卡前列素氨丁三醇治疗孕产妇产后出血的临床观察

目的 观察卡前列素氨丁三醇预防孕产妇产后出血的疗效.方法 收集本院2008年1月～2011年2月收治的产后出血患者100例,随机分为两组,每组50例.对照组患者产后经宫体注射缩宫素20IU,效果欠佳者,加量静脉滴注缩宫素;治疗组患者产后同时给予缩宫素20IU和250μg卡前列素氨丁三醇,比较两组患者用药后止血时间、产后2h出血量、总有效率和不良反应的发生情况.结果 治疗组的止血时间（15.3±3.5）min与对照组（35.5±7.6）min比较明显缩短;治疗组的出血量（164.3±10.6）mL与对照组的（267.6±15.5）mL也显著减少,差异具有统计学意义（P〈0.05）.治疗组的总有效率为94.0%,而对照组为74.0%,差异有统计学意义（P〈0.05）.结论 卡前列素氨丁三醇可用于常规治疗宫缩乏力性产后出血患者疗效确切,具有安全高效等优点,不良反应少,值得临床进一步研究推广.     

Ketorolac inhibits choroidal neovascularization by suppression of retinal VEGF

We assessed the effect of topical ketorolac on laser-induced choroidal neovascularization (CNV), measured retinal PGE₂ and VEGF levels after laser treatment, and determined the effect of ketorolac on PGE₂ and VEGF production. Six laser burns were placed in eyes of rats which then received topical ketorolac 0.4% or artificial tears four times daily until sacrifice. Fluorescein angiography (FA) was performed at 2 and 3 weeks and retinal pigment epithelium-choroid-sclera flat mounts were prepared. The retina and vitreous were isolated at 1, 3, 5, 7, and 14 days after laser treatment and tested for VEGF and PGE₂. Additional animals were lasered and treated with topical ketorolac or artificial tears and tested at 3 and 7 days for retinal and vitreous VEGF and PGE_2. Ketorolac reduced CNV on FA by 27% at 2 weeks (P < 0.001) and 25% at 3 weeks (P < 0.001). Baseline retina and vitreous PGE₂ levels were 29.4 μg/g and 16.5 μg/g respectively, and reached 51.2 μg/g and 26.9 μg/g respectively, 24 h after laser treatment (P < 0.05). Retinal VEGF level was 781 pg/g 24 h after laser treatment and reached 931 pg/g by 7 days (P < 0.01). Ketorolac reduced retinal PGE₂ by 35% at 3 days (P < 0.05) and 29% at 7 days (P < 0.001) and retinal VEGF by 31% at 3 days (P = 0.10) and 19% at 7 days (P < 0.001). Topical ketorolac inhibited CNV and suppressed retinal PGE₂ and VEGF production.     

Effects of a non-steroidal (ketorolac tromethamine) and a steroidal (dexamethasone) anti-inflammatory drug on refractive state and ocular growth

Topical steroidal anti‐inflammatory drugs (SAID) and non‐steroidal anti‐inflammatory drugs (NSAID) are known to affect fluid balance. The effects of twice daily topical applications of Maxidex (dexamethasone, a SAID), Acular (ketorolac, a NSAID), and saline were examined biometrically on the development of refractive errors and eye growth in chicks raised from days 3–12 wearing either a monocular +10 D, 0 D, or –10 D lens. Biometric analysis showed that neither SAID nor NSAID nor saline affected refractive error compensation but that the anti‐inflammatory drugs affected eye growth. In chicks reared with a +10 D lens, dexamethasone induced a decrease in axial length (AL), vitreous chamber (VC) and anterior chamber (AC) depth, while ketorolac only induced a decrease in AC. In –10 D lens chicks dexamethasone again induced a decrease in AL and VC, but did not affect AC depth, whereas ketorolac only induced an increase in AC depth. Taken together, these results suggest that anti‐inflammatory drugs can induce changes in ocular size without affecting refractive state and, as such, have implications for the management of progressive myopia.     

高效液相色谱法测定酮咯酸氨丁三醇注射液的含量

目的 :建立一种用高效液相色谱法测定酮咯酸氨丁三醇注射液含量的方法。方法 :采用HypersilODS2C185 μm柱 ,甲醇 水 冰醋酸 (5 5∶4 4∶1)为流动相 ,流速约为 1.2mL·min-1,检测波长为 2 4 9nm。结果 :该方法酮咯酸氨丁三醇含量线性范围为 0 .0 96～ 0 .336g·L-1,r =0 .9999,回收率为 99.38% ,RSD为 0 .4 2 % (n =6 )。结论 :该方法简便、准确 ,能满足制剂质量标准的要求。     

