Hu rau: emily.li@wecistanche.com

Lub raum ua haujlwm hauv Acromegaly

PC Eskildsen et al

TSAB NTAWVCreatinine tshem tawm thiab tso zis txhua hnub albumin thiab P2-microglobulin excretion rates (radioimmunoassays) tau ntsuas ntau zaus hauv 14 tus neeg mob acromegaly. Kaum ib tus neeg mob tau kho nrog bromocriptine, 5 txog 55 mg / hnub. Qhov kev ua ntawm tus kab mob no tau soj ntsuam los ntawm kev ntsuas cov zis loj hlob hormone excretion (xov tooj cua-immunoassay).

Cistanche rau kev txhim kholub raum ua haujlwm

Raws li kev pom zoo nrog kev tshawb nrhiav yav dhau los, peb pom qhov kev tshem tawm creatinine nce siab. Txawm li cas los xij, tsis muaj kev sib raug zoo ntawm qhov sib txawv no thiab qhov tso zis loj hlob hormone excretion. Urinary albumin thiab /I2-microglobulin excretion tus nqi tsis txawv ntawm peb cov txiaj ntsig yav dhau los hauv 27 tus neeg laus tswj cov ntsiab lus. Tsis muaj kev sib raug zoo ntawm cov zis loj hlob hormone excretion thiab tso zis albumin los yog &-microglobulin excretion tus nqi. Bromocriptine kev kho mob txo cov zis loj hlob hormone excretion ntawm 220 mus rau 91 ng / 24 teev, p<0.0l, but="" no="" significant="" alterations="" were="" induced="" in="" the="" above-mentioned="">lub raum ua haujlwmsib txawv.

Nws paub zoo tias glomerular filtration rate (GFR),lub raumPlasma flow (RPF), thiabraumQhov loj me yog nce hauv acromegaly (5, 9). Hmoov tsis zoo, tsis muaj cov ntaub ntawv hais txog kev sib raug zoo ntawm cov kev hloov pauv thiab qib ntawm kev loj hlob hormone nce. Tab sis kev tswj hwm ntawm koob tshuaj loj hlob hormone (10 mg / hnub) rau 4 hnub ua rau muaj kev nce hauv GFR thiab RPF (1). Cov kev tshawb pom no thiab kev ua qauv qhia ntawm kev nce ntshav plasma kev loj hlob hormone concentration hauv kev tswj tsis tau zoo ntawm cov menyuam yaus hnub nyoog qis dua (7), coj Mogensen (12, 13) los qhia tias kev loj hlob hormone yog qhov tseem ceeb rau kev nce hauvraumqhov loj thiab kev ua haujlwm feem ntau pom nyob rau hauv cov menyuam yaus uas muaj ntshav qab zib tsawg.

Txhawm rau elucidate kev sib raug zoo ntawm kev loj hlob hormone thiablub raum ua haujlwm, creatinine clearance, urinary albumin, thiab fi2-microglobulin excretion rates raug ntsuas nyob rau hauv cov neeg mob acromegalic uas muaj ntau qhov sib txawv ntawm cov zis loj hlob hormone excretion.

MATERIAL THIAB MUAB

Kaum plaub tus neeg mob acromegalic, 9 tus poj niam thiab 5 txiv neej hnub nyoog 32-75 xyoo (txhais tau tias 55 xyoo) tau tshawb xyuas ntau zaus hauv 7 lub hlis. Kev kuaj mob tau ua raws li cov txheej txheem tau piav qhia dhau los (3). Kaum ib tus neeg mob tau kho nrog bromocriptine (ParlodelB) hauv koob tshuaj 5 txog 55 mg ib hnub (txhais tau tias 20 mg ib hnub). Hauv 7 tus neeg mob, kev kho mob tseem tsis tau pib lossis tsis txuas ntxiv ntawm ib lossis ob qhov kev tshawb nrhiav. Peb tus neeg mob tsis tau kho thaum lub sijhawm tshawb nrhiav. Tsib ntawm cov neeg mob muaj cov ntshav qab zib tsis-insulin-dependant hauv kev tswj cov metabolism hauv kev ua haujlwm zoo (ua kom ntshav qabzib <10.5 mmo="" l,="" glucosuria="">< 3="" g="" 24="" h).="" peb="" tus="" neeg="" mob="" tau="" mob="" ntshav="" siab="" kho="" nrog="" thiazide="" thiab="" propranolol="" lossis="" methyldopa,="" 160-130/105-90="">
Yam tsawg kawg yog ob zaug thaum lub sijhawm soj ntsuam, cov zis tau sau rau ib lub sijhawm 24 teev thiab khaws cia tob tob kom txog thaum kev soj ntsuam. Albumin, µglobulin, thiab kev loj hlob hormone raug ntsuas los ntawm kev siv xov tooj cua-immunoassays (4, 8, 11). Creatinine tau ntsuas nrog cov txheej txheem kuaj pom. Qhov sib txawv ntawm tus kheej hauv cov zis tso zis ntawm creatinine yog qhov nruab nrab 7 O / o, thaj tsam 4-17 feem pua.

