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«“√ “√ √“™∫— ≥±‘µ¬ ∂“π ªï ∑’Ë Ú˜ ©∫— ∫∑’Ë Ò ¡.§.-¡’ .§. ÚıÙı π√‘ “ øŸ µ√–°Ÿ ≈ ·≈–§≥– ÒˆÛ „πÀ≈Õ¥‡≈◊ Õ¥º‘ ¥ª√°µ‘ ∑’Ë µ√«®æ∫πà “ ®–‡°‘ ¥®“°°“√‡ ’ ¬ ¡¥ÿ ≈√–À«à “ß “√ Õπÿ ¡Ÿ ≈‡ √’ °— ∫ “√µâ “πÕπÿ ¡Ÿ ≈‡ √’ . °“√ »÷ °…“π’È Õ¥§≈â Õß°— ∫°“√√“¬ß“π„π — µ«å ∑¥≈Õß∑’Ë æ∫«à “ — µ«å ∑’Ë ¡’ “√Õπÿ ¡Ÿ ≈ ‡ √’ ‡æ‘Ë ¡¢÷È πÀ√◊ Õ — µ«å ∑’Ë ¢“¥ “√µâ “π Õπÿ ¡Ÿ ≈‡ √’ ®–¡’ °“√µ“¬¢Õ߇π◊È Õ‰µ Ÿ ß °«à “ª√°µ‘ ¯-ÒÒ . °“√√— °…“ºŸâ ªÉ «¬‚√§‰µ™π‘ ¥ √ÿ π·√ß §«“¡º‘ ¥ª√°µ‘ „π ¡¥ÿ ≈√–À«à “ß “√Õπÿ ¡Ÿ ≈‡ √’ °— ∫ “√µâ “πÕπÿ ¡Ÿ ≈‡ √’ ∑’Ë æ∫„πºŸâ ªÉ «¬‰µÕ— °‡ ∫™π‘ ¥µà “ßÊ ∑’Ë ¡’ §«“¡º‘ ¥ª√°µ‘ „π°“√∑”ß“π¢Õß ‡´≈≈å ∫ÿ º‘ «„πÀ≈Õ¥‡≈◊ Õ¥ ∑”„Àâ §‘ ¥«à “ ∑—È ß ÕßÕ¬à “ßπà “®– — ¡æ— π∏å °— π. Õπÿ π∏‘ ®“°¢â Õ¡Ÿ ≈°“√»÷ °…“¥— ß °≈à “«¢â “ßµâ π∑”„Àâ ‰¥â ¢â Õ √ÿ ª«à “ºŸâ ªÉ «¬ ‚√§‰µ‡√◊È Õ√— ß™π‘ ¥√ÿ π·√ß Õ“∑‘ ºŸâ ªÉ «¬ ‚√§‰µ‡ ◊Ë Õ¡ ¿“æ™π‘ ¥ focal seg- mental glomerulosclerosis ·≈– ºŸ â ªÉ «¬‰µ≈â ¡‡À≈«‡√◊ È Õ√— ß∑— È ßÀ≈“¬ ≈â «π ¡’ §«“¡º‘ ¥ª√°µ‘ À≈— ° Ú ª√–°“√ §◊ Õ °“√¢“¥ “√µâ “πÕπÿ ¡Ÿ ≈‡ √’ ·≈–°“√ ¢“¥ “√ÕÕ°ƒ∑∏‘Ï ¢¬“¬À≈Õ¥‡≈◊ Õ¥, ∑”„Àâ À≈Õ¥‡≈◊ Õ¥À¥µ— «º‘ ¥ª√°µ‘ . ‡æ√“–©–π—È π°“√√— °…“∑’Ë „Àâ º≈ª√–- ‚¬™πå §◊ Õ (Ò) °“√„Àâ “√µâ “πÕπÿ ¡Ÿ ≈ ‡ √’ ‡™à π «‘ µ“¡‘ π´’ ·≈–«‘ µ“¡‘ πÕ’ ·≈– (Ú) °“√„Àâ “√ÕÕ°ƒ∑∏‘Ï ¢¬“¬À≈Õ¥ ‡≈◊ Õ¥ Õ“∑‘ “√¬— ∫¬—È ß‡Õπ´— ¬¡å ª√— ∫ ‡ª≈’Ë ¬π·Õß®‘ ‚Õ‡∑π ‘ π, “√µâ “πµ— « √— ∫·Õß®‘ ‚Õ‡∑π ‘ π Ú, ·≈– “√ °— ¥ °— È π™à Õß∑“ß·§≈‡´’ ¬¡ ‡ªì πµâ π. º≈°“√√— °…“¥â «¬«‘ ∏’ ¥— ß°≈à “«æ∫ «à “ (Ò) √–¥— ∫¢Õß “√Õπÿ ¡Ÿ ≈‡ √’ ≈¥≈ß „π¢≥–∑’Ë “√µâ “πÕπÿ ¡Ÿ ≈‡ √’ Ÿ ߢ÷È π Ÿà √–¥— ∫ª√°µ‘ , (Ú) §«“¡º‘ ¥ª√°µ‘ ¢Õß