药物性肝损伤后肝炎相关再生障碍性贫血1例报告

正肝炎相关再生障碍性贫血(hepatitis-associated aplastic anemia,HAAA)是指发生于急性或慢性肝炎后期,以外周血全血细胞减少和骨髓三系细胞增生低下为特征的骨髓衰竭综合征(bone marrow failure,BMF)~([1])。这一概念由Lorenz和Quaiser于1955年首次提出~([2])。HAAA发病率较低,在西方国家占再生障碍性贫血(aplastic anemia,AA)的2%～5%,在东方国家占4%～10%~([3-5]),而尚无确切数据显示其在肝炎患者中的发病率。     

铁过载检测与祛铁治疗

临床上对于低危骨髓增生异常综合征(myelodysplastic syndromes,MDS)、再生障碍性贫血(aplastic anemia,AA)以及β珠蛋白生成障碍性贫血等疾病的患者来说,输血治疗是挽救其生命和     

双重移植成功治疗重型再生障碍性贫血1例并文献复习

正再生障碍性贫血(aplastic anemia,AA)是一种由于物理、化学、生物等因素导致的骨髓衰竭性疾病,临床表现为贫血、出血、感染。重型再生障碍性贫血(severe aplastic anemia,SAA)以及极重型再生障碍性贫血(VSAA)死亡率高,严重威胁患者的生命。目前认为,同胞全相合异基因造血干细胞移植术(MSD-HSCT)是治疗SAA和VSAA最有效的方法[1]。对于40岁以上的SAA或VSAA患者,还可以选择强化免疫抑制     

强化免疫抑制治疗联合阿伐曲泊帕成功救治并发脑出血的肝炎相关再生障碍性贫血1例

<正>再生障碍性贫血(aplastic anemia,AA)是以全血细胞减少、骨髓造血功能衰竭为特征的一种血液系统疾病^[1]。老年AA约占全部AA病人的1/3^[2]，具有发病率高、感染及出血风险大、治疗耐受性差、生存期短等特点。肝炎相关再生障碍性贫血(hepatitis associated aplastic anemia,HAAA)是一种特殊类型的AA，较为罕见^[3]，起病较急，病情更为凶险，多见于急性肝炎后的2～3个月。     

系统性红斑狼疮相关性再生障碍性贫血临床分析

系统性红斑狼疮(systemic lupus erythematosus,SLE)可累及全身各个器官系统,病程中可有血液系统异常,但合并再生障碍性贫血者少见,国内有个案报道,其发病机制不清.本研究诊治10例系统性红斑狼疮相关性再生障碍性贫血(SLE associated aplastic anemia,SLEAAA),与同期的慢性再生障碍性贫血(chronic aplastic anemia,CAA)通过检查其骨髓、T细胞亚群、造血祖细胞体外培养集落产率的差异,探讨其发病机制及治疗方法.     

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再生障碍性贫血(aplastic anemia,AA)是一组不同病因引起的机体造血功能衰竭综合征,以骨髓造血红髓容量减少和外周血全血细胞减少为特征.患者临床表现为贫血、出血和感染,但发病缓急、病情轻重又不全相同.临床上,全血细胞减少的患者应考虑AA的可能,进一步行骨髓穿刺和骨髓活检常可确诊.     

儿童肝炎相关再生障碍性贫血1例报告

<正>肝炎相关性再生障碍性贫血(hepatitis associated aplastic anemia,HAAA)是指由肝炎引起的一种特殊类型的再生障碍性贫血。临床表现为急性肝炎数周至数月之后发生的血细胞减少,多见于青年男性,儿童较为罕见[1-2]。1病例资料患儿男性,1岁5个月,主因"发现尿色黄18 d,皮肤及巩膜黄染10 d"于2018年2月2日入本院。患儿18 d前出现尿色黄,无发热、咳嗽、呕吐、腹泻、皮疹等不适,未予诊治。10 d前,     

中性粒细胞为0的成人重型再生障碍性贫血强化免疫抑制治疗研究

目的评价兔抗人胸腺细胞免疫球蛋白(anti-thymocyte globulin,ATG)联合环孢素A(cyclosporine,CsA)强化免疫抑制治疗(intensive immunosuppressive therapy,IIST)中性粒细胞为0的成人再生障碍性贫血的疗效。方法回顾性分析2014年1月至2018年3月国内三家医院86例接受IIST的重型再生障碍性贫血(severe aplastic anemia,SAA)临床资料。将免疫抑制治疗前中性粒细胞为0的SAA定义为暴发型再生障碍性贫血(fulminant aplastic anemia,FAA),与SAA、极重型再生障碍性贫血(very SAA,vSAA)比较对IIST的疗效。结果 86例患者中,FAA 19例,vSAA 23例,SAA 44例。3个月总有效率分别为21.1%,56.5%和54.5%,6个月总有效率分别为42.1%,60.9%和72.7%。FAA组患者3个月的有效率明显低于vSAA和SAA组(21.1%vs. 56.5%,P=0.032;21.1%vs. 54.5%,P=0.023),6个月的有效率明显低于SAA组(42.1%vs. 72.7%,P=0.028),疗效与中性粒细胞计数显著相关(P=0.019)。三组的中位起效时间分别为17.0个月,4.0个月和3.0个月,FAA组慢于vSAA组、SAA组(P=0.031,P=0.001)。FAA组患者总生存率明显低于vSAA和SAA组(63.2%, 91.3%和95.5%,P=0.001),生存率与中性粒细胞计数及疗效显著相关(P=0.026,P=0.010)。结论中性粒细胞为0的成人FAA临床预后严重不良,需要探索新的治疗方案。     

