慢性肺源性心脏病患者动脉血PaCO2与血清胃泌素水平及幽门螺杆菌的关系

目的了解慢性肺源性心脏病(简称肺心病)患者 PaCO2与血清胃泌素水平及幽门螺杆菌的关系,探讨肺心病合并上消化道出血的原因.方法观察组肺心病患者 44例均符合 1977年全国肺心病会议制定的诊断标准.对照组 42例为随机选取的健康成人,两组性别、年龄无差异. PaCO2由本院血气分析室用 nova- 3型仪器测定,同时测定患者血清胃泌素,由首都医科大学临床检测中心运用放射免疫方法专人测定,用 C13呼气实验 (C- UBT)检测幽门螺杆菌的感染情况.全部数据以均值±标准差表示 (x± s),均数差别显著性以 t检验及逐步回归测算确定 PaCO2与血清胃泌素及幽门螺杆菌的关系.结果肺心病组与对照组 PaCO2、血清胃泌素及幽门螺杆菌两组对照有极显著性差异( P<0.001).结论肺心病患者血清胃泌素水平较正常人明显升高,且幽门螺杆菌的感染率明显升高,与 PaCO2呈正相关,易于并发上消化道出血.     

肝硬化患者血清胃泌素的变化及其与幽门螺杆菌感染的关系

为了探讨肝硬化患者血清胃泌素变化的意义及其与幽门螺杆菌感染的关系。检测４６例乙肝后肝硬化患者血清胃泌素及ＨＰ感染的变化，并检测２０例门诊健康体检患者胃泌素的变化为对照，结果显示：肝硬化患者空腹血清胃泌素浓度为１５９．３±４２．１ｎ／Ｌ，对照组为９６．８±３２．４ｎｇ／Ｌ，两者差异有显著性。Ｃｈｉｌｄ－Ｐｕｇｈ分级Ａ、Ｂ、Ｃ级空腹血清胃泌素浓度分别为１２１．４±４３．６ｎｇ／Ｌ、１６６．３±５１．５     

小儿幽门螺杆菌感染胃动素胃泌素水平及临床意义

目的 :探讨小儿幽门螺杆菌 (Hp)相关性胃炎的胃动素胃泌素水平及临床意义。方法 :采用放射免疫分析对4 9例 Hp阳性和 36例阴性胃炎患儿的血浆胃动素和血清胃泌素进行对比分析。结果 :Hp阳性组血浆胃动素水平低于 Hp阴性组和正常对照组 (t值分别为 2 .6 0 4、4 .4 30 ,P<0 .0 5 ,P<0 .0 1) ,Hp阳性组血清胃泌素水平高于 Hp阴性组和正常对照组 (t值分别为 3.335、3.82 1、P值均 <0 .0 1)。结论 :Hp感染可导致胃炎患儿血中胃动素水平降低和胃泌素水平升高 ,早期干预有重要临床意义     

十二指肠球部溃疡治疗前后血清胃泌素的变化

对５１例幽门螺杆菌阳性及１８例Ｈｐ阴性的十二指肠球部溃疡患者血清胃泌素进行测定，并观察Ｈｐ阳性ＤＵ患者经雷尼替丁加抗Ｈｐ治疗及单用雷尼替丁治疗前后血清轩泌素变化。     

严重烧伤患者血清胃泌素水平与应激性溃疡的关系

目的探讨严重烧伤患者血清胃泌素水平与应激性溃疡的关系。方法30例严重烧伤患者根据是否并发应激性溃疡出血而分为出血组与非出血组,分时段采血,采用ELASA法测定血清胃泌素水平并与正常健康人进行对照。结果严重烧伤患者早期胃泌素水平明显降低,伤后5～12小时处于最低水平,在12～24小时出现升高,然后在烧伤1周后保持至一个相对稳定的水平。出血组与非出血组胃泌素水平比较差异有显著性（P〈0.01）。结论血清胃泌素水平与烧伤患者应激性溃疡出血密切相关。     

非静脉曲张性急性上消化道出血血清胃泌素检测的意义

<正>急性上消化道出血为临床常见病,多与胃酸分泌异常有关。但检测血清胃泌素水平能否预测上消化道出血及其危险性的报道较少。为此,本文探讨了血清胃泌素水平变化与非静脉曲张性急性上消化道出血之间关系。     

