氨溴特罗口服液佐治毛细支气管炎的临床体会

目的评价氨溴特罗口服液治疗毛细支气管炎的疗效。方法106例1个月～2岁毛细支气管炎患儿随机分为2组治疗组56例,对照组50例观察治疗前后临床症状体征的变化。结果氨溴特罗口服液治疗7d后在缓解气促、咳痰、咳嗽持续时间、口罗音消失,缩短住院天数明显优于对照组。总有效率高于对照组(P<0.01)。结论氨溴特罗口服液改善毛细支气管炎的症状体征、总有效率优于对照组。且具有口感好,不良反应轻等特点。     

中西医结合治疗婴幼儿毛细支气管炎63例疗效观察

目的观察中西医结合治疗小儿毛细支气管炎的临床疗效。方法将126例毛细支气管炎患儿随机分为对照组和观察组各63例,两组患儿均采用利巴韦林及普米克、可必特压缩吸入,对照组加氨溴特罗口服溶液口服,观察组加清金化痰汤口服,疗程均为7 d。观察两组患儿咳嗽、喘憋缓解时间,肺部啰音消失时间,治愈率及总有效率,出现呼吸衰竭或(和)心力衰竭并发症情况。结果观察组在喘憋、咳嗽明显减轻时间和肺部啰音消失时间明显优于对照组,差异有统计学意义(P<0.01);观察组治愈率及总有效率均优于对照组,差异有统计学意义(P<0.05);观察组出现呼吸衰竭或(和)心力衰竭并发症概率低于对照组,差异有统计学意义(P<0.01)。结论中西医结合治疗小儿毛细支气管炎可缩短疗程,提高疗效,明显减少呼吸衰竭和心力衰竭等并发症。     

异丙托溴铵、沙丁胺醇雾化吸入治疗毛细支气管炎疗效观察

目的探讨异丙托溴铵、沙丁胺醇雾化吸入治疗毛细支气管炎患儿的疗效。方法将符合诊断标准毛细支气管炎54例患儿随机分为治疗组28例、对照组26例。两组均予抗病毒、抗感染、糖皮质激素及止咳化痰等治疗,治疗组加用0.025%异丙托溴铵0.5mL、0.5%沙丁胺醇0.25mL雾化吸入。结果治疗组喘憋、哮鸣音、咳嗽消失及住院天数均短于对照组(P均<0.05),有显著差异。结论异丙托溴铵、沙丁胺醇雾化吸入治疗毛细支气管炎可缩短喘憋、咳嗽及住院时间。     

氨溴特罗口服液改善支气管炎患儿呼吸道症状临床疗效观察

目的评估氨溴特罗口服液在临床上用于治疗支气管炎患儿的咳嗽、痰液黏稠、排痰困难、哮鸣音等临床表现的疗效及安全性。方法117例8个月至10.5岁患急性支气管炎、支气管炎伴喘息儿童,随机分为治疗组(氨溴特罗口服液)和对照组(盐酸氨溴索糖浆)。观察两组治疗前、治疗后1、3、5d咳嗽、痰液黏稠、排痰困难、哮鸣音评分及综合评分变化。结果治疗组、对照组治疗后咳嗽、痰液黏稠、排痰困难、哮鸣音均较治疗前明显减轻(P<0.05);治疗组治疗1、3、5d后缓解咳嗽症状、排痰困难症状、哮鸣音的有效率及缩短上述表现持续时间均优于对照组(P<0.05);在减少痰量与痰液黏稠持续时间上的疗效两组无显著性差异(P>0.05);治疗组治疗5d后呼吸道症状改善的总有效率高于对照组。结论氨溴特罗口服液对于改善支气管炎患儿的咳嗽、痰液黏稠、排痰困难、喘息等临床症状疗效显著。     

