部分脾栓塞术治疗老年人脾功能亢进

我们自1987年11月至1990年2月采用部分脾栓塞术(PSE)治疗39例肝脏疾病伴脾功能亢进(脾亢),取得较好疗效。现将其中4例60岁以上老年患者治疗情况报告如下。材料和方法一、一般资料男3例,女1例。年龄60～66岁。均为经肝活检病理证实的肝硬化。其中伴腹水2例,食道静脉曲张2例。肝功能均为Child C级。B超示脾面积为80.3～192.9cm~2。骨髓检查为脾亢骨髓象。外周血白细胞平均2.4×10~9/L、血小板平均24×10~~/L、血红蛋白     

脾栓塞治疗免疫性血小板减少性紫癜

采用脾栓塞术治疗13例免疫性血小板减少性紫癜,其中9例于一次或二次脾栓塞后7～22天血小板升至106×10~9/L～295×10~9/L(平均207×10~9/L)。1例伊文斯综合征患者溶血得到改善。本组病例近期有效率69.2%,与手术切脾疗效相近,无严重并发症发生。     

部分脾栓塞术治疗乙肝后肝硬化并脾功能亢进42例

2000年以来,我院对42位脾亢患者行部分脾动脉栓塞(PSE)手术,效果良好,总结如下。 临床资料:42例患者,男30例,女12例,年龄23～60岁。确诊为肝炎后肝硬化(乙型失代偿期)并脾功能亢进。伴食管静脉曲张20例,少量腹水7例。B超脾厚40～69mm,平均57mm。实验室检查:42例血小板均下降(23×10~9/L～80×10~9/L),30例白细胞<4.0×10~9/L,25例红细胞<3.5×10~(12)/L。34例作骨髓穿刺涂片均提示造血细胞增生活跃。 治疗方法:充分做好术前准备。2％利多卡因局麻采用Seldinger氏股动脉穿刺插管,将导管送至腹腔动脉先行腹腔动脉造影,观察脾脏大小、血管分布、走向及脾静脉门静脉有     

脾动脉栓塞治疗肝硬化脾功能亢进15例临床观察

脾功能亢进 (脾亢 )是肝硬化失代偿期的严重并发症之一 ,患者可因脾亢导致血小板、白细胞及血红蛋白减少 ,从而引起出血倾向、抵抗力下降及重症感染 ,危及患者生命。目前有手术脾切除、脾动脉栓塞、超声引导脾内注射硬化剂等方法治疗肝硬化脾功能亢进。我院对 15例患者行部分脾动脉栓塞术 ,经临床观察效果满意 ,现报告如下。1　资料和方法1.1　临床资料　男 13例 ,女 2例 ,年龄 35～ 66岁 ,平均 4 6.3岁。 15例均诊断为肝炎后肝硬化 ,按 Child分级法 ,肝功能属 A级 2例 ,B级 13例。 15例患者白细胞均低于 4 .0× 10 9/L,血小板低于 10 0×…     

部分性脾栓塞治疗肝硬化脾功能亢进的临床分析

目的：探讨部分性脾栓塞术(PSE)治疗肝硬化脾功能亢进的临床价值及并发症。方法：14例肝硬化脾亢患者，均行PSE术。结果：10例患者脾亢缓解，外周血白细胞及血小板升至正常。最常见的并发症是腹痛，发热。14例中3例并发胸腔积液，1例同时并发脾脓肿和胸腔积液，1例并发腹水。结论：PSE术能有效地缓解脾亢，但应注意有严重并发症发生的可能。     

慢性粒细胞白血病急红变自发脾破裂1例

慢性粒细胞白血病(慢粒)急红变少见,并自发性脾破裂更为罕见,现将我院1例报告如下;1 病例介绍 患者,男,63岁,因乏力腹胀2个月,于1986年11月22日入院.查体;一般情况良好.脾助下4cm,WBC34.6×10~9/L,Sg0.58,st0.09,中晚幼粒0.06,E 0.03,B 0.05,Hb 128g/L,BPC189×10~9/L,骨髓增生极度活跃,粒:红为12.3:1,原十早幼粒0、045,中晚幼粒0.51,杆状及分叶核0.245,E 0.025,B 0.044,早幼红0.05,中晚幼红0.06.诊断慢粒.服马利兰牌回缩,血象正常出院,未规律服马利兰症状复发,又于1988及1989年两次住院,用羟基脲(HU)及6—疏鸟嘌呤(6-TG)治疗血象接近正常,症状缓解出院.1990年2月第4次住院,脾助下7cm,WBC20.5×10~9/L,Hb102g/L,BPC89×10~9/L ,骨髓增生明显活跃,粒:红为3.66:1,早幼粒0.035,中晚幼粒0.345,杆状及分叶核0.305,E 0.04,В0.03.原红0.01,早幼红0.015,中晚幼红0.18.予     

