鸢尾素对新生大鼠高胆红素血症抗炎作用的研究

摘要目的：探讨鸢尾素干预高胆红素血症新生大鼠脑组织炎症反应的影响。方法：将66只新生SD（Sprague-Dawley）大鼠,采用抽签法随机分为正常对照组（A组）和模型组（M组）,于7日龄、10日龄采用腹腔注射胆红素溶液的方法建立高胆红素血症模型。末次注射后,从A组、M组中随机选取6只大鼠,用于验证模型建立成功,然后将M组随机分为B组与C组,C组大鼠侧脑室注射80μg/kg剂量鸢尾素溶液,余各组注射等量磷酸盐缓冲液。侧脑室注射后,根据不同处死点,将A、B、C各组进一步分为3个亚组,在各时间点进行神经行为学检测,苏木精-伊红染色（hematoxylin-eosin staining, HE）检测皮质或海马神经细胞形态,酶联免疫吸附测定（enzyme-linked immunosorbent assay, ELISA）检测肿瘤坏死因子（tumor necrosis factor-alpha, TNF-α）、白细胞介素1β（interleukin-1 beta, IL-1β）、白细胞介素-6 （interleukin, IL-6） 的浓度。结果：平面翻正反射：12h时,3组大鼠所需时间无显著性差异（P>0.05）;24h时,B、C组大鼠长于A组大鼠（P<0.05）;48h时,B组大鼠长于A、C组大鼠（P<0.05）,A、C2组大鼠无显著性差异（P>0.05）。各时间点3组大鼠方向趋向性试验均无显著性差异（P>0.05）。HE：A组大鼠皮质神经元结构清晰完整,但海马神经元数量出现减少;B、C组大鼠皮质、海马等区域神经元数目减少,结构紊乱,可见不同程度病理损害,C组优于B组。Elisa：B组脑组织各时间点TNF-α、IL-1β、IL-6的浓度均高于A组（P<0.05）;C组脑组织各时间点TNF-α、IL1β、IL-6的浓度均低于B组,差异具有显著性意义（P<0.05）;C组大鼠脑组织TNF-α浓度在12h时高于A组大鼠（P<0.05）,在24h、48h低于A组大鼠（P<0.05）;C组大鼠脑组织IL-6的浓度在12h、24h均低于A组大鼠（P<0.05）,48h时,C组大鼠脑组织IL-6的浓度与A组大鼠无显著性差异（P>0.05）;C组大鼠脑组织IL-β的浓度在3个时间点均与A组大鼠无显著性差异（P>0.05）。结论：鸢尾素可有效减少高胆红素血症新生大鼠脑组织TNF-α、IL-1β、IL-6的释放,发挥抗炎作用。     

鸢尾素对新生大鼠高胆红素血症细胞凋亡的影响

摘要目的：探究鸢尾素对新生大鼠高胆红素血症细胞凋亡的影响。方法：将96只新生SD大鼠随机分为对照组（N组）和模型组（M组）,于7和10日龄腹腔注射胆红素溶液进行造模。造模成功后将M组随机分为T0组、T1组、T2组、T3组。T1、T2、T3组分别侧脑室注射40、60和80 μg/kg的鸢尾素溶液,余各组注射等量磷酸盐缓冲液溶液。侧脑室注射24h后,神经行为学、苏木精-伊红染色（Hematoxylin-Eosin staining,HE）、原位末端标记法（terminal-deoxynucleoitidyl transferase mediated nick end labeling,Tunel）检测海马区病理改变并统计凋亡率,Western Blot检测海马Bcl-2、Bax和Caspase-3蛋白相对表达量。结果：侧脑室注射鸢尾素后。平面翻正反射：T3组所需时间少于T0、T1、T2组且多于N组（P<0.01）;负趋地性反射：T3组所需时间少于T0、T1、T2组（P<0.01,P<0.05）。HE染色：M组海马神经细胞核固缩、裂解,排列紊乱。T1、T2、T3组细胞形态等不同程度改善。Tunel染色：M组Tunel+细胞增多,布满视野;N组Tunel+细胞少,呈零星分布;T3组凋亡率低于T0、T1组（P<0.05）。Western Blot：各组Bcl-2蛋白相对表达量无显著性意义（P>0.05）;T0组Bax蛋白高于其余各组（P<0.05）,T3组低于T1组（P<0.05）;T0组Bcl-2/Bax值低于N、T3组（P<0.05）,T1、T2组均低于T3组（P<0.05）;T0组Caspase-3蛋白高于其余各组（P<0.05）,N组低于T1组（P<0.05）,T1组高于T3组（P<0.05）。结论：鸢尾素可能通过减少Bax、Caspase-3蛋白表达,升高Bcl-2/Bax值来减轻神经细胞凋亡且与鸢尾素注射剂量相关。     

