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吲哚菁绿清除试验在肝病中的临床应用 预览
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作者 郭维博 杨婧 《系统医学》 2019年第2期196-198,共3页
吲哚菁绿(ICG)清除试验是临床上评估肝脏储备功能准确而实用的一种检查方法,近年来吲哚菁绿在清除试验在肝脏损伤诊断中运用逐渐增多,该方式诊断时具有无创、快速特点,可了解患者实际肝脏损伤程度,了解患者实时病情,对各种肝病进行早期... 吲哚菁绿(ICG)清除试验是临床上评估肝脏储备功能准确而实用的一种检查方法,近年来吲哚菁绿在清除试验在肝脏损伤诊断中运用逐渐增多,该方式诊断时具有无创、快速特点,可了解患者实际肝脏损伤程度,了解患者实时病情,对各种肝病进行早期诊断筛查、早期警示肝功能不全或隐匿性肝脏疾病、早期判断预后。该试验相对于胆红素、凝血酶原时间等化验指标、Child-Pugh评分更具有优越性和科学性,能更好地指导临床治疗或手术方案的建立以及治疗效果的评判,因此在肝脏疾病的诊疗中具有较大的临床价值。 展开更多
关键词 吲哚菁绿(ICG) 清除试验 肝脏储备功能 肝病
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组学技术在肝脏疾病证本质领域的研究进展
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作者 李维薇 杨燕 汪受传 《中华中医药杂志》 CAS CSCD 北大核心 2019年第2期684-687,共4页
组学技术可全面研究机体在疾病状态下体内基因表达、蛋白调控及代谢紊乱情况,其研究方法和中医学的整体观念相符合,是研究证候微观标准的先进方法。组学技术可作为肝脏疾病证本质研究的科学手段。文章通过对近十年组学技术用于肝脏疾病... 组学技术可全面研究机体在疾病状态下体内基因表达、蛋白调控及代谢紊乱情况,其研究方法和中医学的整体观念相符合,是研究证候微观标准的先进方法。组学技术可作为肝脏疾病证本质研究的科学手段。文章通过对近十年组学技术用于肝脏疾病证本质研究的相关文献进行梳理,以乙型病毒性肝炎、肝硬化及肝癌等肝脏疾病为例,介绍了肝病领域已经发现的一系列证候相关生物标志物。但目前研究也存在纳入标准不统一、将证候实质局限总结为单一层面(如基因、蛋白及代谢物)的紊乱等问题。多组学的联用及构建基因-蛋白-代谢物-证候系统将有助于构建精确的辨证体系,揭示中医证候的生物学本质。 展开更多
关键词 肝脏疾病 组学技术 中医证候 乙型病毒性肝炎 肝硬化 肝癌
小鼠肝损伤模型研究初探
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作者 张璐 魏韬 +5 位作者 周晶琳 王祥美 白清杰 刘广旭 杨静波 祝慧慧 《中国继续医学教育》 2019年第8期167-169,共3页
目的探讨肝脏部分切除的小鼠模型制备方法,建立简单、安全、有效的肝损伤方法,为筛选抗肝损伤药物提供较为理想的模型。方法明确小鼠肝脏4个解剖功能单位(中叶、左外叶、右叶和尾叶),结扎并切除肝脏左外叶和中叶,建立70%肝切除小鼠模型... 目的探讨肝脏部分切除的小鼠模型制备方法,建立简单、安全、有效的肝损伤方法,为筛选抗肝损伤药物提供较为理想的模型。方法明确小鼠肝脏4个解剖功能单位(中叶、左外叶、右叶和尾叶),结扎并切除肝脏左外叶和中叶,建立70%肝切除小鼠模型。结果肝左外叶和中叶约占小鼠肝脏总重量的68%,术后7天小鼠生存状况良好,肝切除小鼠模型成功建立。结论本研究通过建立肝脏部分切除的小鼠模型,探讨部分肝切除小鼠模型方法的安全性和用于后续实验的实用性,以期通过该模型揭示肝脏病变的发生机制,并推动相关研究的发展。 展开更多
关键词 小鼠 肝损伤 肝切除术 动物模型 人类疾病 肝再生
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Elastography-based screening for esophageal varices in patients with advanced chronic liver disease
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作者 Rafael Paternostro Thomas Reiberger Theresa Bucsics 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第3期308-329,共22页
Elastography-based liver stiffness measurement(LSM)is a non-invasive tool for estimating liver fibrosis but also provides an estimate for the severity of portal hypertension in patients with advanced chronic liver dis... Elastography-based liver stiffness measurement(LSM)is a non-invasive tool for estimating liver fibrosis but also provides an estimate for the severity of portal hypertension in patients with advanced chronic liver disease(ACLD).The presence of varices and especially of varices needing treatment(VNT)indicates distinct prognostic stages in patients with compensated ACLD(cACLD).The Baveno VI guidelines suggested a simple algorithm based on LSM<20 kPa(by transient elastography,TE)and platelet count>150 G/L for ruling-out VNT in patients with cACLD.These(and other)TE-based LSM cut-offs have been evaluated for VNT screening in different liver disease etiologies.Novel point shear-wave elastography(pSWE)and two-dimensional shear wave elastography(2D-SWE)methodologies for LSM have also been evaluated for their ability to screen for“any”varices and for VNT.Finally,the measurement of spleen stiffness(SSM)by elastography(mainly by pSWE and 2D-SWE)may represent another valuable screening tool for varices.Here,we summarize the current literature on elastography-based prediction of“any”varices and VNT.Finally,we have summarized the published LSM and SSM cut-offs in clinically useful scale cards. 展开更多
