目的 了解沙利度胺對(duì)白塞病黏膜損害的療效。 方法 對(duì)2002年1月－2008年12月間61例白塞病患者的臨床資料進(jìn)行回顧性研究，所有納入患者均無(wú)重要內(nèi)臟器官的損害。沙利度胺治療劑量100 mg/d，治療療程12周，以后逐步減量。 結(jié)果 48例完全緩解（在治療期間無(wú)口腔及外生殖器潰瘍），但停藥后潰瘍復(fù)發(fā)。7例出現(xiàn)上下肢體麻木感，停藥后麻木感消失。 結(jié)論 沙利度胺對(duì)白塞病的口腔及外生殖器潰瘍治療有效，100 mg/d的治療劑量合適。
目的探討血液透析時(shí)用于體外循環(huán)抗凝的不同劑量低分子肝素對(duì)導(dǎo)管通暢性的影響。方法回顧性納入 2012 年 6 月—2018 年 1 月三六三醫(yī)院血液凈化室使用長(zhǎng)期導(dǎo)管作為血液透析通路的患者。根據(jù)血液透析時(shí)低分子肝素的劑量，分為<60 U/kg 組和≥60 U/kg 組，記錄并統(tǒng)計(jì)兩組的一般參數(shù)、尿激酶封管溶栓次數(shù)、出血事件、透析管路重度凝血例次及導(dǎo)管功能障礙的發(fā)生率。結(jié)果共納入病例 48 例，其中<60 U/kg 組 31 例，≥60 U/kg 組 17 例，兩組在年齡、性別占比、是否糖尿病，以及血紅蛋白、血小板、白蛋白、低密度脂蛋白膽固醇、超敏 C 反應(yīng)蛋白參數(shù)方面比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）；<60 U/kg 組和≥60 U/kg 組導(dǎo)管功能障礙發(fā)生率分別為 16.1% 和 29.4%（χ2=0.507，P=0.476），出血事件分別為 1.77 次/1 000 導(dǎo)管日和 2.81 次/1 000 導(dǎo)管日（χ2=1.500，P=0.221），差異皆無(wú)統(tǒng)計(jì)學(xué)意義；尿激酶使用次數(shù)分別為 27.89 次/1 000 導(dǎo)管日和 36.18 次/1 000 導(dǎo)管日（χ2=5.927，P=0.015），管路嚴(yán)重凝血次數(shù)分別為 6.88 次/1 000 導(dǎo)管日和 2.30 次/1 000 導(dǎo)管日（χ2=5.140，P=0.023），差異皆有統(tǒng)計(jì)學(xué)意義。結(jié)論在血液透析中使用小于 60 U/kg 的低分子肝素進(jìn)行體外抗凝時(shí)，與使用大于等于 60 U/kg 的劑量相比并不降低血液透析長(zhǎng)期導(dǎo)管的通暢率。
【摘要】 目的 探討新診斷的多發(fā)性肌炎（PM）、皮肌炎（DM）和無(wú)肌病性皮肌炎（ADM）肺部病變發(fā)生率、臨床特點(diǎn)及相關(guān)因素?！》椒ā』仡櫺苑治?008年1月—2010年7月新確診的206例PM、DM、ADM臨床表現(xiàn)、肺部影像學(xué)、肺功能、超聲心動(dòng)圖和實(shí)驗(yàn)室指標(biāo)?！〗Y(jié)果 206例患者中合并肺部病變156例，以肺間質(zhì)病變（ILD）最多見(jiàn)，占患者總數(shù)的51.46%。在性別、病程、是否吸煙方面合并ILD與無(wú)ILD患者相比差異無(wú)統(tǒng)計(jì)學(xué)意義，合并ILD患者年齡大于無(wú)ILD組。合并ILD患者呼吸困難、發(fā)熱、雷諾現(xiàn)象、關(guān)節(jié)炎或關(guān)節(jié)痛概率增加。合并ILD組白蛋白低于無(wú)ILD組，血沉和免疫球蛋白IgM高于無(wú)ILD組。急性ILD組中女性患者及出現(xiàn)雷諾現(xiàn)象的概率高于慢性組。206例患者中死亡13例，其中周?chē)头伟?例，特發(fā)性血小板減少并顱內(nèi)出血1例，嚴(yán)重肺部感染11例；死亡患者中10例伴肺間質(zhì)纖維化。合并急性ILD患者死亡率較慢性組高2倍?！〗Y(jié)論 PM、DM、ADM患者肺部病變發(fā)生率高，以ILD多見(jiàn)，發(fā)熱、年齡大、白蛋白降低、血沉升高、雷諾現(xiàn)象及關(guān)節(jié)炎或關(guān)節(jié)痛都是合并ILD的相關(guān)因素。合并急性ILD患者預(yù)后差，死亡者常合并肺部感染。【Abstract】 Objective To explore the prevalence, clinical features, and predictive factors of pulmonary involvement in newly diagnosed polymyositis (PM), dermatomyositis (DM) and amyopathic dermatomyositis (ADM), in order to carry out early diagnosis and treatment, and improve the prognosis. Methods The clinical manifestations, chest imaging, pulmonary function test, ultrasonic cardiography and laboratory results of 206 inpatients with PM, DM and ADM in West China Hospital of Sichuan University from January 2008 to July 2010 were reviewed retrospectively. Results One hundred and fifty-six out of 206 patients developed PM/DM/ADM associated lung diseases, including 106 cases (51.46%) of interstitial lung disease (ILD). There was no significant difference in gender, disease duration, and smoking or not between the ILD and non-ILD group, but patients in the ILD group were significantly older than non-ILD group. The results also showed that patients with ILD were much more likely to have symptoms of breathing difficulties, fever, Raynaud phenomenon and arthritis/arthralgia. The patients with ILD had lower level of albumin but higher levels of ESR and IgM; In the group of acute ILD, female patients and the ratio of Raynaud phenomenon were higher than those in the chronicity group. Of the 206 patients, 13 patients died, including 1 death of peripheral lung cancer, 1 of essential thrombocytopenia and intracranial hemorrhages, and 11 of severe lung infection, and 10 in these patients developed ILD. Mortality in patients with acute ILD was 2 times higher than the chronicity group. Conclusion The prevalence of lung diseases is high in patients with PM, DM and ADM. ILD is the main pulmonary involvement, and fever, older age at onset, hypoalbuminemia, higher values of blood sedimentation, Raynaud phenomenon and arthritis or arthralgia were the predictive factors for developing ILD. Patients with acute ILD have poor prognosis. Death cases often have pulmonary infections.