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1.
本文对病毒性重症肝炎与肝性脑病的诊治研究进展进行综述。在对病毒性重症肝炎与肝性脑病等定义与病因等进行分析的基础上总结治疗病毒性重症肝炎与肝性脑病的方法,即干扰素、拉米夫定、谷氨酸、降低颅内压、免疫调节剂、细胞再生因子、前列腺素E1以及中西医结合等。  相似文献   

2.
黄酮类化合物对脂氧合酶活性的影响及其生物学作用   总被引:4,自引:0,他引:4  
脂氧合酶(LOX)与急慢性炎症、动脉粥样硬化、高血压和肿瘤等多种疾病的发生发展有关,抑制其活性可能对这些疾病的预防和治疗起重要作用。多种黄酮类化合物,如查耳酮、黄酮醇、黄酮和黄烷醇等对5-LOX,12-LOX和15-LOX具有抑制作用,其机制可能为抑制LOX的表达、与酶结合或与酶活性中心产生的自由基反应等,且抑制作用与结构有关。黄酮类化合物对LOX的抑制作用可能是其具有抗炎、抗肿瘤和抗心脑血管疾病等生物学作用的原因之一。  相似文献   

3.
案例分析栏目主要刊登关于典型病例的用药选择、药品不良反应个案、药物滥用误用等对临床合理用药具有借鉴意义的稿件。在病例临床资料中,应包括患者基本信息、既往病史、临床检查与诊断、治疗情况、处理与预后等。讨论部分应参考2019年以后的相关文献对药品与不良反应的关联性评价与分析、不良反应发生机制、防范措施、用药注意事项、个体化用药及对临床的警示意义等进行深入分析。案例分析类文章均需提供尽量详细的中英文摘要。  相似文献   

4.
案例分析栏目主要刊登关于典型病例的用药选择、药品不良反应个案、药物滥用误用等对临床合理用药具有借鉴意义的稿件。在病例临床资料中,应包括患者基本信息、既往病史、临床检查与诊断、治疗情况、处理与预后等。讨论部分应参考2018年以后的相关文献对药品与不良反应的关联性评价与分析、不良反应发生机制、防范措施、用药注意事项、个体化用药及对临床的警示意义等进行深入分析。案例分析类文章均需提供尽量详细的中英文摘要。  相似文献   

5.
病例监测栏目主要刊登关于典型病例的用药选择、药品不良反应个案、药物滥用误用等对临床合理用药具有借鉴意义的稿件。在病例临床资料中,应包括患者基本信息、既往病史、临床检查与诊断、治疗情况、处理与预后等。讨论部分应参考2010年以后的相关文献对药品与不良反应的关联性评价与分析、不良反应发生机制、防范措施、用药注意事项、个体化用药及对临床的警示意义等进行深入分析。病例监测类文章均需提供尽量详细的中英文摘要。  相似文献   

6.
病例监测栏目主要刊登关于典型病例的用药选择、药品不良反应个案、药物滥用误用等对临床合理用药具有借鉴意义的稿件。在病例临床资料中,应包括患者基本信息、既往病史、临床检查与诊断、治疗情况、处理与预后等。讨论部分应参考2010年以后的相关文献对药品与不良反应的关联性评价与分析、不良反应发生机制、防范措施、用药注意事项、个体化用药及对临床的警示意义等进行深入分析。病例监测类文章均需提供尽量详细的中英文摘要。  相似文献   

7.
案例分析栏目主要刊登关于典型病例的用药选择、药品不良反应个案、药物滥用误用等对临床合理用药具有借鉴意义的稿件。在病例临床资料中,应包括患者基本信息、既往病史、临床检查与诊断、治疗情况、处理与预后等。讨论部分应参考2013年以后的相关文献对药品与不良反应的关联性评价与分析、不良反应发生机制、防范措施、用药注意事项、个体化用药及对临床的警示意义等进行深入分析。案例分析类文章均需提供尽量详细的中英文摘要。  相似文献   

8.
病例监测栏目主要刊登关于典型病例的用药选择、药品不良反应个案、药物滥用误用等对临床合理用药具有借鉴意义的稿件。在病例临床资料中,应包括患者基本信息、既往病史、临床检查与诊断、治疗情况、处理与预后等。讨论部分应参考2006年以后的相关文献对药品与不良反应的关联性评价与分析、不良反应发生机制、防范措施、用药注意事项、个体化用药及对临床的警示意义等进行深入分析。病例监测类文章均需提供尽量详细的中英文摘要。  相似文献   