关键词 ELASTOGRAPHY LIVER STIFFNESS SPLEEN STIFFNESS Shear wave Magnetic resonance ELASTOGRAPHY VARICES Portal hypertension Cirrhosis ADVANCED chronic LIVER disease
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5741例血清铁蛋白增高病例的临床分析 预览
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作者 徐云云 胡安群 刘海燕 《标记免疫分析与临床》 CAS 2019年第1期102-106,共5页
目的通过对铁蛋白增高患者的临床资料进行分析,探讨血清铁蛋白增高的临床意义,进一步指导铁蛋白的临床应用。方法回顾性分析2016年6月1日至2017年5月31日在安徽医科大学附属安庆医院住院的血清铁蛋白增高的5741例患者临床资料。结果分析... 目的通过对铁蛋白增高患者的临床资料进行分析,探讨血清铁蛋白增高的临床意义,进一步指导铁蛋白的临床应用。方法回顾性分析2016年6月1日至2017年5月31日在安徽医科大学附属安庆医院住院的血清铁蛋白增高的5741例患者临床资料。结果分析5741例血清铁蛋白增高患者,483例患者血清铁蛋白在1900μg/L以上,5258例患者血清铁蛋白在400~1900μg/L;其中炎症性疾病2246例(39.12%)、肿瘤性疾病1725例(30.05%)、心脑血管代谢性疾病1136例(19.79%)、肝脏良性疾病310例(5.40%)、手术外伤应激性疾病209例(3.64%)、血液系统良性疾病49例(0.85%)、及胃息肉、腹股沟疝、耳鸣等其他疾病66例(1.15%)。结论血清铁蛋白在多种疾病中增高,与炎症性疾病、肿瘤性疾病、心脑血管代谢性疾病、肝脏良性疾病、手术外伤应激性疾病、血液系统良性疾病等密切相关,对于这些疾病的诊断、治疗与预后有一定价值,因此铁蛋白检测具有重要的临床价值。 展开更多
关键词 铁蛋白 炎症性疾病 手术外伤应激性疾病 心脑血管代谢性疾病 血液系统良性疾病 肿瘤 肝脏疾病
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小儿局灶性结节性肝脏增生临床诊治经验探讨
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作者 胡嘉健 王焕民 韩炜 《临床小儿外科杂志》 CAS 2019年第2期112-117,共6页
目的探讨小儿局灶性结节性肝脏增生的临床特点、诊断方法及治疗经验,提高其诊治水平。方法回顾性分析2006年1月至2018年1月由首都医科大学附属北京儿童医院经手术切除及病理检查证实为局灶性结节性肝脏增生的患儿临床资料,其中男童9例,... 目的探讨小儿局灶性结节性肝脏增生的临床特点、诊断方法及治疗经验,提高其诊治水平。方法回顾性分析2006年1月至2018年1月由首都医科大学附属北京儿童医院经手术切除及病理检查证实为局灶性结节性肝脏增生的患儿临床资料,其中男童9例,女童13例,发病年龄7个月至11岁1个月,中位年龄4岁6个月,所有病灶为单发,均经不规则性肝切除术治疗。结果临床表现:22例局灶性结节性肝脏增生(focal nodular hyperplasia,FNH)患儿中腹痛7例,腹部膨隆或包块4例,体检发现11例;实验室检验:肝功异常8例,AFP升高3例,均于术后恢复正常;影像学检查:所有22例均行超声检查,10例拟诊断为FNH,拟诊断正确率为45.5%;误诊为肝脏血管瘤5例,其中肝母细胞瘤1例,间叶错构瘤1例。20例行CT(含增强)检查,11例拟诊断为FNH,拟诊断正确率为55%。3例术前行MRI检查,1例拟诊断为FNH,2例未予明确诊断。术后肿瘤最长径线5~15 cm,中位长度8 cm,其中≥10 cm者5例,最大肿物体积为15 cm×10 cm×8 cm。所有病例为单发病灶,均行手术切除,病理提示肿物中央灰白色放射样瘢痕特征11例(50%)。术后随访0.5~10.8年,未见复发或严重并发症发生。结论小儿局灶性结节性肝脏增生在临床及影像学上有一定特征,联合应用CT等影像学检查和AFP水平及肝功能实验室检查指标能提高其诊断水平,最终确诊需术后病理检查,手术切除治疗能够有效解除病灶,远期预后良好。 展开更多
关键词 儿童 手术 肝脏病变 影像学
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3种常用改善肝功能药物治疗药物性肝损伤的效果比较 预览
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作者 张兴顺 《数理医药学杂志》 2019年第2期245-246,共2页
目的:探讨与比较3种常用改善肝功能药物治疗药物性肝损伤的效果。方法:于2015年10月~2017年10月期间,选取某院收治的84例药物性肝损伤患者,按数字表随机分为3组,每组28例。A组给予还原型谷胱甘肽治疗,B组采用多烯磷脂酰胆碱注射液,C组... 目的:探讨与比较3种常用改善肝功能药物治疗药物性肝损伤的效果。方法:于2015年10月~2017年10月期间,选取某院收治的84例药物性肝损伤患者,按数字表随机分为3组,每组28例。A组给予还原型谷胱甘肽治疗,B组采用多烯磷脂酰胆碱注射液,C组采用硫普罗宁注射液,比较3组药物成本、治疗效果及不良反应情况。结果:A组治疗总有效率(89.29%)相比B组(71.43%)、C组(75.00%),明显高于后者(χ^2=2.77、3.74,P<0.05);A组[(235.12±7.61)元]、C组[(135.20±7.61)元]药物成本均低于B组[(316.11±4.04)元],3组比较差异显著(P<0.05);3组不良反应发生率比较,无显著差异(P>0.05)。结论:针对药物性肝损伤患者,采用原型谷胱甘肽治疗,效果要好于硫普罗宁、多烯磷脂酰胆碱,成本费用较合理,可将其当作治疗此病的优选药。 展开更多
关键词 原型谷胱甘肽 多烯磷脂酰胆碱 硫普罗宁 肝疾病
