膏,制作高尿酸血症大鼠动物模型.灌胃给药褐藻糖胶、柠檬酸钾和东哥阿里提取物,2周后采血并进行代谢实验,检测血清尿酸、尿素氮,24小时尿液体积、pH值、尿酸浓度及总量,分析三种活性物质对机体尿酸水平、尿酸排泄、肾脏功能的影响.结果:三种物质均可显著降低高尿酸血症模型大鼠的血清尿酸水平,其中东哥阿里提取物组的24小时排泄尿酸总量较模型组显著降低,褐藻糖胶对实验大鼠的血清尿素氮水平升高有抑制作用.结论:三种活性物质对高尿酸血症大鼠血清尿酸浓度有降低作用,其中褐藻糖胶对肾脏功能有保护作用,从而保证尿酸的顺利排泄,而东哥阿里在降低血尿酸水平的同时,24小时尿液中排泄的尿酸总量也显著低于模型对照组,其机制可能与抑制尿酸生成有关.     

Difference in 24-Hour Urine Composition between Diabetic and Non-Diabetic Adults without Nephrolithiasis

Background

Diabetic patients are more likely to develop kidney stones than the general population. The underlying mechanisms for this disparity remain to be elucidated. Little is known about the relationship between urine composition and diabetes mellitus in non-stone-forming individuals. We sought to examine the differences in the 24-hour (24-h) urine composition between diabetic and non-diabetic adults who were not stone formers.

Methods

A convenience sample of 538 individuals without a history of nephrolithiasis, gout, hyperparathyroidism, or gastroenteric diseases participated in this study. The 24-h urine profiles of 115 diabetic adults were compared with those of 423 non-diabetic adults. Diabetes was defined by self-reported physician diagnosis or medication use. All participants were non-stone formers confirmed by urinary tract ultrasonography. Participants provided a fasting blood sample and a single 24-h urine collection for stone risk analysis. Student’s t-test was used to compare mean urinary values. Linear regression models were adjusted for age, gender, body mass index, hypertension, fasting serum glucose, serum total cholesterol, estimated creatinine clearance rate and urinary factors.

Results

Univariable analysis showed that the diabetic participants had significantly higher 24-h urine volumes and lower urine calcium and magnesium excretions than non-diabetic participants (all P < 0.05). After multivariate adjustment, no significant differences in 24-h urine composition were observed between diabetic and non-diabetic participants except for a slightly increased 24-h urine volume in diabetic participants (all P > 0.05). The main limitation of this study is that the convenience samples and self-reported data may have been sources of bias.

Conclusion

Our data showed that there were no differences in 24-h urine composition between diabetic and non-diabetic adults who are not stone formers. The reason for it might be the improved glycemic control in diabetic individuals in our study. Therefore, a tighter glycemic control might reduce stone formation in diabetic adults.     

苯磺酸氨氯地平对维持性血液透析患者残余肾功能的保护作用

目的:研究苯磺酸氨氯地平对维持性血液透析(MHD)患者残余肾功能的保护作用,为MHD患者降压方案的治疗提供依据。方法:选取2014年4月至2016年2月我院收治的MHD患者90例,按照随机数字表法分为硝苯地平组(A组)、血管紧张素抑制剂或血管紧张素转化酶抑制剂组(B组)、苯磺酸氨氯地平组(C组),每组各30例。各组分别给予相应药物进行治疗12个月,观察治疗前、治疗后6个月、治疗后12个月尿量、血生化指标、尿素清除指数(Kt/V)、残余肾尿素清除率(KRU)及心血管事件发生率。结果:治疗前各组患者尿量、KRU和Kt/V比较无统计学差异(P0.05),治疗后3组患者尿量、KRU均显著降低(P0.05),治疗后6个月、12个月B组和C组尿量、KRU显著高于A组(P0.05),B组C组尿量、KRU比较无统计学差异(P0.05),治疗后6个月、12个月三组Kt/V比较无统计学差异(P0.05)。三组患者治疗中急性心血管事件比较无统计学差异(P0.05),治疗后6个月、12个月A组和C组透析前高血钾发生率显著高于B组(P0.05)。治疗前、治疗后6个月、12个月三组患者平均动脉压、脱水量比较比较无统计学差异(P0.05)。结论:苯磺酸氨氯地平具有维持血液透析患者残余肾功能的作用,相较血管紧张素抑制剂或血管紧张素转化酶抑制剂其高血钾发生率较低,值得临床推广应用。     

