目的:观察以血尿为主要表现的免疫球蛋白A型肾病(immunoglobulin A nephropathy,IgAN)患者使用水蛭素治疗的近期疗效和副作用。方法:选择1998～2007年我科经肾组织活检病理证实的以血尿为主要表现的IgAN患者262例,按口服水蛭素(肠溶脉...目的:观察以血尿为主要表现的免疫球蛋白A型肾病(immunoglobulin A nephropathy,IgAN)患者使用水蛭素治疗的近期疗效和副作用。方法:选择1998～2007年我科经肾组织活检病理证实的以血尿为主要表现的IgAN患者262例,按口服水蛭素(肠溶脉血康胶囊)和潘生丁不同,随机分成水蛭素组和潘生丁组。以尿红细胞形态及计数、24 h尿蛋白定量、血肌酐(serum creatinine,Scr)、内生肌酐清除率(creatinine clearance rate,Ccr)、血脂4项、凝血5项和副作用等为疗效评价指标。结果:两组患者治疗半年后,水蛭素组尿红细胞畸形率与计数和24 h尿蛋白定量均较治疗前显著下降(P<0.01),且显著低于潘生丁组(P<0.05):水蛭素组Ccr较治疗前明显升高,并显著高于潘生丁组(P<0.01);水蛭素组患者的血脂也有改善,但差异无统计学意义;水蛭素抗凝作用明显强于潘生丁(P<0.01)。综合判定,水蛭素组的总有效率、完全缓解率和显著缓解率均显著高于潘生丁组(P<0.01)。两组发生副作用的病例数均较少,水蛭素组胃肠道不良反应的发生率也显著低于潘生丁组(P<0.05)。结论:水蛭素在降低IgAN血尿、蛋白尿和肾脏保护方面比潘生丁更具有优势。展开更多
A rapid and validated UPLC-MS method was developed for investigating the absorbed components of Paederia scandens(Lour.) Merrill(P.scandens) in rat plasma.The bioactive constituents in plasma samples from rats adminis...A rapid and validated UPLC-MS method was developed for investigating the absorbed components of Paederia scandens(Lour.) Merrill(P.scandens) in rat plasma.The bioactive constituents in plasma samples from rats administrated orally with P.scandens extract were analyzed by Ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS).Four prototype compounds were identified in rat serum as potential bioactive components of P.scandens by comparing their retention times and mass spectrometry data or by mass spectrometry analysis and retrieving the reference literatures.Glucuronidation after deglycosylation was the major metabolic pathway for the iridoid glycosides in P.scandens.These results showed that the methods had high sensitivity and resolution and were suitable for identifying the bioactive constituents in plasma after oral administration of P.scandens.providing helpful chemical information for further pharmacological and mechanistic researched on the P.scandens.展开更多
基金supported by the National Natural Science Foundation(Nos.81274013 and 81473315)the National Natural foundationof the major program of China(No.81130069)+1 种基金the Chinese National S&T Special Project on Major New Drug Innovation(No.2011ZX09307-002-01)the program for Changjiang Scholars and Innovative Research Team in University of Ministry of Education of China(No.IRT1140)
文摘A rapid and validated UPLC-MS method was developed for investigating the absorbed components of Paederia scandens(Lour.) Merrill(P.scandens) in rat plasma.The bioactive constituents in plasma samples from rats administrated orally with P.scandens extract were analyzed by Ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS).Four prototype compounds were identified in rat serum as potential bioactive components of P.scandens by comparing their retention times and mass spectrometry data or by mass spectrometry analysis and retrieving the reference literatures.Glucuronidation after deglycosylation was the major metabolic pathway for the iridoid glycosides in P.scandens.These results showed that the methods had high sensitivity and resolution and were suitable for identifying the bioactive constituents in plasma after oral administration of P.scandens.providing helpful chemical information for further pharmacological and mechanistic researched on the P.scandens.
