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长期预防性治疗结合按需治疗控制遗传性血管性水肿——2021版WAO/EAACI国际遗传性血管性水肿管理指南解读
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作者 汪慧英 郭胤仕 +1 位作者 姚我 程雷 《中华预防医学杂志》 CAS CSCD 北大核心 2024年第5期698-705,共8页
2021版世界过敏组织(WAO)/欧洲过敏与临床免疫学会(EAACI)国际遗传性血管性水肿(hereditary angioedema,HAE)管理指南主要以高质量的随机对照试验为依据,对HAE进行临床分型,就HAE的按需治疗、短期预防性治疗和长期预防性治疗药物给予分... 2021版世界过敏组织(WAO)/欧洲过敏与临床免疫学会(EAACI)国际遗传性血管性水肿(hereditary angioedema,HAE)管理指南主要以高质量的随机对照试验为依据,对HAE进行临床分型,就HAE的按需治疗、短期预防性治疗和长期预防性治疗药物给予分级推荐,并针对不同HAE患病人群提供管理策略。本文主要对HAE的短期、长期预防性治疗和按需治疗部分进行解读,并补充最新临床证据,以期为HAE的长期管理提供参考。 展开更多
关键词 遗传性血管性水肿 按需治疗 长期预防性治疗 指南
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遗传性血管性水肿诊治的“院内多学科会诊协作网联动线上线下全程管理”模式的初探
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作者 姚我 吴定钱 +6 位作者 沈颖 沈磊 李燕 葛柳雅 张松照 陈炯 汪慧英 《中华预防医学杂志》 CAS CSCD 北大核心 2024年第3期406-413,共8页
遗传性血管性水肿(hereditary angioedema,HAE)是一种常染色体显性遗传的罕见病,患病率约为50 000分之一,以反复发作、不可预测的皮肤或黏膜下水肿为临床特征,累及咽喉部可导致潜在的致命风险。其疾病的罕见性、临床表现的多样性,造成... 遗传性血管性水肿(hereditary angioedema,HAE)是一种常染色体显性遗传的罕见病,患病率约为50 000分之一,以反复发作、不可预测的皮肤或黏膜下水肿为临床特征,累及咽喉部可导致潜在的致命风险。其疾病的罕见性、临床表现的多样性,造成医务人员认识不足,导致临床的误诊误治。因此,提高医务人员对HAE的认识非常重要。本院建立以院内多学科会诊(multi-disciplinary treatment,MDT)团队、省内协作网联动、线上线下患者管理和媒体宣教交互的管理模式(“院内MDT协作网联动线上线下全程管理”),通过这种模式的推广,显著提高了浙江省HAE患者的精准诊断,缩短了诊断时间,显著降低了患者的严重喉头水肿发作急救,同时为HAE的临床诊治提供参考。 展开更多
关键词 遗传性血管性水肿 管理模式 临床路径 C1酯酶抑制物
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Sleep-related hypoxemia aggravates systematic inflammation in emphysematous rats 被引量:15
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作者 FENG Jing Ambrose An-Po Chiang +5 位作者 WU Qi CHEN Bao-yuan CUI Lin-yang LIANG Dong-chun ZHANG Ze-li yao wo 《Chinese Medical Journal》 SCIE CAS CSCD 2010年第17期2392-2399,共8页
Background Sleep disturbance is common in patients with emphysema. This study aimed to develop a novel model of sleep-related hypoxemia (SRH) in emphysema (SRHIE) with rats, and to explore the inflammatory status ... Background Sleep disturbance is common in patients with emphysema. This study aimed to develop a novel model of sleep-related hypoxemia (SRH) in emphysema (SRHIE) with rats, and to explore the inflammatory status of SRHIE in lung, liver, pancreas, carotid artery and whole blood.Methods Seventy-five male Wistar rats were assigned to 5 groups with 15 per group according to the exposure conditions. The protocols varied with the degree of hypoxia exposure and severity of pre-existing emphysema caused by cigarette smoke exposure: (1) SRH control (SRHCtrl) group, sham smoke exposure (smoke exposure, exposed to smoke of 15 cigarettes twice everyday, 16 weeks) and SRH exposure (12.5% O2, 3 hours, SRH exposure, divide total hypoxia time (1.5 hours or 3 hours) into 4 periods evenly (22.5 minutes or 45 minutes) and distribute these hypoxia periods evenly into physiological sleep time of rats identified by electroencephalogram, week 9 to week 16); (2) Emphysema control (ECtrl) group, smoke exposure and sham SRH exposure (21% O2, 3 hours); (3) Short SRH in emphysema (SRHShort) group, smoke exposure and short SRH exposure (12.5% O2, 1.5 hours); (4) Mild SRH in emphysema (SRHMild) group,smoke exposure and mild SRH exposure (15% O2, 3 hours); (5) Standard SRH in emphysema (SRHStand) group, smoke exposure and SRH exposure (12.5% O2, 3 hours). ECtrl, SRHShort, SRHMild and SRHStand groups were groups with emphysematous rats. Two days before the end of exposure, 5 rats in each group were randomly selected for arterial blood gas analysis. In the rest 10 rats in each group, we obtained blood samples and bronchoalveolar lavage fluid (BALF)for routine tests. We also obtained tissue blocks of lung, liver, pancreas, and right carotid artery for pathologic scoring and measurements of liver oxidative stress (measuring hepatic oxidative stress enzymes, superoxide dismutase (SOD) activity, catalase (CAT) activity and malondialdehyde (MDA) concentration).Results Emphysematous groups had higher mean linear intercept (MLI) and mean alveolar number (MAN) values than SRHCtrl group. MLI values in SRHStand group were the highest (ail P 〈0.05). O2Sat in SRHStand rats when SRH exposure was (83.45±1.76)%. Histological scores of lung, liver, pancreas and right carotid artery were higher in emphysematous groups than SRHCtrl group, and SRHStand group were the highest (all P 〈0.05) (SOD and CAT values were lower and MDA values were higher in groups with emphysema than without and in SRHStand group than in ECtrl group (all P 〈0.05)). MDA values were the highest in SRHStand group (all P 〈0.05). Total cellular score in BALF and White blood cell (WBC) in whole blood were the highest in SRHStand group (all P 〈0.05). Lymphocyte ratios were the highest in SRHStand group both in BALF and blood (all P 〈0.05). Red blood cell (RBC) and hemoglobin in emphysematous groups were higher than that in SRHCtrl group, and SRHStand group were higher than ECtrl group (all P 〈0.05).Conclusions With a proper novo model of SRHIE with Wistar rats, we have demonstrated SRH may aggravate the degree of emphysematous changes, polycythemia,oxidative stress and systematic inflammation. SRH and emphysema may have a synergistic action in causing systematic damages, and lymphocyte may be playing a central role in this process. Longer duration and more severe extent of SRHIE exposure also seem to result in more serious systematic damages. The mechanisms of all these concerned processes remain to be studied. 展开更多
关键词 sleep-related hypoxemia EMPHYSEMA INFLAMMATION oxidative stress bronchoalveolar lavage fluid superoxide dismutase CATALASE malondialdehyde
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