兰索拉唑治疗十二指肠溃疡临床观察

兰索拉唑为新一代质子泵抑制剂,为了观察其近期临床疗效及对幽门螺杆菌（HP）清除率,我们自1995年以来对十二指肠溃疡50例临床治疗效果进行观察。1对象和方法1．1对象全部病例均经电子胃镜证实为活动期十二指肠溃疡,均符合下列标准（本院自定标准）;①溃疡面积≥3mm×3mm,＜20mm×20mm,除此范围不计;溃疡数目≤2个,复合溃疡和霜斑样溃疡者不列入;②治疗前2天停用一切抗溃疡药物或诱发溃疡药物;③无严重并发症,如合并幽门梗阻或大出血等;④非妊娠及哺乳妇女;⑤全部病例均有不同程度的返酸、喷气、空腹痛及夜间痛。随机分为两组…     

溃汤散治疗胃及十二指肠溃疡34例小结

１９９０年以来,笔者自拟溃疡散治疗胃及十二指肠溃疡３４例,疗效显著,兹报告如下。１　临床资料本组３４例中,男２６例,女８例;年龄最小２５岁,最大６４岁,３０岁以下３例,３１～４０岁１１例,４１～５０岁１３例,５１岁以上７例;病程最短５个月,最长２１年。全部病例,具有溃疡病典型病史、症状和体征,均经Ｘ线钡餐或纤维胃镜检查确定诊断,其中经Ｘ钱钡餐检查确诊者２１例,纤维胃镜检查诊断者１３例,全部病例中胃溃疡６例,十二指肠球部溃疡２５例,复合性溃疡３例。溃疡面最小０．３ｃｍ×０．５ｃｍ,最大１．０ｃｍ×…     

奥美拉唑加维生素K1治疗胃十二指肠溃疡出血的临床疗效

目的探究奥美拉唑加维生素K1治疗胃十二指肠溃疡出血的疗效。方法选取某院2010年5月至2014年5月收治的20例胃十二指肠溃疡出血的患者为研究对象,并对及的将其分为两组,每组10例。对照组采用西咪替丁加止血敏进行治疗,观察组采用奥美拉唑加维生素K1进行治疗,并对两组患者的治疗效果进行对比。结果观察组患者治疗的总有效率为100%,对照组患者治疗的总有效率是80%。两组总有效率存在明显差异,且差异具有统计学意义(P<0.05)。结论奥美拉唑加维生素K1对胃十二指肠溃疡出血的治疗效果显著,值得在临床上推广与使用。     

Development of ulcerative colitis during the course of rheumatoid arthritis： Association with selective IgA deficiency

A 56-year-old woman with a 29-year history of rheumatoid arthritis (RA) was admitted to the hospital, complaining of high fever, abdominal pain and severe bloody diarrhea. Colonoscopy revealed friable and edematous mucosa with spontaneous bleeding, diffuse erosions and ulcers extending from the rectum to the distal transverse colon. Histopathological findings of rectal biopsies were compatible with ulcerative colitis (UC). Being diagnosed as having severe active leftside DC, she was successfully treated with intravenous methylprednisolone followed by prednisolone and leukocytapheresis. Laboratory tests revealed low serum and saliva IgA levels, which might play a role in the development of UC. To our knowledge, this is the first case of UC occurring during the course of RA, accompanied by selective IgA deficiency.     

Effects of adacolumn selective leukocytapheresis on plasma cytokines during active disease in patients with active ulcerative colitis

AIM: To investigate the relationship between ulcerative colitis (UC) clinical activity index (CAI) and circulating levels of IL-1ra, IL-10, IL-6 and IL-18. METHODS: Blood levels of IL-lra, IL-10, IL-6 and IL-18 were measured in 31 patients with active UC, the mean CAI was 11.1, ranging from 5-25; and 12 healthy individuals as controls. Patients were given granulocyte and monocyte adsorptive apheresis (GMA) with Adacol-umn. Leucocytes which bear the FcyR and complement receptors were adsorbed to the column leucocytapher-esis carriers. Each patient could receive up to 11 GMA sessions over 8 wk. RESULTS: We found strong correlations between CAI and IL-10 (r = 0.827, P < 0.001), IL-6 (r = 0.785, P < 0.001) and IL-18 (r = 0.791, P < 0.001). IL-lra was not correlated with CAI. Following GMA therapy, 24 of the 31 patients achieved remission and the levels of all 4 cytokines fell to the levels in healthy controls. Further, blood levels of IL-lra and IL-10 increased at the column outflow and inflow at 60 min suggesting release from leucocytes that adhered to the carriers. CONCLUSION: Elevated blood levels of IL-6 and IL-18 together with peripheral blood granulocytes and mono-cytes/macrophages in patients with active UC show acti-vative behaviour and increased survival time can be pro-inflammatory and the targets of GMA therapy.     

OCTN and CARD15 gene polymorphism in Chinese patients with inflammatory bowel disease

AIM： To investigate the single nucleotide polymorphism （SNPs） distribution of NOD2/CARD15 （R702W, G908R）, OCTN1 1672CFT and OCTN2-207G/C in Chinese patients with inflammatory bowel disease （IBD）. METHODS： A total of 61 patients with Crohn＇s disease （CD）, 151 patients with ulcerative colitis （UC）, and 200 unrelated healthy controls were genotyped. Genotyping was performed by sequence specific primer polymerase chain reaction （PCR-SSP） or by restriction fragment length polymorphism （PCR-RFLP） analysis. RESULTS： Among the subjects in our study groups, including patients with CD, UC and healthy controls, none had OCTN and CARD15 variants and very rare IBD family history was found in our patients with the percentage of 0 （0/61 with CD） and 1.3% （2/151 with UC）. CONCLUSION： Our results indicate that although OCTN or CARD15 variation is associated with susceptibility to IBD in Western populations, these might be rare and may not be associated with susceptibility to IBD in Chinese patients.     

B超诊断消化性溃疡穿孔30例

我院2000-2006年对怀疑胃十二肠溃疡穿孔，而经X线平透无膈下游离气体者进行了B超检查，在诊断上获得了满意效果，报道如下。     

洛赛克治疗十二脂肠球部溃疡疗效观察

报道洛赛克加庆大霉素治疗十二脂肠溃疡４０例，近期有效率９７．５％，明显高于雷尼替丁加庆大霉素组８３．３％，经３年随访，前者复发率为４２．２９％，明显低于后组９２％，提示洛赛克可作为治疗十二脂肠溃疡的首选药。     

泮托拉唑治疗胃十指肠溃疡出血的临床观察

目的 评价泮托拉唑(富诗坦)对胃十二指肠溃疡所致上消化道出血的疗效和安全性，并与洛赛克对比。方法 选择胃十二指肠出血病人85例，泮托拉唑治疗组50例，其中胃溃疡(GU)20例，十二指肠球部溃疡(DU)30例。洛赛克对照组35例，其中GUl5例，DU20例。方法：分别用泮托拉唑或洛赛克40mg加入5％GS250ml，ivdrip(30～60min)，q12h，共5d。观察生命体征与出血情况。结果 两组出血情况差异无显著性，(P＞0．05)。治疗后3d内泮托拉唑组有40例(80％)止血，赛洛克组有30例(85．7％)止血，4～5d内止血分别为8例(16％)和4例(11．4％)，止血显效率泮托拉唑组80％，洛赛克组85．7％，总有效率两组分别为96％和97．1％。两组均未出现明显不良反应。结论 泮托拉唑是治疗胃十二指肠溃疡出血安全、有效的药物。