抗病毒治疗对乙型肝炎病毒感染者肾移植术后临床转归的影响

目的 探讨乙型肝炎病毒感染者肾移植术后临床转归及治疗对策.方法 将术前乙肝病毒标志物阳性(HBsAg阳性、HBeAg阳性或HBeAb阳性、HBV DNA阳性或阴性)的32例肾移植术后患者分为抗病毒治疗组和无抗病毒治疗组两组.观察两组(术前1周至术后9年)的肝功能(ALT、AST、TBIL、PT)变化、病毒复制(HBV DNA)及存活情况.结果 抗病毒治疗组23例患者肝功能损害复常率为82.60%,存活率为82.60%,HBV DNA(PCR法)下降(≥2 log10)或保持低复制率为86.95%;未抗病毒组9例患者肝功能损害复常率为22.22%,存活率为11.11%,HBV DNA(PeR法)下降(≥2log10)或保持低复制率为11.11%.抗病毒组肝功能复常率、存活率及HBV DNA下降或保持低复制率高于无抗病毒组,两组比较差异有统计学意义(P<0.05).19例拉米夫定治疗患者6例出现病毒学反弹31.58%,1例加用阿德福韦酯,2例换用恩替卡韦后好转,其余3例肝功能衰竭死亡.结论 持续有效的抗病毒治疗可以有效控制乙肝病毒复制,促进肝功能恢复,减少肝衰竭发生,提高乙肝病毒感染者肾移植术后患者存活率.在治疗过程中出现病毒学反弹应及时换用或加用有效药物减少肝衰竭发生.     

慢性乙肝患者血清趋化因子RANTES水平与肝功能生化指标等的相关性研究

Objective To investigate the level of the serum chemokine RANTES and its correlation with serum biochemical indices of liver function test, HBeAg and HBV DNA load in patients with chronic hepatitis B.Methods 144 patients with chronic hepatitis B (observed group) and 18 normal cases (control group) were enrolled in this study. The serum level of chemokine RANTES was detected with an ABC-ELISA assay. Statistical analysis was performed on the software of SPSS13.0. Results The serum chemokine RANTES level in the observed group (3930.12 ng/ml±2856.96) ng/ml was significantly higher than that in the control group (329.46 ng/ml±152.23) ng/ml. The results from the observed group indicated the positive correlation of serum RANTES level with indices of liver function test, including ALT (r=0. 197, P=0.018), AST(r=0.239, P=0.004) and TBil (r=0.316, P=0.001), but did not with PTA (r=-0.078, P=0.357). Neither difference of serum chemokine RANTES level between HBeAg-positive group and HBeAg-negative group nor that between high HBV DNA load group (≥105 copies/ml) and low HBV DNA load group (< 105 copies/ml) were statistically significant (P=0.407 and 0.185, respectively). Conclusions Serum chemokine RANTES level in patients with chronic hepatitis B elevates significantly and is not affected by HBeAg or HBV DNA load. Its positive correlation with indices of liver function test indicates that RANTES might play an important rule in the pathogenesis of chronic hepatitis B.     