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Effects of Yigan Tiaozhi Decoction on Serum NO, Endotoxin and RBP4 in Patients with Nonalcoholic Fatty Liver Disease 预览
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作者 韦美华 祖亚洁 《世界中西医结合杂志(英文)》 2019年第1期24-28,共5页
OBJECTIVE:To explore the effects of Yigan Tiaozhi Decoction on serum nitric oxide (NO), endotoxin and retinol binding protein 4 (RBP4) in patients with nonalcoholic fatty liver disease (NAFLD), and to provide evidence... OBJECTIVE:To explore the effects of Yigan Tiaozhi Decoction on serum nitric oxide (NO), endotoxin and retinol binding protein 4 (RBP4) in patients with nonalcoholic fatty liver disease (NAFLD), and to provide evidence for clinical treatment of such patients. METHODS:A total of 92 patients with NAFLD admitted to Army General Hospital 263 Clinic from March 2013 to March 2017 were selected, and all patients were divided into the control group (n=46) and the observation group (n = 46) according to the random number table method. The patients in the control group were given conventional treatment, and the patients in the observation group were treated with Yigan Tiaozhi Decoction on the basis of the control group. Liver function, blood lipid levels, serum NO, endotoxin, RBP4 levels and clinical efficacy were observed and compared between the 2 groups before and after treatment. RESULTS:Before treatment, there was no significant difference in serum alanine aminotransferase, glutamyltranspeptidase, aspartate aminotransferase, total cholesterol and triglyceride levels between the 2 groups (P>0.05); after treatment, the serum levels of alanine aminotransferase, glutamyltranspeptidase, aspartate aminotransferase, total cholesterol and triglyceride in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05); before treatment, there was no significant difference in serum NO, endotoxin and RBP4 levels between the 2 groups (P>0.05); after treatment, the serum NO, endotoxin and RBP4 levels in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05); the total effective rate of treatment in the observation group (89.13%) was significantly higher than that in the control group (76.09%), and the difference was statistically significant (P<0.05). CONCLUSION:Yigan Tiaozhi Decoction is effective in NAFLD, which can reduce serum NO, endotoxin and RBP4 levels, improve liver function and reduce blood lipi 展开更多
关键词 Yigan Tiaozhi Decoction NONALCOHOLIC fatty liver disease SERUM NO ENDOTOXIN RETINOL binding protein 4
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Current therapies and novel approaches for biliary diseases
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作者 Indu G Rajapaksha Peter W Angus Chandana B Herath 《世界胃肠病理生理学杂志:英文版(电子版)》 2019年第1期1-10,共10页