Cov txiaj ntsig tau muab piv nrog cov uas tau txais hauv 27 tus neeg laus tswj kev kawm (txhais tau tias muaj hnub nyoog 45 xyoos), siv cov txuj ci zoo ib yam (13). Kev txheeb xyuas kev txheeb xyuas tau ua tiav siv Wilcoxon qhov kev sim rau kev soj ntsuam tsis sib xws thiab ua khub.

Cistanche rau kev txhim kholub raum ua haujlwm

TSEEM CEEB

Fig. I shows the urinary excretion rate of albumin and &-microglobulin plotted against the urinary excretion rate of growth hormone in all urine samples collected from the 14 acromegalic patients. l t clearly appears that no correlation exists between these variables. In spite of an abnormal high urinary growth hormone excretion rate (>100 ng / 24 teev) ntawm ntau tshaj li ib nrab ntawm cov kev tshawb fawb, cov zis albumin tso zis yog nyob rau hauv ib txwm muaj nyob rau hauv yuav luag txhua kis. Qhov siab tshaj plaws albumin excretion tus nqi tau pom nyob rau hauv ib tug poj niam mob ntshav qab zib nrog ib tug urinary GH excretion tus nqi ze rau qhov ib txwm muaj. Cov zis &-microglobulin excretion yog nyob rau hauv ib txwm muaj nyob rau hauv txhua rooj plaub.

Fig. 1. Cov zis tso zis ntawm albumin thiab 2-microglobulin npaj tawm tsam urinary growth hormone excretion hauv 14 tus neeg mob acromegaly, tshawb xyuas los ntawm 2 mus rau 4 zaug. Lub sab sauv ib txwm muaj qhia los ntawm kab dotted. ▲=Acromegalic cov neeg mob ntshav qab zib mellitus

Daim duab 2 qhia tias tsis muaj kev sib raug zoo ntawm creatinine clearance thiab urinary loj hlob hormone excretion tus nqi. Txawm hais tias tus neeg mob lub hnub nyoog nruab nrab ntawm 55 xyoo, qhov creatinine tshem tawm ntawm 2 120 ml / min / 1.73 m * tau pom nyob rau hauv ze li ib nrab ntawm cov kev tshawb fawb.
Table kuv qhialub raum ua haujlwmthiab urinary GH excretion nyob rau hauv xya tus neeg mob ua ntej thiab thaum lub sij hawm kho bromocriptine. Ntxiv 3 tus neeg mob kho nrog ntau koob tshuaj bromocriptine suav nrog hauv lub rooj. Lub sijhawm nruab nrab ntawm ob qhov kev ntsuas yog los ntawm 0.5 mus rau 7 lub hlis, qhov nruab nrab ntawm 3.3 lub hlis. Cov kev kho mob ua rau txo qis hauv cov zis loj hlob hormone excretion, qhov nruab nrab ntawm 91 ng / 24 teev, piv rau qhov nruab nrab ntawm 220 ng / 24 teev ua ntej pib lossis nce kev kho bromocriptine. Qhov txo qis me me tau pom nyob rau hauv ob qho tib si tso zis albumin thiab µglobulin excretion tus nqi thaum kho bromocriptine. Cov zis albumin thiab 82-microglobulin excretion tus nqi tsis txawv ntawm peb cov kev tswj hwm yav dhau los. Creatinine tshem tawm tau nce mus rau ze li qub ua ntej thiab tom qab kho bromocriptine.

Fig. 2. Creatinine clearance plotted tiv thaiv urinary loj hlob hormone excretion nyob rau hauv 14 cov neeg mob acromegaly, soj ntsuam los ntawm 2 mus rau 4 zaug. ▲= cov neeg mob acromegalic uas muaj ntshav qab zib mellitus.

Kev sib tham

Kev tshawb nrhiav tam sim no tau tsim los kawm txog kev sib raug zoo ntawmlub raum ua haujlwmthiab kev loj hlob hormone secretion rate. Peb cov txiaj ntsig hauv acromegaly tsis qhia txog kev sib raug zoo ntawmlub raum ua haujlwmthiab urinary loj hlob hormone excretion. Cov zis albumin thiab 2-microglobulin excretion tus nqi tsis yog qhov tseem ceeb ntawm peb cov kev tswj hwm yav dhau los (14). Hauv kev pom zoo nrog ntau qhov kev tshawb fawb yav dhau los, peb pom GFR nce siab (5, 9). Cov txheej txheem ntawm qhov siab GFR thiab RPF (filtration feem tsis hloov pauv) hauv acromegaly tsis nkag siab tag nrho. Kev loj hlob ntawm cov kua dej extracellular (ECV) thiab cov menyuam yaus tshiab loj tau pom tias yog qhov ua rau (5, 6, 9). GFR thiab RPF muaj kev sib raug zoo nrog ECV hauv cov txiv neej ib txwm thiab cov neeg mob acromegalic (5, 9). Kev loj hlob ntawm cov tshuaj hormones hauv txiv neej rau ob peb hnub nce ECV (10) thiab GFR thiab RPF (1). Lub raum ua haujlwm tsis hloov pauv thaum lub sij hawm luv luv kev loj hlob hormone nce hauv cov txiv neej (15). Txhim kho cov nyhuv ntawm kev loj hlob hormone raulub raum ua haujlwmHauv cov dev tuaj yeem raug tshem tawm yog tias cov tsiaj tau muab tso rau ntawm cov ntsev tsawg (2). Cov kws sau ntawv tau qhia tias sodium tuav thiab nce ECV yog qhov tseem ceeb heev rau cov txiaj ntsig tam sim no. Nws yuav tsum tau hais tias qhov txo qis hauv GFR thiab RPF tom qab hypophysectomy hauv txiv neej tsis cuam tshuam nrog kev hloov pauv tseem ceeb hauv ECV (6). Tsis tas li ntawd, qhov txo qis hauv GFR thiab RPF tau pom tias tshwm sim ntawm tus nqi nrawm dua li qhov txo qis hauv lub raum, qhia tias cov kev hloov pauv tseem ceeb ua haujlwm tsis yog vim qhov txo qis.raumloj (6).