40例部分脾动脉栓塞术治疗肝硬化门脉高压、脾功能亢进疗效观察

对门脉高压发病机制的研究及其并发脾功能亢进的介入治疗研究 ,是控制肝硬化并发脾功能亢进而导致血小板、白细胞及血红蛋白减少以及合并出血 ,抵抗力下降导致严重感染而危及生命的有效治疗方法 ,本文对 40例肝硬化 ,门脉高压、脾功能亢进患者进行部分脾动脉栓塞术 ,取得较好疗效。资料与方法一、临床资料男性 2 9例 ,女性 11例 ,年龄 14～ 5 8岁 ,平均 45岁。 40例均为肝炎后肝硬化 ,病程 3～ 2 0年 (平均 9.8年 ) ,白细胞均低于 4.0× 10 9/Ｌ ;血小板低于 10 0× 10 9/Ｌ(最低 2 4× 10 9/Ｌ ,最高5 1× 10 9/Ｌ) ,并有皮肤粘膜出血倾向…     

晚期慢性淋巴细胞白血病伴脾大的脾切除治疗

慢性淋巴细胞白血病 (简称慢淋 )在我国发生率较低 ,在全部白血病中约占 4%。三分之二的患者在 60岁以上。我们曾对 3例晚期慢淋伴有显著脾大患者施行脾切除术 ,效果甚好 ,现报告如下。1　病例报告例 1　男 ,61岁。1 981年 1 1月因乏力在外院发现肝脾肿大 ,血常规异常 ,转来我院。当时白细胞为70× 1 0 9/L,血红蛋白为 1 1 7g/L,血小板为 63×1 0 9/L,经骨髓穿刺等检查确诊为慢淋 ,曾先后服用瘤可宁、CCNU等治疗。 1 990年 4月 1日因脾脏逐渐肿大、腹部胀满、明显贫血而再次入院。体检 :贫血貌 ,双侧锁骨下可触及数个黄豆大小淋巴结。心…     

部分脾动脉栓塞治疗肝硬化脾功能亢进的作用机制

脾功能亢进(脾亢)是由肝硬化、门静脉高压引起的常见并发症，目前临床治疗脾亢的主要方式是脾切除和部分脾动脉栓塞(PSE)。脾切除治疗脾亢效果确切，可显著改善脾亢患者临床症状。相比于脾切除，部分脾动脉栓塞通过栓塞脾动脉分支使部分脾实质梗死，能够达到与部分脾切除术相似的临床疗效，并保留脾脏及脾脏自身功能。虽然PSE是治疗脾亢的有效方法，但是目前国内外关于PSE对肝纤维化、免疫及肝再生影响的研究报道并不多。本文总结了脾亢发生的常见病因、PSE治疗脾亢机制、不同栓塞方法和材料的治疗效果，以及PSE对肝纤维化、免疫及肝再生的影响，为临床脾亢治疗提供理论依据和新的思路。     

TIPS与PSE术治疗乙型肝炎肝硬化并发脾功能亢进症患者疗效研究

目的 研究经颈静脉肝内门体静脉分流术(TIPS)联合部分脾动脉栓塞术(PSE)治疗乙型肝炎肝硬化并发脾功能亢进症患者的疗效。方法 2018年1月～2021年1月我院诊治的乙型肝炎肝硬化并发脾功能亢进症患者72例,随机分为PSE治疗组36例和联合组36例,分别行PSE治疗或PSE联合TIPS术治疗,随访1年。结果 在治疗后1 w,联合组外周血PLT和WBC计数分别为(76.1±25.8)×10⁹/L和(4.2±1.2)×10⁹/L,显著高于PSE治疗组【分别为(45.8±13.7)×10⁹/L和(2.4±0.5)×10⁹/L,P<0.05】;在治疗后12 m,联合组外周血PLT和WBC计数分别为(59.3±18.7)×10⁹/L和(2.8±0.9)×10⁹/L,显著高于PSE治疗组【分别为(45.6±14.2)×10⁹/L和(2.0±0.6)×10⁹/L,P<0.05】;联合组血清白蛋白水平为(37.9...     

日本血吸虫病与肠线虫病联合化疗的效果

血吸虫病人合并感染肠线虫者(A组)采取;吡喹酮40mg/kg加阿苯达唑200mg和复方甲苯咪唑400mg(尚含左旋咪唑100mg)分2d顿服,1个半月后血吸虫阴转率88.0％,蛔虫、鞭虫和钩虫阴转率分别为77.4％、23.6％及100.0％。对不合并血吸虫病的肠线虫病患者采取两种联合化疗方案:B组—阿苯达唑200mg和复方甲苯咪唑200mg(尚含左旋咪唑50mg)顿服,蛔虫、鞭虫和钩虫的阴转率分别为66.7％、18.8％和62.5％,较A组结果稍低;C组—阿苯达唑100mg和噻嘧啶900mg顿服的驱虫效果差,蛔虫和鞭虫的阴转率分别为50.0％及11.1％。3种驱虫方案对血吸虫和蛔虫的减卵率可达97.0％～99.9％;对钩虫的减卵率达68.9％～100％;对鞭虫的效果差。相应增加药物的剂量及改进服法,当可提高疗效。     

Age-dependent changes of protein structure II. Conformational differences of aldolase of young and old rabbits

Conformational differences between aldolase from old and young rabbit muscle are revealed and described by means of UV difference spectroscopy, thermal perturbation difference spectra, and UV fluorescence. These two objects differ in thermal stability of protein conformation, but similar conformational transitions are observed on substrate binding.     

