蔗糖铁注射液联合肠内营养制剂治疗骨科术后贫血的疗效观察

目的探讨蔗糖铁注射液联合肠内营养制剂治疗骨科术后患者贫血的疗效。方法选择骨折术后贫血患者128例,随机分为观察组和对照组,每组64例。2组均使用肠内营养制剂的基础上,观察组采用静脉滴注蔗糖铁注射液,对照组采用口服硫酸亚铁片补铁。观察组术后前3 d每天给予蔗糖铁200 mg,对照组口服硫酸亚铁片300 mg,3次/d,疗程1周。比较2组患者术后贫血的治疗效果及药物不良反应。结果 2组患者贫血状况都得到改善,观察组改善的情况高于对照组,差异有统计学意义(P<0.05)。观察组2例(4.6%)发生轻微过敏反应,经药物治疗后治愈;对照组出现25例(39.0%)不良反应,2组患者不良反应发生率差异有统计学意义(P<0.05)。结论与口服铁剂比较,静脉滴注蔗糖铁注射液能更好的纠正骨折术后贫血,改善肠内营养的疗效,促进患者尽快康复。     

右旋糖酐铁与蔗糖铁治疗胃大部切除术后缺铁性贫血的疗效及安全性比较

目的:比较右旋糖酐铁与蔗糖铁治疗胃大部切除术后缺铁性贫血的临床疗效及安全性。方法:将90例胃大部切除术后缺铁性贫血患者随机均分为右旋糖酐铁组和蔗糖铁组。所有患者均于胃大部切除术后给予抗溃疡、胃肠减压、抗感染等常规治疗。在此基础上,右旋糖酐铁组患者给予右旋糖酐铁注射液100 mg,深部肌肉注射,每周3次;蔗糖铁注射液组患者给予蔗糖铁注射液100 mg加入0.9%氯化钠注射液10 ml中,静脉滴注,每周3次。两组患者疗程均为2周。观察两组患者的临床疗效,治疗前后血常规指标[血红蛋白(HGB)、血细胞比容(HCT)、平均红细胞血红蛋白浓度(MCH)、血清铁蛋白(SF)、转铁蛋白饱和度(TS)]、术后恢复情况(感染例数、平均住院天数)及不良反应发生情况。结果:两组患者的总有效率、术后恢复情况比较,差异均无统计学意义(P>0.05)。治疗前两组血常规指标比较,差异均无统计学意义(P>0.05);治疗后两组患者血常规指标均显著高于同组治疗前,差异有统计学意义(P<0.05),但两组间比较差异无统计学意义(P>0.05)。蔗糖铁组患者不良反应发生率显著低于右旋糖酐铁组,两组比较差异有统计学意义(P<0.05)。结论:右旋糖酐铁、蔗糖铁治疗胃大部切除术后缺铁性贫血的疗效相当,但蔗糖铁的安全性优于右旋糖酐铁。     

蔗糖铁注射液治疗缺铁性贫血的疗效观察

目的观察蔗糖铁注射液治疗缺铁性贫血(IDA)的临床疗效,并观察不良反应的发生情况。方法将自2008年10月至2010年10月我科收治的57例IDA患者随机分为观察组30例和对照组27例,观察组给予蔗糖铁注射液静脉滴注,对照组给予琥珀酸亚铁口服,总疗程均为8周,治疗后测定血红蛋白(Hb)和血清铁蛋白(SF),比较两组的临床疗效并观察不良反应的发生情况。结果观察组和治疗组治疗后总有效率间的差异无统计学意义(P>0.05);但是观察组治愈率明显优于对照组,差异有统计学意义(P<0.05);并且观察组Hb和SF指标改善情况亦明显优于对照组,差异有统计学意义(P<0.05);观察组不良反应的发生率仅为3.33%,明显低于对照组(29.6%)差异有统计学意义(P<0.05)。结论蔗糖铁注射液治疗IDA疗效显著,耐受性好,不良反应少。     

