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1.
奈替米星(乙基西索米星)是一种半合成氨基糖苷类抗生素,由西索米星乙酰化而成,其抗菌谱广,活性高,耳肾毒性较其他氨基糖苷类小,已广泛用于国内外临床,现将其药理作用及下呼吸道感染的临床效果及药效等。结果表明,每日1次单用奈替米星组疗效较合用头孢唑林及阿米卡星组好。  相似文献   

2.
氨基糖苷类抗生素属静止期杀菌药,主要不良反应是肾毒性和耳毒性,尤其儿童和老人更易发生. 1 病例简介[案例1] 庆大霉素、丁胺卡那霉素连续注射导致幼儿耳聋  相似文献   

3.
庆大霉素是从放线菌科单孢子菌属发酵培养液中提取的,系碱性化合物,常用硫酸盐,易溶于水,性质稳定,以水针剂供临床使用,因价廉、疗效可靠,是目前常用的氨基糖苷类抗生素.但庆大霉素在氨基糖苷类抗生素中肾毒性最大,出现肾中毒也最常见.肾毒性表现为蛋白尿、管型尿、尿中红细胞,严重时肾功能受损,甚至发生急性肾功能衰竭.所以在临床应用中应注意以下几点:(1)老年人应尽量少用或不用此类抗生素,确因病情需要而使用时,应严密观察尿常规及肾功能变化,每2~3天查一次,早发现可能发生的肾损害并给予及时处理.  相似文献   

4.
<正>小诺霉素属于氨基糖苷类抗生素,抗菌谱近似庆大霉素,与其他氨基糖苷的交叉耐药性较轻。本品的特点是对氨基糖苷乙酰转移酶AAC(6ˊ)稳定,因此小诺霉素对产生该酶的耐药菌可有效。临床主要用于大肠杆菌、绿脓杆菌等革兰阴性杆菌引起的感染。由于抗菌谱广、杀菌力强、无需皮试、耳、肾毒性小等优点,是一种较好的替代庆大霉素的新  相似文献   

5.
氨基糖苷类抗生素抗茵谱广,杀菌活性强,与β-内酰胺类抗生紊和非典型结构的β-内酰胺类抗生素有显著的协同作用,特别是具有抗生索后效应,因此在治疗严重的院内感染中具有相当重要的价值,由于氨基糖苷类抗生素的优势与毒性作用都极为突出,为了保证达到有效的治疗浓度和避免潜在的毒性作用,在临床需监测血药浓度,给药方案个体化。虽然测定的方法不少,但测定的成本较高或者效果不理想,不能满足临床上的要求,所以,研究快速、准确、经济的监测方法成为当务之急。现将氨基糖苷类药物的血药浓度监测现状和发展趋势综述如下:  相似文献   

6.
抗生素引起的肾损害主要是药物或其代谢产物所致的过敏反应,许多抗生素具有潜在肾毒性,其损害作用随剂量增大、疗程延长而加重,尤其是大剂量联合用药、不合理用药、滥用药时尤为突出。抗生素引发肾毒性,主要是指能引起可逆性蛋白尿、血尿、管型尿、氮质血症、少尿、无尿,某些抗生素药物甚至引起肾小管坏死、急性肾功能衰竭。氨基糖苷类抗生素氨基糖苷类抗生素的肾毒性与药物剂量及药物在肾皮质区蓄积有密切关系,血药浓度越高,肾毒性越大,血尿素氮和肌酐水平也愈高。一般剂量时仅出现多尿;较大剂量早期多尿,当肾小管细胞进一步受损,可引起少尿性肾衰,伴有氮质血症;更大剂量早期可见肾脏功能细胞有改变,随后产生细胞坏死。目前按其肾毒  相似文献   

