{"nowTime30":1785137377870,"lyBarModerator":null,"metaSearch":{"description":"慢性移植肾肾病是肾移植一年后导致移植肾失功的常见病因，目前发生机理尚未完全明确。\n一、慢性移植肾肾病的诊断\n临床表现大部分表现为移植肾功能缓慢下降，伴有进展性蛋白尿和高血压。并影响肾实质的所有成分，包括肾血管、肾小球、肾间质和肾小管。肾血管病变可见血管内膜增厚，内膜下结缔组织聚集，并可见单核细胞、肌","keywords":"慢性肾病中的慢性移植肾肾病的治疗原则_洞医","title":"慢性肾病中的慢性移植肾肾病的治疗原则_洞医","channels":null},"identificate":{"id":"0300b4bddfaf11e6a61c00163e04584d","isDel":0,"createAt":1484985344390,"createBy":"b1a5ca4ddfad11e6a61c00163e04584d","createName":"小海螺","updateAt":0,"updateBy":null,"updateName":null,"userId":"b1a5ca4ddfad11e6a61c00163e04584d","realName":"赵玉","certifiedStatus":2,"phone":"111111111111","email":"2276635444@qq.com","hospitalId":"31c19c1b453011e69d4700163e005165","departmentId":"2000","illName":"","illId":"793a72a2bb5f11e6a61c00163e04584d","cardType":1,"cardImg":"http://01luntan.com/ly_img/1484985951761.jpg","idCardImg":"","identityType":2,"stop":0,"departmentName":"儿科","hospitalName":null},"canEdit":null,"adList":[],"lyBar":{"id":"1696","isDel":0,"createAt":1483439342218,"createBy":"system","createName":"system","updateAt":0,"updateBy":null,"updateName":null,"userId":null,"name":"北京协和医院肾内科","type":101,"twoCode":"http://zhao01.com/zly_img/zly_wx.jpg","image":null,"provinceId":"110000","cityId":"110101","illId":null,"hospitalId":"15009","keyWord":null,"totleTopic":0,"barDesc":null,"discussBarType":null,"metaSearch":"{\"description\":\"洞医为您提供:北京协和医院肾内科电话、北京协和肾内科专家、协和医院肾脏内科病友的治疗经验等相关信息，让您在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"北京协和医院肾内科电话_北京协和肾内科专家_协和医院肾脏内科_洞医\",\"title\":\"北京协和医院肾内科电话_北京协和肾内科专家_协和医院肾脏内科_洞医\"}","adInfo":null},"isLikeThisTopic":null,"lastTopics":[{"id":"2188","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"慢性肾功能衰竭康复期的饮食注意事项","content":"<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　慢性肾功能衰竭康复期的饮食疗法！慢性肾衰竭常常被大众认为就是尿毒症，其实肾功能衰竭并不等于尿毒症，肾功能衰竭期的患者，根据肌酐等检查指标和自身的症状表现等，可以诊断病情处于什么阶段和肾脏损害程度，经过规范的治疗可以阻止血肌酐持续升高，阻断病情发展到尿毒症。实现良性带病生存。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　l、保证热量的需求：这是饮食治疗的前提，因为热量摄入不足可引起蛋白质合成减少和肌蛋白分解增加。热量摄入量一般应为每日125.5&mdash;146.4kl/kg.氮(克);热量(焦)摄入比应为1：250&mdash;400;碳水化合物应占热量摄入的70%左右;脂肪摄入应避免胆固醇含量高的食物，不饱合脂肪酸：饱和脂肪&ge;1&mdash;2。对进食量减少的患者，可适当增加植物油，非糖尿病患者可适当增加糖的摄入以满足热量的需求。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　2、优质蛋白质饮食：益于降低血尿毒氮，减轻慢性肾功能衰竭ZDSEWFRF4T44R4症状;并能减轻肾小球的高滤过和肾小管的高代谢而延缓肾功能恶化的进程;此外限制蛋白质摄入的同时也限制了磷的摄取，有助于减轻继发性甲状腺功能亢进症的程度。蛋白质限制的量根据患者的肾功能有所区别。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　(1)低蛋白质饮食应用需符合下列条件：①降低氮质摄入的同时，必须能免维持氮的平衡;②摄入的饮食中有足够的必需氨基酸，其中高生物价蛋白质应占大部分65%一75%;③含足够热量;④可口可用⑤当无法保证摄取足够热量，或有严重蛋白尿时，不宜采用LPD.</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　(2)低蛋白质饮食应用需注意以下内容：①LPD的应用宜在慢性肾功能不全代偿期(第一期)开始。②不应片面追求血BUN下降.对慢性肾功能衰竭患者来说，过低的BUN和Scr水平，则可能预示预后不良和死亡率增高。③应该看到低蛋白质饮食对透析前期患者的不利影响.一些学者观察到透析前低蛋白质饮食将加重透析时营养不良，增加对感染的易感性。④慢性肾功能衰竭患者食欲减退和肾功能减退程度呈正比，如不适当低蛋白质饮食，则更加营养不良。⑤在蛋白质饮食中，为避免高磷不宜食用蛋黄，肉、鱼等宜水煮后弃水食用。⑥患者对低蛋白质饮食的顺应性较差。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　3、低蛋白加麦淀饮食：麦淀粉是面粉抽去蛋白质后的制品，每100克麦淀粉含蛋白质仅O.25一O.6g(以上海淀粉一厂生产的白鹤牌蛋白质含量最低，仅O.25%)，比大米的2.6%、面粉的9.9%要低得多，但却提供1464.4kJ的热能。此外，土豆、白薯、藕粉、地力、芬丝等均为低蛋白类食品，但以麦淀粉的蛋白含量最低，由于口味差，需在烹调中进行调整。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　4、低蛋白加必需氨基酸(EAA)，如肾安干糖浆：慢性肾功能衰竭患者体内氨基酸代谢紊乱，表现为EAA水平下降而非必需氨基酸常过剩。由于饮食中的蛋白质含EAA不可能&gt;50%，故需补充EAA。适用于：①无明显并发症的CRF患者;②低频度血透患者;③维持性血透伴营养不良者。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　5、低蛋白加&alpha;一酮酸(KAA)，如开同(肾灵)：&alpha;一酮酸是氨基酸的前体，在体内可以转变为氨基酸，故有益于改善慢性肾功能衰竭患者的营养不良，酮酸本身不含氮，不会引起体内氮代谢产物的增多;而且：①对PTH有一定抑制作用，有助于肾性骨病治疗;②能恢复尿毒症时红细胞表面一些酶的活性，有益于延长红细胞的寿命;③能改善尿毒症病人的酸中毒。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　慢性肾功能衰竭康复期的饮食疗法！相信大家对肾病的症状都有一定的了解，当然，知识了解还是不足够的，我们要运用到自己的身上。祝您早日康复哦！</p>\n<p>&nbsp;</p>","barId":"1696","topicTypeId":null,"topicThemeId":"1023","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":5},{"id":"1947","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"慢性肾衰低钙高磷如何护理","content":"<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal; text-align: left;\">　　 &nbsp; 肾衰竭有急性与慢性之分，急性肾衰竭发病突然，可在数天、数周或数月间，肾功能迅速衰竭，并引发其他并发症；慢性肾衰竭是指肾功能慢性衰竭的症状。