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1.
胆汁反流性胃炎患者胆囊排空功能研究 总被引:11,自引:3,他引:11
目的研究胆汁反流性胃炎(BRG)患者胆囊(GB)排空功能及其与胆汁反流的关系.方法采用随机、双盲和对照的方法,应用实时超声检查研究了32例BRG患者和26例健康对照者的空腹GB容量(FGV)和餐后GB排空功能.结果FGV(cm3,x±sx)BRG患者(235±15)明显大于对照组(197±13,P<001).餐后15minGB排出量(GEF)BRG患者即显著减少(P<001),餐后45min减少达最大(453%vs703%).最大GEFBRG患者(654%)明显少于对照组(802%,P<001).GB排空速度BRG患者显著慢于对照组(P<001).结论BRG患者GB排空明显不良,可能系GB收缩无力和(或)Oddi括约肌松弛不良所致;餐后GEF减少与FGV增多有关,从而使消化间期排入肠道的胆汁增多,当同时存在胃肠运动功能紊乱时即可反流入胃 相似文献
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目的研究急性病毒性肝炎(AVH)患者胆囊(GB)排空功能及其与病情程度和转归的关系.方法用实时超声研究了32例AVH患者及26例健康对照者GB排空功能.结果空腹GB容量(FGV)AVH患者(1022±231)明显小于对照组(1979±151)(P<0001),随病程延长,FGV渐增多.FGV减少与病情程度呈显著负相关(P<005).餐后GB排出量(GEF)AVH组显著少于对照组(P<0001),其减少与病情程度呈明显负相关(P<001),与血清胆红质、ALT水平呈显著负相关(P<005~001).60min最大GEF及GB排空速度明显减少、减慢(P<0001).恢复期FGV及餐后GEF均恢复正常.结论AVH患者存在FGV和餐后GEF异常.其机制与肝细胞损害,泌胆功能障碍及神经—激素调控失调有关. 相似文献
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非溃疡性消化不良患者体表胃电图与胃液体排空功能的研究 总被引:7,自引:0,他引:7
检测31例非溃疡性消化不良(NUD)患者及9例健康人(HS)空腹体表胃电图与胃液体排空功能,并观察了西沙必利对NUD患者空腹体表胃电图与胃液体排空功能的影响。结果表明NUD患者半排空时间(T12)显著高于HS组(P<001);胃液体排空延迟的NUD患者(NUD2组)FP值较胃液体排空正常的NUD患者(NUD1组)及HS组明显减低;NUD2组正常慢波百分比也较NUD1组及HS组显著减少;而且所有检查者的T12值与体表胃电图的FP值及正常慢波百分比值呈良好的相关性(P<001)。NUD2组服用西沙必利后FP值和正常慢波百分比值均恢复正常,消化不良症状积分及胃液体排空功能显著改善。体表胃电图的AP值3组之间无差异(P>005),NUD2组服用西沙必利后AP值未发现明显变化(P>005)。 相似文献
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功能性消化不良的体表胃电图研究 总被引:10,自引:2,他引:8
研究功能性消化不良(FunctionalDyspepsia,FD)体表胃电图,探讨FD发病的病理生理机制。方法23名DF患者及20名健康志愿者,应用DigtlapperEGG记录仪进行EGG检查,检查时间为餐前半小时、餐后回小时,试餐4%Kcal(50g火腿肠、营多牌方便面1包、400ml开水)。结果健康组餐前主频(pF)、主功率(DP)、正常节律百分发比(N%)为:2.9±0.1cpm、57.6±15.2bp、90.9±1.9%;餐后:3.010.ICpm、212.78±72.5bp(P<0.01)、92.6±2.1%。FD组餐前DF、DP、N%为:2.8±0.1cmp、489.1±157.9bp、81.86±5.5%;餐后分别为:3.1±0.2cpm、475.5±122.3bp、67.5±4.4%(P<0.05)。结论m患者存在胃电节律紊乱,此种节律紊乱主要表现在餐后功率降低及正常节律百分比下降,提示FD患者可能存在胃肌电活动异常。EGG作为一种无创性胃动力检查方法,可用于FD患者的临床及研究工作。 相似文献
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内镜下Oddi括约肌测压的临床意义 总被引:2,自引:0,他引:2
