天花粉化学成分与药理活性

对天花粉的主要成分及天花粉蛋白、植物凝血素和多糖等的化学结构、药理作用的研究进行了综述。     

蛇凝血素酶对颅脑手术患者凝血功能和出血量的影响

目的 探讨蛇凝血素酶对颅脑手术患者凝血功能和出血量的影响。方法颅脑手术患者36例，随机分为治疗组和对照组各18例， 治疗组患者术前肌内注射蛇凝血素酶1 kU并静脉滴注蛇凝血素酶1 kU，对照组患者静脉注射09%氯化钠注射液4 mL。分别于手术前、手术开始后1 h、手术结束时抽取两组患者血样，测定凝血因子Ⅱ时间(PT)、活化部分凝血活酶时间(APTT)、凝血因子Ⅰ(FIB)、血小板(PLT)，观察并记录两组患者术中出血量。结果对照组患者平均术中出血量(520±160) mL， 治疗组患者平均术中出血量(435±120) mL，治疗组术中出血量明显低于对照组(P＜005)； 对照组患者术后PT 、APTT与术前比较，有明显升高，且差异有显著性(P＜005），治疗组患者术后PT、 APTT与术前比较无明显改变(P＞005)，两组患者术前、术中与术后FIB、PLT均无明显改变。结论蛇凝血素酶能有效维持颅脑手术患者凝血功能并降低术中出血量。     

Usefulness of serum des-γ-carboxy prothrombin in detection of hepatocellular carcinoma

AIM: Des-gamma-carboxy prothrombin (DCP) has been reported to be more sensitive and specific in diagnosing hepatocellular carcinoma (HCC) when compared with alpha-fetoprotein (AFP). However, its ability to identify small HCC still remains unclear. Thus, we conducted a cross-sectional case control study to evaluate whether DCP is better than AFP for differentiating HCC from nonmalignant liver disease and further evaluate the usefulness of DCP in early diagnosis of small HCC. METHODS: Serum DCP and AFP levels were determined in 127 patients. Among these patients, 32 were with non-cirrhotic chronic hepatitis, 34 were with compensated cirrhosis, and 61 were with HCC. The cut-off value for the DCP and AFP were set as 40 mAU/mL and 20 ng/mL, respectively. To compare the diagnostic value of DCP and AFP in distinguishing HCC from nonmalignant chronic liver disease, receiver operating characteristic (ROC) curves were constructed for each assay. RESULTS: The accuracy, sensitivity and specificity of DCP were higher than AFP in detecting HCC (81.9%, 77% and 86.4% vs 68.5%, 59% and 77.3%, respectively). The area under the ROC (AUROC) curves revealed that DCP had a better accuracy than AFP in diagnosis of HCC (0.85 [95%CI, 0.78-0.91] vs 0.73 [95%CI, 0.65-0.81], P = 0.013). In 39 patients with solitary HCC, the positive rates of DCP were 100% in patients with tumor size larger than 3 cm, 66.7% in patients with tumor size 2-3 cm and 50% in patients with tumor size less than 2 cm. The positive rates of AFP in patients with tumor size larger than 3 cm, 2-3 cm and less than 2 cm were 55.6%, 50%, and 33.3%, respectively. The median level of DCP in HCC patients with tumor size larger than 3 cm was significantly higher than those with tumor size 2-3 cm and those with the size of less than 2 cm. CONCLUSION: Our study indicates that DCP has a better diagnostic value than AFP in differentiating HCC from nonmalignant chronic liver disease. DCP has not only a stronger correlation with HCC than AFP in tumor size but also more effectiveness than AFP in detecting small size of HCC.     

蛇凝血素酶对颅脑手术患者出血量和凝血功能的影响

目的 探讨蛇凝血素酶对颅脑手术患者出血量和凝血功能的影响.方法 颅脑手术患者42例,随机分为治疗组和对照组每组21例.治疗组患者术前30min肌肉注射蛇凝血素酶1ku,术前15min静注蛇凝血素酶1ku;对照组患者术前15静注0.9%氯化钠注射液4ml.分别于手术前、手术开始后1h、手术结束时抽取两组患者血样,测定凝血因子酶原时间(PT),活化部分凝血活酶时间(APTT)、纤维蛋白原浓度(FIB)、血小板(PLT),观察并记录两组患者术中出血量.结果 对照组患者术中出血量平均(780 160)ml,治疗组患者平均出血量(560 135)ml,治疗组术中出血量明显低于对照组(P＜0.05).对照组患者术后PT、APTT与术前比较,有明显延长,且差异有显著性(P＜0.05).治疗组患者术后PT、APTT与术前比较,无明显改变(P＞0.05).两组患者术前、术中与术后FIB、PLT均无明显改变.结论 蛇凝血素酶能有效预防颅脑手术患者凝血功能并降低术中出血量.     