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\"><strong style=\"color: #333333;\">　　慢性肾衰竭的致病元凶是谁？</strong></p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　1、肾脏疾病：是导致尿毒症发生的最直接和最主要的原因。各类肾病，如没有有效控制病情，最终结局都将是发生尿毒症，如肾小球肾炎、肾病综合征、肾结石、尿路梗阻、肾血管疾病、遗传性肾病、肾肿瘤等。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　2、其他伴随疾病：如糖尿病、高血压、红斑狼疮、过敏性紫癜等，随着病程迁延均可发生肾损害，进一步就可恶化为尿毒症。其中，糖尿病肾病和高血压肾病是最常见和最严重的继发性肾病类型，是此类因素导致慢性肾衰竭发生的主要原因。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　3、药物损伤肾脏而导致尿毒症发生：抗生素、部分抗炎药、医用造影剂、抗肿瘤药物以及部分中药等均属于肾毒性药物，容易对肾脏造成损伤，由此引发尿毒症形成。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\"><strong style=\"color: #333333;\">　　慢性肾功能衰竭的症状</strong></p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　（1）低钠血症：慢性肾衰患者对钠的调节功能差。由于肾小管吸收钠的功能减退，加之一些其他因素，如常服利尿剂、腹泻、长期进食无盐饮食等，易产生低钠血症。由于钠和水的丢失，引起血容量减少。失钠导致肾功能迅速变坏，故低钠常可使一个原来病情比较稳定的患者出现尿毒症状。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　（2）低钙和高磷：由于患者尿碗排出减少，血磷升高。肾衰退时1，25（OH）2D3生成减少加之厌食等原因，肠道吸收钙减少，血钙降低。高血磷、低血钙刺激甲状旁腺素，可致继发性甲状旁腺功能亢进。肾衰时，高血磷要抑制肾不管细胞合成有活性的维生素D-1，25（OH）2D3而导致钙盐沉着障碍，引起肾性骨病。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　（3）低钾血症和高钾血症：由于厌食、呕吐、腹泻及利尿剂的使用，可致低钾血症。慢性肾功能衰竭的症状有哪些？其临床表现是：四肢无力、腹胀、心律失常和腱反射迟钝等。当尿毒症患者并发感染、酸中毒或长期服保钾利尿剂、输含钾多的库存血、或严重少尿时均可致高钾血症。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　（4）代谢性酸中毒：酸中毒是慢性肾衰患者的常风症状。由于肾小管生成氨、排泌氢离子及重吸收重碳酸盐的能力降低，加之腹泻失碱等因素，几乎所有的尿毒症患者都有轻重不同的代谢性酸中毒。轻度代谢性酸中毒一般无明显症状。当CO2-CP&lt;13mmol/L时，才会出现明显症状，如呼吸深大而长、食欲不振、恶心、呕吐、疲乏、头痛、躁动不安，严重者可发生昏迷。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\"><strong style=\"color: #333333;\">　　慢性肾衰竭的护理有哪些</strong></p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\"><strong style=\"color: #333333;\">　　①保持良好的心情</strong></p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　不要有过大的心理压力，压力过重会导致酸性物质的沉积，影响代谢的正常进行。适当的调节心情和自身压力可以保持弱碱性体质，从而预防慢性肾衰竭的发生。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\"><strong style=\"color: #333333;\">　　②生活要规律</strong></p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　慢性肾衰竭的护理有哪些？生活习惯不规律的人，如彻夜唱卡拉OK、打麻将、夜不归宿等生活无规律，都会加重体质酸化。容易患糖尿病。应当养成良好的生活习惯，从而保持弱碱性体质，使肾病远离自己。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\"><strong style=\"color: #333333;\">　　③控制饮食结构</strong></p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　避免酸性物质摄入过量，加剧酸性体质。慢性肾衰竭饮食禁忌？饮食的酸碱平衡对于糖尿病的治疗及并发症的防治是非常重要的一个环节。饮食方面要多吃富含植物有机活性碱的食品，少吃肉类，多吃蔬菜。恰玛古富含植物有机活性碱，能迅速排除体内酸毒，澄清尿液酸毒，从而真正的保护肾脏。不要食用被污染的食物，如被污染的水，农作物，家禽鱼蛋等，要吃一些绿色有机食品，要防止病从口入。远离烟、酒。烟、酒都是典型的酸性食品，毫无节制的抽烟喝酒，极易导致人体的酸化，使得肾病有机可乘。</p>\n<p>&nbsp;</p>","barId":"1696","topicTypeId":null,"topicThemeId":"1022","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":5},{"id":"3654","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"云火活肾对于治疗尿毒症","content":"<p><span style=\"color: rgb(51, 51, 51); font-family: &#39;Hiragino Sans GB&#39;, Helvetica, &#39;microsoft yahei&#39;, simsun, arial; font-size: 14px; line-height: 32px; background-color: rgb(252, 252, 252);\">,69岁。我奶奶一直肾衰竭，最近查出尿毒症.还没开始做血透，看到有中医的云火火肾，想了解一下.我奶奶是否可以接受这个治疗</span></p><p><span style=\"color: rgb(51, 51, 51); font-family: &#39;Hiragino Sans GB&#39;, Helvetica, &#39;microsoft yahei&#39;, simsun, arial; font-size: 14px; line-height: 32px; background-color: rgb(252, 252, 252);\">想了解一下云火活肾治疗尿毒症，尚未做血透</span></p>","barId":"1696","topicTypeId":null,"topicThemeId":"1020","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"5552","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"不仅让你知道解酒的最快方法、更回答你民间的解酒方法靠不靠谱、解酒酶到底好使不好使","content":"<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp; &nbsp;</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">在看了武侠小说萧峰喝了数十碗白酒还面不改色心不跳，我就想知道<strong>解酒的最快方法</strong>、还有民间的<strong>解酒方法</strong>靠不靠谱。在查阅相关医学文献后发现：从酒精的代谢过程来看，所谓&ldquo;靠谱的&rdquo;解酒途径主要分两种：一、延缓酒精在胃肠道的吸收，避免血中乙醇浓度的升高；二、解酒需要增加乙醇脱氢酶和乙醛脱氢酶的数量，或提高它们的活性。