米卡芬净单药及联合两性霉素B对小鼠侵袭性肺曲霉病的治疗作用

目的评价米卡芬净单药及联合两性霉素B对小鼠侵袭性肺曲霉病(IPA)的治疗作用。方法采用环磷酰胺骨髓抑制、烟曲霉孢子滴鼻接种构建中性粒细胞减少小鼠IPA模型。实验动物随机分为为4组:模型对照组(NS+5%GS,A组)、米卡芬净治疗组[5 mg/(kg.d),B组]、两性霉素B治疗组[1 mg/(kg.d),C组]和米卡芬净[5 mg/(kg.d)]加两性霉素B[1mg/(kg.d)]治疗组(D组),治疗从接种第2天开始,每天1次,共7 d。①动物生存期观察:每组15~16只小鼠,接种后每天观察1次至第21天。共进行2批次实验,分别给予2×105和6×106个孢子/小鼠。②肺的真菌负荷:每组9只小鼠,给予1.5×104个孢子/小鼠。治疗结束后取肺,匀浆后梯度稀释培养,记取菌落数并计算肺的真菌负荷量。结果①生存分析:第1批次,米卡芬净、两性霉素B单药及联合用药治疗均能延长小鼠生存期,但3种治疗方案在延长生存期方面差异无显著性(B组、C组分别与A组比较均有P<0.05,D组与A组比较P<0.01)。第2批次,联合用药组生存期长于其它各组,米卡芬净及两性霉素B单药治疗组与模型组比较差异无显著性(D组与A组比较P<0.01;D组分别与B组及C组比较均有P<0.05)。②肺的真菌负荷:两性霉素B单药及联合用药均能降低肺的真菌负荷,米卡芬净单药不降低肺的真菌负荷(C组与A组比较P<0.01;D组与A组比较P<0.05;B组与C组比较P<0.05;B组与D组比较P<0.01)。结论单独应用米卡芬净或两性霉素B及联合用药均能够延长中性粒细胞减少IPA小鼠生存期,当孢子接种量为6×106/小鼠时,联合用药优于单独应用米卡芬净或两性霉素B。单独应用米卡芬净不降低肺的真菌负荷,联合用药或两性霉素B单药在降低肺的真菌负荷方面均优于对照组及米卡芬净组。     

丽珠肠乐治疗早期新生儿高胆红素血症的临床效果观察

目的比较丽珠肠乐（双歧杆菌活菌制剂）与酶诱导剂（鲁米那、尼可刹米）在治疗早期新生儿高胆红素血症的临床疗效。方法将92例早期新生儿高胆红素血症的病人随机分为治疗组49例．以丽珠肠乐（双歧杆菌活菌制剂350mg／d）配以蓝光照射治疗,对照组43例以酶诱导剂鲁米那5mg／（kg·d）,尼可刹米100mg／（kg·d）并配以蓝光照射,总疗程5夭。结果治疗组显效率（77.6％）高于对照组（44.2％）,P＜0.01。结论双歧杆菌活菌制剂治疗早期新生儿高胆红素血症优于酶诱导剂。     

