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肝肾联合移植的适应证及时机 被引量:2
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作者 杜国盛 石炳毅 +3 位作者 宋继勇 朱志东 郑德华 崔洪涛 《中国组织工程研究》 CAS CSCD 2013年第5期832-836,共5页
背景:肝肾联合移植以来,肾功能不全甚至肾功能衰竭已不再是肝脏移植的禁忌症。目的:探寻肝肾联合移植适应证及移植时机,以利合理应用稀缺的实体器官供体。方法:收集接受肝肾联合移植患者15例,回顾性分析其移植前状态与移植后移植肾及原... 背景:肝肾联合移植以来,肾功能不全甚至肾功能衰竭已不再是肝脏移植的禁忌症。目的:探寻肝肾联合移植适应证及移植时机,以利合理应用稀缺的实体器官供体。方法:收集接受肝肾联合移植患者15例,回顾性分析其移植前状态与移植后移植肾及原肾恢复情况间的状态。结果与结论:入组15例肝肾联合移植患者均手术顺利,至今存活,随访1.5-8(3.6±1.2)年。入组患者中出现移植肾功能延迟恢复1例,行床旁连续性肾脏替代治疗治疗2周后肾功能逐渐恢复;1例移植前行连续性肾脏替代治疗治疗4周的肝肾综合征患者,移植后2个月行肾图检查提示原肾功能恢复正常;另2例移植前连续性肾脏替代治疗超过6周的肝肾综合征患者,移植后行肾图提示原肾功能未恢复;伴有原发肾病的终末期肝病患者移植前24h尿蛋白>500mg、肾小球滤过率<30mL/min或经穿刺活检证实肾小球硬化率>30%,肝肾联合移植后行肾图提示原肾逐渐失功。移植前行连续性肾脏替代治疗治疗超过6周的肝肾综合征患者,需施行肝肾联合移植;移植前伴有原发肾病的终末期肝病患者,如果24h尿蛋白>500mg、肾小球滤过率<30mL/min或经活检证实肾小球硬化率>30%,需施行肝肾联合移植。 展开更多
关键词 器官移植 肝移植 联合移植 适应证 连续性脏替代治疗 移植时机 功能 尿蛋白 肾小球硬化率 穿刺活检 免疫抑制剂 其他基金
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肾康注射液治疗慢性肾功能衰竭的实验研究 被引量:1
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作者 易明娟 徐涛 +5 位作者 谢子清 郭蓉晓 李娟 叶传蕙 谭亿明 徐万薏 《中药新药与临床药理》 CAS CSCD 1991年第Z1期18-23,共6页
肾康注射液是以黄芪、大黄为主的中药静脉滴注制剂。以6g/kg对5/6肾切除慢性肾衰(CRF)大鼠连续器注8周,可明显降低血尿素氮、肌酐,提高肌酐清除率,改善贫血,可以降低残存肾小球硬化率,减轻肾小管损伤与扩张,从而延缓CRF病理的进展。其... 肾康注射液是以黄芪、大黄为主的中药静脉滴注制剂。以6g/kg对5/6肾切除慢性肾衰(CRF)大鼠连续器注8周,可明显降低血尿素氮、肌酐,提高肌酐清除率,改善贫血,可以降低残存肾小球硬化率,减轻肾小管损伤与扩张,从而延缓CRF病理的进展。其作用机理与改善氮质代谢,改善肾脏微循环,增加肾血流量,增强机体免疫功能等有关,这就为该药治疗CRF的中医治则——“益气活血、化瘀泄浊”提供了现代医学的理论依据。 展开更多
关键词 康注射液 慢性功能衰竭 尿素氮 肌酐 肾小球硬化率
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Association of glomerular filtration rate with arterial stiffness in Chinese women with normal to mildly impaired renal function 被引量:4
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作者 Su-Yan Bian Hong-Yang Guo +6 位作者 Ping Ye Lei-Ming Luo Hong-Mei Wu Wen-Kai Xiao Li-PingQi He-Peng Yu Liu-Fa Duan 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2012年第2期158-165,共8页
Objective Both decreased glomemlar filtration rate (GFR) and arterial stiffness were considered as risk factors for atherosclerosis. Previous studies have suggested the association between central arterial stiffness... Objective Both decreased glomemlar filtration rate (GFR) and arterial stiffness were considered as risk factors for atherosclerosis. Previous studies have suggested the association between central arterial stiffness and the degree of GFR loss. Whether decreased GFR contributes to peripheral artery stiffness remains controversial. Moreover, data analyzed from a cohort of Chinese women are rare. Our aim was to explore the relationship between GFR and regional arterial stiffness in Chinese women. Methods In this cross-sectional study, we randomly recruited 1131 adult women residents with GFR 〉 60 mL/min per 1.73 m2 estimated by the Chinese Modification of Diet in Renal Disease equation from three large communities. Central and peripheral arterial stiffness were estimated simultaneously by measuring carotid-femoral pulse wave velocity (PWVcf) and carotid-radial PWV (PWVcr) using a validated automatic