</span></p>\n<p style=\"line-height: 200%; text-align: center;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\"><img title=\"不仅让你知道解酒的最快方法、更回答你民间的解酒方法靠不靠谱、解酒酶到底好使不好使\" src=\"http://01luntan.com/ly_img/uimgs/1503042765921.jpg\" alt=\"不仅让你知道解酒的最快方法、更回答你民间的解酒方法靠不靠谱、解酒酶到底好使不好使\" width=\"600\" height=\"449\" /></span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp; &nbsp;</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">上文中的第一点，非常容易做到的：饮酒前垫些食物，能够减缓饮酒的速度，并能稍微减少酒精的吸收，延长酒精代谢时间；在饮酒过程中注意多喝水，让酒精通过尿液排出，补充水分和矿物质。俄罗斯人一般主张在喝伏特加的时候吃些油炸土豆，还是有一定道理的。</span></p>\n<p style=\"line-height: 200%; text-align: center;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\"><img title=\"不仅让你知道解酒的最快方法、更回答你民间的解酒方法靠不靠谱、解酒酶到底好使不好使\" src=\"http://01luntan.com/ly_img/uimgs/1503042243654.jpg\" alt=\"不仅让你知道解酒的最快方法、更回答你民间的解酒方法靠不靠谱、解酒酶到底好使不好使\" width=\"600\" height=\"450\" /></span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">关于第二点，市面的</span> <span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">&ldquo;解酒药&rdquo;基本没有任何作用。乙醇脱氢酶和乙醛脱氢酶的数量和活性是遗传决定的，外源无法补充，并且这些酶类都是一些蛋白质，通过口服，胃酸就让这些药物失去活性。<strong>&ldquo;解酒药&rdquo;让人感到清醒、觉得舒服，主要是因为其中含有利尿、止痛和兴奋的成分，可以缓解头痛、恶心症状，但它们无从真正&ldquo;解酒&rdquo;，反而让肝脏在代谢酒精的同时，来对付这些外来药物，到头来加重肝脏的负担。</strong></span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">民间的&ldquo;酒席宝典&rdquo;：</span></p>\n<p style=\"line-height: 200%; text-align: center;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\"><img title=\"不仅让你知道解酒的最快方法、更回答你民间的解酒方法靠不靠谱、解酒酶到底好使不好使\" src=\"http://01luntan.com/ly_img/uimgs/1503042854496.jpg\" alt=\"不仅让你知道解酒的最快方法、更回答你民间的解酒方法靠不靠谱、解酒酶到底好使不好使\" width=\"600\" height=\"450\" /></span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">碳酸饮料如雪碧：透明的雪碧兑进白酒，是酒桌上常用的&ldquo;障眼术&rdquo;。但是，碳酸饮料富含二氧化碳气体，使胃容积膨胀，增加酒精吸收的面积；并且二氧化碳还能促进酒精进入空肠的速度，增加酒精吸收，所以用碳酸饮料兑酒会使人更易醉酒。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">蜂蜜水：研究提示蜂蜜水中的果糖能使机体摄入的酒精在更短时间内消失，但进一步的研究发现，果糖仅仅是提高了乙醇脱氢酶的效率，而乙醇的产物&mdash;&mdash;对身体危害更大的乙醛&mdash;&mdash;没有丝毫影响。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">非甾体抗炎药如阿司匹林：可以缓解饮酒后的头痛，但对酒精代谢并无任何作用，并且它们和酒精同时摄入，会增加胃出血和肝损伤的风险。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">中草药如葛根汤：葛根是传统医学里提到的解酒良方，部分市面&ldquo;解酒药&rdquo;的成分里就含有葛根，但有研究表明，葛根是乙醛脱氢酶</span><span style=\"font-size: 19px; line-height: 200%;\">2</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">的抑制剂，在大量饮酒后饮用葛根，反而可能增加乙醛相关肿瘤的风险。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">&nbsp; &nbsp;如此看来，酒桌之上，如果没有萧峰的体，又没有段誉的命，还是少饮为妙。找良医网友情提示：饮酒伤身，解酒无方。</span></p>\n<p>&nbsp;</p>","barId":"1696","topicTypeId":null,"topicThemeId":"1019","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":5},{"id":"1616","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"肾盂肾炎患者主要症状","content":"<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　对于肾盂肾炎，大家或许还不是很清楚，这是一种常见的肾脏疾病，在男性和女性当中，发病率都是很高的，但是，哪些症状预示着患了肾盂肾炎呢？这是很多人关心的问题，下面我们就来看看吧。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　肾盂肾炎是指肾脏盂的炎症，大都由细菌感染引起，一般伴下泌尿道炎症，临床上不易严格区分。根据患者临床病程及临床表现，可将肾盂肾炎分为急性及慢性两期，而慢性肾盂肾炎是导致慢性肾功能不全的重要原因。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　肾盂肾炎患者无乱是急性期，还是慢性期，起病多以少尿开始，并且可有前驱症状以及水肿、高血压、肾功能损害等症状。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　<strong style=\"color: #333333;\">1.前驱症状：</strong>大多数肾盂肾炎患者在发病前一个月均有先驱感染史，急性患者起病多突然，慢性患者则呈隐性缓慢起病。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　<strong style=\"color: #333333;\">2.起病：</strong>肾盂肾炎患者多以少尿开始，或逐渐少尿，甚至无尿。可同时伴有肉眼血尿，持续时间不等，但镜下血尿持续存在，尿常规变化与急性肾小球肾炎基本相同。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　<strong style=\"color: #333333;\">3.水肿：</strong>水肿为肾盂肾炎患者常见临床症状，大部分患者在开始少尿时则出现水肿，以面部及下肢为重。水肿一旦出现难以消退。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　<strong style=\"color: #333333;\">4.高血压：</strong>部分患者在起病时便伴有高血压，也有在起病以后过程中出现高血压，一旦血压增高，呈持续性，不易自行下降。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　<strong style=\"color: #333333;\">5.肾功能损害：</strong>患者肾功能损害呈持续性加重，并且肾小球滤过率明显降低和肾小管功能障碍同时存在。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　肾盂肾炎可发生于各种年龄，以育龄妇女最多见，根据患者临床表现可将其分为急性肾盂肾炎以及慢性肾盂肾炎。急性肾盂肾炎患者起病较急骤，病变可为单侧或双侧，局限或广泛，可轻可重，轻者仅累及肾盂粘膜。患者临床上可有泌尿系症状、胃肠道症状等。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　泌尿系症状：急性肾盂肾炎患者有腰痛，多为钝痛或酸痛，程度不一，少数有腹部绞痛，沿输输尿管向膀胱方向放射，体检时在上输尿管点，即腹直肌外缘与脐平线交叉点或肋腰点，即腰大肌外缘与十二肋交叉点有压痛，肾叩痛阳性。