目的 本研究旨在探讨老年肾功能不全继发脑血管疾病患者肾功能与头颅MR特征性改变的相关性以及患者头颅MR信号改变的影响因素。方法 选择2015年4月—2016年4月我科住院的老年脑血管病患者103例,依据简化MDRD方程计算eGFR水平将患者进行分组,通过比较分析肾功能不全患者与对照组头颅MR腔隙灶、脑白质高信号的差异性,应用统计学分析方法,探讨老年脑小血管疾病MR病变程度与肾功能、年龄、血压等的相关性,从而推测肾功能不全患者继发脑血管疾病的危险因素。结果 本研究患者的平均年龄(84.23±4.92)a,按eGFR<60 mL·min^-1·1.73 m^-2定义为肾功能不全组52例,肾功能正常组51例。组间患者腔隙灶数目、脑白质高信号评分、混合病变与否差异有统计学意义(P<0.05)。Logistic回归分析头颅MRI发生混合病变与年龄、高血压基础病、肾功能不全与否存在相关关系,且均为正相关。结论 ①肾功能不全与头颅MRI的混合病变及严重脑白质高信号改变呈正相关,肾功能不全可反映头颅MRI的混合病变及脑白质高信号的严重程度。②年龄、高血压是脑小血管病的危险因素。

Objective To investigate the correlation of cranial MRI with renal insufficiency in elderly CVD patients, and find the risk factor of CVD. Methods 103 elderly patients with cerebrovascular disorder between April 2015 and April 2016 were identified in Guangzhou first people's hospital. Participants were grouped by the simplified MDRD equation based on eGFR levels, to confirm imaging results by detailed examination of cranial MRI. Lacunar lesions and White-matter hyperintensity were accessed and compared between renal dysfunction group and controlled group to identify the differences. Through statistical analysis, risk factors to cerebrovacular disease were considered. Results In the 103 elderly patients, the mean age of (84.23±4.92),had being divided into two groups according to eGFR< 60 ml·min^-1·1.73 m^-2:renal insufficiency group (n=52) and normal renal function group (n=51).There were statistical significance in the number of lacunar lesions,score of white-matter hyperintensity,mixed lesions between groups(P<0.05). Logistic regression analysis showed a positive correlation between age, hypertension and renal insufficiency. Conclusion ①Renal insufficiency is positively correlated with the mixed lesions and severe white-matter hyperintensity in cranial MRI,and could reflect its severity. ②Age and hypertension were risk factors for cerebral small vessel diseases.

目的 探讨儿童肾病综合征(NS)的红细胞分布宽度(RDW)与肾功能损害的关系。方法 收集168例NS患者作为观察组,根据eGFR分期分为三组,按照起病时长4月为界限分为两组;选健康儿童100例为对照组。检测各组血常规、肝肾功能等,采用SPSS 21.0软件进行统计分析。结果 ①与对照组相比,NS患儿的RBC[(4.86±0.69)vs(4.32±0.48)],RDW[(13.39±1.69)vs(12.99±1.04)]升高,差异有统计学意义(P<0.05);②RDW在肾功能3期(14.60±1.36)较2期(12.84±0.79)升高,在起病时长≤4月患儿(13.66±1.78)较健康儿童(12.99±1.04)上升,差异有统计学意义(P<0.05);红细胞平均容积(MCV)在起病时长≤4月较对照组下降,起病时间>4月组较起病时长≤4月上升,差异有统计学意义(P<0.05)。结论 儿童NS患者的RBC、RDW较健康儿童升高,RDW在肾功能3期较2期升高。

Objective To investigate the relationship between red cell distribution width(RDW) and renal function damage in children with nephrotic syndrome(NS). Methods 168 NS patients were chosen as the observation group, divided into three groups by eGFR level, while also divided into two groups by onset duration of 4 months. 100 healthy children were included as the control group. The blood routine, biomedical function of liver and kidney were detected. Data were analyzed by SPSS 21.0. Results ① Compared to control group, NS patients have higher levels of RBC[(4.86±0.69) vs (4.32±0.48)] and RDW[(13.39±1.69) vs (12.99±1.04)], P<0.05; ② RDW is higher in the third phase of renal function than the second [(14.60±1.36) vs(12.84±0.79)], and also higher in the onset duration of less than 4 months group than the control group [(13.66±1.78) vs (12.99±1.04)], P<0.05; Mean corpuscular volume is lower in the onset duration group of less than 4 months than the control group, and higher in the onset duration group more than 4 months than the onset duration group of less than 4 months, P<0.05. Conclusion The RBC, RDW are higher in children NS patients than in the healthy children; RDW is higher in the third renal function than the second renal function.