À≈Õ¥‡≈◊ Õ¥À¥µ— «‰¥â °≈— ∫ Ÿà ¿“«–ª√°µ‘ , ∑”„Àâ §«“¡¥— π¿“¬„πÀ≈Õ¥‡≈◊ Õ¥ΩÕ¬ ‚°≈‡¡Õ√Ÿ ≈— ≈¥≈߇ªì πª√°µ‘ ª√‘ ¡“≥ ‡≈◊ Õ¥‡≈’È ¬ß‰µ‡æ‘Ë ¡¢÷È π, (Û) °“√∑”ß“π ¢Õ߉µ¥’ ¢÷È π : „πºŸâ ªÉ «¬‚√§‰µ‡ ◊Ë Õ¡ ¿“æ §à “°“√™”√–§√’ Õ–µ‘ π’ π‡æ‘Ë ¡®“° π“∑’ ≈– ÙÙ.¯ ± ÚÙ ¡‘ ≈≈‘ ≈‘ µ√/Ò.˜Û µ“√“߇¡µ√ ‡ªì ππ“∑’ ≈– ˆ.ˆ ± ÛÙ ¡‘ ≈≈‘ ≈‘ µ√/Ò.˜Û µ“√“߇¡µ√ À≈— ß °“√√— °…“, ·≈–„πºŸâ ªÉ «¬‰µ≈â ¡‡À≈« ‡√◊È Õ√— ß §à “™”√–§√’ Õ–µ‘ π’ π‡æ‘Ë ¡®“° π“∑’ ≈– Ò˜ ± Ò ¡‘ ≈≈‘ ≈‘ µ√/Ò.˜Û µ“√“߇¡µ√ ‡ªì ππ“∑’ ≈– ÚÛ ± ÒÚ ¡‘ ≈≈‘ ≈‘ µ√/Ò.˜Û µ“√“߇¡µ√ πÕ°®“° π’È °“√»÷ °…“°“√∑”≈“¬‰µ à «πÕ‘ π- ‡µÕ√å µ‘ ‡∑’ ¬¡¢Õ߉µ æ∫«à “„πºŸâ ªÉ «¬ ‚√§‰µ‡ ◊Ë Õ¡ ¿“æ√ÿ π·√ß ·≈–‚√§‰µ ≈â ¡‡À≈«‡√◊È Õ√— ß §à “ FE ·¡°π’ ‡´’ ¬¡ ∑’Ë º‘ ¥ª√°µ‘ ≈¥≈ß®“°√â Õ¬≈– ˜.Ú ± Ú ·≈– ÒÛ ± ˆ.Û ‡ªì π√â Õ¬≈– ı.˜ ± Û ·≈– ÒÒ.Ù ± ˆ µ“¡≈”¥— ∫. ®‘ π¥“, π√‘ “ øŸ µ√–°Ÿ ≈, ∏«— ™™— ¬ ™— ¬«— ≤π- √— µπå , √— ™π’ ‡´Á π»‘ √‘ «— ≤π“, ‚ ¿‘ ™“ ∏√√¡Õ“√’ , ·≈–§≥–. Intrarenal hemodynamic al- ternation and tubular functions in nephrotic syndrome associated with focal segmental glo-merulosclerosis (FSGS) : a pathogenetic and thera- peutic implication. In: Andreucci VE, Dal Canton A, editors. Current therapy in nephrology. Wichtig Editore, Milano 1993; 107-14. Ù. π√‘ “ øŸ µ√–°Ÿ ≈, ‡ “«≥’ ¬å ‡¬Á πƒ¥’ , √— ™π’ ‡´Á π»‘ √‘ «— ≤π“, ‡∑«’ «— ≤π“, ‡Õ¡Õ√ ‡≈“À–- ‰æ∫Ÿ ≈¬å , °ƒ…¥“ «— ≤π“‡æÁ ≠‰æ∫Ÿ ≈¬å , ·≈– §≥–. Peritubular capillary flow de- termines tubulointerstitial disease in idiopathic nephrotic syndrome. Ren Fail 2000; 22: 329-35. ı. π√‘ “ øŸ µ√–°Ÿ ≈, ∑— »π’ ¬å æ“π‘ ™°ÿ ≈, ª√’ ¥“- «√√≥ ™— ¬ ÿ √‘ ¬–, ∂‘ µ ‘ √‘ ‘ ßÀå , ª√– ‘ ∑∏‘Ï øŸ µ√–°Ÿ ≈, ÿ ∑∏‘ ≈— °…≥å ª∑ÿ ¡√“™. Endo- thelial cell cytotoxicity induced by nephrotic serum. In: Proceedings 2nd Congress of the Federation of Im- munological Societies of Asia- Oceania, Bangkok, Monduzzi Editors 2000; 27-31. ˆ. McIntgre M, Bohr DF, Dominiczak AF. Endothelial function in hyper- tension. Hypertens 1999; 34: 539- 45. ˜. Koja G, Hanison D. Interactions Be- tween NO and reactive oxygen spe- cies; pathophysiologic importance in a therosclerosis, hypertension, dia- betes and heart failure. Cardiovasc Res 1999; 43: 562-71. ¯. Diamond JR, Bonventre JV, Karnovsky MJ. A role for oxygen free radicals in aminonucleoside nephrosis. Kidney Int 1986; 29: 478- 83. ˘. Wardle EN. Oxidative processes in glomerulonephritides : additional facts. Nephron 2000; 85: 103-06. Ò. Shah SV. Role of reactive oxygen metabolites in experimental glomeru- lar disease. Kidney Int 1989; 35: 1093-106. ÒÒ. Bahga R, Veda N, Shah SV. Oxi- dant mechanisms in glomerular dis- ease. In: Gonich HC, editor. Cur- rent nephrology. St. Louis, Mosby: 1997. p 135-51. ‡Õ° “√Õâ “ßÕ‘ ß Ò. ª√– ‘ ∑∏‘Ï øŸ µ√–°Ÿ ≈, «‘ »‘ …Øå ‘ µª√’ ™“, ‡ “«- ≥’ ¬å ‡¬Á πƒ¥’ , ¡“§ÿâ ¡§√Õß ‚ª…¬–®‘ π¥“, √— ™π’ ‡´Á π»‘ √‘ «— ≤π“, ‡∑«’ «— ≤π“, ·≈–§≥–. Glomerular endothelial dysfunction determines disease progression : A hypothesis. Am J Nephrol 1997; 17: 533-40. Ú. Baldwin DS. Chronic glomerulone- phritis : non immunologic mechanism of progressive glomerular disease. Kidney Int 1992; 21: 109-20. Û. ª√– ‘ ∑∏‘Ï øŸ µ√–°Ÿ ≈, ¡“§âÿ ¡§√Õß ‚ª…¬–-