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1.
卡托普利加美托洛尔治疗扩张型心肌病20例   总被引:3,自引:0,他引:3  
邹忠全  刘丽华  刘文晶 《新医学》2000,31(6):342-342
目的:观察卡托普利加美托洛尔治疗扩张型心肌病心力衰竭的临床疗效。方法:治疗组20例给予卡托普利(6.25mg/d至75mg/d)和美托洛尔(6.25mg/d至75mg/d),对照组22例给予常规治疗。结果:总有效率治疗组90%,对照组为50%,两组比较有显著性差异,P〈0.05;两组均未见不良反应。结论:卡托普利联用美托洛尔治疗扩张型心肌病心力衰竭简单易行,且有预防洋地黄中毒的作用,对依赖洋地黄的  相似文献   

2.
目的:比较甲基强的松龙与地塞米松大剂量静脉冲击治疗神经免疫性疾病的不良反应,方法:甲强龙20mg.kg^-1.d^-1成人不超过1g/d,地塞米松5mg.kg^-1.d^-1成人不超过250mg/d,连续3天为1疗程,每例病人接受3个疗程,前瞻性观察记录各种不良反应。结果:甲强龙组64例与地塞米松组38例的不良反应,统计学处理差异无显著意义,结论:同等效价的甲强龙与地塞米松治疗不良反应并无明显差别  相似文献   

3.
自1975年Waagstein首次将β受体阻滞药应用于扩张型心肌病(DCM)心力衰竭以来,多项临床试验证实该类药物治疗DCM有效,但用药持续多久和能否停药尚不清楚,作者进行了研究。 13例服用β受体阻滞药的DCM病人,其中男9例,女4例,年龄44岁至78岁,平均62岁。均服用美托洛尔维持量 20 mg/d至 120 mg/d[(62±34) mg/d]持续 30至60(47±10)个月,心功能 NYHAⅠ级至Ⅲ级,以 4周至 8周的间隔递减美托洛尔。治疗前、减量及停药后评价心功能。 美托洛尔减量前心功能 N…  相似文献   

4.
雷公藤多甙用于肾移植患者的治疗   总被引:1,自引:0,他引:1  
目的:研究雷公藤多甙(TⅡ)地肾移植术后患者的免疫抑制治疗效果。方法:中药雷公藤多甙治疗同种异体肾移植患者28例,该药作为辅助性免疫抑制剂与环孢霉素(CsA)_硫唑嘌呤+强的松三联方案同时应用15例,剂量为0.5 ̄1mg/kg/d口服,作为三联方案的替代剂应用13例,剂量1 ̄2mg/kg口服,替代CsA5例,替代Pred5例,替代Aza3例。结果:作为辅助用药可减少Pred用量5 ̄10mg/d替代  相似文献   

5.
抑颤汤治疗帕金森病临床对照观察   总被引:18,自引:2,他引:16  
目的:探讨抑颤汤合用西药治疗帕金森病(PD)的临床疗效。方法:对照组32例采用美多巴和溴隐停治疗,治疗组(中西医结合组)40例在此治疗基础上加用抑颤汤口服,12周为1个疗程;结果:据帕金森病UPDRS功能评定量表评分,治疗组疗效高于对照组(P<0.05),西药用量较对照组减少1/4-1/2(P<0.05),结论:中西医结合治疗帕金森病能提高疗效,减少西药用量和药物不良反应。  相似文献   

6.
神经胶质生长因子促进受损周围神经功能恢复   总被引:18,自引:5,他引:13  
俞志明  刘康 《现代康复》2000,4(8):1182-1183
目的评价了重组体人类神经胶质生长因子Ⅱ(rhGGF2)对大鼠坐骨神经挤压伤后运动功能恢复的效果。方法73只大白鼠被分为3组。一组(n=5)实施模拟挤压操作在二组(n=34)、三组(n=34)中,每只动物选一5mm长的坐骨神经段承受100g挤压2h。其中,三组用rhGGF2治疗(1mg/kg挤压后皮下注射,1次/d,连续4d),二组用相同量的载体治疗。通过计算坐骨神经功能指数(SF1)和测量趾长伸肌  相似文献   

