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乳酸及碱缺失与创伤失血性休克患者急诊输血治疗的相关性探索 被引量:2
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作者 张晓琳 苏双报 +1 位作者 施建设 吴耀建 《中国输血杂志》 CAS 2023年第6期508-511,共4页
目的探讨乳酸及碱缺失对创伤失血性休克患者有无急诊输注红细胞需求的影响。方法回顾性分析本院2019年1月—2021年12月期间126名创伤失血性休克患者,将有效救治(99例)病例根据入院24 h内有无输血结局分为未输血组(36例)与输血组(63例)... 目的探讨乳酸及碱缺失对创伤失血性休克患者有无急诊输注红细胞需求的影响。方法回顾性分析本院2019年1月—2021年12月期间126名创伤失血性休克患者,将有效救治(99例)病例根据入院24 h内有无输血结局分为未输血组(36例)与输血组(63例)。比较2组入院时乳酸(Lac)、碱缺失(BE)及血红蛋白(Hb)、血细胞比容(Hct)及24 h后血红蛋白(Hb)、血细胞比容(Hct)变化以及ICU住院天数,采用二元Logistic回归分析急诊入院时有无输血需求的危险因素,运用受试者工作曲线(ROC)分析各危险因素单独及联合指标与有无输血需求的相关性。结果未输血组入院时Lac平均水平(2.90±1.82)低于输血组(5.80±2.83)(P<0.05),而BE、Hb、Hct(-1.76±3.24,120.78±20.83,35.76±6.11)均高于输血组(-5.91±4.69,101.32±29.68,29.97±8.48)(P<0.05);入院24 h后2组Hb、Hct平均水平(92.75±16.66,78.49±15.91)、(27.62±5.24,22.60±4.74),均较入院时低(P<0.05);二元Logistic统计分析确定Lac(OR=1.74,95%CI 1.493-2.927,P<0.01)、BE(OR=0.77,95%CI 0.676-0.883,P<0.01)、Hb(OR=0.97,95%CI 0.954-0.989,P<0.01)、Hct(OR=0.90,95%CI 0.844=0.96,P<0.01)对创伤失血性休克患者有无红细胞输注需求有指导意义,且血乳酸升高是独立危险因素(P<0.05),而年龄与性别的影响不具有统计学意义(P>0.05);ROC曲线分析表明Lac及BE预测创伤失血性休克患者有无急诊输注红细胞需求AUG最大值分别为(0.875,0.766)明显优于Hb、Hct(0.692,0.682),Lac最佳阈值为3.6 mmol/L,Hb最佳阈值为106 g/L;联合四项检测指标获得AUG最大为0.910,较单独指标高。以Lac及Hb的最佳阈值作为输血指征比较预测价值,结果显示Lac预测价值优于Hb。结论Lac及BE对创伤失血性休克患者有无急诊输注红细胞需求具有一定的指导意义,二者联合Hb、Hct有助于更及时、更准确判断患者输血需求,优化急诊患者输血管理。 展开更多
关键词 创伤 失血性休克 乳酸 缺失 输血管理 急诊 血红蛋白 碱缺乏
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Progression of diethylnitrosamine-induced hepatic carcinogenesis in carnitine-depleted rats 被引量:4
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作者 Salim S Al-Rejaie Abdulaziz M Aleisa +5 位作者 Abdulaziz A Al-Yahya Saleh A Bakheet Abdulmalik Alsheikh Amal G Fatani Othman A Al-Shabanah Mohamed M Sayed-Ahmed 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第11期1373-1380,共8页
AIM:To investigate whether carnitine deficiency is a risk factor during the development of diethylnitrosamine (DENA)-induced hepatic carcinogenesis. METHODS:A total of 60 male Wistar albino rats were divided into six ... AIM:To investigate whether carnitine deficiency is a risk factor during the development of diethylnitrosamine (DENA)-induced hepatic carcinogenesis. METHODS:A total of 60 male Wistar albino rats were divided into six groups with 10 animals in each group.Rats in group 1(control group)received a single intraperitoneal(i.p.)injection of normal saline. Animals in group 2(carnitine-supplemented group) were given L-carnitine(200 mg/kg per day)in drinking water for 8 wk.Animals in group 3(carnitine-depleted group)were given D-carnitine(200 mg/kg per day)and mildronate(200 mg/kg per day)in drinking water for 8 wk.Rats in group 4(DENA group)were injected with a single dose of DENA(200 mg/kg,i.p.)and 2 wk later received a single dose of carbon tetrachloride(2 mL/kg) by gavage as 1:1 dilution in corn oil.Animals in group 5(DENA-carnitine depleted group)received the same treatment as group 3 and group 4.Rats in group 6 (DENA-carnitine supplemented group)received the same treatment as group 2 and group 4.RESULTS:Administration of DENA resulted in a significant increase in alanine transaminase(ALT), gamma-glutamyl transferase(G-GT),alkaline phosphatase(ALP),total bilirubin,thiobarbituric acid reactive substances(TBARS)and total nitrate/ nitrite(NOx)and a significant decrease in reduced glutathione(GSH),glutathione peroxidase(GSHPx), catalase(CAT)and total carnitine content in liver tissues.In the carnitine-depleted rat model,DENA induced a