目的:觀察乙酰半胱氨酸注射液(NAC)治療慢性重型乙型肝炎的療效。方法:收治的慢性重型肝炎早、中期分為對照組(57例),治療組(58例),對照組給予一般支持治療、門冬氨酸鉀鎂,血漿或白蛋白等基礎治療及促肝細胞生長素100mg/d。治療組在對照組的基礎上加用乙酰半胱氨酸注射液8g/d靜脈滴注,療程30d,并于用藥前,用藥后15d,30d分別抽血查肝功,凝血酶原活動度。結果:治療組血清總膽紅素(TBil),凝血酶原活動度(PTA)的改善程度明顯優于對照組,差異有統計學意義。結論:乙酰半胱氨酸注射液能明顯降低患者血清TBil,提高PTA,對重型肝炎的治療有較好的幫助。
目的:探討甲胎蛋白(AFP)含量與慢加急性肝衰竭預后的關系,進一步了解肝衰竭患者AFP含量的變化。方法:將回顧分析的65 例慢加急性肝衰竭患者根據最后治療結果分為存活組與死亡組,分析對比兩組在不同時間AFP含量的差異,同時觀察AFP含量與總膽紅素(TBil),凝血酶原活動度(PTA)的關系。結果:65 例患者中AFP含量高于正常者53 例(81.54%),存活組不同時期的AFP含量平均值均高于死亡組,有顯著差別(Plt;0.01)。AFP含量升高(≥300 IU/mL)主要分布在血清總膽紅素lt;510 μmoL/ mL,凝血酶原活動度gt;30 %患者中,隨AFP含量升高,病死率下降。結論:慢加急性肝衰竭患者血清AFP含量升高反應了肝細胞再生活躍,提示預后良好。
方法 回顧分析從2007年1月-2009年12月收治的12例成人Still病患者的臨床資料，觀察其臨床特點。 結果 12例患者體溫均≥39.0℃，有一過性皮疹、關節疼痛，周圍血常規白細胞總數、中性粒細胞增高（白細胞≥15.0×109/L、中性粒細胞≥80%），血沉、C-反應蛋白、血清鐵蛋白增高，骨髓涂片為增生性骨髓像，其次有咽痛，肝、脾、淋巴結腫大等臨床表現。糖皮質激素是治療的主要措施。 結論 成人Still病臨床表現復雜多樣，實驗室檢查缺乏特異性，血清鐵蛋白檢測值的明顯增高有助于診斷。患者經糖皮質激素治療后預后效好。【Abstract】 Objective To observe the clinical characteristics of adult onset Still’s disease and enhance the awareness of the disease. Methods The clinical data of 12 patients with Still’s disease from January 2007 to December 2009 were retrospective analyzed. The clinical characteristics of the disease were observed. Results Twelve patients had high fever (body temperature≥39.0℃), evanescent eruption, arthralgia, increase of leucocyte and neutrophilic granulocyte (leucocyte≥15.0×109/L, neutrophilic granulocyte≥80%), blood sedimentation, and C-reactive protein, increase of serum ferritin, bone marrow smear being hyperplasticmyelogram, as well as the tumefaction of angina, liver, spleen, and lymphaden. Glucocorticoid was the main measure of the treatment. Conclusions Clinical presentation of adult Still’s disease is various with involvement of many systems with lack of specificity of the lab inspection. Obvious increase of detected value of serum ferritin attributes greatly to the diagnosis. The prognosis of the patients who have undergone glucocorticoid treatment is very good.