肺栓塞18例急诊临床特征分析

目的 探讨肺栓塞患者的临床特点、诊断和治疗方案,以提高对肺栓塞的诊治水平,减少误诊.方法 分析2004～2007年期间急诊由CT肺动脉造影确诊的肺栓塞18例的临床资料.结果 呼吸困难11例(61%),"肺梗死三联征"患者仅1例(6%);低氧血症8例(44%),SⅠQⅢTⅢ 6例(33%),血浆D-二聚体>500 μg/L 15例(83%),CT肺动脉造影示栓子累及46支肺动脉;8例接受溶栓治疗,10例接受抗凝治疗;死亡2例.结论 肺栓塞临床表现缺乏特异性,易误诊、漏诊,早期诊断和规范溶栓抗凝治疗对预后有重要影响,CT肺动脉造影是确诊肺栓塞的有效方法.     

心肺复苏过程中血管活性物质水平的研究

目的:探讨心跳骤停和心肺复苏过程中血管活性物质水平的变化。方法:对28例心跳骤停和心肺复苏病人,以及18例危重病人用放免的方法测定其血清前列环素(PGI_2)、血栓素(TXA_2)、内皮素(ET)和心钠素(ANP)水平,并进行对照研究。结果:随着自主循环的建立,ET和ANP水平明显降低,而PGI_2和TXA_2水平增高,其中PGI_2/TXA_2比例增高更为显著。危重病人组随着病情的恢复和稳定也出现上述变化。危重病人和心跳骤停病人组比较,其PGI_2和TXA_2水平高于心跳骤停组,而ET和ANP水平低于心跳骤停组。结论:心跳骤停和心肺复苏过程中体内血管活性物质水平发生显著变化。其中心钠素和内皮素水平的增高可能是预后不良的指标,而PGI_2/TXA_2比例增高有利于复苏成功。     

A Correlative Study on Serum Lp(a) in Patients of CerebralInfarction with that in their Children

Serum lipoprotein(a){Lp(a)}level is genetically determined and remains almost constant throughout life.Its elevation has significant familiar centripetal tendency.Based on its properties,we selected the patients with cerebral infarction(CI)and definite family history of the disease and their children for the assay of serum Lp(a)level and investigated the correlation of the level in parental to that in filial generation and its clinical significance.     

A Correlative Study on Serum Lp(a) in Patients of Cerebral Infarction with thatin Their Childre

Serumlipoprotein(a){Lp(a)}levelisgeneticallydeterminedandremainsalmostconstantthroughoutlife.Itselevationhassignificantfamiliarcentripetaltendency.Basedonitsproperties,weselectedthepatientswithcerebralinfarction(CI)anddefinitefamilyhistoryofthediseas...     

脓毒症血清对大鼠小肠微血管内皮细胞ICAM-1的影响及肾上腺髓质素的干预作用

Objective To observe the levels of intercellar adhesion molecule-1(ICAM-1)of rat intestinal mucosa microvascular endothelial cells in sepsis rat,and to investigate the possible protective effect of adrenomedullin on the expression of intercellar adhesion molecule-1(ICAM-1)of rat intestinal mucosa microvascular endothelial cells,and to confirm whether adrenomedullin can decrease released inflammatory factors to slow down or inhibit the occurrence and development of sepsis.Methods The rat intestinal mucosa microvascular endothelial cells were isolated and cultured in vitro,and it was divided into sham operated(sham operated serum),sepsis serum(with addition of sepsis serum)and ADM serum(with 0.lng/kg adrenomedullin 6h after sepsis treatment)groups.The soluble ICAM-1(sICAM-1)content in RIMMVECs culture supernatant was measured by ELISA at the 24th hour after serum stimulation.Results The ICAM-1 content in the supernatant of sepsis group [(0.33 ±0.04)ng/L] was obviously higher than that in sham operated [(0.15 ± 0.02)ng/L] and ADM [(0.17 ± 0.04)ng/L] group(P ＜ 0.05),but ADM group was no significantly different compared with sham operated group(P ＞ 0.05).Conclusions ADM could decrease the expression of ICAM-I in RIMMVECs,and the low level of ICAM-1 could suppress its downstream inflammation factors and inhibit the occurrence and development of sepsis.     

现代灾害的特点与救援原则

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