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近年临床经验表明，头孢三嗪或头孢噻肟加甲硝唑可能是治疗与中耳炎、乳突炎、鼻窦炎或青紫型先天性心脏病有关的脑脓肿的最好的经验性联合用药。 | [
{
"indices": [
9,
10,
11,
12
],
"label": "dru",
"score": 1,
"text": "头孢三嗪"
},
{
"indices": [
14,
15,
16,
17
],
"label": "dru",
"score": 1,
"text": "头孢噻肟"
},
{
"indices": [
19,
20,
21
],
"label": "dru",
"score": 1,
"text": "甲硝唑"
},
{
"indices": [
28,
29,
30
],
"label": "dis",
"score": 1,
"text": "中耳炎"
},
{
"indices": [
32,
33,
34
],
"label": "dis",
"score": 1,
"text": "乳突炎"
},
{
"indices": [
36,
37,
38
],
"label": "dis",
"score": 1,
"text": "鼻窦炎"
},
{
"indices": [
40,
41,
42,
43,
44,
45,
46,
47,
48
],
"label": "dis",
"score": 1,
"text": "青紫型先天性心脏病"
},
{
"indices": [
52,
53,
54
],
"label": "dis",
"score": 1,
"text": "脑脓肿"
}
] |
如果怀疑葡萄球菌（如头颅穿透伤、脑室腹膜分流术以及瓣膜修复术并发心内膜炎引起的脑脓肿），主张选用万古霉素加第三代头孢菌素（也可用甲硝唑）。 | [
{
"indices": [
4,
5,
6,
7
],
"label": "mic",
"score": 1,
"text": "葡萄球菌"
},
{
"indices": [
10,
11,
12,
13,
14
],
"label": "dis",
"score": 1,
"text": "头颅穿透伤"
},
{
"indices": [
16,
17,
18,
19,
20,
21,
22
],
"label": "pro",
"score": 1,
"text": "脑室腹膜分流术"
},
{
"indices": [
25,
26,
27,
28,
29
],
"label": "pro",
"score": 1,
"text": "瓣膜修复术"
},
{
"indices": [
32,
33,
34,
35
],
"label": "dis",
"score": 1,
"text": "心内膜炎"
},
{
"indices": [
39,
40,
41
],
"label": "dis",
"score": 1,
"text": "脑脓肿"
},
{
"indices": [
48,
49,
50,
51
],
"label": "dru",
"score": 1,
"text": "万古霉素"
},
{
"indices": [
53,
54,
55,
56,
57,
58,
59
],
"label": "dru",
"score": 1,
"text": "第三代头孢菌素"
},
{
"indices": [
64,
65,
66
],
"label": "dru",
"score": 1,
"text": "甲硝唑"
}
] |
对于证实有绿脓杆菌感染或有免疫功能缺陷的患者，建议使用头孢噻甲羧肟加万古霉素作为初始的经验治疗。 | [
{
"indices": [
5,
6,
7,
8,
9,
10
],
"label": "dis",
"score": 1,
"text": "绿脓杆菌感染"
},
{
"indices": [
13,
14,
15,
16,
17,
18
],
"label": "dis",
"score": 1,
"text": "免疫功能缺陷"
},
{
"indices": [
27,
28,
29,
30,
31,
32
],
"label": "dru",
"score": 1,
"text": "头孢噻甲羧肟"
},
{
"indices": [
34,
35,
36,
37
],
"label": "dru",
"score": 1,
"text": "万古霉素"
},
{
"indices": [
43,
44,
45,
46
],
"label": "pro",
"score": 1,
"text": "经验治疗"
}
] |
如果原发病是脑膜炎，由于抗青霉素的肺炎球菌的增多，一般使用万古霉素加头孢三嗪治疗。 | [
{
"indices": [
6,
7,
8
],
"label": "dis",
"score": 1,
"text": "脑膜炎"
},
{
"indices": [
12,
13,
14,
15
],
"label": "dru",
"score": 1,
"text": "抗青霉素"
},
{
"indices": [
17,
18,
19,
20
],
"label": "mic",
"score": 1,
"text": "肺炎球菌"
},
{
"indices": [
29,
30,
31,
32
],
"label": "dru",
"score": 1,
"text": "万古霉素"
},
{
"indices": [
34,
35,
36,
37
],
"label": "dru",
"score": 1,
"text": "头孢三嗪"
}
] |
如果临床和放射学检查示病情改善较慢，建议全身应用抗生素至少4～6周。 | [
{
"indices": [
2,
3,
4,
5,
6,
7,
8,
9,
10,
11,
12,
13,
14,
15,
16
],
"label": "sym",
"score": 1,
"text": "临床和放射学检查示病情改善较慢"
},
{
"indices": [
2,
3,
4,
5,
6,
7,
8,
9
],
"label": "pro",
"score": 1,
"text": "临床和放射学检查"
},
{
"indices": [
20,
21,
22,
23,
24,
25,
26
],
"label": "pro",
"score": 1,
"text": "全身应用抗生素"
}
] |
在高氯性代谢性酸中毒，碳酸氢根的降低被氯离子所替代，而后者可通过血清电解质的测量获得。 | [
{
"indices": [
1,
2,
3,
4,
5,
6,
7,
8,
9
],
"label": "dis",
"score": 1,
"text": "高氯性代谢性酸中毒"
},
{
"indices": [
11,
12,
13,
14
],
"label": "ite",
"score": 1,
"text": "碳酸氢根"
},
{
"indices": [
11,
12,
13,
14,
15,
16,
17,
18,
19,
20,
21,
22,
23,
24
],
"label": "sym",
"score": 1,
"text": "碳酸氢根的降低被氯离子所替代"
},
{
"indices": [
19,
20,
21
],
