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41.
ALBERTO Q FARIAS LUCIANA L GONÇALVES EDUARDO LR CANÇADO ANTONIO C SEGURO SILVIA B CAMPOS CLARICE P ABRANTES-LEMOS FLAIR J CARRILHO 《Journal of gastroenterology and hepatology》2006,20(1):147-152
Background and Aims: Primary biliary cirrhosis (PBC) might be complicated by osteoporosis, whose etiology remains unknown but seems to be multifactorial. Prevalence rates of 30% to 60% for distal renal tubular acidosis (DRTA) have been reported in PBC patients, generally as incomplete DRTA. Although it is undisputed that a reduced bone mineral density (BMD) is the expected outcome among patients who have been suffering from longstanding chronic metabolic acidosis, it is unclear if incomplete DRTA is also associated with metabolic bone disease in PBC patients. The present study was undertaken to compare the BMD of PBC patients with and without DRTA.
Methods: The BMD of 23 PBC patients (11 with DRTA and 12 without), all with normal clearance of creatinine, was assessed by dual energy radiograph absorptiometry. The diagnosis of DRTA was made if the urine pH was above 5.4 in all samples after the oral acid overload, showing tubular inability to acidify urine in the presence of test-induced systemic metabolic acidosis.
Results: Densitometric signs of osteoporosis were found in 82% of DRTA cases and in 83% of patients without DRTA (difference not significant). There were no significant differences in BMD measurement, T and Z scores of patients with and without DRTA.
Conclusions: The present study could not support a correlation between the presence of DRTA and the bone loss observed in PBC patients. 相似文献
Methods: The BMD of 23 PBC patients (11 with DRTA and 12 without), all with normal clearance of creatinine, was assessed by dual energy radiograph absorptiometry. The diagnosis of DRTA was made if the urine pH was above 5.4 in all samples after the oral acid overload, showing tubular inability to acidify urine in the presence of test-induced systemic metabolic acidosis.
Results: Densitometric signs of osteoporosis were found in 82% of DRTA cases and in 83% of patients without DRTA (difference not significant). There were no significant differences in BMD measurement, T and Z scores of patients with and without DRTA.
Conclusions: The present study could not support a correlation between the presence of DRTA and the bone loss observed in PBC patients. 相似文献
42.
门脉高压症患者肝脏储备功能评估的临床研究 总被引:1,自引:0,他引:1
目的 :探讨肝硬化门脉高压症患者术前肝脏储备功能的评估方法。方法 :用L ogistic多元回归法分析了 80例门脉高压症断流患者术后出现肝功能不全的相关因素 ,从中筛选与肝功不全关系最密切的危险因子。结果 :排除手术操作本身的影响后 ,术后发生肝功不全影响最大的因素依次为 :肝性脑病 ( ENC)、血浆吲哚氰绿潴留试验 ( ICGR15)及门静脉充血指数 ( PCI)等 ,而术前的血清总胆红素 ( TBIL)、白蛋白 ( A)、A/G比值、总胆汁酸( TBA)、透明质酸 ( HA)、凝血酶原时间 ( PT)、门静脉内径 ( dp)、门静脉流速 ( Vp)及门静脉流量 ( Qp)等因素 ,在多元回归中所占比例不大。结论 :综合分析术前患者临床指标和肝功能实验室检查有助于评价肝硬化患者肝储备功能 ,预测手术风险及术后转归 相似文献
43.
影响肝外伤手术死亡的危险因素分析 总被引:3,自引:1,他引:2
目的分析影响肝外伤手术死亡的危险因素,探讨其临床意义。方法根据AAST和ISS标准,回顾性分析90例肝外伤手术病例,对影响手术死亡的危险因素进行单因素比较和Logistic回归分析。结果死亡15例,其中Ⅲ级2例、Ⅳ级4例、Ⅴ级9例,总体手术死亡率17%。Ⅳ~Ⅴ级肝外伤手术方式的单因素比较提示:清创性肝切除术的相对危险度是0.73;而规则性肝切除术、肝静脉或肝后下腔静脉修补术相对危险度分别是1.32、1.52。Logistic回归分析提示:ISS分会和术中失血量是影响手术死亡率的2个独立因素。结论ISS分值、术中失出血量和手术方式是影响肝外伤手术死亡的3个重要因素,娴熟的手术技能和合理的手术方式可以减少术中出血量和降低手术死亡率。 相似文献
44.
胃癌根治术中肝动脉变异及意义 总被引:1,自引:0,他引:1
目的介绍胃癌根治术时发现肝动脉变异情况。方法回顾性分析208例胃癌根治术时遭遇的肝动脉变异情况。结果208例中发现肝动脉变异3例,术中游离时注意保留肝脏、胆囊的血供分支。结论胃癌根治术时应注意肝动脉变异可能,避免损伤邻近器官的血供。 相似文献
45.
