【目的】探讨百草枯(paraquat,PQ)中毒后发生急性呼吸窘迫综合症(acute respiratory distress syndrome,ARDS)时血管外肺水(extravacular lung water,EVLW)是否增加,及EVLW预测PQ中毒后发生ARDS及死亡的可能。【方法】该研究为单中心随...【目的】探讨百草枯(paraquat,PQ)中毒后发生急性呼吸窘迫综合症(acute respiratory distress syndrome,ARDS)时血管外肺水(extravacular lung water,EVLW)是否增加,及EVLW预测PQ中毒后发生ARDS及死亡的可能。【方法】该研究为单中心随机对照性研究,对31例急性PQ中毒患者常规给予PiCCO监测,检测组间EVLW的差异,评估EVLW是否可替代氧合指数作为ARDS的诊断标准。【结果】ARDS组同非ARDS组EVLW比较,发现12 h后ARDS组EVLW(9.45±3.61)ml/kg较非ARDS组EVLW(6.85±1.30)ml/kg有明显差异;EVLW和氧合指数吻合程度统计学意义显著;发现24 h后生存组EVLW[24 h EVLW(6.97±1.82)ml/kg,36 h EVLW 6.82±2.22)ml/kg,48 h EVLW(6.60±0.92)ml/kg,60 h EVLW(6.75±1.84)ml/kg,72 h EVLW(8.12±2.00)ml/kg,84 h EVLW(6.92±1.56)ml/kg,96 h EVLW(7.03±1.55)ml/kg,108 h EVLW(5.95±1.57)ml/kg,120 h EVLW(6.69±2.85)ml/kg,132 h EVLW(7.17±3.09)ml/kg]明显低于死亡组EVLW[24 h EVLW(12.65±3.80)ml/kg,36 h EVLW(15.37±3.79)ml/kg,48 h EVLW(16.94±5.18)ml/kg,60 h EVLW(12.90±2.95)ml/kg,72 h EVLW(13.10±0.96)ml/kg,84 h EVLW(10.26±2.65)ml/kg,96 h EVLW(12.29±1.78)ml/kg,108 h EVLW(14.27±2.63)ml/kg,120 h EVLW(15.87±4.32)ml/kg,132 h EVLW(18.72±2.27)ml/kg]。【结论】PQ中毒死亡组EVLW明显高于生存组;发生ARDS的EVLW明显高于非ARDS患者;本研究中发现ARDS组24 h EVLW即显著增高。EVLW可以代替氧合指数作为ARDS诊断标准之一。展开更多
Background It is the first multicenter clinical study in China to investigate zanamivir use among Chinese adolescents and adults with influenza-like illness （ILl） since 2009, when inhaled zanamivir （RELENZA ） was ...Background It is the first multicenter clinical study in China to investigate zanamivir use among Chinese adolescents and adults with influenza-like illness （ILl） since 2009, when inhaled zanamivir （RELENZA ） was marketed in China. Methods An uncontrolled open-label, multicentre study to evaluate the antiviral activity, and safety of inhaled zanamivir （as Rotadisk via Diskhaler device）; 10 mg administered twice daily for 5 days in subjects≥12 years old with ILl. Patients were enrolled within 48 hours of onset and followed for eight days. Patients were defined as being influenza-positive if the real-time reverse transcriptase-polymerase chain reaction real-time reverse transcriptase-polymerase chain reaction （rRT-PCR） test had positive results. Results A total of 400 patients 〉12 years old were screened from 11 centers in seven provinces from March 2010 to January 2011. Three hundred and ninety-two patients who took at least one dose of zanamivir were entered into the safety analysis. The mean age was 33.8 years and 50% were male. Cardiovascular diseases and diabetes were the most common comorbidities. All the reported adverse events, such as rash, nasal ache, muscle ache, nausea, diarrhea, headache, occurred in less than 1% of subjects. Mild sinus bradycadia or arrhythmia occurred in four subjects （1%）. Most of the adverse events were mild and did not require any change of treatment. No severe adverse events （SAE） or fatal cases were reported. Bronchospasm was found in a 38 years old woman whose symptoms disappeared after stopping zanamivir and without additional treatment. All the 61 influenza virus isolates （43 before enrollment, 18 during treatment） proved to be sensitive to zanamivir. Conclusions Zanamivir is well tolerated by Chinese adolescents and adults with ILls. There is no evidence for the emergence of drug-resistant isolates during treatment with zanamivir. （ChiCTR-TNRC-10000938）展开更多
