乌司他丁联合奥曲肽治疗急性胰腺炎的疗效及对细胞因子和淀粉酶的影响

目的：探讨乌司他丁联合奥曲肽治疗急性胰腺炎的临床疗效以及对细胞因子和淀粉酶的影响。方法：选取在本院接受治疗的急性胰腺炎患者168例,将其随机分为乌司他丁组、奥曲肽组和联合治疗组3组,每组各56例。3组均进行常规治疗,在此基础上,乌司他丁组给予乌司他丁静脉滴注,奥曲肽组给予奥曲肽静脉泵注,联合用药组给予两种制剂的联合应用。观察3组临床治疗效果以及治疗前后细胞因子和淀粉酶的变化情况。结果：联合治疗组总有效率明显高于乌司他丁组和奥曲肽组,差异具有统计学意义（P〈0.05）。3组治疗后细胞因子和淀粉酶水平都有一定程度的改善,而乌司他丁组和奥曲肽组对细胞因子和淀粉酶变化的影响是一致的,差异无统计学意义（P〉0.05）;而联合治疗组细胞因子和淀粉酶水平变化明显优于单独用药组,且差异均具有统计学意义（P〈0.05）。结论：乌司他丁和奥曲肽联合应用治疗急性胰腺炎在改善患者临床症状和体征、降低细胞因子和淀粉酶等方面都要明显优于两种药物单独使用,具有更好的治疗效果,值得临床大力推广和应用。     

急性有机磷中毒血清淀粉酶与疾病预后相关性探讨

目的 探讨急性有机磷中毒血清淀粉酶变化的临床意义。方法 患者入院当日采取血通过血清淀粉酶速率法检测血清淀粉酶。结果 61例中有机磷中毒患者中20例有淀粉酶增高，其中8例中间综合症及8例呼吸心跳骤停患者有均4例淀粉酶升高，且升高程度与病情严重程度呈正相关。结论 急性有机磷中毒可出现淀粉酶增高，且其增高程度对评估患者预后有重要意义。     

法莫替丁预防内镜逆行胰胆管造影术后胰腺炎的临床研究--附46例报告

目的 :探讨法莫替丁预防内镜逆行胰胆管造影 (endoscopicretrogradecholangiopan creatography ,ERCP)术后急性胰腺炎的作用。方法 :86例胆胰疾病患者分为法莫替丁组 4 6例和安慰剂组4 0例 ,分别在ERCP术前 1日和当日静脉滴注生理氯化钠 5 0 0mL加法莫替丁 2 0mg和单纯生理氯化钠 5 0 0mL ,每日 2次。术前、术后 4小时及 2 4小时分别测定血清淀粉酶并观察有无急性胰腺炎的临床表现如腹痛、呕吐、发热等。结果 :ERCP术后法莫替丁组及安慰剂组急性胰腺炎的发生率分别为 7% (3/ 4 6 )、13% (5 / 4 0 ) ,P <0 0 1;术后 4小时高淀粉酶血症的发生率分别为 30 % (14 / 4 6 )、 4 8% (19/ 4 0 ) ,P <0 0 5。术后 2 4小时两组血清淀粉酶水平差异无统计学意义。结论 :法莫替丁可减少ERCP术后急性胰腺炎的发生率     

微生物产生的淀粉酶抑制剂研究Ⅲ淀粉酶抑制剂抑制动力学研究

Ｓ－２－３５淀粉酶抑制剂是一种易溶于水、不溶于有机溶剂的白色粉末，其紫外谱图呈末端吸收，红外谱图在３３９１、１５７２、１４１０、１０３０及９２７ｃｍ￣（－１）处有明显吸收峰。该抑制剂在ｐＨ６．５的条件下对ａ－淀粉酶有明显的抑制作用（ＩＤ＿（５０）为１．７×１０－５ｍｏｌ／Ｌ）．在３７℃，ｐＨ６．５的磷酸缓冲液中，Ｓ－２－３５抑制剂对淀粉酶的抑制作用与抑制剂的浓度关系密切，在抑制剂浓度较小的情况下，抑制剂与酶的结合呈直线关系，随着抑制剂浓度增大，残留活力曲线则出现漂移。根据Ｄｉｘｏｎ图和Ｌｉｎｅｗｅａｖｅｒ－Ｂｕｒｋ图的研究表明，Ｓ－２－３５淀粉酶抑制剂对淀粉酶的结合和底物呈竞争性抑制，抑制常数Ｋ＿ｉ为１．５～１．６×１０￣（－６）ｍｏｌ／Ｌ。     