患者常有尿频、尿急、尿痛等膀胱刺激症状，这些膀胱刺激症状可先于全身症状出现。儿童患者的泌尿系系症状常不明显，起病时除高热等全身症状外，常有惊厥、抽搐发作。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　胃肠道症状：急性肾盂肾炎患者可出现胃肠道症状，可有食欲不振、恶心、呕吐，个别患者还可出现中上腹或全腹疼痛。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　除此之外，患者还可出现高热、寒战等症状，体温多在38℃~39℃之间，也可高达40℃。热型不一，一般呈弛张型，也可呈间歇或稽留型，伴头痛、全身酸痛。</p>\n<p style=\"margin-top: 0px; margin-bottom: 0px; line-height: 26px; padding: 8px 0px; font-size: 14px; overflow: hidden; font-family: Tahoma, Arial, sans-serif; white-space: normal;\">　　在了解了肾盂肾炎的症状之后，大家一定要格外重视，一旦发现肾盂肾炎的蛛丝马迹，大家一定要趁早到医院就诊，别错过最佳的治疗时机哦，倘若疾病加重，那就不好了。</p>\n<p>&nbsp;</p>","barId":"1696","topicTypeId":null,"topicThemeId":"1016","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":5},{"id":"5554","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"尿毒症透析效果与高血压的相关性","content":"<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp; </span><strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">尿毒症透析</span></strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">效果与高血压的相关性方面非常密切，对肾脏病晚期尿毒症患者而言，高血压患病率具有高、顽固、不易控制三个特点。</span><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">首先我们谈谈正常的血压特点。正常血压在</span><span style=\"font-size: 19px; line-height: 200%;\">120/80mmHg</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">左右，脉压</span><span style=\"font-size: 19px; line-height: 200%;\">30</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">～</span><span style=\"font-size: 19px; line-height: 200%;\">40mmHg</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">。血压波动有昼夜节律，夜间血压最低，晨起活动后迅速上升，在上午</span><span style=\"font-size: 19px; line-height: 200%;\">6</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">～</span><span style=\"font-size: 19px; line-height: 200%;\">10</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">点和下午</span><span style=\"font-size: 19px; line-height: 200%;\">4</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">～</span><span style=\"font-size: 19px; line-height: 200%;\">8</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">点各有一高峰。影响血压波动的因素较多，如活动、饱食、情绪激动、精神紧张、寒冷、失眠、吸烟、饮酒和饮咖啡等都会影响血压的变化。高血压患者应当学会自己在家中监测血压，可以随时取得数值，这种检测结果更接近日常生活状态，结果更可靠。测血压的要求：</span><span style=\"font-size: 19px; line-height: 200%;\">1</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、安静休息</span><span style=\"font-size: 19px; line-height: 200%;\">5</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">∽</span><span style=\"font-size: 19px; line-height: 200%;\">10</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">分钟，坐</span><span style=\"font-size: 19px; line-height: 200%;\">/</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">卧位；</span><span style=\"font-size: 19px; line-height: 200%;\">2</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、袖带须松紧合适，下缘距肘上</span><span style=\"font-size: 19px; line-height: 200%;\">1-2</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">厘米，与心脏水平；</span><span style=\"font-size: 19px; line-height: 200%;\">3</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、放气速度缓慢均匀，声音刚出现时为收缩压（</span><span style=\"font-size: 19px; line-height: 200%;\">SBP</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">）声音消失时为舒张压（</span><span style=\"font-size: 19px; line-height: 200%;\">DBP</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">）</span></p>\n<p style=\"line-height: 200%; text-align: center;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\"><img title=\"尿毒症透析效果与高血压的相关性\" src=\"http://01luntan.com/ly_img/uimgs/1503060448502.jpeg\" alt=\"尿毒症透析效果与高血压的相关性\" width=\"600\" height=\"450\" /></span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">尿毒症透析患者</span></strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">控制血压的意义是什么呢？高血压一般没有症状，但长期高血压可以造成心脏、脑血管、肾脏等内脏器官的损害，一旦出现难以逆转，所以医学界把高血压称为&ldquo;沉默杀手&rdquo;。高血压的危害非常多：增加脑出血风险，可造成中风</span><span style=\"font-size: 19px; line-height: 200%;\">, </span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">痴呆；心脏损害突出，导致高血压性心脏病、心肌梗塞，心力衰竭等；与肾脏损害互为因果，高血压本身可导致肾功能不全；还可加速全身动脉粥样硬化的产生。