"label": "ite",
"score": 1,
"text": "氯离子"
},
{
"indices": [
32,
33,
34,
35,
36,
37,
38,
39
],
"label": "pro",
"score": 1,
"text": "血清电解质的测量"
}
] |
此外，梗阻也可发生于右心室腔内（右心室双腔），右心室流出道（圆锥部），肺动脉主干以及肺动脉的左右肺内肺外分支。 | [
{
"indices": [
3,
4,
5,
6,
7,
8,
9,
10,
11,
12,
13,
14,
15,
16,
17,
18,
19,
20,
21,
22,
23,
24,
25,
26,
27,
28,
29,
30,
31,
32,
33,
34,
35,
36,
37,
38,
39,
40,
41,
42,
43,
44,
45,
46,
47,
48,
49,
50,
51,
52,
53
],
"label": "sym",
"score": 1,
"text": "梗阻也可发生于右心室腔内（右心室双腔），右心室流出道（圆锥部），肺动脉主干以及肺动脉的左右肺内肺外分支"
},
{
"indices": [
3,
4
],
"label": "dis",
"score": 1,
"text": "梗阻"
},
{
"indices": [
10,
11,
12,
13
],
"label": "bod",
"score": 1,
"text": "右心室腔"
},
{
"indices": [
16,
17,
18,
19,
20
],
"label": "bod",
"score": 1,
"text": "右心室双腔"
},
{
"indices": [
23,
24,
25,
26,
27,
28
],
"label": "bod",
"score": 1,
"text": "右心室流出道"
},
{
"indices": [
30,
31,
32
],
"label": "bod",
"score": 1,
"text": "圆锥部"
},
{
"indices": [
35,
36,
37,
38,
39
],
"label": "bod",
"score": 1,
"text": "肺动脉主干"
},
{
"indices": [
42,
43,
44,
45,
46,
47,
48,
49,
50,
51,
52,
53
],
"label": "bod",
"score": 1,
"text": "肺动脉的左右肺内肺外分支"
}
] |
肺动脉瓣狭窄的发生有家族倾向。 | [
{
"indices": [
0,
1,
2,
3,
4,
5
],
"label": "dis",
"score": 1,
"text": "肺动脉瓣狭窄"
}
] |
本病的继发病变为右心室向心性的肥厚，室腔可能偏小，心内膜下心肌可有缺血性病变，甚至有右心室心肌梗死。 | [
{
"indices": [
8,
9,
10,
11,
12,
13,
14,
15,
16
],
"label": "sym",
"score": 1,
"text": "右心室向心性的肥厚"
},
{
"indices": [
8,
9,
10
],
"label": "bod",
"score": 1,
"text": "右心室"
},
{
"indices": [
18,
19
],
"label": "bod",
"score": 1,
"text": "室腔"
},
{
"indices": [
18,
19,
20,
21,
22,
23
],
"label": "sym",
"score": 1,
"text": "室腔可能偏小"
},
{
"indices": [
25,
26,
27,
28,
29,
30
],
"label": "bod",
"score": 1,
"text": "心内膜下心肌"
},
{
"indices": [
25,
26,
27,
28,
29,
30,
31,
32,
33,
34,
35,
36,
37
],
"label": "sym",
"score": 1,
"text": "心内膜下心肌可有缺血性病变"
},
{
"indices": [
42,
43,
44,
45,
46,
47,
48
],
"label": "dis",
"score": 1,
"text": "右心室心肌梗死"
}
] |
亦有患者劳动时感胸痛或上腹痛，可能由于当时心排出量不能相应提高，致使心肌供血不足或心律失常所致，这些都是预后可虑的信号，应着手准备手术。 | [
{
"indices": [
4,
5,
6,
7,
8,
9,
10,
11,
12,
13
],
"label": "sym",
"score": 1,
"text": "劳动时感胸痛或上腹痛"
},
{
"indices": [
8
],
"label": "bod",
"score": 1,
"text": "胸"
},
{
"indices": [
11,
12
],
"label": "bod",
"score": 1,
"text": "上腹"
},
{
"indices": [
21,
22,
23,
24,
25,
26,
27,
28,
29,
30
],
"label": "sym",
"score": 1,
"text": "心排出量不能相应提高"
},
{
"indices": [
21,
22,
23,
24
],
"label": "ite",
"score": 1,
"text": "心排出量"
},
{
"indices": [
34,
35,
36,
37,
38,
39
],
"label": "dis",
"score": 1,
"text": "心肌供血不足"
},
{
"indices": [
41,
42,
43,
44
],
"label": "dis",
"score": 1,
"text": "心律失常"
},
{
"indices": [
65,
66
],
"label": "pro",
"score": 1,
"text": "手术"
}
] |
患儿的生长发育往往正常，甚至有心力衰竭者亦不消瘦，面容往往硕圆（50%），大多无青紫，面颊和指端可能暗红；狭窄严重者可有青紫，大多由于卵圆孔的右向左分流所致，如房间隔缺损很大，可有严重青紫，并有杵状指（趾）及红细胞增多，但有蹲踞者很少见。 | [
{
"indices": [
15,
16,
17,
18
],
"label": "dis",
"score": 1,
"text": "心力衰竭"
},
{
"indices": [
22,
23
],
"label": "sym",
"score": 1,
"text": "消瘦"
},
{
"indices": [
25
],
"label": "bod",
"score": 1,
"text": "面"
},
{
"indices": [
40,
41
],
"label": "sym",
"score": 1,
"text": "青紫"
},
{
"indices": [
43,
44
],
"label": "bod",
"score": 1,
"text": "面颊"
},
{
"indices": [
43,
44,
45,
46,
47,
48,
49,
50,
51
],
"label": "sym",
"score": 1,
"text": "面颊和指端可能暗红"
},
