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我院采用糖皮质激素(以下简称激素)预防经确诊的钩体病赫氏反应41例取得明显效果,方法是: 首剂地塞米松20毫克静推,或以氢化考的松300毫克加入液体中静滴,继之用青霉素钠盐240万—320万μ加入10％葡萄糖液500毫升中,以每分钟30滴静滴,同时给以青霉素80万μ,每八小时肌注一次。结果无一例出现赫氏反应。激素的作用机理:1.激素稳定细胞溶酶体膜,阻止了其中水解酶及促进心肌抑制因子形成的释放,提高了机体对钩体毒素的耐受力,减轻了毒素对机体的损害。2.激素与受体结合,可促进肺Ⅱ型上皮细胞内板层体形成和分泌肺表面活性物质,从而维持肺泡的稳定性。本组首次氢化考的松未超过300毫克,地塞米松未超过20毫克,与穆国尧1984年在四川医学报告需用氢考500毫克才能预防赫氏反应为低,这是否与我们同时用大剂量青霉素有关,
Our hospital with glucocorticoid (hereinafter referred to as hormone) to prevent the diagnosis of leukoplakia Hodgkin’s reaction in 41 cases achieved significant results, the method is: the first dose of dexamethasone 20 mg static push, or hydrocortisone 300 mg add liquid In the intravenous infusion, followed by penicillin sodium 2.4 million -320 million μ 10% glucose solution 500 ml, intravenous infusion of 30 drops per minute, given penicillin 800000 μ, intramuscular injection once every eight hours. None of the results appear Herz’s reaction. The mechanism of action of hormones: 1. Hormones stabilize the lysosomal membrane of cells, which prevents the hydrolysis of enzymes and promote the release of myocardial inhibitory factor to improve the body’s tolerance to hook toxins, reducing toxins on the body’s damage. 2. Hormone and receptor binding, can promote the formation of type II epithelial cells lamellar body and secretion of pulmonary surfactant, so as to maintain the stability of alveolar. This group for the first time hydrogenated cortisone did not exceed 300 mg, dexamethasone did not exceed 20 mg, and Mu Guoyao in 1984 in Sichuan Medical Report required hydrogen test 500 mg to prevent Heath reaction is low, whether this is with us at the same time High-dose penicillin-related,