幽门螺杆菌感染根除疗法与血糖水平对2型糖尿病患者胃轻瘫的影响

目的探讨幽门螺杆菌(Hp)感染根除疗法与血糖水平对2型糖尿病患者胃轻瘫的影响。方法选取我院于2017年8月～2018年7月收治的100例Hp感染2型糖尿病胃轻瘫患者按照随机数字表法分为两组,对照组50例予以常规降糖及莫沙必利治疗,研究组50例在对照组基础上加以抗Hp感染治疗。比较两组患者临床疗效、Hp根除情况、空腹血糖、餐后2h血糖、血浆胃动素、血清胃泌素、生长抑素水平以及不良反应发生情况。结果研究组临床有效率(96.00%)显著高于对照组(72.00%)(P 0.05),研究组Hp根除率(96.00%)显著高于对照组(14.00%)。两组患者干预前空腹血糖、餐后2h血糖、血浆胃动素、血清胃泌素及生长抑素水平比较差异无统计学意义(P 0.05),干预后两组空腹血糖、餐后2h血糖、血浆胃动素、血清胃泌素及生长抑素水平均较干预前显著降低,且研究组低于对照组(P 0.05)。研究组不良反应发生率(2.00%)与对照组(4.00%)比较差异无统计学意义(P 0.05)。结论血糖水平在2型糖尿病胃轻瘫的发病过程中发挥重要的作用,Hp感染根除疗法可有效缓解Hp感染2型糖尿病胃轻瘫患者临床症状。     

自身免疫性胃炎根除幽门螺杆菌后的相关研究

目的探讨自身免疫性胃炎根除幽门螺杆菌(Hp)后对血清壁细胞抗体(PCA)、血清胃泌素、血清维生素B12、胃内pH值的影响。方法 104例患者均经胃镜及血清壁细胞抗体(PCA)诊断为自身免疫性胃炎(AIG),Hp感染由13C尿素呼气试验或快速尿素酶试验检查证实。患者随机分为两组:治疗组54例,对照组50例。治疗组采用经典根除幽门螺杆菌方案,共服药10d。治疗结束后4～8周,检测Hp根除情况。对照组不用任何对Hp有影响的药物,且与治疗组在同一时间作Hp检测、胃镜及PCA、血清胃泌素、血清维生素B12等检查。结果治疗组Hp根除率为83.8%,对照组根除率为0%(χ2=76.2,P<0.01),在患者根除Hp后PCA阳性率下降,转阴率为72.2%,对照组PCA转阴率为0%(χ2=57.3,P<0.01),具有统计学意义。治疗组治疗与对照组比较自身免疫性胃炎根除Hp后,PCA阳性率明显下降,血清胃泌素降低,胃内pH值及血清维生素B12升高(P<0.01),均具有统计学意义。治疗组上腹部胀痛症状改善明显,对照组中原有上腹部胀痛症状无改善,治疗组贫血明显改善,对照组贫血改善不明显。结论自身免疫性胃炎根除Hp后,PCA阳性率下降,血清胃泌素降低,胃内pH值及血清维生素B12升高。对于Hp感染的自身免疫性胃炎建议根除Hp。     

大肠癌血清胃泌素水平及影响因素的观测

观测３２例大肠癌空腹血清胃泌素水平,并与对照组（３７例）作比较。结果大肠癌组空腹血清胃泌素水平（１６４．２３ｎｇ±３９．４８ｎｇ／Ｌ）显著高于对照组（７３．０３ｎｇ±８．６０ｎｇ／Ｌ）。大肠癌血清胃泌素水平与性别、Ｄｕｋｅｓ分期及组织学类型无明显相关。     

68例肺心病呼吸衰竭死亡患者的血气分析

目的:通过对肺心病呼吸衰竭患者治愈组及死亡组血气的分析,探讨pH、PaCO2、PaO2三项指标对其预后的影响。方法:死亡组68例与同期治愈组60例作为对照,分析两组pH值、PaCO2、PaO2值。结果:死亡组三项指标分别为:pH值7.178±0.12,PaCO2(130±50)mm Hg(1 mm Hg=0.133 kPa),PaO2(60±25)mm Hg,对照组三项指标分别为:pH值7.284±0.74、PaCO2(100±25)mm Hg,PaO2(65±20)mm Hg,经过统计学处理,两组pH、PaCO2差异有显著性(P<0.01),PaO2差异无显著性(P>0.05)。结论:pH、PaCO2是影响肺心病呼吸衰竭患者预后的主要因素,PaCO2并非是影响预后的主要因素。     