为观察胆石症、胆囊切除术后等胆系疾病及功能性消化不良(FD)、糖尿病胃轻瘫(DGP)等非胆系疾病Oddi括约肌(SO)功能变化,通过内镜采用灌注式高分辨多道胃肠功能测定仪,对15例胆系疾病患者、13例非胆系疾病患者进行Oddi括约肌测压。结果显示,胆系疾病组的胆总管压力、SO基础压及蠕动波振幅明显高于非胆系疾病组(6.86±0.63kPa与1.27±0.10kPa,P<0.01;7.31±0.95kPa与1.87±0.16kPa,P<0.01;32.00±1.2kPa与24.14±1.5kPa,P<0.05);同时,非胆系疾病组的十二指肠压、SO蠕动频率及间期较胆系疾病组明显降低、减慢及延长(1.42±0.26kPa与0.30±0.10kPa,P<0.01;3.6±1.2次/分与2.2±0.4次/分,P<0.05;7.4±1.2秒与11.0±1.8秒,P<0.05)。结果显示,无论是胆系疾病还是FD及DGP等非胆系疾病均有SO功能紊乱,但表现形式相反,对指导临床诊断与治疗有一定价值。 相似文献
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胆汁反流性胃炎患者Oddi括约肌松弛不良:硝苯吡啶改善胆囊排空作用研究 总被引:10,自引:4,他引:6
目的 研究胆汁反流性胃炎(BRG) 患者胆囊(GB) 排空异常的发生机制.方法 按随机、双盲及对照的原则,用实时超声研究了38 例BRG 患者和30 例正常对照组GB 排空功能及硝苯吡啶(Ni) 对GB 排空的影响.结果 空腹GB 容量BRG 组明显多于对照组( P< 0-01) ,服Ni前后GB 容量无明显变化( P> 0-05) . 餐后15min 起GB 排出量(GEF) 即明显少于对照组( P< 0-01) ,45min 时更著. 口服Ni 后25min BRG 组GEF 即显著增加( P< 0-01) ,20 mg Ni 更著;GB排空速度明显增快( P< 0-01) ;最大GB 排空时间明显缩短( P< 0-01) . 服Ni 前后血浆促胃液素水平无明显差异( P> 0-05) . 对照组口服Ni 后GEF 明显减少( P< 0-01) ,20 mg者更著.结论 Oddi 括约肌松弛不良可能为BRG 患者GB 排空异常的发生机制之一;口服Ni 有明显改善其GB 排空的作用,但对消化间期GB 排空无明显影响,Ni 改善GB 排空不依赖促胃液素. 相似文献
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食管测压对反流性食管炎的诊断价值 总被引:3,自引:2,他引:3
目的探讨食管测压对反流性食管炎的诊断价值.方法使用专用软件控制的高分辨多道灌注测压系统(PCpolygrafHR瑞典产)测定了正常人12例及反流性食管炎患者32例的食管下括约肌动力指标、胸腹段长度及食管体动力参数.结果患者组LESP,LESRP压力(kPa)明显低于对照组(10±07对26±10;01±04对04±02,P均<001);食管中远段振幅(kPa)亦低于对照组(干咽:46±33对65±26,53±37对91±37,P均<005;湿咽:53±33对89±36,61±46对±124±45,P均<005).患者组LESL1(cm)比对照组短(17±08对26±09,P<001).结论反流性食管炎患者LESP低下,LSEL1过短,食管体中远段动力低下,为临床选用动力药提供了客观依据 相似文献
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尿毒症患者的体表胃电图研究 总被引:7,自引:2,他引:7
目的应用体表胃电图研究尿毒症患者是否存在胃肌电活动损害.方法应用双电极DiggtrapperEGG对25例有胃肠道症状的尿毒症患者和25例健康志愿者进行餐前、餐后各30min胃电图检查,试餐200832KJ(100g营养麦片,200mL开水).结果健康组餐前主频(DF)、主功率(DP)及正常节律百分比(N%)分别为29min-1±01min-1,576bp±152bp,909%±19%;餐后:30min-1±01min-1,21278bp±725bp(P<001),926%±21%.尿毒症组餐前DF、DP、N%分别为11min-1±02min-1,6504bp±480bp,470%±39%;餐后12min-1±02min-1,3648bp±245bp,338%±31%.以上结果与健康组相比均有显著性差异.结论尿毒症患者存在胃电节律紊乱,此种节律紊乱主要表现在正常节律百分比明显下降及餐后功率降低,提示尿毒症患者存在胃肌电活动异常.EGG作为一种无创性胃动力检查方法,可用于严重肾功能衰竭、尿毒症患者的临床及研究工作 相似文献
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溴化异丙托品与氨茶碱片对支气管扩张作用的对比观察 总被引:6,自引:0,他引:6
目的比较定量雾化吸入溴化异丙托品与口服氨茶碱片对支气管扩张的作用。方法对26例稳定期慢性阻塞性肺疾病(COPD)患者采用安慰剂控制的双盲交叉试验,于试验前及试验后30分,1,2,3,4,5,6小时分别测定第一秒用力呼气容积(FEV1)。结果使用溴化异丙托品及氨茶碱后FEV1平均峰值较基础值增加分别为34%及19%(P<0.01);达峰时间分别为1~2小时及2~3小时;FEV1较基础值增加>15%的患者分别为90%及50%(P<0.01);FEV1>15%的平均持续时间为3.6小时及1.6小时,6小时内FEV1较基础值平均增加分别为18%及8%(P<0.01)。结论对COPD患者雾化吸入溴化异丙托品较口服氨茶碱片能更有效的扩张支气管作用 相似文献