Chronic liver diseases that inevitably lead to hepatic fibrosis, cirrhosis and/or hepatocellular carcinoma have become a major cause of illness and death worldwide. Among them, cholangiopathies or cholestatic liver di... Chronic liver diseases that inevitably lead to hepatic fibrosis, cirrhosis and/or hepatocellular carcinoma have become a major cause of illness and death worldwide. Among them, cholangiopathies or cholestatic liver diseases comprise a large group of conditions in which injury is primarily focused on the biliary system. These include congenital diseases (such as biliary atresia and cystic fibrosis), acquired diseases (such as primary sclerosing cholangitis and primary biliary cirrhosis), and those that arise from secondary damage to the biliary tree from obstruction, cholangitis or ischaemia. These conditions are associated with a specific pattern of chronic liver injury centered on damaged bile ducts that drive the development of peribiliary fibrosis and, ultimately, biliary cirrhosis and liver failure. For most, there is no established medical therapy and, hence, these diseases remain one of the most important indications for liver transplantation. As a result, there is a major need to develop new therapies that can prevent the development of chronic biliary injury and fibrosis. This mini-review briefly discusses the pathophysiology of liver fibrosis and its progression to cirrhosis. We make a special emphasis on biliary fibrosis and current therapeutic options, such as angiotensin converting enzyme-2 (known as ACE2) over-expression in the diseased liver as a novel potential therapy to treat this condition. 展开更多
关键词 Chronic liver disease BILIARY FIBROSIS CURRENT THERAPIES for BILIARY FIBROSIS ANGIOTENSIN CONVERTING enzyme-2 Gene therapy
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Procyanidin B2 protects against diet-induced obesity and nonalcoholic fatty liver disease via the modulation of the gut microbiota in rabbits
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作者 Ya-Wei Xing Guang-Tao Lei +2 位作者 Qing-Hua Wu Yu Jiang Man-Xiang Huang 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第8期955-966,共12页
BACKGROUND Procyanidins have beneficial effects on metabolic syndrome and antimicrobial activity,but the mechanisms underlying these effects are unclear.AIM To investigate the effects of procyanidin B2(PB2)on non-alco... BACKGROUND Procyanidins have beneficial effects on metabolic syndrome and antimicrobial activity,but the mechanisms underlying these effects are unclear.AIM To investigate the effects of procyanidin B2(PB2)on non-alcoholic fatty liver disease and to explore the possible mechanism.METHODS Thirty male New Zealand white rabbits were randomized into three groups.All of them were fed either a high-fat-cholesterol diet(HCD)or chow diet.HCD-fed rabbits were treated with vehicle or PB2 daily for 12 wk.Body weight and food intake were evaluated once a week.Serum biomarkers,such as total cholesterols,triglycerides,and aspartate transaminase,were detected.All rabbits were sacrificed and histological parameters of liver were assessed by hematoxylin and eosin-stained sections.Moreover,several lipogenic genes and gut microbiota(by 16S rRNA sequencing)were investigated to explore the possible mechanism.RESULTS The HCD group had higher body weight,liver