乌司他丁联合地塞米松治疗急性呼吸窘迫综合征的疗效观察

目的观察注射用乌司他丁联合地塞米松磷酸钠注射液治疗急性呼吸窘迫综合征的临床效果。方法选取2016年3月—2017年3月成都市第二人民医院收治的急性呼吸窘迫综合征患者96例为研究的对象,将所有患者随机分为对照组和治疗组,每组各48例。对照组静脉滴注地塞米松磷酸钠注射液,5 mg加入到5%葡萄糖注射液250 m L中,2次/d。治疗组在对照组的基础上静脉滴注注射用乌司他丁,5万单位加入到5%葡萄糖注射液250 m L中,2次/d。两组患者均连续治疗2周。观察两组的临床疗效,比较两组的住院时间、住重症监护室(ICU)时间、病死率和肺功能指标。结果治疗后,对照组和治疗组的总有效率分别为77.1%、95.8%,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组住院时间、住ICU时间、病死率均低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组氧合指数均显著升高,治疗组呼吸频率显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论注射用乌司他丁联合地塞米松磷酸钠注射液治疗急性呼吸窘迫综合征具有较好的临床疗效,可以改善肺功能,缩短住院时间和住ICU时间,降低病死率,具有一定的临床推广应用价值。     

地塞米松对大鼠光气急性肺损伤血管生成素-1、2的影响

目的 探讨地塞米松对大鼠光气急性肺损伤(ALI)血管生成素-1、2(Ang-1,2)表达的影响.方法 采用大鼠光气吸入性肺损伤动物模型.36只SD大鼠随机(随机数字法)分为3组:正常对照组(吸入与光气染毒组同等流量的空气)、光气染毒组(吸入8.33 mg/L纯度为100％的光气5min)、地塞米松处理组(尾静脉注入2.5 mg/kg地塞米松1h后,吸入同等剂量的光气).染毒2h后收集支气管肺泡灌洗液(BALF)测定中性粒细胞细胞数、蛋白含量和肺湿/干质量比(W/D).采用双抗体夹心酶标免疫分析法(ELISA法)测定各组血清和BALF中Ang-1,2水平.RT-PCR法对肺脏组织中Ang-1,2和Tie-2mRNA的水平进行半定量研究.Western blot技术检测肺脏组织中Ang-1,2和Tie-2蛋白含量.结果 与正常对照组比较,光气染毒组肺W/D、BALF中中性粒细胞数和蛋白含量明显升高,差异具有统计学意义(P＜0.01);与光气染毒组比较,地塞米松处理组的肺W/D、BALF中中性粒细胞数和蛋白含量明显降低,差异具有统计学意义(P＜0.01).与正常对照组比较,光气染毒组血清、BALF及肺组织中Ang-1和Tie-2表达明显下降,差异具有统计学意义(P＜0.01);与光气染毒组比较,地塞米松处理组Ang-1和Tie-2表达明显升高,差异具有统计学意义(P＜0.01).与正常对照组比较,光气染毒组血清、BALF及肺组织中Ang-2表达明显升高,差异具有统计学意义(P＜0.01);与光气染毒组比较,地塞米松处理组Ang-2表达明显下降,差异具有统计学意义(P ＜0.05,P＜0.01).结论 地塞米松可能通过抑制Ang-2表达并促进Ang-1和Tie-2表达来有效地保护大鼠光气吸入性急性肺损伤.     

Improvements of cognitive functions in mice heavily infected by Angiostrongylus cantonensis after treatment with albendazole,dexamethasone, or co-therapy