蛇凝血素酶治疗颅脑手术后渗血172例

目的 探讨蛇凝血素酶治疗颅脑手术后渗血的疗效 。方法295例患者随机分为治疗组172例和对照组123例，治疗组术前静脉注射2 kU蛇凝血素酶，皮肤切口处皮下注射蛇凝血素酶1 kU加09%氯化钠注射液30～50 mL，术中手术野外用蛇凝血素酶2 kU 加09%氯化钠注射液100 mL，术后静脉注射蛇凝血素酶2 kU·d 1；连用3 d。对照组术前、术中、术后给予常规止血药物。观察两组术后渗血情况，检测术后引流液中血红蛋白(Hb)含量。结果治疗组显效159例，有效10例，总有效率9825%；对照组显效58 例，有效36例，总有效率7642%。治疗组疗效显著优于对照组，且差异有显著性(P＜005)； 治疗组术后引流液Hb含量为(232±93) mg·L 1，对照组为(716±133) mg·L 1，治疗组显著低于对照组，两组比较，差异有极显著性(P＜001）。结论蛇凝血素酶辅助治疗颅脑手术后渗血疗效显著，作用优于常规止血药。     

简便经济的蓖麻毒素提取分离法

本文用改进的L法提取分离蓖麻毒素,得蓖麻凝血素(R_Ⅰ)、蓖麻毒素(R_Ⅱ)和杂蛋白(R_Ⅲ)三个成分。R_Ⅰ凝血性强,毒性弱;R_Ⅱ凝血性弱,而毒性很强,(小鼠致死剂量为0.25μg);R_Ⅲ无上述活性。     

槲寄生（mistletoe）提取物——植物凝血素抗肿瘤作用的遗传学机制及其应用的研究概况

在欧洲，人们广泛使用槲寄生的提取物对肿瘤患者进行辅助性治疗。而近十几年研究发现其中的植物凝血素是其抗肿瘤作用的主要成分。本文就槲寄生中提取植物凝血素的应用及其作用的遗传学机制等方面作一综述。     

急性脑梗死患者抗凝血酶原抗体变化及巴曲酶对其影响

国外众多报道,抗凝血素抗体（anti-prothrombins antibodies,IgM／IgG,或aPT1／aPT2）为血管血栓性病变进展、复发的重要检测指标之一。巴曲酶为一降纤药物,主要降解纤维蛋白,从而防治血栓形成。本研究试图探讨凝血素抗体与脑梗死发生、发展的关系及巴曲酶对其的影响,从而进一步探讨巴曲酶新的分子机制。     

Levels of plasma des-γ-carboxy protein C and prothrombin in patients with liver diseases

AIM: To study the plasma des-γ-carboxy protein C activity, antigen and prothrombin levels in patients with liver diseases and their clinical significance. METHODS: Plasma protein C activity (PC:C) was detected by chromogenic assay and antigen (PC:Ag) and des-γ-carboxy protein C (DCPC) were detected by ELISA. Total prothrombin and unabsorbed prothrombin in plasma were detected by ecarin chromogenic assay. RESULTS: Compared with the control, the levels of PC:C and PC:Ag in patients with hepatocellular carcinoma (HCC) and liver cirrhosis (LC) were lower (PCC: 104.65±23.0%,62.50±24.89%, 56.75±20.14%, PC:Ag: 5.31±1.63 μg/mL, 2.28±1.15 μg/mL, 2.43±0.79 μg/mL, P<0.05). The levels of PC:Ag in patients with acute viral hepatitis (AVH) also was lower (2.98±0.91 μg/mL, P<0.01), but PC:C was close to the control (93.76±30.49%, P>0.05). The levels of DCPC in patients with HCC were remarkably higher (0.69±0.29 μg/mL,1.18±0.63 μg/mL, 0.45±0.21 μg/mL, P<0.05) and its averagewas up to 50% of total PC:Ag. But those of DCPC in patients with AVH were not significantly different from the control. The levels of total prothrombin were lower in patients with LC, but higher in patients with HCC. The levels of unabsorbed prothrombin were predominantly higher than those of other groups. CONCLUSION: PC:C and PC:Ag in patients with liverdiseases (except PC:C in AVH) were lower. The total prothrombin was lower in patients with LC. The higher level of unabsorbed prothrombin may be used as a scanning marker for HCC. DCPC may be used as a complementary marker in the diagnosis of HCC.