Measurement of endogenous Na+,K+-ATPase inhibitors in human plasma and urine using high-performance liquid chromatography

This study was undertaken to assess endogenous Na+,K+-ATPase inhibitors in both plasma and urine in the same subjects. Samples were chromatographed on reverse-phase HPLC using an acetonitrile gradient and the eluent screened using Na+,K+-ATPase inhibition and cross-reaction with anti-digoxin antibodies. The donors were divided into inhibiting and non-inhibiting subjects using a previously described method, plasma action on ouabain binding and on Na+,K+-ATPase activity. Three Na+,K+-ATPase inhibitors (1P, 2P and 3P) were detectable in plasma; the antibodies cross-reaction of the peaks 2P and 3P were larger than that of peak 1P. The peaks 2P and 3P were significantly higher in inhibiting subjects as compared to non-inhibiting subjects. The 24-h urine is resolved into two peaks inhibiting Na+,K+-ATPase activity (1U and 2U). Peak 2U cross-reacted with anti-digoxin antibodies to a greater extent than peak 1U and is significantly larger in inhibiting subjects in terms of Na+,K+-ATPase inhibition. These data support the heterogeneity of human Na+,K+-ATPase inhibitor in both plasma and urine.     

Glomerular filtration rate and blood pressure monitoring in awake baboons

Minimally invasive techniques were used to collect urine with an external catheter together with automated intermittent monitoring of arterial blood pressure in awake male baboons. Using endogenous creatinine, 24-hour creatinine clearances were measured for 2 to 3 consecutive days in four intact and in four uninephrectomized baboons. Despite large differences in urinary volume and sodium excretion, reproducibility of 24-hour creatinine clearances was within 15% in 15 of 19 studies obtained from 6 of 8 animals. Arterial blood pressure was monitored intermittently at 30 to 60 minute intervals over 24 hours with a Dinamap monitor and recorder. Mean blood pressure averaged 71 +/- 4.4 to 89 +/- 5.5 mm Hg in different animals. Blood pressure tended to be lower at night than during the day. In separate studies using 15 to 60 minute urine collection periods, inulin clearance was compared in awake and in anesthetized animals with endogenous or exogenous creatinine clearance measured simultaneously. The clearance of creatinine systematically exceeded the clearance of inulin, even in intact animals with a normal serum creatinine. The creatinine-to-inulin clearance ratio averaged 1.16 +/- 0.03 at a serum concentration of 0.7 to 0.8 mg/dl; 1.27 +/- 0.03 at a serum creatinine of 1.0 to 1.1 mg/dl and 1.56 +/- 0.04 at a serum creatinine greater than 10 mg/dl. All values exceed unity significantly (p less than 0.001). Thus, renal function, including inulin clearance, can be measured in awake baboons. Duplicate or triplicate 24-hour urine collections are needed to assess the reliability of creatinine excretion. However, creatinine clearance overestimates glomerular filtration rate, as it does in humans.     

Effect of hydrochlorothiazide on urine saturation with brushite,in vitro collagen calcification by urine,and urinary inhibitors of collagen calcification

