T淋巴细胞亚群及炎性细胞因子与慢性浅表性胃炎和十二指肠球部溃疡的关系

目的:检测慢性浅表性胃炎和十二指肠球部溃疡患者外周血T淋巴细胞亚群水平的变化及炎性细胞因子白细胞介素-6(IL-6)和白细胞介索-8(IL-8)的血清含量,分析其与幽门螺杆菌(Hp)的关系,探讨可能的发病机制.方法:收集91例经内镜检查证实慢性浅表性胃炎和十二指肠球部溃疡患者的血清标本,用流式细胞仪测T淋巴细胞亚群值,用酶联免疫吸附法(ELISA)检测IL-6和IL-8含量,并分析其与Hp的关系.结果:慢性浅表性胃炎和十二指肠球部溃疡患者外周血CD8及CD4/CD8与正常对照组比较差异有显著性(P＜0.01).血清IL-6含量与正常对照组比较差异有显著性(P＜0.01).血清IL-8含量与正常对照组比较差异有显著性(P＜0.01).Hp阳性者IL-6含量低于Hp阴性者(P＜0.01).Hp阳性者IL-8含量高于Hp阴性者.结论:慢性浅表性胃炎和十二指肠球部溃疡患者CD8细胞数较正常人显著升高,CD4/CD8比值较正常人显著降低.血清IL-6、IL-8含量明显增高.Hp阳性者IL-8含量增高而IL-6含量下降.     

洛赛克治疗十二指肠球部溃疡并出血疗效观察

目的探讨洛赛克治疗十二指肠球部溃疡并出血的疗效。方法将经胃镜确诊为十二指肠球部溃疡并出血的60例患者，随机分为治疗组和对照组。治疗组30例，给予洛赛克40mg，静脉滴注，2次／d，连用5天；对照组30例，给予雷尼替丁100mg，静脉滴注，2次／d，连用5天；比较这两种抑酸剂对十二指肠球部溃疡并出血的疗效。结果治疗组总有效率为96．7％，对照组总有效率为70．O％，两组总有效率比较差异有显著性（P〈0．05）。结论洛赛克治疗十二指肠球部溃疡并出血有很高的止血率，无明显副作用，是治疗十二指肠球部溃疡并出血的一种安全、有效的药物，值得临床推广使用。     

复发性阿弗他溃疡患者外周血T淋巴细胞亚群水平测定及意义

目的 探讨复发性阿弗他溃疡（RAU）患者的免疫学发病机制.方法 应用流式细胞仪检测法测定270例RAU患者（RAU组）和44例健康人（对照组）外周血T淋巴细胞亚群水平.结果 RAU组外周血CD＋3、CD＋4T淋巴细胞水平及CD＋4/CD＋8均明显低于对照组, CD＋8T淋巴细胞水平明显高于对照组,P均〈0.001.结论 外周血T淋巴细胞亚群功能紊乱在RAU发病中具有重要作用.     

感染卫氏并殖吸虫小鼠外周血T淋巴细胞及其亚群的变化和…

用江西二倍体型卫氏并殖吸虫囊蚴２０，４０和８０个经口感染小鼠，应用酸性α－醋酸萘酯酶染色法观察感染前后及肌注转移因子后外周血Ｔ淋巴细胞及其亚群的变化。结果表明：小鼠感染早期Ｔ淋巴细胞略有升高，后减少，轻，中重感染组减少时间依次推后，降低水平与感染度不相关。从感染第４ｄ起、辅助性Ｔ细胞和抑制性Ｔ细胞呈反向变化，前者减少，后者稍增，Ｔｈ／Ｔｓ比值４周后降至最低水平；肌注转移因子后，第１，２周Ｔ淋巴细胞     

