双环铂引起全血细胞减少

1例71岁男性患者因右肺癌切除术后化疗,给予双环铂650 mg加入5%葡萄糖注射液1000 mL静脉滴注,4 h内输注完毕。次日,患者出现双下肢无力,恶心。3周后患者行第2次化疗,方案与第1次相同。次日,患者出现恶心、右侧鼻腔出血。实验室检查：WBC 3.04×109/L,N 0.50,L 0.37,Hb 83 g/L,RBC 2.76×1012/L,PLT 35×109/L。立即行鼻腔局部止血等对症治疗。3 d后鼻腔出血消失,血常规逐渐恢复正常,实验室检查：WBC 4.04×109/L,N 0.53,L 0.35,Hb 86 g/L,RBC4.16×1012/L,PLT 87×109/L。     

229例全血细胞减少病因分析

目的分析全血细胞减少患者的病因特点,以提高对相关疾病的认识。方法对229例全血细胞减少患者的病因进行回顾性分析。结果通过骨髓和外周血细胞形态分析可确定病因12种,前三位病因分别是:急性白血病126例(17.55%),骨髓增生异常综合征45例(6.27%),再生障碍性贫血25例(3.48%)。结论血液系统疾病引起的全血细胞减少通过骨髓和外周血细胞形态分析而确诊     

格列齐特致全血细胞减少1例

1 临床病例 患者男,63岁.既往有2型糖尿病半年,未正规诊疗,入本院2个月前在本院查空腹血糖11.5 mmol/L,血常规正常,尿常规示:GLU(++),给予格列齐特治疗(新乡中杰医药公司0802132).     

疟疾合并全血细胞减少1例报告

疟疾是由疟原虫引起的虫媒传染病,是最常见的寄生虫病之一,其分布极为广泛。热带非洲地区儿童每年因患疟疾而死亡的超过100万人,在我国公元前1~2世纪最早医书之一《素问》已有疟论和刺疟篇等详细论述。解放后由于积极采取防治措施,我国疟疾的发病率已显著下降,但为彻底消灭本病,尚需进一步加强防治措施。我科于2006年8月收治1例疟疾合并全血细胞减少患者,现报告如下:1病历摘要患儿,女,11岁,朝鲜族,吉林省延吉市人。因发热一周伴全血细胞下降于2006年8月15日入院。患儿缘于入院前一周始无明显诱因畏寒、发热,曾至我院门诊以“上感”给予抗病…     

肝病性全血细胞减少65例分析

对肝病所致的早系和多系血细胞减少症做动态观察,必要时做骨髓像检查,以便诊治。     

全血细胞减少172例临床分析

目的探讨全血细胞减少的临床病因。方法对初诊的172例全血细胞减少病例进行回顾性分析。结果根据不同的临床表现、辅助检查显示以巨幼细胞性贫血占比例最大,其次为再生障碍性贫血/急性白血病、自身免疫性疾病等。结论全血细胞减少的病因最多的为巨幼细胞性贫血。     

全血细胞减少症病因研究进展

全血细胞减少症是指外周血液中白细胞、红细胞及血小板均有不同程度的减少。它是多种病因作用的结果,并不是一种独立的疾病,是临床比较常见的一种血液学表现。病因复杂,按照病因分类,可以分为造血系统疾病和非造血系统疾病两大类。     

全血细胞减少86例临床分析

全血细胞减少多因造血系统疾病引起,但亦可由非造血系统疾病引起,临床上常引起误诊或漏诊.造血系统引起的全血细胞减少常见于再生障碍性贫血(AA)、急性白血病(AL)、骨髓增生异常综合征(MDS)、多发性骨髓瘤(MM)及巨幼细胞性贫血等.非造血系统疾病引起的全血细胞减少常见于急慢性肝病、结缔组织病、感染性疾病、恶性肿瘤等.现将我院近年来收治的86例全血细胞减少患者的病因分析如下.     

