冠心病与幽门螺杆菌细胞毒素的关系

目的：研究幽门螺杆菌（ＨＰ）感染细胞毒素相关蛋白基因Ａ（ＣａｇＡ）Ⅰ型菌株和Ⅱ型菌株与冠心病（ＣＨＤ）之间的关系。方法：测定５４ 例ＣＨＤ患者与５１ 例非ＣＨＤ的对照组的血清ＨＰ抗体及ＣａｇＡ 抗体阳性率并进行比较。结果：ＣＨＤ组ＨＰ抗体血清学阳性率高于对照组（４８．１５％ ∶４１．１８％ ）,但两组之间无显著性差异（ Ｐ＞ ０．０５）;ＣＨＤ组ＣａｇＡ抗体的血清学阳性率明显高于对照组（３１．４８％ ∶１５．６９％ ）,两组之间有极显著性差异（ Ｐ＜ ０．０１）。结论：ＣＨＤ组ＨＰＣａｇＡ＋ 菌株感染的血清学阳性率明显高于对照组,提示ＨＰＣａｇＡ及其细菌毒素有可能在ＣＨＤ的发病中起一定作用。     

健脾理气冲剂治疗功能性消化不良的疗效观察

功能性消化不良（ＦＤ）是一种非常多见的症侯群,在消化内科疾病中约占２０％～４０％,目前已有胃复安、吗丁啉、西沙必利等促胃动力剂治疗ＦＤ,但有时会产生一定的副作用,且疗效并非十分满意。为了开发中药促动力剂,我们观察了健脾理气冲剂治疗ＦＤ的临床疗效,现将结果报告如下。１　对象与方法１．１　研究对象：所选病例均为本院门诊患者,男３４例,女５２例;年龄２０～７５岁,平均（５２±１１．４９）岁,符合《现代胃肠病学》有关运动障碍样型ＦＤ诊断标准及中医脾虚气滞证诊断标准。试验前４周经胃镜检查除外胃肠肿瘤、Ａ型…     

血清抗脂阿拉伯甘露聚糖及38kDa抗体的检测对涂阴肺结核及肺外结核诊断价

目的 评估血清抗脂阿拉伯甘露聚糖３８ｋＤａ抗体（ＬＡＭ－３８ｋＤａ－ＩｇＧ）检测对涂阴肺结核和肺外结核的诊断价值。方法 采用斑点免疫金渗滤法检测５７例涂阴肺结核，５２例肺外结核，３２例涂阳肺结核，２９例肺癌患者及３３例正常人血清中的ＬＡＭ－３８ｋＤａ－ＩｇＧ。结果 涂阴肺结核组ＬＡＭ－３８ｋＤａ－ＩｇＧ阳性率为７３．７％，其中痰结核杆菌涂（－）培（＋）组为８４．６％，涂（－）培（－）组为７０．５％；肺外结核组阳性率为７１．２％；涂（＋）肺结核组阳性率９３．８％；肺癌组假阳性率３１％；健康组假阳性率９．１％。结论 提示血清ＬＡＭ－３８ｋＤａ－ＩｇＧ测定对涂阴肺结核和肺外结核有一定的辅助诊断价值。     

高通量透析的临床研究

目的：观察高通透性聚砜膜Ｆ６０滤过器进行血液透析对尿毒症血透患者小分子溶质和β２微球蛋白（β２Ｍ）的清除作用及对血浆蛋白、血脂的影响，并与常规血液透析（ＣＨＤ）进行对比。方法：将规律透析患者分为两组，实验组（ＨＰＤ组）采用Ｆ６０滤过器，每周透析３×４ｈ，ＣＨＤ组每周透析３×５ｈ，对两组患者进行临床观察。结果：两组患者ＫＴ／Ｖ、ＴＡＣ及透析前、后血ＢＵＮ、Ｃｒ的下降率差异不显著；ＨＰＤ、ＣＨＤ两组血磷下降率分别为５５．３３０±１４．０８０％、４２．５２５±１７．８９７％，Ｐ＜０．０５；ＣＨＤ组透析后血β２Ｍ较透析前增高２５．４０８±１４．３５４％，而ＨＰＤ组透析后血β２Ｍ较透析前下降４４．５７０±１４．３３３％，Ｐ＜０．００１；ＨＰＤ组透析一年后血清β２Ｍ较实验开始时下降１１．８９８±３．１４１％；ＨＰＤ一年后甘油三酯较前下降２４．８１±１０．９３％，Ｐ＜０．０５；ＣＨＤ组一年后甘油三酯及胆固醇较前升高，分别升高１９．５７±８．２５％、２０．４２±９．６２％，Ｐ＜０．０１。结论：ＨＰＤ对磷的清除优于ＣＨＤ，并能有效清除β２Ｍ，改善脂蛋白代谢     