乙型肝炎患者外周血T淋巴细胞亚群的变化

目的分析乙型肝炎病毒(HBV)感染者外周血淋巴细胞亚群的变化,以了解细胞免疫在乙型肝炎发病中的作用。方法使用流式细胞仪检测100例乙型肝炎患者和20例正常人外周血CD3+、CD4+和CD8+T淋巴细胞亚群百分比。结果 15例急性肝炎患者T淋巴细胞亚群与正常对照组比,差异无统计学意义(P>0.05),而43例慢性肝炎、26例乙型肝炎肝硬化和16例慢性肝衰竭患者CD3+淋巴细胞百分率分别为56.15±8.94%、48.85±9.01%和55.86±9.03%,均显著低于正常对照组的66.35±8.93%(P<0.05);慢性肝炎、乙型肝炎肝硬化和慢性肝衰竭患者CD4+淋巴细胞百分率分别为30.46±7.51%、26.71±7.03%和29.03±7.64%,,均显著低于正常对照组的35.72±7.52%(P<0.05);慢性肝炎、乙型肝炎肝硬化和慢性肝衰竭患者CD8+淋巴细胞百分率分别为21.93±5.06%、18.71±5.53%和21.15±5.62%,均显著低于正常对照组的24.58±4.92%(P<0.05);慢性肝炎、乙型肝炎肝硬化和慢性肝衰竭患者CD4+/CD8+比值分别为1.34±0.60、1.35±0.53和1.34±0.58,均低于正常对照组的1.58±0.47(P<0.05)。结论 HBV感染者体内存在T细胞亚群失衡和细胞免疫功能紊乱,提示细胞免疫参与了乙型肝炎的发病和疾病进展。     

奥美拉唑治疗十二指肠球部溃疡并发出血疗效观察

目的观察奥美拉唑治疗十二指肠球部溃疡并发出血的效果。方法选取在我院住院治疗的90例确诊患有十二指肠球部溃疡并发出血的患者,随机分为观察组和常规组各45例。两组患者均给予暂禁食、纠正休克、补液及6氨基乙酸和止血芳酸治疗等治疗措施,血红蛋白在70 g/L以下患者,给予输全血。同时,常规组静脉滴注甲氰咪哌,1.2 g/次,1次/d。观察组给予奥美拉唑静脉滴注,2次/d,40 mg/次,治疗3 d后改为奥美拉唑口服,2次/d,20 mg/次。治疗10 d后比较两组患者的治疗效果。结果常规组中显效7例,有效30例,无效8例;观察组中显效22例,有效21例,无效2例。观察组疗效优于对照组,差异有统计学意义(P0.05)。结论奥美拉唑治疗十二指肠球部溃疡并发出血具有显著疗效,起效快,安全性高,适合在临床上推广应用。     

休克患者外周血T淋巴细胞亚群的变化

<正>患者在休克发展的进程中常伴随一些致命并发症,尤其是全身炎性反应综合征(SIRS),成为导致多器官功能障碍综合征(MODS)或多器官衰竭(MOF)的关键环节,伤亡率和伤残率很高~〔1,2〕。休克时机体的免疫功能包括非特异性和特异性免疫功能均受到广泛影响,休克引起的免疫功能障碍是导致肠源性感染的重要前提,是多器官结构损伤和功能障碍的重要因素~〔3,4〕。本文回顾内科、外科、重症医学科(ICU)等发生休克的患者外     

OTSC吻合夹治疗十二指肠球部溃疡并大出血后再出血的2例临床诊治体会

近年来,最新OTSC吻合夹在内镜治疗消化道大出血、穿孔及消化道瘘等疾病中逐渐被应用,通过文献查阅,OTSC吻合夹用于消化道出血止血迅速、有效,多为成功案例,再出血概率较低,但国内总体报道相关病例不多,较少提供一些止血后再出血的病例,近期我院消化内镜治疗中心2例十二指肠球部溃疡并大出血应用OTSC吻合夹止血后出现再出血,...     

高血压患者T淋巴细胞亚群分析

测定４０例高血压患者和３０例正常人Ｔ淋巴细胞亚群；结果显示高血压组ＣＤ４＋、ＣＤ８＋、ＣＤ３＋显著低于对照组（Ｐ＜０．０１．Ｐ＜０．０５），其中以高血压Ⅲ期患者改变最显著（Ｐ＜０．０５）。提示高血压存在有免疫功能紊乱。     

慢性HCV感染患者外周血T淋巴细胞亚群的检测

目的探讨慢性丙型肝炎病毒(HCV)感染患者T细胞亚群水平以及与丙型肝炎病毒复制的关系。方法以间接免疫荧光一流式细胞仪、ELISA法和RT-PCR检测了26例慢性HCV感染患者外周血T细胞亚群(其中HCV-RNA阳性17例,HCV-RNA阴性9例)。结果慢性HCV感染患者外周血CD_4~ 淋巴细胞亚群,CD_4~ /CD_8~ 比值明显低于正常对照组(P<0.01)。血清HCV-RNA阳性患者的CD_4~ /CD_8~ 比值明显低于HCV-RNA阴性患者(P<0.05)。结论提示细胞免疫功能受抑制可能是HCV持续感染的原因。     

