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肾上腺皮质激素类

肾上腺皮质激素类的相关文献在1993年到2022年内共计135篇,主要集中在内科学、外科学、药学 等领域,其中期刊论文134篇、会议论文1篇、专利文献101700篇;相关期刊89种,包括家庭医生、河北中医、中国病理生理杂志等; 相关会议1种,包括2007年全国临床医学新进展(海口)学术研讨会等;肾上腺皮质激素类的相关文献由441位作者贡献,包括仝小林、叶智文、彭解人等。

肾上腺皮质激素类—发文量

期刊论文>

论文:134 占比:0.13%

会议论文>

论文:1 占比:0.00%

专利文献>

论文:101700 占比:99.87%

总计:101835篇

肾上腺皮质激素类—发文趋势图

肾上腺皮质激素类

-研究学者

  • 仝小林
  • 叶智文
  • 彭解人
  • 杨梦兰
  • 王君
  • 王坤
  • 罗佐杰
  • 迟永春
  • 陈旭
  • C.Kasperk

肾上腺皮质激素类

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  • 期刊论文
  • 会议论文
  • 专利文献

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    • 张雅静; 岳伟
    • 摘要: 皮肌炎的临床特征是皮肤改变和骨骼肌炎症反应,亦可累及其他器官。发病机制包括易感基因、环境应激源、免疫和非免疫诱发机制。临床主要表现为亚急性进行性近端肌无力、皮疹或二者兼有,以及肌外表现,如心脏异常、间质性肺病和恶性肿瘤。辅助检查包括肌炎自身抗体、肌酶谱、肌电图。针对皮肤损害,予以抑制光敏感药物和抗疟药;合并肌肉受累时系统性激素治疗是一线方案;免疫抑制剂常用于难治性皮肌炎或激素出现不良反应时的添加治疗;其他治疗方法还包括钙调磷酸酶抑制药、环磷酰胺、生物制剂、Janus激酶抑制剂等。
    • 王改; 王巍伟; 王雅卿; 张倩; 李芳
    • 摘要: 目的 探究乌司他丁联合肾上腺皮质激素对脓毒症患儿肠黏膜屏障功能、中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase associated lipocalin,NGAL)、可溶性髓样细胞触发性受体1(soluble triggering receptor expressed on myeloid cells-1,TREM-1)水平的影响.方法 选取我院接诊的82例脓毒症患儿作为研究对象,按照随机数字表法分为乌司他丁组和联合治疗组41例.乌司他丁组采用乌司他丁进行治疗,联合治疗组在乌司他丁组基础上增加肾上腺皮质激素进行治疗.采用血气分析仪检测乳酸(lactic acid,LA)水平;采用急性生理和慢性健康(acute physiology and chronic health,APACHEⅡ)评分评估疾病严重程度.采用酶联免疫吸附测定法(enzyme-linked immunosorbent assay,ELISA)检测肝素结合蛋白(heparin-binding protein,HBP)、前白蛋白(prealbumin,PA)、视黄醇结合蛋白(retinol-binding protein,RBP)、白细胞介素6(interleukin-6,IL-6)、白细胞介素10(interleukin-10,IL-10)、二胺氧化酶(diamine oxidase,DAO)、肠脂肪酸结合蛋白(intestinal fatty acid binding protein,IFABP)、D-乳酸、NGAL、TREM-1水平.采用全自动生化分析仪检测肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)、肌钙蛋白I(troponin I,cTnI)水平.采用流式细胞仪检测免疫功能指标.观察2组患儿LA值、治疗效果,并计算LCR.结果 与乌司他丁组相比,联合治疗组LA、HBP、IL-6、CK-MB、cTnI、CD8+、DAO、IFABP、D-乳酸、NGAL、TREM-1水平、APACHEⅡ评分较低(P<0.05).与乌司他丁组相比,联合治疗组LCR,PA、RBP、IL-10、CD3+、CD4+、NK水平以及治疗总有效率较高(P<0.05).结论 乌司他丁联合肾上腺皮质激素可有效改善儿童脓毒症患儿临床症状,促进肠黏膜屏障功能恢复正常,下调NGAL、TREM-1水平,值得在临床上推广应用.
    • 王世充; 郑以州
    • 摘要: 原发免疫性血小板减少症(ITP)是一种由血小板抗体介导的自身免疫性出血性疾病.ITP发病率随患者年龄增长而升高,因此对老年人ITP的诊治更需予以重视.一方面,ITP老年患者合并的基础疾病较多,导致对其诊断难度增加;另一方面,以糖皮质激素和(或)静脉输注免疫球蛋白(IVIG)为基础的一线治疗方案,对ITP老年患者的疗效不佳,并且ITP老年患者易发生糖尿病、高血压、血栓和出血,以及骨质疏松等并发症.老年人ITP的二线治疗方案包括血小板生成素受体激动剂(TPO-RA)、利妥昔单抗、氨苯砜、达那唑等.脾切除术通常为ITP老年患者对其他治疗无效时的选择.笔者拟就近年老年人ITP的流行病学特征、诊断及治疗等相关研究进展进行综述,旨在为ITP老年患者的治疗提供参考.
