目的分析听性脑干反应(auditory brainstem response,ABR)在婴幼儿分泌性中耳炎(otitis media with effusion,OME)中的临床应用价值。方法收集2017年1月至2019年12月在驻马店市第一人民医院神经电生理室进行常规筛查ABR的2177例婴幼儿资...目的分析听性脑干反应(auditory brainstem response,ABR)在婴幼儿分泌性中耳炎(otitis media with effusion,OME)中的临床应用价值。方法收集2017年1月至2019年12月在驻马店市第一人民医院神经电生理室进行常规筛查ABR的2177例婴幼儿资料,对确诊OME的227例婴幼儿的ABR结果进行回顾性分析。结果统计数据显示,约90%的OME患儿ABR出现以波形分化良好、潜伏期显著延长(>5 sd)为特征的特异性改变;Ⅴ波阈值引出多集中在60~90 dB(88.5%),低分贝组到高分贝组对比(P<0.05)及各亚组间两两比较(P<α')差异均有统计学意义;单耳(62.1%)罹患率明显高于双耳(37.9%);以年龄进行分段,各年龄组之间患儿数量比较差异有统计学意义(P<0.05);各亚组患儿数量两两对比:7~9月龄组和1~3岁组对比,10~12月龄组和1~3岁组对比差异无统计学意义(P>α'),其他亚组对比差异均有统计学意义(P<α')。确诊OME患儿发病年龄集中在1~6月龄(82.4%),6月龄后发病显著减少;部分患儿合并感音神经性听力损失(14.5%)和中枢性脑损害(22.9%)。结论在3岁以下的婴幼儿中,ABR技术的良好应用对于婴幼儿OME的诊断,对侧别、持续时间、严重程度、是否存在合并症等的判断以及治疗方案设定具有重要意义。展开更多
The combination of high aminotransferases (hepatocellular injury) and jaundice has been reported to lead to a mortality rate of 10% to 50% for different drugs, a phenomenon known as “ Hy’s rule." However, Hy’s...The combination of high aminotransferases (hepatocellular injury) and jaundice has been reported to lead to a mortality rate of 10% to 50% for different drugs, a phenomenon known as “ Hy’s rule." However, Hy’s rule has never been validated, and limited data exist on predictors for outcome in hepatocellular and other forms of drug-induced liver disease. All reports of suspected hepatic adverse drug reactions received by the Swedish Adverse Drug Reactions Advisory Committee (1970- 2004) were reviewed. Cases with bilirubin levels 2 or more times the upper limit of normal (ULN) were analyzed. A total of 784 cases were retrieved-409 with hepatocellular injury, 206 with cholestatic injury, and 169 with mixed liver injury. The mortality/transplantation rate was 9.2% , and bilirubin (median 18.7 × ULN [IQR 12.6- 25]; range 4.5- 42) was higher (P < .0001) in the deceased/transplant recipients compared with the surviving patients (median 5.5 × ULN [IQR 3.3- 9.5]; range 2.0- 38). A total of 7.8% with cholestatic and 2.4% with a mixed pattern died. The mortality rate in hepatocellular injury for different drugs varied from 40% (6 of 15) for halothane to 0% (0 of 32) for erythromycin, in total 12.7% . Using logistic regression analysis, age, aspartate aminotransferase (AST) and bilirubin were found to independently predict death or liver transplantation in the hepatocellular group, whereas among patients with cholestatic/mixed liver injury, bilirubin was the only independent predictor. In conclusion, hepatocellular jaundice has a high but variable mortality rate, depending on the drug involved. The AST and bilirubin levels are the most important predictors of death or liver transplantation.展开更多
文摘目的分析听性脑干反应(auditory brainstem response,ABR)在婴幼儿分泌性中耳炎(otitis media with effusion,OME)中的临床应用价值。方法收集2017年1月至2019年12月在驻马店市第一人民医院神经电生理室进行常规筛查ABR的2177例婴幼儿资料,对确诊OME的227例婴幼儿的ABR结果进行回顾性分析。结果统计数据显示,约90%的OME患儿ABR出现以波形分化良好、潜伏期显著延长(>5 sd)为特征的特异性改变;Ⅴ波阈值引出多集中在60~90 dB(88.5%),低分贝组到高分贝组对比(P<0.05)及各亚组间两两比较(P<α')差异均有统计学意义;单耳(62.1%)罹患率明显高于双耳(37.9%);以年龄进行分段,各年龄组之间患儿数量比较差异有统计学意义(P<0.05);各亚组患儿数量两两对比:7~9月龄组和1~3岁组对比,10~12月龄组和1~3岁组对比差异无统计学意义(P>α'),其他亚组对比差异均有统计学意义(P<α')。确诊OME患儿发病年龄集中在1~6月龄(82.4%),6月龄后发病显著减少;部分患儿合并感音神经性听力损失(14.5%)和中枢性脑损害(22.9%)。结论在3岁以下的婴幼儿中,ABR技术的良好应用对于婴幼儿OME的诊断,对侧别、持续时间、严重程度、是否存在合并症等的判断以及治疗方案设定具有重要意义。
文摘The combination of high aminotransferases (hepatocellular injury) and jaundice has been reported to lead to a mortality rate of 10% to 50% for different drugs, a phenomenon known as “ Hy’s rule." However, Hy’s rule has never been validated, and limited data exist on predictors for outcome in hepatocellular and other forms of drug-induced liver disease. All reports of suspected hepatic adverse drug reactions received by the Swedish Adverse Drug Reactions Advisory Committee (1970- 2004) were reviewed. Cases with bilirubin levels 2 or more times the upper limit of normal (ULN) were analyzed. A total of 784 cases were retrieved-409 with hepatocellular injury, 206 with cholestatic injury, and 169 with mixed liver injury. The mortality/transplantation rate was 9.2% , and bilirubin (median 18.7 × ULN [IQR 12.6- 25]; range 4.5- 42) was higher (P < .0001) in the deceased/transplant recipients compared with the surviving patients (median 5.5 × ULN [IQR 3.3- 9.5]; range 2.0- 38). A total of 7.8% with cholestatic and 2.4% with a mixed pattern died. The mortality rate in hepatocellular injury for different drugs varied from 40% (6 of 15) for halothane to 0% (0 of 32) for erythromycin, in total 12.7% . Using logistic regression analysis, age, aspartate aminotransferase (AST) and bilirubin were found to independently predict death or liver transplantation in the hepatocellular group, whereas among patients with cholestatic/mixed liver injury, bilirubin was the only independent predictor. In conclusion, hepatocellular jaundice has a high but variable mortality rate, depending on the drug involved. The AST and bilirubin levels are the most important predictors of death or liver transplantation.
