德宏州艾滋病抗病毒治疗脱失找回病人疗效及影响因素

目的了解德宏州艾滋病抗病毒治疗脱失找回病人再次入组治疗后艾滋病病毒(HIV)病毒载量(HIVRNA)抑制情况,分析其影响因素,为脱失找回病人提供治疗和管理建议。方法收集德宏州2015年6月至2017年12月脱失找回再次入组抗病毒治疗且至少有一次近期病毒载量结果的HIV感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)基本情况、脱失原因、病毒载量、随访情况、药物方案等,运用Logistic回归分析疗效及影响因素。结果 306例HIV/AIDS病人纳入分析,其中男性占72.9%(223例);传播途径为异性性传播147例(48.0%),注射吸毒传播147例(48.0%);入组平均年龄(41.5±10.2)岁,31～49岁223例(72.9%);已婚占62.7%(192例);小学及以下文化占71.2%(218例);农民占85.0%(260例);脱失原因非健康原因占79.7%(244例),504人次非健康原因中病人自身依从性的原因导致脱失占82.5%(416/504);最终本组病人中10.5%(32例)发生再次终止治疗;最近一次病毒载量结果显示222例(72.5%)病人HIV-RNA400拷贝/mL,HIV-RNA50拷贝/mL的病人比例为64.1%(196例)。Logistich回归多因素结果显示,HIV感染者、目前继续保持在治状态、接受1天1次的服药方案病毒抑制率高。结论脱失找回再次入组治疗病人仍然有望获得较高比例的HIV-RNA完全抑制,加强依从性教育,优化药物方案,选用1天1次的服药方案可以更好地保证病人的依从性,从而进一步提高治疗效果。     

慢性肺源性心脏病并发心律失常59例临床分析

心律失常是慢性肺源性心脏病(简称肺心病)的常见并发症之一。我院2000~2004年共诊治肺心病患者117例,合并心律失常者59例,现将其临床治疗分析如下。1资料与方法117例均符合全国肺心病学术会议慢性肺源性心脏病诊断标准。合并心律失常者59例中,男性40例,女性19例,年龄52-72岁,平     

70例艾滋病患儿高效抗反转录病毒治疗的临床观察

Objective To observe the treatment response and potential issues related to antiretroviral therapy (ART) in pediatric patients with acquired immunodeficiency syndrome (AIDS) and to provide a basis for revising the treatment guideline and improving the clinical practice. Methods Children eligible for ART according to the current treatment guideline were recruited from Dehong area. Enrolled patients were provided with ART and followed up for regular clinical check and laboratory tests. Results By the end of March 2009, a total of 70 children had received ART. Among them, 60 patients were treated with regimen including zidovudine (AZT)+ lamivudine (3TC)+nevirapine (NVP). Twelve, eighteen, twenty-three and nineteen patients have tested for HIV viral load after 3 month, 6 month, 12 month and 18 month treatment, respectively. Among them, 7, 12,14 and 14 patients respectively achieved HIV viral load lower than 1000 copy/mL. Average CD4+ Tlymphocyte count increased from (317.8±288.8) × 106/L at baseline to (1037.2±1086. 1) × 106/Lafter 18 month treatment. Side effects mainly occurred within the first 3 months of treatment. Nearly 50% of children had gastrointestinal symptoms. Resistance to 3TC, NVP and efavirenz (EFV) were found in five patients who have completed 12 months of treatment. Conclusions Pediatric AIDS patients show good compliance and treatment response to ART. Most side effects happen in the first 3months of treatment and the most common side effects are gastrointestinal symptoms.     

原发性肝癌肝动脉栓塞化疗术后的临床观察

目的 观察原发性肝癌选择性肝动脉栓塞化疗(TACE)术后近期的临床情况.方法 回顾分析98例患者术后的不良反应及处理.结果 98例病员术后有85例发热,89例腹痛,29例恶心、呕吐,51例肝功损伤,1例肾功损伤,11例血细胞减少.结论 TACE治疗原发性肝癌具有创伤小、安全、并发症少、化疗副作用小、恢复快等特点,是治疗原发性肝癌中晚期安全有效的方法.     

70例艾滋病患儿高效抗反转录病毒治疗的临床观察

目的 观察AIDS患儿抗病毒治疗疗效及存在的临床问题,为提高我国现行儿童AIDS规范治疗和管理水平提供依据.方法 根据我国现行儿童AIDS治疗方案,为德宏州符合条件的AIDS患儿提供抗反转录病毒治疗(ART),并定期进行临床随访观察和相关实验室检测.结果 截至2009年3月底,共有70例AIDS患儿进行抗病毒治疗,采用齐多夫定(AZT)+拉米夫定(3TC)+奈韦拉平(NVP)方案的共60例.治疗3、6、12和18个月时有12、18、23和19例患儿检测病毒载量(VL),VL≤1000拷贝/mL的分别有7、12、14和14例.CD4+T淋巴细胞计数治疗前为(317.8±288.8)×106/L,18个月时回升至(1037.2±1086.1)×106/L.不良反应多出现于治疗的前3个月,近50%患儿有不同程度的消化道反应.对治疗12个月的5例耐药患儿检测表明,均出现对3TC、NVP和依非韦伦不同程度的耐药.结论 儿童抗病毒治疗具有良好的依从性,治疗效果明显,不良反应主要发生在治疗的前3个月,以消化道反应最常见.