非溃疡性消化不良与幽门螺杆菌感染关系的临床研究

为了解非溃疡性消化不良（ＮＵＤ）发病机理，对６４例ＮＵＤ患者进行前瞻性的研究。结果表明：６４例ＮＵＤ患者中６２例幽门螺杆菌（ＨＰ）检测阳性（９６．９％），用得乐治疗２个月后复查，阳性率下降为２２．２％，治疗前后比较差异非常显著（Ｐ〈０．０１）。研究证明，ＮＵＤ发病与ＨＰＤ发病与ＨＰ感染有密切关系。     

人乳头瘤病毒与大肠癌的发生及病理组织学相关性的研究

目的 了解人乳头瘤病毒（ＨＰＶ）与大肠癌的发生及病理组织学的关系。方法 用多重引物ＰＣＲ方法检测了４６例大肠癌标本和３６例对照组织的ＨＰＶ ＤＮＡ,并与病理组织９学结果进行比较。结果 大肠癌总ＨＰＶ阳性率为４１．３％,其中ＨＰＶ１６为２３．９％,与对照组比较,差异有显著性（Ｐ〈０．０５）。总ＨＰＶ和ＨＰＶ１６的阳性纺,高分化腺癌组为３８．９％和１６．７％,中分化组为３８．５％和２３．１％,低分化组     

老年高血压病患者中2型糖尿病的诊断

目的：探讨老年高血压病患者中２型糖尿病（ＤＭ２）的发病情况及诊断,方法对１６８例老年高血压病患者进行空腹血糖检查和标准口服葡萄糖耐量试验,比较２型糖尿病筛查方法及相关因素。结果（１）１６８例老年高血压病患者中４６例伴有２型糖尿病,未诊断率为２７．３８％。（２）ＦＰＧ≥７．８ｍｍｏｌ／Ｌ时敏感性和特异性分别为６７．３９％和９９．１２％;ＦＰＧ≥７．０ｍｍｏｌ／ＬＪＦ ＴＸＤＧ２ＮＴＧ Ｔ ＴＲＦ Ｎ     

间质性肺疾病支气管肺泡灌洗液中性粒细胞趋化因子和肿瘤坏死因子水平及其临床意义

目的探讨间质性肺疾病（ＩＬＤ）时中性粒细胞趋化因子（ＮＣＦ）和肿瘤坏死因子（ＴＮＦα）与ＩＬＤ活动性的关系。方法用膜滤过和放射免疫法检测１１例结节病、７例特发性肺间质纤维化（ＩＰＦ）患者和８名健康者血清及支气管肺泡灌洗液（ＢＡＬＦ）中ＮＣＦ活性及ＴＮＦα水平。结果７例ＩＰＦ患者ＢＡＬＦ中ＮＣＦ、ＴＮＦα分别为２０３±４４ｃｅｌｓ／１０ＨＰ、１１７±２９ｎｇ／Ｌ，明显高于８名对照组（８３±４５ｃｅｌｓ／１０ＨＰ、６５±１４ｎｇ／Ｌ、Ｐ＜０．０１）；１１例结节病患者ＢＡＬＦ中ＮＣＦ、ＴＮＦα分别为１８６±５０ｃｅｌｓ／１０ＨＰ、１２±３ｎｇ／Ｌ，明显高于８名对照组（Ｐ＜０．０１）。ＩＰＦ组ＢＡＬＦ中ＮＣＦ、ＴＮＦα均与中性粒细胞百分比呈正相关（ＮＣＦ：ｒ＝０．８９，Ｐ＜０．０１，ＴＮＦα：ｒ＝０．８６，Ｐ＜０．０５），结节病组ＢＡＬＦ中ＮＣＦ、ＴＮＦα均与淋巴细胞百分比呈正相关（ＮＣＦ：ｒ＝０．７８，Ｐ＜０．０１；ＴＮＦα：ｒ＝０．７３，Ｐ＜０．０１）。结论ＩＰＦ和结节病患者ＢＡＬＦ中ＮＣＦ、ＴＮＦα水平可做为肺泡炎活动性的标志     