消化性溃疡出血的FORREST分级及其与预后关系

本文采用Ｆｏｒｒｅｓｔ分级前瞻性的调查国人消化性溃疡出血与再出血的关系。结果２６３例中Ⅰａ、Ⅰｂ、Ⅱａ、Ⅱｂ和Ⅲ级各占２．７、１４．４、８．０、１２．９和６２．０％；其再出血率分别是１００、４７、５７、１４和１．８％。认为消化溃疡出血的内镜下征象可提供预后信息；Ｆｏｒｒｅｓｔ分级在实践上是可行的。     

CLINICAL CHARACTERISTICS AND TREATMENT FOR PATIENTS PRESENTING WITH BLEEDING DUODENAL VARICES

Background and Aim: Bleeding from ectopic varices, including duodenal varices, is uncommon, but it can be difficult to manage. The clinical data of patients diagnosed and treated for duodenal varices were reviewed to investigate the strategy for treatment. Methods: The present study reviewed the clinical data of 10 patients with duodenal varices (mean age, 58.2 ± 15.6 years) at our associated institutes during the period between January 1996 and December 2008. Results: Nine patients had duodenal varices located in the second portion, whereas in one case they were located in the duodenal bulbus. The underlying diseases included liver cirrhosis in eight patients, and extrahepatic portal vein obstruction in two patients. The lesions were identified with bleeding from varices in eight of 10 patients. Initial hemostasis was achieved in all eight patients. However, among four patients treated endoscopically only, two patients died from rebleeding from varices and two died from hepatic failure resulting from variceal bleeding. Additional interventional radiology (IVR) was used in three patients and additional surgery was carried out in one case. One patient who was treated with balloon‐occluded retrograde transvenous obliteration rebled during IVR and died from bleeding. Two patients who underwent double balloon‐occluded embolotherapy and one case who had surgery achieved good clinical outcomes. Conclusions: Although endoscopic treatment is useful for initial hemostasis of hemorrhagic duodenal varices, the patients who underwent additional IVR after endoscopic treatment achieved good outcomes.     

血吸虫病患者吡喹酮治疗后外周血T细胞亚群的检测

应用碱性磷酸酶抗碱性磷酸酶（ＡＰＡＡＰ）桥联酶标法对１８例慢性血吸虫病（慢血）患者,２２例晚期血吸虫病（晚血）患者进行了吡喹酮治疗前后的外周血Ｔ细胞亚群检测,发现治疗前慢血、晚血ＣＤ３＋、ＣＤ８＋百分比均显著升高,与对照组比较有显著性差异。ＣＤ４＋百分比低于对照组,无显著性差异。治疗３个月后检查,两组ＣＤ４＋上升、ＣＤ８＋减少,其百分比基本达到正常水平,ＣＤ４＋／ＣＤ８＋比值上升高于对照组,有显著性差异。结果提示,吡喹酮治疗血吸虫病可能具有参与免疫调节、增强Ｔ淋巴细胞功能的作用,但不能改善免疫紊乱。     

TEN YEAR FOLLOW-UP OF GASTROINTESTINAL HEMORRHAGE PATIENTS

Abstract The mortality and morbidity of the 241 survivors of an acute gastrointestinal hemorrhage treated between 1958 and 1964 are reported. The major purpose of this study was to assess the subsequent risk to life and health of patients presenting with acute upper gastrointestinal bleeding. Patients without dyspepsia and with a negative single contrast barium meal study had an excellent prognosis. Life Table analysis showed that the gastric ulcer patients had a mortality not significantly different from that of the Australian population, with the higher risk of death from ulcer balanced by a lower risk of fatal vascular disease. Duodenal ulcer patients had an increased mortality attributable to a 290% increase in deaths from vascular disease, but only one of the 84 died of an ulcer complication. The association between duodenal ulcer and vascular disease has been present for decades. It is unlikely to be associated with hypertension, diabetes mellitus, diet, stress, or smoking and deserves further study.     

