目的觀察臨床常用的免疫抑制劑對急性胰腺炎時炎癥相關(guān)性細胞因子紊亂的調(diào)節(jié)作用,并探討免疫抑制劑治療胰腺炎的效果和機理。方法實驗用雄性SD 大鼠38只, 共分6組: 正常對照組(n=6); 胰腺炎組 (n=8),采用開腹胰管注射5%?;悄懰徕c制備急性胰腺炎動物模型; 余下4組(均為n=6)在胰腺炎誘導(dǎo)成功后0.5 h按靜脈注射藥物不同分為: 5Fu治療組、甲基強的松龍治療組、環(huán)磷酰胺治療組及氨甲碟呤治療組。手術(shù)后24 h處死動物,分別檢查血中TNFα、IL1、IL6、IL10、TGFβ及胰淀粉酶和胰腺濕重。結(jié)果在急性胰腺炎時,動物血中的炎癥性細胞因子和抗炎癥細胞因子均顯著增高,在使用免疫抑制劑治療后,上述細胞因子均有不同程度下降。其血胰淀粉酶和胰腺濕重也明顯好轉(zhuǎn)。 結(jié)論免疫抑制劑可以抑制急性胰腺炎時異常增高的炎癥細胞因子和抗炎癥細胞因子。通過矯正免疫異常的方式緩解胰腺炎所致的病理生理紊亂,達到治療急性胰腺炎的目的。
【摘要】 目的 探討子宮部位異位妊娠的臨床特征和處理對策。 方法 回顧分析2002年9月-2009年9月間收治的31例子宮部位異位妊娠患者的臨床資料。 結(jié)果 31例患者中,初診確診僅8例,誤診率74.2%。除5例因難以控制的大出血行經(jīng)腹病灶清除術(shù)加子宮修補術(shù)或全子宮切除術(shù)外,其余26例患者均經(jīng)氨甲喋呤(MTX)治療加清宮術(shù)或?qū)m腔鏡下病灶清除術(shù)保守治療成功。 結(jié)論 子宮部位異位妊娠容易誤診,超聲檢查是診斷的主要方法。保守治療安全、有效,可保留生育能力。氨甲喋呤治療加清宮術(shù)可作為治療子宮部位異位妊娠的主要方法。【Abstract】 Objective To investigate the clinical characteristics and treatment of ectopic pregnancy in the uterus. Methods The clinical data of 31 patients diagnosed as ectopic pregnancy from September 2002 to September 2009 were analyzed retrospectively. Results During preliminary diagnosis, only eight patients were accurately diagnosed.The error rate of first diagnosis was 74.2%. Five patients suffered focal cleaning and uterus neoplasty or total hysterectomy due to uncontrollable bleeding.The other 26 patients were successfully cured by conservation treatment of methotrexate (MTX) combined with dilatation and curettage or clearance of focal lesion under hysteroscopy. Conclusion Misdiagnosis of ectopic pregnancy in the uterus is easy to make.The ultrasonography is the main method for the diagnosis of ectopic pregnancy in the uterus.Conservative treatment is proved to be safe and effective and can preserve the patients’ fertility. Administration of MTX combined with dilatation and curettage is an main therapeutic method in handling ectopic pregnancy in the uterus.