纳洛酮治疗急性乙醇中毒昏迷的临床分析

目的观察纳洛酮临床治疗急性乙醇中毒昏迷的疗效。方法随机将55例急性乙醇中毒昏迷患者分为常规治疗的常规组（27例）和常规治疗＋纳洛酮治疗的治疗组（28例）,分别观察、记录用药后到清醒时间,加以比较分析。结果应用纳洛酮组平均清醒时间为140 min,常规组平均清醒时间为226 min,2组比较,差异有非常显著性（P〈0.01）。结论纳洛酮治疗急性乙醇中毒昏迷,有显著的解毒催醒作用,有利于急性乙醇中毒的观察治疗,对于早期发现意外并发症具有一定的意义。     

纳洛酮治疗乙醇中毒患者的临床效果研究

目的研究纳洛酮治疗急性乙醇中毒的临床效果。方法回顾性分析我院2007年6月至2008年6月之间收治的急性乙醇中毒患者50例,所有患者给予静脉通道补液,并针对急性乙醇中毒的临床表现分期分别给予患者采取不同的纳洛酮治疗模式。结果所有患者治疗后意识逐渐.恢复,呼吸恢复正常,血压逐渐回升至正常,病情在3～12h症状消失,完全清醒,可稳步行走,纳洛酮组治愈率为100%。结论纳洛酮在临床急性乙醇中毒急救中具有作用快,治疗简便,疗效确切的特点,从而易于临床上的广泛应用。     

纳洛酮治疗急性乙醇中毒的临床分析

目的观察纳洛酮治疗急性乙醇中毒的临床疗效。方法将64例急性乙醇中毒病例随机分成两组,治疗组31例,对照组33例,两组在性别、年龄及病因等方面无差异性(P>0.05)。两组均常规给予洗胃、利尿、补液、补充维生素、保护胃黏膜治疗。治疗组同时给予纳洛酮0.4mg静脉注射,严重者间隔30min可重复使用1次,随后给予10%葡萄糖250mL+纳洛酮0.8mg静脉滴注。对比两组的显效时间、症状消失时间,并进行统计学分析。结果纳洛酮治疗组患者症状改善,清醒时间明显提前于对照组,差异有显著性(P<0.01)。结论纳洛酮治疗急性乙醇中毒见效快,疗效确切,不良反应小,是救治急性乙醇中毒的安全有效的药物。     

纳洛酮治疗急性乙醇中毒262例疗效观察

目的总结纳洛酮治疗急性乙醇中毒的疗效和经验。方法对纳洛酮治疗的262例急性乙醇中毒患者的临床资料进行回顾性分析,并以184例常规方法治疗的病例作对照。结果纳洛酮治疗组轻中度中毒症状消失时间、重度中毒神志清醒时间分别为(0.5±0.2)h、(3.2±0.4)h,而对照组分别为(2.6±0.7)h、(9.8±2.1)h,两组比较差异有统计学意义(P<0.01)。纳洛酮治疗组的治愈率(100%)高于对照组(98.4%)。结论纳洛酮是治疗急性乙醇中毒的有效药物,作用迅速可靠。     

纳洛酮联合甲氯芬酯治疗重度乙醇中毒88例临床分析

目的 探讨纳洛酮联合甲氯芬酯治疗重度急性乙醇中毒的疗效.方法 将134例重度乙醇中毒患者随机分为对照组和治疗组.治疗组88例,采用纳洛酮联合甲氯芬酯治疗,对照组46例在常规治疗的基础上使用纳洛酮治疗,比较两组疗效.结果 治疗组显效56例,有效29例,总有效率96.6％;对照组分别为17例、18例、76.1％.两组总有效率差异有统计学意义(x2=4.00,P＜0.05).结论 纳洛酮联合甲氯芬酯治疗重度急性乙醇中毒疗效确切,值得推广应用.     

