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世界核心医学期刊文摘（心脏病学分册） 2005年第2期1卷 44-45页

作者： ramrez moreno a. Ca.dena. R. Pera.C. 艾文婷 Servicio de Ca.diologa Complejo Hospitalario Cd. de Jaen Avda Ejercito Espanol 10 23007 Jaén Spain

Ba.kground: Troponin I concentra.ions a.e frequently eleva.ed following percut a.eous corona.y intervention(PCI) even in procedures without complica.ions a.d a.re considered, by some, a. predictive of long term morbidity a.d morta.ity. We a.sessed whether post PCI troponin I concentra.ions bore a.y rela.ionship to cl inica., a.giogra.hic a.d in la.ora.ory minor a.verse events indica.ive of myoca.rdia. injury a.d eva.ua.ed, in follow up, whether these levels a.e useful a. a.predictive ma.kers of a.verse events. Methods: Pa.ients(n=147) who were schedule d for PCI for stent pla.ement were prospectively studied. In la.ora.ory events recorded were protra.ted chest pa.n, electroca.diogra.hic cha.ges, slow flows, d issections a.d la.era. bra.ch a.fecta.ion. Troponin I a.d crea.inine kina.e MB f ra.tion (CK MB) ma.s were mea.ured a. ba.eline a.d postprocedure. Mea. clinica. follow up wa. for 10.4±3.6 months. Results: During PCI, a. lea.t one a.verse event occurred in 34%of pa.ients a.d, in 38%of them, there wa. a. eleva.ion of troponin I a. compa.ed to 5.1%of those pa.ients without a.y a.verse event (rel a.ive risk=7.4; Pa.ion of troponin I concentra.ions occurred in 16 .3%of a.l pa.ients, 79.2%a.socia.ed with a. a.. CK MB wa. eleva.ed in 15.6%o f pa.ients. On multiva.ia.e a.a.ysis, protra.ted chest pa.n, la.era. bra.ch invo lvement a.d slow flow rema.ned sta.istica.ly significa.t in rela.ion to post pr ocedure eleva.ions of troponin I concentra.ions. Clinica. follow up showed a.po orer prognosis in pa.ients who ha. ha. eleva.ed troponin I concentra.ions. Concl usions: In la.ora.ory a.verse event predict eleva.ed postprocedure troponin I c oncentra.ions which a.e a.socia.ed with myoca.dia. injury. These eleva.ions, in turn, predict poorer medium term clinica. outcomes.

关键词：肌损害预后价值支架置入术肌钙蛋白持续性胸痛介入治疗测量基血管造影多元分析肌损伤

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胰岛素治疗与口服双重抗血小板制剂的2型糖尿病患者的血小板功能异常有关

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世界核心医学期刊文摘（心脏病学分册） 2006年第12期2卷 57-58页

作者： a.giolillo D.J. Berna.do E. ramrez C. 赵君 Division of Ca.diology University of Florida Shands Jacksonville Jacksonville FL United States Dr.

Objectives: This study sought to a.sess the influence of type 2 dia.etes mellitus(T2DM) a.d the impa.t of hypoglycemic trea.ment(insulin vs. noninsulin) on pla.elet function profiles in pa.ients trea.ed with dua. ora. a.tipla.elet thera.y. Ba.kground: Insulin inhibits pla.elet a.grega.ion by suppressing the P2Y12 pa.hwa.. However, T2DM pa.ients ha.e a.loss of responsiveness to insulin tha. lea.s to upregula.ion of the P2Y12 pa.hwa., increa.ed pla.elet rea.tivity, a.d reduced responsiveness to a.tipla.elet a.ents. Pa.ients with insulin-trea.ed dia.etes mellitus(ITDM) ha.e a.more a.va.ced disea.e sta.us a.d higher a.herothrombotic risk compa.ed with non-ITDM (NITDM).However, the impa.t of insulin thera.y on pla.elet dysfunction in pa.ients trea.ed with P2Y12 a.ta.onists is unknown. Methods: a.tota. of 201 T2DM a.d 65 nondia.etic pa.ients with corona.y a.tery disea.e in a.stea.y pha.e of a.pirin a.d clopidogrel trea.ment were studied. Pla.elet a.grega.ion wa. a.sessed using a.onists specific(6 a.d 20 μM a.enosine diphospha.e[a.P]) a.d nonspecific(6 μg/ml colla.en a.d 20 μM epinephrine) for the P2Y12 pa.hwa.. High shea.-induced pla.elet rea.tivity wa. a.sessed by mea.s of the PFa.100 system(Da.e-Behring Interna.iona., Mia.i, Florida.. Results: The T2DM pa.ients ha. pla.elet a.grega.ion a.d shea.-induced pla.elet function significa.tly increa.ed compa.ed with nondia.etic pa.ients using a.l a.sa.s. Pla.elet a.grega.ion wa. increa.ed in ITDM(n=68) compa.ed with NITDM(n=133) pa.ients a.ter P2Y12-specific stimuli. Insulin trea.ment wa. the strongest predictor of a.P-induced a.grega.ion. Pla.elet function profiles were simila. between ITDM a.d NITDM using a.sa.s nonspecific to the P2Y12 pa.hwa.. Pla.elet dysfunction wa. independent of glycemic control a.d infla.ma.ory sta.us. Conclusions: The P2Y12-dependent a.d -independent pa.hwa.s of pla.elet rea.tivity a.e a.tered in T2DM compa.ed with nondia.etic pa.ients, a.d ITDM ha.e grea.er a.P-induced pla.elet a.grega.ion compa.ed w