消化性溃疡与幽门螺杆菌感染关系的中西医结合研究

经过纤维胃镜检查的３６１０例病人中有７７８例为消化性溃疡病人。对其中４０１例消化性溃疡病人胃窦部粘膜作了幽门螺杆菌（ＨＰ）检测、ＨＰ阳性者为３５６例，阳性率为８６．６％。与同期检测胃炎组阳性率５５．１％相比明显为高，差异显著。ＨＰ被认为是慢性胃窦炎的主要病因，也是消化性溃疡的重要致病因素。根除ＨＰ可提高ＤＵ治愈率，降低ＤＵ复发。ＨＰ阳性率在中医证型中表现为非脾虚组明显高于脾虚组，其中以脾胃湿热组最高。     

PCR检测对男性尖锐湿疣HPV_（6．11）的诊断价值

ＰＣＲ检测对男性尖锐湿疣ＨＰＶ＿（６．１１）的诊断价值黄世明，李广云，山东省千佛山医院（２５００１４）赵庆利，魏学斌，白强近年来，我们采用聚合酶链反应（ＰＣＲ）技术检测了３５例男性尖锐湿疣患者的人乳头瘤病毒（ＨＰＶ）６．１１型。阳性率为１００％。资料...     

功能性消化不良与幽门螺杆菌感染的关系研究

目的：检测功能性消化不良（FD）病人幽门螺杆菌（HP）感染情况,探讨HP感染与FD的关系。方法：对137例FD患者及56例正常对照组行快速尿素酶检测,Warthin-Starry银染及（或)^14C呼气试验,对FD并HP感染病人行抗HP治疗,以症状积分比较症状改善情况及总有效率。结果：1．FD病人HP感染率为67．15％。2．经抗HP治疗FD患者症状明显改善。结论：HP感染可能是FD的一个致病因素,抗HP是治疗的FD的一个重要手段。     

幽门螺杆菌阳性功能性消化不良的治疗选择

目的：探讨根除幽门螺杆菌（HP）、改善胃动力及抗焦虑药对HP阳性功能性消化不良（FD）症状的效果。方法：HP阳性的FD160例随机的分为3个治疗组：胶体次枸橼酸铋（B）合并呋喃唑酮（F）及羟氨苄青霉素（A）三联疗法（BFA方案,60例）、西沙必利（CIS,60例）和多虑平（DXP,40例）,对其疗效作前瞻性随机对照研究。结果：CIS总有效率显著高于BFA（P＜0．05）,DXP总有效率介于两者之间。临床类型中,CIS对运动障碍型FD疗效优于BFA（P＜0．01）;而对溃疡型FD,BFA比CIS效果更佳（P＜0．05）;伴有焦虑、多疑、多梦及严重失眠的女性FD,DXP常常收到良好的效果,并优于BFA或CIS（P＜0．05）。不同年龄、性别及病程对疗效亦产生一定的影响。结论：HP阳性FD没有必要常规行根除HP治疗,但对溃疡型FD尤其病程较长者,根除HP治疗对改善FD症状有较好的效果。改善胃动力更适合于运动障碍型、年龄较小及病程较短的FD患者。上述治疗无效,尤其病程较长且同时伴有神经衰弱征候群的女性FD患者,推荐给予抗焦虑药治疗。     