艾曲泊帕联合环孢素A治疗输血依赖非重型再生障碍性贫血疗效分析

回顾性分析2019年至2021年于江苏省人民医院血液科接受艾曲泊帕联合环孢素A（CsA）的13例初治输血依赖非重型再生障碍性贫血（transfusion-dependent non-severe aplastic anemia,TD-NSAA）患者的临床资料,评估艾曲泊帕联合CsA治疗TD-NSAA的疗效、不良反应等。...     

系统性红斑狼疮患者贫血机制及治疗进展

SLE患者在病程中多数可发生不同程度的贫血。有报道,其贫血的发生率可高达73％-90％,贫血的轻重与病程长短和病情的严重程度有关,多数为轻至中度贫血,少数为重度贫血。近年的研究结果显示,SLE贫血可分为免疫性贫血和非免疫性贫血,前者包括自身免疫性溶血性贫血(autoimmune hemolytic anemia,AIHA)、微血管内溶血性贫血(microangio- pathic hemolytic anemia,MAHA)、再生障碍性贫血(aplastic     

CAPD patients as renal transplant patients

Most authors state that the continuous ambulatory peritoneal dialysis (CAPD) patient is not at increased risk when transplanted. These patients are always exposed to the risk of peritonitis, which may increase if patients are peritoneally dialyzed while immunosuppressed. The postoperative course of patients transplanted from our CAPD program from 1979 through August 1985 was evaluated. The transplant survival of patients dialyzed by CAPD, home hemodialysis, and at a free-standing dialysis facility were compared. Pretransplant dialysis modality did not influence long-term transplant success. Three of seven patients who required dialysis postoperatively developed peritonitis. The dialysis catheter was removed in two patients and one was treated by lavaging the peritoneal cavity with antibiotics. There was one instance of dialysate leaking through a drain in the transplant bed. This patient was converted to hemodialysis for subsequent dialysis. The dialysis catheters were removed at the time of discharge from hospital. Literature review confirmed this experience. Peritoneal dialysis post-transplant exposes the patient to a 10-33% risk of peritonitis and a 10% risk of a wound complication. Peritoneal dialysis patients are subject to risks unique to peritoneal dialysis. These complications do not translate into excessive morbidity or graft loss.     

急性脑梗死患者认知障碍的临床特征分析

目的探讨急性脑梗死患者认知障碍的临床特征,并分析其相关影响因素。方法采用简易精神状态检查法（MMSE）和洛文斯顿作业治疗用认知成套测验（LOTCA）进行神经心理测验,用日常生活活动能力（ADL）量表对患者ADL进行评定,神经功能缺损评分评定患者神经功能缺损程度,分析急性脑梗死患者认知障碍的临床特征。结果①260例急性脑梗死患者中有认知障碍者108例,占41.5%,主要表现为注意障碍64例（59.4%）,定向障碍37例（34.2%）,思维运作障碍45例（39.8%）,结构性失用34例（31.4%）,视失认29例（27.5%）,空间失认23例（21.3%）,空间知觉障碍18例（16.7%）,单侧忽略15例（13.9%）,图形背景分辨障碍12例（11.1%）,运动失用9例（8.3%）。②急性脑梗死患者认知障碍与病变部位、临床类型、ADL及病情程度有关,以皮质部位发生认知障碍的危险性高（OR=2.965,95%C I：1.329-6.611）;多发病灶者较单发病灶者更易发生认知障碍（OR=2.190,95%C I：1.022-4.693）;ADL越差,发生认知障碍的危险性越高（P〈0.05）;认知障碍随病情程度加重而加重（P〈0.05）。结论急性脑梗死患者常伴发认知障碍,认知障碍可多种类型共存或交叉并存。可表现为注意障碍、定向障碍、思维运作障碍、结构性失用、视失认、空间失认、空间知觉障碍、单侧忽略、图形背景分辨障碍、运动失用,其中以注意障碍最多见;急性脑梗死患者认知障碍与发生在皮质部位、多发病灶、ADL差和病情程度重等因素有关。     

Resuscitation of hospitalized patients

Effects of in-hospital resuscitations performed by a trained resuscitation team were studied over a 20-month period during which 1653 deaths were registered. Resuscitative attempts were made in 61 patients with a mean age of 71 years (range 0-86 years). The underlying disease was ischaemic heart disease in 38 cases and most arrests occurred in general wards. Twenty-one patients were initially resuscitated; 12, however, died after an average of 3.2 days while still in hospital. Nine patients were discharged and seven are still alive after two and a half years.