目的:观察乙酰半胱氨酸注射液(NAC)治疗慢性重型乙型肝炎的疗效。方法:收治的慢性重型肝炎早、中期分为对照组(57例),治疗组(58例),对照组给予一般支持治疗、门冬氨酸钾镁,血浆或白蛋白等基础治疗及促肝细胞生长素100mg/d。治疗组在对照组的基础上加用乙酰半胱氨酸注射液8g/d静脉滴注,疗程30d,并于用药前,用药后15d,30d分别抽血查肝功,凝血酶原活动度。结果:治疗组血清总胆红素(TBil),凝血酶原活动度(PTA)的改善程度明显优于对照组,差异有统计学意义。结论:乙酰半胱氨酸注射液能明显降低患者血清TBil,提高PTA,对重型肝炎的治疗有较好的帮助。
目的:探讨甲胎蛋白(AFP)含量与慢加急性肝衰竭预后的关系,进一步了解肝衰竭患者AFP含量的变化。方法:将回顾分析的65 例慢加急性肝衰竭患者根据最后治疗结果分为存活组与死亡组,分析对比两组在不同时间AFP含量的差异,同时观察AFP含量与总胆红素(TBil),凝血酶原活动度(PTA)的关系。结果:65 例患者中AFP含量高于正常者53 例(81.54%),存活组不同时期的AFP含量平均值均高于死亡组,有显著差别(Plt;0.01)。AFP含量升高(≥300 IU/mL)主要分布在血清总胆红素lt;510 μmoL/ mL,凝血酶原活动度gt;30 %患者中,随AFP含量升高,病死率下降。结论:慢加急性肝衰竭患者血清AFP含量升高反应了肝细胞再生活跃,提示预后良好。
方法 回顾分析从2007年1月-2009年12月收治的12例成人Still病患者的临床资料，观察其临床特点。 结果 12例患者体温均≥39.0℃，有一过性皮疹、关节疼痛，周围血常规白细胞总数、中性粒细胞增高（白细胞≥15.0×109/L、中性粒细胞≥80%），血沉、C-反应蛋白、血清铁蛋白增高，骨髓涂片为增生性骨髓像，其次有咽痛，肝、脾、淋巴结肿大等临床表现。糖皮质激素是治疗的主要措施。 结论 成人Still病临床表现复杂多样，实验室检查缺乏特异性，血清铁蛋白检测值的明显增高有助于诊断。患者经糖皮质激素治疗后预后效好。【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.