抗病毒治疗对乙型肝炎病毒感染者肾移植术后临床转归的影响

目的 探讨乙型肝炎病毒感染者肾移植术后临床转归及治疗对策.方法 将术前乙肝病毒标志物阳性(HBsAg阳性、HBeAg阳性或HBeAb阳性、HBV DNA阳性或阴性)的32例肾移植术后患者分为抗病毒治疗组和无抗病毒治疗组两组.观察两组(术前1周至术后9年)的肝功能(ALT、AST、TBIL、PT)变化、病毒复制(HBV DNA)及存活情况.结果 抗病毒治疗组23例患者肝功能损害复常率为82.60%,存活率为82.60%,HBV DNA(PCR法)下降(≥2 log10)或保持低复制率为86.95%;未抗病毒组9例患者肝功能损害复常率为22.22%,存活率为11.11%,HBV DNA(PeR法)下降(≥2log10)或保持低复制率为11.11%.抗病毒组肝功能复常率、存活率及HBV DNA下降或保持低复制率高于无抗病毒组,两组比较差异有统计学意义(P<0.05).19例拉米夫定治疗患者6例出现病毒学反弹31.58%,1例加用阿德福韦酯,2例换用恩替卡韦后好转,其余3例肝功能衰竭死亡.结论 持续有效的抗病毒治疗可以有效控制乙肝病毒复制,促进肝功能恢复,减少肝衰竭发生,提高乙肝病毒感染者肾移植术后患者存活率.在治疗过程中出现病毒学反弹应及时换用或加用有效药物减少肝衰竭发生.     

慢性乙肝患者血清趋化因子RANTES水平与肝功能生化指标等的相关性研究

Objective To investigate the level of the serum chemokine RANTES and its correlation with serum biochemical indices of liver function test, HBeAg and HBV DNA load in patients with chronic hepatitis B.Methods 144 patients with chronic hepatitis B (observed group) and 18 normal cases (control group) were enrolled in this study. The serum level of chemokine RANTES was detected with an ABC-ELISA assay. Statistical analysis was performed on the software of SPSS13.0. Results The serum chemokine RANTES level in the observed group (3930.12 ng/ml±2856.96) ng/ml was significantly higher than that in the control group (329.46 ng/ml±152.23) ng/ml. The results from the observed group indicated the positive correlation of serum RANTES level with indices of liver function test, including ALT (r=0. 197, P=0.018), AST(r=0.239, P=0.004) and TBil (r=0.316, P=0.001), but did not with PTA (r=-0.078, P=0.357). Neither difference of serum chemokine RANTES level between HBeAg-positive group and HBeAg-negative group nor that between high HBV DNA load group (≥105 copies/ml) and low HBV DNA load group (< 105 copies/ml) were statistically significant (P=0.407 and 0.185, respectively). Conclusions Serum chemokine RANTES level in patients with chronic hepatitis B elevates significantly and is not affected by HBeAg or HBV DNA load. Its positive correlation with indices of liver function test indicates that RANTES might play an important rule in the pathogenesis of chronic hepatitis B.     

慢性乙肝患者血清趋化因子RANTES水平与肝功能生化指标等的相关性研究

Objective To investigate the level of the serum chemokine RANTES and its correlation with serum biochemical indices of liver function test, HBeAg and HBV DNA load in patients with chronic hepatitis B.Methods 144 patients with chronic hepatitis B (observed group) and 18 normal cases (control group) were enrolled in this study. The serum level of chemokine RANTES was detected with an ABC-ELISA assay. Statistical analysis was performed on the software of SPSS13.0. Results The serum chemokine RANTES level in the observed group (3930.12 ng/ml±2856.96) ng/ml was significantly higher than that in the control group (329.46 ng/ml±152.23) ng/ml. The results from the observed group indicated the positive correlation of serum RANTES level with indices of liver function test, including ALT (r=0. 197, P=0.018), AST(r=0.239, P=0.004) and TBil (r=0.316, P=0.001), but did not with PTA (r=-0.078, P=0.357). Neither difference of serum chemokine RANTES level between HBeAg-positive group and HBeAg-negative group nor that between high HBV DNA load group (≥105 copies/ml) and low HBV DNA load group (< 105 copies/ml) were statistically significant (P=0.407 and 0.185, respectively). Conclusions Serum chemokine RANTES level in patients with chronic hepatitis B elevates significantly and is not affected by HBeAg or HBV DNA load. Its positive correlation with indices of liver function test indicates that RANTES might play an important rule in the pathogenesis of chronic hepatitis B.     