To clarify further the beneficial effect of thiazide diuretics on recurrent calcium nephrolithiasis, the effect of short-term hydrochlorothiazide therapy on urine saturation with brushite (CaHPO₄·2H₂O), in vitro collagen calcification by urine, and urinary inhibitors of calcification was studied.In 22 patients with idiopathic calcium oxalate/phosphate stones the urine calcium excretion decreased, the urine magnesium excretion increased and the urine magnesium/calcium ratio increased significantly (P < 0.001) during hydrochlorothiazide therapy. Supersaturation of the urine with brushite, which was present in 19 of the 22 patients, was reduced significantly (P < 0.001) in all during thiazide therapy, and to the undersaturated range in 16. The ability of urine to calcify collagen in vitro also decreased significantly (P < 0.001) during thiazide therapy, a change that correlated significantly (r = 0.4513, P < 0.05) with the decrease in brushite saturation. The concentration of urinary inhibitors of calcification, as determined with an in vitro collagen calcification system, was decreased significantly (P < 0.01) by thiazide therapy.It was concluded that, in addition to decreasing urine calcium excretion and increasing urine magnesium excretion, thiazide diuretics decrease the urinary brushite saturation and thus may prevent spontaneous nucleation or crystal growth, or both, of calcium phosphate. The ability of thiazides to decrease collagen calcification in vitro suggests that they may also prevent crystal growth on a nidus of organic matrix. Thiazides do not appear to act by increasing the excretion of urinary inhibitors of calcification.     

Evaluation of the liberation of urinary necrosis enzymes (NAG-AAP) after administration of plasma expanders: study of dextran 40, hydroxyethyl starch and polymerized gelatin

We studied the 24-hour urinary elimination of enzymatic markers of renal tubular necrosis (NAG-AAP) in 21 patients (mean age 34.6 years old) who were treated with plasma expanders before peridural anesthesia. The patients were divided into three groups of seven subjects each: - 14 ml/Kg -1 of dextran 40 was administered to group 1 - 14 ml/Kg -1 of gelatin was administered to group 2 - 14 ml/Kg -1 of hydroxyethyl starch was administered to group 3. Urinary elimination of N-acetylglucosaminidase and of alanine aminopeptidase was determined in the 24-hour urine the day before surgery (controls), the day of surgery (G1) and the day after surgery (G2). The values of the samples, taken after plasma expander administration, did differ significantly from the control values (G1, G2). Therefore the administration of 14 ml/Kg -1 of dextran, gelatin or hydroxyethyl starch does not affect the renal tubular epithelium.     

一种高尿酸血症大鼠模型诱导方法的改良和效果评价研究

目的: 探索短期内诱导高尿酸血症大鼠模型的有效方法,并对模型效果进行评价。方法: 雄性SD大鼠随机分为对照组(CT组,6只)和5个模型组(M1-M5组),每组8只;M1组(每天酵母膏10 g/kg+腺嘌呤100 mg/kg 2次灌胃,于模型诱导的第7日1次性腹腔注射氧嗪酸钾300 mg/kg)、M2组(每天酵母膏10 g/kg+腺嘌呤100 mg/kg灌胃2次,于模型诱导第1、3、7日每天腹腔注射1次氧嗪酸钾300 mg/kg)、M3组(每天酵母膏10 g/kg+腺嘌呤100 mg/kg灌胃 2次,每天腹腔注射1次氧嗪酸钾300 mg/kg)、M4组(每天酵母膏20 g/kg+腺嘌呤100 mg/kg灌胃 2次,每天腹腔注射1次氧嗪酸钾300 mg/kg)、M5组(每天酵母膏30 g/kg+腺嘌呤100 mg/kg灌胃2次,每天腹腔注射1次氧嗪酸钾300 mg/kg)、CT组(5个模型组按相同的时间、体重计算等体积灌胃和腹腔注射生理盐水),造模7 d;分别在造模结束时和2周后采集24 h尿样和血样检测尿酸、肌酐水平,取肾脏和胃称重,观察肾脏病理变化。结果: 与CT组相比,造模结束后,所有模型组大鼠体重均显著降低(P＜0.01);除M2组外,其他造模组大鼠均有亡,M4组和M5组因死亡率高未做后续分析,M1和M3组分别死亡4例和2例;造模结束后,模型大鼠血尿酸、尿尿酸水平明显升高(P＜0.01),并且M2组的血尿酸水平显著高于其他各组(P＜0.05);继续喂养2周后,各模型组的血尿酸和尿尿酸水平仍显著升高(P＜0.05);各模型组大鼠肾脏重量也明显增加(P＜0.01);病理检查显示,模型组大鼠肾脏出现明显炎症反应和结构破坏。结论: 采用酵母膏(10 g/kg)、腺嘌呤(100 mg/kg)联合氧嗪酸钾(300 mg/kg)间隔(第1、3、7日)注射的方案可在短期内安全地诱导高尿酸血症大鼠模型,模型效果持续时间较长,适合在相关研究中应用。     

Circadian variation in renal function of the obese rat.