静脉应用蔗糖铁治疗慢性肾功能衰竭患者肾性贫血的临床效果评价

目的探讨静脉应用蔗糖铁治疗慢性肾功能衰竭患者肾性贫血的临床效果。方法根据随机数字表法进行2012年2月至2018年2月90例慢性肾功能衰竭肾性贫血患者分成不同组。对照组给予促红细胞生成素治疗,观察组则给予促红细胞生成素联合静脉应用蔗糖铁治疗。比较两组慢性肾功能衰竭肾性贫血治疗效果;贫血纠正时间、症状缓解时间;治疗前后患者血红蛋白、转铁蛋白饱和度、血清铁蛋白、血细胞比容;治疗不良反应发生率。结果观察组慢性肾功能衰竭肾性贫血治疗效果高于对照组,P <0.05;观察组贫血纠正时间、症状缓解时间优于对照组,P <0.05;治疗前两组血红蛋白、转铁蛋白饱和度、血清铁蛋白、血细胞比容相近,P> 0.05;治疗后观察组血红蛋白、转铁蛋白饱和度、血清铁蛋白、血细胞比容优于对照组,P <0.05。观察组治疗不良反应率和对照组无明显差异,P> 0.05。结论促红细胞生成素联合静脉应用蔗糖铁治疗慢性肾功能衰竭肾性贫血的应用效果确切,可纠正贫血,改善实验室指标,无明显不良反应,安全有效,值得推广应用。     

蔗糖铁联合促红细胞生成素治疗血液透析患者肾性贫血的疗效观察

目的:观察蔗糖铁联合促红细胞生成素(EPO)治疗血液透析患者肾性贫血的临床效果,探讨血液透析患者肾性贫血的最佳治疗方案.方法:选择血液透析伴肾性贫血患者136例,随机分为对照组与观察组,各68例.对照组采用EPO治疗,观察组患者采用蔗糖铁联合EPO治疗.治疗8周后观察2组临床疗效和血红蛋白(Hb)、红细胞(RBC)、红细胞压积(HCT)、血清铁蛋白(SF)及血清转铁蛋白饱和度(TSAT)水平.结果:治疗8周后,观察组总有效率为86.8%高于对照组的72.1%,差异有统计学意义(P<0.05).治疗8周后,观察组Hb、RBC、HCT、SF及TSAT水平均优于对照组,差异有统计学意义(P<0.05).结论:治疗血液透析患者肾性贫血时,首选蔗糖铁联合EPO治疗,可有效为善贫血症状、提高临床疗效.     

蔗糖铁注射液治疗异常子宫出血相关性贫血的疗效

目的 探讨蔗糖铁注射液治疗异常子宫出血相关性贫血的疗效。方法 选取2019年1月～2021年6月收治的82例异常子宫出血相关性贫血患者列为研究对象,随机分为观察组（42例）和对照组（40例）,其中观察组采用静脉输入蔗糖铁注射液,对照组口服琥珀酸亚铁治疗。治疗1周后,比较治疗前后铁代谢指标、红细胞指标变化、临床疗效和不良反应情况。结果 治疗后,观察组血清转铁蛋白（Serum Transferrin,SF）和转铁蛋白饱和度（Transferrin Saturation,TS）水平高于对照组,差异具有统计学意义（P <0.05）;治疗后,观察组红细胞（red blood cell,RBC）和血红蛋白（hemoglobin,Hb）水平高于对照组,差异具有统计学意义（P <0.05）;观察组临床总有效率为95.23%,明显高于对照组80.00%,差异具有统计学意义（P <0.05）;观察组患者不良反应发生率为4.76%,低于对照组22.50%,差异具有统计学意义（P <0.05）。结论 蔗糖铁注射液治疗妇科异常子宫出血相关性贫血,可有效改善贫血症状,降低不良反应发生率,提...     

蔗糖铁注射液联合复方阿胶浆治疗产后贫血69例

目的观察蔗糖铁注射液联合复方阿胶浆治疗产后贫血的临床疗效,并总结和分析产后贫血的护理要点。方法将138例产后贫血患者随机分为对照组和观察组,各69例,对照组患者给予蔗糖铁注射液治疗,观察组患者在对照组基础上加用复方阿胶浆治疗,蔗糖铁注射液治疗3 d,复方阿胶浆治疗4周。分别观察治疗前后红细胞(RBC)、血红蛋白(Hb)、红细胞比容(HCT)、血清铁蛋白(SF)、总铁结合力(TIBC)等指标的变化,结合患者症状和体征的改善情况评价疗效,并观察不良反应发生情况。结果对照组总有效率为65.22%,低于观察组的79.71%(P<0.05);两组患者治疗后的RBC,Hb,HCT均较治疗前显著上升(P<0.05),且观察组患者升高更明显(P<0.05);两组患者治疗后的SF较治疗前有显著上升(P<0.05),而Tf较治疗前显著下降(P<0.05),且观察组患者较对照组SF升高更明显,而TIBC下降更多(P<0.05)。两组患者不良反应发生率比较无明显差异(P>0.05)。结论蔗糖铁注射液联合复方阿胶浆治疗产后贫血临床疗效良好,能有效促进红系造血、改善患者贫血症状,且不良反应小,值得临床推广。     