丙种球蛋白联合五水头孢唑林钠治疗先天性心脏病患儿术后肺部感染的临床研究

目的 对先天性心脏病患儿术后肺部感染使用丙种球蛋白联合五水头孢唑林钠治疗的疗效进行分析探讨.方法 先天性心脏病行手术治疗的患儿67例按照随机分配的原则分为对照组(n=34)和观察组(n=33).2组患儿均行常规治疗,在此基础上,对照组患儿采用丙种球蛋白进行治疗,观察组患儿采用丙种球蛋白联合五水头孢唑林钠进行治疗,对2组患儿的血气指标[动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)]、炎症指标[白细胞(WBC)计数、血清降钙素原(PCT)、血清C-反应蛋白(CRP)]、恢复时间进行对比分析.结果 观察组和对照组治疗后,PaO2水平明显升高,PaCO2、WBC、PCT、CRP水平明显降低(P<0.05);观察组治疗后PaO2水平高于对照组,而PaCO2、WBC、PCT、CRP水平明显低于对照组(P<0.05);观察组非肺动脉高压患儿和肺动脉高压患儿呼吸困难消失时间,肺部啰音消失时间,X线胸片异常消失时间和平均住院时间均明显优于对照组(P<0.05).结论 对先天性心脏病患儿术后肺部感染使用丙种球蛋白联合五水头孢唑林钠治疗的疗效显著,起效快,值得在临床上进一步推广使用.     

Effects of indomethacin on intragastric pH and meal-stimulated serum gastrin secretion in rheumatoid arthritis patients

The effects of oral indomethacin on intragastric pH and serum gastrin were investigated in rheumatoid arthritis patients. Nine patients (1 male, 8 female) without a history of peptic ulcer disease and 6 patients with a history of peptic ulcer disease (5 male, 1 female) were studied. To obviate Helicobacter pylori infection as a confounding factor, only patients with positive H. pylori serology were included. After a 5-day period of placebo treatment and after a 5-day period of indomethacin (50 mg t.d.s.; total dose 750 mg), 24-h intragastric pH and basal and meal-stimulated serum gastrin levels were measured in a double-blind placebo controlled cross-over study. There were no differences in the median 24-h pH values between placebo and indomethacin irrespective of peptic ulcer disease history. Indomethacin resulted in a higher basal and stimulated gastrin response than placebo in patients with a history of peptic ulcer disease. The basal and incremental responses were lower in patients with a history of peptic ulcer disease than in patients without a history of peptic ulcer disease, both during indomethacin and placebo. The same basal and stimulated incremental serum gastrin responses were found during placebo and indomethacin treatment in patients without a history of peptic ulcer disease. No correlation was established between median 2-h post-prandial intragastric pH and post-prandial incremental serum gastrin concentration. We conclude that indomethacin does not influence the intragastric pH of rheumatoid arthritis patients irrespective of history of peptic ulcer disease.     

慢性肺心病患者D-二聚体水平及其与血气分析的相关性研究

目的研究慢性肺源性心脏病患者血液D-二聚体（D-dimer）的水平及其与二氧化碳分压（PaCO2）、氧分压（PaO2）的相关性。方法选择慢性肺心病患者50例,测定血浆中D-dimer的含量及血气分析中PaCO2、PaO2,同时对D-dimer水平与PaCO2、PaO2进行相关性分析;并与健康组作对照。结果患者组血浆D-dimer的含量显著高于正常对照组（P〈0.05）,且患者组D-dimer与PaCO2呈显著正相关,与PaO2呈显著负相关。结论肺心病患者存在血液凝血状态异常,高碳酸血症与缺氧是参与血液凝血状态异常的因素。对慢性肺心病患者进行监测D-dimer水平,有助于采取有效的防治措施,可控制病情的发展,改善疾病的预后。     

Involvement of the corporal mucosa and related changes in gastric acid secretion characterize patients with iron deficiency anaemia associated with Helicobacter pylori infection

