ปีที่ ๓๒ ฉบับที่ ๓ กรกฎาคม-กันยายน ๒๕๕๐

The Journal of the Royal Institute of Thailand °“√´à Õ¡·´¡‚√§À≈Õ¥‡≈◊ Õ¥„πºŸâ ªÉ «¬‚√§‰µ‡√◊È Õ√— ß Vol. 32 No. 3 Jul.-Sep. 2007 568 §«“¡º‘ ¥ª√°µ‘ ¢Õߪ√‘ ¡“≥ ‡≈◊ Õ¥À≈à Õ‡≈’È ¬ß‰µ à «π‡´≈≈å ∫ÿ ∑à Õ‰µ Õ¬à “ßµà Õ‡π◊Ë Õß„πºŸâ ªÉ «¬‚√§‰µ‡√◊È Õ√— ß ‡ªì πªí ≠À“„À≠à ∑’Ë ‰¡à “¡“√∂·°â ‰¢ ‰¥â Õ¬à “ß‡∫Á ¥‡ √Á ® „πºŸâ ªÉ «¬‚√§‰µ ‡√◊È Õ√— ß∑ÿ °§π ºŸâ ªÉ «¬‚√§‰µ‡√◊È Õ√— ß∑’Ë ¡’ °“√∑”ß“π¢Õ߉µæ√à Õ߉¡à ¡“° (adequate renal functional reserve) ‡ªì πºŸâ ªÉ «¬°≈ÿà ¡‡¥’ ¬«∑’Ë Õ“®‰¥â √— ∫º≈ ª√–‚¬™πå ®“°°“√√— °…“ªÑ Õß°— π¥â «¬ ¬“ÕÕ°ƒ∑∏‘Ï ¢¬“¬À≈Õ¥‡≈◊ Õ¥À≈“¬ µ— «√à «¡°— π ‡æ√“–ºŸâ ªÉ «¬¥— ß°≈à “«¡’ ‡π◊È Õ‰µ∑’Ë ¥’ Õ¬Ÿà ‡À≈◊ Õ‡æ’ ¬ßæÕ Õ’ °∑—È ß °√–∫«π°“√´à Õ¡·´¡À≈Õ¥‡≈◊ Õ¥ ¬— ߇ ’ ¬À“¬‰¡à ¡“° ·µà ºŸâ ªÉ «¬‚√§‰µ °≈ÿà ¡¥— ß°≈à “«µâ ÕßÕ“»— ¬«‘ ∏’ °“√µ√«® ∑’Ë æ‘ ‡»…πÕ°‡Àπ◊ Õ®“°°“√µ√«® ∑—Ë «‰ª ´÷Ë ß‰¡à “¡“√∂§— ¥°√ÕߺŸâ ªÉ «¬ ‚√§‰µ¥— ß°≈à “«·µà ‡π‘Ë π Ê ‡æ√“–°“√ µ√«®‚¥¬«‘ ∏’ ∑—Ë «‰ª¥— ß°≈à “«µ√«® §— ¥°√Õ߉¥â ‡¡◊Ë ÕºŸâ ªÉ «¬¡’ °“√∑”≈“¬ ‡π◊È Õ‰µ‰ª¡“°°«à “√â Õ¬≈– ı ·≈â « ‡æ√“–©–π—È π °“√µ√«®°“√∑”ß“π ¢Õ߉µ‚¥¬«‘ ∏’ ∑—Ë «‰ª¡— °µ√«®æ∫ ºŸâ ªÉ «¬∑’Ë ‰µ∂Ÿ °∑”≈“¬Õ¬à “ß°«â “ß ¢«“ß ºŸâ ªÉ «¬¥— ß°≈à “«¡— °¡’ §«“¡ º‘ ¥ª√°µ‘ „π°√–∫«π°“√´à Õ¡·´¡ À≈Õ¥‡≈◊ Õ¥Õ¬à “ß™— ¥‡®π °“√√— °…“ ¥â «¬¬“ÕÕ°ƒ∑∏‘Ï ¢¬“¬À≈Õ¥‡≈◊ Õ¥ √à «¡°— ∫°“√√— °…“¥â «¬¬“Õ◊Ë π Ê „π ºŸâ ªÉ «¬∑’Ë ¡’ ‡π◊È Õ‰µª√°µ‘ ‡À≈◊ Õ®”π«π ®”°— ¥ (limited renal functional reserve) ¡— °‰¡à ª√– ∫º≈ ”‡√Á ® ‡π◊Ë Õß®“°ª√‘ ¡“≥À≈Õ¥‡≈◊ Õ¥∑’Ë ¬— ß ∑”ß“πª√°µ‘ Õ¬Ÿà ‡À≈◊ Õπâ Õ¬‡°‘ π°«à “ ∑’Ë ®–™à «¬ π— ∫ πÿ π°“√∑”ß“π„Àâ ‡æ’ ¬ßæÕ°— ∫§«“¡µâ Õß°“√¢Õß√à “ß°“¬ ‰¥â °“√´à Õ¡·´¡À≈Õ¥‡≈◊ Õ¥„π ºŸâ ªÉ «¬‚√§‰µ‡√◊È Õ√— ߥ— ß°≈à “«‰¡à “¡“√∂ °√–∑”‰¥â ‡π◊Ë Õß®“°¢“¥ªí ®®— ¬ ”§— ≠ „π°“√´à Õ¡·´¡ Õ“∑‘ ‡´≈≈å µâ π °”‡π‘ ¥¢Õ߇´≈≈å ∫ÿ º‘ «„πÀ≈Õ¥‡≈◊ Õ¥ °“√¢“¥ VEGF °“√‰¡à “¡“√∂º≈‘ µ ‰π∑√‘ °ÕÕ°‰´¥å ‰¥â ‡æ’ ¬ßæÕ ∑“ßÕÕ° ”À√— ∫°“√√— °…“ºŸâ ªÉ «¬‚√§‰µ‡√◊È Õ√— ß ¢—È π ÿ ¥∑â “¬¥— ß°≈à “«∑’Ë §π∑—Ë «‰ª„Àâ §«“¡ π„®°— πÕ¬Ÿà §◊ Õ °“√√— °…“¥â «¬ ‡´≈≈å µâ 𰔇𑠥¢Õ߇´≈≈å ∫ÿ º‘ «„π À≈Õ¥‡≈◊ Õ¥ °“√√— °…“°√–∑”‚¥¬ π”‡≈◊ Õ¥¢ÕߺŸâ ªÉ «¬‚√§‰µ‡√◊È Õ√— ß¡“ ‡æ“–‡≈’È ¬ß„π∑’Ë ‡æ“–‡≈’È ¬ß∑’Ë ¡’ Õ“À“√ ·≈–ªí ®®— ¬®”‡ªì πµà Õ°“√·∫à ßµ— «·≈– ‡µ‘ ∫‚µ¢Õ߇´≈≈å µâ 𰔇𑠥¢Õ߇´≈≈å ∫ÿ º‘ «„πÀ≈Õ¥‡≈◊ Õ¥Õ¬à “ß‡æ’ ¬ßæÕ ‡ ¡◊Ë Õ ‰ ¥â ®” π«π ‡ ´≈ ≈å ¡ “ °µ “ ¡∑’Ë µâ Õß°“√§◊ Õ Ò-Ò ≈â “π‡´≈≈å / ¡‘ ≈≈‘ ≈‘ µ√ π”¡“©’ ¥°≈— ∫‡¢â “√à “ß°“¬ ¢ÕߺŸâ ªÉ «¬ °“√»÷ °…“„πºŸâ ªÉ «¬‚√§ ‰µ‡√◊È Õ√— ß°≈ÿà ¡Àπ÷Ë ßª√–¡“≥ Ú °«à “√“¬ ∑’Ë ¡’ Õ— µ√“°√Õß “√‡©≈’Ë ¬ Û + ¡‘ ≈≈‘ ≈‘ µ√/π“∑’ /Ò.