Objective To explore the relationship between HBV DNA and the clinical manifestations, pathological types, injury severity, and prognosis with HBV-GN. Methods 102 patients with HBV-GN were divided into 3 groups, accor...Objective To explore the relationship between HBV DNA and the clinical manifestations, pathological types, injury severity, and prognosis with HBV-GN. Methods 102 patients with HBV-GN were divided into 3 groups, according to the serum titer of the HBV DNA. 24-h urine protein excretion, and other parameters were measured. Renal biopsy were performed. The association between HBV DNA and the pathological stage of membranous nephropathy was analyzed in 78 patients with HBV-MN. 24-h urine protein excretion was used for the evaluation of the prognosis, and the relationship between HBV DNA and prognosis were analyzed. Results Several findings were demonstrated with the increase of serum HBV DNA： 24-h urine protein excretion, plasma cholesterol, and triglycerides increased significantly（P〈0.05）, while the plasma level of albumin decreased significantly（P〈0.05）; The changes of serum creatinine, C3 and C4 were found but no statistical significance. Glomerular deposition of HBVAg increased, and the pathological injury was more severe. The clinical remission rate was lower in the high replication group after treatment as compared with the low replication group（P〈0.01）. Conclusion With the increase of serum HBV DNA, the urine protein excretion and the kidney injury were more severe, and the clinical remission rate was decreased.展开更多
Objective:To evaluate the effects of rituximab versus mycophenolate mofetil or cyclophosphamide as control in lupus nephritis by meta-analysis.Methods:A systematic search was carried out up to January 2022,obtaining 7...Objective:To evaluate the effects of rituximab versus mycophenolate mofetil or cyclophosphamide as control in lupus nephritis by meta-analysis.Methods:A systematic search was carried out up to January 2022,obtaining 7 studies involving 645 participants with lupus nephritis at the commencement of the investigation;198 of them were treated with rituximab,while 447 were treated with mycophenolate mofetil or cyclophosphamide.We determined the odds ratio(OR)and mean difference(MD)with 95%confidence index(CI)to compare rituximab’s efficacy to that of mycophenolate mofetil or cyclophosphamide as control in lupus nephritis using random-or fixed-effects model by dichotomous or continuous techniques.Results:The rituximab group showed significantly higher complete renal remission rate(OR=2.52;95%CI 1.30-4.91,P=0.006)and total renal remission rates(OR=2.22;95%CI 1.36-3.63,P=0.001)than the control group.However,there was no significant difference in terms of end Systemic Lupus Erythematosus Disease Activity Index(SLEDAI)score(MD-1.16;95%CI-2.88-0.57,P=0.19),proteinuria(MD-0.31;95%CI-0.70-0.09,P=0.013),and serum creatinine(MD 0.01;95%CI-0.04-0.07,P=0.64)between the rituximab group and the control.Conclusion:Rituximab exhibited significantly greater complete renal remission rate and total renal remission rates,with no significant difference in terms of shorter-end SLEDAI,proteinuria,and serum creatinine,compared with the control in individuals with lupus nephritis.展开更多