9.
案例分析栏目主要刊登关于典型病例的用药选择、药品不良反应个案、药物滥用误用等对临床合理用药具有借鉴意义的稿件。在病例临床资料中,应包括患者基本信息、既往病史、临床检查与诊断、治疗情况、处理与预后等。讨论部分应参考2017年以后的相关文献对药品与不良反应的关联性评价与分析、不良反应发生机制、防范措施、用药注意事项、个体化用药及对临床的警示意义等进行深入分析。案例分析类文章均需提供尽量详细的中英文摘要。  相似文献   

10.
开展社区全科医学教育促进医学人才培养   总被引:1,自引:0,他引:1  
为促进我国社区全科医学人才的培养,笔者从师资队伍建设、教学内容改革、社区实践等方面进行了理论与实践研究,提出发展在职培训、探索在校医学生的社区全科医学教育、科研与教学相结合等改革措施,并对社区医学人才的继续教育、使用与管理等问题进行了探讨。  相似文献   

11.
比伐卢定是2000年被FDA批准上市的抗凝血药物,它通过直接抑制凝血酶发挥抗凝作用,已被批准应用于PCI/PTCA、HIT/HITTS、ACS等领域。现有研究表明比伐卢定在临床抗凝治疗中有较好的安全性,可以用于常规治疗方案(肝素与糖蛋白IIb/IIIa抑制剂)的替代治疗,而且可以降低出血风险和死亡率。本文主要介绍凝血酶直接抑制剂比伐卢定的药理作用及临床研究,总结分析其安全性及经济效益,并且结合国内临床应用情况,分析其在国内的临床运用前景。  相似文献   

12.
FDA在2000年批准了一种新的直接凝血酶抑制剂比伐卢定应用于临床,该药是水蛭素的类似物,它通过抑制凝血酶的活性位点而起效。国外将其与其他常用的抗凝药进行了比较研究,认为比伐卢定可以作为普通肝素和血小板糖蛋白Ⅱb/Ⅲa拮抗剂的替代药物应用于非高危患者的经皮冠脉介入治疗。  相似文献   

13.
目的:对比研究比伐芦定及普通肝素联合糖蛋白受体拮抗剂替罗非班(H-T)用于中国急性冠脉综合征(ACS)患者经皮冠状动脉介入(PCI)围手术期抗凝治疗的成本效果,为中国人群PCI围手术期抗凝治疗药物的合理选用提供理论依据。方法:参考我国随机、双盲、多中心Ⅲ期临床实验BRIGHT的研究结果,通过建立决策树模型及Markov长期外推模型,模拟计算使用比伐芦定或H-T治疗患者的调整质量生命年(QLAYs)及治疗成本,对比伐芦定用于中国人群PCI抗凝治疗的成本效益进行分析和研究。结果:比伐芦定和H-T组的治疗总成本分别为46 404.80元和43 552.14元,使用比伐芦定患者可获得的QALYs为10.07,采用H-GPI治疗方案的患者QALYs为9.98。增量成本效果分析显示,采用比伐芦定可提高患者的健康效益(△E>0),但同时增加了治疗成本(△C>0),其增量成本效果比(ICER)为28 575.77元/QALYs,小于3倍部分城市人均GDP,提示采用比伐芦定具有成本效果优势。一维敏感度分析显示本研究结果稳定可靠。结论:在我国目前整体经济形势下,与H-T的二联抗凝方案相比,比伐芦定用于PCI抗凝具有成本效果优势,可替代传统抗凝方案用于ACS患者PCI围手术期抗凝治疗。  相似文献   

14.
The objectives of the present study were to assess pharmacokinetics, pharmacodynamics, tolerability and safety of intravenous administration of bivalirudin, a direct thrombin inhibitor, in healthy Chinese subjects. 48 subjects were equally divided into 4 groups (0.5 mg/kg, 0.75 mg/kg, 1.05 mg/kg intravenous bolus, and 0.75 mg/kg intravenous bolus followed by an infusion of 1.75 mg/kg per hour for 4 h) by a randomized, single-blind and placebo-controlled (bivalirudin groups: n=9/group; placebo groups: n=3/group) design. The safety observations showed that bivalirudin was well tolerated in the studied dose range, all adverse events were mild in severity. The half-life of bivalirudin was approximately 0.57 h (34 min), exposure increased in a dose-dependent manner. In group receiving a 0.75 mg/kg intravenous bolus followed by 1.75 mg/kg per hour infusion for 4 h, bivalirudin concentrations remained at 5000-5500 μg/l within the 4 h infusion period, which was similar to the reported data of Caucasian patients and can provide the desired anticoagulant effects. There was a strong correlation between bivalirudin concentration and anticoagulant effect. A Sigmoid model was used to fit the pharmacodynamic parameters activated clotting time (ACT), activated partial thromboplastin time (APTT) and prothrombin time (PT) and bivalirudin concentrations. The findings of this study suggest that the same dosing regimens of bivalirudin may be administered to Chinese and Caucasian patients. Ongoing and future studies in large populations may add further information.  相似文献   