    • 张靖文; 李恩有
    • 摘要: 依托咪酯是咪唑的羟化盐,因其独特的安全特性,广泛应用于临床麻醉.依托咪酯在临床应用中最主要的限制就是其对肾上腺皮质功能的抑制作用.笔者总结了依托咪酯的应用现状及其不良反应,同时介绍了多种依托咪酯衍生物的研究进展.
    • 杨建钢; 王旭; 杨玉彬; 杨策
    • 摘要: 脓毒症是病原微生物感染引发的危及生命的器官功能障碍.由于病理生理机制的复杂性,自1991年对其概念的界定以来,已历经3次重要修订,但仍难以形成广泛共识.特别是在拯救脓毒症运动背景下,脓毒症发病率和死亡率居高不下、特效药物匮乏以及诸多经验性救治措施难以奏效的严峻现实表明,脓毒症非病原依赖性瀑布样介质反应尚有广阔的探索空间.肾上腺作为神经-内分泌-免疫调控网络的重要效应器官,通过接驳中枢应激信号和局部微环境反应,以效应激素形式参与对脓毒症机体反应的非线性、复杂性调控.其功能障碍的早期识别、替代治疗以及在脓毒症机体紊乱内环境中的再认识,无疑是脓毒症诊治的核心环节之一.近30年来,针对肾上腺皮质激素的多项临床研究以及争议性推荐意见进一步凸显其重要价值.为此,笔者基于预测性、预防性、个体化、参与性的"4P"医学模式,立足转化医学视角,从脓毒症定义及其内涵的变化,分析肾上腺皮质激素的诊治价值,并从内源性和外源性肾上腺皮质激素角度,阐述脓毒症治疗中基于神经-内分泌-免疫网络的微环境调控理论,尝试从肾上腺皮质激素(种类、用量、单独和联合治疗、时间窗)分析脓毒症理论研究瓶颈与临床实践困惑,旨在为脓毒症的肾上腺皮质激素应用提供有益的借鉴和启示.
    • 易守红; 周武平; 何纯青; 古浩然; 杨鹏彬; 赵卫军
    • 摘要: 目的 比较外固定架固定和切开复位内固定治疗创伤性四肢骨折的临床疗效,观察两种术式对机体炎症应激反应的影响.方法 选取2016年5月至2018年11月解放军陆军第947医院收治的200例创伤性四肢骨折患者,随机分为对照组和观察组,每组各100例,前者采用传统切开复位内固定治疗,后者采用外固定架治疗,比较两组患者的临床疗效和并发症发生情况,以及手术前后炎症应激反应指标的变化.结果 观察组患者术中出血量、住院时间、住院费用及骨折愈合时间均小于对照组(P0.05).结论 外固定架固定与切开复位内固定两种术式治疗创伤性四肢骨折均能取得良好的短期疗效,但前者术中出血更少,术后机体炎症应激反应程度更轻微,利于患者的骨折愈合和功能恢复,降低了手术费用.
    • 黎晓新; 王宁利; 梁小玲; 徐格致; Xiao-yan Li; Jenny Jiao; Jean Lou; Yehia Hashad; 中国视网膜静脉阻塞地塞米松玻璃体腔植入剂研究组
    • 摘要: 目的 评估地塞米松玻璃体腔植入物(DEX)治疗中国患者视网膜静脉阻塞继发黄斑水肿(RVO-ME)的安全性和有效性.方法 为期6个月的随机、双盲、假注射对照、多中心、3期临床研究,此后接续为期2个月的开放标签的延展研究.视网膜分支(BRVO)或中央静脉阻塞(CRVO)患眼于基线时接受DEX植入(n=129)或假注射(n=130)治疗;治疗后6个月时,两组中满足再治疗标准的全部患眼均再次接受DEX植入治疗.有效性变量包括最佳矫正视力(BCVA)和黄斑中心凹视网膜厚度(CRT).BCVA检查采用早期治疗糖尿病视网膜病变研究组视力表进行.光相干断层扫描(OCT)检查采用德国Heidelberg公司Spectralis OCT仪或德国Zeiss公司Cirrus OCT仪进行.结果 治疗后6个月中(主要终点),DEX治疗组BCVA较基线提高≥15个字母的时间早于假注射组(P<0.001).治疗后第2个月时(效应峰值),DEX治疗组、假注射组BCVA较基线提高≥15个字母患者百分比分别为34.9%,11.5%.DEX治疗组、假注射组平均BCVA较基线分别提高(10.6±10.4)、(1.7±12.3)个字母;平均CRT分别较基线下降(407±212)、(62±224) μm (P<0.001).DEX治疗组CRVO、BRVO患眼治疗效果均优于假注射组.主要常见治疗相关不良事件为眼压升高,均可通过局部降眼压药物控制;无患者需要接受抗青光眼手术.结论 DEX治疗中国患者RVO-ME具有良好的安全性和显著的临床疗效;单次植入DEX较假注射可获得持续3~4个月的视力和解剖结构改善.%Objective To evaluate the safety and efficacy ofdexamethasone intravitreal implant 0.7 mg (DEX) for treatment of macular edema associated with retinal vein occlusion (RVO).Methods This study was a six-month,randomized,double-masked,sham-controlled,multicenter,phase 3 clinical trial with a 2-month open-label study extension.Patients with branch or central RVO received DEX (n=129) or sham procedure (n=130) in the