降钙素原检测对新生儿败血症早期诊断治疗及病情评估的临床意义

目的：探讨降钙素原（PCT）对新生儿败血症的早期诊断及病情评估的价值。方法：将2008年7月～2010年7月我院收治的新生儿败血症55例作为研究对象,其中合并休克的20例作为重症组,其余35例作为轻症组,将同期住院非败血症新生儿40例作为对照组,用免疫色谱法对比检测新生儿败血症与其他新生儿患者在入院时及住院抗生素治疗1周后血浆PCT及C反应蛋白（CRP）浓度的变化。结果：新生儿败血症患者入院时（急性期）PCT较对照组明显升高[（15.6±7.1）μg/L vs（0.8±0.4）μg/L]（P〈0.01）],经抗生素治疗1周后下降接近正常[（1.2±1.0）μg/L],与对照组比较差异无统计学意义（P〉0.05）;PCT的敏感性、特异性（89.0%、82.4%）均高于CRP（78.2%、69.6%）;新生儿败血症PCT重症较轻症患者明显增高（P〈0.01）。结论：PCT的检测对新生儿败血症的早期诊断、病情及治疗效果的评估有一定价值。     

血清降钙素原水平检测在脓毒症患者中的临床意义

目的探讨脓毒症患者检测血清降钙素原水平的临床意义。方法收集脓毒症患者100例入脓毒症组及健康体检成年人80例为对照组,检测脓毒症组和对照组血清降钙素原水平。脓毒症患者予以Sepsis集束化治疗及乌司他丁治疗。检测治疗前及治疗后PCT、CRP水平,及APACHEⅡ评分,探讨PCT水平变化及其与APACHEⅡ评分的关系,探讨不同预后患者PCT水平的差异。结果脓毒症患者血清PCT水平明显高于对照组(P<0.01),且随着治疗进展血浆PCT水平逐渐降低(P<0.01)。死亡患者PCT水平明显高于存活患者(P<0.05)且PCT与APACHEⅡ评分呈正相关(P<0.05)。结论血浆PCT水平对脓毒症患者的诊断及严重程度评价有重要价值。     

95例脑梗死患者血小板参数检测的临床意义

目的:探讨血小板参数与脑梗死患者发病的关系。方法:Sysmex XE-2100血细胞计数仪检测PLT、PCT、MPV、PDW。结果:脑梗死组PLT减少、MPV增高,有显著差异(P<0.05或P<0.01);PCT及PDW则无显著差异(P>0.05)。经有效治疗后MPV治疗后减小(P<0.05)。结论:MPV增高是脑梗死的独立危险因素,动态观察MPV对脑梗死的疗效观察有一定的临床意义。     

Predictive value of procalcitonin, interleukin-6, and C-reactive protein for survival in postoperative patients with severe sepsis

Purpose

To prospectively evaluate the performance of procalcitonin (PCT), interleukin-6 (IL-6), and C-reactive protein (CRP) as percentage of baseline (POB) in predicting hospital survival, we studied 64 consecutive, postoperative patients with severe sepsis.

Materials and Methods

Plasma PCT, IL-6, and CRP were serially measured from day 1 (onset of sepsis) to day 14 in parallel with clinical data until day 28. Multivariate logistic regression and univariate analysis of predictive accuracy of PCT-, IL-6-, and CRP-POB were performed. Newly derived binary prediction rules were evaluated by calculating sensitivity, specificity, positive predictive value, and negative predictive value.

Results

In survivors, PCT and IL-6 significantly decreased from days 1 to 14, whereas CRP did not. In nonsurvivors, the inflammation markers mostly increased within the second week. At day 7, logistic regression analysis revealed PCT-POB as an independent determinant for survival. Especially, PCT-POB not exceeding 50% and PCT-POB not exceeding 25% with CRP-POB not exceeding 75% on day 7 indicated a favorable outcome with a positive predictive value/sensitivity of 75%/97% and 92%/67%, respectively. In comparison, pretest likelihood to survive by day 28 and observed survival rate were 60% and 67%, respectively.

Conclusions

Prediction rules of decrease in PCT-POB on day 7 in combination with CRP-POB may serve to monitor efficacy and guide duration of therapy in critically ill patients.     

福尔可定联合头孢唑林钠治疗急性支气管炎的临床研究

目的 探讨福尔可定联合头孢唑林钠治疗急性支气管炎的临床疗效.方法 选择2019年7月—2021年7月河南省人民医院收治的80例急性支气管炎患者,随机分为对照组和治疗组,每组各40例.对照组患者静脉滴注注射用头孢唑林钠,1 g/次加入生理盐水200 mL中,2次/d.在对照组的基础上,治疗组口服复方福尔可定口服溶液,10...     

血小板4项参数对慢性乙型肝炎预后的影响

目的:探讨血小板参数在慢性乙型肝炎患者预后中的意义.方法:收集我院2003年1月～2005年4月诊治的124例肝炎患者,分为3组,慢性乙型肝炎患者45例为甲组,重型肝炎早期患者42例为乙组,重型肝炎晚期患者37例为丙组.选取我院同时间段68例健康体检者为对照组.比较4组血小板4项参数血小板计数(PLT)、平均血小板体积...     

Devil's Claw-a review of the ethnobotany, phytochemistry and biological activity of Harpagophytum procumbens

Ethnopharmacological relevance

Harpagophytum procumbens subps. procumbens (Burch.) DC. ex Meisn. (Pedaliaceae) is an important traditional medicine growing in the Kalahari region of southern Africa where it is consumed as a general health tonic and for treating diverse ailments including arthritis, pain, fever, ulcers and boils.

Aim of the review

To provide a comprehensive overview of the ethnobotany, phytochemistry and biological activity of H. procumbens and possibly make recommendations for further research.