Abstract：

Objective To observe the treatment response and potential issues related to antiretroviral therapy (ART) in pediatric patients with acquired immunodeficiency syndrome (AIDS) and to provide a basis for revising the treatment guideline and improving the clinical practice. Methods Children eligible for ART according to the current treatment guideline were recruited from Dehong area. Enrolled patients were provided with ART and followed up for regular clinical check and laboratory tests. Results By the end of March 2009, a total of 70 children had received ART. Among them, 60 patients were treated with regimen including zidovudine (AZT)+ lamivudine (3TC)+nevirapine (NVP). Twelve, eighteen, twenty-three and nineteen patients have tested for HIV viral load after 3 month, 6 month, 12 month and 18 month treatment, respectively. Among them, 7, 12,14 and 14 patients respectively achieved HIV viral load lower than 1000 copy/mL. Average CD4+ Tlymphocyte count increased from (317.8±288.8) × 106/L at baseline to (1037.2±1086. 1) × 106/Lafter 18 month treatment. Side effects mainly occurred within the first 3 months of treatment. Nearly 50% of children had gastrointestinal symptoms. Resistance to 3TC, NVP and efavirenz (EFV) were found in five patients who have completed 12 months of treatment. Conclusions Pediatric AIDS patients show good compliance and treatment response to ART. Most side effects happen in the first 3months of treatment and the most common side effects are gastrointestinal symptoms.     

70例艾滋病患儿高效抗反转录病毒治疗的临床观察

Objective To observe the treatment response and potential issues related to antiretroviral therapy (ART) in pediatric patients with acquired immunodeficiency syndrome (AIDS) and to provide a basis for revising the treatment guideline and improving the clinical practice. Methods Children eligible for ART according to the current treatment guideline were recruited from Dehong area. Enrolled patients were provided with ART and followed up for regular clinical check and laboratory tests. Results By the end of March 2009, a total of 70 children had received ART. Among them, 60 patients were treated with regimen including zidovudine (AZT)+ lamivudine (3TC)+nevirapine (NVP). Twelve, eighteen, twenty-three and nineteen patients have tested for HIV viral load after 3 month, 6 month, 12 month and 18 month treatment, respectively. Among them, 7, 12,14 and 14 patients respectively achieved HIV viral load lower than 1000 copy/mL. Average CD4+ Tlymphocyte count increased from (317.8±288.8) × 106/L at baseline to (1037.2±1086. 1) × 106/Lafter 18 month treatment. Side effects mainly occurred within the first 3 months of treatment. Nearly 50% of children had gastrointestinal symptoms. Resistance to 3TC, NVP and efavirenz (EFV) were found in five patients who have completed 12 months of treatment. Conclusions Pediatric AIDS patients show good compliance and treatment response to ART. Most side effects happen in the first 3months of treatment and the most common side effects are gastrointestinal symptoms.     

急性安眠药中毒155例临床救治分析

本院自 1995年以来 ,已成功抢救了很多服药自杀者 ,其中以服安眠药者为最多。本文就 1995年 7月至 2 0 0 1年 6月对 15 5例口服安眠药中毒患者的抢救分析如下。1　临床资料1 1　一般资料　本组患者 15 5例 ,男 2 3例 ,女 132例。 2 5岁以下 10 5例 ,2 5～ 35岁 16例 ,35岁以上     

米力农联合单硝酸异山梨酯治疗充血性心力衰竭急性发作的疗效观察

目的观察米力农联合单硝酸异山梨酯治疗充血性心力衰竭(CHF)急性发作的临床疗效。方法选择2012年6月至2014年6月在德宏州人民医院急诊科就诊的214例充血性心力衰竭急性发作患者,随机分为研究组和对照组,每组107例。两组患者给予内科常规抗心力衰竭治疗。研究组在常规抗心力衰竭治疗的基础上加用米力农联合单硝酸异山梨酯静脉泵入。观察2组临床症状,分别于给药前、给药48 h后测定左室射血分数(LVEF)、左室舒张末期内经(LVEDD)及血浆氨基末端B型钠利尿肽前体(NT-proBNP)浓度。结果研究组患者治疗后临床症状,左心室射血分数(52.5±6.4)%较对照组(46.2±8.0)%,左室舒张末期内径(57.9±6.9)mm较对照组(62.8±7.2)mm均有明显改善,血浆NT-proBNP浓度(2215.5±539.6)pg/mL,较对照组(2643.5±38.6)pg/mL亦显著降低(P<0.05)。结论米力农联合单硝酸异山梨酯短期治疗充血性心力衰竭急性发作疗效好,不良反应少,是一种安全有效的方法。