目的 研究低分子肝素联用乙酰半胱氨酸治疗间质性肺炎的疗效观察以及对其安全性进行评估。方法 选取间质性肺炎患者96例,随机分为对照46例及观察组50例,对照组予以常规治疗,观察组患者在对照组基础上联合加用低分子肝素和乙酰半胱氨酸,两组患者均接受为期3个月的疗程。比较治疗前后两组患者的临床症状、各项肺功能指标。结果 治疗后观察组患者呼吸困难自评分数和治疗前对比有改善(P＜ 0. 05),而治疗前后对照组无改变。 治疗后观察组的肺功能各项指标(VC% pred、FVC% pred、FEV1% pred、TLC% pred)比治疗前高;对照组经治疗后各项分功能指标的改善程度较治疗前差异不明显(P＞ 0.05); 且治疗后观察组的VC% pred、FVC% pred比对照组高。观察组在治疗后, HRCT 检测发现肺部出现磨玻璃影、网格影以及小叶间隔增厚的比例低于治疗前;而对照组以上指标治疗前后的改变比例差异无统计学意义 (P＞0.05) 。两组治疗后六分钟步行距离、血清Ⅲ型胶原水平较治疗前均有改善;但治疗后观察组的六分钟步行距离、血清Ⅲ型胶原水平高于对照组(P＜0.05)。治疗后两组患者没有发生明显不良反应。结论 联合应用低分子肝素、乙酰半胱氨酸来治疗间质性肺炎疗效显著,改善肺纤维化效果理想,且能帮助恢复患者的运动能力,研究过程中未发现明显不良反应,故提倡临床推广。

目的 探讨糖尿病胃轻瘫大鼠不同血糖水平对Cajal间质细胞(ICC)的影响及其机制。方法 选择雌性Wista大鼠60只进行随机分组,实验组40只,对照组20只。实验组糖尿病Wista大鼠模型以单次腹腔注射链脲佐菌素法诱导。免疫组织化学荧光染色检测不同血糖浓度大鼠胃ICC数量及网络结构。结果 实验组大鼠血糖浓度高于对照组,ICC数量,低于对照组,且比较差异有统计学意义(P<0.05)。实验组大鼠中血糖浓度越高,ICC数量越低,说明血糖浓度升高可能与平滑肌及神经末梢之间缝隙连接的减少及其ICC网络的超微结构损伤及异常有关。结论 DM小鼠胃组织中血糖水平的升高,可能是DM胃中ICC数量减少的原因;外源性降低血糖能改善DM相关的胃肠道ICC病变。

Objective To observe the effects of glucose fluctuations on Cajal interstitial cells (ICC) of rats with diabetic gastroparesis(DGP) and its mechanistic. Methods 60 Wistar rats were selected and randomly divided into two groups. 20 rats in experimental group and 40 rats in control group. Used immunofluorescence staining to detect the amount of gastric ICC and network structure in DGP rats with different glucose levels. Results The blood glucose concentration in the experimental group was significantly higher than that in the control group, the amount of ICC in the experimental group was significantly lower than that in the control group(P<0.05). The amount of ICC decreased with the increase of glucose levels. In the experimental group, The gap junctions between smooth muscle and nerve endings, ultrastructural damage and abnormalities of the ICC network were probably related to glucose level. Conclusion The increase of glucose level was probably the cause of the decrease of the amount in ICC. Exogenousy decrease glucose levels probably can help to improve the lesion of ICC with DGP.