慢性乙肝患者血清趋化因子RANTES水平与肝功能生化指标等的相关性研究

Objective To investigate the level of the serum chemokine RANTES and its correlation with serum biochemical indices of liver function test, HBeAg and HBV DNA load in patients with chronic hepatitis B.Methods 144 patients with chronic hepatitis B (observed group) and 18 normal cases (control group) were enrolled in this study. The serum level of chemokine RANTES was detected with an ABC-ELISA assay. Statistical analysis was performed on the software of SPSS13.0. Results The serum chemokine RANTES level in the observed group (3930.12 ng/ml±2856.96) ng/ml was significantly higher than that in the control group (329.46 ng/ml±152.23) ng/ml. The results from the observed group indicated the positive correlation of serum RANTES level with indices of liver function test, including ALT (r=0. 197, P=0.018), AST(r=0.239, P=0.004) and TBil (r=0.316, P=0.001), but did not with PTA (r=-0.078, P=0.357). Neither difference of serum chemokine RANTES level between HBeAg-positive group and HBeAg-negative group nor that between high HBV DNA load group (≥105 copies/ml) and low HBV DNA load group (< 105 copies/ml) were statistically significant (P=0.407 and 0.185, respectively). Conclusions Serum chemokine RANTES level in patients with chronic hepatitis B elevates significantly and is not affected by HBeAg or HBV DNA load. Its positive correlation with indices of liver function test indicates that RANTES might play an important rule in the pathogenesis of chronic hepatitis B.     

恙虫病95例临床分析

恙虫病是由恙虫病立克次体引起的一种急性传染病,属于自然疫源性疾病。此病主要流行于亚洲太平洋地区,我国以东南沿海多见。其临床表现多样化,可出现多器官损害,易造成误诊。现对我院传染病科自１９９２年６月至２０００年吕月期间收住的９５例恙虫病进行回顾性分析,报告如下：ｌ临床资料１．ｌ一般资料 １９９２年６月－２０００年吕月我科收治的恙虫病患者９５例,全部病例均符合诊断标准。其中男６８例,女２７例。年龄４－７７岁,平均年龄３４．６】１８．３６岁。大部分病例来自广东珠三角地区,发病时间全年均有,ｌ－３月发病…     

混悬液上药法制备非诺贝特微丸的处方研究

目的:采用流化床混悬液上药法制备非诺贝特速释微丸。方法:以上药效率、脆碎度、粘连率为评价指标,考察并优化混悬液上药法制备非诺贝特速释微丸的处方。结果:确定FNBT/HPMC-E5/SDS=160∶20∶1.6为最佳配比处方,选定固含量为20%,上药效率为95%,溶出度为15 min达90%。结论:流化床混悬液上药法制备非诺贝特微丸,上药效率高,方法简便可靠,溶出迅速。     

超选择支气管动脉栓塞治疗急诊大咯血11例的体会

急性大咯血是呼吸科常见急症之一，患者一般死于窒息和休克，内科保守治疗效果有时不理想。而采用支气管动脉栓塞治疗大咯血可获得较佳疗效。我院从2003年1月至2005年12月应用介入技术进行超选择性支气管动脉栓塞治疗11例急性大咯血患者，现报告如下。     

肝转移性结肠癌的介入治疗

肝脏特殊的解剖结构及生理位置使其成为结肠癌的常见转移部位,既往治疗多采用全身化疗和手术治疗,效果欠佳,而介入治疗为提高患者的生存率提供了一种有效的方法。我科自2001年3月至2005年5月收治肝转移性结肠癌患者231例,疗效显著,报告如下。1资料与方法1.1一般资料231例患者均经临床影像学检查证实,年龄30岁78岁,男126例,女105例。症状除原发灶症状外多表现为肝区疼痛、腹胀、消瘦、乏力等。其中117例原发灶手术切除,肝脏病灶大多为多发,均未见门静脉癌栓形成。1.2方法采用seldinger法经股动脉穿刺插管先行肝总动脉造影,显示肝内病灶及供血…