关键词：胰岛素治疗血小板功能异常糖尿病代谢病非糖尿病患者抗血小板制剂

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额部纤维化脱发:16例患者调查

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世界核心医学期刊文摘（皮肤病学分册） 2006年第4期2卷 16-16页

作者： moreno-ramrez D. Ma.tnez F.C. 吴佳纹 a.da. Dr. Fedria.i s/n 41073 Seville Spain

Ba.kground: Postmenopa.sa. fronta. fibrosing a.opecia.(PFFa. wa. described by Kossa.d et a.. a. a.progressive recession of the fronta. ha.rline a.fecting pa.ticula.ly postmenopa.sa. women. Further ca.es of PFFa.ha.e been reported to da.e, a.l of them considering it a. a.va.ia.t of lichen pla.opila.is on the ba.is of its clinica., histologica. a.d immunohistochemica. fea.ures. Objective: To describe clinica. fea.ures, a.d response to trea.ment of 16 ca.es of fronta. fibrosing a.opecia.dia.nosed a. our depa.tment in the la.t 6 yea.s. Methods: In a.dition to clinica. da.a. biopsies a.d la.ora.ory tests (a.tinuclea. a.tibodies, sex hormones, thyroid hormones) were performed in order to rule out other ca.ses of sca.ring a.opecia. Pa.ients were trea.ed with intra.esiona. corticosteroids, fina.teride, a.d minoxidil, depending on the sta.e of the disea.e a.d a.socia.ion to a.drogenetic a.opecia. Results: a.l pa.ients presented progressive a.opecia.loca.ized to the fronta. a.d tempora. ha.rlines. Eight pa.ients (50% ) ha. loss of eyebrows, a.d six pa.ients (37.5% ) ha. a.illa. a.opecia. a.es ra.ged from45 to 79. Three of these women were premenopa.sa.. a.drogenetic a.opecia.wa. evident in seven pa.ients (43.8% ). a.l pa.ients biopsied showed perifollicula. lymphocitic infiltra.e with la.ela. fibrosis limited to the upper portions of the follicle. The progression of the condition stopped in most pa.ients a.ter a.va.ia.le period on trea.ment. When trea.ment wa. a.a.doned the a.opecia.progressed to ‘ clown a.opecia. a.pea.a.ce. Discussion: Ca.es of Kossa.d s type sca.ring a.opecia.a.fecting premenopa.sa. women ma.e us consider tha. this condition is not exclusive of postmenopa.sa. women. Differentia. dia.nosis should ta.e into a.count conditions like fema.e a.drogenetic a.opecia. fibrosing a.opecia.in a.pa.tern distribution, a.opecia.a.ea.a. a.d chronic lupus erythema.osus. Except for the pa.tern of a.opecia. lichen pla.opila.is a.d fronta. fibrosing a.opecia.a.e indistinguish

关键词：雄激素性脱发米诺地尔非那司提扁平苔癣瘢痕性脱发抗雄激素皮损内注射免疫组化特征发际线

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奥美拉唑引起的皮肤色素沉着类似灰色皮病

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世界核心医学期刊文摘（皮肤病学分册） 2006年第9期2卷 7-7页

作者： ramrez-Hernndez M Ma.tnez-Escriba.o J.a.Ma.tnez-Ba.ba.E. 冯义国 Depa.tment of Derma.ology Virgen de la Arrixaca University Hospital 30120 El Palmar Murcia Spain

Ba.kground: Omepra.ole ha. been a.socia.ed with multiple a.verse effects including skin rea.tions but, to da.e, cuta.eous hyperpigmenta.ion ha. not been described a. a. a.verse effect of this drug. Observa.ions: We describe a.ca.e of a.52-yea.-old Ca.ca.ia. woma. who developed skin hyperpigmenta.ion in the upper trunk, mimicking a.hy derma.osis, 2 months a.ter initia.ing omepra.ole trea.ment. Histopa.hologic exa.ina.ion of a.skin biopsy ta.en from a.pigmentedma.ule showed derma. ma.ropha.ges conta.ning golden-brown gra.ules, which a.so displa.ed a.sulphur pea. on energy-dispersive X-ra. microa.a.ysis. High-performa.ce liquid chroma.ogra.hy (HPLC) a.d ma.s spectrometry were a.so performed on the drug a.d on a.biopsy specimen revea.ing the sa.e chroma.ogra.s a. well a. the sa.e ma.s spectra. Conclusions: a.cording to our results, omepra.ole itself ma. induce cuta.eous pigmenta.ion a.d, to our knowledge, this is the first report of this finding.

关键词：皮肤色素沉着奥美拉唑皮病灰色组织病理检查高效液相色谱活检标本不良反应

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