中风后癫痫的临床研究

本文报告３６例中风后癫痫发作的临床和ＣＴ资料。通过回顾性病历复习和随访发现，中风后癫痫的发生率占同期住院中风患者的５．２６％，以蛛网膜下腔出血和脑栓塞发生癫痫比率最高，分别为１５％和１２．５％。癫痫发作与ＣＴ所见病灶分布密切相关，皮质病灶较皮质下病灶更易发生病病。癫痫发作可发生于中风后任何时期，但早期癫痫以出血性中风多见，而迟发性癫痫则更多见于脑梗塞患者。     

乳腺癌化疗患者外周置人中心静脉导管相关上肢静脉血栓形成的临床诊疗

目的探讨乳腺癌化疗患者外周置人中心静脉导管（PICC）相关上肢静脉血栓形成的临床诊疗。方法回顾性分析北京协和医院2011至2012年938例乳腺癌化疗患者中,PICC相关有症状上肢静脉血栓形成的发生率、诊断和治疗。结果10例乳腺癌患者出现PICC相关有症状上肢静脉血栓,发生率为1．1％（10/938）,每1000个导管留置日中的血栓例数为0．11,共携带导管1035d,置管后血栓发生中位时间23．5（4～176）d,9例患者采用低分子肝素抗凝,中位抗凝时间为14（3～50）d,5例患者抗凝后继续使用导管,所有患者均无肺栓塞发生。结论PICC相关上肢静脉血栓形成在乳腺癌化疗患者中发生率低,早期诊断及治疗后,仍可取得较好的临床结局。     

恶性肿瘤并发下肢深静脉血栓形成53例临床分析

目的探讨恶性肿瘤患者并发下肢深静脉血栓（LDVT）的病因、诊断、治疗及预防措施。方法对53例恶性肿瘤并发LDVT患者的临床资料进行回顾性分析。结果 33例痊愈（62.26%）,20例有效（37.74%）,随访6个月,49例LDVT患者无复发,4例发生血栓形成后综合征（7.55%）。结论对恶性肿瘤患者应高度警惕LDVT的发生,同时应积极预防、早期诊断及实施正确治疗。     

下肢深静脉滤网置入联合血栓溶栓术后的护理体会

目的:探讨急性下肢深静脉血栓形成患者采用下肢深静脉滤网置入联合血栓溶栓术治疗中的护理措施.方法:通过对我科10例老年住院患者采取下肢深静脉滤网置入联合溶栓术的治疗,同时给予心理护理,疏导患者的紧张情绪,变换体位,抬高患肢,以利于静脉回流,降低下肢深静脉血栓并发症的发生.结果:全部病例通过积极的预防治疗和护理,未发生并发症而获痊愈.结论:对老年患者进行早期合理的治疗干预以及术后有效的护理,改善患者预后,有利于降低下肢深静脉血栓的再发生率.     

Dermatan sulphate in patients with heparin-induced thrombocytopenia

Patients with thromboembolic diseases who develop heparin-induced thrombocytopenia (HIT) type II require an alternative anticoagulation strategy. Dermatan sulphate (DS) was administered to five patients with thromboembolic diseases who developed HIT type II and showed an in vitro cross-reactivity with low molecular weight heparins. The platelet count and the extension of thrombosis were monitored during DS administration. In four of the five patients the platelet count rapidly increased after heparin was discontinued and DS started. A low platelet count persisted in the single patient with cross-reactivity to DS, up to 4 d after its discontinuation. None of the patients experienced thrombus extension, haemorrhagic side-effects or other adverse events.     