{
"indices": [
46,
47
],
"label": "bod",
"score": 1,
"text": "指端"
},
{
"indices": [
53,
54,
55,
56
],
"label": "sym",
"score": 1,
"text": "狭窄严重"
},
{
"indices": [
60,
61
],
"label": "sym",
"score": 1,
"text": "青紫"
},
{
"indices": [
67,
68,
69
],
"label": "bod",
"score": 1,
"text": "卵圆孔"
},
{
"indices": [
67,
68,
69,
70,
71,
72,
73,
74,
75
],
"label": "sym",
"score": 1,
"text": "卵圆孔的右向左分流"
},
{
"indices": [
80,
81,
82,
83,
84
],
"label": "dis",
"score": 1,
"text": "房间隔缺损"
},
{
"indices": [
90,
91,
92,
93
],
"label": "sym",
"score": 1,
"text": "严重青紫"
},
{
"indices": [
97,
98,
99,
100,
101,
102,
103,
104,
105,
106,
107,
108
],
"label": "sym",
"score": 1,
"text": "杵状指（趾）及红细胞增多"
},
{
"indices": [
99
],
"label": "bod",
"score": 1,
"text": "指"
},
{
"indices": [
101
],
"label": "bod",
"score": 1,
"text": "趾"
},
{
"indices": [
104,
105,
106
],
"label": "ite",
"score": 1,
"text": "红细胞"
},
{
"indices": [
111,
112,
113
],
"label": "sym",
"score": 1,
"text": "有蹲踞"
}
] |
颈静脉有明显的搏动（a波）者提示狭窄严重，此种收缩期前的搏动在肝区亦可摸到；有心衰时a波则模糊不清，而有右心室收缩时三尖瓣反流的高耸V波。 | [
{
"indices": [
0,
1,
2
],
"label": "bod",
"score": 1,
"text": "颈静脉"
},
{
"indices": [
0,
1,
2,
3,
4,
5,
6,
7,
8,
9,
10,
11,
12
],
"label": "sym",
"score": 1,
"text": "颈静脉有明显的搏动（a波）"
},
{
"indices": [
16,
17,
18,
19
],
"label": "sym",
"score": 1,
"text": "狭窄严重"
},
{
"indices": [
23,
24,
25,
26,
27,
28,
29,
30,
31,
32,
33,
34,
35,
36
],
"label": "sym",
"score": 1,
"text": "收缩期前的搏动在肝区亦可摸到"
},
{
"indices": [
31,
32
],
"label": "bod",
"score": 1,
"text": "肝区"
},
{
"indices": [
39,
40
],
"label": "dis",
"score": 1,
"text": "心衰"
},
{
"indices": [
42,
43,
44,
45,
46,
47,
48
],
"label": "sym",
"score": 1,
"text": "a波则模糊不清"
},
{
"indices": [
52,
53,
54
],
"label": "bod",
"score": 1,
"text": "右心室"
},
{
"indices": [
52,
53,
54,
55,
56,
57,
58,
59,
60,
61,
62,
63,
64,
65,
66,
67
],
"label": "sym",
"score": 1,
"text": "右心室收缩时三尖瓣反流的高耸V波"
},
{
"indices": [
58,
59,
60
],
"label": "bod",
"score": 1,
"text": "三尖瓣"
}
] |
心脏多不增大，只有严重狭窄而有心力衰竭者方见心脏扩大；左侧胸骨旁可摸得右心室的抬举搏动。 | [
{
"indices": [
0,
1
],
"label": "bod",
"score": 1,
"text": "心脏"
},
{
"indices": [
9,
10,
11,
12
],
"label": "sym",
"score": 1,
"text": "严重狭窄"
},
{
"indices": [
15,
16,
17,
18
],
"label": "dis",
"score": 1,
"text": "心力衰竭"
},
{
"indices": [
22,
23,
24,
25
],
"label": "sym",
"score": 1,
"text": "心脏扩大"
},
{
"indices": [
22,
23
],
"label": "bod",
"score": 1,
"text": "心脏"
},
{
"indices": [
27,
28,
29,
30
],
"label": "bod",
"score": 1,
"text": "左侧胸骨"
},
{
"indices": [
27,
28,
29,
30,
31,
32,
33,
34,
35,
36,
37,
38,
39,
40,
41,
42
],
"label": "sym",
"score": 1,
"text": "左侧胸骨旁可摸得右心室的抬举搏动"
},
{
"indices": [
35,
36,
37
],
"label": "bod",
"score": 1,
"text": "右心室"
}
] |
心音图上示振幅呈渐强后弱的棱形振动，振幅高峰在收缩中期或更晚；频率中或高。 | [
{
"indices": [
0,
1,
2
],
"label": "pro",
"score": 1,
"text": "心音图"
},
{
"indices": [
0,
1,
2,
3,
4,
5,
6,
7,
8,
9,
10,
11,
12,
13,
14,
15,
16,
17,
18,
19,
20,
21,
22,
23,
24,
25,
26,
27,
28,
29,
30,
31,
32,
33,
34,
35
],
"label": "sym",
"score": 1,
"text": "心音图上示振幅呈渐强后弱的棱形振动，振幅高峰在收缩中期或更晚；频率中或高"
}
] |
胸部X线检查可发现轻中度狭窄时心脏大小正常，重度狭窄时如心功能尚可，心脏仅轻度增大；如有心力衰竭，心脏则明显增大，甚至大到少见的程度，主要为右心室和右心房扩大。 | [
{
"indices": [
0,
1,
2,
3,
4,
5
],
"label": "pro",
"score": 1,
"text": "胸部X线检查"
},
{
"indices": [
0,
1,
2,
3,
4,
5,