15.
Carswell CI  Plosker GL 《Drugs》2002,62(5):841-870
Bivalirudin, a synthetic analogue of hirudin, is a specific and reversible inhibitor of thrombin which binds directly with both fluid-phase and clot-bound thrombin. In patients with unstable angina undergoing percutaneous transluminal coronary angioplasty (PTCA), results from a large well designed study and its reanalysis (n = 4312) indicate that bivalirudin is more effective than heparin in the prevention of ischaemic complications for up to 90 days after the start of treatment. In addition, among patients undergoing PTCA for post myocardial infarction (MI) bivalirudin may be more effective than heparin in preventing ischaemic complications for up to 180 days after treatment was started. Data from dose-finding studies indicate bivalirudin has potential in the treatment of patients with unstable angina not undergoing percutaneous coronary intervention (PCI); however, well designed comparative studies are needed before firm conclusions can be made. Among patients with acute ST elevation MI, randomised trials have demonstrated bivalirudin to be significantly more effective than heparin in improving early patency in patients receiving thrombolytic therapy with streptokinase. Data from the Hirulog and Early Reperfusion/Occlusion (HERO)-1 trial (n = 412) indicate that bivalirudin recipients were significantly more likely to have Thrombin Inhibition in Myocardial Ischaemia (TIMI) grade 3 flow at 90 to 120 minutes than heparin recipients. In addition, data from the HERO-2 trial (n = 17 073) show bivalirudin was significantly more effective than heparin in reducing adjudicated 96-hour reinfarction and 30-day investigator-reported death/reinfarction than heparin. Bivalirudin was as effective as heparin in reducing 30-day mortality. Data from a meta-analysis of four randomised trials among patients undergoing PTCA or treatment for acute coronary syndromes indicate that, at after 30 to 50 days of follow-up, bivalirudin was significantly more effective than heparin in reducing the incidence of nonfatal MI and the combined endpoint of death or nonfatal MI. The most significant adverse events associated with bivalirudin are bleeding complications. In individual trials, bivalirudin was as well tolerated as heparin with, in general, a reduced incidence of bleeding complications. Additionally, bivalirudin provides a more consistent, predictable anticoagulant response. In 4312 patients with unstable angina undergoing PTCA the incidence of retroperitoneal bleeding, blood transfusion and major haemorrhage was significantly lower in bivalirudin than heparin recipients. Data from the HERO-2 trial in patients with acute MI indicate that although bivalirudin recipients had a significantly higher incidence of mild or moderate bleeding than heparin recipients, there was no difference in intracranial haemorrhage, severe bleeding or transfusions. Data from a meta-analysis among 5674 patients with ischaemic heart disease show bivalirudin recipients were at a significantly lower risk of haemorrhagic events than heparin recipients. CONCLUSIONS: Bivalirudin is an effective alternative to heparin in the prevention of ischaemic complications in patients with unstable angina undergoing PTCA. In addition, the drug has shown potential in the treatment of patients with unstable angina not undergoing PCI. For patients with MI, it is clear that bivalirudin can replace heparin in the management of MI where streptokinase is used as the thrombolytic agent. Further data are required on the efficacy of bivalirudin in patients undergoing thrombolysis with newer thrombolytics.  相似文献   

16.
目的

建立不同分离原理的高效液相色谱法,对7家企业的比伐芦定原料药中相关杂质进行分析,为全面控制比伐芦定有关物质提供依据。

方法

采用反相高效液相色谱法(RP-HPLC)对11个杂质进行分离分析;采用亲水色谱法(HILIC-HPLC)对4个工艺杂质进行控制;采用分子排阻色谱法(SEC-HPLC)对聚合物进行测定。

结果

建立的RP-HPLC方法可将主成分及11个杂质有效分离,11个杂质的校正因子均在0.8~1.2,比伐芦定检出浓度为0.1 μg·mL−1,检测限为0.004%;建立的HILIC-HPLC方法可将主成分及4个工艺杂质有效分离,比伐芦定检出浓度为0.3 μg·mL−1,检测限为0.01%;在SEC-HPLC条件下聚合物和比伐芦定依次出峰,两者分离度为2.9,比伐芦定检出浓度为6 ng·mL−1,检测限为0.000 6%。采用主成分自身对照法计算7家企业15批样品中15种已知杂质及聚合物,不同企业的产品杂质含量与其生产工艺存在一定的相关性。