Effect of hypophysectomy on caffeine elimination in rats

Two groups of 8-week-old Sprague-Dawley male rats were used: 8 hypophysectomized (H[-]), operated on day 0, treated by daily sc tetracosactid (ACTHs: 10 micrograms), and thyroxine (T4:5 micrograms/100 g); 7 sham-operated, treated by sc saline solution. ACTHs, T4, saline solution were administered on days 7-16. The animals received po caffeine (CAF) 4 mg/kg as citrate salt on day 15. Ten blood samples were drawn from the tail. Plasma CAF concentrations were determined by HPLC. CAF apparent clearance and apparent volume of distribution were lower in H(-) rats than in controls: 0.281 +/- 0.072 vs 0.455 +/- 0.165 l/kg/h (-38%; P less than 0.05) and 0.520 +/- 0.239 vs 1.28 +/- 0.266 l/kg (-59%; P less than 0.01) respectively. CAF half-life was lower in H(-) rats than in controls: 1.33 +/- 0.621 vs 2.12 +/- 0.676 h (-37%; P less than 0.01). CAF is a drug with a low hepatic extraction ratio and low plasma protein binding. CAF clearance is therefore primarily dependent on intrinsic clearance, which depends on the activity of the enzymes involved in CAF metabolism. These data suggest that hepatic CAF metabolism is reduced in H(-) rats treated by SC ACTHs and T4. The decrease in CAF apparent volume of distribution is probably related to dehydration, as suggested by increase in urine flow and hematocrit. The CAF half-life was probably low because the volume of distribution was proportionally more decreased than the clearance. Our results suggest that the pituitary gland plays a role in the regulation of hepatic CAF metabolizing enzymes.     

米卡芬净与伏立康唑联合治疗侵袭性真菌感染的临床研究

目的评价米卡芬净静脉注射后口服伏立康唑治疗ICU侵袭性真菌感染(IFI)疗效及安全性。方法将侵袭性真菌感染患者,根据不同抗真菌治疗方法分成两组,A组(16例)采用米卡芬净静注后伏立康唑口服联合疗法;B组(16例),米卡芬净组静脉滴注米卡芬净(100 mg/d),观察两组患者的疗效和不良反应。结果 A组的总有效率为87.5%(14/16),药物相关的不良反应发生率6.3%(1/16);B组的总有效率56.3%(9/16),药物相关的不良反应发生率为25%(4/16)。两组总有效率较高,但有显著性差异(P0.05),A组不良反应率显著低于B组。结论两种方案对侵袭性真菌感染的患者均有效,米卡芬净联合伏立康唑疗法比单独应用米卡芬净更具有疗效优势,且安全性好,不良反应少,有显著性差异(P0.05)。     

新生儿早期体重下降与高胆红素血症的相关性研究

目的探讨新生儿早期体重下降与高胆红素血症之间的相关性,为临床早期干预提供依据。方法选择本院产科2008年6—12月出生的足月正常新生儿461例,连续监测新生儿出生时及出生后第1d、第2d和第3d的体重及经皮测量胆红素值,根据新生儿出生后第3d的经皮测量胆红素值将新生儿分为正常组、临界组和发病组,分析新生儿每天体重下降与发生高胆红素血症之间的关系。结果发病组新生儿出生后第2d、第3d体重下降程度明显高于正常组的新生儿,经统计学分析,P〈0．05,差异具有统计学意义。新生儿发病组出生后第1d、第2d、第3d每天经皮测量胆红素值较正常组的新生儿明显增高,经统计学分析,P〈0．001,差异具有统计学意义。结论新生儿体重下降程度与高胆红素血症发生具有一定的相关性。     