王家岭3·28透水事故获救矿工消化功能的分析

目的分析长期饥饿应激条件对消化系统的影响。方法2010年3月28日王家岭煤矿透水事故中153名矿工,被困井下,处于断食、应激状态。8d后115例矿工获救并住院,均男性,年龄（38．7±7．6）岁（19。54岁）。观察其消化系统症状,入院后连续7～10d检测转氨酶、胆红索、脂肪酶、淀粉酶、电解质等生化指标。结果115例矿工中,21例矿工表现腹部不适和腹痛,有2例矿工表现恶心,但未有呕吐等症状;49．6％的矿工有低白蛋白血症;33．3％的矿工丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）增高;40．3％的矿工总胆红素增高;74．5％的矿工有电解质异常,表现为低钠血症、低钾血症和,或低钙血症。结论长时间的饥饿应激可致低白蛋白血症及血生化紊乱,循序渐进的进食方案及补液治疗有助于恢复。     

Two rare cases of benign hyperlipasemia in children

Gullo’s syndrome is a newly identified condition characterized by a chronic elevation of pancreatic amylase and/or lipase in the absence of pancreatic disease. Until now, only one case of benign isolated hyperlipasemia in children has been recorded. We describe two children with benign and not familial increase of serum lipase. Case 1: a six year old girl presented with occasional discovery of serum lipase elevation. Medical history was silent for pancreatic hyperenzymemia. The screening for possible causes for elevated lipase (genetic, autoimmune and infectious diseases) was normal. The serum lipase increased three fold over the upper limit (193 U/L; reference range 0-60 U/L), with daily fluctuation of values. Both ultrasound scan and magnetic resonance imaging were normal. The genetic mutation associated with chronic pancreatitis was negative. We followed up this patient for two years with blood tests every six months and she did not show any signs or symptoms of pancreatic disease, except for the high level of lipase serum. Case 2: an eight year old girl complained of nausea, vomiting and severe abdominal pain in the epigastric region after eating for the last two weeks. Full blood count, electrolytes, C-reactive protein, liver and renal function were normal. Serum lipase was 96 U/L (reference range 0-60 U/L). The screening for the possible causes of pancreatic disease was negative. Endoscopy of the upper gastrointestinal tract, ultrasound, computed tomography scan and magnetic resonance imaging were normal. One year after the presentation of the symptoms, the patient became asymptomatic although the level of serum lipase continued to be high.     

Stability of human α-salivary amylase in aged forensic samples

The unequivocal tissue identification in forensic casework samples is a key step for crime scene reconstruction. Just knowing the origin of a fluid can sometimes be enough to either prove or disprove a fact in court. Despite the importance of this test, very few data are available in literature concerning human saliva identification in old forensic caseworks. In this work the stability of human α-amylase activity in aged samples is described by using three different methods integrated with DNA profiling techniques. This analytical protocol was successfully applied on 26-years old samples coming from anonymous threat letters sent to prosecutors who were working on “the Monster of Florence”, a case of serial murders happened around Florence (Italy) between 1968 and 1985.     

急性胰腺炎患者PCT、ALB、AMY及CRP水平检测的临床价值

目的探讨急性胰腺炎患者降钙素原(PCT)、血清白蛋白(ALB)、淀粉酶(AMY)及C反应蛋白(CRP)水平检测的临床价值。方法选取2016年11月至2017年12月在我院接受治疗的急性胰腺炎(AP)患者109例作为AP组,包括50例轻症急性胰腺炎(MAP)患者和59例重症急性胰腺炎(SAP)患者,同时选取在我院体检的50例健康人作为对照组。分别采用电化学发光法、溴甲酚绿法、干片法和免疫比浊法对血清PCT、ALB、AMY及CRP水平进行检测。分析4种指标单独及联合检测对急性胰腺炎诊断的意义。结果 AP组患者血清PCT、AMY和CRP水平明显高于对照组(P<0.05),且SAP组患者血清PCT、AMY和CRP水平与MAP组相比有明显升高(P<0.05);AP组患者血清ALB水平与对照组相比显著降低(P <0.05),与MAP组相比,SAP组患者血清ALB水平降低程度更为显著(P <0. 05)。AP组PCT、ALB、AMY及CRP单独及联合检测的阳性率均高于对照组(P <0. 05),且AP组联合检测的阳性率均显著高于单项指标检测(P <0. 05)。PCT、ALB、AMY及CRP联合检测的灵敏度为94.50%,准确度为89.31%,明显高于单项检测指标的结果 (P <0.05)。结论 PCT、ALB、AMY及CRP联合检测可显著提高急性胰腺炎诊断的灵敏度和准确度,具有较好的临床应用价值。