7.
人工肝支持系统治疗重症肝炎临床研究   总被引:81,自引:8,他引:73  
目的:探讨人工肝支持系统(ALSS)治疗重症直炎的疗效和血浆置换,血浆吸附,血液灌流治疗重肝的适应证。方法:治疗组64例,对照组60例。2组病例内科基础治疗相同,治疗组加用ALSS治疗,其中PE每次置换40-60mg/kg异体同一血浆;PP每次交换100-150ml/kg血浆,DHP每次交换170-250mg/kg全血量,2-7日治疗1次,址现情稳定好转。  相似文献   

8.
《新医学》1994,(8)
儿童结核短程间断化疗作者在1978~1992年对130例肺、淋巴结、胸膜、骨、关节和腹部结核的患儿,给予短程断抗结核化疗。方法:110例给予异烟肼(10~15mg/kg,最大量400mg),利福平(10~15mg/kg,最大量600mg),链霉素(3...  相似文献   

9.
异基因骨髓移植合并巨细胞病毒感染的预防与治疗   总被引:11,自引:0,他引:11  
目的 评价赛美维(ganciclovir) 在异基因骨髓移植(alloBMT) 合并巨细胞病毒(CMV) 感染中应用的有效性及安全性。方法 观察alloBMT 合并CMV 患者60 例,其中预防组40 例,治疗组20 例。赛美维预防方案为:静滴5 mg/kg ,每12 小时1 次,- 9~- 2 天。alloBMT 后自中性粒细胞≥1.0×109/L及BPC≥30×109/L开始用药,剂量5 mg ·kg - 1 ·d- 1 ,每周用药5 天,直至+ 100 天。治疗方案为:静滴5 mg/kg ,每12 小时1 次,2~3 周,之后按原剂量每周用药5 天,再持续2~3 周。结果 预防性应用赛美维20 例均未发生活动性CMV 感染,而未用赛美维预防对照组20 例中即有5 例发生活动性CMV 感染( P< 0.05) 。用赛美维预防治疗组20 例中显效17 例(占85% )。赛美维的主要不良反应为白细胞及血小板减少,但均为可逆性。结论 赛美维对于alloBMT 合并CMV 感染的预防与治疗的疗效可靠、用药安全,可作为一线用药。  相似文献   

10.
帕罗西汀佐治慢性前列腺炎63例   总被引:9,自引:2,他引:7  
邓春华  丘少鹏  梁宏  张徐龙 《新医学》2000,31(10):599-599
目的:探讨帕罗西汀佐治慢性前列腺炎(CP)的临床疗效。方法:治疗组63例在常规治疗的基础上,口服帕罗西汀,20mg/d至40mg/d,疗程3个月;对照组38例仅用常规治疗。比较两组治疗前后的前列腺疾患症状主平分、生活质量评分、抑郁量评分及焦虑量评分、以及最大尿道闭合压胶列腺内尿液反流程度的变化。结果:治疗组病人上述参数明显下降,其下降幅度均显著大于对照组。结论:应用帕罗西汀佐治CP可明显提高临床疗  相似文献   

11.
The effect of micafungin dose scheduling on the treatment of candidemia is unknown. Neutropenic mice with disseminated Candida glabrata infection were treated with single intraperitoneal micafungin doses of 0 to 100 mg/kg of body weight and sacrificed 7 days later. The maximal decline in kidney fungal burden was 5.8 log(10) CFU/g. A 1-week pharmacokinetic-pharmacodynamic study revealed a micafungin serum half-life of 6.13 h. In mice treated with > or =50 mg/kg, there was maximal fungal decline without regrowth during the 1-week dosing interval. Next, doses associated with 34% (34% effective dose [ED(34)]) and 50% (ED(50)) of maximal kill were administered at one of three dose schedules: a single dose at t = 0, two equal doses at t = 0 and t = 3.5 days, and 7 equal doses daily. Some mice received a single dose of 100 mg/kg. Fungal burden was examined on days 1, 5, and 7. In mice treated with the ED(34), microbial kill with the daily therapy initially lagged behind the intermittent doses but exceeded it by day 7. In mice treated with the ED(50), daily and intermittent doses had equivalent day 7 effects. In mice treated with 100 mg/kg, there was no regrowth. The relative likelihoods that the area under the concentration-time curve/MIC ratio was linked to microbial kill versus peak concentration/MIC ratio or time above the MIC was 10.3 and 10,161.2, respectively. In all the experiments, no paradoxical increase in fungal burden was observed with high micafungin doses. However, only a single Candida isolate was tested. Regimens that simulated micafungin concentration-time profiles in patients treated with a single micafungin dose of 1,400 mg once a week demonstrated maximal fungal decline. Once-weekly micafungin therapy is as efficacious as daily therapy in a murine model of disseminated candidiasis.  相似文献   