外周动静脉同步换血法治疗重症新生儿高胆红素血症效果观察

[目的 ]观察外周动静脉同步换血法治疗重症新生儿高胆红素血症的疗效。 [方法 ]对 6例重症高胆红素血症患儿采用了外周动静脉同步换血疗法。外周静脉输血 ,输液泵控制速度 2 0 0ml/h～ 3 0 0ml/h ,外周动脉抽血速度参照输入速度。换血前后行血常规、血生化、肝功能、血培养等检查 ;以多功能监护仪监测心率、呼吸、血压、体温 ;随诊10个月至 2a ,观察有无胆红素脑病后遗症表现。 [结果 ] 6例患儿血清总胆红素在换血前 ( 844 .0 7±3 14 .3 4) μmol/L ,换血后 ( 4 0 8.2 7±160 .40 ) μmol/L ,换血前后差异有统计学意义 (P <0 .0 1) ,总胆红素换出率为 5 1.3 3 % ,换血后白细胞、血清钾、氯略有下降 ,血清钙略为上升 ,其余生化指标均无变化 ,换血前后血培养均为阴性 ,生命体征稳定 ;追踪观察 ,1例出现胆红素脑病后遗症表现 ,其余 5例发育正常。 [结论 ]外周动静脉同步换血法具有实用、易行、安全、并发症少等优点 ,是治疗重症新生儿高胆红素血症的有效方法。     

抚触配合光疗在新生儿高胆红素血症中的应用

目的:探讨抚触配合光疗在新生儿高胆红素血症中的应用效果.方法:依据血清胆红素水平将180例新生儿高胆红素血症患儿分为轻度、中度、重度(A组、B组、C组)三组各60例,各组再随机分为实验组(A1组、B1组、C1组各30例)与对照组(A2组、B2组、C2组各30例),对照组给予蓝光照射治疗与常规护理,实验组在对照组基础上联合抚触.测量并记录治疗后第2、4、6天患儿黄疸指数、哭闹时间,以及患儿每日摄入奶量、大便次数、体重、睡眠时间.结果:治疗后第2、4、6天三组中实验组较对照组患儿黄疸指数降低、哭闹时间减少(P＜0.05,P＜0.01),且三组中实验组较对照组每日摄入奶量多、大便次数多、体重增长快、睡眠时间长(P＜0.01).结论:在蓝光照射治疗同时给予抚触可降低不同程度新生儿高胆红素血症患儿血清胆红素水平,使其摄入奶量多、大便次数多、体重增长快;能提高患儿治疗依从性,促进其神经系统的发育.     

Population pharmacokinetics of micafungin in adult patients

We performed population pharmacokinetic analysis of micafungin in adult patients treated with doses between 12.5 and 200 mg/day. Our analysis identified a breakpoint patient weight of 66.3 kg above which serum clearance increased by approximately 50%. Patients with weight >66.3 kg may need larger doses to achieve similar exposures to those <66.3 kg. However, the clinical implications are still unknown.     

抚触在高胆红素血症新生儿中应用的研究进展

从抚触的概念、研究历史、手法、对高胆红素血症新生儿的作用及机制和抚触手法、力度、部位、时机、次数对高胆红素血症新生儿的影响等方面综述了抚触在高胆红素血症新生儿中应用的研究进展.     

郴州地区住院新生儿高胆红素血症临床特点及病因构成分析

目的：分析郴州地区住院新生儿高胆红素血症的临床特点及病因构成。方法选取2012年1~12月该院新生儿高胆素血症患儿534例,收集一般临床资料,检测总胆红素水平、人巨细胞病毒(HCMV)基因、6-磷酸葡萄糖脱氢酶(G-6PD)的酶活性,筛查新生儿溶血病,并进行统计分析。结果新生儿高胆素血症患儿中 G-6PD 酶缺乏症患儿43例,占8.0%;ABO 溶血病患儿98例,占18.4%;HCMV 感染患儿153例,占28.6%;细菌感染患儿149例,占27.9%。结论该地区新生儿高胆红素血症患儿病因以感染性因素为主,加强患儿胆红素水平监测,并对检验结果和病因进行分析,可有效预防和降低高胆红素血症对新生儿的损害。     

