比阿培南致继发性血小板增多症病例报告并文献复习

目的:提高对碳青霉烯抗生素不良反应的认识。方法:报道1例外伤并感染患者使用比阿培南而导致继发性血小板增多症,并且复习碳青霉烯类抗生素不良反应相关文献。结果:停用比阿培南1周后,该患者血小板逐渐降至正常。结论:碳青霉烯类抗生素有可能引起血小板增多症,临床需关注由此可能导致的血管栓塞等不良反应。     

原发性血小板增多症并急性心肌梗死1例

患者女性,53岁。因反复胸痛2d,加重并持续8h入院。否认糖尿病、高脂血症,无烟酒嗜好。查体:BP160/110mmHg。P93次/min。急性痛苦貌,两肺呼吸音清。心界不大,心律齐无杂音,第一心音减弱。心电图示:V1～V6导联ST段弓背上抬0.2mV～0.4mV。肌钙蛋白:0.24ng/ml。血常规:白细胞计数13.4×109/L,红细胞计数4.21×109/L,血小板计数1178×1012/L。骨髓报告:①增生活跃,G=78%,E=1.5%,G/E=52;②粒系增生活跃,中性分叶核粒细胞比例升高,中、晚幼粒细胞无增多,嗜酸粒细胞易见,③红系增生偏低,比例减少。未见明显泪滴样RBC及其它RBC碎片;④淋巴…     

胃恶性间质瘤合并继发性血小板增多症1例

胃恶性间质瘤患者1例,临床表现为继发性血小板增多症．手术后血小板数量恢复正常,血小板增多症可能是反应肿瘤负荷的重要指标．     

小儿继发性血小板增多症80例临床分析

1984年4月至2000年3月,我科收治继发性血小板增多症患儿80例,现分析如下。     

肺组织细胞增多症1例并文献复习

目的探讨肺组织细胞增多症的发病特点、诊断和治疗方法。方法结合收治的1例肺组织细胞增多症患者的临床资料,对该病的发病特点,诊断和治疗方法进行综合分析。结果肺组织细胞增多症好发于吸烟人群,临床上多表现为活动后呼吸困难以及反复气胸。X线表现为中上肺野多发小结节状改变,晚期表现为多发囊状以及纤维化改变。病理表现为嗜酸性肉芽肿。约一半病人经激素或不经任何治疗后症状缓解,三分之一病人病情急性加重,导致呼吸衰竭。结论肺组织细胞增多症是一种罕见疾病,容易误诊,HRCT对诊断很重要,确诊需要病理。治疗以激素治疗为主。     

原发性血小板增多症并发急性心肌梗死1例

患者 ,男 ,46岁。原发高血压史 6年 ,血压最高达 2 5 0 / 1 5 0mmHg( 1mmHg =0 .1 33kPa) ,一直以福辛普利 1 0mgbid控制血压在 1 40～ 1 2 0 / 1 0 0～ 80mmHg ,否认糖尿病、高脂血症 ,无烟酒嗜好。 1个月前无明显诱因发作胸前区憋疼 ,向左肩、后背放射 ,持续 1～ 2min ,经舌下含化速效救心丸缓解。入院当日再次发作剧烈胸前区疼痛 ,伴大汗、恶心 ,持续 3h不缓解入院。心电图示Ⅱ、Ⅲ、aVF和V4～ 6、V7～ 9导联ST段抬高 0 .1 5～ 0 .40mV ,心肌肌钙蛋白T亚基 ( + )。诊断 :急性下壁、侧壁、后壁心肌梗死。发病 4h行急诊PCI。冠状动脉…     

原发性血小板增多症并发急性心肌梗死2例报告及文献复习

原发性血小板增多症（Essential Thrombocydlemia,ET）致急性心肌梗死（AMI）由于症状不典型,易被医生忽视而漏诊、漏治。本文报道2冽原发性血小板增多症致AM／并作文献复习,旨在加深对该病的认识和了解。     

原发性血小板增多症并门脉海绵样变性门脉高压症1例报道

门脉海绵样变性属非肝病性门脉高压症,病因与发病机制不十分清楚。多见于儿童,成人少见,并发原发性血小板增多症更属罕见。     

恶性胸腺瘤并红细胞增多症1例及文献复习

目的:提高对恶性胸腺瘤合并红细胞增多症的认识。方法:报告1 例恶性胸腺瘤并红细胞增多症,并且复习有关文献。结果:该病十分罕见。其发病机制与恶性肿瘤分泌促红细胞生成素有关,也可能是胸腺瘤所致T细胞免疫功能紊乱所致。结论:真性红细胞增多症的诊断必须排除原发病因,特别是中老年患者,一定要常规筛查胸、腹等各部位的肿瘤,以免漏诊。     

Study of Adverse Whole Blood Donor Reactions in Normal Healthy Blood Donors: Experience of Tertiary Health Care Centre in Jammu Region

Whole blood donation is generally a safe procedure, but sometimes adverse reactions of varying severity may occur during or at completion of blood donation process. The aim of the present study was to estimate the frequency and type of adverse events during blood donation. This retrospective study conducted from November 2011 to December 2012 at Department of Blood Transfusion Medicine GMC Jammu. All whole blood donations at our Department was analyzed. All adverse events occurring during or at end of donation were noted using standardized format. Overall 108 adverse events were reported in relation to 29,524 donations, resulting in overall adverse event rate of 0.365 %. Presyncopal reactions in other words vasovagal reactions of mild intensity, were the most commonly observed adverse reactions and accounted for approximately 58/108 (53.70 %) of all adverse reactions noted. Only 0.365 % of blood donations were complicated by adverse events and most of these events were presyncopal symptoms. Our study reinforces that blood donation is a very safe procedure which could be made even more event free by following certain friendly, reassuring and tactful practices.     