Angiostrongylus cantonensis, the causative agent of human eosinophilic meningitis and eosinophilic meningoencepalitis, has been reported to cause cognitive impairments in the host. To determine whether drug treatment improves the cognitive functions, BALB/c mice infected with 50 third-stage larvae were treated with albendazole, dexamethasone, or co-therapy since day 7 or 14 post-infection for one or two weeks. Abilities of spatial memory and learning of these animals were assessed with the Morris water maze.Our results showed that body weight was significant higher then infected group in the albendazole and combined therapy groups. Significantly lower worm recovery rates were found in mice treated with the same groups. The mice treated with dexamethasone since day 7 for 14 day had significant longer time in the remaining groups were found in forced swimming test. The animals treated with albendazole and combined therapy since day 7 for 14 days was demonstrated to have significantly shorter latencies to the platform in learning memory on day 3 and 4. Mice in these two groups were demonstrated to have significantly higher sores in spatial memory tests. These results indicate that treatment with albendazole or combined therapy may be more efficient in preventing brain damages and depression as well as preserving their capabilities in learning and memory. Therefore, administration of albendazole alone or combined with dexamethasone should have higher efficacies than dexamethasone alone in treatment of BALB/c mice infected with a heavy dose of 50 third-stage larvae of A. cantonensis.     

Acute emesis: moderately emetogenic chemotherapy

This paper is a review of the recommendations for the prophylaxis of acute emesis induced by moderately emetogenic chemotherapy as concluded at the Perugia Consensus Conference, which took place at the end of March 2004. The review focuses on new studies appearing since the last consensus conference in 1997. The following issues are addressed: dose and schedule of antiemetics, different groups of antiemetics such as corticosteroids, serotonin (5-HT₃)-receptor antagonists, dopamine D₂ receptor antagonists, and neurokinin (NK₁) receptor antagonists. Antiemetic prophylaxis in patients receiving multiple cycles of moderately emetogenic chemotherapy is also reviewed. Consensus statements are given, including optimal dose and schedule of 5-HT₃-receptor antagonists and of dexamethasone. The new 5-HT₃-receptor antagonist, palonosetron, is a reasonable alternative to the well-established agents of this class—ondansetron, granisetron, tropisetron and dolasetron. It is concluded that the best prophylaxis in patients receiving moderately emetogenic chemotherapy is still the combination of one of the 5-HT₃-receptor antagonists and dexamethasone. The results of studies adding a NK₁-receptor antagonist to this combination are awaited and might change future recommendations.     

不同时间应用地塞米松对预防腹腔镜术后恶心呕吐的比较

目的：比较不同时间应用地塞米松对预防术后恶心呕吐的影响。方法：120例腹腔镜胆囊切除术患者,随机分为3组,各40例。1组麻醉诱导前给予地塞米松10 mg,2组于手术后给予地塞米松10 mg,3组为对照组。观察三组术后恶心呕吐情况。结果：1、2组术后恶心呕吐数量均显著低于3组,同时1组亦明显低于2组。结论：不同时间应用地塞米松对预防术后恶心呕吐有影响,麻醉前应用效果优于手术后。     

HPLC法测定美白、祛斑类健康产品中地塞米松的方法研究

目的建立羡白、祛斑类健康产品中地塞米松的HPLC方法。方法采用饱和NaCl溶液与乙酸乙酯提取样品,采用HPLC法,以依利特Hypersil 0DS2（5μm,4．6mm×200mm）为色谱柱,以乙腈·水（28：72）为流动相,检测波长为240nm,流速为1．0mL·min^-1。结果能有效检出地塞米松。结论此方法简便、准确,可作为美白、祛斑类健康产品中非法添加的地塞米松成分的确认方法。     