˜Û µ“√“ß ‡¡µ√ °”≈— ß√Õª√–‡¡‘ πº≈°“√»÷ °…“ Õ¬Ÿà . ‡Õ° “√Õâ “ßÕ‘ ß Ò. Brown WW, Peters RM, Ohmit SE, Keane WF, Collins A, Chen SC, et al. Early detection of kidney disease in community settings : The kidney early evaluation program (KEEP). Am J Kid- ney Dis 2005; 42: 22-35. Ú. Futrakul N, Butthep P, Futrakul P. Biomakers of endothelial injury in focal segmental glomerulosclerotic nephrosis. Ren Fail 2005; 27: 393-395. Û. Ong-Ajyooth L, Ong-Ajyooth S, Parichatikanond P. Oxidative stress and antioxidants in idiopathic IgA nephropathy. Intern Med J Thai 2003; 19: 212-217. Ù. Ong-Ajyooth L, Ong-Ajyooth S, Tiensong K, Nilwarangkur S. Reduced free radi- cal scavenger and chronic renal failure. J Med Assoc Thai 1997; 80: 101- 108. ı. Ong-Ajyooth L, Ong-Ajyooth S, Sirisalee K, Nilwarangkur S. Lipoproteins and lipid peroxidation abnormalities in patients with chronic renal disease. J Med Assoc Thai 1996; 79: 505-512. ˆ. Ong-Ajyooth L, Ong-Ajyooth S, Likid- lilid A, Chantachum Y, Shayakul C, Nilwarangkur S. Role of lipid peroxi- dation, trace elements and antioxidant enzyme in chronic renal disease patients. J Med Assoc Thai 1996; 79: 791- 800. ˜. Futrakul N, Tosukhowong P, Patumraj S, Siriviriyakul D, Tipprukmas N, Futrakul P. Treatments of hemodynamic maladjustment and oxidative stress prevent renal disease progression in chronic glomerulonephritides. Ren Fail 2003; 25: 839-844. ¯. Futrakul N, Panichakul T, Butthep P, et al. Ganaderma lucidum suppresses endothelial cell cytotoxicity and pro- teinuria in persistent proteinuric focal segmental glomerulosclerosis (FSGS) nephrosis. Clin Hemorheol Microcirc 2004; 31: 267-272. ˘. Futrakul N, Sila-asna M, Futrakul P. Therapeutic strategy towards renal re- gression in chronic kidney disease. Asian Biomedicine (in press).