The influence of food and water intake on renal function was assessed by comparisons between the hyperphagic Zucker obese rat and its lean littermate, which demonstrates nocturnal dominance in activity. Serum creatinine and cortisol levels, creatine kinase activities, creatinine and urine clearances, and sodium and potassium excretion rates were measured over a 24-hour period in both lean and obese rats (n = 24 each). Six rats in each group were studied every 8 h to permit characterization over a 12-hour light/dark cycle at 2-hour intervals. Urine and creatinine clearances were increased in lean rats during the dark phase coincident with onset of eating. Similarly, renal sodium and potassium excretion rates were markedly increased during the dark cycle, despite relatively constant serum potassium and sodium levels over the 24-hour period. In contrast, no circadian patterns in urine and creatinine clearances were found in the obese rat, which exhibits continuous feeding habits throughout the 24-hour period. Moreover, renal electrolyte excretion in the obese rat was modestly increased during the dark cycle, unlike the significant differences over time observed in lean rats. Serum creatinine levels were increased during the dark cycle in both rat groups. Creatine kinase activity, a measure of ambulatory activity, was constant in lean rats during the study period. Although creatine kinase activity was increased in obese rats during the dark cycle, no correlations with renal functional parameters were found. These results indicate that differences in food and water intake are significant determinants in diurnal cyclic changes in renal function.     

Idiopathic calcium nephrolithiasis. 2. Differences between hypercalciuric and normocalciuric persons with recurrent kidney stone formation and persons without such a history.

Normocalciuric and hypercalciuric patients with idiopathic recurrent calcium nephrolithiasis were compared with healthy individuals without such a history to examine the factors that predispose normocalciuric patients to stone formation. The urine calcium excretion rate was higher in the normocalciuric patients than in the control subjects (227 v. 183 mg/24 h; P less than 0.01), but the urine calcium concentration was not significantly different. The urine magnesium and citrate excretion rates and concentrations were lower in the normocalciuric patients than in the control subjects (P less than 0.001), while the urine uric acid and oxalate excretion rates and concentrations and the urine saturation with brushite (CaHPO4-2H2O) were not significantly different. These results suggest the importance of slight increases in the urine calcium excretion rate together with decreased urine magnesium and citrate excretion rates in normocalciuric persons with recurrent calcium stone formation. The urine of the hypercalciuric patients was more highly saturated with brushite than the urine of the normocalciuric patients and the control subjects, and the excretion rates of uric acid and oxalate were increased in the hypercalciuric patients. The hypercalciuric patients had a higher urine creatinine excretion rate than the normocalciuric patients and a higher daily urine volume than the control subjects, which suggests that differences in lean body mass or fluid and food intake, or both, may be important determinants of these differences in crystalloid excretion. As in the normocalciuric patients, the urine citrate excretion rate and concentration were decreased in the hypercalciuric patients compared with the control subjects.     

