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化瘀解毒汤对脓毒血症APACHEⅡ评分、ISTH DIC评分及外周血树突状细胞表面物质表达水平的影响 被引量:9
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作者 韩冬 王雪松 +2 位作者 陈炜 昌震 黄铭 《中华中医药学刊》 CAS 北大核心 2020年第1期210-213,共4页
目的探讨化瘀解毒汤对脓毒血症患者APACHEⅡ评分、ISTH DIC评分及外周血树突状细胞表面物质表达水平的影响。方法将66例脓毒症患者随机分为对照组和化瘀解毒组,每组33例。对照组给予抗感染、补充血容量、积极治疗原发疾病、吸氧等综合治... 目的探讨化瘀解毒汤对脓毒血症患者APACHEⅡ评分、ISTH DIC评分及外周血树突状细胞表面物质表达水平的影响。方法将66例脓毒症患者随机分为对照组和化瘀解毒组,每组33例。对照组给予抗感染、补充血容量、积极治疗原发疾病、吸氧等综合治疗,化瘀解毒组在上述基础上加用化瘀解毒汤治疗,每日1剂,持续治疗2周。检测血清炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)]水平变化,应用急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)、DIC评分评估脓毒症患者病情严重程度,应用流式细胞仪分析树突状细胞相关表面分子CD80、CD83、CD86表达情况,比较临床疗效。结果与治疗前比较,两组血清IL-6、TNF-α、PCT水平均降低(P<0.01),APACHEⅡ评分、ISTH DIC评分均降低(P<0.01),CD80、CD86水平均降低(P<0.01),CD83水平无差异(P>0.05);与对照组比较,化瘀解毒组血清IL-6、TNF-α、PCT水平均较低(P<0.01),APACHEⅡ评分、ISTH DIC评分均较低(P<0.01),CD80、CD86水平均较低(P<0.01),总有效率较高(P<0.01)。结论化瘀解毒汤辅助治疗脓毒血症疗效显著,可有效降低APACHEⅡ评分、ISTH DIC评分,可能与调节外周血树突状细胞表面物质表达有关。 展开更多
关键词 脓毒症 化瘀解毒汤 APACHEⅡ评分 isth dic评分 树突状细胞功能
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Disseminated Intravascular Coagulation at Diagnosis in Acute Myeloblastic Leukaemia
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作者 Masba Uddin Chowdhury Masuda Begum +5 位作者 Md. Rafiquzzaman Khan Amin Lutful Kabir Shafiqul Islam Khushbun Nahar Layla Fahmida Ahamed Jamal Uddin Tanin 《Journal of Biosciences and Medicines》 2021年第10期124-134,共11页
<strong>Background: </strong>Disseminated Intravascular Coagulation (DIC) is a life threatening complication frequently observed in acute leukemia. Among the morphological varieties of Acute Myeloid Leukae... <strong>Background: </strong>Disseminated Intravascular Coagulation (DIC) is a life threatening complication frequently observed in acute leukemia. Among the morphological varieties of Acute Myeloid Leukaemia (AML), Acute Promyelocytic Leukaemia (APL) is well established to cause DIC. But there have been reports noted that abnormal DIC parameters also commonly observed in the patients with non-APL AML. This study evaluated the DIC parameters & DIC score according to International Society of Thrombosis and Haemostasis (ISTH) in newly diagnosed non-APL AML patients. <strong>Materials and Methods:</strong> This cross-sectional observational study was conducted in the Department of Haematology, BSMMU, Dhaka, Bangladesh. 48 newly diagnosed non-APL AML patients were enrolled. Platelets count was measured by auto analyzer (Sysmax XT 2000i/Pentra ABX-120DX) as well as checked manually. Prothrombin time, fibrinogen, D-Dimer were measured using STAGO Coagulation analyzer. The ISTH-DIC scoring system was used to calculate DIC score. The statistical analysis was carried out using the Statistical Package for Social Sciences version 24.0 for Windows. Chi-Square test & Fisher exact test was used for categorical variables. Unpaired t-test was used to compare mean between groups. For all statistical tests, p-value less than 0.05 was considered as statistically significant. <strong>Results: </strong>By analyzing 48 newly diagnosed patients with non-APL AML, found that DIC developed in 14.6% patients at presentation. Among the DIC parameters, PT and D-dimer were significantly higher in patients presented with DIC. Patients with DIC exhibit lower expression of CD117, CD34, HLA-DR and statistically significant association with negative expression of HLA-DR (p-value 0.034). No significant association was found between presence of DIC and age, gender, bleeding at presentation, morphological type, WBC count or peripheral blast percentage.<strong> Conclusion:</strong> Abnormalities of DIC parameters in common in patients with AML. A significant portion of patients with DIC have no apparent symptom or bleeding. So, routine screening of DIC parameter at presentation is recommended for early diagnosis & effective management of DIC. 展开更多
关键词 Acute Myeloblastic Leukaemia Disseminated Intravascular Coagulation isth-dic Scoring System
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相同国际血栓与止血协会评分下血栓弹力图参数在创伤大失血及脓毒症中的差异及意义 被引量:3
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作者 李晓彤 李鑫 +2 位作者 孙旖旎 李露 马晓春 《中国实用内科杂志》 CAS CSCD 北大核心 2021年第6期515-520,共6页
目的探讨在相同国际血栓与止血协会(ISTH)评分下,利用血栓弹力图(TEG)评价脓毒症及创伤大失血患者凝血状态的差异及意义。方法纳入中国医科大学附属第一医院重症医学科收治的脓毒症(247例)及创伤大失血患者(61例)共308例,在显性弥散性... 目的探讨在相同国际血栓与止血协会(ISTH)评分下,利用血栓弹力图(TEG)评价脓毒症及创伤大失血患者凝血状态的差异及意义。方法纳入中国医科大学附属第一医院重症医学科收治的脓毒症(247例)及创伤大失血患者(61例)共308例,在显性弥散性血管内凝血(DIC)(ISTH≥5分)和隐性DIC(ISTH<5分)两种情况下进行比较。比较脓毒症与创伤大失血患者的一般情况,入ICU 1、2、3 d(后称d1、d2、d3)检测患者常规凝血指标和TEG参数;同时记录患者的输血输液情况,包括输血制品类型及输注量。结果(1)隐性DIC患者中,与脓毒症患者相比,创伤大失血患者d1时K值显著增高,α角和MA值显著降低(P<0.05)。而在d2、d3时创伤大失血患者TEG结果恢复至正常,脓毒症患者TEG结果随时间变化无明显变化。(2)显性DIC患者中,创伤大失血和脓毒症患者在d1时均表现为R值、K值升高,α角及MA值降低,而在d2、d3时创伤大失血患者TEG结果恢复至正常,脓毒症患者TEG结果随时间变化无明显改善。(3)创伤大失血组输血人数较脓毒症组更多,输血量也较脓毒症组更大;经输血治疗,创伤大失血患者d2时R值、K值、Angle值、MA值较d1时明显改善(P<0.05);而脓毒症患者输血后TEG参数无明显改变(P>0.05)。结论利用TEG监测发现,创伤大失血患者的低凝状态经输血治疗后可明显改善,TEG能反映创伤大失血患者凝血功能并指导治疗;而脓毒症患者在不同ISTH评分下TEG表现存在差异,TEG对脓毒症患者凝血功能监测的临床价值尚不能确定。 展开更多
关键词 血栓弹力图 创伤 脓毒症 国际血栓与止血协会评分 弥散性血管内凝血
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