低分子肝素钙联合阿司匹林治疗急性脑梗死疗效观察

将120例脑梗死患者随机分成两组,对照组给予阿司匹林肠溶片口服 丹参注射液静滴,治疗组在此基础上加用低分子肝素钙0.6 ml皮下注射.比较两组治疗前后神经功能缺损程度评分变化情况,并进行临床疗效判定.结果 治疗组总有效率98.3%,对照组总有效率81.7%,两组比较有统计学差异(P＜0.05).两组治疗后神经功能缺损程度评分均较治疗前降低,但治疗组降低更明显(P均<0.05).血液学指标两组均无显著改善.认为低分子肝素钙联合阿司匹林治疗急性脑梗死疗效确切,使用安全.     

阿司匹林肠溶片联合辛伐他汀治疗老年短暂性脑缺血发作的疗效观察

目的 探讨辛伐他汀治疗老年短暂性脑缺血发作的临床疗效.方法 将60例短暂性脑缺血发作患者随机分为两组各30例,观察组给予阿司匹林肠溶片联合辛伐他汀治疗,对照组给予长春西汀注射液治疗,比较两组患者的临床疗效.结果 观察组总有效率为100%,对照组总有效率为73.33%,观察组疗效明显优于对照组,差异有统计学意义(P＜0.05).结论 阿司匹林肠溶片联合辛伐他汀治疗老年短暂性脑缺血发作疗效满意,可应用于临床推广.     

天麻素注射液治疗2型糖尿病合并短暂性脑缺血发作的临床观察与分析

目的观察采用天麻素治疗2型糖尿病合并短暂性脑缺血发作的(TIA)患者80例,与常规疗法行比较,讨论应用天麻素治疗2型糖尿病合并短暂性脑缺血发作(TIA)的有效性及安全性。方法择选该院白2012年1月—2014年12月住院治疗的80例TIA患者,根据住院时间随机分为观察组与对照组,观察组应用舒血宁、低分子肝素钙、阿司匹林肠溶片;治疗组应用舒血宁、低分子肝素钙、阿司匹林肠溶片的同时,加用天麻素注射液。1次/d,疗程均为14 d。结果:治疗组有效率治疗组95%,对照组80%,两组比较差异有统计学意义(P0.05),应用天麻素治疗2型糖尿病合并短暂性脑缺血发作可防止血管痉挛,并改善微循环,控制TIA发作,临床治疗效果显著。结论经过研究论证,应用天麻素治疗2型糖尿病合并短暂性脑缺血发作可防止血管痉挛,并改善微循环,控制TIA发作,临床治疗效果显著,具有药物显效快并缩短病程的优点,在研究中还发现,经过治疗,天麻素治疗的远期治疗效果较其它同类药物更加持久和稳定,可从根本上改善并提高2型糖尿病患者合并短暂性脑缺血发作患者的生活质量。     

脑心通胶囊在缺血性脑卒中二级预防中的应用

目的比较脑心通胶囊和阿司匹林肠溶片在缺血性脑卒中二级预防中的疗效和安全性。方法将90例缺血性脑卒中患者随机分为两组：脑心通胶囊组和阿司匹林组各45例。脑心通胶囊组给予步长脑心通胶囊口服,0.4g/粒,2粒/次,3次/d。阿司匹林组给予阿司匹林肠溶片口服,25mg/片,3片/次,1次/d。合并高血压、糖尿病和高血脂者,分别给予降压、降糖和降脂治疗,吸烟者戒烟。随访1年,比较两组患者缺血性脑卒中复发率和药物不良反应发生率。结果两组患者缺血性脑卒中复发率、不良反应发生率间差异均有统计学意义（P〈0.05）。结论脑心通胶囊在缺血性脑卒中二级预防中的疗效优于阿司匹林,安全性较高,值得推广应用。     

