急性心肌梗死PCI术后应用红细胞生成素对临床疗效影响研究

目的:探讨红细胞生成素(EPO)用于急性脑梗死PCI术后临床治疗效果。方法:将84例急性脑梗死行急诊PCI治疗的患者依照随机数字表法分为PCI组(42例)和PCI+EPO组(42例)。PCI组行PCI和常规药物治疗,PCI+EPO组在PCI组治疗方案上加用EPO治疗,比较两组术前及术后1周的心功能指标(LVESD、LVEDD、EV和AV),心肌损伤指标(Cys C、IMA)及炎症指标(CRP、IL-6、IL-10和MDC);随访6个月,比较两组心肌梗死面积、BNP含量及心血管不良事件的发生情况。结果:术前两组的各项指标间比较均无统计学差异(P>0.05);术后1周各指标有明显改变,且PCI+EPO组LVESD、LVEDD、IMA、CRP、IL-6、MDC明显低于PCI组(P<0.05),EV、AV、Cys C及IL-10明显高于PCI组(P<0.05);随访6个月,PCI+EPO组心肌梗死面积、血清BNP水平及心血管不良事件发生率均小于PCI组(P<0.05)。结论:急性心肌梗死应用PCI结合低剂量EPO多次给药治疗的安全性高,能明显的抑制机体炎症反应,减轻心肌损伤,改善心功能。

Is ERCP really necessary in case of suspected spontaneous passage of bile duct stones?

AIM:To investigate the usefulness of magnetic resonance cholangiopancreatography (MRCP) and the need for endoscopic retrograde cholangiopancreatography (ERCP) in cases of suspected spontaneous passage of stones into the common bile duct.METHODS:Thirty-six patients with gallbladder stones were clinically suspected of spontaneous passage of stones into the common bile duct because they presented with clinical symptoms such as abdominal pain and fever,and showed signs of inflammatory reaction and marked rise of hepatobiliary enzymes.These symptoms resolved and they showed normalized values of blood biochemical parameters after conservative treatment without evidence of stones in the common bile duct on MRCP.All these patients were subjected to ERCP within 3 d of MRCP to check for the presence of stones.RESULTS:No stones were detected by ERCP in any patient,confi rming the results of MRCP.CONCLUSION:When clinical symptoms improve,blood biochemical parameters have normalized,and MRCP shows there are no stones in the common bile duct,it can be considered the stone has spontaneously passed and thus ERCP is not necessary.