Adverse reactions and influencing factors in children with primary immunodeficiencies receiving intravenous immunglobulin replacement

ObjectivesWe aimed to determine adverse reactions and influencing factors, within the scope of the number of patients and total infusions, in patients with primary immunodeficiencies receiving intravenous immunoglobulin (IVIG) replacement.Materials and methodsChildren with primary immunodeficiencies receiving IVIG replacement in Izmir Dr Behcet Uz Children’s Hospital, between June 2014 and June 2016, were included in our study.ResultsThe total number of the patients receiving IVIG replacement was 145 (37 female, 108 male). The number of total IVIG infusions was 1214. Adverse reactions were observed in 44.8% of the patients and 14.2% of the infusions. Common variable immunodeficiency was the most common diagnosis of the patients and adverse reactions most commonly developed in this group (24.2%). In all infusions the most frequent adverse reaction was headache (7.8%); fever was the most frequent immediate side effect (3.9%), whereas headache was the most common delayed adverse effect (5.1%). By logistic regression analyses, history of adverse reaction to IVIG in previous infusions, existence of concomitant infectious disease, past or family history of atopic disease, to receive IVIG infusion at the first time, or being under 10 years old were found associated with adverse reactions. There was no correlation between the concentration of IVIG preparations and the rate of side-effect development.ConclusionsIn our study no severe adverse reaction to IVIG was observed, but many mild or moderate side effects occurred. Therefore, IVIG indications must be well identified. Patients, family of the patients and health care workers must be informed for adverse reactions.     

硝普钠不良反应的临床分析及对策

目的分析静脉应用硝普钠（sNP）治疗心力衰竭发生的不良反应,探讨其处理对策。方法心功能Ⅲ～Ⅳ级（NYHA分级）住院患者138例,静脉滴注硝普钠25-50mg＋5％Glucose250-500ml,起始剂量为0．1μg·k^-1·min^-1,或以20-40μg／min静脉滴注,调整滴速,直至达到所需疗效。平均治疗剂量为0．5-8．0μg·kg^-1·min^-1,最大剂量〈10μg·kg^-1·min^-1。血压过低时加用多巴胺。结果应用硝普钠发生不良反应23例,发生率为16．67％,其中出现低血压6例,出汗、心悸3例,恶心、呕吐4例,腹部肌肉痉挛性疼痛5例,皮疹3例,恶心、呕吐伴腹部肌肉痉挛2例,伴有药物性静脉炎15例。结论静脉应用硝普钠过程中必须严密观察病情变化,一旦发生不良反应,立即停止静脉滴注并采取积极的对策,避免造成严重后果。     

Adverse reactions to Mycobacterium bovis bacille Calmette-Guérin (BCG) vaccination against tuberculosis in humans, veterinary animals and wildlife species

The Mycobacterium bovis strain, bacille Calmette-Guérin (BCG) is one of the most widely used human vaccines and remains one of the safest vaccines available. It has been used in human populations for over 80 years and 100 million children receive the vaccine annually. It has also been employed extensively for vaccine studies in laboratory animal hosts and is currently being developed for use in a variety of livestock and wild animals. Despite the large number of doses delivered since is first usage in 1921, reports of adverse reactions arising from the use of the BCG vaccine are relatively uncommon and where serious reactions do occur they are often the result of vaccination of immuno-compromised individuals. Factors that may influence the development of adverse reactions to BCG include the potency and dose of the vaccine strain, the route of delivery, the age and immune status of the host, and the skill levels of the operator administering the vaccine. Circumstances affecting the notification of adverse reactions include the lack of clear case definitions of abnormal vaccine reactions, and a scarcity of systematic surveillance and functioning reporting systems. With continued use of the BCG and the development of a new generation of prophylactic and therapeutic vaccines against tuberculosis in different host species, the risk factors associated with adverse reactions may need to be reappraised.     

莫雷西嗪对阵发性心房颤动的疗效评价

目的 评估莫雷西嗪治疗阵发性心房颤动(房颤)患者的有效性和不良反应以及其对房颤负荷的影响.方法 入选阵发性房颤患者212例,给莫雷西嗪单药干预,并随访观察治疗1、6、12个月后房颤的再发情况、负荷量和不良反应.结果 服用莫雷西嗪1、6、12个月房颤再发率仅34％、32％、35％;用药前与用药后1、6、12个月平均心率,最大心率和最小心率均无明显变化,房颤负荷均有明显下降,并未见死亡和恶性室性心律失常.结论 莫雷西嗪可以作为预防、治疗阵发性房颤发作的选择药物之一.     

Complications of therapeutic plasma exchange: experience with 4857 treatments

Plasma exchange (PE) is a technique of extracorporeal blood purification which removes large molecular weight substances from plasma. The Department of Dialysis, Zagreb University Hospital Center's database, which includes data on 509 patients, or 4857 PE treatments, was retrospectively analyzed to test the safety of PE. A total of 231 adverse reactions were recorded (4.75% of treatments). The most common complications were paresthesias (2.7%), hematoma at the puncture site (2.4%), clotting (1.7%), mild to moderate allergic reactions (urticaria; 1.6%) and bleeding (0.06%). True anaphylactoid reactions were recorded in five procedures. The incidence of severe, potentially life-threatening adverse reactions was 0.12%. The prophylactic use of calcium and potassium was responsible for a low incidence of electrolyte disturbances. There was no lethal outcome associated with PE. When carried out by experienced staff, PE is a relatively safe procedure. The use of fresh frozen plasma is associated with a higher rate of adverse reactions.