不同光疗时间对新生儿高未结合胆红素血症治疗效果影响的研究

目的：探讨光疗时间对新生儿高未结合胆红素血症的效果及副作用。方法：随机将104例高未结合胆红素血症患儿分成两组,研究组（A组）52例,对照组（B组）52例。分别予以不同的光疗时间,比较两组光疗效果及副作用。结果：A组光疗效果显著优于B组（P〈0.01）,两组光疗副作用发生率、恢复时间差异有显著性（P〈0.01）。结论：间歇光疗时间副作用少,达到了预期效果。     

Nursing diagnoses of hospitalized infants with physiologic hyperbilirubinemia: A cross sectional study

Background and aimNursing diagnoses are the common language of nurses which indicate the labels given to human responses to health problems/developmental processes. Neonatal physiologic hyperbilirubinemia is a developmental disorder common in neonates. The responses to this health problem need to be identified.This study aimed to find physiologic hyperbilirubinemia related nursing diagnoses in some domains of the NANDA-I classification in hospitalized newborns in a maternal-neonatal educational hospital in Tehran, Iran.MethodsIn this cross-sectional study, a checklist contains labels, defining characteristics and related factors of selected nursing diagnosis of six domains of the NANDA-I classification and a maternal-neonatal information questionnaire were used for conveniently selected 140 hospitalized newborns with physiologic hyperbilirubinemia. The data was analyzed using SPSS software 23 (IBM Corp, Armonk, NY).FindingsRisk for deficient fluid volume, Risk for electrolyte imbalance (hyponatremia/hypocalcemia/hypernatremia), risk for vascular trauma, risk for impaired skin integrity, risk for infection, risk for injury (retinal damage/bilirubin hyperbilirubinemia) and risk for thermal injury were the nursing diagnoses identified for more than 90% of the neonates.ConclusionThe nursing diagnoses identified in this study for physiologic neonatal hyperbilirubinemia can guide clinical neonatal nurses in providing high-quality care in neonatal settings.     

Reduced clearance of leukocytes from lungs in septic rats

Leukocytes have previously been shown to sequestrate in the lungs and liver in association with traumatic and septic shock. In a rat model of gram-negative sepsis of intra-abdominal origin, a previously described in vivo technique was used for dynamic studies of leukocyte sequestration in different organs using white blood cells labeled with 111-indium-oxine. One group of rats was either studied immediately after induction of sepsis or for 6 h under a scintillation camera for continuous registration of the activity distribution (i.e., presence of leukocytes). Another group was studied 12 h after induction of sepsis for 60 min. The activity increased immediately over the lungs, indicating sequestration of the leukocytes during the first 6 h, but there was no significant difference in this respect between septic and control animals. It does not seem possible to study leukocyte sequestration dynamically in this way. When the labeled leukocytes were administered 12 h after induction of sepsis, however, the activity of septic animals' lungs was seen to remain elevated over the time period studied compared with control rats, in which the activity slowly decreased. In the liver and spleen, the activity increased in both groups, but significantly more so in control animals, which may be explained by disturbed leukocyte margination and cell turnover in the septic animals. This study has indicated that leukocyte distribution in different organs is affected by sepsis and this reaction can be studied using radiolabeled leukocytes.     