index,serum lipid profile,insulin resistance,serum glucose,and hepatic steatosis compared to the CHOW group.PB2 treatment prevented HCD-induced increases in body weight and hypertriglyceridemia in association with triglyceride accumulation in the liver.PB2 also ameliorated low-grade inflammation,which was reflected by serum lipopolysaccharides and improved insulin resistance.In rabbit liver,PB2 prevented the upregulation of steroid response element binding protein 1c and fatty acid synthase and the downregulation of carnitine palmitoyltransferase,compared to the HCD group.Moreover,HCD led to a decrease of Bacteroidetes in gut microbiota.PB2 significantly improved the proportions of Bacteroidetes at the phylum level and Akkermansia at the genus level.CONCLUSION Our results indicate the possible mechanism of PB2 to improve HCD-induced features of metabolic syndrome and provide a new dietary supplement. 展开更多
关键词 PROCYANIDIN Rabbit Non-alcoholic FATTY liver disease GUT MICROBIOTA 16S rRNA
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《2018年国际肝移植协会意见:非酒精性脂肪性肝炎的管理和治疗》摘译 预览
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作者 张霞霞(译) 徐有青(审校) 《临床肝胆病杂志》 CAS 北大核心 2019年第1期64-66,共3页
非酒精性脂肪性肝病(NAFLD)发病率呈全球逐年上升趋势,其发病机理与遗传因素、饮食结构、缺乏运动等不良生活习惯息息相关。随着NAFLD发病机制的多途径研究,相应的药物治疗呈现多样性。该部分患者目前已成为肝移植的主要人群。国际肝移... 非酒精性脂肪性肝病(NAFLD)发病率呈全球逐年上升趋势,其发病机理与遗传因素、饮食结构、缺乏运动等不良生活习惯息息相关。随着NAFLD发病机制的多途径研究,相应的药物治疗呈现多样性。该部分患者目前已成为肝移植的主要人群。国际肝移植协会根据现有临床循证学研究证据明确了NAFLD患者生活方式、药物治疗及饮酒量的共识意见。共识意见中的证据质量和推荐强度见表1。 展开更多
关键词 脂肪肝 疾病管理 治疗学 诊疗准则
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介入超声对获得性免疫缺陷综合征相关性肝脏疾病的诊断与治疗价值
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作者 张晖 刘建建 +1 位作者 马鑫 陆清 《中国临床医学》 2019年第1期10-13,共4页
目的:探讨介入超声对获得性免疫缺陷综合征(即艾滋病)相关性肝脏疾病的临床诊断及治疗价值。方法:选择2014年4月至2018年4月上海市公共卫生临床中心艾滋病相关性肝脏疾病需明确病理诊断及治疗的患者55例,超声引导下行病灶穿刺活检、抽... 目的:探讨介入超声对获得性免疫缺陷综合征(即艾滋病)相关性肝脏疾病的临床诊断及治疗价值。方法:选择2014年4月至2018年4月上海市公共卫生临床中心艾滋病相关性肝脏疾病需明确病理诊断及治疗的患者55例,超声引导下行病灶穿刺活检、抽吸及置管引流等操作,观察并记录诊断符合率、治愈率及患者并发症。结果:18例实质性肿块及4例弥漫性肝脏肿大的穿刺活检中,病理诊断恶性肿瘤16例,良性病变6例,诊断符合率100%;对33例48个囊性及囊实混合性病灶行穿刺治疗,穿刺抽脓15例次,置管33例次,其中治愈31例、好转2例。仅1例肝脓肿患者穿刺置管后发生恶心,未作处理。结论:介入超声对艾滋病相关性肝脏疾病的诊断与治疗具有微创、安全、方便、有效的特点,且医护人员术中易防护,患者治疗费用低,是一种值得推广的首选诊疗方法。 展开更多
关键词 介入超声 获得性免疫缺陷综合征 肝脏疾病 诊断治疗
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Bariatric surgery in patients with non-alcoholic fatty liver disease-from pathophysiology to clinical effects
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作者 Tea L Laursen Christoffer A Hagemann +4 位作者 Chunshan Wei Konstantin Kazankov Karen L Thomsen Filip K Knop Henning Grφb?k 《世界肝病学杂志:英文版(电子版)》 2019年第2期138-149,共12页
