胺碘酮在老年人慢性心力衰竭合并心律失常中的应用研究

目的探讨胺碘酮治疗老年人慢性心力衰竭合并心律失常的临床效果。方法将2009年3月—2011年4月我院收治的老年人慢性心力衰竭合并心律失常49例,在常规抗心力衰竭治疗基础上,给予胺碘酮治疗。结果治疗后心率、射血分数、QT间期离散度、心律失常均有明显改善,差异有统计学意义(P<0.05)。治疗前后对比差异有统计学意义(P<0.05)。结论胺碘酮治疗老年人慢性心力衰竭合并心律失常的临床效果好,不良反应小,值得临床推广。     

步长稳心颗粒治疗老年人慢性心力衰竭合并心律失常的疗效观察

目的 观察步长稳心颗粒对老年人慢性心力衰竭合并心律失常的治疗效果.方法 将慢性心力衰竭合并心律失常的老年患者共68例随机分成两组,对照组给予常规抗心衰药物+胺碘酮治疗,治疗组在常规抗心衰药物、胺碘酮基础上加用步长稳心颗粒治疗,观察4周,比较治疗前后患者的临床症状、实验室检查、静息心电图及动态心电图的变化.结果 治疗4周后,治疗组总有效率97.1％,对照组总有效率82.7％,两组总有效率差异有统计学意义(x2=9.322,P＜0.05).结论 稳心颗粒对于老年人慢性心力衰竭合并心律失常患者能够发挥良好作用,安全可靠.     

口服胺碘酮治疗慢性心力衰竭合并室性心律失常的临床效果分析

目的探讨口服胺碘酮治疗慢性心力衰竭合并室性心律失常临床效果。方法选择我院2009年8月至2011年8月慢性心力衰竭合并室性心律失常患者84例,随机分为观察组和对照组。对照组采用常规治疗,观察组同时给予胺碘酮口服。结果观察组总有效率显著高于对照组,差异有统计学意义(P<0.05);观察组病死率和再次入院率显著低于对照组,差异有统计学意义(P<0.05)。结论口服胺碘酮治疗能够显著改善慢性心力衰竭合并室性心律失常临床症状,降低患者病死率,提高临床治疗效果,疗效显著。     

胺碘酮联合红花治疗慢性心力衰竭合并室性心律失常的疗效观察

目的 探讨胺碘酮联合红花治疗慢性心力衰竭合并室性心律失常的临床疗效及安全性.方法 将入组的60例患者随机分为观察组和对照组各30例,均给予常规治疗,观察组加用胺碘酮及红花,对照组加用酒石酸美托洛尔和红花,比较二者临床疗效.结果 对照组患者总有效率为60.00％,明显低于观察组的90.00％,差异有统计学意义(P＜0.05).两组患者均未发现严重药物不良反应.结论 胺碘酮联合红花治疗慢性心力衰竭合并室性心律失常能有效降低心室率、临床疗效显著、安全性高,值得临床推广应用.     

美托洛尔与胺碘酮治疗慢性心力衰竭并心房颤动26例分析

目的 观察美托洛尔联合胺碘酮治疗慢性充血性心力衰竭并心房颤动的治疗效果.方法 选择慢性心力衰竭伴心房颤动的患者52例,随机分为两组,每组26例.两组均予以原发病相应的对症治疗及抗心衰常规治疗,对照组加用胺碘酮治疗,观察组加用胺碘酮与美托洛尔治疗.观察并比较两组疗效、治疗前后HR、左心室射血分数(LVEF)、校正后QT间期(QTc)和药物不良反应.结果 两组疗效比较,差异有统计学意义(P＜0.05).HR、LVEF和QTc变化,两组差异有统计学意义(P＜0.05).两组均未出现严重不良反应.结论 美托洛尔联合胺碘酮治疗慢性心力衰竭并心房颤动效果好,使用安全、耐受性好、不良反应少.     

稳心颗粒与胺碘酮配合治疗冠心病合并心律失常的临床观察

目的 稳心颗粒与胺碘酮治疗冠心病合并心律失常的临床疗效对比观察.方法 将80例冠心病合并心律失常患者随机分为两组,治疗组(40例)口服稳心颗粒及胺碘酮片,对照组(40例)口服胺碘酮片,疗程均为4周.结果 总有效率治疗组为95%,对照组为87.5%,两组比较差异无统计学意义(P＞0.05),胺碘酮片用量治疗组比对照组减少1/2,两组比较差异有统计学意义(P＜0.05).结论 稳心颗粒对治疗冠心病心律失常疗效确切,安全,并可减少胺碘酮的用量.     