BACKGROUND: Recent studies have reported an association between iron deficiency anaemia and Helicobacter pylori. Helicobacter pylori could cause iron deficiency anaemia by altering iron absorption. We observed that most patients with Helicobacter pylori infection and iron deficiency anaemia present a chronic superficial pangastritis. AIM: To investigate whether Helicobacter pylori-positive patients with iron deficiency anaemia have peculiar histological and functional features when compared with non-anaemic Helicobacter pylori-positive subjects. PATIENTS: Fifty-one patients with iron deficiency anaemia, in whom chronic superficial Helicobacter pylori gastritis was the only gastrointestinal finding, and 103 non-anaemic Helicobacter pylori-positive controls were included in the study. Thirty-seven patients were randomly matched with 37 controls of the same sex and age. METHODS: Gastroscopy, with antral (n=3) and body (n=3) biopsies, was performed. Gastrin and pepsinogen I levels and antiparietal cell antibodies were evaluated. Intragastric pH was also measured. RESULTS: Gastritis involved the corporal mucosa in 90% of patients compared to 42.7% of controls (P < 0.0001). The mean inflammatory score in the gastric body was significantly higher among patients than in controls (2.2 vs. 0.6; P=0.012). Gastrin was significantly higher in patients than in controls (mean 60.2 vs. 29 pg/mL; P=0.0069). Intragastric pH was higher in patients than in controls (median 5.7 vs. 2; P=0.0026). CONCLUSIONS: These data suggest that patients with iron deficiency anaemia and Helicobacter pylori infection have a peculiar pattern of gastritis with corporal involvement and related changes in intragastric pH.     

不同菌型幽门螺杆菌感染消化性溃疡患者IL-10、TNF-α的表达情况观察

目的：观察不同菌型幽门螺杆菌（H．pylori）感染消化性溃疡患者白介素-10（IL-10）、肿瘤坏死因子-α（ TNF-α）的表达情况。方法选择2012年3月至2014年11月接受治疗的100例H．pylori感染消化性溃疡患者作为研究病例,分别测定患者血清中IL-10、TNF-α水平。记录患者血清中IL-10、TNF-α水平含量,并比较H．pylori感染十二指肠球部溃疡与胃溃疡血清中IL-10、TNF-α水平含量。结果 IL-10的表达水平Ⅰ型H．pylori感染检测值显著高于H．pylori阴性组,差异有统计学意义（ P ＜0?．05）;Ⅰ型H．pylori感染组检测值仅稍高于Ⅱ型H．pylori感染组,差异无统计学意义（P＞0．05）。 TNF-α的表达水平Ⅰ型H．pylori感染检测值均显著高于H．pylori阴性组及Ⅱ型H．pylori感染组,差异均有统计学意义（ P ＜0．05）。 IL-10的表达水平在Ⅰ型H．pylori感染及Ⅱ型H．pylori感染十二指肠球部溃疡均与胃溃疡基本相符,差异均无统计学意义（ P ＞0．05）;TNF-α的表达水平在Ⅰ型H．pylori感染十二指肠球部溃疡显著高于胃溃疡,差异有统计学意义（ P ＜0．05）;TNF-α的表达水平在Ⅱ型H．pylori感染十二指肠球部溃疡仅稍高于胃溃疡,差异无统计学意义（ P ＞0．05）。结论不同菌型H．pylori感染消化性溃疡患者血清中的IL-10、TNF-α水平差异较大,可以为临床上消化性溃疡的诊断提供有利价值。     

非甾体类抗炎药相关性上消化道出血的临床特点

目的探讨非甾体类抗炎药相关性上消化道出血的临床特点。方法选择因呕血或黑便就诊并行胃镜检查确诊的216例患者,分为NSAIDs组和非NSAIDs组,比较两组患者临床特点、内镜特点及幽门螺杆菌（HP）感染情况。结果结果显示两组患者的性别、出血方式比较差异无显著性（P〉0．05）;而年龄、出血前消化道症状、心血管病史、HP感染及内镜特点两组比较差异有显著性（P〈0．05）。结论非甾体类抗炎药相关性上消化道出血多见于老年人,有心血管病史,以粘膜糜烂及胃溃疡居多,HP感染增加了NSAIDs相关性胃黏膜损害。     

Recurrence of peptic ulcer in uraemic and non-uraemic patients after Helicobacter pylori eradication: a 2-year study