Non-alcoholic fatty liver disease(NAFLD)is increasingly recognized as a significant liver disease,and it covers the disease spectrum from simple steatosis with a risk of development of non-alcoholic steatohepatitis(NA... Non-alcoholic fatty liver disease(NAFLD)is increasingly recognized as a significant liver disease,and it covers the disease spectrum from simple steatosis with a risk of development of non-alcoholic steatohepatitis(NASH)to fibrosis,subsequent cirrhosis,end-stage liver failure,and liver cancer with a potential need for liver transplantation.NAFLD and NASH are closely related to obesity,metabolic syndrome,and type 2 diabetes(T2D).The role of gut hormones,especially glucagon-like peptide 1(GLP-1),is important in NAFLD.Bariatric surgery has the potential for inducing great weight loss and may improve the symptoms of metabolic syndrome and T2D.Recent data demonstrated significant effects of bariatric surgery on GLP-1 and other gut hormones and important lipid metabolic and inflammatory abnormalities in the pathophysiology of NAFLD.Therefore,bariatric surgery may reverse the pathological liver changes in NAFLD and NASH patients.In the present review,we describe NAFLD and NASH pathophysiology and the primary effects of bariatric surgery on metabolic pathways.We performed a systematic review of the beneficial and harmful effects and focused on changes in liver disease severity in NAFLD and NASH patients.The specific focus was liver histopathology as assessed by the invasive liver biopsy.Additionally,we reviewed several non-invasive methods used for the assessment of liver disease severity following bariatric surgery. 展开更多
关键词 Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis BARIATRIC surgery Insulin resistance Gut HORMONES Glucagon-like peptide 1 STEATOSIS Inflammation Fibrosis
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探讨营养护理干预对于肝病合并糖尿病的应用效果 预览
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作者 牟君 《糖尿病新世界》 2019年第3期11-12,15共3页
目的对营养护理干预在肝病合并糖尿病患者中的临床运用情况进行观察与分析。方法按就诊前后顺序,将该院肝病科于2017年4月—2018年3月所接诊的70例肝病合并糖尿病患者分成两组,即常规组与干预组;常规组采取常规基础护理措施,在此基础之... 目的对营养护理干预在肝病合并糖尿病患者中的临床运用情况进行观察与分析。方法按就诊前后顺序,将该院肝病科于2017年4月—2018年3月所接诊的70例肝病合并糖尿病患者分成两组,即常规组与干预组;常规组采取常规基础护理措施,在此基础之上,再对干预组患者予以营养护理干预措施。结果干预组患者在脂肪、糖类、蛋白质、膳食纤维、动物蛋白等的摄入优于常规组,差异有统计学意义(P<0.05);干预组患者各项指标(空腹血糖、餐后2 h血糖、血红蛋白以及体质指数)均比常规组患者低,差异有统计学意义(P<0.05)。结论对肝病合并糖尿病患者予以营养护理干预,可改善患者营养物质的摄入,控制其血糖水平,值得推广。 展开更多
关键词 肝病 糖尿病 营养护理
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何若苹治疗乙肝病毒性肝病经验探析 预览
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作者 叶娜妮 张依静 +2 位作者 李振兴 黄硕 何若苹 《浙江中医药大学学报》 CAS 2019年第2期131-133,139共4页
[目的]总结何若苹治疗乙肝病毒性肝病经验。[方法]通过侍诊学习以及对典型医案的收集、整理,试从病因病机、辨证论治、用药法度三方面总结何若苹诊治乙肝病毒性肝病经验,并举一则验案加以分析。[结果]何若苹认为乙肝病毒性肝病属湿热疫... [目的]总结何若苹治疗乙肝病毒性肝病经验。[方法]通过侍诊学习以及对典型医案的收集、整理,试从病因病机、辨证论治、用药法度三方面总结何若苹诊治乙肝病毒性肝病经验,并举一则验案加以分析。[结果]何若苹认为乙肝病毒性肝病属湿热疫毒为患,病机为湿热疫毒熏蒸肝胆而急性起病,日久耗肝阴,克脾土,伤肾阴,瘀热入络成肝积,血水不利成臌胀,毒瘀积聚成肝癌。初期宜清利,常需顾护脾胃;中期宜辨证调脏,可益阴柔肝、健脾疏肝、滋肾养肝;末期宜扶正祛邪兼顾,及时治疗变证。用药需分期论治,明察宜忌,初期忌补,中期需活血,末期忌攻,并结合天人相应观,根据四时调整用药,若微观指标异常则对症用药。所举验案,以健脾疏肝法疗肝病,效果肯定。[结论]何若苹治疗乙肝病毒性肝病初期重清利,中期重调脏,末期重达变,经验独到,疗效显著,值得借鉴。 展开更多
关键词 乙肝病毒 肝病 肝癌 黄疸 转氨酶 医案 何若苹 名医经验
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血清ALT、AST、GGT检测在肝脏疾病诊断中应用 预览
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作者 陈世佳 《中外医疗》 2019年第5期190-192,共3页
