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低凝血酶原血
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     Biaxial(-)with low birefringence.
     双折射率
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     Their specific properties are described in some detail: high surface activity and low critical micelle concentration;
     临界胶束浓度;
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Cephalosporins are widely used in clinical practice owing to their remarkably broad-spectrum of antibacterial activity.However,cephalosporins may have a few side effects associated with haematological diseases.Cephalosporin may induce an immune-mediated hemolytic anemia,but some patients can also present a positive Coombs' test without the evidences of hemolysis.Cephalosporins can result in neutropenia through an immune mechanism in rare cases,neverthless many clinical trails show that the third- and the fourth-generation...

Cephalosporins are widely used in clinical practice owing to their remarkably broad-spectrum of antibacterial activity.However,cephalosporins may have a few side effects associated with haematological diseases.Cephalosporin may induce an immune-mediated hemolytic anemia,but some patients can also present a positive Coombs' test without the evidences of hemolysis.Cephalosporins can result in neutropenia through an immune mechanism in rare cases,neverthless many clinical trails show that the third- and the fourth-generation cephalosporin may be safety to patients with neutropenia and fever.Coagulopathies and bleeding are probably the most serious side effects caused by cephalosporins.Most cases of bleeding are caused by either vitamin K-responsive hypoprothrombinemia and decreased activities of coagulant factors depending on vitamin K,or an acquired platelet functional defect.The complications of coagulopathies and bleeding may be observed frequently in cases using cephalosporins containing N-MTZ molecular structure.Knowledge of haemotological side effects related to cephalosporins can help physicians use them reasonably.Clinicians should pay more attention to patients with absence of vitamin K while the cephalosporins containing N-MTZ molecular structure are being administrated.

头孢菌素是临床上常用的一类广谱抗生素 ,随着头孢菌素的广泛使用 ,少数患者可出现血液系统毒性反应。头孢菌素可诱发免疫性溶血性贫血 ,也可仅表现为Coombs实验阳性而无溶血的证据。在个别病例中 ,头孢菌素可通过免疫机制导致白细胞减少甚至粒细胞缺乏 ,但大量临床资料表明 :第三、四代头孢菌素用于粒细胞缺乏病人发热的治疗是安全的。凝血功能障碍和出血是头孢菌素的血液学毒性反应中最严重的 ,主要由于干扰了维生素K的代谢引起低凝血酶原血症和依赖维生素K的凝血因子活性降低 ,同时还可抑制血小板聚集 ,尤其是含有N MTZ结构的头孢菌素 ,表现尤为突出。了解头孢菌素的血液学毒性反应有利于临床医生合理用药 ,尤其对有维生素K缺乏可能的病人 ,在使用N MTZ头孢菌素时应格外慎重

Although anaphylaxis induced by vitamin K1 seldom happens, 4 allergic cases were observed in the patients we treated recently who were given intramuscular injection of vitamin K1 before renal biopsy. To provide the best clinical evidence, we searched MEDLINE (May 2005) and evaluated the studies. The studies were only case reports and retrospective reviews which showed the anaphylaxis were mainly allergic dermatitis with different manifestation and reaction time. The serious reactions such as allergic shock...

Although anaphylaxis induced by vitamin K1 seldom happens, 4 allergic cases were observed in the patients we treated recently who were given intramuscular injection of vitamin K1 before renal biopsy. To provide the best clinical evidence, we searched MEDLINE (May 2005) and evaluated the studies. The studies were only case reports and retrospective reviews which showed the anaphylaxis were mainly allergic dermatitis with different manifestation and reaction time. The serious reactions such as allergic shock was very rare. We conclude that although vitamin K1 anaphylaxis is rare, strict indications should be followed and the drug surveillance on adverse events should be strengthened.

尽管维生素K1过敏临床罕见,但我科近期在肾活检前肌注维生素K1后先后发生了4例过敏反应。为提供最佳证据指导临床治疗,作者对MEDLINE数据库(截至2005年5月)中有关维生素K1过敏的研究进行了检索和评价。结果发现,维生素K1过敏的相关研究仅为个案报告或回顾性分析。其主要反应为过敏性皮炎,皮疹表现多样,出现和持续时间不一,而过敏性休克等严重副反应极少发生。在肾活检前常规使用维生素K1应注意以下几点:①对于并无维生素K1缺乏或低凝血酶原血症的患者不必常规使用,尤其是在用于非促进止血用途时应尽可能换用其他作用相似的药物;②如果确有必要使用,在非紧急情况下应尽量避免静脉内使用;③维生素K1过敏的发生率不高且程度较轻,因此不推荐在使用该药的同时常规使用抗组胺药物和糖皮质激素。同时应加强药物不良反应的监测工作。

 
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