糖尿病并发急性心梗患者的临床治疗效果观察

目的探讨糖尿病并发急性心梗患者的临床治疗效果。方法选取2014年12月—2017年12月该院冠心病监护病房收治的糖尿病并发急性心梗患者35例作为观察组,选取同期于该院接受治疗的非糖尿病合并急性心梗患者35例作为对照组,对两组患者同时进行重组链激酶静脉治疗,分析治疗效果。结果观察组患者的IRA再通率为45.71%(16/35),明显低于对照组患者的IRA再通率65.71%(23/35),差异有统计学意义(P0.05)。观察组患者的病死率为14.29%(5/35),对照组患者的病死率为17.14%(6/35),两组患者病死率之间的对比差异无统计学意义(P0.05)。观察组患者年龄明显大于对照组,并且观察组男性患者比例明显高于对照组,差异有统计学意义(P0.05)。观察组患者的溶栓时间明显长于对照组,差异具有统计学意义(P0.05)。两组患者的胸痛发生率差异无统计学意义(P0.05)。对所有患者进行实验室检查,观察组患者的BS、TC浓度明显高于对照组,HDL-C明显低于对照组,差异有统计学意义(P0.05),其余各项对比差异无统计学意义(P0.05)。观察组患者在泵衰竭、感染和房室传导阻滞方面的发生率明显高于对照组,差异有统计学意义(P0.05)。在室速/室颤、梗死后心绞痛、出血等方面的对比差异无统计学意义(P0.05)。结论糖尿病并发急性心梗患者的临床治疗效果明显比非糖尿病并发急性心梗患者差,在对糖尿病并发急性心梗患者进行治疗时,要根据患者的实际情况采取对症治疗措施,提升对患者的治疗效果。     

疏血通治疗非ST段抬高急性心肌梗死疗效观察

目的探讨疏血通注射液治疗非ST段抬高急性心肌梗死的疗效。方法选择住院的非ST段抬高急性心肌梗死患者63例。随机分为对照组和治疗组。对照组常规给予阿司匹林、单硝酸异山梨酯、辛伐他汀、低分子肝素等治疗;治疗组在对照组治疗的基础上加用疏血通注射液治疗。两组均治疗观察两周。结果治疗组总有效率为93.7%,优于对照组的80.6%(P<0.05)。治疗组症状缓解或消失,治疗组患者心电图、心肌酶与对照组比较差异均有统计学意义(P<0.05)。治疗组在用药过程中未见不良反应。结论在常规治疗的基础上,给予疏血通注射液治疗非ST段抬高急性心肌梗死安全有效。     

丹红注射液治疗急性心肌梗死溶栓后再灌注损伤的疗效分析

目的研究丹红注射液治疗急性心肌梗死溶栓后再灌注损伤的疗效。方法选取2012年4月~2015年3月我院收治的急性心肌梗死患者62例作为研究对象,将其随机分为对照组与观察组,各31例。对照组给予尿激酶、阿司匹林、低分子肝素钙治疗,观察组在对照组的治疗基础上给予丹红注射液治疗,两组溶栓后再通情况与并发症发生率比较。结果 1观察组再灌注心律失常发生率低于对照组,胸痛缓解率高于对照组,差异有统计学意义(P0.05)。观察组再通率为61.29%,对照组再通率为48.39%,差异无统计学意义(P0.05)。2观察组的心力衰竭、心绞痛发生率低于对照组,差异有统计学意义(P0.05)。结论丹红注射液的应用可降低急性心肌梗死患者心力衰竭、心绞痛发生率,对心脏缺血再灌注损伤可起到保护作用,值得临床推广与应用。     