6,
7,
8,
9,
10,
11,
12,
13,
14,
15,
16,
17,
18,
19,
20
],
"label": "sym",
"score": 1,
"text": "胸部X线检查可发现轻中度狭窄时心脏大小正常"
},
{
"indices": [
15,
16
],
"label": "bod",
"score": 1,
"text": "心脏"
},
{
"indices": [
22,
23,
24,
25,
26,
27,
28,
29,
30,
31,
32
],
"label": "sym",
"score": 1,
"text": "重度狭窄时如心功能尚可"
},
{
"indices": [
28,
29,
30
],
"label": "ite",
"score": 1,
"text": "心功能"
},
{
"indices": [
34,
35
],
"label": "bod",
"score": 1,
"text": "心脏"
},
{
"indices": [
34,
35,
36,
37,
38,
39,
40
],
"label": "sym",
"score": 1,
"text": "心脏仅轻度增大"
},
{
"indices": [
44,
45,
46,
47
],
"label": "dis",
"score": 1,
"text": "心力衰竭"
},
{
"indices": [
49,
50
],
"label": "bod",
"score": 1,
"text": "心脏"
},
{
"indices": [
49,
50,
51,
52,
53,
54,
55
],
"label": "sym",
"score": 1,
"text": "心脏则明显增大"
},
{
"indices": [
57,
58,
59,
60,
61,
62,
63,
64,
65
],
"label": "sym",
"score": 1,
"text": "甚至大到少见的程度"
},
{
"indices": [
70,
71,
72
],
"label": "bod",
"score": 1,
"text": "右心室"
},
{
"indices": [
70,
71,
72,
73,
74,
75,
76,
77,
78
],
"label": "sym",
"score": 1,
"text": "右心室和右心房扩大"
},
{
"indices": [
74,
75,
76
],
"label": "bod",
"score": 1,
"text": "右心房"
}
] |
二维超声可看到肺动脉瓣的厚度和收缩时的开启情况，狭窄后的扩张亦可看到，右心室腔和三尖瓣亦易探得。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "pro",
"score": 1,
"text": "二维超声"
},
{
"indices": [
7,
8,
9,
10
],
"label": "bod",
"score": 1,
"text": "肺动脉瓣"
},
{
"indices": [
24,
25
],
"label": "sym",
"score": 1,
"text": "狭窄"
},
{
"indices": [
28,
29
],
"label": "sym",
"score": 1,
"text": "扩张"
},
{
"indices": [
35,
36,
37,
38
],
"label": "bod",
"score": 1,
"text": "右心室腔"
},
{
"indices": [
40,
41,
42
],
"label": "bod",
"score": 1,
"text": "三尖瓣"
}
] |
如将Bruton病改为X连锁无丙种球蛋白血症（XLA），将瑞士型无丙种球蛋白血症改为严重联合免疫缺陷病（SCID）等。 | [
{
"indices": [
2,
3,
4,
5,
6,
7,
8
],
"label": "dis",
"score": 1,
"text": "Bruton病"
},
{
"indices": [
11,
12,
13,
14,
15,
16,
17,
18,
19,
20,
21
],
"label": "dis",
"score": 1,
"text": "X连锁无丙种球蛋白血症"
},
{
"indices": [
23,
24,
25
],
"label": "dis",
"score": 1,
"text": "XLA"
},
{
"indices": [
29,
30,
31,
32,
33,
34,
35,
36,
37,
38,
39
],
"label": "dis",
"score": 1,
"text": "瑞士型无丙种球蛋白血症"
},
{
"indices": [
42,
43,
44,
45,
46,
47,
48,
49,
50
],
"label": "dis",
"score": 1,
"text": "严重联合免疫缺陷病"
},
{
"indices": [
52,
53,
54,
55
],
"label": "dis",
"score": 1,
"text": "SCID"
}
] |
不同补体成分缺陷有不同临床表现，共同特征是反复感染和易患风湿性疾病。 | [
{
"indices": [
2,
3,
4,
5,
6,
7
],
"label": "dis",
"score": 1,
"text": "补体成分缺陷"
},
{
"indices": [
21,
22,
23,
24
],
"label": "dis",
"score": 1,
"text": "反复感染"
},
{
"indices": [
28,
29,
30,
31,
32
],
"label": "dis",
"score": 1,
"text": "风湿性疾病"
}
] |
补体缺陷伴风湿性疾病机制不详，尤其是上游成分C2、C4及C3缺陷，伴风湿性疾病几率高达80%，远高于下游成分缺陷（C5～9）的发病几率（10%），这些主要是系统性红斑狼疮、皮肌炎、硬皮病、过敏性紫癜、血管炎和膜增殖性肾炎。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "dis",
"score": 1,
"text": "补体缺陷"
},
{
"indices": [
5,
6,
7,
8,
9
],
"label": "dis",
"score": 1,
"text": "风湿性疾病"
},
{
"indices": [
18,
19,
20,
21
],
"label": "bod",
"score": 1,
"text": "上游成分"
},
{
"indices": [
18,
19,
20,
21,
22,
23,
24,
25,
26,
27,
28,
29,
30,
31
],
"label": "sym",
"score": 1,
"text": "上游成分C2、C4及C3缺陷"
},
{
"indices": [
22,
23
],
"label": "bod",
"score": 1,
"text": "C2"
},
{
"indices": [
25,
26
],
"label": "bod",
"score": 1,
"text": "C4"
},
{
"indices": [
28,
29