Objective:Our goal was to examine the impact of Zhuangshen Gujing decoction on proteinuria associated with chronic nephritis.Methods:72 patients with chronic nephritis proteinuria were divided randomly into two groups...Objective:Our goal was to examine the impact of Zhuangshen Gujing decoction on proteinuria associated with chronic nephritis.Methods:72 patients with chronic nephritis proteinuria were divided randomly into two groups;one group was treated with Zhuangshen Gujing(n=36;treatment group)and the other group was treated with irbesartan(n=36;control group).After 6 months’treatment,urine protein and renal function were evaluated.Results:Proteinuria resolved completely in four patients in the treatment group;complete disease resolution was observed only among three individuals in the control group.Of the 32 cases remaining in the treatment group,15 had substantial responses to Zhuangshen Gujing decoction,9 had partial responses,and 8 had no response to treatment;the overall the response rate was 73.33%.Among the 33 cases remaining in the control group,12 had a substantial response to irbesartan,5 had a partial response,and 16 had no response to treatment;the overall response rate among the controls was 57.67%(P=0.031).We also observed statistically significant differences with respect to quantitative comparisons of urinary protein at 24 days after a single course of treatment(P=0.001).Conclusion:Zhuangshen Gujing decoction is effective in treating chronic nephritis proteinuria.展开更多
Background: The mortality rate is higher in SLE patients with lupus nephritis (LN) than in those without nephropathy. Objectives: The aim of this study was to identify the factors affecting the long-term renal outcome...Background: The mortality rate is higher in SLE patients with lupus nephritis (LN) than in those without nephropathy. Objectives: The aim of this study was to identify the factors affecting the long-term renal outcome in 102 patients with LN. Methods: This was a retrospective cohort study. Logistic regression analysis was used in a model to determine how independent variables predicted the outcome. The survival analysis was based on the Kaplan-Meier curve with subjects censored for death. Results: The 15-year survival rate was 93.5%, and the renal function non-deterioration rate was 78.3%. No influence of individual types of immunosuppressant drugs used was found on the renal function deterioration rate. In this study, the results of analysis identified only daily urinary protein excretion level as having any significant effect on the risk of progression of LN to renal failure. Conclusions: These results suggest that remission induction therapy and maintenance therapy focused on long-term preservation of renal function need to be selected for LN patients with a high daily urinary protein value at the start of treatment and for LN patients who fail to show any reduction of the daily urinary protein excretion level to 0.5 g or less at one year after the biopsy.展开更多