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目的评估氨溴特罗口服液在临床上用于治疗支气管炎患儿的咳嗽、痰液黏稠、排痰困难、哮鸣音等临床表现的疗效及安全性。方法117例8个月至10.5岁患急性支气管炎、支气管炎伴喘息儿童,随机分为治疗组(氨溴特罗口服液)和对照组(盐酸氨溴索糖浆)。观察两组治疗前、治疗后1、3、5d咳嗽、痰液黏稠、排痰困难、哮鸣音评分及综合评分变化。结果治疗组、对照组治疗后咳嗽、痰液黏稠、排痰困难、哮鸣音均较治疗前明显减轻(P<0.05);治疗组治疗1、3、5d后缓解咳嗽症状、排痰困难症状、哮鸣音的有效率及缩短上述表现持续时间均优于对照组(P<0.05);在减少痰量与痰液黏稠持续时间上的疗效两组无显著性差异(P>0.05);治疗组治疗5d后呼吸道症状改善的总有效率高于对照组。结论氨溴特罗口服液对于改善支气管炎患儿的咳嗽、痰液黏稠、排痰困难、喘息等临床症状疗效显著。     

雾化吸入糖皮质激素联合特布他林及异丙托溴铵治疗毛细支气管炎的疗效及预后

目的观察糖皮质激素联合异丙托溴铵、特布他林雾化吸入治疗毛细支气管炎的疗效,探讨不同疗程吸入糖皮质激素对毛细支气管炎预后的影响。方法将108例收治住院的毛细支气管炎患儿随机分为3组,均采用综合治疗。治疗1组予布地奈德混悬液联合特布他林、异丙托溴铵三联雾化吸入治疗7d,继续丙酸氟替卡松雾化吸入治疗至12周;治疗2组予布地奈德混悬液联合特布他林溶液二联雾化吸入治疗7d;对照组单用特布他林溶液雾化吸入治疗7d。观察3组患儿临床症状消失时间、住院天数,并进行临床疗效评定及追踪停药1a为喘息性疾病患病人数及患病率。结果治疗1组和治疗2组在咳嗽、喘憋症状缓解、肺部哮鸣音消失时间及缩短住院天数方面均优于对照组(Pa<0.05),治疗1组在临床缓解率方面较治疗2组更具优势(P<0.05)。治疗1组在停药1a喘息性疾病患病率明显降低,与对照组比较差异有统计学意义(P<0.05),治疗2组在停药1a喘息性疾病患病率与对照组比较稍低,但无显著性差异(P>0.05)。结论糖皮质激素联合特布他林二联雾化吸入治疗毛细支气管炎疗效肯定,糖皮质激素联合特布他林、异丙托溴铵三联雾化吸入治疗毛细支气管炎,对急性期症状的缓解优势更为明显,毛细支气管炎患儿吸入性糖皮质激素早期干预治疗至12周,可降低发展为支气管哮喘的几率。     

氨溴特罗口服液对症治疗急性支气管肺炎临床观察

目的观察氨溴特罗口服液对症治疗儿童急性支气管肺炎的临床疗效。方法选择2010年6月至12月在中国医科大学附属盛京医院诊治的符合临床诊断标准的159例急性支气管肺炎患儿,其中肺炎支原体感染组78例、非支原体感染组81例。在给予常规抗感染治疗的基础上,每组又随机分为4组,分别为氨溴特罗口服液组、盐酸丙卡特罗组、氨溴索口服液组及对照组。观察各组入院3d、6d时咳嗽、咳痰改善的评分、肺功能的变化,并比较各组住院治疗时间。结果 (1)肺炎支原体感染组中,入院3d时,氨溴特罗口服液组在咳嗽改善方面与盐酸丙卡特罗组差异无统计学意义,而与氨溴索口服液及对照组相比,差异有统计学意义,其在咳痰、肺功能、住院天数上均有统计学意义(P<0.05)。入院6d时,氨溴特罗口服液组咳嗽、咳痰、肺功能、住院天数方面与其他组比较,差异均有统计学意义(P<0.05)。(2)非肺炎支原体感染组中,入院3d时,氨溴特罗口服液组在咳痰方面与氨溴索口服液组差异无统计学意义,肺功能、住院天数有统计学意义(P<0.05)。入院6d时,氨溴特罗口服液组咳嗽、咳痰、肺功能、住院天数方面与其他组比较,差异均有统计学意义(P<0.05);(3)氨溴特罗口服液组入院...     