纳洛酮联合醒脑静和葛根素治疗急性乙醇中毒的临床体会

目的:探讨纳洛酮联合醒脑静和葛根素治疗急性乙醇中毒的临床疗效。方法:选择2011年1月—2011年12月急诊科收治的急性乙醇中毒患者129例,随机将患者分为3组,每组43例,3组患者经相关检查和明确诊断后进行常规治疗,纳洛酮组给予静脉注射纳洛酮,纳洛酮联合醒脑静组给予静脉注射纳洛酮和醒脑静,纳洛酮联合葛根素组给予静脉注射纳洛酮和葛根素,测定各组显效时间和痊愈时间,进行对比。结果:纳洛酮联合醒脑静组的显效时间和痊愈时间较纳洛酮组短,差异具有统计学意义(P<0.05);纳洛酮联合葛根素组的显效时间和痊愈时间较纳洛酮组短,差异具有统计学意义(P<0.05);纳洛酮联合醒脑静组和纳洛酮联合葛根素组差异无统计学意义(P>0.05)。结论:治疗急性乙醇中毒时,纳洛酮联合醒脑静或葛根素的疗效优于单用纳洛酮。     

纳洛酮救治急性乙醇中毒40例疗效观察

目的:观察纳洛酮在抢救治疗急性乙醇中毒的作用及治疗效果。方法:在常规治疗基础上,应用纳洛酮,剂量从0.4mg～3.2mg。结果:纳洛酮催醒作用快,无不良反应。结论:纳洛酮可作为救治急性乙醇中毒的首选药物。     

纳洛酮抢救急性乙醇中毒的疗效观察

目的探讨纳洛酮抢救急性乙醇中毒的临床效果。方法选取来某院进行急救的急性乙醇中毒患者100例。将入组患者按照治疗方式分为观察组和对照组,每组50例患者。两组患者入院后均给予常规急性乙醇中毒处理,观察组患者在以上治疗基础上,再给予静脉注射纳洛酮进行治疗。结果观察组患者的急性乙醇中毒症状缓解时间以及意识完全恢复时间均显著短于对照组患者,组间比较差异具有统计学意义(P<0.05)。观察组患者临床治疗效果显著优于对照组患者,组间比较差异具有统计学意义(P<0.05)。结论对于急性乙醇中毒患者来说,在常规临床治疗基础上,给予纳洛酮进行治疗,能够显著缩短患者的急性乙醇中毒症状缓解时间以及意识完全恢复时间,从而显著提高临床急救效果。     

纳洛酮治疗急性乙醇中毒的效果观察

我院于2003年2月至2005年9月用盐酸纳洛酮治疗急性乙醇中毒42例,效果明显,现报告如下:1临床资料与方法1.1一般资料选择2003年2月至2005年9月我院治疗的急性乙醇中毒57例。其中,42例给予纳洛酮治疗(A组),15例患者因     

纳洛酮治疗急性乙醇中毒20例临床疗效观察

本院于1998年8月～1999年8月收治急性乙醇中毒50例，其中应用盐酸纳洛酮治疗的20例，将20例纳洛酮治疗的病例作为治疗组，在其他一般方法治疗急性乙醇中毒的病例中，随机筛选出与治疗组中毒患条件相近的20例作为对照组，现将两组治疗效果的对比观察报道如下。     

阿立哌唑的血药浓度与其治疗精神分裂症疗效的相关性分析

目的：探讨阿立哌唑在中国精神分裂症病人体内的血药浓度与临床疗效的关系。方法：采用高效液相色谱-质谱联用(HPLC-MS)的方法测定30例精神分裂症病人体内阿立哌唑的血浆药物浓度,疗效评定采用阳性与阴性症状量表(PANSS)评分,用SPSS 11．0统计软件包对血药浓度与疗效评分进行统计分析。结果：治疗wk1,2,3,4末的阿立哌唑血药峰浓度与wk 1,2,3,4末的PANSS减分率无相关性,而wk 3,4末的平均稳态谷浓度与wk 4末的PANSS减分率呈正相关(r＞0．500,P＜0．05)。同时,将稳态血药谷浓度分为小于350．0μg·L~(-1)组和大于350．0μg·L~(-1)组病人的疗效进行比较,结果前者的PANSS减分率明显低于后者,两者的差异有统计学意义(P＜0．05)。结论：根据本实验研究结果,初步得出阿立哌唑的临床疗效与其稳态谷浓度高低有关,其稳态谷浓度在350．0μg·L~(-1)以上时,疗效较好。     

Effects of intravenous ethanol and of 4-methylpyrazole on alcohol drinking in alcohol-preferring rats