胺碘酮治疗充血性心力衰竭合并室性心律失常疗效观察

目的 对胺碘酮治疗充血性心力衰竭并室性心律失常的安全性及疗效进行探讨.方法 随机将160例符合条件的充血性心力衰竭并室性心律失常患者分为对照组及治疗组,在常规治疗的基础上加胺碘酮治疗于治疗组,给予常规抗心力衰竭加倍他乐克治疗于对照组,对比分析两组患者在抗室性心律失常、左室射血分数、心脏性猝死、心力衰竭再住院率、药物不良反应等方面的情况.结果 治疗组心功能改善和抗心律失常疗效优于对照组,再入院率和病死率低于对照组,差异有统计学意义(P＜0.05),两组的不良反应差异无统计学意义(P＞0.05).结论 胺碘酮治疗充血性心力衰竭合并室性心律失常安全、有效,不良反应轻.     

胺碘酮联合稳心颗粒治疗心力衰竭合并心律失常的临床效果观察

目的：探讨胺碘酮联合稳心颗粒治疗心力衰竭合并心律失常的临床效果。方法选取本院2012年1月～2014年1月收治的心66例力衰竭合并心律失常患者作为研究对象,随机分为结合组和对照组,对照组给予胺碘酮治疗,结合组在对照组的基础上给予稳心颗粒治疗,比较两组的效果。结果结合组的总有效率显著高于对照组（P＜0.05）,且治疗后的心率明显低于对照组（P＜0.05）,QT间期和左室射血分数显著高于对照组（P＜0.05）,不良反应发生率显著低于对照组,差异有统计学意义（P＜0.05）。结论胺碘酮联合稳心颗粒治疗心力衰竭合并心律失常可明显提高疗效,改善心功能,降低不良反应,应用效果显著。     

美托洛尔、胺碘酮与门冬氨酸钾镁治疗50例心肌梗死合并心律失常观察

目的:探讨美托洛尔、胺碘酮与门冬氨酸钾镁对心肌梗死合并心律失常的患者心功能影响.方法:选取心肌梗死合并心律失常患者98例随机分为观察组(n=50,采用美托洛尔、胺碘酮与门冬氨酸钾镁治疗)和对照组(n=48,采用美托洛尔治疗),比较两组临床疗效的差异.结果:观察组治疗总有效率明显高于对照组(P＜0.05).观察组患者心力衰竭、心源性休克发生率低于对照组,但两者比较差异无统计学意义.观察组存活率明显高于对照组.治疗前,两组LVEF、SV、LVESV与LVEDV比较差异无统计学意义,治疗后,全部患者LVEF与SV明显高于治疗前,LVESV与LVEDV明显低于治疗前(P＜0.05),观察组LVEF与SV明显高于对照组,LVESV与LVEDV明显低于对照组(P＜0.05).结论:美托洛尔、胺碘酮与门冬氨酸钾镁治疗心肌梗死合并心律失常患者的临床疗效显著,有助于降低临床不良事件,并改善心功能指标.     

胺碘酮治疗心力衰竭合并快速型心律失常患者的临床观察

目的 探讨胺碘酮治疗心力衰竭合并快速型心律失常患者的效果.方法 选择本院心力衰竭合并快速型心律失常患者32例,均采用胺碘酮进行治疗,治疗前后分别统计患者的血压情况和副反应情况.结果 治疗后患者平均心率为（75.3±7.4）/min,平均收缩压为（123.8±10.1）mm Hg,平均舒张压为（79.3±9.8）mm Hg,与治疗前相比,差异有统计学意义（P＜0.05）;治疗后有2例患者出现轻度静脉炎现象.结论 胺碘酮治疗心力衰竭合并快速型心律失常临床疗效满意.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.     

Trichinellosis in immigrants in Switzerland

We describe a case of trichinellosis diagnosed at the Division of Infectious Diseases, Hospital of Lugano, in January 2009. This case was associated with a cluster of cases and was traced to the consumption of contaminated meat after a wild boar hunt in Bosnia.