甲泼尼龙联合顺尔宁治疗重症毛细支气管炎的临床和诱导痰细胞学研究

目的 研究甲泼尼龙(MP)联合顺尔宁治疗重症毛细支气管炎(毛支)的疗效和治疗前后诱导痰细胞学的变化.方法 将64例重症毛细支气管炎患儿随机分为两组,治疗组32例联用MP和顺尔宁治疗,对照组32例用地塞米松治疗.分别观察两组的喘憋消失时间、肺部体征消失时间和住院天数.同时分析治疗组用MP和顺尔宁联合治疗前后的诱导痰细胞学变化.结果 与对照组相比,治疗组的喘憋消失时间、肺部体征消失时间和住院天数均明显缩短(P均＜0.01).经MP和顺尔宁联合治疗后,治疗组的嗜酸性粒细胞和肥大细胞的比例明显下降(P均＜0.001).结论 MP和顺尔宁联合治疗重症毛支的疗效优于常规治疗方法,同时对其诱导痰细胞学有显著影响.     

氨溴特罗口服液治疗婴幼儿支气管肺炎72例

目的评估氨溴特罗口服液治疗婴幼儿支气管肺炎的疗效。方法收集本院儿科2008年6月-2011年8月收治的婴幼儿支气管肺炎患儿83例。年龄0.5～37.0个月。随机分为治疗组42例和对照组41例。2组均采用综合治疗,治疗组口服氨溴特罗口服液,对照组服用盐酸氨溴索颗粒,观察2组患儿的疗效、肺部啰音改善情况及不良反应发生情况。结果治疗组显效18例(42.8%),有效20例(47.6%),无效4例(9.6%),总有效率为90.4%;对照组显效9例(22.2%),有效20例(50.0%),无效12例(27.8%),总有效率为72.2%。2组总有效率比较差异有统计学意义(P<0.05)。治疗组啰音消失时间为(6.1±2.4)d,对照组啰音消失时间为(8.4±2.7)d,2组比较差异有统计学意义(t=1.94,P<0.05)。对照组2例用药24 h出现皮疹,未处理自行消失;治疗组未发现明显不良反应。结论氨溴特罗口服液对改善婴幼儿支气管肺炎的临床表现较盐酸氨溴索颗粒显著。     

白三烯受体拮抗剂(顺尔宁)治疗小儿毛细支气管炎疗效观察

目的 观察白三烯受体拮抗剂(顺尔宁)对小儿毛细支气管炎的临床疗效.方法 将60例毛细支气管炎患儿随机分为对照组(30例)及顺尔宁治疗组(30例).顺尔宁治疗组患儿除常规治疗外,予以口服顺尔宁,每天4mg,每晚1次,共服28d;对照组除未服顺尔宁外,其余治疗同顺尔宁治疗组.比较两组患儿临床症状的改善情况、治疗有效率以及喘息复发率.结果 顺尔宁与常规治疗有效率分别为96.7%和80.0%,差异有显著性(X2=4.04,P＜0.05).顺尔宁治疗组咳嗽消失、喘憋消失、肺部哮鸣音消失及平均治疗天数明显短于对照组,差异有显著性(P＜0.05).两组复发率差异无显著性(P＞0.05).结论 顺尔宁能明显改善毛细支气管炎患儿的咳喘症状,疗效较好.     

Allergic factors associated with the development of asthma and the influence of cetirizine in a double-blind, randomised, placebo-controlled trial: First results of ETA®

There is a common progression known as the allergic march from atopic dermatitis to allergic asthma. Cetirizine has several antiallergic properties that suggest a potential effect on the development of airway inflammation and asthma in infants with atopic dermatitis. Methods. Over a two year period, 817 infants aged one to two years who suffered from atopic dermatitis and with a history of atopic disease in a parent or sibling were included in the ETAC^® (Early Treatment of the Atopic Child) trial, a multi-country, double-blind, randomised, placebo-controlled trial. The infants were treated for 18 months with either cetirizine (0.25mg/ kg b.i.d.) or placebo. The number of infants who developed asthma was compared between the two groups. Clinical and biological assessments including analysis of total and specific IgE antibodies were performed. Results. In the placebo group, the relative risk (RR) for developing asthma was elevated in patients with a raised level of total IgE (≥ 30 kU/I) or specific IgE (≥ 0.35 kUA/I) for grass pollen, house dust mite or cat dander (RR between 1.4 and 1.7). Compared to placebo, cetirizine significantly reduced the incidence of asthma for patients sensitised to grass pollen (RR = 0.5) or to house dust mite (RR = 0.6). However, in the population that included all infants with normal and elevated total or specific IgE (intention-to-treat - ITT), there was no difference between the numbers of infants developing asthma while receiving cetirizine or placebo. The adverse events profile was similar in the two treatment groups. Discussion. Raised total IgE level and raised specific IgE levels to grass pollen, house dust mite or cat dander were predictive of subsequent asthma. Cetirizine halved the number of patients developing asthma in the subgroups sensitised to grass pollen or house dust mite (i.e. 20% of the study population). In view of the proven safety of the drug, we propose this treatment as a primary pharmacological intervention strategy to prevent the development of asthma in specifically sensitised infants with atopic dermatitis.     