],
"label": "bod",
"score": 1,
"text": "C3"
},
{
"indices": [
34,
35,
36,
37,
38
],
"label": "dis",
"score": 1,
"text": "风湿性疾病"
},
{
"indices": [
50,
51,
52,
53,
54,
55,
56,
57,
58,
59,
60,
61
],
"label": "sym",
"score": 1,
"text": "下游成分缺陷（C5～9）"
},
{
"indices": [
50,
51,
52,
53
],
"label": "bod",
"score": 1,
"text": "下游成分"
},
{
"indices": [
57,
58,
59,
60
],
"label": "bod",
"score": 1,
"text": "C5～9"
},
{
"indices": [
78,
79,
80,
81,
82,
83,
84
],
"label": "dis",
"score": 1,
"text": "系统性红斑狼疮"
},
{
"indices": [
86,
87,
88
],
"label": "dis",
"score": 1,
"text": "皮肌炎"
},
{
"indices": [
90,
91,
92
],
"label": "dis",
"score": 1,
"text": "硬皮病"
},
{
"indices": [
94,
95,
96,
97,
98
],
"label": "dis",
"score": 1,
"text": "过敏性紫癜"
},
{
"indices": [
100,
101,
102
],
"label": "dis",
"score": 1,
"text": "血管炎"
},
{
"indices": [
104,
105,
106,
107,
108,
109
],
"label": "dis",
"score": 1,
"text": "膜增殖性肾炎"
}
] |
雄激素类药物，如stanozolol或danazol可促进C1脂酶抑制物合成，可试用于C1脂酶抑制物缺陷，其他补体成分缺陷治疗主要为对症治疗。 | [
{
"indices": [
0,
1,
2,
3,
4,
5
],
"label": "dru",
"score": 1,
"text": "雄激素类药物"
},
{
"indices": [
8,
9,
10,
11,
12,
13,
14,
15,
16,
17
],
"label": "dru",
"score": 1,
"text": "stanozolol"
},
{
"indices": [
19,
20,
21,
22,
23,
24,
25
],
"label": "dru",
"score": 1,
"text": "danazol"
},
{
"indices": [
29,
30,
31,
32,
33,
34,
35
],
"label": "bod",
"score": 1,
"text": "C1脂酶抑制物"
},
{
"indices": [
43,
44,
45,
46,
47,
48,
49,
50,
51
],
"label": "dis",
"score": 1,
"text": "C1脂酶抑制物缺陷"
},
{
"indices": [
55,
56,
57,
58,
59,
60
],
"label": "dis",
"score": 1,
"text": "补体成分缺陷"
},
{
"indices": [
66,
67,
68,
69
],
"label": "pro",
"score": 1,
"text": "对症治疗"
}
] |
有红斑狼疮体质的人，特别是女性，受到外界的诱因，如紫外线、药物及感染等刺激，引起体内一系列免疫紊乱，导致发病。 | [
{
"indices": [
1,
2,
3,
4
],
"label": "dis",
"score": 1,
"text": "红斑狼疮"
},
{
"indices": [
32,
33
],
"label": "dis",
"score": 1,
"text": "感染"
},
{
"indices": [
45,
46,
47,
48
],
"label": "dis",
"score": 1,
"text": "免疫紊乱"
}
] |
也可有皮肤出血和溃疡。 | [
{
"indices": [
3,
4,
5,
6
],
"label": "dis",
"score": 1,
"text": "皮肤出血"
},
{
"indices": [
8,
9
],
"label": "dis",
"score": 1,
"text": "溃疡"
}
] |
②暴发或急性发作出现以下表现之一者：全身极度衰竭伴有剧烈头痛；剧烈腹痛，常类似急腹症；指尖的指甲下或指甲周围出现出血斑；严重口腔溃疡。 | [
{
"indices": [
18,
19,
20,
21,
22,
23
],
"label": "sym",
"score": 1,
"text": "全身极度衰竭"
},
{
"indices": [
18,
19
],
"label": "bod",
"score": 1,
"text": "全身"
},
{
"indices": [
26,
27,
28,
29
],
"label": "sym",
"score": 1,
"text": "剧烈头痛"
},
{
"indices": [
28
],
"label": "bod",
"score": 1,
"text": "头"
},
{
"indices": [
31,
32,
33,
34
],
"label": "sym",
"score": 1,
"text": "剧烈腹痛"
},
{
"indices": [
33
],
"label": "bod",
"score": 1,
"text": "腹"
},
{
"indices": [
39,
40,
41
],
"label": "dis",
"score": 1,
"text": "急腹症"
},
{
"indices": [
43,
44
],
"label": "bod",
"score": 1,
"text": "指尖"
},
{
"indices": [
43,
44,
45,
46,
47,
48,
49,
50,
51,
52,
53,
54,
55,
56,
57,
58
],
"label": "sym",
"score": 1,
"text": "指尖的指甲下或指甲周围出现出血斑"
},
{
"indices": [
46,
47
],
"label": "bod",
"score": 1,
"text": "指甲"
},
{
"indices": [
50,
51
],
"label": "bod",
"score": 1,
"text": "指甲"
},
{
"indices": [
56,
57,
58
],
"label": "bod",
"score": 1,
"text": "出血斑"
},
{
"indices": [
60,
61,
62,
63,
64,
65
],
"label": "sym",
"score": 1,
"text": "严重口腔溃疡"
},
{
"indices": [
62,
63,
64,
65
],