卡前列素氨丁三醇注射液联合缩宫素对高危再次剖宫产出血和泌乳功能的影响

目的观察卡前列素氨丁三醇注射液(欣母沛)联合缩宫素对高危再次剖宫产出血和泌乳功能的影响。方法选择2010年1月至2012年3月高危再次剖宫产产妇60例,采用随机数字表法,将产妇随机分为试验组和对照组,每组30例。对照组给予缩宫素20 U静脉滴注+缩宫素20 U子宫肌肉注射+卡前列甲酯栓1 mg肛塞,试验组应用缩宫素20 U静脉滴注+卡前列素氨丁三醇注射液250μg子宫肌肉注射。观察两组术中、术后24 h出血量、术后24 h尿量,记录泌乳始动时间、术后48 h泌乳量评分。结果试验组术中、术后24 h出血量和泌乳始动时间分别是(378.04±44.98)mL,(157.88±28.03)mL和(29.88±6.12)h,明显少于对照组的(454.56±42.82)mL,(193.60±29.88)mL和(36.56±5.79)h(P<0.05);试验组术后24 h尿量、术后48 h泌乳量评分分别是(1 401.64±290.21)mL和(2.04±0.73)分,显著高于对照组的(1 080.92±202.29)mL和(1.56±0.77)分(P<0.05)。结论卡前列素氨丁三醇注射液联合缩宫素可明显减少高危再次剖宫产出血,改善泌乳功能。     

酮咯酸氨丁三醇对兔角膜细胞及纤连蛋白的影响

目的探讨酮咯酸氨丁三醇（Ketorolac tromethamine 0.5%, Acular,安贺拉）对培养兔角膜细胞及细胞外基质纤连蛋白（Fibronectin,FN）的影响。方法选用原代及传代兔角膜细胞,实验组加入含不同浓度酮咯酸氨丁三醇的培养液,对照组加入等量空白培养液,采用四甲基偶氮唑蓝（MTT）比色法检测其对细胞增殖的抑制,倒置相差显微镜观察其对细胞的形态学改变,并进一步采用免疫细胞化学和ELISA研究其对角膜细胞分泌FN的影响。结果酮咯酸氨丁三醇浓度为50-175μg/ml时,作用24、48、72h均抑制角膜细胞的增殖（P均〈0.05）,并呈剂量依赖性。免疫细胞化学显示对照组可见胞浆着色及胞间丝状着色,而加药组仅见胞浆少量着色。ELISA结果显示低浓度时FN含量增加,而高浓度时其含量明显减少。结论酮咯酸氨丁三醇对角膜细胞的增殖有抑制效应,呈剂量依赖性,并且高浓度时可明显减少FN的含量。酮咯酸氨丁三醇可能通过抑制角膜细胞的增殖和减少细胞外基质,从而防止屈光术后的屈光回退。     

卡前列素氨丁三醇预防剖宫产产后出血的疗效观察

目的探讨卡前列素氨丁三醇在预防剖宫产产后出血中的应用价值。方法将该院2011年7月—2012年1月收治的140例有高危产后出血因素产妇随机分成2组:治疗组70例;对照组70例。对照组患者仅给予缩宫素治疗;治疗组患者则采用缩宫素+卡前列素氨丁三醇治疗。观察两组剖宫产患者的产后出血率、术后2 h出血量、术后24 h出血量、术后24 h Hb和RBC指标下降水平及其不良反应发生情况。结果治疗组患者产后出血率、术后2 h出血量、术后24 h出血量均明显小于对照组(P0.05);治疗组患者术后24 h Hb和RBC下降值显著性低于对照组(P0.05)。结论临床上应用缩宫素+卡前列素氨丁三醇预防剖宫产产后出血的效果良好。     

缩宫素联合卡前列素氨丁三醇治疗产后出血的效果分析

目的观察缩宫素联合卡前列素氨丁三醇治疗产后出血的临床疗效。方法选取于本院分娩的80例产妇,随机分为两组;观察组40例,给予缩宫素静脉滴注联合卡前列素氨丁三醇治疗;对照组40例,仅给予缩宫素肌内注射治疗;观察两组临床疗效。结果观察组总有效率明显高于对照组,差异有统计学意义（P〈0．05）;观察组第三产程时间,产后2、24h出血量,产后出血发生率等均明显优于对照组,差异有统计学意义（P〈0．05）。结论缩宫素联合卡前列素氨丁-二醇治疗产后出血的效果显著,值得临床推广应用。     

酮咯酸氨丁三醇控释片的制备工艺研究及处方优化

目的:采用双层渗透泵技术制备酮咯酸氨丁三醇控释片,并应用Box-Behnken设计-效应面法获得优化处方.方法:以药物累积释放度为考察指标,采用单因素试验筛选片芯处方和包衣处方;选择2 h、16h药物累积释放度和0～16 h释药曲线的相关系数为优化指标,含药层聚氧乙烯(PEON10)用量、聚乙二醇(PEG-4000)用...