不同给药方法预防及减少舒芬太尼诱发咳嗽反射效果比较

目的比较不同给药方法预防及减少舒芬太尼诱发咳嗽反射的效果。方法采用随机分组方法,将入选患者分为6组,每组20²2例。A组:利多卡因1 mg/kg静注;B组:地塞米松10 mg静注;C组:氟比洛芬酯1 mg/kg静注;D组:右美托咪定1μg/kg,10 min泵注;E组:舒芬太尼0.4μg/kg,30 s推注;F组:舒芬太尼正常推注(干预措施为推注等剂量生理盐水)。除E组外,其他组均给予舒芬太尼0.4μg/kg推注,2 s内推注完毕。观察舒芬太尼推注1 min后患者咳嗽发生例数及咳嗽严重程度。结果各组咳嗽反射的发生率差异虽无统计学意义(P>0.05),但从趋势上来看,E组(舒芬太尼缓慢推注)发生率(9.1%)略低于其他各组(28.6%22例。A组:利多卡因1 mg/kg静注;B组:地塞米松10 mg静注;C组:氟比洛芬酯1 mg/kg静注;D组:右美托咪定1μg/kg,10 min泵注;E组:舒芬太尼0.4μg/kg,30 s推注;F组:舒芬太尼正常推注(干预措施为推注等剂量生理盐水)。除E组外,其他组均给予舒芬太尼0.4μg/kg推注,2 s内推注完毕。观察舒芬太尼推注1 min后患者咳嗽发生例数及咳嗽严重程度。结果各组咳嗽反射的发生率差异虽无统计学意义(P>0.05),但从趋势上来看,E组(舒芬太尼缓慢推注)发生率(9.1%)略低于其他各组(28.6%³1.8%)。E组(舒芬太尼缓慢推注)的咳嗽严重程度轻于其他各组,差异有统计学意义(P<0.05)。结论舒芬太尼缓慢静注能够明显降低麻醉诱导期舒芬太尼引起的咳嗽反应发生率,并减轻其引起咳嗽反射的严重程度。     

地塞米松对人颗粒脂肪裸鼠移植成活的影响

目的：探讨地塞米松对自体脂肪颗粒移植成活率、脂肪纤维化及坏死程度的影响。方法将抽脂获得的颗粒脂肪组织经洗涤纯化后分为两组,实验组（A组）加入地塞米松,对照组（B组）不加地塞米松,只加入同等体积的生理盐水,将经过不同处理的两组脂肪分别移植于裸鼠背部皮下,3个月后取出裸鼠皮下的脂肪组织,测量其重量,计算其成活率,并进行HE染色测定脂肪的囊腔数,评价其纤维化及坏死程度。结果湿重测定结果显示实验组脂肪颗粒注射移植的成活率（19.77±2.22）%高于对照组（12.80±1.73）%,两组间差异有统计学意义（P〈0.01）。HE染色结果显示实验组脂肪的囊腔数（209.68±16.74）显著高于对照组（11.72±1.11）,两组间差异有统计学意义（P〈0.01）。结论地塞米松可以提高颗粒脂肪移植后的成活率,并能有效降低注射脂肪的纤维化和坏死程度。     

圣肤霜中地塞米松稳定性的影响因素及处方工艺优化

目的：考察圣肤霜中地塞米松的稳定性,剔除影响因素,优化处方工艺.方法：采用分散均匀性和高温破坏实验方法,定量筛查影响地塞米松稳定性的因素,调整处方、改进工艺.结果：基质中pH 〉 7.3时地塞米松含量不稳定,呈明显的下降趋势;地塞米松在极性较强的溶液中溶解性降低,是导致药物分散不均匀的主要因素.以适量氮酮溶解地塞米松,依照工艺制备成乳膏可达到均匀分散的效果.调整处方pH在5.5 ～6.5 之间,地塞米松含量稳定.结论：以加速破坏实验和溶解度考察法综合分析影响药物稳定性的因素,该方法科学合理,适用于处方工艺的快速筛查及优化.     

地塞米松联合丙种球蛋白治疗小儿急性特发性血小板减少性紫癜的效果观察

目的 探讨不同治疗方法对小儿急性特发性血小板减少性紫癜的临床疗效.方法 选择2011年7月～2013年7月本院收治的93例特发性血小板减少性紫癜患儿为研究对象,将其随机分为对照组（46例）和观察组（47例）,两组患者均采用地塞米松注射液治疗,观察组另外加用丙种球蛋白,比较两组临床疗效、血小板上升时间、血小板恢复正常时间及出血停止时间.结果 观察组的总有效率为95.7％,明显高于对照组的78.3％ （P＜0.05）;观察组患者的血小板上升时间、血小板恢复正常时间及出血停止时间明显短于对照组（P＜0.05）.结论 地塞米松联合丙种球蛋白治疗小儿急性特发性血小板减少性紫癜能提高治疗效果,改善临床症状,迅速提高血小板数,改善出血症状,值得临床推广使用.