device. Augmentation Index at heart rate 75 beats/minutes (AIx-75) was measured by pulse wave analysis as a composite parameter reflecting both large and distal arterial properties. Results The mean estimated GFR (eGFR) of the study group was 100.05 + 23.26 mL/minute per 1.73 m2. Subjects were grouped by tertiles of eGFR level. PWVef and AIx-75 increased ongoing from the top to the bottom eGFR tertile, while the values of PWVcr were comparable. Both univariate Pearson correlations and multiple stepwise regression analyses showed that eGFR significantly correlated to PWVcf, but not to PWVcr and AJx-75. Conclusions In Chinese women with normal to mildly impaired renal function, decreased eGFR affected carotid-to-femoral rather than carotid-to-radial stiffening. This provides rational to conduct future prospective studies to investigate predictors of atherosclerosis in this population. 展开更多
关键词 Arterial stiffness Augmentation index Pulse wave velocity Glomerular filtration rate Chinese women
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Difference between CKD-EPI and MDRD equations in calculating glomerular filtration rate in patients with cirrhosis 被引量:1
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作者 Yu-Wei Chen Han-Hsiang Chen +3 位作者 Tsang-En Wang Ching-Wei Chang Chen-Wang Chang Chih-Jen Wu 《World Journal of Gastroenterology》 SCIE CAS CSCD 2011年第40期4532-4538,共7页
AIM:To evaluate the difference between the performance of the (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations in cirrhotic patients. METHODS: From Jan 2004 to Oct 2008, 4127 cirrhotic patients wer... AIM:To evaluate the difference between the performance of the (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations in cirrhotic patients. METHODS: From Jan 2004 to Oct 2008, 4127 cirrhotic patients were reviewed. Patients with incomplete data with respect to renal function were excluded; thus, a total of 3791 patients were included in the study. The glomerular filtration rate (GFR) was estimated by the 4-variable MDRD (MDRD-4), 6-variable MDRD (MDRD-6), and CKD-EPI equations.RESULTS:When serum creatinine was 0.7-6.8 mg/dL and 0.6-5.3 mg/dL in men and women, respectively, a significantly lower GFR was estimated by the MDRD-6 than by the CKD-EPI. Similar GFRs were calculated by both equations when creatinine was > 6.9 mg/dL and > 5.4 mg/dL in men and women, respectively. In predicting in-hospital mortality, estimated GFR obtained by the MDRD-6 showed better accuracy [81.72%; 95% confidence interval (CI), 0.94-0.95] than that obtained by the MDRD-4 (80.22%; 95%CI, 0.96-0.97), CKD-EPI (79.93%; 95%CI, 0.96-0.96), and creatinine (77.50%; 95%CI, 2.27-2.63). CONCLUSION: GFR calculated by the 6-variable MDRD equation may be closer to the true GFR than that calculated by the CKD-EPI equation. 展开更多
关键词 Chronic Kidney Disease Epidemiology Col-laboration Estimated glomerular filtration rate LIVERCIRRHOSIS Modification of Diet in Renal Disease Renalfunction
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