甲氨喋呤联合中药保守治疗异位妊娠50例分析

本院应用甲氨喋呤联合中药保守治疗异位妊娠50例,取得了较好疗效,现总结报道如下.     

重度烧伤患者休克期血浆B型钠尿肽含量变化及意义

Objective To study the plasma content of B-type natriuretic peptide (BNP) in patients with severe burn during shock stage and probe its clinical significance. Methods Forty-two patients aged 18-60 years, with total burn surface area ≥30%TBSA or full-thickness burn area ≥10% TBSA, hospital-ized within 4 hours after burn, were divided into A group (with total burn surface area 30% -50% TBSA or full-thickness burn area 10% -20% TBSA, n = 21 ), and B group (with total burn surface area 50% TB-SA or full-thickness burn area > 20% TBSA, n = 21 ). Twenty patients admitted during the same time for plastic surgery were enrolled as control group. The plasma levels of BNP, creatine kinase (CK), CK-MB, troponin I (Tnl) of all patients were determined on admission. The levels of BNP, Tnl and fluid resuscita-tion volume were examined at 8, 16, 24, 48 post burn hour (PBH) in A and B groups. Analysis of correla-tion between BNP and fluid resuscitation volume was performed. Results On admission: BNP level in A group (68±19 ng/L) and B group (99±38 ng/L) , respectively, was increased as compared with that in control group (17±7 ng/L, P <0.01 ). Tnl level in A group (2.13±0.67 μg/L) and B group (2.98± 0.58μg/L), respectively, was increased as compared with that in control group (0.12 ± 0.03 μg/L, P < 0.01). There was no obvious difference in CK, CK-MB levels among A, B, and control groups ( P > 0.05). BNP levels in A, B groups continuously rose during 8 - 48 PBH, and they were positively correlated with fluid resuscitation volume. TnI level peaked at 24 PBH, and decreased at 48 PBH. Conclusions The plasma level of BNP is sensitive to reflect changes in myocardial ischemia and hypoxia as a rise in level of TnI in shock stage of severe burn, and it was positively correlated with fluid resuscitation volume. BNP can be used to guide fluid resuscitation during shock stage.     

冠心病患者血清同型半胱氨酸与叶酸、维生素B12水平的变化

目的 探讨冠心病患者血清同型半胱氨酸(HCY)与叶酸、维生素B12浓度的变化及其相关性。方法 选择84例经冠状动脉造影术证实为冠心病的患者，应用荧光偏振免疫分析法(FPIA)测定血清HCY浓度，离子捕获免疫分析法(ICIA)测定血清叶酸浓度，非均相微粒子酶免疫分析法（MEIA)测定血清维生素B12浓度。结果 冠心病患者血清HCY浓度增高，与正常对照组比较有显著性意义(P＜0．001)，而叶酸、维生素B12浓度则降低，与正常对照组比较有显著性意义(P＜0．001)，以上两种变化呈负相关(P＜0．001)。结论 同型半胱氨酸血症是冠心病的新的独立危险因素，叶酸、维生素B12缺乏可能是诱发高HCY的重要因素。     

地塞米松对狼疮性肾炎患者外周全血培养细胞IL-12,IFN-γ分泌水平的影响

目的：探讨狼疮性肾炎（LN）患者外周循环IL－12，IFN－γ分泌水平的变化，以及肾上腺皮质激素对其分泌的影响。方法：选取16例活动性LN患者和10例正常人，采集静脉血标本分空白组，LPS／PHA刺激组及LPS／PHA＋DXM组作体外全血细胞培养，然后应用酶联免疫吸附法（ELISA）检测培养上清IL－12，IFN－γ分泌水平，经扣除血浆基础细胞因子水平后作为该例标本的IL－12或IFN－γ分泌量。结果：LN患者的全分泌水平，经扣除血浆基础细胞因子水平后作为该例标本的IL－12或IFN－γ分泌量。结果：LN患者的全血培养细胞IL－12及IFN－γ的分泌量明显高于正常人（IL－12：P＜0．005，IFN－γ：P＜0．001）；而且两者均与系统性红斑狼疮疾病活动指数（SLEDIA）呈不同程度的正相关关系；DXM对IL－12及IFN－γ分泌均有显著的抑制作用（均P＜0．01），而且在LN患者抑制作用更明显。结论：IL－12及IFN－γ分泌上调在LN的发病中起重要作用，抑制IL－12及IFN－γ的产生可能是它治疗LN中的机制之一。     

IL-12表达障碍与支气管哮喘关系研究进展

支气管哮喘是由Th2介导的Ⅰ型变态反应,与内源性IL-12生成不足有关,该文综述了IL-12的生物学效应、IL-12表达障碍与支气管哮喘的关系以及IL-12、重组IL-12（rIL-12）在支气管哮喘治疗方面的应用前景。IL-12与Ⅰ型变态反应关系密切,内源性IL-12表达不足使支气管哮喘患者免疫系统向Th2方向偏移,在过敏原或病毒等外因的刺激下发生支气管哮喘。用IL-12对支气管哮喘进行免疫治疗已在动物实验中取得了显著效果,将IL-12、rIL-12或IL-12的内源性诱生物应用于人体的方法也在不断探索中并取得了一定效果,基于IL-12的治疗方法可能为支气管哮喘等变应性疾病的免疫治疗开辟新的途径。     

青霉素皮肤点刺试验的运用

青霉素具有杀菌力强，毒性低的特点，临床应用广泛，但5％～6％的人群对青霉素过敏，使用时可发生I型变态反应，严重者可导致过敏性休克。为保证青霉素的用药安全，《中华人民共和国药典》规定：使用青霉素前必须进行皮肤过敏试验，皮试阴性者方可使用。青霉素过敏试验的方法有：皮内试验、[第一段]     

米非司酮配伍米索前列醇终止12～16周妊娠30例

资料和方法 我院妇产科门诊自1997年5月～1998年10月17个月间药物流产共302例，其中12～16周30例，占药物流产率9．9％，年龄20～45岁，初产妇6例，经产妇24例。