7.
冠心病与血清胆红素的关系探讨   总被引:1,自引:0,他引:1  
刘萍 《广西医学》2004,26(8):1173-1174
氨基糖苷类抗生素有不同程度的肾毒性,本院1998年1月到2 0 0 3年3月收治38例应用氨基糖苷类抗生素庆大霉素、妥布霉素、阿米卡星、奈替米星的过程中,出现急性肾功能损害的老年患者,现报告分析如下。1 资料与方法1 1 一般资料 本组38例,男性2 2例,女性16例,年龄6 2~75岁,平均年龄6 8岁。原发疾病为慢性支气管炎或支气管扩张、慢性阻塞性肺气肿、肺原性心脏病合并肺部感染16例,尿路感染5例,慢性胆囊炎伴冠心病5例,急性胃肠炎5例,急性阑尾炎4例,子宫内膜癌3例。38例患者用药前尿常规及肾功能检查在正常范围。1 2 方法 16例静脉滴注庆大霉…  相似文献   

8.
氨基糖苷类抗生素耳毒性基础研究与临床防制   总被引:1,自引:0,他引:1  
氨基糖苷类抗生素 (AmAn)临床应用极为普遍 ,其抗菌谱较广、作用强、相对不易耐药 ,对G-杆菌 ,尤其对不易控制的大肠杆菌、变形杆菌、绿脓杆菌等引起的严重感染以及特种菌如结核杆菌感染起着重要作用 ,5 0年代以来大量的临床和实验研究证实AmAn可损害内耳感受器 ,引起听功能受损和前庭功能障碍 ,其发生率高达 2 0 %~ 30 % [1] 。目前 ,对AmAn耳毒性的机制尚不清楚 ,同时也缺乏有效的治疗方法和药物 ,因此 ,对AmAn耳毒性防制的基础与临床研究极为重要。1 避免在妊娠期使用AmAn类药物AmAn可通过胎盘屏障进入胎儿体…  相似文献   

9.
抗生素注射氨基糖苷类抗生素,如链霉素、庆大霉素、卡那霉素等抗感染时,这些药对肾脏毒性大,浓度超高时对肾小管损害较大,故宜多喝水,以稀释并加快药物排泄。  相似文献   

10.
氨基糖苷有肾毒性及耳毒性作用。虽然已有测定其血清水平的设备,肾及听力损伤仍有友生。最近报告了一例疑为细菌性心内膜炎病人,接受一疗程庆大霉素治疗后出现双侧前庭损伤,且为不可逆性。病人不能工作已一年多。用药剂量为5.6mg/kg,共治疗19天。在开始治疗的2周内测定了最低药物浓度,但未测定峰值。 Kapusnik等提出,过去对氨基糖苷的用法可能既未达到最大药效,也  相似文献   

11.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

12.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

13.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

14.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

15.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

16.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

17.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

18.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

19.
Objective To measure Derpl and Blot5 allergen levels in asthmatics' homes in Hongkong.Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derpl and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.Results The levels of Derpl allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g)and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derpl and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P< 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 =0 μg/g of dust as compared with Derpl in bed and on the floor (4.3% and 14.5% respectively, P< 0.05).Conclusions Derpl and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.  相似文献   

20.
ANTI-PROLIFERATION EFFECT OF ORIDONIN ON HL-60 CELLS AND ITS MECHANISM   总被引:4,自引:0,他引:4  
Objcetive To investigate the anti-proliferation effect of oridonin on leukemic HL-60 cells and its mechanism. Methods HL-60 cells in vitro in culture medium were given different concentrations of oridonin. The inhibitory rate of cells were measured by microculture tetrazolium (MTT) assay, cell apoptotic rate was detected by flow cytometry (FCM), morphology of cell apoptosis was observed by hoechst 33258 fluorescence staining, and the activity of telomerase was detected using telomere repeat amplification protocol (TRAP) PCR-ELISA before and after apoptosis occurred. Results Oridonin could decrease telomerase activity, inhibit growth of HL-60 cells, and cause apoptosis significantly. The suppression was both in time- and dose-dependent manner. Marked morphological changes of cell apoptosis including condensation of chromatin and nuclear fragmentation were observed clearly by hoechst 33258 fluorescence staining especially after cells were treated 48-60 hours by oridonin. Conclusions Oridonin has apparent anti-proliferation and apoptotic effects on HL-60 cells in vitro, decreasing telomerase activity of HL-60 cells may be one of its most important mechanisms. These results will provide strong laboratory evidence of oridonin for clinical treatment of acute leukemia.  相似文献   

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