左卡尼汀联合促红细胞生成素对肾性贫血的疗效观察

目的:通过观察左卡尼汀联合促红细胞生成素对尿毒症维持性血液透析患者肾性贫血的疗效,探讨左卡尼汀在肾性贫血中的治疗价值。方法:将维持性血液透析患者60例随机分成两组,两组均于血液透析后皮下注射促红细胞生成素(EPO),治疗组每次加用左卡尼汀1.0 g静脉注射,连续治疗12周。治疗前后比较血红蛋白(Hb)、红细胞比容(Hct)并评价。结果:两组治疗前后的Hb、Hct均有升高,而治疗组较对照组升高差异具有统计学意义(P<0.05)。而血压、心率、肾功能等指标在治疗前后无明显变化。结论:左卡尼汀联合促红细胞生成素对肾性贫血治疗效果好,优于单用促红细胞生成素纠正贫血。     

慢性肾衰患者血细胞参数分析及意义

肾性贫血、凝血机制不良及出血倾向是慢性肾衰患者的常见并发症,一般认为肾性贫血是红细胞生成素下降所致的正细胞性贫血;造成凝血机制不良的原因是多方面的,我们主要通过对慢性肾衰患者的血红蛋白,红细胞参数和血小板参数进行了检测分析,探讨了血小板参数与凝血机制不良之间的关系以及肾衰患者贫血的性质。     

肾性贫血治疗中静脉铁剂的合理应用

肾性贫血的治疗,不仅需要合理应用促红细胞生成素(EPO),还需要及时有效地补充铁剂,否则,即使长期大剂量使用EPO,贫血也难以纠正.据统计,在美国接受EPO治疗的终末期慢性肾衰患者中,50%以上存在缺铁[1].对于如何应用EPO,临床上已积累了较为丰富的经验[2],但对于如何补充铁剂临床上还认识不足.由于口服补铁尚未证实有效,静脉补铁近年受到人们愈来愈多的关注,并且临床也证实有效[3,4].本文从临床实用角度,介绍肾性贫血治疗中静脉铁剂的合理应用.     

生血宁片联合促红细胞生成素治疗腹膜透析患者贫血的疗效观察

贫血是慢性肾衰患者的主要并发症之一,作者应用重组人促红细胞生成素（r-HuEPO）联合生血宁治疗腹膜透析贫血患者35例,并与单用促红细胞生成素进行对比,有比较确切的疗效,现报道如下。     

左卡尼丁治疗血液透析尿毒症性贫血临床观察

目的：观察左卡尼丁联合促红细胞生成素对尿毒症性贫血的疗效及不良反应。方法：80例尿毒症血液透析患者随机分为两组。每组各40例,80例患者均使用相同的透析器U/kg,采用相同的透析方式,每次血液透析后予以促红细胞生成素50~70 U/kg,每周2次皮下注射。治疗组加用左卡尼丁,1g次/,3次/周,治疗3个月。结果：两组治疗4周后,Hb（血红蛋白）及HCT（红细胞比容）均开始上升,至12周,治疗组Hb（血红蛋白）及HCT（红细胞压积）升高明显高于对照组,差异有统计学意义（P〈0.001）。治疗组于治疗12周红细胞生成素用量减少55%,对照组为16%。且治疗组高血压发生率及胃肠道反应发生率低于对照组。结论：左卡尼丁与促红细胞生成素可提高治疗尿毒症性贫血的疗效,并减少促红细胞生成素用量及不良反应。     

肿瘤与贫血

癌性贫血可由恶性肿瘤本身如促红细胞生成素缺乏,炎性细胞介质的骨髓抑制作用、溶血、急慢性出血、骨髓受侵、副瘤综合征等引起,还可由手术、化疗、放疗、生物免疫治疗所致。恶性肿瘤患者贫血不但会明显影响患者的一般生存,而且在不同程度上会影响放疗化疗等治疗的疗效,治疗上尽量避免输血,必须输血尽量输成分血或使用重组人促红细胞生成素。     

两种方案治疗肾衰血液透析病人贫血疗效对比

目的对比促红细胞生成素(erythropoietin,EPO)常规疗法与其联用左卡尼汀和苯丙酸诺龙对慢性肾衰血液透析病人贫血的疗效。方法选择28例慢性肾衰血透病人,随机分为A,B两组,A组给予EPO和补充叶酸、铁剂、维生素B12等常规治疗,B组除上述治疗外,加用苯丙酸诺龙、左卡尼汀。观察用药12周后贫血改善情况。结果两组病人治疗后贫血均有改善。B组改善更为明显。结论促红细胞生成素联合苯丙酸诺龙和左卡尼汀治疗慢性肾衰血液透析病人贫血比促红素常规疗法更有效。     

肾性贫血

各种原因导致肾脏器质性损害,发生慢性肾功能不全或尿毒症后,肾脏不能维持其正常生理机能而引起的贫血,称为肾性贫血。是临床常见盆血之一,近年研究较多,特加以介绍。发病机制一、红细胞生成减少 1.红细胞生成素减少业已证明其主要原因是病肾不能产生足够的红细胞生成素(Ery—thropoietin,EP)。EP的作用是促进红细胞的成熟,它是一种糖蛋白,是刺激红系集落系统(CFU—E)向原红细胞分化的特异性促生成素,能促进干细胞分化为     