RAMÓN BATALLER VICENTE ARROYO PERE GINÈS 《Journal of gastroenterology and hepatology》1997,12(11):723-733
Ascites is one of the earliest and most common complications of patients with cirrhosis. A typical circulatory dysfunction characterized by arterial vasodilation, high cardiac output and stimulation of vasoactive systems is commonly present in these patients and is associated with a poor prognosis. The treatment of ascites has been based on the combination of a low-sodium diet and the administration of diuretics. The reintroduction of paracentesis and the recent introduction of the transjugular intrahepatic portosystemic shunt (TIPS) are the most relevant innovations in the treatment of ascites during the past two decades, although controlled trials in large series of patients are needed to delineate whether TIPS is a safe and useful treatment for these patients. 相似文献
46.
47.
慢性HBV感染患者HBsAg亚型分析 总被引:2,自引:0,他引:2
对包括慢性肝炎、肝炎肝硬变和原发性肝癌在内的100例慢性HBV感染者作了HBsAg亚型分析。结果显示,在这组病例中adr亚型占61%,adw占33%,ayr占2%,adwr占4%。adr亚型有随年龄增长更占优势的趋向。adr和adwr亚型感染者HBsAg滴度较adw组显著增高,且e抗原阳性率亦较高。上述发现提示,具有adr和adwr亚型的HBV株可能具有较强的复制活性,不易被清除,从而导致受感染者 相似文献
48.
J. B. DILAWARI N. NAGPAL Y. K. CHAWLA U. KAUR J. VERMA H. BALI K. M. DAS S. SURI 《Journal of gastroenterology and hepatology》1993,8(2):202-205
Hepatic venous outflow tract obstruction, Budd-Chiari syndrome (BCS), leads to portal hypertension and to the development of collaterals that bypass the obstruction. Described here is a BCS patient with an unusually large transdiaphragmatic collateral between the left hepatic and left innominate veins, which decompressed the oesophageal varices. This has not been reported earlier in the literature. 相似文献
49.
Kentaro Yamashita Hiroyuki Tsukuda Yasuyo Mizukami Jun Ito Shigeo Ikuta Yoshihiro Kondo Hiroshi Kinoshita Yasunori Fujisawa Kohzoh Imai 《Journal of gastroenterology》1997,32(5):684-688
A case of hepatic infarction with portal thrombosis is reported. A 63-year-old woman with liver cirrhosis and esophageal varices
was admitted for treatment of the esophagel varices. Endoscopic variceal ligation (EVL) and endoscopic injection sclerotherapy
(EIS) were performed. Two months later, she experienced right hypochondralgia and right flank pain. Serum transaminase levels
were suddenly elevated, and computed tomography scans of the liver showed multiple small nodular lesions. Her condition worsened,
and she died of hepatic failure. Autopsy revealed splenic and portal vein thrombosis, multiple hepatic infarction, and evidence
of chronic pancreatitis. We believe that liver cirrhosis and chronic pancreatitis were the main risk factors for the portal
thrombosis, and the treatment for esophageal varices appeared to have triggered the thrombosis. The hepatic infarction was
caused by the portal thrombosis. 相似文献
50.
Takakura Yoshinobu Fujita Takuya Hashida Mitsuru Sezaki Hitoshi 《Pharmaceutical research》1990,7(4):339-346
As part of the strategy for the design of macromolecular carriers for drug targeting, the disposition characteristics of macromolecules were studied in mice bearing tumors that served as target tissues. Eight kinds of macromolecules including four polysaccharides and four proteins with different molecular weights and electric charges were used; tissue distribution and tumor localization after intravenous injection were studied. Pharmacokinetic analysis revealed that the tissue radioactivity uptake rate index calculated in terms of clearance was different among the tested compounds; especially, the urinary radioactivity excretion clearances and the total hepatic radioactivity uptake clearances varied widely. Compounds with low molecular weights (approximately 10 kD) or positive charges showed lower tumor radioactivity accumulation; radioactivity was rapidly eliminated from the plasma via rapid urinary excretion or extensive hepatic uptake, respectively. On the other hand, large and negatively charged compounds, carboxymethyl dextran, bovine serum albumin, and mouse immunoglobulin G, showed higher radioactivity accumulation in the tumor (calculated total amounts were 15.6, 10.8, and 20.8% of the dose, respectively) and prolonged retention in the circulation. These results demonstrated that the total systemic exposure rather than the uptake rate index was correlated with total tumor uptake. Molecular weight and electric charge of the macromolecules significantly affected their disposition characteristics and, consequently, determined radioactivity accumulation in the tumor. It was concluded that a drug–carrier complex designed for systemic tumor targeting should be polyanionic in nature and larger than 70,000 in molecular weight. 相似文献