Los ntawm cov kev tshawb fawb saum toj no, nws zoo nkaus li, tsis yog qhov kev tshawb pom ntawm qhov siab pom feem (GFR / RPF) lossis nce tso zis ntau ntxiv ntawm albumin thiab p2-microglobulin feem ntau pom nyob rau hauv cov menyuam yaus uas muaj kev tswj xyuas tsis zoo. Mob ntshav qab zib mellitus (12, 13), tuaj yeem piav qhia raws li kev loj hlob hormone.

Txhim khoLub raum ua haujlwm-Cistanche

TSEEM CEEB

Peb xav qhia peb ua tsaug rau Sandoz, Copenhagen, muab cov bromocriptine (Parlodele).

CEEB TOOM

1, Corvilain, J., Abramow, M. & Bergans, A.: Qee qhov cuam tshuam ntawm tib neeg kev loj hlob hormone ntawm lub raum hemodynamics thiab ntawm tubular phosphate thauj hauv txiv neej. J Clin Invest 41: 1230, 1962.
2, Corvilain, J.: Efftct de I'hormonc de croissance sur I'cxcretion rCrde de phosphates. Acta Clin Vet suppl. 3: 1, 1966, XIV.
3, Ikkildsen, PC, Svendsen, P. Aa., Vang, L. & Nerup, J.: Kev kho mob ntev ntawm acromegaly nrog bromocriptine. Acta Endocr 87: 687, 1978.
4, Evrin, P.-E., Peterson, PA, Wide, L. & Berggsrd, J.: Radioiminunoassay ntawm j32-microglobulin hauv tib neeg cov kua dej lom neeg. Scand J Clin Lab Invest 28: 439, 1971.

5, Falkheden, T. & Sjogren, B.: Extracellular kua ntim thiablub raum ua haujlwmnyob rau hauv pituitary insufficiency thiab acromegaly. Acta Endocr 4G: 80, 1964.
6, Falkheden, T. k Wickbom, J.:Lub raum ua haujlwmthiabraumQhov loj me tom qab hypophysectomy hauv txiv neej. Acta Endocr 45: 348, 1965.
7, Hansen, UA. P.: Cov qauv kev loj hlob hormone hauv cov menyuam yaus mob ntshav qab zib mellitus. Dan Mcd Bull 19, suppl. Ib., 1972.
8, Hanssen, KF: Inimunoreactive loj hlob hormone hauv tib neeg cov zis. Acta Endocr 7 1 : 665, 1978.
9, Ikkos, D., Ljunggren, H. & Luft, R.: Glomerular filtration rate thiablub raumPlasma ntws hauv acromegaly. Acta Endocr 21: 226, 1956.
10, Ikkos, D., Luft, R. k Gemzell, C. A,: Cov nyhuv ntawm tib neeg txoj kev loj hlob hormone hauv txiv neej. Acta Endocr 32: 341, 1959.
11, Milcs, DW, Mogensen, CE & Gundersen, HJG: Radioimmunoassay rau urinary albumin siv ib qho tshuaj tiv thaiv kab mob. Scand J Clin Lab Invest 26: 5, 1970.
12, Moog. CE:Lub raum ua haujlwmthiab glomerular permeability rau macromolecules hauv cov menyuam yaus mob ntshav qab zib. Dan Med Bull 19, suppl. Peb 3, 1972.
13, Mogensen, CE:Lub raum ua haujlwmhloov ntshav qab zib. Ntshav Qab Zib 25: 872, 1976.

14, Parving, H.-H., Worm, AM, Knudsen. I,., Mogensen, CE & Rossing, N.: Urinary albumin thiab j3n-microglobulin excretion rates rau cov neeg mob uas muaj kab mob ntawm daim tawv nqaij. Acta Dermatoven 57: 305, 1977

15, Parving, H.-H., Noer. I., Mogensen, CE k Svendsen, P. Aa.:Lub raum ua haujlwmnyob rau hauv ib txwm txiv neej thaum lub sij hawm luv luv txoj kev loj hlob hormone infusion. Acta Endocr 89: 796. 1978.