12.
Mezlocillin pharmacokinetics in pediatric oncology patients   总被引:1,自引:1,他引:0       下载免费PDF全文
The pharmacokinetics of mezlocillin were studied in 31 children (age, 2 to 19 years) with malignancies and normal renal and hepatic functions. Mezlocillin was administered intravenously over 30 min every 4 h at doses ranging from 12.2 to 125 mg/kg. Blood samples were obtained over one dosage interval at steady state. For all patients, the mean clearance was 0.21 +/- 0.11 liter/h per kg, the mean distribution volume was 0.26 +/- 0.13 liter/kg, and the mean elimination half-life was 0.97 +/- 0.51 h. Trough concentrations were 23.0 +/- 29.9 mg/liter before the dose was administered and 20.4 +/- 27.5 mg/liter at the end of the dosing interval. Peak concentrations averaged 245 +/- 90.4 mg/liter, and average concentrations for the dosing interval were 83.7 +/- 40.4 mg/liter. There were no apparent effects of sex, malignancy, age, or dose on either the kinetic parameters or plasma concentrations. Overall, the disposition parameters for mezlocillin in this patient group were comparable to those reported in adults.  相似文献   

13.
For children with ambulatory pneumonia, the World Health Organization (WHO) recommends oral amoxicillin (15 mg/kg of body weight/dose) thrice daily (t.i.d.) or oral cotrimoxazole (4 mg of trimethoprim/kg/dose) twice daily (b.i.d.). The more frequent amoxicillin dosing may lead to compliance problems. To compare the pharmacokinetics and levels of amoxicillin in plasma in the current WHO acute respiratory infection recommendations with the 25-mg/kg/dose b.i.d. regimen, we performed a two-group parallel study of 66 children ages 3 to 59 months with pneumonia. Amoxicillin was given orally at 25 mg/kg/dose b.i.d. or 15 mg/kg/dose t.i.d. Amoxicillin concentrations were determined by high-performance liquid chromatography after the first dose on days 1 and 3. After the first dose on day 1, the mean area under the concentration-time curve (AUC) for amoxicillin after the 25-mg/kg dose was 54.7 versus 24.9 micro g. h/ml after the 15-mg/kg dose. After the first dose on day 3, the mean AUC was 44.1 versus 28.5 micro g. h/ml. All but two children had plasma amoxicillin concentrations above 0.5 micro g/ml for >50% of the dose interval on both days. Six children on day 1 and five children on day 3 had concentrations above 1.0 micro g/ml for <50% of the dose interval. On day 1, 16 of 27 children in the b.i.d. group and 11 of 26 children in the t.i.d. group had concentrations that were above 2.0 micro g/ml for <50% of the dose interval, and on day 3, 18 of 31 children in the b.i.d. group and 8 of 31 children in the t.i.d. group had concentrations that were above 2.0 micro g/ml for <50% of the dose interval. Amoxicillin b.i.d. is a feasible alternative for t.i.d. dosing. To lengthen the time above the MIC at higher concentration levels, a 30- to 40-mg/kg/dose b.i.d. should be considered instead of the 25 mg/kg/dose used in this study.  相似文献   