study eye at baseline;all patients who met re-treatment criteria received DEX at month 6.Efficacy measures included Early Treatment Diabetic Retinopathy Study (ETDRS),best-corrected visual acuity (BCVA),and central retinal thickness (CRT) on optical coherence tomography.Results Time to > 15-letter BCVA improvement from baseline during the first 6 months (primary endpoint) was earlier with DEX than sham (P< 0.001).At month 2 (peak effect),the percentage of patients with ≥ 15-letter BCVA improvement from baseline was DEX:34.9%,sham:11.5%;mean BCVA change from baseline was DEX:10.6± 10.4 letters,sham:1.7 ± 12.3 letters;and mean CRT change from baseline was DEX:-407 ± 212 μm,sham:-62 ± 224 μm (all P<0.001).Outcomes were better with DEX than sham in both branch and central RVO.The most common treatment-emergent adverse event was in-creased intraocular pressure (IOP).Increase sin IOP generally were controlled with topical medication.Mean IOP normalized by month 4,and no patient required incisional glaucoma surgery.Conclusions DEX had a favorable safety profile and provided clinically significant benefit in a Chinese patient population with RVO.Visual and anatomic outcomes were improved with DEX relative to sham for 3-4 months after a single implant.
    • 姜洋; 李莹; 金玉梅; 张军燕
    • 摘要: 目的:探讨在飞秒激光小切口角膜基质透镜取出术(SMILE)后应用0.1%溴芬酸钠滴眼液替代糖皮质激素的安全性、有效性及耐受性。方法前瞻性病例对照研究。将2015年4至8月在北京协和医院眼科接受SMILE手术的60例近视眼患者按随机数字表法随机分为3个组,均选取右眼进行用药后情况观察(共60只眼),每组20只眼。溴芬酸钠组患者SMILE术后应用0.1%溴芬酸钠滴眼液2次/d应用10 d;地塞米松-溴芬酸钠组患者SMILE术后3 d应用地塞米松-妥布霉素滴眼液4次/d,术后第4天开始改为应用0.1%溴芬酸钠滴眼液2次/d,至术后10 d;地塞米松组患者SMILE术后应用地塞米松/妥布霉素滴眼液4次/d应用10 d。所有患者在术前及术后1 d、10 d、1个月、3个月进行检查,包括裸眼视力、眼压、角膜地形图和主观症状与不良反应。3个组间观察指标比较采用单因素方差分析。结果3个组患者在术后10 d、1及3个月裸眼视力差异无统计学意义(F=0.77,0.30,0.36;P>0.05)。地塞米松组患者在术后10 d、1及3个月各观察时间段眼压均值均高于溴芬酸钠组及地塞米松-溴芬酸钠组,但差异无统计学意义(F=0.56,0.98,0.63;P>0.05)。溴芬酸钠组患者术前、术后1及3个月角膜地形图角膜表面非对称指数(SAI)均值分别为:0.33±0.10、0.50±0.17、0.55±0.21;地塞米松-溴芬酸钠组及地塞米松组分别为:0.33±0.08、0.49±0.16、0.60±0.37;0.31±0.12、0.52±0.23、0.55±0.19;3个组患者术后1及3个月SAI指数差异无统计学意义(F=0.09,0.21;P>0.05)。溴芬酸钠组患者术前、术后1及3个月角膜地形图表面规则指数(SRI)均值分别为:0.15±0.12、0.34±0.18、0.40±0.18;地塞米松-溴芬酸钠组及地塞米松组分别为:0.18±0.17、0.33±0.26、0.33±0.26;0.30±0.25、0.41±0.28、0.34±0.29;3个组患者术后1及3个月SRI指数方面差异亦无统计学意义(F=0.74,0.39;P>0.05)。3个组患者中仅溴芬酸钠组术后10 d存在1例患者双眼视疲劳症状、术后1及3个月存在1例患者单眼干眼症状,余各组患者术后术后各时间段均无不适主观症状与不良反应发生。