研究结果表明：心血管的死亡率与血压水平成正比。合理降压可以减少严重并发症的发生；收缩压每降低</span><span style=\"font-size: 19px; line-height: 200%;\">10</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">毫米汞柱，可减低</span><span style=\"font-size: 19px; line-height: 200%;\">56</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">％的中风和</span><span style=\"font-size: 19px; line-height: 200%;\">37</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">％的冠心病发生。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp; &nbsp;</span><strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">尿毒症透析</span></strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">患者血压控制在多少呢？目标血压应个体化，为其可耐受的最低血压，多要求控制在</span><span style=\"font-size: 19px; line-height: 200%;\">130-140/80-90mmHg</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">左右。对于<strong>尿毒症透析</strong>的患者，高血压的治疗是一种综合治疗，需要终生治疗，其内容包括生活方式的改变与危险因素的控制、血液净化治疗、药物治疗、手术治疗等。<strong>尿毒症透析</strong>患者的生活方式改变也非常重要，是成功控制血压的基础和前提，重要程度已经远远超过药物治疗。因此应当重视生活保健。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;&nbsp;</span><strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">尿毒症透析</span></strong><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">患者平时要保持乐观向上的生活态度和稳定的情绪；保持生活起居规律，睡眠充足；肥胖患者要注意控制体重；戒除烟酒等不良嗜好；坚持适量运动，按照循序渐进、持之以恒，量力而行的原则，可以参加慢跑、打太极拳等活动；另外，排便宜选坐位，要多吃粗粮及蔬菜，以防便秘。饮食以清淡为主，避免进食肥腻、刺激性、高胆固醇及腌制的食物，烹调方法应以蒸、滚、氽为主，避免煎炸，少肉多菜，肉类以瘦肉为主，去膏去皮，少盐、少糖、少油，多吃含维生素和纤维素丰富的蔬菜和水果。提高睡眠质量对血压控制也很有意义。可以中午小睡，使全身放松；晚餐宜少，清淡为主；睡前娱乐活动要有节制，不可计较输赢或过于认真激动，不宜长时间看电视；起床宜缓特别对于长期服用降压药的患者，应当缓缓起身，防止过急而晕倒。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">对于少尿或无尿的透析患者，调整透析处方，合理控制体重对控制血压非常有帮助。这类患者的高血压多为容量依赖性，通过降低体重，可以控制</span><span style=\"font-size: 19px; line-height: 200%;\">50-80%</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">的高血压。排除体内过多的水负荷，也是药物治疗的前提。但主要困难是：</span><span style=\"font-size: 19px; line-height: 200%;\">1</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、透析间期体重上升过多，进水过多达不到干体重，透析时患者难以耐受大剂量的超滤</span> <span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">；</span><span style=\"font-size: 19px; line-height: 200%;\"> 2</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、部分患者为保持残余尿量不愿多透。患者充分认识到高血压的危害，饮食上限制盐的摄入（</span><span style=\"font-size: 19px; line-height: 200%;\">2-3</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">克</span><span style=\"font-size: 19px; line-height: 200%;\">/</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">天），限制水摄入，尽量使每日体重上升不超过</span><span style=\"font-size: 19px; line-height: 200%;\">1</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">公斤。过多的水分应当透析时尽量清除，因为残余尿量的保持是以增加心血管系统的负荷为代价的，应当主动配合医生评价并逐渐达到干体重。必要时可以请医生协助调整透析液钠浓度或改变透析剂量、模式。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">当然药物治疗也非常重要，但是应当记住降压不能只靠吃药，药物治疗不是降压治疗的全部，健康生活方式应当贯彻一生。<strong>尿毒症透析</strong>的患者朋友应当注意几个用药的细节问题：</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">1</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、应当规律用药，坚持终身治疗；</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">2</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、尽量选用长效药物；</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">3</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、按照血压波动规律服药，降压药应该在高峰到来之前服用，即早起后和下午</span><span style=\"font-size: 19px; line-height: 200%;\">4-5</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">点服药最好；</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">4</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、吃药别忘了测血压；</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">5</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、没有症状也要吃药，高血压治疗应依据病人的血压水平，而不是症状的有无或轻重。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">几种常用药物的使用注意事项：洛汀新、蒙诺：有良好的心脏保护作用、降压平稳，部分患者可能造成血钾；洛活喜：长效药物，效果肯定，降压平稳，副作用小；缓释异博定：作用强大，长效，但有可能导致心动过缓、心衰，使用中应当监测脉搏；倍他乐克：虽然降压作用较弱，但有心脏保护作用，长期服用效果好，有可能降低心率，注意监测脉搏，不宜突然停药，否则心率加快；心痛定：短效药物、血压波动大，可以短期服用，不宜作为长期用药依赖；哌唑嗪：效果短暂，可能造成体位性低血压，在生活中体位变动应当注意，避免晕倒。