14.
OBJECTIVE: Intravenous ibuprofen (IBU) has been found to be as effective as indomethacin for the treatment of patent ductus arteriosus (PDA) in preterm infants and has been associated with fewer adverse effects in comparative phase III studies. The dose regimen used (10-5-5 mg/kg/day) was based on limited pharmacokinetic data and no phase II study was available to determine the optimal dose of IBU for this indication. The present study was designed to determine the minimum effective dose regimen (MEDR) of IBU (one course) required to close ductus arteriosus in preterm infants. METHOD: A double-blind dose-finding study was conducted using the continual reassessment method, a Bayesian sequential design. Two distinct target closure rates were initially chosen according to postmenstrual age (PMA) at birth: 80% in infants with a PMA of 27-29 weeks, and 50% in infants with a PMA < 27 weeks. Forty neonates (20 in each PMA group) with PDA were treated between days 3 and 5 of life. Four different dose regimens were tested: loading doses of 5, 10, 15 or 20 mg/kg, followed by two doses (1/2 loading dose) at 24-h intervals. Efficacy was evaluated by echocardiography 24 h after the third infusion. RESULTS: In infants with a PMA of 27-29 weeks, the estimated MEDR was 10-5-5 mg/kg with a final estimated probability of success of 77% (95% credibility interval: 56-92%). The 15-7.5-7.5 mg/kg dose regimen had a better estimated probability of success (88%, 95% credibility interval: 68-97%), but resulted in more minor renal adverse effects. In contrast, in infants with a PMA < 27 weeks, the estimated MEDR was 20-10-10 mg/kg with an estimated probability of success of 54.8% (95% credibility interval: 22-84%), whereas the conventional dose regimen resulted in a low estimated probability of success (30.6%, 95% credibility interval: 13-56%). In these infants, compared with those with a PMA of 27-29 weeks, minor renal adverse effects were more frequent from the 10-5-5 mg/kg/day dose regimen and did not appear to be clearly dose related. CONCLUSION: This study confirms that the currently recommended dose regimen (10-5-5 mg/kg) of IBU is associated with a high closure rate (80%) and few adverse effects in premature infants with a PMA of 27-29 weeks. The failure rate was much higher below 27 weeks. A higher dose regimen (20-10-10 mg/kg) might achieve a higher closure rate. However, tolerability and safety of this dose regimen should be assessed in a larger population before considering the use of these doses for ductus arteriosus closure.  相似文献   

15.
We determined the dose response of the ADP antagonist clopidogrel (0.3-50 mg/kg p.o.) in rat models of thrombosis and provoked bleeding and correlated these activities to ex vivo platelet activation. Carotid artery thrombosis was induced by FeCl(2). Bleeding time was measured by mesenteric vessel puncture and renal cortex or cuticle incision. Platelet biomarkers included standard ADP-induced aggregation, P2Y(12) receptor occupancy, and phosphorylation of vasodilator-stimulated phosphoprotein. Clopidogrel decreased thrombus weight up to 78%, caused maximal prolongation of cuticle and mesenteric bleeding, but had little effect on renal bleeds. Due to the steep mesenteric dose response, further comparisons concentrated on cuticle bleeding. The half-maximal inhibitory dose (ED(50)) for thrombus reduction was 2.4 +/- 0.4 mg/kg, with 10 mg/kg providing optimal blood flow preservation and thrombus reduction. The ED(50) for bleeding was 10.5 +/- 3.4 mg/kg. Increased bleeding was intermediate (3-fold) at 10 mg/kg and maximal (6-fold) at 30 mg/kg. All biomarkers were affected, but with differing sensitivity. ED(50)s for peak platelet aggregation to 10 microM ADP (11.9 +/- 0.4 mg/kg) and the vasodilator-stimulated phosphoprotein index (16.4 +/- 1.3 mg/kg) approximated the higher ED(50) for bleeding. ED(50)s for ligand binding (3.0 +/- 0.3 mg/kg) and late aggregation (5.1 +/- 0.4 mg/kg) better matched the lower ED(50) for antithrombotic activity. Aspirin exerted lesser effects on bleeding (42-70% increase in all models) and thrombosis (24% inhibition). In summary, antithrombotic doses of clopidogrel have limited effects on bleeding and standard measures of platelet aggregation. Other biomarkers may be more sensitive for tracking antithrombotic efficacy.  相似文献   