结论0.1%溴芬酸钠滴眼液用于SMILE术后可以替代糖皮质激素应用,安全、有效、具有良好的耐受性,在术后视力、眼压、眼表恢复方面均可获得满意的效果。(中华眼科杂志,2017,53:18-22)%Objective To study the safety, efficacy and tolerability of the usage of 0.1%bromfenac sodium eye drops in small incision lenticule extraction (SMILE). Methods Prospective case control study. Three groups were observed, including 60 patients (60 eyes) undergoing SMILE for myopia. After surgery, 20 patients (20 eyes) were treated with 0.1%bromfenac sodium eye drops twice daily for 10 days, 20 patients (20 eyes) were treated with topical compound tobramycin eye drops 4 times daily for 10 days, and 20 patients (20 eyes) were treated with topical compound tobramycin eye drops 4 times daily for 3 days and 0.1%bromfenac sodium eye drops twice daily thereafter for 7 days. All of the patients were examined preoperatively and at 1 day, 10 days, 1 month and 3 months postoperatively, including visual acuity, intraocular pressure, topography and adverse reactions. The differences among the 3 groups were analyzed by the single factor analysis of variance. Results There was no significant difference among the 3 groups in the uncorrected visual acuity at 10 days, 1 month and 3 months postoperatively(F=0.77, 0.30, 0.36. P=0.47, 0.75, 0.69). The intraocular pressure in the dexamethasone group at 10 days, 1 month and 3 months postoperatively was higher than the other two groups with no significant difference(F=0.56, 0.98, 0.63. P=0.57, 0.38, 0.54). The surface asymmetry index of patients was 0.33±0.10, 0.50±0.17 and 0.55±0.21 in the bromfenac sodium group, 0.33 ± 0.08, 0.49 ± 0.16 and 0.60 ± 0.37 in the dexamethasone-bromfenac sodium group, and 0.31±0.12, 0.52±0.23 and 0.55±0.19 in the dexamethasone group;preoperatively and at 1 and 3 months, respectively. There was no significant difference among the 3 groups in the surface asymmetry index at 1 and 3 months postoperatively (F=0.09, 0.21. P=0.91, 0.81). The surface regularity index of patients was 0.15 ± 0.12, 0.34 ± 0.18 and 0.40 ± 0.18 in the bromfenac sodium group, 0.18 ± 0.17, 0.33 ± 0.26 and 0.33±0.26 in the dexamethasone-bromfenac sodium group, and 0.30±0.25, 0.41±0.28 and 0.34±0.29 in the dexamethasone group preoperatively and at 1 and 3 months, respectively. There was no significant difference among the 3 groups in the surface