dramatic increase in serum ALT,G-GT,ALP and total bilirubin,as well as a progressive reduction in total carnitine content in liver tissues.Interestingly, L-carnitine supplementation resulted in a complete reversal of the increase in liver enzymes,TBARS and NOx,and a decrease in total carnitine,GSH,GSHPx, and CAT induced by DENA,compared with the control values.Histopathological examination of liver tissues confirmed the biochemical data,where L-carnitine prevented DENA-induced hepatic carcinogenesis while D-carnitine-mildronate aggravated DENA-induced hepatic damage. CONCLUSION:Data from this study suggest for the first time that:(1)carnitine deficiency is a risk factor and should be viewed as a mechanism in DENA- induced hepatic carcinogenesis;(2)oxidative stress plays an important role but is not the only cause of DENA-induced hepatic carcinogenesis;and(3) long-term L-carnitine supplementation prevents the development of DENA-induced liver cancer. 展开更多
关键词 Carnitine deficiency D-carnitine L-CARNITINE DIETHYLNITROSAMINE Hepatic carcinogenesis
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Constitutive androstane receptor agonist, TCPOBOP,attenuates steatohepatitis in the methionine choline-deficientdiet-fed mouse 被引量:3
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作者 Edwina S Baskin-Bey Akira Anan +2 位作者 Hajime Isomoto Steven F Bronk Gregory J Gores 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第42期5635-5641,共7页
AIM: To ascertain whether constitutive androstane receptor (CAR) activation by 1,4-bis-[2-(3,5,- dichloropyridyloxy)] benzene (TCPOBOP) modulates steatohepatitis in the methionine choline-deficient (MCD) diet... AIM: To ascertain whether constitutive androstane receptor (CAR) activation by 1,4-bis-[2-(3,5,- dichloropyridyloxy)] benzene (TCPOBOP) modulates steatohepatitis in the methionine choline-deficient (MCD) diet-fed animal.METHODS: C57/BL6 wild-type mice were fed the MCD or standard diet for 2 wk and were treated with either the CAR agonist, TCPOBOP, or the CAR inverse agonist, androstanol.RESULTS: Expression of CYP2B10 and CYP3A11, known CAR target genes, increased 30-fold and 45-fold, respectively, in TCPOBOP-treated mice fed the MCD diet. TCPOBOP treatment reduced hepatic steatosis (44.6 + 5.4% vs 30.4 + 4.5%, P 〈 0.05) and serum triglyceride levels (48 + 8 vs 20 + 1 mg/dL, P 〈 0.05) in MCD diet- fed mice as compared with the standard diet-fed mice. This reduction in hepatic steatosis was accompanied by an increase in enzymes involved in fatty acid microsomal co-oxidation and peroxisomal p-oxidation, namely CYP4A10, LPBE, and 3-ketoacyI-CoA thiolase. The reduction in steatosis was also accompanied by a reduction in liver cell apoptosis and inflammation. In contrast, androstanol was without effect on any of the above parameters.CONCLUSION: CAR activation stimulates induction of genes involved in fatty acid oxidation, and ameliorates hepatic steatosis, apoptosis and inflammation. 展开更多
关键词 Apoptosis CYP4A Fatty acid oxidation Inflammation
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脂质沉积性肌病一例
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作者 肖柏 吴星恒 《中华儿科杂志》 CAS CSCD 北大核心 2003年第7期556-556,共1页
关键词 脂质沉积性肌病 肌电图 体内脂质代谢异常 碱缺乏性肌病
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输血是创伤后多器官衰竭的一个独立性危机因素
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《国际外科学杂志》 1998年第1期37-37,共1页
关键词 多器官衰竭 独立性 创伤后 碱缺乏 全身炎症反应综合征 输血量 乳酸盐 危机 血小板活化因子 创伤严重度评分
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