阿奇霉素对阿霉素与白蛋白致小鼠肾损害的保护作用*

目的:研究阿奇霉素对阿霉素与白蛋白致小鼠肾损害的肾脏保护作用。方法:取BALB/c雄性小鼠40只,按照随机数表法平均分为空白对照组(Ctrl组)、肾损害模型组(ADR+BSA组)、阿奇霉素治疗组(Azm组)及醋酸泼尼松阳性对照组(Pdn组);ADR+BSA、AZM及Pdn三组每周5 d尾静脉注射9.8 mg·kg^-1阿霉素,腹腔注射10 mg·kg^-1血清白蛋白,对照组注射生理盐水,持续4周造模;之后,AZM组每天给予62.5 mg·kg^-1阿奇霉素灌胃,Pdn组每天给予12.5 mg·kg^-1醋酸泼尼松灌胃,其余两组给予等量生理盐水,持续6周后,收集并记录24 h尿量,检测尿蛋白量、内生肌酐清除率,取血检测血清生化指标和免疫因子。结果:与Ctrl组相比,ADR+BSA组小鼠24 h尿蛋白定量显著升高(P＜0.05),Ccr显著降低(P＜0.05);经过阿奇霉素治疗后的小鼠,24 h蛋白定量相比于ADR+BSA组显著降低(P＜0.05),Ccr显著升高(P＜0.05)。结论:阿奇霉素对阿霉素与白蛋白致小鼠的肾损害有一定的保护作用。     

高胱氨酸尿对大鼠肾脏自噬水平的抑制作用

摘要 目的：探讨胱氨酸尿症中高胱氨酸浓度对大鼠肾脏自噬水平的影响。方法：通过液相色谱串联质谱（LC-MS/MS）测定Slc7a9基因敲除大鼠24小时尿液胱氨酸浓度确定高尿胱氨酸;通过IHC（免疫组织化学）染色筛选无结石产生的胱氨酸尿症大鼠、观察肾脏组织结构有无明显变化;通过Western blot测定肾脏组织中的LC3-I、LC3-II、p62和mTOR的蛋白相对表达量,以检测自噬水平的变化,并探索变化原因;通过组织切片Masson染色法检测肾脏髓质纤维化程度。结果：10只无结石胱氨酸尿症大鼠尿液胱氨酸显著高于对照组;未发现有胱氨酸结石的生成与肾脏结构性变化;Masson染色提示胱氨酸尿症大鼠发现轻度肾脏纤维化过程;肾脏组织自噬标记蛋白LC3-I、LC3-II蛋白相对表达量、LC3-II/LC3-I比值以及自噬当量p62相对表达较对照组均显著降低,mTOR相对表达量显著升高。以上差异均有统计学意义（P＜0.05）。结论：在胱氨酸尿症大鼠模型上,发现无结石形成情况下的尿高胱氨酸水平可通过mTOR途径抑制大鼠肾脏组织的自噬水平,自我保护作用减弱,由此参与胱氨酸尿症的肾脏损伤过程。     

Nocturnal polyuria and saluresis in renal allograft recipients.

The evolution of nocturnal polyuria and saluresis in renal allograft recipients was studied by comparing the day to night (D:N) ratios of urine volume and sodium excretion in 15 patients who had undergone transplantation less than one year previously (recent-transplant group) with those in 11 patients who had undergone transplantation at least one year previously. Eleven patients with chronic renal failure and 12 normal subjects served as controls. Patients in the recent-transplant group had significantly lower D:N ratios of urine volume and sodium excretion than the patients who had undergone transplantation at least a year before, while the ratios in this last group did not differ significantly from those in the normal subjects. Nocturnal polyuria and saluresis gradually subsided in five patients studied for three months. Chronic renal failure and uraemic autonomic neuropathy were unlikely causes of the nocturia. The patients in the recent-transplant group had significantly lower D:N ratios of urine volume than the controls with chronic renal failure, and the mean Valsalva ratio in eight of them was not significantly different from that in the normal subjects. An undue sensitivity of renal allografts to postural influences was proposed.     

Fluid regulation and reproductive cyclicity in female rats treated neonatally with testosterone and methandrostenolone

Female rats injected with 1 mg of testosterone propionate on day 5 after birth weighed significantly more during the immediate postpubertal period than methandrostenolone-treated (1 mg) or vehicle-injected control females. There were no differences between groups in 24-hour intakes of food or water, when expressed on a per unit body weight basis. Testosterone- and methandrostenolone-treated rats ingested less water than controls in response to acute extracellular dehydration but not after cellular dehydration. The volume of the 'sexually dimorphic nucleus' of the preoptic area was significantly greater in brains taken from the two steroid-injected groups compared to control females. Testosterone had a stronger androgenic effect than methandrostenolone in terms of disrupting the estrous cycle.     