Studies were undertaken to determine if elevated blood alcohol concentrations (BAC), produced by intravenous (IV) infusion of ethanol or by intraperitoneal (IP) administration of 4-methylpyrazole (4-MP), could reduce the free-choice oral alcohol consumption of adult male alcohol-preferring rats (P-rats). The IV infusion of ethanol either on a 24 or 12 (dark) hourly dose schedule reduced the amount of ethanol voluntarily ingested. There was a significant (p<0.05) inverse correlation between the amount of ethanol consumed orally and the amount of ethanol infused. Daily fluid and caloric intakes were not compromised. When the amount of ethanol infused was 85% or more of the control oral intake, there was a significant correlation between ethanol intake and tail-blood alcohol levels, taken at 5 min (r=0.98; p<0.05) and 55 min (r=0.93,p<0.05) after the last dark cycle infusion. Below the preinfusion level of 85%, the BAC were variable and did not correlate well with total ethanol intake. After a single IP injection of 4-MP, 90 mg/kg body wt, BAC increased from 10 mg% to 50–65 mg% for 2–3 days. Concomitant with the rise in BAC, these animals decreased their drinking of 10% ethanol and proportionately increased their water intake. The present studies suggest that pharmacological factors, distinct from orosensory cues, are important in regulating voluntary ethanol drinking behavior in the P-rats.     

Initial sensitivity and acute tolerance to ethanol in the P and NP lines of rats

We recently reported that selectively bred, alcohol-preferring (P) and alcohol-nonpreferring (NP) rats differ in sensitivity to a single sedative-hypnotic dose of ethanol, as measured by performance in the jump test. The present study examines the contributions of initial sensitivity and acute tolerance development to this difference. Initial sensitivity, assessed by brain alcohol content upon loss of the aerial righting reflex, was not significantly different between P and NP groups given 3 g ethanol/kg body weight intraperitoneally. Acute tolerance was indexed from blood alcohol concentrations (BAC) upon recovery of jumping performance following two successive ethanol doses. Practiced P and NP rats were required to jump 35 cm to a descending platform following the IP injection of 2.0 g ethanol/kg. The NP group took signiificantly longer (74 min) than the P (33 min) group whereupon BAC₁ of NP rats (234 mg%) was significantly lower than that of P rats (250 mg%). A second injection (1.0 g/kg) was given immediately after the animals reached the 35 cm criterion. Again, NP rats took significantly longer (124 min) than P rats (52 min) to jump 35 cm and BAC₂ of NP animals was lower (295 mg%) than that of P rats (343 mg%). The difference between BAC₂ and BAC₁, the measure of tolerance development, was significantly larger for P rats (90 mg%) than for NP rats (61 mg%). No significant differences in blood ethanol elimination weree observed between the groups. The data indicate no difference in initial sensitivity between P and NP animals but that P rats develop acute tolerance more rapidly and/or to a greater degree than do NP rats. The results are consistent with a relationship in these selectively bred lines of rats between alcohol preference and the development of acute tolerance.     

支原体耐药性与抗菌药消耗量相关性研究

目的：了解支原体耐药性与抗生素消耗量之间的相关性。方法：对112份解脲支原体阳性标本进行9种抗菌药敏感性试验，统计2002～2003年有关药物的消耗量，分析解脲支原体耐药率与相应药品消耗量之间的关系。结果：多因素逐步回归分析表明上年度相关药物成人剂型的消耗量是有显著性意义的相关因素（r=0．858，F=16.778，P〈0．01）。结论：支原体的耐药率主要与上一年度的相关药物消耗量相关。     

病毒性肝炎患者血清一氧化氮水平的动态变化及其规律的临床研究

目的 :研究病毒性肝炎患者血清一氧化氮 ( NO)水平的动态变化及其规律 ,探讨其临床诊断价值。方法 :对188例各型病毒性肝炎患者的血清 NO水平进行检测 ,分析其动态变化 ,并与生化指标和肝纤维化指标进行对照研究。结果 :各组肝炎患者血清 NO浓度均明显高于正常对照组 ,而且各组间比较有显著性差异 ( F=3.6 1,P<0 .0 1) ;在各型肝炎的病情活动期 ,血清 NO明显升高 ,而随着病情的逐渐恢复 ,血清 NO的浓度逐渐下降 ( P<0 .0 5或 <0 .0 1) ;在肝纤维化血清学标志物 HA、L N、IV- C和 PC 明显升高的患者中 ,其血清 NO含量也明显升高 ;在 AL T与 NO的关系中 ,急性肝炎患者呈极显著负相关 ( r=- 0 .92 17,P<0 .0 1) ,重型肝炎患者呈极显著正相关 ( r=0 .6 776 ,P<0 .0 1) ,慢性肝炎无明显相关性 ( r=0 .12 4 7,P>0 .0 5 )。在 TBil与血清 NO的关系中 ,急、慢性肝炎和重型肝炎患者无明显相关性 (分别为 r=- 0 .0 815、r=0 .2 5 5 3和 r=- 0 .345 2 ,P>0 .0 5 )。结论 :病毒性肝炎时血清 NO浓度的变化与肝内炎症程度、肝病严重程度及病程的演变方向密切相关 ,同时也是反映肝纤维化的一个敏感指标     