RT-PCR法测定牵拉性撕脱伤血管上E-选择素量的变化

目的：探讨牵拉性撕脱伤血管上的E－选择素的变化。方法：分级的牵拉力造成不同的血管损伤，用RT－PCR法测定损伤血管上E－选择素的量。结果：撕脱伤血管上E－选择素mRNA表达随牵拉力增加而升高。结论：内皮细胞损伤越重E－选择素的表达越明显，提示E－选择素可能与血栓形成有关。     

全髋关节置换术后深静脉血栓的预防

目的观察低分子肝素及足底静脉泵(A-V泵)系统对全髋关节置换术(THR)患者预防深静脉血栓形成(DVT)的效果。方法选择我院2004年6月～2005年6月行THR的患者40例,20例应用低分子肝素,20例间歇性应用A-V泵。全部患者于术前第1天、第3天及第7天晨测下肢髌上、髌下、踝上10cm周径,术后7d用多普勒超声仪来诊断DVT。结果两组患者术后第1天的下肢周径明显增加(P<0.05),第3天时足底静脉泵组下肢周径明显较低分子肝素组小(P<0.05),7d后两组逐渐缓解,与术前无明显差异。在低分子肝素应用组,4例发生DVT(20%),其中2例为近端血栓、2例为远端血栓;A-V泵组,1例(5%)发生DVT,为近端血栓。两组中血栓总发生率有显著性差异(P<0.05)。结论在全髋关节置换术后,A-V脉冲系统可以显著地降低深静脉血栓的发生率和血栓形成范围。     

Quantitation of thrombin-antithrombin III complexes in human blood

Abstract. Human thrombin-antithrombin III complex was generated in defibrinated plasma by activation of the intrinsic coagulation system and isolated using affinity chromatography on insolubilized heparin and gel filtration. The resulting material probably contained factor Xa-antithrombin III and factor IXa-antithrombin III as well, although no specific identification of these complexes was made. An antiserum was raised, in rabbits, against this complex and rendered specific for neoantigens by absorption with fresh human plasma in the presence of inhibitors (heparin and p-nitrophenyl-p'-guanidinoben-zoate). Further purification of the ‘specific’ antibodies was achieved by immunoabsorption on the insolubilized complex. Polystyrene particles were coated with the resultant antisera and used in an agglutination test for the determination of thrombin-antithrombin III complexes in the plasma of healthy subjects and various patients. Purified thrombin-antithrombin III complex at a concentration of 0.3-0.6 μ/ml caused a distinct agglutination of the particles, whereas purified prothrombin and antithrombin III at concentrations of 250 μg/ml did not. Coagulation of human blood resulted in a progressive generation of agglutinating activity in the serum, reaching a maximum titre of 1/320 to 1/640. Sera from patients with rheumatoid arthritis also agglutinated the particles but this activity would be removed by absorbing the rheumatoid factor on insolubilized human IgG. The thrombin-antithrombin III titre in 95% of plasma samples from fifty-six male and thirty-two female healthy subjects was less than or equal to 1/8. In nine patients with overt signs of intravascular coagulation of various origin, the thrombin-antithrombin III titres varied from 1/30 to 1/120. It is concluded that in vivo activation of the coagulation system is associated with the appearance of circulating thrombin-antithrombin III complexes which can be directly assayed in plasma on the basis of their neoantigenic expression.     

抗人活化血小板单克隆抗体在脑血栓诊断中的应用研究

利用抗人活化血小板α-颗粒膜蛋白(α-Granule Membrane Protein,GMP-140)单克隆抗体SZ-51经放射免疫法评估22例急性脑血栓患者体内血小板的活化程度。结果为血浆内GMP-140的含量在脑血栓急性期显著增高(P<0.01),缓解期恢复正常,血小板表面GMP-140分子数未见显著改变,提示血浆内GMP-140的浓度可作为脑血栓急性期体外诊断新的参考指标。当兔颈动脉植入人血栓并用~(125)I-SZ-51作为示踪剂,4h后离体血栓与血液的放射活性比值(T/B)高达6.8:1,而用~(125)I-IgG时T/B值仅为1.4:1,提示单克隆抗体SZ-51在体内能与血栓结合,为脑血栓新的体内定位诊断方法提供了一定的理论依据。