"label": "dis",
"score": 1,
"text": "口腔溃疡"
}
] |
③肾功能进行性下降，伴高血压。 | [
{
"indices": [
1,
2,
3,
4,
5,
6,
7,
8
],
"label": "sym",
"score": 1,
"text": "肾功能进行性下降"
},
{
"indices": [
1,
2,
3
],
"label": "ite",
"score": 1,
"text": "肾功能"
},
{
"indices": [
11,
12,
13
],
"label": "dis",
"score": 1,
"text": "高血压"
}
] |
④出现狼疮肺炎或肺出血。 | [
{
"indices": [
3,
4,
5,
6
],
"label": "dis",
"score": 1,
"text": "狼疮肺炎"
},
{
"indices": [
8,
9,
10
],
"label": "dis",
"score": 1,
"text": "肺出血"
}
] |
近年报道，可应用经颅多普勒超声（TCD）诊断儿童狼疮性脑病，认为TCD有效、简便、无创、价优，有助于长期随访观察SLE病情。 | [
{
"indices": [
9,
10,
11,
12,
13,
14
],
"label": "pro",
"score": 1,
"text": "颅多普勒超声"
},
{
"indices": [
16,
17,
18
],
"label": "pro",
"score": 1,
"text": "TCD"
},
{
"indices": [
24,
25,
26,
27,
28
],
"label": "dis",
"score": 1,
"text": "狼疮性脑病"
},
{
"indices": [
32,
33,
34
],
"label": "pro",
"score": 1,
"text": "TCD"
},
{
"indices": [
56,
57,
58
],
"label": "dis",
"score": 1,
"text": "SLE"
}
] |
注意血压，必要时加用血管扩张剂。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "pro",
"score": 1,
"text": "注意血压"
},
{
"indices": [
8,
9,
10,
11,
12,
13,
14
],
"label": "pro",
"score": 1,
"text": "加用血管扩张剂"
}
] |
可因心肌功能受损或血流动力学负荷过重引起。 | [
{
"indices": [
2,
3,
4,
5,
6,
7
],
"label": "dis",
"score": 1,
"text": "心肌功能受损"
},
{
"indices": [
9,
10,
11,
12,
13,
14,
15,
16,
17
],
"label": "sym",
"score": 1,
"text": "血流动力学负荷过重"
},
{
"indices": [
9,
10,
11,
12,
13,
14,
15
],
"label": "ite",
"score": 1,
"text": "血流动力学负荷"
}
] |
此外，原发性心肌病如心内膜弹力纤维增生症、先天性心肌病和病毒性心肌炎所致者亦不常见。 | [
{
"indices": [
3,
4,
5,
6,
7,
8
],
"label": "dis",
"score": 1,
"text": "原发性心肌病"
},
{
"indices": [
10,
11,
12,
13,
14,
15,
16,
17,
18,
19
],
"label": "dis",
"score": 1,
"text": "心内膜弹力纤维增生症"
},
{
"indices": [
21,
22,
23,
24,
25,
26
],
"label": "dis",
"score": 1,
"text": "先天性心肌病"
},
{
"indices": [
28,
29,
30,
31,
32,
33
],
"label": "dis",
"score": 1,
"text": "病毒性心肌炎"
}
] |
高排血量型心力衰竭可能与严重的贫血（Rh同种免疫性疾病、珠蛋白生成障碍性贫血、双胎间输血）或体循环动静脉瘘有关。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6,
7,
8
],
"label": "dis",
"score": 1,
"text": "高排血量型心力衰竭"
},
{
"indices": [
15,
16
],
"label": "dis",
"score": 1,
"text": "贫血"
},
{
"indices": [
18,
19,
20,
21,
22,
23,
24,
25,
26
],
"label": "dis",
"score": 1,
"text": "Rh同种免疫性疾病"
},
{
"indices": [
28,
29,
30,
31,
32,
33,
34,
35,
36,
37
],
"label": "dis",
"score": 1,
"text": "珠蛋白生成障碍性贫血"
},
{
"indices": [
39,
40,
41,
42,
43
],
"label": "pro",
"score": 1,
"text": "双胎间输血"
},
{
"indices": [
46,
47,
48,
49,
50,
51,
52
],
"label": "dis",
"score": 1,
"text": "体循环动静脉瘘"
}
] |
心律失常同样可导致心力衰竭。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "dis",
"score": 1,
"text": "心律失常"
},
{
"indices": [
9,
10,
11,
12
],
"label": "dis",
"score": 1,
"text": "心力衰竭"
}
] |
引起心力衰竭的其他原因，如继发的心肌功能障碍、心律失常如前所述。 | [
{
"indices": [
2,
3,
4,
5
],
"label": "dis",
"score": 1,
"text": "心力衰竭"
},
{
"indices": [
16,
17,
18,
19,
20,
21
],
"label": "dis",
"score": 1,
"text": "心肌功能障碍"
},
{
"indices": [
23,
24,
25,
26
],
"label": "dis",
"score": 1,
"text": "心律失常"
}
] |
2.小婴儿心力衰竭（出生后2至3个月）左向右分流型的心脏结构畸形多在此时期出现心力衰竭的典型表现，这与生后肺血管阻力降低和肺血流量增加有关。 | [
{
"indices": [
5,
6,
7,
8
],
"label": "dis",
"score": 1,
"text": "心力衰竭"
},
{
"indices": [
19,
20,
21,
22,
23,
24,
25,
26,
27,
28,
29,
30,
31
],
"label": "sym",
"score": 1,
"text": "左向右分流型的心脏结构畸形"