氯吡格雷联用阿司匹林治疗糖尿病并发急性脑梗死临床分析

目的探讨氯吡格雷与阿司匹林联用治疗糖尿病并发急性脑梗死的临床价值。方法选择2011年4月至2015年2月我院收治的糖尿病并发急性脑梗死患者150例作为研究对象,随机分为三组,每组50例。三组患者均给予常规治疗,在此基础上,对照一组患者给予阿司匹林治疗,对照二组患者给予氯吡格雷治疗,观察组患者联用阿司匹林、氯吡格雷治疗。观察分析三组患者的临床疗效以及NIHSS评分。结果观察组患者治疗总有效率(92.0%)显著高于对照一组(70.0%)和对照二组患者(72.0%),差异有统计学意义(P0.05);观察组患者临床疗效显著优于对照一组和对照二组患者(P0.01)。治疗后观察组患者NIHSS评分显著低于对照一组和对照二组患者,差异有统计学意义(P0.01)。结论联用阿司匹林与氯吡格雷治疗糖尿病并发急性脑梗死患者,能发挥药物协同作用,增强疗效;同时能改善患者脑部血供,减轻神经功能缺损,促进神经功能恢复。     

注射用低分子量肝素钙治疗不稳定型心绞痛的疗效评价

目的探讨注射用低分子量肝素钙治疗不稳定型心绞痛的临床疗效及安全性。方法选择在本院就诊的不稳定型心绞痛患者90例,分为对照组和观察组。对照组采用常规治疗;观察组在对照组基础上给予注射用低分子量肝素钙。结果观察组总有效率明显高于对照组。结论应用注射用低分子量肝素钙治疗不稳定型心绞痛疗效佳,具有良好的安全性。     

氯吡格雷联合阿司匹林治疗糖尿病并发急性脑梗死的临床研究

目的探讨氯吡格雷联合肠溶阿司匹林治疗糖尿病并发急性非心源性脑梗死的早期疗效和安全性。方法选择90例糖尿病并发首次非心源性急性脑梗死的患者,随机分为治疗组(45例)和对照组(45例)。治疗组给予氯吡格雷联合肠溶阿司匹林治疗,对照组给予肠溶阿司匹林治疗,分别在治疗前后进行临床疗效评定、神经功能缺损评分(NDS)及发生出血不良反应统计。结果在糖尿病并发急性非心源性脑梗死的早期治疗中,两组临床疗效比较和神经功能缺损评分比较有统计学意义(P0.05);两组均无发生脑出血,两组不良反应比较差异无统计学意义(P0.05)。结论氯吡格雷联合肠溶阿司匹林在糖尿病并发急性非心源性脑梗死的早期治疗中疗效显著,优于单用肠溶阿司匹林,且不良反应轻,出血发生率低,值得临床推广应用。     

肿瘤病人弓形虫感染分析

在肿瘤的发生和发展进程中 ,多伴有免疫功能低下或缺陷 ,从而极易遭受各种感染。弓形虫是机会感染因子 ,当患者免疫功能受损时 ,易于感染 ,还会使隐性感染激活 ,引起低热不退、淋巴结肿和脑神经系统的反应 ,此现象尚未引起临床医师的重视。近年来 ,我们对 4 0 9例肿瘤病人进行了弓形虫感染及弓形虫病的分析观察 ,报告如下 :1　材料与方法1 1　材料　 30 4例病人血清取自江西省肿瘤医院住院或门诊病人 ,随机抽样后低温保存待检 ,10 5例取自其他医院送检样品 ,有急性症状者随到随检 ,以便及时做病原学检测。1 2　弓形虫病诊断方法1 2 1　免疫…     

A patient with rectal ulcer with severe stenosis presenting with perforated peritonitis

We report a patient with rectal ulcer with severe stenosis, who underwent urgent surgical treatment for perforated peritonitis. The 54-year-old man suddenly developed cramping abdominal pain and fever while hospitalized, with signs of peritoneal irritation. An emergency laparotomy was performed, and severe stenosis of the rectum and a perforated lesion on the oral side approximately 10 cm distant from the stenosis were found, with massive abdominal purulent fluid. He was treated by rectosigmoid colon resection with transverse colon loop colostomy. Histopathologically, the stenosis was caused by ulceration extending to all muscular layers of the rectum, with inflammatory changes. Benign rectal stenosis is so rare that differential diagnosis from malignancy may be difficult when there are inflammatory changes in the surrounding tissues. However, it is necessary to keep in mind the likelihood of this disease in differentiation from rectal cancer. Received: December 21, 1998 / Accepted: May 28, 1999     