溃疡样型功能性消化不良食管酸敏感性及胃食管反流的研究

为研究溃疡样型功能性消化不良（FD）食管下端的酸敏感性及病理性胃食管反流,对53例溃疡样型FD患者及20例健康对照者进行了食管的酸敏感性测定,其中47例FD和16例对照者又接受了24小时动态PH检测。结果显示67．9％溃疡样型FD患者酸刺激呈阳性,42．5％溃疡样型FD患者有病理性胃食管反流,显著高于对照组（P＜0．01）。显示食管下端酸敏感性的增高和病理性和病理性胃食管反流可能是疼痛性FD发病的病理生理机制之一。     

Symptom clusters cannot be used in distinguishing Helicobacter pylori positive or negative patients with functional dyspepsia

Background: A retrospective study was done in consecutive patients in order to seek out whether dyspepsia subgroups (reflux-like, ulcer-like, and, dysmotility-like dyspepsia) can be useful in describing Helicobacter pylori positive and negative functional dyspepsia.Methods: Consecutive patients who underwent upper gastrointestinal endoscopy were included if no macroscopic lesions in oesophagus, stomach or duodenum were seen. Antral biopsy specimens were taken for detection of H. pylori. A validated questionnaire was used. Results: Six hundred patients fulfilled the inclusion criteria. Three hundred were positive for H. pylori. In the H. pylori positive (HP+) patients only 3 (1.2%) had `pure' reflux-like dyspepsia, 17 (6.9%) had ulcer-like dyspepsia and 10 (4%) suffered from dysmotility-like dyspepsia. In the H. pylori negative (HP−) patients these figures were 6 (2.3%), 17 (6.6%) and 7 (2.7%), respectively (ns). The majority of patients had a combination of complaints belonging to the three subgroups. Reflux-like dyspepsia was present in 179 (73%) HP+ dyspeptics and 195 (76%) HP−'s (ns). Ulcer-like dyspepsia was present in 213 (88%) HP+ cases and 233 (92%) HP−'s (ns). Dysmotility-like dyspepsia was present in 197 (81%) HP+'s and 212 (82%) HP−'s (ns).Conclusions: It is concluded that it is not possible to identify patients suffering from H. pylori infection on basis of symptom clusters.     

The prevalence and risk factors of functional dyspepsia in a multiethnic population in the United States

BACKGROUND AND AIMS: The prevalence of functional dyspepsia (FD) in the general population is not known. The aim of this study is to measure the prevalence of FD and its risk factors in a multiethnic volunteer sample of the U.S. population. METHODS: One thousand employees at the Houston VA Medical Center were targeted with a symptom questionnaire asking about upper abdominal symptoms, followed by a request to undergo endsocopy. Dyspepsia was defined by the presence of epigastric pain, fullness, nausea, or vomiting, and FD was defined as dyspepsia in the absence of esophageal erosions, gastric ulcers, or duodenal ulcers or erosions. The presence of dyspepsia and FD was examined in multiple logistic regression analyses. RESULTS: A total of 465 employees completed the relevant questions and of those 203 had endoscopic examination. The age-adjusted prevalence rate of dyspepsia was 31.9 per 100 (95% CI: 26.7-37.1), and 15.8 per 100 (95% CI: 9.6-22.0) if participants with concomitant heartburn or acid regurgitation were excluded. Subjects with dyspepsia were more likely to report smoking, using antacids, aspirin or nonsteroidal antiinflammatory drugs (NSAIDs), and consulting a physician for their symptoms (p < 0.05) than participants without dyspepsia. Most (64.5%) participants with dyspepsia who underwent endoscopy had FD. The age-adjusted prevalence rate of FD was 29.2 per 100 (95% CI: 21.9-36.5), and 15.0 per 100 (6.7-23.3) if subjects with GERD were excluded. Apart from a trend towards association with older age in the multiple regression analysis, there were no significant predictors of FD among participants with dyspepsia. CONCLUSIONS: Most subjects with dyspepsia have FD. The prevalence of FD is high but predictors of FD remain poorly defined.     