Serum antimuscarinic activity during clozapine treatment

This study attempts: (1) to verify that serum antimuscarinic activity is related to clozapine dose, and more importantly to clozapine plasma concentrations; (2) to explore whether norclozapine has serum antimuscarinic activity; (3) to explore whether antimuscarinic activity is related to clozapine side effects; and (4) to compare the serum antimuscarinic activities of clozapine with those of antiparkinsonian drugs and other antipsychotics.In 39 patients participating in a double-blind clozapine study, the [3H]QNB assay was used to measure serum antimuscarinic activity: (1) on baseline medications; (2) after a 4-week haloperidol trial; (3) after a 16-week clozapine trial of either 100, 300, or 600 mg/d; and (4) after 1 or 2 consecutive 16-week clozapine trials with remaining doses in nonresponders.Clozapine levels predicted serum antimuscarinic activity better than clozapine dose. At the end of the 1st clozapine trial, the correlation with the levels explained 69% of the variance of serum antimuscarinic activity (r = 0.83, P < 0.001, N = 34). Clozapine levels were good predictors of serum antimuscarinic activity only in patients taking 300 or 600 mg/d. After correcting for clozapine levels, the within-subject correlation between norclozapine levels and serum antimuscarinic activity was relatively high and significant (r = 0.54, F = 26.7, df = 1.65, P < 0.001). Constipation was significantly associated with higher serum antimuscarinic activity during the 1st clozapine trial. Clozapine was associated with clearly higher antimuscarinic activity than other antipsychotics or low doses of antiparkinsonians. In vitro studies and new clinical studies are needed to verify whether norclozapine may significantly contribute to antimuscarinic activity during clozapine treatment.     

TPA 与 IPA 检测不同人群中血小板聚集率的相关性和一致性分析

目的：研究比浊法（ TPA）与电阻抗法（ IPA）对不同人群中血小板聚集率检测结果的相关性和一致性情况。方法根据180例患者不同情况,分为高血脂组、正常血脂组以及阵发性室上性心动过速预行射频消融手术的患者作为对照组。对不同组患者采用两种不同方法对血小板聚集率进行检测,比较两种方法测定的结果,同时进行一致性和相关性分析。结果两种检测方法的检测结果进行比较,测定结果数值分布情况进行分析,对照组差异无统计学意义（ P ＞0(．05）,但其他2组及总体组显示分布差异有统计学意义（ P ＜0．05）。两种方法检测结果直线相关性分析显示,对照组两种方法结果存在正相关性（ r ＝0．50, P ＜0．05）;正常血脂组直线相关,两种方法存在程度较低的正相关性（ r ＝0．48, P ＜0．05）;高血脂组两种方法检测结果相关程度最低（P＜0．05）,线性关系为低度相关（ r ＜0．40）;总体组也存在正相关性（ r ＝0．45, P ＜0．05）。采用Kappa系数分析两方法检测数据,结果显示对照组、正常血脂组和总体组,具有较弱的相关性;而高血脂组则无一致性关系。结论采用全血IPA和TPA检测不同人群中血小板聚集率无较强的关联性,特别对于合并高脂血症的患者,因此临床检验中两种方法不应相互替代。     

Robustness of chlorzoxazone as an in vivo measure of cytochrome P450 2E1 activity