小剂量长疗程促红细胞生成素治疗老年肾性贫血的临床观察

本文采用重组人体促红细胞生成素(Recombinant Human Erythropoietin rHuEpo)小剂量长疗程治疗老年慢性肾功衰竭(CRF)重症贫血的临床疗效,并作初步探讨。     

重组人促红细胞生成素联合氨甲环酸在高龄股骨颈骨折全髋关节置换术围术期血液管理中应用

目的观察高龄股骨颈骨折患者行全髋关节置换术(THA)后,重组人促红细胞生成素联合氨甲环纠正贫血的临床疗效。方法选取2014年1月至2015年6月收治行THA的高龄股骨颈骨折患者90例,应用重组人促红细胞生成素联合氨甲环酸纠正贫血者为治疗组,未应用者为对照组,观察两组患者红细胞计数(RBC)、血红蛋白(Hb)、红细胞比容(Hct)指标,检测患者生命体征,分析临床疗效。结果治疗组患者术后RBC、Hb、Hct值明显高于对照组,贫血的发生率明显降低,差异有统计学意义(P<0.05)。结论应用重组人促红细胞生成素联合氨甲环酸可有效的预防和纠正TKA围术期贫血。     

Glutamine supplementation in vitro and in vivo,in exercise and in immunodepression

In situations of stress, such as clinical trauma, starvation or prolonged, strenuous exercise, the concentration of glutamine in the blood is decreased, often substantially. In endurance athletes this decrease occurs concomitantly with relatively transient immunodepression. Glutamine is used as a fuel by some cells of the immune system. Provision of glutamine or a glutamine precursor, such as branched chain amino acids, has been seen to have a beneficial effect on gut function, on morbidity and mortality, and on some aspects of immune cell function in clinical studies. It has also been seen to decrease the self-reported incidence of illness in endurance athletes. So far, there is no firm evidence as to precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression that occurs after prolonged, strenuous exercise. However, there is increasing evidence that neutrophils may be implicated. Other aspects of glutamine and glutamine supplementation are also addressed.     

Temporal changes in the oxidation state in in vitro blood

The rates at which the paramagnetic compounds deoxyhemoglobin (Hb) and methemoglobin (MHb) form in vivo within an area of hemorrhage are unknown. The present experiment establishes the baseline concentrations and rates of change in paramagnetic hemoglobin concentrations, as well as the pH in normal heparinized and clotted human blood maintained in vitro at 37 degrees C under anaerobic conditions over 30 hours. There was a moderate increase in Hb concentration in normal heparinized blood (average increase was 15.5%, rate = 0.50%/hour) and a slight increase in MHb concentration in the heparinized blood and clots (average increase was 1.4%, rate = 0.044%/hour). A second experiment was done to verify the activity of the RBC systems responsible for maintaining the hemoglobin molecule in the reduced state. Conversion of MHb to Hb in these samples proceeded at a rate of 5.6%/hour. In a third experiment, blood from 11 normal subjects maintained at 4 degrees C 25 degrees C was analyzed for MHb concentration over the course of 28 days. The level of MHb formation remained in the range of normal for at least 11 days in all subjects. The authors conclude that at basal conditions created in vitro, the blood levels of both Hb and MHb remain at relatively low levels. Therefore, if the accumulation of Hb and/or MHb occurs in acute in vivo hematomas it must be driven by intrinsic tissue factors.     

Carcinoma in situ in cryptorchid testes in post-pubertal patients]

The pathohistologic analysis of testis sections of 37 postpuberty patients with different types of cryptorchism is performed. The tissue samples were taken during orchiopehy, fixed in Bouin's solution and treated by the standard histologic techniques. The morphologic criteria are presented for identification of the presence of the so called carcinoma in situ cells found in two cases. Besides, in 13 patients rare, mainly single, atypical germinative cells were found in a smaller number of the seminiferous tubules. It has been concluded that the presence of carcinoma in situ cells in undescended testes of some patients and considering the simple way of sampling, lack of complications and high reliability of the diagnostic procedure, it is absolutely justified to take routine biopsy of testes during orchiopexy in each postpuberty and perhaps prepuberty patient.     

我国医用辐射防护研究概况

医学放射学技术的迅速发展及介入放射学在临床广泛应用，使更多的人受到电离辐射的照射，同时也促进了医疗照射防护工作的发展。文中重点综述了我国医用辐射防护工作者近年来在Ｘ射线ＣＴ的医疗照射防护、对介入放射学工作者的剂量监测以及应用医疗照射防护体系，降低医疗照射剂量等方面所作出的成绩和研究进展     

新时期军医学院人才培养的思考

在新的历史条件下 ,军医学院迎接未来高技术局部战争的挑战 ,适应部队武器装备的不断更新以及医学科技、社会发展对人才素质提出的新要求 ,必须在更为广阔的时空背景下找准人才培养的着眼点 ,科学确立人才培养方向 ,提高人才培养质量。现就人才培养思考如下 :1　改变教育观念 ,     

成批煤气爆燃烧伤的救治体会

报道治疗因煤气泄漏爆炸烧伤病员7例，经应用MEBT技术积极救治，其中6例于伤后17天痊愈出院，另一例特重伤员也于伤后30天康复出院。作者认为：应严格按照MEBT／MEBO要求进行规范治疗，正确处理生命体征、休克、感染、脏器功能和创面的辨证关系。同时，不能忽视外科营养在过程中的重要作用，它是创面修复的物质保证。