Nutritional habits in functional dyspepsia and its subgroups: a comparative study

Objective: Research data demonstrating nutritional habits of functional dyspepsia (FD) patients are very limited. This is the first study to evaluate nutritional habits in FD subgroups according to Rome III criteria. Our aim was to evaluate nutritional habits of FD patients and determine the food items that may provoke a dyspepsia symptom. Methods: A total of 168 adults with FD and 135 healthy control subjects participated in the study. FD subjects were divided into epigastric pain syndrome (EP-FD), postprandial distress syndrome (PS-FD), mixed (MX-FD) subgroups according to Rome Criteria III. Subjects completed a questionnaire that included a short-form food frequency questionnaire. Furthermore, subjects were asked to list the food items that were causing a dyspepsia symptom. Results: Functional dyspepsia subjects had a slightly higher BMI (26.1?±?4.97?kg/m²) than control subjects (24.6?±?4.08?kg/m²). The most common symptom triggering foods among all the FD groups were fried and fatty foods (27.1%), hot spices (26.4%), and carbonated drinks (21.8%). In FD subgroups, carbonated drinks were more likely to cause a symptom in PS-FD group (37.3%) than MX-FD (25.7%) and EP-FD (22.1%) groups. There was no difference in frequency of main meals and snacks among any of the groups. Conclusion: Fatty and spicy foods and carbonated drinks were the most common symptom triggering food items in FD group. In subgroups, carbonated drinks and legumes were more likely to cause a symptom in PS-FD. Removing these food items during the course of treatment might help alleviate the symptoms.     

以罗马Ⅲ标准为基础的功能性消化不良临床研究

背景:功能性消化不良(FD)发病率较高,自2006年罗马Ⅲ标准发布以后,中国大陆地区关于FD的临床研究并不多见。目的:探讨以罗马Ⅲ标准为基础的FD的临床特征。方法:选取2009年4月～2010年4月上海长海医院收治的符合罗马Ⅲ标准的100例FD患者,对其一般情况、治疗效果、重叠症相关因素等进行分析。结果:100例FD患者以女性多见,平均发病年龄(40.9±12.3)岁。根据症状分型,餐后不适综合征(PDS)患者30例,上腹痛综合征(EPS)22例,混合型48例。行对症治疗后,71.0%的FD患者症状消失。随着体重指数(BMI)升高,FD患者的消化不良症状呈加重趋势,但差异无统计学意义(P=0.08)。38.0%的FD患者重叠肠易激综合征(IBS),22.0%重叠胃食管反流病(GERD)。FD重叠IBS患者的餐后胞胀不适发生率明显高于单独FD患者(P=0.02)。结论:对症治疗可使多数FD患者的症状改善,BMI可能与FD症状有关。FD重叠IBS患者的餐后饱胀不适发生率显著高于单独FD患者。     

Systematic approach toward the clinical diagnosis of functional dyspepsia.

Functional dyspepsia (FD) is the most common condition in patients consulting with upper gastrointestinal tract symptoms, resulting in up to 5% of visits to family physicians. By definition, patients with FD have no clinical, biochemical or endoscopic evidence of an organic disease that is likely to explain their symptoms. The process to be used in a structured interview for establishing a clinical diagnosis of FD is presented. The steps are as follows: determine the duration and the course of the disease; characterize the current syndrome and review the alarm symptoms; elicit the patient-perceived dominant symptom and/or condition; and identify the patient's reason for consulting and address the psychosocial factors. According to the clinical characteristics of the three most frequent causes of dyspepsia (peptic ulcer, gastroesophageal reflux and FD) and acknowledging that these conditions may coexist rather than overlap in some patients, an algorithm is suggested for establishing a working diagnosis of FD and indications for investigation, and initiating a management strategy.     

功能性消化不良及其分型组的胃窦十二指肠运动

本研究对功能性消化不症状分型的常规标准做了一些调整，并观测了３９例ＦＤ患者空腹及餐后胃窦十二指肠运动，以探讨ＦＤ患乾胃窦十二指肠运动状况及其与分型组之间的关系。结果显示〈ＦＤ患者空腹及餐后胃窦十二指肠动力减弱，在胃窦表现为运动指数、平均振幅和频率均显著低于正常组，在十二指肠表现为平均振