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老年人非溃疡性消化不良的超声胃动力学研究──47例检测结果对照分析 总被引:1,自引:0,他引:1
采用单切面实时超声显像法对31例老年非溃疡性消化不良患者及16例健康对照者进行流体胃动力学多项指标检测。结果显示:患者组胃液体排空T_1/2为38.8±10.5分钟,对照组29.4±7.7分钟,差异有显著性(P<0.05)。同时患者组的胃窦收缩频率为3.3±1.0次/2分钟、胃窦收缩幅度为0.4±0.1、胃窦运动指数为1.5±0.9,对照组分别为4.4±1.7次/2分钟、0.6±0.2及2.7±1.9,差异均有显著性(P<0.05),且患者组胃液体排空时间延长与其胃窦运动指数下降相关(P<0.01)。老年患者组男性胃液体排空T_1/2为35.2±7.7分钟,女性为44.4±12.1分钟,差异有极显著性(P<0.01),表明老年男性患者胃液体排空T_1/2正常,而女性患者延迟。提示胃动力学功能障碍在老年人非溃疡性消化不良发病中起一定作用。 相似文献
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肿瘤病人弓形虫感染分析 总被引:5,自引:0,他引:5
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… 相似文献
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Takeda A Imaseki H Okazumi S Shimada H Takayama W Hayashi H Suzuki T Ochiai T 《Journal of gastroenterology》2000,35(1):56-59
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 相似文献
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Infection with Rhodococcus equi in a patient with sarcoidosis treated with corticosteroids 总被引:5,自引:0,他引:5
G Hillerdal I Riesenfeldt-Orn A Pedersen E Ivanicova 《Scandinavian journal of infectious diseases》1988,20(6):673-677
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. 相似文献
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D'ESTE D.; PASQUAL A.; BERTAGLIA M.; MENEGHELLO M. P.; ZANOCCO A.; DELISE P.; D'ESTE F.; PASCOTTO P. 《European heart journal》1995,16(11):1632-1636
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 1678 years; group 3, 25control subjects with a mean age of2.64, range 1376 years. Each subject underwent atrial transoesophageal stimulation withthe following protocol: programmed atrial stimulation with 1and 2 stimuli during atrial pacing of 100. min1 and 150.min1; atrial stimulation for 10 s at a rate of 200300400500600.min1 with intervals of 10 s between stimulations, fivesuccessive ramp-up atrial stimulations for 9 swith the rate increasing from 100 to 800. min1 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. 相似文献
16.
Isenberg DA 《Lupus》2008,17(5):400-404
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. 相似文献
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