慢性乙型肝炎血清五种免疫球蛋白与T细胞亚群的关系

对确诊的ASC、CPH和CAH病人(共计86例)检测IgE与T细胞亚群及其它免疫球蛋白。结果表明,IgE和IgG明显升高,二者均与CD_4/CD_3比值呈负相关,IgE较其它免疫球蛋白能更灵敏地反映肝脏损害程度。     

ENPROSTIL AND RANITIDINE: COMPARATIVE EFFICACY AND SAFETY IN PATIENTS WITH DUODENAL ULCER

Abstract This randomised, double-blind, double-dummy, multiclinic study of duodenal ulcer healing compared the efficacy and safety of enprostil with ranitidine. The six week trial admitted 164 patients with endoscopically demonstrated duodenal ulcer. Ratings of symptoms and adverse events were collated from patients' daily diaries, and endoscopy was repeated to verify healing after four weeks and, if appropriate, after six weeks. Medication used was enprostil (35 μg capsule) or ranitidine hydrochloride (150 mg tablet) with matching placebos twice daily. After six weeks, 81 % of patients treated with enprostil and 95% of those treated with ranitidine had healed ulcers, a statistically significant difference (p = 0.007). There were no differences between treatment groups for the number of days until the daytime ulcer pain completely ceased. Night-time ulcer pain ceased significantly earlier in the group receiving ranitidine (p = 0.019) and was less severe during the week before the last visit (p = 0.001); daytime pain for ranitidine users was also less severe (p = 0.020) during this week. Mild to moderate adverse experiences were reported by 44% of enprostil and 35% of ranitidine patients. There were no severe adverse events. In conclusion, both enprostil and ranitidine were found to be safe and effective in the treatment of duodenal ulcer. However, the ranitidine regimen used in this trial produced better results than the enprostil regimen.     

慢性胃病中几种胃肠激素水平的改变和意义

本文用RIA法测定352例胃镜病理诊断的胃十二指肠病患者之胃液,血清表皮生长因子（EGF），生长抑素（SS）和胃泌素（GAS）水平。结果表明，胃液EGF水平在胃癌明显升高，在消化性溃疡降低；血清SS及GAS水平在各种胃十二指肠病中均显著高于正常对照，溃疡病的血清SS和GAS水平呈负相关趋势。各种胃病血清SS水平相近，胃液SS水平胃癌显著高于良性胃病，且胃癌胃液SS显著高于其血清SS水平。幽门螺杆菌（HP）感染不影响溃疡病的血清GAS和SS水平及慢性浅表性胃炎的血清SS水平，HP感染严重时慢性萎缩性胃炎的血清SS水平显著升高。     

奥美拉唑和硫糖铝治疗十二指肠球部溃疡胃内24小时pH监测

对３０例十二指肠球部溃疡患者，分别投予奥美拉唑并以硫糖铝作为对照，用单昌体锑电极监测服药前后胃内２４小时ＰＨ变化，观察奥美拉唑对胃酸分泌的影响。分别在２４小时、８：００－２０：００时，和２０：００－８：００时的三个时间段进行分析。结果显示：观察的ＰＨ指标，在奥美拉唑组服药后明显升高（Ｐ均＜０．００１），硫糖铝组服药前后无变化（Ｐ均＞０．０５），奥美拉唑与硫糖铝组比较，差异显著（Ｐ均＜０．００１），     

THE INFLUENCE OF SMOKING ON THE HEALING OF DUODENAL ULCER TREATED WITH OXMETIDINE OR CIMETIDINE

The influence of smoking on duodenal ulcer healing was examined during a double blind study of 83 patients randomly allocated to oxmetidine or cimetidine treatment. Smoking habits were recorded but patients were not advised to change these. Smokers and nonsmokers were similar clinically and did not differ in compliance with medication. Both H₂-receptor antagonists were equally effective and after four weeks of treatment ulcers were healed in 76% of patients. Ulcer healing occurred significantly less frequently in smokers (69%) than nonsmokers (89%). Smokers with healed ulcers consumed fewer cigarettes per day (mean ± SE: 15.8±1.4) than those whose ulcers did not heal (22.2±2.7). When smokers were grouped according to daily cigarette consumption, a direct relationship was found between increasing cigarette consumption and decreasing frequency of ulcer healing. No reduction in ulcer healing was apparent in patients who smoked nine cigarettes a day, or less. (Aust NZ J Med 1983; 13:687-590.)