新生儿G6PD缺乏症并发高胆红素血症的临床分析

目的：回顾性分析新生儿GBPD缺乏症并发新生儿高胆红素血症的临床特点,探讨G6PD缺乏症在新生儿期发病的诱因、临床进程及诊治效果。方法：2007—10—201206收治的12例新生儿G6PD缺乏症并发高胆红素血症患儿,对其病因、临床表现及转归进行分析。结果：黄疸高峰出现在生后第2～7天,血清总胆红素（STB）峰值为（417．38±154．73）μmol／L,STB〉342μmol／L占66．7％。血红蛋白（Hb）为52～164g／L,平均为（123．37±34．54）g／L,Hb〈140g／L占66．7％;血网织红细胞（Ret）为1．31％～4．22％,均值（2．50±0．94）％。G6PD／6PGD比值平均为（0．44±0．18）。回归分析显示STB与G6PD／6PGD比值、HB和Ret均无明显相关性（r=-0．175,-0．180,0．272;P=0．587,0．576,0．393）。合并疾病及并发症：感染4例,窒息缺氧1例,ABO溶血病2例,核黄疸2例。结论：G6PD缺乏所致新生儿高胆红素血症发病早,黄疸进展快而严重,大多数患儿无明显诱因;G6PD活性和Hb水平不能完全反映黄疸的严重性或溶血程度。对新生儿早期重度黄疸应提高对本病的认识,常规行G6PD活性的检查,并给予积极治疗能有效预防胆红素脑病的发生。     

Comparison of micafungin and voriconazole in the treatment of invasive fungal infections in kidney transplant recipients

What is known and Objective: Invasive fungal infections are a major threat to renal transplant recipients. Micafungin and voriconazole are two useful antifungal agents for treating such infections. Our objective is to evaluate the comparative efficacy and safety of micafungin and voriconazole in the initial treatment of such infections. Methods: In this prospective, multicentre, open‐labelled, randomized, controlled trial, renal transplant recipients with invasive fungal infections were assigned to receive either micafungin or voriconazole. The enrolled subjects received a kidney transplant between March 2008 and March 2010 at one of the two transplant centres in Henan Province, China. The efficacy and adverse effects of the two treatments were compared. Results and Discussion: The clinical trial enrolled 65 patients, of whom 31 were treated with micafungin, and 34 with voriconazole. The rates of microbiological evidence of infection in the micafungin and voriconazole groups were 64·5% and 70·5%, respectively, whereas the rates of Candida as the major cultured fungus were 80·0% and 75·0%, respectively. Complicated bacterial infection rates in the two treatment groups were 38·7% and 32·4%, respectively, whereas complicated CMV viral infection occurred at a rate of 19·2% and 23·5%, respectively. Fungal infection within one to 3 months after transplant was 83·6% (26/31) and 85·3% (29/34) in the micafungin and voriconazole groups, respectively. There was no significant difference between the two groups in terms of efficacy, survival beyond 10 days and discontinuation of treatment because of lack of efficacy (P > 0·05). Mortality rates in the micafungin and voriconazole groups were 9·7% (3/31) and 12·1% (4/33), respectively. Rates of adverse effects in the two groups were 41·9% and 51·6% (P > 0·05), respectively. What is new and Conclusions: This is the first comparison of micafungin and voriconazole in renal transplant patients. Our study shows that the effectiveness of micafungin was similar to that of voriconazole in such patients.     

抚触在新生儿高胆红素血症患儿护理中的应用

目的:探讨抚触在新生儿高胆红素血症患儿护理中的应用效果。方法:将我院72例新生儿高胆红素血症患儿随机分为对照组35例和观察组37例,对照组采用常规护理,观察组在常规护理的基础上加新生儿抚触干预,比较分析两组的临床效果。结果:观察组有效率明显高于对照组(P<0.05);观察组患儿的血清胆红素浓度及黄疸消退时间均低于对照组(P<0.05)。结论:应用抚触在新生儿高胆红素血症患儿护理中有较好的临床疗效,值得临床推广应用。     

Effects of vitamin C and melatonin on cysteamine-induced duodenal ulcer in a cholestatic rat model: A controlled experimental study

