Objective To explore the efficacy of alprostadil combined with Bailing capsule in the treatment of early chronic kidney disease. Methods A total of 94 early stage chronic kidney disease patients were selected and divided into treatment group(n=46) and control group(n=48).The patients in control group were treated with Bailing capsule,5 capsules,tid,po.The patients in treatment group were treated with Bailing capsule combined with 2 mL alprostadil in 20 mL 0.9% sodium chloride injection,intravenous injection,qd.The patients were treated for 4 weeks as a course of treatment in both groups.After 2 courses of treatment,the improvement of renal function,the changes in cytokine levels including NK cells and T cell subsets C C$D^{+}_{3}$,C$D^{+}_{4}$,C$D^{+}_{8}$,adverse reactions of two groups were observed. Results The effective rates of the control group and the treatment group were 60.42%,91.30%,respectively(P<0.05).The renal function index 24 h urine protein were(1.15±0.35) g,serum creatinine were(78.52±10.63) μmol·L-1,urea nitrogen were(8.23±1.65) mmol·L-1,all of which were decreased significantly(P<0.05).The levels of NK cells were(21.89±2.73)%,T cell subsets C$D^{+}_{3}$ were(71.02±5.61)%,C$D^{+}_{4}$ were(38.84±3.52)%,C$D^{+}_{4}$/C$D^{+}_{8}$ were(1.28 ± 0.14),which were increased significantly,while the level of C$D^{+}_{8}$ were(30.21±3.03)% was decreased significantly(P<0.05).There was no significant difference between two groups in the adverse reactions(P>0.05). Conclusion The combination of alprostadil and Bailing capsule is effective to early stage chronic kidney disease by improving the renal function and regulating the level of cytokines.
分别对两组早期慢性肾脏病患者的临床治疗情况、肾功能改善情况、细胞因子水平变化情况、不良反应发生情况进行比较和分析。分别于治疗前后采用酶联免疫吸附法测定24 h尿蛋白,采用全自动生化分析仪测定血肌酐和尿素氮。分别于治疗前后采集空腹外周静脉血,采用流式细胞术直接免疫标记技术测定NK细胞和T细胞亚群 C
、C
、C
,并计算 C
/C
比值。
ALICIC RZ,SHORT RA,CORBETT CL,et al.Medica-tion intervention for chronic kidney disease patients transitioning from hospital to home:study design and baseline characteristics[J].Am J Nephrol,2016,44(2):122-129.
Abstract BACKGROUND: The hospital readmission rate in the population with chronic kidney disease (CKD) is high and strategies to reduce this risk are urgently needed. METHODS: The CKD-Medication Intervention Trial (CKD-MIT; www.clinicaltrials.gov; NCTO1459770) is a single-blind (investigators), randomized, clinical trial conducted at Providence Health Care in Spokane, Washington. Study participants are hospitalized patients with CKD stages 3-5 (not treated with kidney replacement therapy) and acute illness. The study intervention is a pharmacist-led, home-based, medication management intervention delivered within 7 days after hospital discharge. The primary outcome is a composite of hospital readmissions and visits to emergency departments and urgent care centers for 90 days following hospital discharge. Secondary outcomes are achievements of guideline-based targets for CKD risk factors and complications. RESULTS: Enrollment began in February 2012 and ended in May 2015. At baseline, the age of participants was 69 11 years (mean SD), 50% (77 of 155) were women, 83% (117 of 141) had hypertension and 56% (79 of 141) had diabetes. At baseline, the estimated glomerular filtration rate was 41 14 ml/min/1.73 m2 and urine albumin-to-creatinine ratio was 43 mg/g (interquartile range 8-528 mg/g). The most frequent diagnosis category for the index hospital admission was cardiovascular diseases at 34% (53 of 155), but the most common single diagnosis for admission was community-acquired acute kidney injury at 10% (16 of 155). CONCLUSION: Participants in CKD-MIT are typical of acutely ill hospitalized patients with CKD. A medication management intervention after hospital discharge is under study to reduce post-hospitalization acute care utilization and to improve CKD management. 2016 S. Karger AG, Basel.
WANGV,VILMEH,MACIEJEWSKI ML,et al.The eco-nomic burden of chronic kidney disease and end-stage renal disease[J].Semin Nephrol,2016,36(4):319-330.
Abstract The growing prevalence and progression of chronic kidney disease (CKD) raises concerns about our capacity to manage its economic burden to patients, caregivers, and society. The societal direct and indirect costs of CKD and end-stage renal disease are substantial and increase throughout disease progression. There is significant variability in the evidence about direct and indirect costs attributable to CKD and end-stage renal disease, with the most complete evidence concentrated on direct health care costs of patients with advanced to end-stage CKD. There are substantial gaps in evidence that need to be filled to inform clinical practice and policy. Published by Elsevier Inc.
PENA-POLANCO JE,FRIED LF.Established and emer-ging strategies in the treatment of chronic kidney disease[J].Semin Nephrol,2016,36(4):311-342.
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KARAH,OZERA,ARPACIH,et al.Effect of alprostadil on erythrocyte deformability in ischemia reperfusion injury[J].Bratisl Lek Listy,2015,116(8):509-511.
Abstract BACKGROUND: Ischemia reperfusion injury (I/R) in lower extremity is a frequent and important clinical phenomenon. Protective effect of alprostadil on local and distant organ injury due to I/R has been well-documented but its effect on erythrocyte deformability needs further investigation. Our aim was to investigate the effect of alprostadil on erythrocyte deformability in infrarenal aorta of rats undergoing I/R. MATERIALS AND METHODS: Our study was conducted with 18 Wistar albino rats. Rats were divided into 3 groups; randomized control group (group C; n=6), I/R group without alprostadil (group I/R; n=6) and I/R group with alprostadil 20 mcg.kg(-1), intraperitoneal (group I/R-A; n=6). Packs of erythrocytes were prepared from heparinized blood samples and deformability measurements were done. RESULTS: Comparisons of the control and I/R-A groups revealed similar results (p=0.240). The values of the IR group were significantly higher than those of the control and IR-A groups (p=0.009, p=0.026, respectively). CONCLUSION: In our study, we detected unfavourable effects of I/R on erythrocyte deformability, which may lead to disturbance in blood flow and hence tissue perfusion in infrarenal rat aorta. We also found that alprostadil had beneficial effects by reversing undesirable effects of I/R (Fig. 1, Ref. 22).
, 周长华, 朱富祥, 吴恒兰
