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预防性输入血小板的剂量和出血的预防

中国全科医学 2010年第31期13卷 3543-3543页

作者： Sherrill J.Slichter Richard M.Kaufman Susan F.assmann 周淑新(译) 不详中国石油中心医院

背景我们对再生障碍性贫血患者预防性输入血小板进行试验,用以评价血小板剂量对出血的影响。方法我们将患血癌或实体瘤做过造血干细胞移植或化疗的住院患者随机分组,当患者晨间血小板计数≤10000/mm3时,分别输入小剂量、中剂量或大剂量... 详细信息

背景我们对再生障碍性贫血患者预防性输入血小板进行试验,用以评价血小板剂量对出血的影响。方法我们将患血癌或实体瘤做过造血干细胞移植或化疗的住院患者随机分组,当患者晨间血小板计数≤10000/mm3时,分别输入小剂量、中剂量或大剂量血小板(1.1×1011,2.2×1011,或4.4×1011血小板/m2体表面积)。每天做临床出血征评估。主要终点为≥2级(基于WHO标准)出血。结果其中有1272例患者至少接受了1次血小板输入,小剂量、中剂量和大剂量组所观察到的主要终点分别为71%、69%和70%(无显著差异)。较高级别出血和其他负性事件发生率3组相似。输入血小板中位数,小剂量组(9.25×1011)明显低于中剂量组(11.25×1011)或大剂量组(19.63×1011)(小剂量组与中剂量组相比,P=0.002;大剂量组与小剂量组相比,大剂量组和中剂量组相比,P<0.001),但低剂量组血小板输入中位次数明显要多(5次对中剂量组3次和大剂量组3次;小剂量组与中剂量组相比和小剂量与大剂量组相比,P<0.001)。研究期间,晨间血小板计数为≤5000/mm3出血发生率为25%,若血小板计数在6000～80000/mm3,出血发生率17%(P<0.001)。结论预防性输入小剂量血小板可减少每例患者血小板的输入数目,但增加了输入次数。当剂量在1.1×1011～4.4×1011血小板/m2时,预防性输入并不影响出血率。

关键词：血小板计数临床出血预防性小剂量 WONCA 论文摘要再生障碍性贫血患者造血干细胞移植

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血小板输注：预防出血的量效分析

中国处方药 2010年第3期9卷 61-61页

作者： Slichter SJ Kaufman RM assmann SF

本研究评价再生障碍性贫血患者使用血小板输注预防出血的有效剂量。将即将进行造血干细胞移植的血液肿瘤和实体肿瘤患者随机分组，当清晨血小板计数≤10000／mm^3时，给予低、中、高剂量血小板输注（按体表面积：1.1×10^11／mm^2，2．2... 详细信息

本研究评价再生障碍性贫血患者使用血小板输注预防出血的有效剂量。将即将进行造血干细胞移植的血液肿瘤和实体肿瘤患者随机分组，当清晨血小板计数≤10000／mm^3时，给予低、中、高剂量血小板输注（按体表面积：1.1×10^11／mm^2，2．2×10^11／mm^2或4．4×10^11／mm^2），评估每日出血情况。主要观察终点为2级或以上出血（WHO）。

关键词：血小板输注量效分析出血预防再生障碍性贫血患者造血干细胞移植血小板计数有效剂量

PROCAM研究中动脉脉压作为冠心病风险预测因素的意义

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世界核心医学期刊文摘(心脏病学分册) 2006年第3期 53-53页

作者： assmann G. Cullen P. Evers T. 马超 Institute of Clinical Chemistry and Laboratory Medicine University of Münster Albert-Schweitzer-Strafle 33 48149 Münster Germany

Aims: To investigate pulse pressure(PP) as an independent predictor of coronary heart disease(CHD) risk. Methods and results: On the basis of a 10-year follow-up of 5389 men aged 35-65 at recruitment into PROCAM, we used a proportional hazards model to calculate the effect of systolic blood pressure(SBP), diastolic blood pressure(DBP), and PP on CHD risk after correcting for age, high-density lipoprotein cholesterol, LDL cholesterol, triglycerides, smoking, diabetes, and family history of premature CHD. Increases of 10 mmHg in DBP, SBP, and PP were associated with an increased CHD hazard ratio(HR) of ～ 10% . When the group was divided into the age groups59 years, this relationship was seen in the age group 50-59 years for DBP, SBP, and PP and in men aged ≥ 60 for PP only(25% increase in HR). Overall, CHD risk in men with PP ≥ 70 mmHg was more three times that of men with PP60 years, and was also present in men who were normotensive at recruitment(SBP ≤ 160 mmHg, DBP ≤ 95 mmHg). Conclusion: In older European men, increased PP is an important independent determinant of coronary risk, even among those initially considered normotensive.

关键词：脉压冠心病冠状动脉病预测因素

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用伊洛前列素治疗难治性肢端溃疡(德语)

世界核心医学期刊文摘（皮肤病学分册） 2005年第5期1卷 33-33页

作者： Von Schmiedeberg S. Artik S. assmann T. T. Ruzicka 罗素菊冯义国 Hautklinik Un iv. Klin. usseldorf Mooren-D¨stra.e 5 40225Düusseldorf Germany

Patientswithsystemicsclerosis(SSc)developoftenacralulcers which are resistant to therapy and may result in gangrene and amputation. We investigated the effect s of iloprost infusion on the acral ulcers and necrosis in patients with five pa tients with SSc and one with mixed connective tissue disease who had been previo usly treated with various modalities without improvement. All patients had Rayna ud phenomenon, acral ulcers and necrosis. Iloprost 25 μg per day was administer ed intravenously daily over six hours for ten consecutive days. Eight weeks late r all patients were treated with a second iloprost therapy cycle for five days. Two patients with severe ulceration received a third cycle until remission occur red. In all cases acral ulcers hea led com pletely and no patient relapsed durin g an observation period of 6 months.

关键词：伊洛前列素肢端系统性硬化症皮损消退雷诺现象静脉滴注

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