</span></p>\n<p>&nbsp;</p>","barId":"1696","topicTypeId":null,"topicThemeId":"1015","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":6},{"id":"4910","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"20岁女子锻炼4小时导致急性肾衰竭 运动过度危害大","content":"<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">　　&ldquo;五一&rdquo;小长假前一天，</span><span style=\"font-size: 19px; line-height: 200%;\">20</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">岁的金慈</span><span style=\"font-size: 19px; line-height: 200%;\">5</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">点半下班后去健身房锻炼。她每天一两个小时的锻炼已持续一个多月，之前也会在家跳跳操、跑跑步。</span></p>\n<p style=\"line-height: 200%; text-align: center;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\"><img title=\"20岁女子锻炼4小时导致急性肾衰竭 运动过度危害大\" src=\"http://01luntan.com/ly_img/uimgs/1496560537881.jpg\" alt=\"20岁女子锻炼4小时导致急性肾衰竭 运动过度危害大\" width=\"400\" height=\"300\" /></span></p>\n<p style=\"line-height: 200%; text-align: center;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">　　&ldquo;想到第二天放假，反正也没有事。&rdquo;于是，没有吃晚饭的金慈刚到健身房，没有热身，就直接上了动感单车，卖力地骑了一个多小时。之后，她跳了一会儿操，就在跑步机上跑了一个小时，另外加上有氧运动，直到晚上</span><span style=\"font-size: 19px; line-height: 200%;\">10</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">点，锻炼了</span><span style=\"font-size: 19px; line-height: 200%;\">4</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">小时，累得不行的她这才停下。&ldquo;健身房里人很多嘛，气氛也超级好，一下子就嗨了。&rdquo;恰好这天，金慈忘了带水杯，喝水不方便，挥汗如雨的她也没顾上喝水。<img title=\"20岁女子锻炼4小时导致急性肾衰竭 运动过度危害大\" src=\"http://01luntan.com/ly_img/uimgs/1496560055588.jpg\" alt=\"20岁女子锻炼4小时导致急性肾衰竭 运动过度危害大\" width=\"400\" height=\"300\" /></span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">　　第二天早晨起床，金慈浑身肌肉酸痛得厉害，觉得自己双腿有些肿，&ldquo;不像那种按下去有个坑的肿，而是肿胀处很硬。&rdquo;第三天，金慈开始恶心、呕吐、吃不下饭，喝了很多水，但小解的次数极少，尿液颜色也很深。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">　　金慈以为自己胃病犯了去了医院，医生做肾功能检查时发现，她的肌酐值已经飙升到</span><span style=\"font-size: 19px; line-height: 200%;\">1100</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">个单位值，&ldquo;高于</span><span style=\"font-size: 19px; line-height: 200%;\">700</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">多，就符合尿毒症的症状了。&rdquo;成都医学院第一附属医院肾病科医生臧丽解释说。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">　　大量补充液体，第一时间做了血液透析和血液滤过。幸运的是，金慈的急性肾衰竭症状得到了缓解，肝脏功能得以恢复。住院</span><span style=\"font-size: 19px; line-height: 200%;\">3</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">周后，金慈肌酐值正常后出院。&ldquo;被堵塞的肾小管重新恢复需要</span><span style=\"font-size: 19px; line-height: 200%;\">3</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">周时间。&rdquo;该院肾病科副主任医师汪力介绍，要是患者再拖下去，肾脏发生不可逆的损伤，即使脱离了生命危险，也极有可能转化成慢性肾衰竭</span></p>\n<p style=\"line-height: 200%; text-align: center;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\"><img title=\"20岁女子锻炼4小时导致急性肾衰竭 运动过度危害大\" src=\"http://01luntan.com/ly_img/uimgs/1496560327504.jpg\" alt=\"20岁女子锻炼4小时导致急性肾衰竭 运动过度危害大\" width=\"400\" height=\"300\" /></span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">关于过度运动有损健康这一问题，看看网友是如果评论的吧：</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">山人：我靠，运动过量会出人命吗，那我只走路了</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">风中浪子：还不如在床上锻炼，没生命危险，唉</span><span style=\"font-size: 19px; line-height: 200%;\">......</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">久伴不离：去年</span><span style=\"font-size: 19px; line-height: 200%;\">261</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">个下蹲遭过的飘过。后遗症严重，运动需慎重</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">绿洲：没带水杯就不喝水？不知道健身房买水喝？每个健身房都有卖水的吧！自作自受！</span></p>\n<p>&nbsp;</p>","barId":"1696","topicTypeId":null,"topicThemeId":"1013","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1}],"pageObj":{"list":[],"list4Map":null,"pageBegin":0,"pageSize":5,"pageNumber":0,"totalPage":0,"totalRow":0},"loginUser":null,"replies":[],"forumUserFans":null,"herfList":[],"only":"0","topic":{"id":"5553","isDel":0,"createAt":1503046598628,"createBy":"b1a5ca4ddfad11e6a61c00163e04584d","createName":"小海螺","updateAt":0,"updateBy":null,"updateName":null,"userId":"b1a5ca4ddfad11e6a61c00163e04584d","title":"慢性肾病中的慢性移植肾肾病的治疗原则","content":"<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp; </span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">慢性移植肾肾病是肾移植一年后导致移植肾失功的常见病因，目前发生机理尚未完全明确。