},
{
"indices": [
26,
27
],
"label": "bod",
"score": 1,
"text": "心脏"
},
{
"indices": [
39,
40,
41,
42
],
"label": "dis",
"score": 1,
"text": "心力衰竭"
},
{
"indices": [
53,
54,
55,
56,
57,
58,
59
],
"label": "sym",
"score": 1,
"text": "肺血管阻力降低"
},
{
"indices": [
53,
54,
55,
56,
57
],
"label": "ite",
"score": 1,
"text": "肺血管阻力"
},
{
"indices": [
61,
62,
63,
64,
65,
66
],
"label": "sym",
"score": 1,
"text": "肺血流量增加"
},
{
"indices": [
61,
62,
63,
64
],
"label": "ite",
"score": 1,
"text": "肺血流量"
}
] |
心力衰竭的药物治疗，可以减轻体循环静脉淤血（利尿剂），改善心肌收缩功能（正性肌力药物）或减轻心脏后负荷（血管扩张剂）。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "dis",
"score": 1,
"text": "心力衰竭"
},
{
"indices": [
12,
13,
14,
15,
16,
17,
18,
19,
20
],
"label": "pro",
"score": 1,
"text": "减轻体循环静脉淤血"
},
{
"indices": [
22,
23,
24
],
"label": "dru",
"score": 1,
"text": "利尿剂"
},
{
"indices": [
27,
28,
29,
30,
31,
32,
33,
34
],
"label": "pro",
"score": 1,
"text": "改善心肌收缩功能"
},
{
"indices": [
36,
37,
38,
39,
40,
41
],
"label": "dru",
"score": 1,
"text": "正性肌力药物"
},
{
"indices": [
44,
45,
46,
47,
48,
49,
50
],
"label": "pro",
"score": 1,
"text": "减轻心脏后负荷"
},
{
"indices": [
52,
53,
54,
55,
56
],
"label": "dru",
"score": 1,
"text": "血管扩张剂"
}
] |
临床常用的利尿剂有袢利尿剂、醛固酮拮抗剂和噻嗪类（氯噻嗪、美托拉宗）。 | [
{
"indices": [
5,
6,
7
],
"label": "dru",
"score": 1,
"text": "利尿剂"
},
{
"indices": [
9,
10,
11,
12
],
"label": "dru",
"score": 1,
"text": "袢利尿剂"
},
{
"indices": [
14,
15,
16,
17,
18,
19
],
"label": "dru",
"score": 1,
"text": "醛固酮拮抗剂"
},
{
"indices": [
21,
22,
23
],
"label": "dru",
"score": 1,
"text": "噻嗪类"
},
{
"indices": [
25,
26,
27
],
"label": "dru",
"score": 1,
"text": "氯噻嗪"
},
{
"indices": [
29,
30,
31,
32
],
"label": "dru",
"score": 1,
"text": "美托拉宗"
}
] |
袢利尿剂（呋塞米、依他尼酸）常用且有效。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "dru",
"score": 1,
"text": "袢利尿剂"
},
{
"indices": [
5,
6,
7
],
"label": "dru",
"score": 1,
"text": "呋塞米"
},
{
"indices": [
9,
10,
11,
12
],
"label": "dru",
"score": 1,
"text": "依他尼酸"
}
] |
第三代β受体阻滞剂（卡维地洛、布新洛尔）另有血管扩张作用，可有效改善血流动力学。 | [
{
"indices": [
3,
4,
5,
6,
7,
8
],
"label": "dru",
"score": 1,
"text": "β受体阻滞剂"
},
{
"indices": [
10,
11,
12,
13
],
"label": "dru",
"score": 1,
"text": "卡维地洛"
},
{
"indices": [
15,
16,
17,
18
],
"label": "dru",
"score": 1,
"text": "布新洛尔"
},
{
"indices": [
22,
23
],
"label": "bod",
"score": 1,
"text": "血管"
},
{
"indices": [
34
],
"label": "bod",
"score": 1,
"text": "血"
}
] |
近年认识到它是引起小儿肾衰竭的重要原因；据估计成年人TIN占急性肾衰竭的5%～15%，进入终末期肾衰中占25%：小儿则分别为5%和6%～8%。 | [
{
"indices": [
9,
10,
11,
12,
13
],
"label": "dis",
"score": 1,
"text": "小儿肾衰竭"
},
{
"indices": [
26,
27,
28
],
"label": "dis",
"score": 1,
"text": "TIN"
},
{
"indices": [
30,
31,
32,
33,
34
],
"label": "dis",
"score": 1,
"text": "急性肾衰竭"
},
{
"indices": [
45,
46,
47,
48,
49
],
"label": "dis",
"score": 1,
"text": "终末期肾衰"
}
] |
前者急起，可表现为急性肾衰竭、肾小管功能障碍及尿沉渣异常，组织学上以肾间质水肿和细胞浸润为主；慢性者常呈一不可逆过程，以间质纤维化和小管萎缩为特点。 | [
{
"indices": [
2,
3
],
"label": "sym",
"score": 1,
"text": "急起"
},
{
"indices": [
9,
10,
11,
12,
13
],
"label": "dis",
"score": 1,
"text": "急性肾衰竭"
},
{
"indices": [
15,
16,
17,
18,
19,
20,
21
],
"label": "dis",
"score": 1,
"text": "肾小管功能障碍"
},
{
"indices": [
23,
24,
25,
26,
27
],
"label": "sym",
"score": 1,
"text": "尿沉渣异常"
},
{
"indices": [