Materials and methods

Peer-reviewed articles on H. procumbens were acquired on Scopus, ScienceDirect and SciFinder, there was no specific timeline set for the search. A focus group discussion was held with different communities in Botswana to further understand ethnobotanical uses of the plant.

Results

Harpogophytum procumbens is used for a wide variety of health conditions in the form of infusions, decoctions, tinctures, powders and extracts. In addition to the common local use for arthritis and pain, other ethnomedicinal uses include dyspepsia, fever, blood diseases, urinary tract infections, postpartum pain, sprains, sores, ulcers and boils. Scientific studies revealed that H. procumbens exhibits analgesic, anti-oxidant, anti-diabetic, anti-epileptic, antimicrobial and antimalarial activities amongst others. Iridoid glycosides and phenylpropanoid glycosides have been the focus of phytochemical investigations as the biological activity has been ascribed to the iridoid glycosides (such as harpagoside and harpagide), which are common in nature and are known to possess anti-inflammatory activity. In addition, it has been shown that the hydrolysed products of harpagoside and harpagide have more pronounced anti-inflammatory activity when compared to the unhydrolysed compounds. Harpagophytum zeyheri is a close taxonomic ally of H. procumbens but H. procumbens is the favoured species of commerce, and contains higher levels of the pharmacologically active constituents. The two are used interchangeably and H. procumbens raw material is often intentionally adulterated with H. zeyheri and this may impact on the efficacy of inadequately controlled health products. The main exporter of this highly commercialised plant is Namibia. In 2009 alone, Harpagophytum exports were worth approximately €1.06 million. The high demand for health products based on this plant has led to over-harvesting, raising concerns about sustainability. Although only the secondary tubers are utilised commercially, the whole plant is often destroyed during harvesting.

Conclusions

Harpagophytum procumbens is used to treat a wide range of ailments. Some of the ethnobotanical claims have been confirmed through in vitro studies, however, when the constituents deemed to be the biologically active compounds were isolated the efficacy was lower than that of the whole extract. This necessitates the use of a different approach where all the metabolites are considered using a robust method such as spectroscopy; the phytochemical data can then be superimposed on the biological activity. Furthermore, there is a need to develop rapid and efficient quality control methods for both raw materials and products because the orthodox methods in current use are time-consuming and labour intensive.     

外周血内PCT、CRP水平对小儿急性腹泻采取抗生素治疗的指导效果评价

目的 考察外周血内降钙素原(procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)水平对小儿急性腹泻采用抗生素治疗的指导效果评价。方法 采集2016年8月～2019年12月于我院诊治的急性腹泻患儿60例,PCT与CRP联合评分≥0.52均为阳性,根据时间顺序随机分为观察组和对照组,每组30例,对照组患者不应用抗生素,观察组患者给予抗生素,比较两组患儿外周血PCT、CRP的水平及二者联合评分、明显黏液脓血便率、大便细菌阳性率及临床治疗有效率。结果 观察组和对照组患儿在外周血PCT、CRP及二者联合评分上相比,差异无统计学意义(P0.05);相比于对照组,观察组患儿的明显黏液脓血便率显著降低,差异具有统计学意义(P0.05),大便细菌阳性率相比,差异无统计学意义(P0.05);观察组患儿的临床治疗有效率显著高于对照组,差异具有统计学意义(P0.05)。结论 外周血内PCT、CRP水平对于无典型症状的小儿急性腹泻抗生素的早期应用具有指导意义,治疗效果良好。     

N-乙酰半胱氨酸雾化吸入治疗对重度AECOPD患者血液中CRP和PCT水平的临床观察

目的探讨急性加重期慢性阻塞性肺疾病(AECOPD)使用N-乙酰半胱氨酸(NAC)雾化吸入治疗的临床效果。方法 120例IV级AECOPD患者随机分为干预组和对照组各60例,治疗0天和10天后观察比较两组的生活质量评分、血气指标及第1s用力呼气容积(FEV1)占预计值%以及血中CRP和PCT水平。结果治疗10天后,两组患者生活质量评分、血气分析各指标及FEV1占预计值%均有明显好转(均P<0.05),且干预组较对照组改善更加明显,差异有统计学意义(均P<0.05)。同时还发现,治疗后AECOPD患者血中CRP和PCT水平较治疗前下降(均P<0.05),且干预组下降更明显,差异有统计学意义(均P<0.05)。结论 N-乙酰半胱氨酸雾化吸入可辅助改善AECOPD患者的临床症状和肺功能,并能减轻炎症,且不良反应较轻,可用于AECOPD的临床治疗。     

慢性阻塞性肺疾病急性加重患者血清PCT、CRP水平变化及其与FEV1%的相关性

目的探讨COPD急性加重患者（AECOPD）血清降钙素原（PCT）、C反应蛋白（CRP）水平变化及其与FEV1%预计值的相关性。方法测定40例COPD患者（急性加重期20例、稳定期20例）、正常对照组的20例健康受试者血清PCT、CRP水平,并分析COPD急性加重期PCT、CRP与第1秒用力呼气流量占预计值百分比（FEV1%）的相关性。结果 COPD急性加重患者PCT、CRP水平高于稳定期患者和对照组,差异有统计学意义（P〈0.05）。COPD稳定期患者血清PCT、CRP水平稍高于健康对照组,两者比较差异不显著（P〉0.05）。相关性分析提示COPD急性加重患者PCT、CRP水平与FEV1%呈负相关（r=-0.583,P〈0.01和r=-0.318,P〈0.05）。结论 COPD急性加重患者血清PCT、CRP处于高水平,其变化与COPD患者病情分期关系密切,可作为COPD急性加重患者存在细菌感染及程度的判断指标,能反映COPD急性加重患者肺功能的损害。