Background: Superoxide dismutase (SOD) is one of the defense mechanisms against free radicals. Cysteamine is a cytotoxic agent, acting through generation of reactive oxygen species (ROS) such as hydrogen peroxide, hydroxyl radical, and superoxide, and may decrease defense activity of SOD against ROS and induce duodenal ulcer. Melatonin is a suicidal antioxidant that has a protective effect against ROS and cytoprotective effect through inhibition of the decrease in SOD activity.Objectives: The primary aim of this study was to assess the effects of pretreatment with vitamin C and melatonin on cysteamine-induced duodenal ulcer. Secondary aims were to compare the ulcerogenic effect of cysteamine and the antiulcer effects of vitamin C and melatonin.Methods: This study was performed in male Wistar rats (200-250 g) in 3 groups of equal size (n = 24): bile duct ligation-induced cholestasis (test), sham, and control groups. In the test and sham groups, laparotomy was performed under general anesthesia and the common bile duct was identified; in sham rats, the common bile duct was left in situ, but in test rats, the common bile duct was isolated and doubly ligated to induce cholestasis. Animals in each group were also divided into 4 equal subgroups (n = 6). These subgroups were treated with vitamin C plus cysteamine, melatonin plus cysteamine, cysteamine alone, and saline, respectively. All animals were euthanized via overdose of ether anesthesia 24 hours after the last injection of cysteamine or saline, and 0.5 mL of blood was collected from the heart ventricle. The duodenum was cut open, washed with saline, fixed, and prepared for calculation of ulcer index (Szabo method) and histopathologic assessment. SOD activity was measured using a branded enzyme kit.Results: In all 3 groups, animals treated with cysteamine had significantly increased mean (SE) ulcer index (test, 4.00 [0.10] vs 1.17 [0.30]; sham, 3.83 [0.16] vs 0.50 [0.22]; control, 3.67 [0.21] vs 0 [0]) and decreased SOD activity (test, 146.41 [2.16] vs 299.83 [1.94] U/mL; sham, 154.75 [2.02] vs 303.08 [0.35] U/mL; control, 157.08 [1.67] vs 314.50 [1.14] U/mL) compared with saline-treated rats (all, P < 0.001). In the test rats, ulcer index was significantly increased and SOD activity was significantly decreased compared with the sham and control groups (both, P < 0.001). Pretreatment with vitamin C and melatonin was associated with attenuation of ulcer index and increased SOD activity compared with rats treated with cysteamine alone (P < 0.001). There were no significant differences in ulcer index or SOD activity between groups administered vitamin C or melatonin.Conclusions: In this experimental study, pretreatment with melatonin or vitamin C in all rats produced significant attenuation of the ulcer index and enhanced SOD activity. Cysteamine-induced duodenal mucosal damage was greater in cholestatic rats compared with sham and control rats.     

以血浆作透析液在肝移植术前的应用

目的以人体新鲜冰冻血浆作透析液行血液透析(PHD)后继续进行连续性静脉-静脉血液滤过(CVVH),观察其对肝移植术前高胆红素血症及血浆细胞因子水平的影响。方法4例拟行肝移植手术的肝功能衰竭患者行PHD治疗6 h后,应用同一滤器(AV600)继续行CVVH治疗24 h。分别检测治疗前后血清胆红素(TB、DB、IB)、总胆汁酸(TBA)、血氨(BA)及细胞因子TNF-a,IL-6和IL-8的水平。结果PHD治疗6 h后患者总胆红素(TB)、直接胆红素(DB)、间接胆红素(IB)和总胆汁酸(TBA)分别下降(24.38±4.89)%(、26.23±2.67)%(、25.02±0.01)%、(27.38±8.59)%(P<0.05);PHD后继续行CVVH治疗24 h,总胆红素(TB)仍有所下降(10.61±0.32)%;CVVH在清除血氨,纠正电解质和酸碱失衡方面比PHD更有效(P<0.05);PHD及CVVH治疗后TNF-aI、L 6、IL-8较治疗前明显下降(P<0.05)。结论对肝功能衰竭患者,PHD联合CVVH治疗能显著降低血清胆红素、总胆汁酸、血氨及炎性细胞因子水平,调节水、电解质和酸碱平衡。