16.
BACKGROUND: Combination therapy of ribavirin with interferon alfa-2b and pegylated interferon alfa-2b is currently approved for the treatment of chronic hepatitis C. Approved ribavirin dosages vary from a fixed dosage of 800 mg/d to as much as 1200 mg/d on the basis of body weight. OBJECTIVE: Our objective was to evaluate ribavirin dosing strategies by comparison of their relative efficacy and toxicity profiles. METHODS: Three models were developed on the basis of data collected from a large phase III trial. A population pharmacokinetic model was used to describe the ribavirin dose-concentration relationship and the influence of covariates. Logistic regression models were developed for both sustained virologic response and hematologic toxicity. Ribavirin concentration was an important explanatory variable for both response and toxicity. Simulations of these models were developed for different ribavirin doses to obtain efficacy and toxicity profiles across the various dosing strategies. These strategies included a fixed 800-mg/d dose, empiric weight-adjusted doses (ie, 1000 mg/d for patients who weighed < or =75 kg and 1200 mg/d for patients who weighed >75 kg [1000/1200 mg/d on the basis of body weights < or =75/>75 kg] and 800 mg/d for patients who weighed <65 kg, 1000 mg/d for patients who weighed from 65 to 85 kg, and 1200 mg/d for patients who weighed >85 kg [800/1000/1200 mg/d on the basis of body weights <65/65-85/>85 kg]), a dose of 13 mg/kg per day, and other per-body weight doses between 9 and 16 mg/kg per day. RESULTS: Simulation results showed that both efficacy and toxicity increased as the milligrams-per-kilogram dose of ribavirin increased. The body weight-based 800/1000/1200-mg/d dose had overall response and toxicity rates that were 6.3% and 2.5% higher than those of the fixed 800-mg/d dose. In particular, patients with genotype-1 disease had a 7.4% increase in response rate. There were no differences in response and toxicity rates between the 800/1000/1200-mg/d and 13-mg/kg per day dose groups. CONCLUSIONS: This simulation suggests that ribavirin dosage (in combination with pegylated interferon alfa-2b) for patients with chronic hepatitis C should be based on body weight.  相似文献   

17.
Fifty-three patients with chronic hepatitis B and active viral replication were studied for 4 weeks while on treatment and for 12 weeks after treatment with the oral nucleoside analogue lamivudine. Children aged 2 to 12 years were randomized to receive twice-daily doses of 0.35, 1.5, or 4 mg of lamivudine solution per kg of body weight or once-daily doses of 3 mg of lamivudine solution per kg. Adolescents aged 13 to 17 years received lamivudine at 100 mg (as tablets). Blood samples for pharmacokinetic assay were taken on days 1 and 28. Lamivudine was rapidly absorbed following oral administration, with the maximum concentration in serum being reached 0.5 to 1 h postdosing. Apparent oral clearance (CL/F) was higher in younger children and decreased with age, with CL/F values for adolescents reaching those seen for adults by the age of 12. All doses produced a dramatic fall in serum hepatitis B virus (HBV) DNA levels, with a median reduction of >/=99.5% after 4 weeks of treatment and with the levels returning to the baseline levels posttreatment. The correlation of dose, area under the concentration-time curve (AUC), and changes in HBV DNA levels, as measured by the Chiron Quantiplex assay, showed maximal antiviral effects (99.9% inhibition and a reduction of the amount of HBV DNA of approximately 3 log(10)) at 3 mg/kg/day, with no discernible increase in effect seen whether the drug was given at 4 mg/kg twice daily or whether it was given once daily or twice daily. The limit of detection of the assay (2.5 pg/ml) was reached for some but not all patients across the dose ranges, with the smallest number (n = 2) of those having values negative by the Chiron Quantiplex assay being in the lowest-dose group. The 13- to 17-year-olds showed a similar overall response in terms of the HBV DNA level reduction compared to that for patients younger than age 13. Analysis of the same samples by PCR, which has a lower limit of sensitivity than the Chiron Quantiplex assay, also showed average drops in HBV DNA levels of about 3 log(10) at 4 weeks for patients for which the AUC was >/=4,000 ng. h/ml, confirming the conclusions given above. Lamivudine treatment was well tolerated at all doses, with no significant adverse events or laboratory data changes. On the basis of pharmacokinetic and pharmacodynamic data, a 3-mg/kg/day dose in children (ages 2 to 12 years) with chronic hepatitis B provides levels of exposure and trough concentrations similar to those seen in adults following the receipt of doses of 100 mg. The 100-mg dose is being evaluated in a large phase III study with HBV-infected pediatric patients.  相似文献   