蔗糖铁联合应用促红细胞生成素治疗血透患者肾性贫血的临床观察

目的观察静脉蔗糖铁(氢氧化铁蔗糖复合物)联合应用重组人促红细胞生成素(rHuEPO)治疗维持性血液透析患者肾性贫血的有效性和安全性。方法将43例维持性血液透析存在贫血的患者随机分为两组,观察组应用蔗糖铁注射液,对照组应用多糖铁复合物胶囊(力蜚能)。两组均联合应用EPO及叶酸、腺苷钴胺治疗;治疗8周后观察患者红细胞(RBC)、血红蛋白(Hb)、红细胞比容(HCT)、血清铁蛋白(SF)及转铁蛋白饱和度(TSAT)等指标的变化情况及有无不良反应。结果观察组Hb、Hct、SF及TSAT均较治疗前有显著升高且高于对照组。两组比较有显著性差异(P<0.01),不良反应少。结论静脉用蔗糖铁联合EPO治疗血液透析患者肾性贫血,疗效确切,安全性好。     

蔗糖铁与琥珀酸亚铁治疗血液透析患者肾性贫血的疗效观察

目的观察静脉与口服两种补铁途径,治疗维持性血液透析患者肾性贫血的效果。方法 48例血液透析患者随机分为两组,治疗组应用蔗糖铁经透析器静脉端直接注射;对照组予琥珀酸亚铁片口服;两组均同时使用重组人促红素(r Hu EPO),治疗12周,治疗前后监测血红蛋白(Hb)、红细胞压积(Hct)、血清铁蛋白(SF)、转铁蛋白饱和度(TSAT),同时观察药物相关的不良反应。结果治疗后两组患者Hb、Hct、SF、TSAT均较治疗前有明显升高(P<0.05),并且治疗组与对照组在改善铁储存和铁利用方面有显著差异(P<0.05),治疗组无明显不良反应;对照组有6例出现胃肠道反应。结论在常规应用r Hu EPO的同时,经静脉注射蔗糖铁治疗肾性贫血疗效明显,不良反应少,安全性高,明显优于口服琥珀酸亚铁,值得推广。     

蔗糖铁注射液与复方阿胶浆用于产后贫血治疗的大样本随机对照研究

目的 探讨产后贫血患者采用蔗糖铁注射液与复方阿胶浆治疗的临床疗效.方法 选取收治的产后贫血患者439例,随机分为对照组219例和观察组220例.对照组给予单纯蔗糖铁注射液治疗,观察组给予蔗糖铁注射液与复方阿胶浆联合治疗.比较2组临床疗效、血常规相关指标、肝肾功能、不良反应发生情况.结果 观察组治疗总有效率为82(.0%明显高于对照组的66.0%,差异有统计学意义(P<0.05);观察组RBC、Hb、HCT、SIBC、TIBC等血常规相关指标明显优于对照组,差异有统计学意义(P<0.05);2组的ALT、AST、Cr、BUN等肝肾指标差异无统计学意义(P>0.05);2组治疗后无明显不良反应发生.结论 产后贫血患者采用蔗糖铁注射液与复方阿胶浆联合治疗,可明显提高患者的临床疗效,改善贫血症状,且无严重不良反应发生,是一种安全、可靠的治疗方法 .     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

Comparison of in vitro cell models in predicting in vivo brain entry of drugs

Although several in vitro models have been reported to predict the ability of drug candidates to cross the blood-brain barrier, their real in vivo relevance has rarely been evaluated. The present study demonstrates the in vivo relevance of simple unidirectional permeability coefficient (P(app)) determined in three in vitro cell models (BBMEC, Caco-2 and MDCKII-MDR1) for nine model drugs (alprenolol, atenolol, metoprolol, pindolol, entacapone, tolcapone, baclofen, midazolam and ondansetron) by using dual probe microdialysis in the rat brain and blood as an in vivo measure. There was a clear correlation between the P(app) and the unbound brain/blood ratios determined by in vivo microdialysis (BBMEC r=0.99, Caco-2 r=0.91 and MDCKII-MDR1 r=0.85). Despite of the substantial differences in the absolute in vitro P(app) values and regardless of the method used (side-by-side vs. filter insert system), the capability of the in vitro models to rank order drugs was similar. By this approach, thus, the additional value offered by the true endothelial cell model (BBMEC) remains obscure. The present results also highlight the need of both in vitro as well as in vivo methods in characterization of blood-brain barrier passage of new drug candidates.