全血细胞减少86例临床分析

全血细胞减少多因造血系统疾病引起,但亦可由非造血系统疾病引起,临床上常引起误诊或漏诊。造血系统引起的全血细胞减少常见于再生障碍性贫血（AA）、急性白血病（AL）、骨髓增生异常综合征（MDS）、多发性骨髓瘤（MM）及巨幼细胞性贫血等。非造血系统疾病引起的全血细胞减少常见于急慢性肝病、结缔组织病、感染性疾病、恶性肿瘤等。现将我院近年来收治的86例全血细胞减少患者的病因分析如下。     

全血细胞减少360例病因分析

目的分析全血细胞减少的病因。方法对本院360例初诊时全血细胞减少患者进行骨髓穿刺细胞学检查。结果 360例患者中,主要为造血系统疾病,共267例。非造血系统引起的全血细胞减少共93例。结论引起全血细胞减少的病因主要为造血系统疾病。     

小剂量阿司匹林肠溶片致全血细胞减少

患者女,67岁。因患风心病,联合瓣膜改变,心脏扩大,心律失常,于2004年起口服阿司匹林肠溶片100mg,1次/d;半年左右减为75mg,1次/d;3个月后又减为25mg,1次/d,至2005年11月5日。同时服用的药物有螺内酯20mg,2次/d,苯那普利2.5mg,1次/d。2005年10月全身出现散在皮疹、瘀斑伴瘙痒,门诊血常规检查WBC3.01×109/L。11月5日患者自行停用阿司匹林。停用之后皮疹逐渐减少,瘙痒减轻。11月11日以风心病、联合瓣膜改变、心律失常、心功能不全、粒细胞减少症收住院。入院查T36.8℃,P66次/min,R20次/min,BP105/70mm Hg(1mm Hg=0.133kPa)。全身皮肤黏膜…     

Aspirin in Cardiovascular Disorders

Clinical trials of aspirin (acetylsalicylic acid) for cardiovascular disorders have employed doses defined for other pharmacological effects of the drug (such as analgesic effects). Antioxidant and anti-inflammatory mechanisms with different dose-response relationships may contribute to the clinical effect of aspirin in cardiovascular disease. The optimal aspirin dose remains uncertain. Although the difference between 325 mg/day and 81 mg/day of aspirin sounds trivial, finding an optimal aspirin dose has enormous potential to reduce ischemic events. Large aspirin doses have not been associated with proportionally greater benefit. For patients with ischemic heart disease, overall consensus defines a range between 75 and 160 mg/day for the secondary prevention of myocardial infarction, stroke, and vascular death. Any benefit of aspirin must be measured against its adverse effects, principally gastrointestinal hemorrhage. The potential for adverse bleeding events may be lower with a 81mg dose, while maintaining clinical benefit. Although current aggregate data is reassuring about aspirin administration, it is increasingly clear that existing aspirin studies are insufficient to conclusively determine an optimal aspirin dose. Platelets can be activated by pathways that are not blocked by aspirin, and the dose of aspirin needed to fully suppress platelet aggregation may be higher in some patients as a result. Higher doses of aspirin than are currently used (75-325 mg/day) may be required in these patients to achieve desired antithrombotic effects. Better understanding of aspirin-resistant populations will facilitate identification of patients who require higher aspirin doses or alternative forms of antiplatelet therapy.     

HPLC法测定阿司匹林肠溶片中阿司匹林的含量

目的：建立阿司匹林肠溶片中阿司匹林的含量测定方法。方法：采用高效液相色谱法测定阿司匹林肠溶片中阿司匹林的含量。色谱柱为Hypersil ODS2（5um,250mm×4.6mm）,流动相为甲醇∶0.5%乙酸溶液（37∶63）;检测波长：276nm;流速：0.8ml·min-1;柱温：25℃;进样量：10μL。结果：阿司匹林在20μg·ml-1-150μg·ml-1范围内与峰面积积分值呈良好的线性关系,回归方程为y=23290x-9400.2,r=0.9991。平均加样回收率为101.2%,RSD=0.94%。结论：本方法操作简单,重复性好,结果准确,为阿司匹林的质量控制提供了方法。     

Aspirin resistance

Aspirin reduces the odds of serious atherothrombotic vascular events and death in a broad category of high risk patients by about one quarter. The term 'aspirin resistance' has been used to describe not only an absence of the expected pharmacologic effects of aspirin on platelets but also poor clinical outcomes, such as recurrent vascular events, in patients treated with aspirin. Various factors such as genetic, nonadherence, variable response to different doses, co-morbid conditions and drug interactions are responsible for aspirin resistance. Many methods, with their limitations, are available to measure the effects on platelets. Despite treatment failures, aspirin remains the single most cost-effective drug for the secondary prevention of atherothrombotic disease. To optimize its clinical effectiveness, clinicians should be aware of the potential causes of aspirin treatment failure, prescribe aspirin in appropriate doses, and encourage patients to take aspirin, stop smoking, and avoid regular use of NSAIDs.     