结论

3种不同原理的方法均专属性良好,灵敏度高,耐用性好,结果可靠,可用于比伐芦定有关物质的质量控制。

  相似文献   

17.
罗新林  刘强  王丽丽 《安徽医药》2013,17(9):1568-1570
目的 探讨高龄急性冠状动脉综合征(ACS)患者行经皮冠状动脉介入治疗(PCI)应用比伐卢定抗凝的疗效及安全性.方法 拟行PCI的年龄≥80岁ACS患者155例,随机分为比伐卢定组(78例)及普通肝素组(77例).比较两组PCI术后24 h、30 d的主要心脑不良事件(MACCE)及出血发生率.结果 两组患者PCI术后24 h、30 d的MACCE发生率差异均无统计学意义(P〉0.05).比伐卢定组患者术后出血发生率明显低于普通肝素组(P〈0.001).结论 与普通肝素相比,比伐卢定在老年ACS接受PCI治疗的人群中,明显减少出血事件,且未增加MACCE发生率.  相似文献   

18.
Moen MD  Keating GM  Wellington K 《Drugs》2005,65(13):1869-1891
Bivalirudin (Angiox, Angiomax) is a synthetic 20-amino acid peptide analogue of hirudin. It is a direct thrombin inhibitor that binds specifically and reversibly to both fibrin-bound and unbound thrombin. Intravenous bivalirudin is approved in Europe for use as an anticoagulant in patients undergoing percutaneous coronary intervention (PCI). In the US, bivalirudin is approved in patients with unstable angina pectoris undergoing percutaneous transluminal coronary angioplasty (PTCA) and has recently been approved for use with provisional glycoprotein (GP) IIb/IIIa inhibition in patients undergoing PCI. Bivalirudin plus provisional GP IIb/IIIa inhibition is effective in patients undergoing PCI. The large, well controlled REPLACE-2 (Randomized Evaluation in PCI Linking Angiomax to Reduced Clinical Events) study showed that bivalirudin plus provisional GP IIb/IIIa inhibition was noninferior to heparin plus planned GP IIb/IIIa inhibition and that bivalirudin was associated with a reduced risk of bleeding complications. In patients with heparin-induced thrombocytopenia (HIT), bivalirudin was effective against ischaemic events and there was a low incidence of bleeding complications. Bivalirudin should be considered as an alternative to heparin plus planned GP IIb/IIIa inhibition in any patient undergoing urgent or elective PCI, especially in any patient with a high risk of bleeding complications.  相似文献   

19.
目的探讨国产注射用比伐卢定(domesticbivalimdin)对大鼠颈总动脉血栓模型血小板活化功能的影响。方法建立大鼠左颈总动脉血栓模型,分为对照组(n=6)、模型组(n=10)、国产注射用比伐卢定联合尿激酶(urokinase,UK)组(B&UK组,n=10)、肝素(heparin)联合尿激酶组(H&UK组,n=10),检测各组治疗前后GMP-140含量及血栓重量。结果与模型组比较,B&UK组及H&UK组血栓重量均明显减轻,而B&UK组与H&UK组之间血栓重量比较差异无统计学意义。模型组、B&UK组及H&UK组GMP-140含量均显著高于对照组;而治疗后GMP-140含量在B&UK组显著低于模型组,相反治疗后GMP-140含量在H&UK组则显著高于模型组。结论国产注射用比伐卢定能在模型中有效抑制血栓形成,但相比肝素,国产注射用比伐卢定能显著抑制血小板活化功能,抑制血小板聚集。在抑制血栓形成过程中国产注射用比伐卢定对血小板活化的影响具有更多优势。  相似文献   

20.
Ximelagatran and bivalirudin are direct thrombin inhibitors that have been studied for the prevention and treatment of thrombosis and have potential advantages over the traditional indirect thrombin inhibitors (i.e., warfarin, unfractionated heparin and low molecular-weight heparin). They are both reversible inhibitors of thrombin and block both circulating and fibrin-bound thrombin. Ximelagatran and bivalirudin possess favourable pharmacokinetic and pharmacodynamic profiles including wider therapeutic indices, faster onsets of action and less interpatient variability compared to indirect thrombin inhibitors. Ximelagatran has shown favourable clinical trial results in venous thromboembolism prophylaxis and atrial fibrillation. Similarly, bivalirudin has shown positive results in patients with acute coronary syndromes, however, further investigation is needed. Ximelagatran and bivalirudin have shown promising results in the management of thrombosis and the results of future studies confirming their use for the aforementioned indications are anticipated.  相似文献   

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