目的探讨肝脏疾病生化检验血清ALT、AST、GGT的临床诊断价值。方法方便2016年1月—2018年7月83例肝脏疾病患者实验组,同期83名健康志愿者为对照组,测定两组血清ALT、AST、GGT水平,观察两组指标差异。结果实验组血清ALT阳性率(92.77%)、... 目的探讨肝脏疾病生化检验血清ALT、AST、GGT的临床诊断价值。方法方便2016年1月—2018年7月83例肝脏疾病患者实验组,同期83名健康志愿者为对照组,测定两组血清ALT、AST、GGT水平,观察两组指标差异。结果实验组血清ALT阳性率(92.77%)、AST阳性率(96.39%)、GGT阳性率(93.97%)高于对照组(χ^2=22.534,20.854,21.790;P<0.05);血清ALT(93.5±16.2)、AST(87.4±10.7)、GGT(92.3±13.4)U/L高于对照组(t=18.430,19.511,21.437;P<0.05)。结论血清ALT、AST、GGT检测肝功能损伤具有较高预测价值,能够为临床筛查、诊断和鉴别肝脏疾病提供有价值的依据参考,值得推广使用。 展开更多
关键词 肝脏疾病 生化检验 ALT AST GGT 诊断价值
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Chronic hepatitis B and metabolic risk factors:A call for rigorous longitudinal studies
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作者 Wai-Kay Seto 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第3期282-286,共5页
Long-term nucleos(t)ide analogue therapy in chronic hepatitis B virus(HBV)infection is effective in suppressing viral replication and reducing liver-related complications.However,HBV-related liver events can still occ... Long-term nucleos(t)ide analogue therapy in chronic hepatitis B virus(HBV)infection is effective in suppressing viral replication and reducing liver-related complications.However,HBV-related liver events can still occur in different patient sub-groups.There is emerging evidence that,similar to chronic hepatitis C virus infection,metabolic risk factors may play a role in the disease process of chronic HBV.While the mechanistic nature of metabolic-HBV interactions remains uncertain,studies in different HBV-infected populations have demonstrated that hepatic steatosis,increased body-mass index,diabetes,or a combination of different metabolic risk factors are associated with an increased risk of hepatocellular carcinoma and cirrhosis.The impact of metabolic risk factors is especially prominent in patients with quiescent virological activity,including on-treatment patients with effective viral suppression.As the proportion of on-treatment chronic HBV patients increases worldwide,longitudinal studies determining the relative risks of different metabolic parameters with respect to clinical outcomes are needed.Future studies should also determine if metabolic-directed interventions can improve disease outcomes in chronic HBV. 展开更多
关键词 HEPATITIS B virus DIABETES OBESITY STEATOSIS Non-alcoholic FATTY liver disease Body-mass index
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肝病患者医院感染的危险因素分析 预览
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作者 吴宗文 《中国卫生产业》 2019年第5期178-180,共3页
目的探究肝病患者医院感染的感染率以及导致感染发生的危险因素,并提出相应的预防对策。方法对该院于2012年11月—2017年12月期间收治的715肝病患者的临床资料进行分析。结果收治的715例肝病患者中出现医院感染的患者54例,医院感染率为7... 目的探究肝病患者医院感染的感染率以及导致感染发生的危险因素,并提出相应的预防对策。方法对该院于2012年11月—2017年12月期间收治的715肝病患者的临床资料进行分析。结果收治的715例肝病患者中出现医院感染的患者54例,医院感染率为7.55%,肝病患者的住院时间过长、患者年龄大以及肝功能损害程度严重、侵入性操作、抗生素药物使用不合理等是导致医院感染发生的危险因素。结论在肝病患者的治疗过程中要注意合理用药,避免滥用抗生素等药物,减少不必要的侵入性操作以降低感染几率,提高患者的生命质量。 展开更多
关键词 肝脏疾病 医院感染 危险因素
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血清免疫球蛋白检测对肝衰竭诊断价值研究 预览
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作者 袁丹聃 毛大平 +1 位作者 薛峰 李道波 《当代医学》 2019年第10期97-99,共3页
