急性胰腺炎(acute pancreatitis, AP)是由高脂血症、胆石症、酒精等原因引起的胰腺组织自我消化,导致胰腺水肿、出血和坏死等炎性损害。有相关研究报道,约10%~25% AP患者可发展为重症急性胰腺炎(severe acute pancreatitis, SAP)。SAP病情进展迅速,并发症较多、死亡率高。持续恶化的器官功能衰竭是导致SAP患者死亡的主要因素之一。炎症瀑布式反应在急性胰腺炎的发病及病情进展中发挥着重要的作用,炎症因子或细胞因子水平的变化可以在血液反应出来。近年来,血液标志物对AP严重程度及SAP预后的预测越来越受到人们的重视。深入了解AP的相关炎症因子或血液标志物有助于找到精确的治疗靶点,对早期干预AP发展有一定的指导意义。因此,本文对AP涉及到的部分重要血液标志物进行综述。Acute pancreatitis (AP) is caused by hyperlipidemia, cholelithiasis, alcohol and other causes of pancreatic tissue self-digestion, resulting in pancreatic edema, bleeding and necrosis and other inflammatory damage. It has been reported that about patients with 10%-25% AP can develop into severe acute pancreatitis. The disease of SAP progressed rapidly, with many complications and high mortality. Worsening organ failure is one of the main factors leading to death in patients with SAP. Inflammatory cascade reaction plays an important role in the pathogenesis and progression of acute pancreatitis, and the changes of inflammatory factors or cytokines can be reflected in the blood. In recent years, people have paid more and more attention to the prediction of blood markers on the severity of AP and the prognosis of SAP. In-depth understanding of AP-related inflammatory factors or blood markers will help to find accurate treatment targets, and have a certain guiding significance for early intervention in the development of AP. Therefore, some important blood markers involved in AP are reviewed in this paper.
目的系统评价硫酸镁对成人重症哮喘的疗效。方法计算机检索Embase、Pub Med、Cochrane Database of Systematic Review、CENTRAL、Web of Science、维普、万方、知网等数据库,检索时间为建库到2015年12月。纳入研究硫酸镁治疗重症哮喘的随机对照试验,结局指标包括肺功能、住院率、心率、呼吸频率及Borg呼吸困难评分。结果共纳入7个随机对照试验,1 241例患有重症哮喘的患者。Meta分析结果显示:两组在肺功能、住院率方面差异有统计学意义,在心率、呼吸以及Borg呼吸困难评分方面差异无统计学意义。结论目前的证据表明,在重症哮喘常规治疗基础上加用硫酸镁,可提高患者肺功能并降低住院率。