Resurgence of measles in Singapore: profile of hospital cases

OBJECTIVE: To ascertain the profile of cases of measles seen at a general hospital during a recent outbreak that occurred despite a measles vaccination program. METHODOLOGY: A retrospective study from January 1991 to March 1998. All patients with measles (ICD code 055. 9) seen at the emergency unit or as inpatients were included. RESULTS: There were 87 cases identified. The diagnosis was clinical in all and proven serologically in 71%. Eighty-five per cent of the cases occurred between January 1997 and March 1998. There was a bi-modal age distribution with peaks in the very young (相似文献   

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孤独症谱系障碍(autistic-spectrum disorders,ASDs)近年来患病率逐年攀升至1%左右,其症状往往伴随终生,成为严重威胁儿童健康和发展的神经发育性疾患;注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)是儿童期最常见的精神障碍,国内报道患病率为4.13%～5.83%,其症状可延续至青少年期,甚至到成年期[1]。这两类精神障碍在成年期的临床表现、共患病、治疗策略和预后与儿童期有哪些不同呢?本文通过回顾相     

EXCITING NEW TREATMENT APPROACHES FOR PATHYPHYSIOLOGIC MECHANISMS OF SICKLE CELL DISEASE

During the past several decades, our understanding of the complex pathophysiology of vasoocclusion associated with sickle cell disease has improved greatly. Interaction of genes, hemoglobin molecules, red cell membrane and metabolic changes, cell-cell interactions and cell-plasma interactions, red cell adhesion to vascular endothelium, activation of coagulation, and vascular reactivity play a role in vaso occlusion. Penicillin prophylaxis of pneumococcal infections and appropriate use of blood transfusions and other supportive measures improved survival of sickle cell patients. Hydroxyurea made a major impact on sickle cell therapy when it was shown to decrease acute painful episodes, acute chest syndrome, and the need for blood transfusion in adults. Significant experience in the use of hydroxyurea has been accumulated in older children. The benefits and risks of hydroxyurea for younger children and long-term risks in all patients will be evaluated in future investigations. Other promising therapies include butyrate compounds, clotrimazole, magnesium supplementation, poloxamer 188, antiadhesion agents, anticoagulant approaches, and nitric oxide. Hemopoietic transplantation remains the only curative therapy. However, several transgenic mouse models are available for studies of gene therapy or other treatment approaches on biochemical, cellular, and pathologic effects of mutant genes.     

Infiltrations of Epstein-Barr virus-carrying cells in granular lymphocyte-proliferative disorders corresponding to chronic active Epstein-Barr virus infection

A 21-year-old man with granular lymphocyte-proliferative disorders (GLPD) associated with chronic active Epstein-Barr virus (EBV) infection is described. Chromosomal analyses revealed several clonal abnormalities and two of them were mainly repetitious. High copy numbers of monoclonal EBV genome were also detected in the proliferative large granular lymphocytes (LGLs), indicating the monoclonal expansion of EBV-infected LGLs. The patient had an indolent course for several years, and there was no evidence of infiltrations of his bone marrow until the end stage. At autopsy, microscopic studies revealed marked infiltrations of LGL in the liver and spleen, and the infiltrating cells were NK-cell immunophenotype. The infiltrated LGLs showed latency I.     