BACKGROUND: The role of Helicobacter pylori in the pathogenesis of peptic ulcer disease in patients with uraemia remains unclear. AIM: To evaluate the long-term effect of H. pylori eradication in these patients. METHODS: Uraemic and non-uraemic patients with peptic ulcer were enrolled in this study. Patients having history of non-steroidal anti-inflammatory drugs use or cardiovascular disease that need aspirin use were excluded. After confirmation of H. pylori infection, they received a triple therapy and were followed up for 2 years. RESULTS: Between September 1999 and December 2005, 34 patients (41%) of the end-stage renal disease [H. pylori (+) group] and 67 (84%) of the non-uraemic patients with peptic ulcer disease (PU group) received anti-H. pylori therapy. After triple therapy, 32 (94%) from the end-stage renal disease group and 64 (96%) from the peptic ulcer group obtained successful eradication. During the 2-year follow-up, three patients in the end-stage renal disease group were excluded because of the presence of cardiovascular disease and aspirin use in two cases and died of heart failure in one case; two patients in peptic ulcer group refused follow-up. Finally, 29 uraemic and 62 non-uraemic patients had achieved the follow-up. Recurrence of peptic ulcer was more in the end-stage renal disease group than in the peptic ulcer group with intention-to-treat analysis (eight of 32, 25% vs. two of 64, 3%, P = 0.001, OR: 10.0, 95% CI: 1.979-50.540) or per-protocol analysis (eight of 29, 28% vs. two of 62, 3%, P < 0.001, OR: 11.4, 95% CI: 2.245-58.168). CONCLUSIONS: Peptic ulcer recurrence after H. pylori eradication is higher in end-stage renal disease patients with peptic ulcer than in peptic ulcer patients without renal disease. Factors aside from H. pylori play an important role in peptic ulcer recurrence in end-stage renal disease patients.     

慢性阻塞性肺疾病患者甲状腺激素水平变化的临床分析

目的观察慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)患者急性加重期和缓解期的血清甲状腺激素变化及其与血PaO2、PaCO2的相关性。方法选择115例COPD急性加重期患者,入院时在未吸氧状态下检测动脉血气分析,于入院时和治疗1周后缓解时分别检测血清甲状腺素(T4)、游离T4(FT4)、三碘甲状腺原氨酸(T3)、游离T3(FT3)及促甲状腺激素(TSH)含量,并与33例正常健康人比较。结果 COPD急性加重期患者血清中T3、FT3、T4、FT4均较对照组显著下降(P0.01),治疗1周后,33例病情缓解者上述指标均明显改善(P0.01),但仍低于正常对照组(P0.01)。血清T3、T4与PaO2呈正相关,血清T3与PaCO2呈负相关,TSH在各组中变化无统计学意义。结论 COPD患者甲状腺激素水平有明显变化,与PaO2、PaCO2变化有一定相关性,动态观察血清甲状腺素的变化,对COPD急性加重期患者的病情轻重判断具有一定的临床参考价值。     

肺心病肺性脑病患者血清烯醇化酶与红细胞内Na+K+-ATP的变化

目的探讨血清烯醇化酶(NSE)及红细胞内Na+K+-ATP酶对肺心病肺性脑病的影响.方法选取36名肺心病肺性脑病患者(A组)抽取6ml静脉血检测NSE及Na+K+-ATP酶的活性与34例无肺性脑病患者(B组)及29例正常老年人比较(C组).结果发现A组的NSE活性较B组患者及C组增加(P＜0.05,且其活性与动脉血氧分压呈负相关(r=-0.514,P=0.018),与二氧化碳分压呈正相关(r=0.482,P=0.035),而红细胞内Na+K+-ATP酶较B组患者及C组下降(P＜0.05),且其活性与动脉血氧分压呈正相关(r=0.431,P=0.014),与二氧化碳分压呈负相关(r=-0.6344,P=0.0041).结论血清NSE活性与红细胞内Na+K+-ATP活性可以反映肺性脑病患者缺氧、CO2潴留引起的脑损害程度.     

Helicobacter pylori infection in patients with upper gastrointestinal symptoms in Arba Minch Hospital: southwestern Ethiopia.

A prospective study was conducted to determine the frequency of occurrence of Helicobacter pylori infection in outpatients presenting with upper gastro intestinal symptoms to Arba Minch Hospital over a one year period. Four hundred and forty four patient, 309 males and 135 females, underwent upper gastro intestinal fiberoptic endoscopy between March 1989 and April 1990. The age range was 14 to 75 years (mean = 35). All 444 patients were examined and tested for infection. Sixty per cent had abnormal endoscopy results. The major endoscopic findings were gastritis in 23% and peptic ulcer disease in 20% of the patients. To identify H. pylori infection, 2 biopsy specimens were taken from the greater curve of the gastric antral mucosa of all patients. The specimens were examined using the urease diagnostic test and Loeffler Methylene Blue stain. Infection was considered present when either of the tests were positive. Infection by H. pylori was found in 324 patients (73%). Among the 173 patients without endoscopic findings, 63% had infection. Of 271 patients with abnormal endoscopic findings, 79% were infected. The results of this study show that H. pylori infection is a common finding in patients with upper gastrointestinal symptoms in Ethiopia. There is a higher prevalence of infection among patients with endoscopic findings. Thus the management of patients with upper gastro-intestinal symptoms in Ethiopia should take H. pylori infection into consideration.