Infection with Rhodococcus equi in a patient with sarcoidosis treated with corticosteroids

A 51-year-old female farmer was diagnosed as having sarcoidosis. During 4 years of observation, slow radiological progression was observed. Cough then developed, necessitating treatment with corticosteroids. After 28 months of continuous treatment with prednisolone in low doses (5-7.5 mg daily), she suffered fever episodes, recurrent haemoptyses, general malaise and loss of weight. A chest roentgenogram showed a left upper lobe infiltrate, which progressed and finally cavitated, and rib destruction. Despite efforts, including a thoracotomy, 22 months passed before a diagnosis could be made. Blood and sputum cultures and cultures from the destroyed rib showed growth of Rhodococcus equi, a common soil organism which can cause infections in foals and other animals. Treatment with rifampicin and erythromycin was successful. R. equi has been reported to cause infection in patients with neoplastic disease and/or immunosuppression, but the disease might be more common than is suggested by the sparse case reports in the literature, owing to lack of familiarity with the organism, which will tend to be overlooked as a contaminant.     

Evaluation of atrial vulnerability with transoesophageal stimulation in patients with atrioventricular junctional: Comparison with patients with ventricular pre-excitation and with normal subjects

The aim of our work was to evaluate the inducibility of atrialfibrillation in a group of patients with atrioventricular junctionalreentrant tachycardia and to compare it with that of patientswith a Kent-type ventricular pre-excitation (Wolff-Parkinson-Whitesyndrome) and a control group. One hundred and twenty-five subjects were separated into groups.Group 1 comprised 49 Wolff-Parkinson-White patients, with amean age of 26.4, range 10.66 years; group 2, 51 patients withatrioventricular junctional reentrant tachycardia inducibleby transoesophageal atrial stimulation andlor clinically documented,with a mean age of 43.4, range 16–78 years; group 3, 25control subjects with a mean age of2.64, range 13–76 years. Each subject underwent atrial transoesophageal stimulation withthe following protocol: programmed atrial stimulation with 1and 2 stimuli during atrial pacing of 100. min^–1 and 150.min^–1; atrial stimulation for 10 s at a rate of 200–300–400–500–600.min^–1 with intervals of 10 s between stimulations, fivesuccessive ‘ramp-up’ atrial stimulations for 9 swith the rate increasing from 100 to 800. min^–1 with intervalsof 10 s between stimulations. The end point was the completionof the protocol or induction of sustained atrial fibrillation(>1 min). The chi-square test was used for statistical analysis. Our resultsshowed that in group 1 atrial fibrillation was induced in 27149patients (55.1%); this was sustained in 13149 (26.5%) and non-sustainedin 14149 (28.5%); in group 2, atrial fibrillation was inducedin 22151 patients (43.0%); it was sustained in 7151 (13.7%)and non-sustained in 15151 (29.4%); in group 3, sustained atrialfibrillation was not induced in any subject and in only onesubject was a non-sustained atrial fibrillation (4 s) induced. The chi-square test showed that group 2 vs group 1 were non-significant,while group 2 vs group 3 and group 1 vs group 3 were significant(P<0.003 and P<0.0007, respectively). Therefore group 2 patients showed a greater atrial vulnerabilityin comparison to the control subjects and a similar vulnerabilityto group 1 patients. It is possible that the greater atrialvulnerability in the patients of group 2 was due to the doublenodal pathway.     

Treating patients with lupus with B-cell depletion

A new era in the treatment of systemic lupus erythematosus has dawned with the increasing introduction of monoclonal antibodies and other approaches, that target the key molecules involved in the pathogenesis of the disease. At present the ability to block the CD20 molecule on those B cells that carry this marker has proved the most effective way to treat patients resistant to conventional immunosuppressive drugs. However, these studies have all been open label and the results of double blind controlled studies are eagerly awaited.