目的探讨高凝状态与IgA血管炎肾炎(immunoglobulin A vasculitis with nephritis,IgAVN)患儿尿蛋白和肾脏病理损伤之间的关系。方法根据凝血功能结果,将349例IgAV患儿分为高凝组(52例)和非高凝组(297例),比较两组间尿蛋白和肾脏病理特征...目的探讨高凝状态与IgA血管炎肾炎(immunoglobulin A vasculitis with nephritis,IgAVN)患儿尿蛋白和肾脏病理损伤之间的关系。方法根据凝血功能结果,将349例IgAV患儿分为高凝组(52例)和非高凝组(297例),比较两组间尿蛋白和肾脏病理特征,并分析IgAVN患儿高凝状态形成的影响因素。结果高凝组患儿尿红细胞计数、24 h尿蛋白定量、尿蛋白/肌酐、尿免疫球蛋白G/肌酐、尿N-乙酰β-D-氨基葡萄糖苷酶水平高于非高凝组(P<0.05);高凝组患儿肾脏病理分级为Ⅲ~Ⅳ级、弥漫性系膜增生、毛细血管内皮细胞增生、肾小球新月体形成>25%比例高于非高凝组(P<0.05)。多因素logistic回归分析结果显示,毛细血管内皮细胞增生、肾小球新月体形成>25%是IgAVN患儿高凝状态形成的影响因素(P<0.05)。结论伴高凝状态IgAVN患儿的肾损伤更为严重,肾小球新月体形成>25%和毛细血管内皮细胞增生是进一步加重IgAVN高凝状态的重要因素。展开更多
乙肝病毒相关性肾炎(hepatitisBvirus-associated glomerular nephritis,HBV-GN)是指由乙型肝炎病毒(hepatitis B virus,HBV)直接或间接诱发的肾小球肾炎,中国是乙型肝炎的高发国家。据数据统计,中国成年人HBV携带率高达10%以上,其中HBV...乙肝病毒相关性肾炎(hepatitisBvirus-associated glomerular nephritis,HBV-GN)是指由乙型肝炎病毒(hepatitis B virus,HBV)直接或间接诱发的肾小球肾炎,中国是乙型肝炎的高发国家。据数据统计,中国成年人HBV携带率高达10%以上,其中HBV-GN的发生率约为9.0%[1]。针对HBV-GN目前临床尚无特效疗法,单纯核苷酸类似物治疗大量蛋白尿HBV-GN的尿蛋白缓解率低[2],临床疗效并不理想。目前通过糖皮质激素、免疫抑制剂类药物来改善患者的临床症状,控制病情进展,但实践证实,长期应用则会加速HBV复制[3]。近年来,随着临床对HBV-GN研究的不断深入,临床上常应用恩替卡韦进行抗病毒治疗,尽管有效抑制了HBV的复制,但还需联合应用糖皮质激素来减少尿蛋白,控制病情进展[4],但目前激素应用的剂量、疗程未见详细报道。现报道潍坊医学院临床医学院采用小剂量糖皮质激素联合恩替卡韦治疗3例乙肝相关性肾炎的成功案例,现报道如下。展开更多
目的分析肾炎康复片结合氯沙坦钾片治疗慢性肾小球肾炎的临床疗效及对IL-1β、IL-1及VEGF水平的影响。方法选择2016年11月—2019年12月医院收治的慢性肾小球肾炎患者85例,依据治疗方式的不同分为观察组43例和对照组42例,对照组患者入院...目的分析肾炎康复片结合氯沙坦钾片治疗慢性肾小球肾炎的临床疗效及对IL-1β、IL-1及VEGF水平的影响。方法选择2016年11月—2019年12月医院收治的慢性肾小球肾炎患者85例,依据治疗方式的不同分为观察组43例和对照组42例,对照组患者入院后给予口服氯沙坦钾片治疗。观察组患者在对照组治疗的基础上,口服肾炎康复片治疗。两组均连续治疗3个月。在治疗期间均低盐、低脂、低蛋白饮食。比较两组治疗疗效;比较两组患者临床症状改善时间;比较两组治疗前后血压、肾功能指标;比较两组治疗前后尿RBC、尿β2-MG和24 h Upro水平,比较两组治疗前、治疗3个月后血清IL-1β、IL-1及VEGF水平。结果观察组治疗总有效率为86.05%,显著高于对照组治疗总有效率的64.29%(P<0.05);观察组患者恶心呕吐时间、浮肿消失时间、疲惫消失时间均较对照组短(P<0.05);观察组治疗后SBP、DBP、BUN、Scr水平低于对照组,Alb水平高于对照组(P<0.05);观察组治疗后尿RBC、尿β2-MG和24 h Upro水平对照组(P<0.05);观察组治疗3个月后血清IL-1β、IL-1及VEGF水平低于对照组(P<0.05)。结论肾炎康复片结合氯沙坦钾片治疗慢性肾小球肾炎效果显著,可有效的改善临床症状,控制血压,减轻肾脏的免疫炎症损伤,延缓肾损伤进程减少蛋白尿,值得临床进一步研究探讨。展开更多
基金supported by the Education Department of Shandong Province,China,No.J11LF21
文摘Objective To explore the relationship between HBV DNA and the clinical manifestations, pathological types, injury severity, and prognosis with HBV-GN. Methods 102 patients with HBV-GN were divided into 3 groups, according to the serum titer of the HBV DNA. 24-h urine protein excretion, and other parameters were measured. Renal biopsy were performed. The association between HBV DNA and the pathological stage of membranous nephropathy was analyzed in 78 patients with HBV-MN. 24-h urine protein excretion was used for the evaluation of the prognosis, and the relationship between HBV DNA and prognosis were analyzed. Results Several findings were demonstrated with the increase of serum HBV DNA： 24-h urine protein excretion, plasma cholesterol, and triglycerides increased significantly（P〈0.05）, while the plasma level of albumin decreased significantly（P〈0.05）; The changes of serum creatinine, C3 and C4 were found but no statistical significance. Glomerular deposition of HBVAg increased, and the pathological injury was more severe. The clinical remission rate was lower in the high replication group after treatment as compared with the low replication group（P〈0.01）. Conclusion With the increase of serum HBV DNA, the urine protein excretion and the kidney injury were more severe, and the clinical remission rate was decreased.
