1700633968
[14] Cattran DC, Appel GB, Hebert LA, et al. Cyclosporine in patients with steroid-resistant membranous nephropathy: a randomized trial. Kidney Int, 2001, 59(4)
:1484-1490.
1700633969
1700633970
[15] Schieppati A, Perna A, Zamora J, et al. Immunosuppressive treatment for idiopathic membranous nephropathy in adults with nephrotic syndrome. Cochrane Database Syst Rev, 2004, 18(4)
:CD004293.
1700633971
1700633972
[16] Senthil Nayagam L, Ganguli A, Rathi M, et al. Mycophenolate mofetil or standard therapy for membranous nephropathy and focal segmental glomerulosclerosis: a pilot study. Nephrol Dial Transplant, 2008, 23(6)
:1926-1930.
1700633973
1700633974
[17] Chan TM, Lin AW, Tang SC, et al. Prospective controlled study on mycophenolate mofetil and prednisolone in the treatment of membranous nephropathy with nephrotic syndrome. Nephrology, 2007, 12(6)
:576-581.
1700633975
1700633976
[18] Praga M, Barrio V, Juárez GF, et al. Tacrolimus monotherapy in membranous nephropathy: a randomized controlled trial. Kidney Int, 2007, 71(9)
:924-930.
1700633977
1700633978
[19] Li X, Lv R, He Q, Li H, et al. Early initiation of tacrolimus or cyclophosphamide therapy for idiopathic membranous nephropathy with severe proteinuria. J Nephrol, 2008, 21(4)
:584-591.
1700633979
1700633980
[20] E Burgess. Management of focal segmental glomerulosclerosis: evidence-based recommendations. Kidney Int Suppl, 1999, 70
:s26-s32.
1700633981
1700633982
[21] J. Stewart Cameron. Focal segmental glomerulosclerosis in adults. Nephrol Dial Transplant, 2003, 18
:vi45-vi51.
1700633983
1700633984
[22] Korbet SM. Primary focal segmental glomerulosclerosis. In: Brady R, Wilcox C, editors. Therapy in Nephrology and Hypertension: A companion to brenner and Rector’s the kidney. Philadelphia: Saunders, 2003, 223-236.
1700633985
1700633986
[23] Ponticelli C, Edefonti A, Ghio L, et al. Cyclosporin versus cyclophosphamide for patients with steroid-dependent and frequently relapsing idiopathic nephrotic syndrome: a multicentre randomized controlled trial. Nephrol Dial Transplant, 1993, 8(12)
:1326-1332.
1700633987
1700633988
[24] Alexopoulos E, Stangou M, Papagianni A, et al. Factors influencing the course and the response to treatment in primary focal segmental glomerulosclerosis. Nephrol Dial Transplant, 2000, 15(9)
:1348-1356.
1700633989
1700633990
[25] Cattran D, Appel G, Hebert L, et al. A randomized trial of cyclosporine in patients with steroid-resistant focal segmental glomerulosclerosis. North America Nephrotic Syndrome Study Group. Kidney Int, 1999, 56(6)
:2220-2226.
1700633991
1700633992
[26] Meyrier A, Noel L, Auriche P, et al. Long-term renal tolerance of cyclosporin A treatment in adult idiopathic nephrotic syndrome. Collaborative Group of the Societe de Nephrologie. Kidney Int, 1994, 45(5)
:1446-1456.
1700633993
1700633994
[27] Cattran DC, Wang MM, Appel G, et al. Mycophenolate mofetil in the treatment of focal segmental glomerulosclerosis. Clin Nephrol, 2004, 62(6)
:405-411.
1700633995
1700633996
[28] Xia Z, Liu G, Gao Y, et al. FK506 in the treatment of children with nephrotic syndrome of different pathological types. Clin Nephrol, 2006, 66(2)
:85-88.
1700633997
1700633998
[29] Tumlin JA, Miller D, Near M, et al. A prospective, open-label trial of sirolimus in the treatment of focal segmental glomerulosclerosis. Clin J Am Soc Nephrol, 2006, 1(1)
:109-116.
1700633999
1700634000
[30] Nakayama M, Kamei K, Nozu K, et al. Rituximab for refractory focal segmental glomerulosclerosis. Pediatr Nephrol, 2008, 23(3)
:481-485.
1700634001
1700634002
（李夏玉 徐莹）
1700634003
1700634004
1700634005
1700634006
1700634008
内科学新进展 第七章 多器官功能障碍综合征
1700634009
1700634010
摘 要 多脏器功能障碍综合征（MODS）是指机体遭受严重创伤、休克、感染等急性损伤24h后，同时或序贯地出现两个或两个以上系统或器官功能障碍或衰竭，即急性多个器官功能障碍已不能维持内环境稳定的临床综合征。全身炎症反应综合征（SIRS）的症状是MODS的主要临床特征，表现为继发于各种打击全身持续高代谢、高动力循环状态及过度的炎症反应。对于MODS治疗，主要措施是针对器官功能的有效支持。现代的免疫疗法和CRRT技术等方法体现了防治结合的原则，取得一定的效果。
1700634011
1700634012
Abstract Multiple organ dysfunction syndrome（MODS）is defined as the original non-organ dysfunction of the body, in serious infection, trauma, shock, and other damage after 24h at the same time or sequential emergence of two or more systems or organ dysfunction or failure. This is a clinical syndrome that the patient’s organ dysfunction has been unable to maintain a stable environment. Systemic inflammatory response syndrome（SIRS）is the main clinical feature of MODS. It refers to persistently high body metabolism, high circulatory state and excessive inflammatory response secondary to t a variety of fight against the body. The main treatment of MODS is effective support to the organ function. Modern immunotherapy, CRRT, and other technical methods combination of the principle of prevention and treatment and achieve positive results.
1700634013
1700634014
多系统器官功能衰竭（multiple system organ failure, MSOF）是指在疾病演进中有两个或两个以上的脏器或系统序贯性进行性发生功能衰竭。它是一种以高血流动力学和高代谢状态为特征的特殊性临床综合征。一个器官衰竭者的死亡率为30％，两个器官衰竭的为60％，三个器官衰竭的为85％，而四个或四个以上的器官衰竭的死亡率几乎为100％。据美国1992年统计，在美国外科监护病房（ICU）中，治疗平均每例MSOF花费15万美元，但真正能救治成功的例数甚微，死亡人数占整个ICU死亡人数的50％以上。MSOF已成为当今外科ICU患者第一位的死因，也是许多疾病的共同归宿。而近年来提出的多脏器功能障碍综合征（MODS）更强调器官障碍是一个过程，在该综合征演变的早期阶段能得到的及时治疗将有利于改变疾病的预后。
1700634015
1700634016
一、MODS的历史回顾
1700634017
[
上一页 ]
[ :1.700633968e+09 ]
[
下一页 ]