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><span style=\"font-family: 宋体; font-size: 19px; line-height: 200%;\">一、慢性移植肾肾病</span><strong style=\"font-family: 宋体; font-size: 19px; line-height: 200%;\">的</strong><span style=\"font-family: 宋体; font-size: 19px; line-height: 200%;\">诊断</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">临床表现大部分表现为移植肾功能缓慢下降，伴有进展性蛋白尿和高血压。并影响肾实质的所有成分，包括肾血管、肾小球、肾间质和肾小管。肾血管病变可见血管内膜增厚，内膜下结缔组织聚集，并可见单核细胞、肌纤维母细胞浸润、内膜弹力层分层和断裂。血管内皮的炎症损伤是慢性移植肾肾病的初始病变，由此导致内膜进展性增厚及管腔狭窄。免疫荧光可见</span><span style=\"font-size: 19px; line-height: 200%;\">IgG</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">、</span><span style=\"font-size: 19px; line-height: 200%;\">C3</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">和纤维蛋白原沉积，管周毛细血管染色</span><span style=\"font-size: 19px; line-height: 200%;\">C4d</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">可阳性。肾小球病变包括肾小球基底膜增厚，偶见双轨形成类似于膜增殖性肾小球肾炎。其它肾小球病理改变还包括肾小球体积增大，可呈分叶状并可见节段性硬化，严重者可见球性硬化。电镜下可见系膜细胞插入及内皮下电子透亮物沉积，部分病例还可见类似膜性肾病的上皮下沉积。免疫复合物沉积不是移植肾肾小球病的主要表现。肾小管间质病变包括不同程度的间质纤维化、灶状淋巴细胞及浆细胞浸润，可见肾小管萎缩和小管上皮细胞脱落。这些病变为非特异性，除慢性移植肾肾病外还可见于其它疾病如</span><span style=\"font-size: 19px; line-height: 200%;\">CsA</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">或</span><span style=\"font-size: 19px; line-height: 200%;\">FK506</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">肾毒性，慢性移植肾肾病其它病理改变还有肾小管周边毛细血管基底膜断裂和分层。</span></p>\n<p style=\"line-height: 200%; text-align: center;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\"><img title=\"慢性肾病中的慢性移植肾肾病的治疗原则\" src=\"http://01luntan.com/ly_img/uimgs/1503047474510.jpg\" alt=\"慢性肾病中的慢性移植肾肾病的治疗原则\" width=\"600\" height=\"450\" /></span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-family: 宋体; font-size: 19px; line-height: 200%;\">二、慢性移植肾肾病的鉴别诊断</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp; 1</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">．膜增殖性肾小球肾炎：膜增殖性肾小球肾炎型的移植肾肾小球病需与其他病理类型的肾小球疾病，特别是与丙型肝炎病毒感染有关的膜增殖性肾小球肾炎及复发性膜增殖性肾小球肾炎相鉴别。这些疾病光镜下表现相似，在电镜下移植肾肾小球病可见基底膜增厚和双轨征，但常无免疫复合物沉积；丙肝病毒有关的膜增殖性肾小球肾炎可见显著的内皮下免疫复合物沉积。由于移植肾肾小球病的患者也可能有丙肝病毒抗体阳性，因此只根据丙肝病毒抗体阳性不能区分移植肾肾小球病和丙肝相关性</span><span style=\"font-size: 19px; line-height: 200%;\">MPGN</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp; 2</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">．肾间质纤维化：某些免疫抑制剂中毒，如</span><span style=\"font-size: 19px; line-height: 200%;\">CsA</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">或</span><span style=\"font-size: 19px; line-height: 200%;\">FK506</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">肾毒性均可致肾间质纤维化，两者常需鉴别诊断。如组织学上有较特征的肾小球病变或肾小管周围毛细血管基底膜断裂及分层则有助于慢性移植肾肾病的诊断；而新形成的肾小动脉管壁玻璃样变则是</span><span style=\"font-size: 19px; line-height: 200%;\">CsA</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">肾毒性的特征性改变。但慢性移植肾肾病的特征性病变并不常见，而移植肾肾小动脉病变也可能不是新形成的，因此光镜下两者很难鉴别，此外这两种病变也可同时存在。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">三、慢性移植肾肾病的治疗</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp;&nbsp;</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">由于慢性移植肾肾病发生机制复杂，治疗存在一定难度。相应的的大规模、前瞻性、随机、对照研究还不多。只能针对影响慢性移植肾肾病的各个环节，包括免疫性和非免疫性方面予以治疗。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp; 1</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">．免疫抑制治疗：目前临床应用的免疫抑制剂对慢性移植肾肾病治疗作用并不明确，但如果慢性移植肾肾病的原因是由于患者使用免疫抑制剂顺应性较差或减量过快，则可加强免疫抑制治疗。部分患者肾活检发现在慢性移植肾肾病的基础上仍有活动性急性排异反应的证据，对该部分患者应用皮质激素冲击治疗可能有效。另一方面，由于</span><span style=\"font-size: 19px; line-height: 200%;\">CsA</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">或</span><span style=\"font-size: 19px; line-height: 200%;\">FK506</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">具有肾毒性，也可能参与慢性移植肾肾病过程，因此对于</span><span style=\"font-size: 19px; line-height: 200%;\">CsA</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">或</span><span style=\"font-size: 19px; line-height: 200%;\">FK506</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">肾毒性患者，减少这些药物，可能受到有益效果。