18.
Phenytoin is an anticonvulsant drug known to interact with many other drugs. Previous data suggest that chronic administration of phenytoin delays urethane-induced loss of righting reflex (LRR) and this phenomenon being potentiated by concomitant administration of ascorbic acid (ASC). Therefore, we examined how phenytoin at two different doses combined or not with ASC (fixed dose) interact with both the latency to, and the duration for urethane-induced LRR in experimental rats. The results showed that lower dose of phenytoin (60 mg/kg rat b.i.d.) has significantly shortened the duration of LRR while higher dose of the drug (120 mg/kg b.i.d.) has delayed the latency to LRR (cut-off period of 15 min). Furthermore, addition of ASC to any of the two doses of phenytoin gave results similar to that observed for latency to and duration of LRR when phenytoin was given alone at the higher dose (120 mg/kg b.i.d.). Our data suggest a resistant effect of chronic administration of phenytoin on latency to and/or duration of loss righting reflex induced by urethane in experimental animals. A dose-response relationship of phenytoin in this regard is expected and needs further investigations. The resistant effect of phenytoin on righting reflex has been augmented when ASC was chronically given in combination. This result supports a possible interaction between the two drugs and needs further investigations at both experimental and clinical levels.  相似文献   

19.
Effects of multiple injections of liposomal doxorubicin on pharmacokinetics, therapeutic outcome, and toxicity were studied in mice using different dosing schedules and dose intensities. Biodistribution of doxorubicin to the cutaneous tissues of mice (skin and paws) and to orthotopically implanted mammary tumors (4T1) was examined. Weekly intravenous administration of pegylated (STEALTH) liposomal doxorubicin (SL-DXR) at a dose of 9 mg/kg (every week x 4 doses) resulted in accumulation of doxorubicin in cutaneous tissues of mice and development of lesions resembling palmar-plantar erythrodysesthesia (PPE). Lengthening the dose interval to every 2 weeks x 4 doses reduced the accumulation of doxorubicin and lowered the incidence of PPE-like lesions. A dose interval of every 4 weeks x 4 resulted in complete clearance of doxorubicin from tissues between subsequent doses and a negligible incidence of PPE-like lesions. Doses of 9 mg/kg SL-DXR given at every week x 2 or every 2 weeks x 2 had similar therapeutic activities, whereas prolonging the dose interval to every 4 weeks x 2 reduced therapeutic activity. Pharmacokinetics, biodistribution, and therapeutic activity were studied in tumor-bearing mice for three dose schedules having the same dose intensity (4.5 mg/kg every 3 days x 4, 9 mg/kg every week x 2, or 18 mg/kg every 2 weeks x 1). For these schedules, larger doses administered less often tended to be superior therapeutically to smaller doses given more often. These data provide the first pharmacokinetic measurements of doxorubicin concentrations in cutaneous tissues and tumors with repeat administration of liposomal formulations, and they provide a useful model for the study of factors leading to PPE in humans.  相似文献   

20.
1-beta-D-Arabinofuranosylthymine (ara-T) was examined for its therapeutic efficacy against encephalitis in mice inoculated intracerebrally with herpes simplex virus. Intraperitoneal treatment with 100 mg of ara-T per kg twice daily for 4.5 days was as effective as treatment with 50 mg of arabinosyladenine 5'-monophosphate per kg. Under the same conditions, doses of 5-iododeoxyuridine or arabinosylcytosine (50 mg/kg each) were not effective. Even when the virus inoculum was as high as 320 or 3,200 50% lethal doses, ara-T increased the life span significantly. Oral treatment with 27 mg of ara-T per kg produced a modest increase in the mean survival time, equal to that of 50 mg of ara-T per kg administered intraperitoneally or subcutaneously. A single dose of ara-T, 800 mg/kg intraperitoneally or 400 mg/kg orally, was effective. The 50% lethal dose of ara-T administered intraperitoneally and that administered orally were more than 10 and 15 g/kg, respectively. The therapeutic indexes (maximal tolerated dose divided by minimal effective dose) in multiple intraperitoneal treatments and in multiple oral treatments were estimated to be more than 25 and 100, respectively.  相似文献   

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