regularity index at 1 and 3 months postoperatively (F=0.74, 0.39. P=0.48, 0.68). In the bromfenac sodium group, one patient complained of binocular visual fatigue at 10 days, and one patient complained of dryness in one eye at 1 and 3 months. Conclusion Bromfenac sodium eye drops can be used to replace corticosteroids after SMILE procedure with high safety and good tolerance. Satisfactory recovery of visual acuity, intraocular pressure and ocular surface could be achieved.
    • 王文红; 张碧丽; 刘艳; 刘妍; 赵林胜; 杨丽潇
    • 摘要: 目的:观察促肾上腺皮质激素(ACTH)联合槐杞黄对频复发肾病综合征(FRNS)患儿的疗效及安全性。方法55例FRNS患儿分为糖皮质激素(GC)维持治疗的对照组(A组,10例)、槐杞黄组(B组,17例)、ACTH组(C组,14例)和ACTH联合槐杞黄组(联合治疗组,D组,14例),连续治疗12个月。分别记录治疗6个月和12个月时各组GC使用量、肾上腺皮质基础分泌水平及肾上腺皮质储备水平,同时记录各组患儿复发率及不良反应情况。结果治疗6个月后,C、D组的GC用量明显低于A、B组(P0.05)。在治疗6个月和12个月后,C、D组患儿复发率均低于A、B组(P0.05). After treatment for 6 months and 12 months, the recurrence rates of nephrotic syndrome were significantly lower in group C and group D than those of group A and group B (P<0.05). Conclusion The simple application of ACTH and the combination of Huaiqihuang can relieve the inhibition of long-term using GC on hypothalamic pituitary adrenal axis in FRNS patients.
    • 潘振宇; 李楠; 顾华; 翟仁友; 杨晋才
    • 摘要: Objective To evaluate the marrow composition and microstructurechangesin animal model of steroid-induced avascular osteonecrosis of femoral head ( SANFH ) by estimating MR transverse relaxation.Methods Sixty pure-bred New Zealand rabbits were divided randomly into 5 groups,including a control group(n=8) and 4(M2w, M4w, M6w, M8w) experimental groups(n=13 × 4). Animal model was established according to the methods mentioned by Yamamoto. At the end of each experiment, MR was performed by GE Signa EXICITE scanner and the original transverse relaxation images were transferred to GE AW4. 2 workstations for the further data analysis using functool software. T2 , T2*values of the region of interest in the femoral head, metaphysis and marrow cavity were calculated, and the color-coded maps were created. Experimental animals were sacrificed and the femoral heads were collected for the followed histomorphological investigation.Results The actual sample size of the control group and the groups of M2w , M4w , M6w , M8w was 8 ( 16 hips ) , 10 ( 20 hips ) , 9 ( 18 hips ) , 9 ( 18 hips ) , 10 ( 20 hips ) . Statistical differences in T2 values(F=51. 