目的 分析复方丹参注射液对轻度子痫前期患者肾功能与妊娠结局的影响。方法 对照组:在1000 mL浓度为5%的葡萄糖注射液中加入60 mL浓度为25%的硫酸镁,每天静滴1次,以连续静滴5 d为一个疗程;观察组:在250 ml浓度为5%的葡萄糖注射液中加入20 mL复方丹参注射液行静脉滴注治疗,每天静滴1次,以连续静滴5 d为一个疗程。结果 观察组的总有效率为96.88%,对照组为78.13%,观察组高于对照组,两组存在差异(P<0.05)。结论 为了有效改善轻度子痫前期患者的妊娠结局及预后,建议在临床中推广使用复方丹参注射液。

Objective The Objective of the investigation was to study how compound danshen injection(CDI)affected the kidney function and pregnant outcomes of patients diagnosed as mild preeclampsia. Methods Samples are randomly divided into two groups:observation group,in which patients were treated with magnesium sulfate,and control group,in which patients were treated with Danshen injection. Results In control group the treatment showed valid effect in 78.13% of the patients,and in observation group the ratio was 96.88%, which was remarkably higher. Conclusion To improve the pregnant outcomes and prognosis of mild preeclampsia,compound danshen injection should be recommended during the clinical practice.

       目的   血清同型半胱氨酸（Hcy）水平与慢性肾脏病（CKD）的进展相关，但中年人群的非线性关联研究较少，本研究旨在寻找慢性肾脏病危险因素。方法   本研究基于NHANES 1996—2006年数据，纳入5 361例45~65岁参与者，以估算肾小球滤过率（eGFR）＜60 mL/（min·1.73 m² ）和尿白蛋白/肌酐比值（uACR）≥30 mg/g评估肾功能下降。结果   通过逻辑回归及平滑曲线拟合分析发现，Hcy每升高1 µmol/L，eGFR降低的风险增加8%（OR=1.08，95%CI：1.06~1.10），uACR升高的风险增加2%（OR=1.02，95%CI：1.00~1.04）。非线性分析显示，Hcy对eGFR的阈值效应拐点为13.4 µmol/L（拐点左侧OR=1.59，95%CI：1.49~1.70；右侧无显著关联）。亚组分析表明，性别、高血压、糖尿病等协变量无交互作用，然而，在敏感性分析中，糖尿病患者中Hcy与eGFR降低的关联更强（交互P=0.015 8）。结论   本研究提示，控制Hcy水平或可延缓美国中年人群（尤其是糖尿病患者）的肾功能衰退。

        Objective   Elevated serum homocysteine（Hcy）levels are linked to chronic kidney disease（CKD）progression，yet the nonlinear relationship in middle-aged populations remains underexplored．Methods  This  study analyzed data from 5 361 participants aged 45–65 years in the NHANES 1996–2006 cohort．Renal dysfunction was defined as an estimated glomerular filtration rate（eGFR）＜60 mL/min/1.73 m²  and urinary albumin-to-creatinine ratio（uACR）≥30 mg/g．Results  Logistic regression and smoothed curve fitting revealed that each 1 µmol/L increase in Hcy elevated the risk of reduced eGFR by 8%（OR=1.08，95% CI：1.06–1.10）and uACR by 2%（OR=1.02，95% CI：1.00–1.04）．A nonlinear threshold effect was identified at 13.4 µmol/L，with a stronger association below this threshold（OR=1.59，95% CI：1.49–1.70）and no significant effect above it．Subgroup analyses showed no interactions with gender or hypertension，but a stronger Hcy-eGFR association was observed in diabetics（interaction P=0.0158）．Conclusions  These findings suggest that controlling Hcy levels may mitigate renal decline，particularly in diabetic populations，warranting further causal investigations．