抗血小板药物在心脑血管疾病中的临床应用

抗血小板治疗是冠心病、缺血性脑卒中、心房颤动等心脑血管疾病的重要治疗措施之一。近年来,随着抗栓领域基础及临床研究的逐步深入,出现了许多新型的抗血小板药物。本文通过对各种抗血小板药物的临床应用进行综述,以期为血栓栓塞性疾病,尤其是心脑血管疾病提供规范化、个体化的抗血小板治疗。     

The effect of hormones on the haemodynamics in animals of different age groups

The investigation was undertaken to study to effect of varying doses of epinephrine, vasopressin, insulin, thyroxin, estradiol-dipropionate on the haemodynamics and contractility of the myocardium of rats in different age groups, as well as the effect of epinephrine and vasopressin on coronary blood circulation in dogs of various age groups. The age group peculiarities of reactions to the hormones were compared with changes in their content in the blood of animals of different age groups.Upon administering small concentrations of the hormones in this study, more pronounced changes in haemodynamics and contractility of the myocardium were observed in senile animals. The administration of larger doses led to more pronounced changes in mature animals. During the process of aging, there is a decrease in the range of the reactions of the cardiovascular system to the action of hormones.In case of long term (14 days) administration of thyroxin, it was found that in senile animals the contractility of the heart was lower than that in short term (4 days) administration. In long term administration of thyroxin, it was found that in mature animals the index for the myocardium's contracting ability was more pronounced than in short term administration.Irregular changes in the concentrations of different hormones in the blood, changes in sensitivity and ability of the myocardium to respond to their action lead to changes in the hormonal regulation of the heart, and to the development of aging metabolic and functional changes.     

Effects of HIV Infection on Pulmonary Artery Pressure in Children

BackgroundPulmonary hypertension may complicate human immunodeficiency virus (HIV) infection and result in right ventricular (RV) failure and premature death. There are limited data of the effects of childhood HIV infection or antiretroviral therapy (ART) on pulmonary artery pressure (PAP).ObjectivesTo establish if there is an association between childhood HIV infection or its treatment and pulmonary artery pressure.MethodsThe study conducted a cross-sectional study of 102 HIV-infected (48 ART-naïve, 54 ART-exposed) and 51 HIV-uninfected children in Jakarta, Indonesia, to estimate PAP using echocardiography parameters: tricuspid regurgitation peak velocity (TRV), left ventricular systolic index and diastolic eccentricity index (EI), and RV systolic function, assessed by tricuspid annulus plane systolic excursion. The association between either ART-naive or ART-exposed HIV and PAP was explored using general linear modelling adjusted for potential confounders.ResultsART-exposed HIV-infected children had higher TRV (adjusted difference: 0.36 m/s; 95% confidence interval [CI]: 0.12 to 0.60; p = 0.003) and diastolic EI (adjusted difference 0.06; 95% CI: 0.01 to 0.11; p = 0.02) than did uninfected children. The EI in ART-exposed children was significantly higher than normal. ART-naive HIV-infected children had a lower tricuspid annulus plane systolic excursion (adjusted difference: –2.2 mm; 95% CI: –3.73 to –0.71; p = 0.004), despite no difference in TRV (adjusted difference: 0.18 m/s; 95% CI: –0.06 to 0.43 m/s; p = 0.14). Seven (13%) ART-exposed and 4 (8.3%) ART-naïve HIV-infected children had pulmonary hypertension. Within-HIV group comparisons showed that accounting for lower respiratory tract infections attenuated the lower RV systolic function in ART-naïve children but not in ART-exposed children (difference: –1.1 mm; 95% CI:–2.8 to 0.7 mm; p = 0.22), but not the higher left ventricular eccentricity indexes in the ART-exposed children (systolic difference: 0.07; 95% CI: 0.02 to 0.12; p = 0.007; diastolic difference: 0.08; 95% CI: 0.02 to 0.14; p = 0.006).ConclusionsART-exposed HIV infection is associated with higher estimated PAP. Reduced RV systolic function is seen in ART-naïve HIV infection. Lower respiratory tract infection partly explains lower systolic RV function in ART-naïve relative to ART-exposed HIV infection.     

Transvenous endomyocardial biopsy using the gastrointestinal biopsy (Olympus GFB) catheter

The use of a GFB biopsy catheter (Olympus) for endomyocardial biopsy in 23 patients is described. The catheter may be introduced alone or through a Cournand catheter. This technique is simple and safe and has a success rate of 100 per cent. There is little problem with cleaning out the blood. The technique of introducing the biopsy catheter through an already positioned Cournand catheter avoids any damage to the veins or perforation through the vein or right atrium; even in patients with large right atria, the procedure of first manipulating a soft rather than a stiff catheter into the right ventricle, and then introducing the biopsy through the Cournand catheter, becomes technically easy. The biopsy specimens measure 2 by 2.5 mm., which are adequate for microscopic examination and bacterial or viral culture studies. There have been no immediate or late complications.