【摘要】 目的 評價尿蛋白與尿肌酐比值檢測在子癇患者中的診斷意義。 方法 回顧分析 35例子癇患者的臨床資料。患者年齡20~34歲,平均年齡(2681±639)歲;孕周22~34周,平均孕周(2902±419)周。平均血壓(15620±1235 )mm Hg(1 mm Hg=0133 kPa)。均檢測24 h尿蛋白及點時尿檢測尿蛋白與尿肌酐比值,采用線形回歸分析尿蛋白與尿肌酐比值與24 h尿蛋白結果相關性。結果 35例患者24 h尿蛋白水平(351±116) g/24 h,〖JP〗直線回歸分析顯示尿蛋白與尿肌酐比值與24 h尿蛋白水平呈正相關(R=0897,Plt;001)。結論 尿蛋白與尿肌酐比值可能是一個重要的用于子癇患者尿蛋白篩查的指標。【Abstract】 Objective To investigate the diagnostic significance of urinary spot protein:creatinine ratio in Eclampsia.Method Thirtfive pregnant patients suffering from eclampsia with average age of (2681±639) years old were enrolled in this study.All patients were examined both urinary protein over 24 hours and urinary spot protein:creatinine ratio. The correlation between urinary protein over 24 hours to urinary spot protein:creatinine ratio with linear regression were analyzed. Result The rinary protein of 35 patients over 24 hours were (351±116) g/24 h,meanwhile the urinary spot protein:creatinine ratio were (0345±017) g/mmol. With linear regression, urinary spot protein:creatinine ratio had a positive correlation with the data of urinary protein over 24 hours (R=0897,Plt;001). Conclusion The spot protein:creatinine ratio is a reasonable test for detecting proteinuria in eclampsia pregnancy.
The prevalence, incidence, and medical expenses of end-stage renal disease (ESRD) is extremely high in Taiwan, China; so decreasing the incidence of ESRD is a major work for kidney disease prevention in Taiwan, China. Current chronic kidney disease (CKD) guideline suggests multidisciplinary team (MDT) care for CKD patient with estimated glomerular filtration rate (eGFR) less than 30 mL/(min·1.73 m2). MDT includes not only nephrologist but also nursing specialty, dietitian, social worker, psychologist, and other professional personnel. The aim of the MDT care is to preserve renal function, decrease complications, provide nutrient support and nephrotoxic drug consultation, establish the concept of renal replacement therapy and preparation for dialysis access, provide the renal transplantation information, and give the psychosocial support. These cares should provide to CKD patients one year before starting renal replacement therapy. The MDT care for CKD could delay the progression from CKD to ESRD, lower the mortality and hospitalization of CKD, slow the renal function decline, provide better medical care and quality of life for patients, and decrease the medical expenditures. Besides, advanced CKD patients receiving MDT care have higher arteriovenous access preparation rate that prevent the additional intervention and hospitalization while starting dialysis. MDT care also decreases the hospitalization costs and medical expenditures, and decrease 3-year mortality rate after dialysis initiation. The further developing MDT care includes: (1) providing personalized renal care and treatment model, and intergraded care by cardiology-nephrology-diabetes-neurology model; (2) new iCKD care with health management platform and care mode combined with communication technology; (3) shared decision making for choice of renal replacement therapy; (4) advance care planning clinic for palliative treatment of ESRD. All MDT care hopes to establish a person-oriented care policy, provides a better quality care model, not only for the patient’s personalized medical care, but also hopes to improve the overall kidney disease care and prevention work. In addition, we can extend the CKD prevention and treatment experience to other countries worldwide.
【摘要】 目的 探討燈盞花素注射液聯合血管緊張素轉換酶抑制劑（ACEI）依那普利治療糖尿病早期腎病的臨床效果。 方法 2006年10月-2009年12月，將59例臨床確診2型糖尿病早期腎病的患者隨機分為治療組（n=30）與對照組（n=29）。對照組在基本治療的基礎上應用依那普利，治療組在基本治療的基礎上聯合應用依那普利和燈盞花素注射液，療程均為3周。觀察治療前后兩組患者24 h尿微量白蛋白排泄率（UAER）、全血黏度、血漿黏度、甘油三酯（TG）、尿素氮（BUN）、血肌酐（SCr）的變化。 結果 兩組患者治療前后自身對比，24 h UAER均有明顯下降（Plt;0.05）；治療組UAER下降較對照組更為明顯（Plt;0.05）。 結論 ACEI聯合燈盞花素，其降低24 h UAER療效優于單純ACEI療效，還可有效降低全血黏度和血漿黏度，降低纖維蛋白原含量，改善患者血液流變性。【Abstract】 Objective To investigate the therapeutic effects of breviscapine combined with angiotensin converting enzyme inhibitor (enalapril) on early diabetic nephropathy. Methods A total of 59 patients with early diabetic nephropathy diagnosed between October 2006 and December 2009 were randomly divided into treatment group (n=30) and control group (n=29). The patients in treatment group were treated by breviscapine combined with enalapril, while the patients were treated with only enalapril in the control group. All of the patients were treated for three weeks. Urinaryalbuminexcretion (UAE), whole blood viscosity, plasma viscosity, triglycercide, blood urea nitrogen and serum creatinine in the two groups were detected before and after the treatment. Results After the threatment, UAE decreased in both of the two groups compared with the value before the treatment (Plt;0.05); the decrease in treatment groups was more obvious than that in the control group (Plt;0.05). Conclusion The combination of breviscapine and enalapril is effective on early diabetic nephropathy.