601, P<0. 01), T2* values(F=36. 889, P<0. 01) were observed between the groups of M2w , M4w , M6w , M8w and control group in all anatomic femoral regions. The T2 and T2* values of the experimental groups were lower than the control group. This decreasing began at the initial stage of the modeling( M2w ) , reached the lowest point at M4w , and then rebounded in group of M6w and M8w. The T2(F=86. 274, P<0. 01), T2*(F=53. 172, P<0. 01) values were statistically different between the different anatomical regions. The T2 and T2*values of the femoral head area were higher than the metaphyseal and marrow cavity area. It was distinguished that both the amount and the size of fat cells increased in marrow and trabeculae, whereas the hematopoietic tissues decreased. Microthrombi in the arterioles and extravasation of erythrocytes were observed in the femora metaphysic at the earlier stage of the modeling. Such pathologic changes showed particular significance in group M4w . Then trabecular bone necrosis, inflammatory reaction and fibrosiswereobserved obviously in group of M6w and M8w . Conclusions Determination of MR transverse relaxation can sensitively reflect the bone marrow composition and microstructure changes in the SANFH models. This technique may have potential applications in the early diagnosis and monitoring the disease progression of SANFH.%目的:定量研究兔激素性股骨头坏死模型( SANFH) MR横向弛豫时间在造模不同时相的变化规律,探讨所反映的骨髓组分及微结构变化。方法健康成年纯种新西兰大白兔60只,采用随机区组抽样方法分为空白对照(8只)及造模2、4、6、8周组(各13只)。制作模具小管并行MR T2 mapping序列MR扫描,评价所得参数即T2值的稳定性。参照Yamamoto的方法对模型组进行造模处理。造模开始前对空白对照组进行MR扫描,各模型组分别在造模后满2、4、6、8周时行MR扫描,将横向弛豫原始图像数据传至GE AW4.2工作站进行后处理,计算各像素T2、T2*值,创建相应参数的彩色编码图,对股骨头区、骺下区及髓腔骺端进行测量域感兴趣区的特征参数值;扫描完成后将实验动物处死,切取股骨头进行组织形态学检查。结果剔除实验期间死亡动物及无效图像资料,MR检查并获得有效数据的空白对照及造模2、4、6、8周组实际样本量分别为8只(16髋)、10只(20髋)、9只(18髋)、9只(18髋)、10只(20髋)。各模型组及空白对照组T2值(F=51.601, P<0.01)、T2*值(F=36.889, P<0.01)组间总体差异有统计学意义。造模各组T2、T2*值均低于空白对照组,造模早期(2周)出现明显下降,4周降至最低,6、8周出现部分恢复;各解剖区域间T2( F=86.274, P<0.01)、T2*(F=53.172, P<0.01)值差异有统计学意义;股骨头区T2、T2*值高于骺下区及髓腔骺端,骺下区高于髓腔骺端(P值均<0.05)。组织形态学变化:造模早期表现为骨髓造血细胞减少及脂肪细胞增生,髓内微血管血栓及出血,4周最为显著,之后出现骨组织坏死,骨小梁变细、部分消失,间质反应(充血、水肿、出血)及纤维化。结论 MR横向弛豫时间可敏感地反映SANFH模型骨髓组分及骨小梁微结构特征性改变,为此病早期诊断及病程监控提供了重要的定量影像学方法。
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