LUTEINIZING HORMONE RECEPTOR MUTATIONS IN DISORDERS OF SEXUAL DEVELOPMENT AND CANCER

Human male sexual development is regulated by chorionic gonadotropin (CG) and luteinizing hormone (LH). Aberrant sexual development caused by both activating and inactivating mutations of the human luteinizing hormone receptor (LHR) have been described. All known activating mutations of the LHR are missense mutations caused by single base substitution. The most common activating mutation is the replacement of Asp-578 by Gly due to the substitution of A by G at nucleotide position 1733. All activating mutations are present in exon 11 which encodes the transmembrane domain of the receptor. Constitutive activity of the LHR causes LH releasing hormone-independent precocious puberty in boys and the autosomal dominant disorder familial male-limited precocious puberty (FMPP). Both germline and somatic activating mutations of the LHR have been found in patients with testicular tumors. Activating mutations have no effect on females. The molecular genetics of the inactivating mutations of the LHR are more variable and include single base substitution, partial gene deletion, and insertion. These mutations are not localized and are present in both the extracellular and transmembrane domain of the receptor. Inactivation of the LHR gives rise to the autosomal recessive disorder Leydig cell hypoplasia (LCH) and male hypogonadism or male pseudohermaphroditism. Severity of the clinical phenotype in LCH patients correlates with the amount of residual activity of the mutated receptor. Females are less affected by inactivating mutation of the LHR. Symptoms caused by homozygous inactivating mutation of the LHR include polycystic ovaries and primary amenorrhea.     

A profile of respiratory symptoms in urban and rural South Australian school children

This report describes the cross-sectional analyses of data from the first year of a longitudinal study using questionnaire and respiratory function data over a 5 year period from a sample of rural South Australian school children. The cumulative or lifetime prevalences of respiratory symptoms were estimated in 825 rural and 1261 urban school children aged between 5 and 15 years in order to determine if the prevalence rates differed between rural and urban school children. The study found the overall cumulative prevalence of asthma and/or wheezy breathing (AWB) to be 24.1% in the rural school children compared to 27.6% in the urban school children. Most children developed AWB symptoms before the age of 7 years, with 20% reporting moderately severe symptoms and 10% having more than one attack per fortnight. The cumulative prevalence of bronchitis, loose/rattly cough (BLRC) differed significantly between the rural school children (34.1%) and urban school children (47.9%). The BLRC symptoms preceded the development of AWB in many cases. Urban school children also reported a higher prevalence of atopic conditions.     

Personality profiles and heart rate variability (vagal tone) in children with recurrent abdominal pain

The aim of the study was to explore psychological factors and autonomic activity in children with recurrent abdominal pain and to compare them with those in a control group of healthy children. The Personality Inventory for Children was used for assessment of developmental, emotional and psychosocial factors in 25 children with recurrent abdominal pain (age, 7-15 y). Parasympathetic and sympathetic functions in these children and in 23 healthy control subjects (age, 7-13 y) were also investigated, non-invasively using a computerized polygraph. Vagal tone (parasympathetic function) was indexed by calculation of respiratory sinus arrhythmia in beats/min. Skin conductance (sympathetic function) was recorded by the constant current method. On the Personality Inventory for Children, 16 patients had high scores on somatic concern. Several patients had scores in the clinical range for depression, withdrawal and anxiety, but the mean scores for these personality profile scales were well within the normal range of healthy children. Interestingly, there was a spike on the L (Lie)-scale for most of the patients and 15 patients had scores above or close to the clinical cut-off value. As compared with the scores in healthy children, vagal tone and sympathetic tone were normal. Conclusion: Many children with recurrent abdominal pain have scores in the clinical range for depression, withdrawal, anxiety and L-scale indicating coping problems, denial and a trend towards somatic concern that may contribute to the evolution of abdominal pain. Autonomic nerve activity was not disturbed in these children.     

Hauttemperaturen verschiedener Körperoberflächenareale des Rumpfes bei Säuglingen

Summary In two groups of infants (3–53 weeks old) skin temperatures were controlled in different areas of the trunk—i.e.: regions of sternum, lungs, heart, liver, spleen, kidneys—at different room-temperatures (group I: 21–25°C; group II: 29–32°C). Rectal temperatures of some probands in both groups also had been controlled simultaneously. A definite change in the reaction to heat was proofed in different periods of the first year of life. In higher environmental temperatures the skin temperature was almost constant at every controll-point of the skin, even in older infants. In lower environmental temperatures the skin temperatures lowered continuously with age till 7. to 9. moth. From 10. to 12. month the lowering of skin temperature discontinued. The rectal temperatures were relatively constant in all infants. Only in infants from 7. to 12. month, whose skin temperatures were controlled in lower as well as in higher environmental temperatures, a tendency to higher rectal temperatures was proofed in warmer environmental temperatures.The significance of these results is discussed.

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Untersuchungen mit Unterstützung durch die Deutsche Forschungsgemeinschaft.