文摘Objective:To evaluate the effects of rituximab versus mycophenolate mofetil or cyclophosphamide as control in lupus nephritis by meta-analysis.Methods:A systematic search was carried out up to January 2022,obtaining 7 studies involving 645 participants with lupus nephritis at the commencement of the investigation;198 of them were treated with rituximab,while 447 were treated with mycophenolate mofetil or cyclophosphamide.We determined the odds ratio(OR)and mean difference(MD)with 95%confidence index(CI)to compare rituximab’s efficacy to that of mycophenolate mofetil or cyclophosphamide as control in lupus nephritis using random-or fixed-effects model by dichotomous or continuous techniques.Results:The rituximab group showed significantly higher complete renal remission rate(OR=2.52;95%CI 1.30-4.91,P=0.006)and total renal remission rates(OR=2.22;95%CI 1.36-3.63,P=0.001)than the control group.However,there was no significant difference in terms of end Systemic Lupus Erythematosus Disease Activity Index(SLEDAI)score(MD-1.16;95%CI-2.88-0.57,P=0.19),proteinuria(MD-0.31;95%CI-0.70-0.09,P=0.013),and serum creatinine(MD 0.01;95%CI-0.04-0.07,P=0.64)between the rituximab group and the control.Conclusion:Rituximab exhibited significantly greater complete renal remission rate and total renal remission rates,with no significant difference in terms of shorter-end SLEDAI,proteinuria,and serum creatinine,compared with the control in individuals with lupus nephritis.
文摘Objective:Our goal was to examine the impact of Zhuangshen Gujing decoction on proteinuria associated with chronic nephritis.Methods:72 patients with chronic nephritis proteinuria were divided randomly into two groups;one group was treated with Zhuangshen Gujing(n=36;treatment group)and the other group was treated with irbesartan(n=36;control group).After 6 months’treatment,urine protein and renal function were evaluated.Results:Proteinuria resolved completely in four patients in the treatment group;complete disease resolution was observed only among three individuals in the control group.Of the 32 cases remaining in the treatment group,15 had substantial responses to Zhuangshen Gujing decoction,9 had partial responses,and 8 had no response to treatment;the overall the response rate was 73.33%.Among the 33 cases remaining in the control group,12 had a substantial response to irbesartan,5 had a partial response,and 16 had no response to treatment;the overall response rate among the controls was 57.67%(P=0.031).We also observed statistically significant differences with respect to quantitative comparisons of urinary protein at 24 days after a single course of treatment(P=0.001).Conclusion:Zhuangshen Gujing decoction is effective in treating chronic nephritis proteinuria.
文摘Background: The mortality rate is higher in SLE patients with lupus nephritis (LN) than in those without nephropathy. Objectives: The aim of this study was to identify the factors affecting the long-term renal outcome in 102 patients with LN. Methods: This was a retrospective cohort study. Logistic regression analysis was used in a model to determine how independent variables predicted the outcome. The survival analysis was based on the Kaplan-Meier curve with subjects censored for death. Results: The 15-year survival rate was 93.5%, and the renal function non-deterioration rate was 78.3%. No influence of individual types of immunosuppressant drugs used was found on the renal function deterioration rate. In this study, the results of analysis identified only daily urinary protein excretion level as having any significant effect on the risk of progression of LN to renal failure. Conclusions: These results suggest that remission induction therapy and maintenance therapy focused on long-term preservation of renal function need to be selected for LN patients with a high daily urinary protein value at the start of treatment and for LN patients who fail to show any reduction of the daily urinary protein excretion level to 0.5 g or less at one year after the biopsy.