国家食品药品监督管理局国家药品标准修订件——阿司匹林散

本品为类白色至淡黄色粉末;遇湿气易变质。     

家兔口服碳酸氢钠对阿斯匹林药代动力学的影响

大剂量或长期服用阿斯匹林后,由于胃粘膜绉壁中未溶解的药物,在局部形成较高的浓度,引起严重的刺激作用,导致胃粘膜溃疡、腹部不适、恶心等。为了减轻对胃肠道的刺激,临床常同服一定量的碳酸氢钠(SB)。但是两药的配伍是否合理,目前看法不一,有人认为 SB 可升高胃液 pH,使阿斯匹林大部分转变成离子型从而减少吸收,且碱化尿液,加速排泄,从而降低血药浓度,降低疗效。也有人认为阿斯匹林在碱性溶液中吸收不受影响,在体内它的解离型与分子型以动态平衡存在,当分子型被吸收后离子型可以予以补充。基于上述不同观点,本实验设计了 SB 与阿斯匹林不同配比的四个处方,从药代动力学方面探讨了 SB 对阿斯匹林的影响,现报道如下。     

Aspirin and heparin in pregnancy

Introduction: A pro-coagulant state during pregnancy can be involved in the occurrence of gestational vascular complications (GVCs) and venous thromboembolism (VTE).

Areas covered: Antithrombotic drugs are used to prevent GVCs and VTE. Aspirin is not efficacious to prevent recurrences in women with previous early loss, while it can prevent pre-eclampsia in some groups of women. Heparins are not effective in the prevention of early recurrent loss and there is uncertainty about their efficacy in women carrying inherited thrombophilias. They could be efficacious in the prevention of GVCs in carriers of inherited thrombophilias, as GVCs have heterogeneous causes, and future studies have to focus on more homogeneous groups of patients. Not enough data are available regarding prophylaxis with heparins to prevent pregnancy-related VTE, but an accurate risk stratification of women during pregnancy and puerperium is crucial for administering prophylaxis in moderate-/high-risk women. Aspirin does not improve live births after assisted reproductive technologies, while heparins increase the number of clinical pregnancies and live births.

Expert opinion: Aspirin is efficacious in the prevention of GVCs in women at risk for pre-eclampsia and in those with antiphospholipid antibodies syndrome. Heparins could give benefit to women at risk for GVCs and/or pregnancy-related VTE.     

HPLC法测定阿苯糖丸中阿司匹林和苯巴比妥的含量

目的:建立以高效液相色谱法同时测定阿苯糖丸中阿司匹林和苯巴比妥含量的方法。方法:色谱柱为Inertsil C8-3,流动相为甲醇-0.05mol.L-1磷酸二氢钠缓冲液(50∶50),流速为1.0mL.min-1,检测波长为210nm,柱温为40℃,进样量为20μL。结果:阿司匹林和苯巴比妥检测浓度的线性范围分别为31.15～498.40、3.2～51.2μg.mL-1(r=0.9999);平均加样回收率分别为101.18%(RSD=1.9%)、100.73%(RSD=1.7%)。结论:本方法简便易行、准确可靠,可用于该制剂的质量控制。     

药物阿司匹林剂型的研究进展

目的为提高阿司匹林的药效且减少其对胃肠道的不良反应,从而为阿司匹林新剂型的研发提供方向。方法通过分析与归纳文献内容等方法对阿司匹林不同剂型的研究意义、方法及结果等进行了论述。结果提出了当前的肠溶剂、缓释或控释剂、复方制剂、泡腾片等剂型的研究现状和存在的问题,指明了阿司匹林剂型的研究趋势和发展方向。结论缓释控释剂型将是阿司匹林剂型的发展方向。选择合适的辅料,简化制备工艺,降低成本,提高药效将是未来研究的重点。