钩端螺旋体病肺弥漫性出血型诊治进展

钩端螺旋体病(简称钩体病)肺弥漫性出血型以呼吸循环障碍为主要特征,病情危重,发展迅速,如诊断和抢救不及时,病死率高。现将近年来的诊治进展结合实践经验综述于下:     

A Study of Hemorrheologic Changes in Patients with Severe Viral Hepatitis

The study of the micro and macro-hemorrheologic changes and theflow conditions of the nail-fold microcirculation in 30 patients with severe viralhepatitis was reported.Normal individuals,and patients with acute icterichepatitis or chronic active hepatitis were employed as the controls.The changes observed in the patients with severe viral hepatitis were asfollows:The reduced viscosity of the whole blood and the plasma viscosityincreased markedly;the dispersion rate of the values of blood viscosity increasedas the clinical state of the patient became worse;and the factors increasing theblood viscosity(i.e.increase of the immuno-globulin level,prolongation of theerythrocyte electrophoretic mobility time,and increase of RBC sedimentation rate)and those decreasing the blood viscosity(i.e.decrease of hematocrit reading,fibrinogen level and platelet aggregation ratio)existed simultaneously in thepatient.The changes of the flow conditions of the nail-fold microcirculation werein close correlation with the increase of blood viscosity and the severity of thedisease.The etiology and mechanism of the above mentioned changes were discussed     

慢性感染性腹泻的治疗

感染性腹泻的原因很多,急性期或诊断明确者,治疗方向清楚,疗效较好。对原因不明的慢性感染性腹泻,则较复杂,若治疗处理不当,既达不到预期疗效,又可能继续延误病情,失去特效治疗时机,故对此类病例的治疗,一定要认真细致,全面考虑,强调以综合治疗为主。     

30例重型病毒性肝炎的血液流变学观察

本实验对30例重肝病人血液宏观和微观流变学及甲皱襞微循环流态进行了观察,并设正常人、急黄肝和慢活肝病人为对照组。重肝病人的主要变化为:全血还原粘度和血浆粘度明显增高;血液粘度值离散度随病情加重而增大;增高和降低血液粘度的因素同时存在,即免疫球蛋白增高、红细胞电泳时间延长、血沉增速,同时红细胞压积、纤维蛋白元减少、血小板聚集功能降低;甲皱襞微循环流态和流速改变与病情和血液粘度增高程度有一定平行关系。文中对上述变化的原因和机理进行了讨论。     

重型病毒性肝炎并发肝肾综合征82例分析

82例均具有重肝临床特征。81例并存1～3种其他合并症。先有肝肾综合征(HRS)再发生其他并发症者仅3例。HRS与其他并发症同时出现者12例。余66例先有其他严重并发症而后导致HRS,其中以肝性脑病、严重感染、上消化道大出血、严重电解质紊乱等为多。院内死亡73例,恶化出院8例,可见其预后恶劣。     

病毒性肝炎患者肝细胞电泳的初步探讨

微循环障碍在病毒性肝炎(简称肝炎)发病机理中的作用已受重视,肝炎的血流变学研究亦屡有报道,然而,组织细胞电泳的资料少见。为了探讨肝细胞电泳对肝炎的临床意义,我们于近两年来在进行肝穿活检时,同时检测肝细胞电泳,现将结果报道于下:     

乙型肝炎及HBsAg携带者252例观察

近年来,对乙型肝炎的预后判断、HBsAg阴转、治疗、预防等问题,国内外虽累有报道,但分岐较多。现将我院治疗的252例乙型肝炎病人随访1～7年的情况,报道如下: 资料与方法 在252例中,男200例,女52例。年龄在4～58岁之间,以20～40岁者最多,占65.4％,其中166例为住院确诊的各型乙型肝炎病人;86例为门诊观察的病人,HBsAg持续阳性半年以上,并有详细记     

重型病毒性肝炎并发肝肾综合征82例分析

重型病毒性肝炎(重肝)发生肝肾综合征(HRS),是一极其危重的并发症,病情严重,治疗困难,预后极差,为了探讨本征的有关特点,现将全军中西医结合治疗重型肝炎协作组收治研究的重肝并有HRS者82例,综合分析如下材料与方法一、资料来源:本资料由第三军医大学、302医院、南京军区肝炎协作组和第二军医大学提供,均系住院经临床和/或病理确诊的重肝病例,诊断分型按总后勤部制订的统一标准,与全国“病毒性肝炎防治方案”一致。     

Platelet Aggregation in Patients with Severe Viral Hepatitis

Platelet aggregation ratio (PAR) was assessed in 45 patients with severe viralhepatitis (SVH) with Born's method.The PAR of normal individuals,patients with acuteicteric hepatitis,and those with chronic active hepatitis were also studied to serve ascontrols.It was found that PAR decreased markedly in SVH patients,which was marked in theearly stage of SVH,more marked in the intermediate stage,and most marked in the latestage.The changes of PAR were in negative correlation with those of serum total bilirubin,and in positive correlation with those of prothrombin activity.The reduction of PAR inSVH patients might be ascribed to the defect of platelets themselves as revealed bycross-over experiments.The results of this study indicate that PAR may be useful in judging the severity ofSVH patients since the degree of PAR reduction parallels closely with the severity of liverdamage.Finally,the condition of platelets in vivo and in vitro in SVH patients werediscussed.