文摘【目的】探讨百草枯(paraquat,PQ)中毒后发生急性呼吸窘迫综合症(acute respiratory distress syndrome,ARDS)时血管外肺水(extravacular lung water,EVLW)是否增加,及EVLW预测PQ中毒后发生ARDS及死亡的可能。【方法】该研究为单中心随机对照性研究,对31例急性PQ中毒患者常规给予PiCCO监测,检测组间EVLW的差异,评估EVLW是否可替代氧合指数作为ARDS的诊断标准。【结果】ARDS组同非ARDS组EVLW比较,发现12 h后ARDS组EVLW(9.45±3.61)ml/kg较非ARDS组EVLW(6.85±1.30)ml/kg有明显差异;EVLW和氧合指数吻合程度统计学意义显著;发现24 h后生存组EVLW[24 h EVLW(6.97±1.82)ml/kg,36 h EVLW 6.82±2.22)ml/kg,48 h EVLW(6.60±0.92)ml/kg,60 h EVLW(6.75±1.84)ml/kg,72 h EVLW(8.12±2.00)ml/kg,84 h EVLW(6.92±1.56)ml/kg,96 h EVLW(7.03±1.55)ml/kg,108 h EVLW(5.95±1.57)ml/kg,120 h EVLW(6.69±2.85)ml/kg,132 h EVLW(7.17±3.09)ml/kg]明显低于死亡组EVLW[24 h EVLW(12.65±3.80)ml/kg,36 h EVLW(15.37±3.79)ml/kg,48 h EVLW(16.94±5.18)ml/kg,60 h EVLW(12.90±2.95)ml/kg,72 h EVLW(13.10±0.96)ml/kg,84 h EVLW(10.26±2.65)ml/kg,96 h EVLW(12.29±1.78)ml/kg,108 h EVLW(14.27±2.63)ml/kg,120 h EVLW(15.87±4.32)ml/kg,132 h EVLW(18.72±2.27)ml/kg]。【结论】PQ中毒死亡组EVLW明显高于生存组;发生ARDS的EVLW明显高于非ARDS患者;本研究中发现ARDS组24 h EVLW即显著增高。EVLW可以代替氧合指数作为ARDS诊断标准之一。
基金This study was supported by grants from National Natural Science Foundation of China （No. 810 30032/H 19, 81070005/H0104） and Beijing Science and Technology Key Projects Foundation （No. D 101100049810002） and GlaxoSmithkline （China） Investment Co. Ltd.
文摘Background It is the first multicenter clinical study in China to investigate zanamivir use among Chinese adolescents and adults with influenza-like illness （ILl） since 2009, when inhaled zanamivir （RELENZA ） was marketed in China. Methods An uncontrolled open-label, multicentre study to evaluate the antiviral activity, and safety of inhaled zanamivir （as Rotadisk via Diskhaler device）; 10 mg administered twice daily for 5 days in subjects≥12 years old with ILl. Patients were enrolled within 48 hours of onset and followed for eight days. Patients were defined as being influenza-positive if the real-time reverse transcriptase-polymerase chain reaction real-time reverse transcriptase-polymerase chain reaction （rRT-PCR） test had positive results. Results A total of 400 patients 〉12 years old were screened from 11 centers in seven provinces from March 2010 to January 2011. Three hundred and ninety-two patients who took at least one dose of zanamivir were entered into the safety analysis. The mean age was 33.8 years and 50% were male. Cardiovascular diseases and diabetes were the most common comorbidities. All the reported adverse events, such as rash, nasal ache, muscle ache, nausea, diarrhea, headache, occurred in less than 1% of subjects. Mild sinus bradycadia or arrhythmia occurred in four subjects （1%）. Most of the adverse events were mild and did not require any change of treatment. No severe adverse events （SAE） or fatal cases were reported. Bronchospasm was found in a 38 years old woman whose symptoms disappeared after stopping zanamivir and without additional treatment. All the 61 influenza virus isolates （43 before enrollment, 18 during treatment） proved to be sensitive to zanamivir. Conclusions Zanamivir is well tolerated by Chinese adolescents and adults with ILls. There is no evidence for the emergence of drug-resistant isolates during treatment with zanamivir. （ChiCTR-TNRC-10000938）