老年原发性高血压患者血压晨峰与早期肾损害的临床观察

目的:探讨老年原发性高血压患者血压晨峰与早期肾损害的关系。方法:选择我院收治的94例老年原发性高血压患者进行24小时动态血压监测,并根据监测结果,将患者分为晨峰组62例和非晨峰组32例,检测和比较两组的血肌酐和尿素氮、12小时尿微量蛋白、尿β2微球蛋白、空腹血糖、血脂等指标。结果:老年高血压患者晨峰组12小时尿微量蛋白、尿β2微球蛋白均显著高于非晨峰组(P0.05);晨峰血压与12小时尿微量白蛋白(r=0.374)、尿β2微球蛋白(r=0.456)呈显著正相关。结论:老年原发性高血压患者血压晨峰与早期肾损害有关,治疗高血压的同时重视控制晨峰血压有重要意义。     

盆底肌功能训练联合阴茎夹对前列腺增生术后患者尿失禁的临床应用分析

目的:分析盆底肌功能训练联合阴茎夹对前列腺增生术后患者尿失禁的临床应用效果。方法:选取我院2017年4月～2019年4月收治的72例前列腺增生术后尿失禁患者,随机分为对照组和观察组各36例,两组均予盆底肌功能训练,观察组加用阴茎夹控制排尿。对比两组术后尿失禁改善情况、排尿改善情况、国际尿失禁咨询委员会尿失禁问卷表简表(ICI-Q-SF)评分变化、压力性尿失禁分度评价及经济费用情况。结果:两组干预后20 d、干预后30 d、干预后90 d尿失禁发生率均较干预后10 d下降,观察组干预后10 d、干预后20 d、干预后30 d、干预后90 d尿失禁发生率均低于对照组,差异均有统计学意义(P0.05)。两组干预后90 d每日总尿量较干预前升高,每日总排尿次数、每日总漏尿次数均较干预前下降;观察组干预后90 d每日总尿量高于对照组,每日总排尿次数、每日总漏尿次数均低于对照组,差异均有统计学意义(P0.05)。两组干预后90d ICI-Q-SF评分均较干预前下降,且观察组干预后90d ICI-Q-SF评分低于对照组,差异均有统计学意义(P0.05)。观察组患者干预后压力性尿失禁临床治愈率高于对照组,差异有统计学意义(P0.05)。两组患者压力性尿失禁分度情况比较差异无统计学意义(P0.05)。观察组阴茎夹使用费用为(70.26±8.51)元,低于对照组的(388.71±26.44)元,差异有统计学意义(P0.05)。结论:在盆底肌功能训练的基础上联合阴茎夹能够有效改善前列腺增生术后患者尿失禁症状及生活质量,且有助于降低患者经济负担,值得临床推广应用。     

Relationship between insulin resistance and low urinary pH in patients with gout, and effects of PPARalpha agonists on urine pH.

Patients with gout frequently have low urinary pH, though the underlying mechanism has not been identified. Recently, nephrolithiasis has been reported to be involved with renal manifestation of metabolic syndrome. The present study was conducted to clarify the mechanism of low urinary pH in gout patients. The relationships between urine pH and factors contributing to metabolic syndrome were investigated. In addition, the effects of PPAR alpha agonists on urine pH were examined. Patients with 24-hour urine samples below a level of pH 5.5 showed higher values for factors constituting metabolic syndrome, compared with those with 24-hour urine pH equal to or greater than 5.5. Multiple regression analysis demonstrated that HOMA index was the only contributing factor to low urinary pH in gout patients, except for serum uric acid. Administrations of PPAR alpha agonists significantly raised 24-hour urine pH levels in gout patients in accordance with a reduction in serum triglyceride concentration, probably through their activities to improve insulin resistance. Our results suggest that insulin resistance plays an important role in the development of low urinary pH in patients with gout and that PPAR alpha agonist is preferable for raising urinary pH of the gout patients with hypertriglyceridemia.