牛角地黄冲剂对大鼠免疫性血小板减少模型血浆血栓素A2、前列环素I2的实验研究

观察牛角地黄冲剂对大鼠免疫性血小板减少模型血栓素A2(TXA2)、前列环素I2(PGI2)的影响.将100只SD大鼠随机分成正常对照组、模型对照组、强的松对照组、牛角地黄冲剂高剂量组、牛角地黄冲剂低剂量组.除正常组外,各组均以注射免抗大鼠血小板血清(APS)造模,分别灌药和蒸馏水,每日1次,连续11天,分别在第7天和第11天各测一半大鼠血浆血栓素B2(TXB2)、6-酮-前列腺素F1α(6-keto-PGF1α)值,并作骨髓涂片检查.结果显示强的松组6-keto-PGF1α水平明显高于正常组水平(P＜0.05)而牛角地黄冲剂高剂量组6-keto-PGF1α浓度明显高于模型组,且接近正常组水平.而各组TXB2水平改变均不显著.说明牛黄地黄冲剂有改善ITP出凝血功能低下的作用,且不改变机体生理平衡.     

静脉丙种球蛋白加地塞米松治疗小儿特发性血小板减少性紫癜临床观察及护理

目的探讨静脉丙种球蛋白(IVIG)加地塞米松治疗小儿特发性血小板减少性紫癜(ITP)的疗效及护理。方法对34例ITP患儿随机分为激素组和静脉丙种球蛋白加地塞米松组(简称丙球组)。结果丙球组出血症状改善迅速，血小板上升时间、峰值时间较激素组明显缩短，两组比较差异有显著意义。结论静脉丙种球蛋白加地塞米松治疗TIP疗效显著。     

Prevalence and treatment of chronic idiopathic thrombocytopenic purpura of childhood in Sweden

The frequency and treatment of children with chronic idiopathic thrombocytopenic purpura in Sweden were characterized using a national enquiry based on a questionnaire. Seventy-five children diagnosed as having chronic idiopathic thrombocytopenic purpura on 1 September 1993 were identified. The prevalence in children between 0.5 and 15.5 years of age was calculated to be 4.6/100 000. The median age at the time of diagnosis was 5 years and the male/female ratio was 1:1.2. Almost half of the patients (43%) were not treated at all during the disease. Steroids (43%) and intravenous immunoglobulin (25%) were most commonly used. Only two children were splenectomized.     

HELLP syndrome in a pregnant patient with a past history of splenectomy for idiopathic thrombocytopenic purpura. Case report

Case: We present a case of HELLP syndrome occuring in a patient who at the age of 8 years had undergone a splenectomy for idiopathic thrombocytopenic purpura. She was diagnosed as having HELLP syndrome 37 weeks of gestation and had a cesarean section. Received: 4 June 1996 / Accepted: 7 October 1996     

Platelet proteins as autoantibody targets in idiopathic thrombocytopenic purpura

Idiopathic thrombocytopenic purpura (ITP), caused by autoantibodies directed against certain platelet antigens, is the most common entity of the immune thrombocytopenias. ITP is an acquired disorder and can affect both children and adults. However, the clinical syndromes of ITP are distinct between children and adults. Childhood (acute) ITP characteristically is acute in onset, occurs within 1-2 weeks of an infection, usually of viral origin, resolves spontaneously within 6 months. Adult (chronic) ITP has an insidious onset and rarely resolves spontaneously. Over the last decade considerable new information has accumulated as to the pathophysiological mechanisms of immune thrombocytopenias. In addition, most of the knowledge on this disorder has been obtained from studies of adult patients with chronic ITP. The present work gives an updated overview of the platelet autoantigens and the molecular immunological reactions in ITP.     

儿童过敏性紫癜及紫癜性肾炎的凝血象及血尿D-二聚体改变

目的　探讨过敏性紫癜及紫癜性肾炎患儿体内否存在高凝状态及其严重程度。方法　使用血液凝固时间自动分析仪和胶体金免疫渗透法对 4 2例过敏性紫癜和紫癜性肾炎以及 2 0例正常对照儿童进行凝血象 (PT、TT、APTT、FIB)和血、尿D -二聚体 (D -D)测定。结果　过敏性紫癜及紫癜性肾炎患儿体内存在不同程度的高凝状态 ,4 2例患儿中TT缩短 2 0例 (4 7 6 % ) ,PT缩短 2 2例 (5 2 4 % )、APTT缩短 18例(4 2 85 % )、血FIB增高 18例 (4 2 8% )、血D -D增高 18例 (4 2 8% )、尿D -D增高 2 0例 (4 7 6 % )。而对照组无1例异常。在对照组、过敏紫癜组、紫癜性肾炎组相互比较中 χ2 >7 79,均有显著性差异。结论　患儿体内外凝血系统被激活 ,为临床上指导用药 ,判断病情提供了理论依据。     

儿童过敏性紫癜不同时期凝血功能状态检测及分析

目的　研究儿童过敏性紫癜 (HSP)发作期及缓解期凝血状态的改变情况及其机制。方法　 2 0 0 1～2 0 0 3年深圳市儿童医院收治的HSP患儿共 6 0例 ,根据发病期和缓解期的不同 ,相应分为HSP发作组 (30例 )和HSP缓解组 (30例 ) ,检测凝血酶原时间比 (PTR)、血浆D 二聚体 (D dimer)及组织因子途径抑制物 (TFPI)水平 ,并与对照组 35例健康体检儿童比较。结果　两组HSP患儿的PTR与对照组比较差异无显著性 (均P >0 0 5 ) ;HSP发作组血浆D dimer明显升高 (P <0 0 5 ) ,而HSP缓解组血浆D dimer浓度下降 ,与对照组差异无显著性(P >0 0 5 ) ;HSP发作组血浆TFPI含量高于对照组 (P <0 0 5 ) ,HSP缓解组降至正常水平 ,和对照组比较差异无显著性 (P >0 0 5 )。结论　HSP患儿发作期凝血解溶状态处于高活动状态 ,随着病情进入缓解期高凝状态可恢复正常 ;TFPI在HSP患儿发作期可能具有防止血管内凝血活动过度和扩散的重要作用。     

健脾益气方治疗慢性肾炎的临床观察

目的:观察自拟的健脾益气方治疗慢性肾小球肾炎的临床效果.方法:45例慢性肾小球肾炎患者随机分为治疗组(25例)和对照组(20例),分别采用健脾益气方、盐酸苯那普利治疗2月.结果:浮肿、乏力、腰酸等症状及体征的改善情况治疗组优于对照组:尿蛋白定性和24小时尿蛋白定量减少的程度治疗组优于对照组(P<0.05).结论:健脾益气方对慢性肾小球肾炎具有良好的治疗效果.     

中西医结合治疗激素敏感型系膜增生性肾炎疗效观察

目的评价中西医结合治疗激素敏感型系膜增生性肾炎的疗效。方法将122例呈肾病综合征表现并对强的松治疗敏感的非IgA系膜增生性肾炎患者随机分为两组,对照组按常规方法使用并撤减强的松治疗,观察组在强的松常规治疗的基础上加用中药治疗。通过观察系膜增生性肾炎的复发及强的松副作用发生情况评价中西医结合治疗系膜增生性肾炎的疗效。结果观察组系膜增生性肾炎的复发率及强的松副作用的发生率显著低于对照组(P<0.01)。结论中西医结合治疗激素敏感型系膜增生性肾炎,可以明显减少复发及明显减少强的松的副作用。