初步的临床研究发现对无急性排异表现的患者，减少</span><span style=\"font-size: 19px; line-height: 200%;\">CsA</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">或</span><span style=\"font-size: 19px; line-height: 200%;\">FK506</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">剂量，同时加用霉酚酸酯（</span><span style=\"font-size: 19px; line-height: 200%;\">2</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">－</span><span style=\"font-size: 19px; line-height: 200%;\">3g/d</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">），可减慢这些患者肾功能下降的速度。但目前还缺乏相应的临床研究。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">2</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">．非免疫抑制治疗：非免疫抑制治疗包括积极控制血压及降血脂治疗。在各种原发性慢性肾小球肾炎中，血管紧张素转换酶抑制剂（</span><span style=\"font-size: 19px; line-height: 200%;\">ACEI</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">）或血管紧张素</span><span style=\"font-size: 19px; line-height: 200%;\">II </span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">受体拮抗剂</span><span style=\"font-size: 19px; line-height: 200%;\">(ARB)</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">都能有效地降低全身及肾小球毛细血管压，减少尿蛋白的排泄。有临床研究发现</span><span style=\"font-size: 19px; line-height: 200%;\">ACEI </span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">或</span><span style=\"font-size: 19px; line-height: 200%;\">ARB</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">能够降低高血压肾移植患者的尿蛋白排泄率，同时不会对肾脏血液动力学带来不良影响，这种疗法对移植肾失功的长期作用有待进一步研究。</span></p>\n<p style=\"line-height: 200%;\"><span style=\"font-size: 19px; line-height: 200%;\">&nbsp; HMG</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">－</span><span style=\"font-size: 19px; line-height: 200%;\">CoA</span><span style=\"font-size: 19px; line-height: 200%; font-family: 宋体;\">还原酶抑制剂，如他汀类常用于降脂治疗，并可延缓移植物血管病变的进展。其它治疗手段包括抗血小板聚集药物、血栓素拮抗剂、鱼油及低蛋白饮食等，但是对慢性移植肾肾病的疗效还需要随机对照的临床试验来验证。</span></p>\n<p>&nbsp;</p>","barId":"1696","topicTypeId":"1","topicThemeId":"1015","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1890,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1503046598630,"isCream":0,"canReply":0,"shareUrl":null,"foodCouponVal":1,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1503046598630,"metaSearch":null,"rn":null},"userAllInfo":{"id":null,"isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":null,"password":null,"level":0,"nickName":null,"realName":null,"signName":null,"head":null,"phone":null,"mobile":null,"wechat":null,"qq":null,"email":null,"address":null,"identityType":0,"userType":0,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":0,"provinceId":null,"cityId":null,"userLevel":0,"modifyNameCount":0,"forumUser":{"id":"b1a5ca4ddfad11e6a61c00163e04584d","isDel":0,"createAt":1484984778320,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":"小海螺","password":"yiren2921","level":0,"nickName":"小海螺78","realName":null,"signName":"开心每一天","head":"http://01luntan.com/ly_img/1484985295689.jpg","phone":null,"mobile":null,"wechat":null,"qq":null,"email":"2276635444@qq.com","address":null,"identityType":6,"userType":2,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":1,"provinceId":"110000","cityId":"110108","userLevel":0,"modifyNameCount":1},"forumUserActiveInfo":{"id":"b1ba5254dfad11e6a61c00163e04584d","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":1705892489293,"updateBy":"b1a5ca4ddfad11e6a61c00163e04584d","updateName":"小海螺","userId":"b1a5ca4ddfad11e6a61c00163e04584d","topicCount":2201,"replayCount":900,"favorteCount":0,"beFavorteCount":0,"creamCount":2,"focusCount":1,"fansCount":4,"integralCount":2357,"foodCouponCount":0,"lastLoginTime":0,"lastLoginIp":null,"downloadCount":0,"uploadCount":0},"newPass":null,"focusBar":null,"counter":null,"forumUserIdentificateDto":null},"theme":{"id":"1015","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"topicTypeId":"1","topicTypeName":"资讯","themeName":"专家观点","barType":"101","schemaName":2,"reward":0},"page":1,"favorties":true,"isSelf":false,"order":"asc"}