目的观察血清免疫球蛋白检测对肝衰竭诊断的价值。方法选取2017年7月至2018年7月在本院诊治的76例肝衰竭患者临床资料(设观察组),另取本院体检的76例健康者(设对照组),均行血清免疫球蛋白测定,比较两组血清免疫球蛋白水平。结果与对照组... 目的观察血清免疫球蛋白检测对肝衰竭诊断的价值。方法选取2017年7月至2018年7月在本院诊治的76例肝衰竭患者临床资料(设观察组),另取本院体检的76例健康者(设对照组),均行血清免疫球蛋白测定,比较两组血清免疫球蛋白水平。结果与对照组比,观察组IgA(13.28±2.31)g/L、IgG(28.02±3.65)g/L、IgM(12.56±2.03)g/L均较高(P<0.05);与治疗前比,早、中、晚期的各项免疫球蛋白治疗后的水平均降低(P<0.05)。结论血清免疫球蛋白检测不仅能作为肝衰竭诊断指标,还能判断病情的严重程度及预后。 展开更多
关键词 肝衰竭 免疫球蛋白 病情程度 预后判断
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Differential hepatic features presenting in Wilson disease-associated cirrhosis and hepatitis B-associated cirrhosis
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作者 Hao-Jie Zhong Huan-Huan Sun +2 位作者 Lan-Feng Xue Eileen M McGowan Yu Chen 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第3期378-387,共10页
BACKGROUND Cirrhosis is a chronic late stage liver disease associated with hepatitis viruses,alcoholism,and metabolic disorders,such as Wilson disease(WD).There are no clear markers or clinical features that define ci... BACKGROUND Cirrhosis is a chronic late stage liver disease associated with hepatitis viruses,alcoholism,and metabolic disorders,such as Wilson disease(WD).There are no clear markers or clinical features that define cirrhosis originating from these disparate origins.We hypothesized that cirrhosis is not one disease and cirrhosis of different etiology may have differential clinical hepatic features.AIM To delineate the liver features between WD-associated cirrhosis and hepatitis Bassociated cirrhosis in the Chinese population.METHODS In this observational study,we reviewed the medical data of consecutive inpatients who had WD-associated cirrhosis or hepatitis B-associated cirrhosis from January 2010 to August 2018,and excluded patients who had carcinoma,severe heart or pulmonary diseases,or other liver diseases.According to the etiology of cirrhosis,patients were divided into two groups:WD-associated cirrhosis group(60 patients)and hepatitis B-associated cirrhosis group(56 patients).The liver fibrosis degree,liver function indices,and portal hypertension features of these patients were compared between the two groups.RESULTS No inter-group differences were observed in the diagnostic liver fibrosis markers,however,clinical features clearly defined the origin of cirrhosis.WD-associated cirrhosis patients(16-29 years)had lower levels of alanine transaminase,aspartate transaminase,and bilirubin,lower prothrombin time,lower incidence of hepatic encephalopathy,and lower portal vein diameter(P<0.05),compared to cirrhosis resulting from hepatitis B in older patients(45-62 years).Importantly,they had decreased risks of progression from Child-Pugh grade A to B(odds ratio=0.046,95%confidence interval:0.006-0.387,P=0.005)and of ascites(odds ratio=0.08,95%confidence interval:0.01-0.48,P=0.005).Conversely,WDassociated cirrhosis patients had a higher risk of splenomegaly(odds ratio=4.15,95%confidence interval:1.38-12.45,P=0.011).CONCLUSION WD-associated cirrhosis presents a higher risk of splenomegaly associated with leukopenia a 展开更多
关键词 Chronic hepatitis B CIRRHOSIS HEPATIC feature Liver function PORTAL hypertension WILSON disease
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