文摘目的探讨高凝状态与IgA血管炎肾炎(immunoglobulin A vasculitis with nephritis,IgAVN)患儿尿蛋白和肾脏病理损伤之间的关系。方法根据凝血功能结果,将349例IgAV患儿分为高凝组(52例)和非高凝组(297例),比较两组间尿蛋白和肾脏病理特征,并分析IgAVN患儿高凝状态形成的影响因素。结果高凝组患儿尿红细胞计数、24 h尿蛋白定量、尿蛋白/肌酐、尿免疫球蛋白G/肌酐、尿N-乙酰β-D-氨基葡萄糖苷酶水平高于非高凝组(P<0.05);高凝组患儿肾脏病理分级为Ⅲ~Ⅳ级、弥漫性系膜增生、毛细血管内皮细胞增生、肾小球新月体形成>25%比例高于非高凝组(P<0.05)。多因素logistic回归分析结果显示,毛细血管内皮细胞增生、肾小球新月体形成>25%是IgAVN患儿高凝状态形成的影响因素(P<0.05)。结论伴高凝状态IgAVN患儿的肾损伤更为严重,肾小球新月体形成>25%和毛细血管内皮细胞增生是进一步加重IgAVN高凝状态的重要因素。
文摘乙肝病毒相关性肾炎(hepatitisBvirus-associated glomerular nephritis,HBV-GN)是指由乙型肝炎病毒(hepatitis B virus,HBV)直接或间接诱发的肾小球肾炎,中国是乙型肝炎的高发国家。据数据统计,中国成年人HBV携带率高达10%以上,其中HBV-GN的发生率约为9.0%[1]。针对HBV-GN目前临床尚无特效疗法,单纯核苷酸类似物治疗大量蛋白尿HBV-GN的尿蛋白缓解率低[2],临床疗效并不理想。目前通过糖皮质激素、免疫抑制剂类药物来改善患者的临床症状,控制病情进展,但实践证实,长期应用则会加速HBV复制[3]。近年来,随着临床对HBV-GN研究的不断深入,临床上常应用恩替卡韦进行抗病毒治疗,尽管有效抑制了HBV的复制,但还需联合应用糖皮质激素来减少尿蛋白,控制病情进展[4],但目前激素应用的剂量、疗程未见详细报道。现报道潍坊医学院临床医学院采用小剂量糖皮质激素联合恩替卡韦治疗3例乙肝相关性肾炎的成功案例,现报道如下。
文摘目的分析肾炎康复片结合氯沙坦钾片治疗慢性肾小球肾炎的临床疗效及对IL-1β、IL-1及VEGF水平的影响。方法选择2016年11月—2019年12月医院收治的慢性肾小球肾炎患者85例,依据治疗方式的不同分为观察组43例和对照组42例,对照组患者入院后给予口服氯沙坦钾片治疗。观察组患者在对照组治疗的基础上,口服肾炎康复片治疗。两组均连续治疗3个月。在治疗期间均低盐、低脂、低蛋白饮食。比较两组治疗疗效;比较两组患者临床症状改善时间;比较两组治疗前后血压、肾功能指标;比较两组治疗前后尿RBC、尿β2-MG和24 h Upro水平,比较两组治疗前、治疗3个月后血清IL-1β、IL-1及VEGF水平。结果观察组治疗总有效率为86.05%,显著高于对照组治疗总有效率的64.29%(P<0.05);观察组患者恶心呕吐时间、浮肿消失时间、疲惫消失时间均较对照组短(P<0.05);观察组治疗后SBP、DBP、BUN、Scr水平低于对照组,Alb水平高于对照组(P<0.05);观察组治疗后尿RBC、尿β2-MG和24 h Upro水平对照组(P<0.05);观察组治疗3个月后血清IL-1β、IL-1及VEGF水平低于对照组(P<0.05)。结论肾炎康复片结合氯沙坦钾片治疗慢性肾小球肾炎效果显著,可有效的改善临床症状,控制血压,减轻肾脏的免疫炎症损伤,延缓肾损伤进程减少蛋白尿,值得临床进一步研究探讨。