AIMS: Chlorzoxazone is metabolized by cytochrome P450 2E1 (CYP2E1) to a single oxidized metabolite, 6-hydroxychlorzoxazone. The aim of the study was to test the robustness of chlorzoxazone as an in vivo probe of CYP2E1 activity in humans, with emphasis on investigating short-term and long-term intra-individual variabilities and effects of different doses of the drug. In addition, the influences of body build, drug metabolizing enzyme genotype, blood sampling time, and moderate recent ethanol intake were investigated. METHODS: The 6-hydroxychlorzoxazone:chlorzoxazone (metabolic) ratio in plasma was measured at 2 h in 28 male and nine female volunteers following a single oral dose of 500 mg chlorzoxazone. Similarly, the metabolic ratios at 4 h and 6 h were measured in 20 of the males. The metabolic ratio at 2 h was also determined 1.5 and 2.5 years later in 13 and seven males, respectively, and weekly for 3 weeks in seven males, after a dose of 500 mg, once at higher (750 mg) and lower (250 mg) doses, and once (500 mg) following moderate ethanol intake (0.5 g kg(-1) body weight) the preceding evening. Genotypes were determined for CYP2E1 as well as for N-acetyltransferase 2 and glutathione transferase M1. RESULTS: Excluding an outlier (ratio = 1.6) the metabolic ratio at 2 h ranged from 0.12 to 0.61 (n = 36). A positive correlation with body weight (r = 0.61, P < 0.001) suggested dose-dependent metabolism of chlorzoxazone. The metabolic ratio decreased with increasing chlorzoxazone dose (P = 0.01), again suggesting dose-dependent metabolism. Long-term (yearly intervals) and short-term (weekly intervals) intra- and interindividual variabilities in metabolic ratio were similar (30% and 63%vs 28% and 54%, respectively). Both inter- and intra-individual variabilities tended to decrease with increasing dose of chlorzoxazone. There was no significant influence of moderate ethanol intake the preceding evening, or of CYP2E1 genotype on the metabolic ratio. CONCLUSIONS: The relatively low intra-individual variability in the metabolism of chlorzoxazone suggests that a single-sample procedure may suffice to assess CYP2E1 activity in vivo. However, chlorzoxazone metabolism is dose-dependent at commonly used doses and it is therefore advisable to adjust the dose for body weight. Moderate intake of ethanol the preceding evening did not significantly affect the chlorzoxazone metabolic ratio.     

N-乙酰半胱氨酸对慢性饮酒大鼠肺纤维化的干预作用的研究

目的：探讨N-乙酰半胱氨酸(NAC)对慢性饮酒大鼠肺组织的病理形态及肺组织超氧化物歧化酶(SOD)、丙二醛(MDA)含量的影响。方法：健康雄性大鼠随机分成乙醇组、乙醇+NAC组、对照组各10只,乙醇组和乙醇+NAC组每日给予乙醇液体饲料,乙醇+NAC组给予NAC 300 mg/（kg?d）。8周后处死,观察肺组织病理改变,检测肺组织中的SOD、MDA的含量。结果：乙醇组肺组织可见不同程度的肺泡壁Ⅱ型上皮细胞增生及肺泡间隔炎性细胞浸润,肺泡间隔中胶原纤维沉积增多;乙醇+NAC组胶原纤维沉积和炎性细胞浸润程度比乙醇组轻。乙醇+NAC组肺泡炎、纤维化评分低于乙醇组（P＜0.05或P＜0.01）。乙醇+NAC组肺组织匀浆SOD活力高于乙醇组,MDA含量低于乙醇组（P＜0.05）。结论：NAC提高慢性饮酒大鼠肺组织SOD的活力,降低MDA的含量,减轻肺组织的纤维化程度,对慢性饮酒大鼠肺纤维化有预防作用。     

Voluntary ethanol drinking by the RAT: effects of 2-aminoethylisothiouronium Salt, a modifier of NAD:NADH and norelegnine, a beta-carboline derivative.

Voluntary intake of ethanol solution (ETOH) was decreased in rats administered 2-aminoethylisothiouronium bromide hydrobromide (AET), an agent reported to alter NAD:NADH ratios in rat liver. Repeated administration of same dose of AET to ETOH-naive rats produced a significant inhibition of liver aldehyde dehydrogenase. Ethanol intake was decreased in rats given noreleagnine (NLG), a beta-carbone derivative reported to inhibit monoamine oxidase. Repeated administration of NLG exerted a significant inhibitory effect on liver alcohol dehydrogenase activity. It is concluded that the observed reduction of ethanol under AET which inhibits liver aldehyde dehydrogenase may reflect an antabuse-like reaction and the reduction of ethanol intake under NLG may be due, in part, to a build-up of alcohol in the blood and brain through inhibition of ethanol metabolism. The results are discussed in reference to the possible mechanism of action underlying voluntary intake of ethanol in rats, implicating alteration of NAD:NADH ratios in the biochemical processes underlying alcohol intake of rats.