23,
24,
25
],
"label": "ite",
"score": 1,
"text": "尿沉渣"
},
{
"indices": [
29,
30
],
"label": "bod",
"score": 1,
"text": "组织"
},
{
"indices": [
34,
35,
36
],
"label": "bod",
"score": 1,
"text": "肾间质"
},
{
"indices": [
34,
35,
36,
37,
38
],
"label": "sym",
"score": 1,
"text": "肾间质水肿"
},
{
"indices": [
40,
41
],
"label": "bod",
"score": 1,
"text": "细胞"
},
{
"indices": [
40,
41,
42,
43
],
"label": "sym",
"score": 1,
"text": "细胞浸润"
},
{
"indices": [
47,
48,
49,
50,
51,
52,
53,
54,
55,
56,
57
],
"label": "sym",
"score": 1,
"text": "慢性者常呈一不可逆过程"
},
{
"indices": [
60,
61
],
"label": "bod",
"score": 1,
"text": "间质"
},
{
"indices": [
60,
61,
62,
63,
64
],
"label": "sym",
"score": 1,
"text": "间质纤维化"
},
{
"indices": [
66,
67
],
"label": "bod",
"score": 1,
"text": "小管"
},
{
"indices": [
66,
67,
68,
69
],
"label": "sym",
"score": 1,
"text": "小管萎缩"
}
] |
前者如细菌、钩端螺旋体、分枝杆菌、CMV病毒、Hanta病毒以及多瘤病毒等。 | [
{
"indices": [
3,
4
],
"label": "mic",
"score": 1,
"text": "细菌"
},
{
"indices": [
6,
7,
8,
9,
10
],
"label": "mic",
"score": 1,
"text": "钩端螺旋体"
},
{
"indices": [
12,
13,
14,
15
],
"label": "mic",
"score": 1,
"text": "分枝杆菌"
},
{
"indices": [
17,
18,
19,
20,
21
],
"label": "mic",
"score": 1,
"text": "CMV病毒"
},
{
"indices": [
23,
24,
25,
26,
27,
28,
29
],
"label": "mic",
"score": 1,
"text": "Hanta病毒"
},
{
"indices": [
32,
33,
34,
35
],
"label": "mic",
"score": 1,
"text": "多瘤病毒"
}
] |
儿科最突出的是系统性红斑狼疮，在13%～67%的狼疮病人中肾小管可见免疫复合物沉着，而且TIN是狼疮肾进展和影响预后的重要因素。 | [
{
"indices": [
0,
1
],
"label": "dep",
"score": 1,
"text": "儿科"
},
{
"indices": [
7,
8,
9,
10,
11,
12,
13
],
"label": "dis",
"score": 1,
"text": "系统性红斑狼疮"
},
{
"indices": [
24,
25
],
"label": "dis",
"score": 1,
"text": "狼疮"
},
{
"indices": [
29,
30,
31
],
"label": "bod",
"score": 1,
"text": "肾小管"
},
{
"indices": [
29,
30,
31,
32,
33,
34,
35,
36,
37,
38,
39,
40
],
"label": "sym",
"score": 1,
"text": "肾小管可见免疫复合物沉着"
},
{
"indices": [
34,
35,
36,
37,
38
],
"label": "bod",
"score": 1,
"text": "免疫复合物"
},
{
"indices": [
44,
45,
46
],
"label": "dis",
"score": 1,
"text": "TIN"
},
{
"indices": [
48,
49,
50
],
"label": "dis",
"score": 1,
"text": "狼疮肾"
}
] |
此外TIN也偶见于原发性或梅毒引起的膜性肾病。 | [
{
"indices": [
2,
3,
4
],
"label": "dis",
"score": 1,
"text": "TIN"
},
{
"indices": [
13,
14
],
"label": "dis",
"score": 1,
"text": "梅毒"
},
{
"indices": [
18,
19,
20,
21
],
"label": "dis",
"score": 1,
"text": "膜性肾病"
}
] |
全身性免疫性紊乱时也可仅间质及小管受累，如肾移植时的排异反应，另一为TINU综合征，即小管间质性肾炎伴眼色素膜炎。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6,
7
],
"label": "dis",
"score": 1,
"text": "全身性免疫性紊乱"
},
{
"indices": [
12,
13
],
"label": "bod",
"score": 1,
"text": "间质"
},
{
"indices": [
12,
13,
14,
15,
16,
17,
18
],
"label": "sym",
"score": 1,
"text": "间质及小管受累"
},
{
"indices": [
15,
16
],
"label": "bod",
"score": 1,
"text": "小管"
},
{
"indices": [
21,
22,
23
],
"label": "pro",
"score": 1,
"text": "肾移植"
},
{
"indices": [
26,
27,
28,
29
],
"label": "sym",
"score": 1,
"text": "排异反应"
},
{
"indices": [
34,
35,
36,
37,
38,
39,
40
],
"label": "dis",
"score": 1,
"text": "TINU综合征"
},
{
"indices": [
43,
44,
45,
46,
47,
48,
49
],
"label": "dis",
"score": 1,
"text": "小管间质性肾炎"
},
{
"indices": [
51,
52,
53,
54,
55
],
"label": "dis",
"score": 1,
"text": "眼色素膜炎"
}
] |
此征1975年始被报道，病人有急性TIN和眼色素膜炎和骨髓肉芽肿，表现有虚弱、厌食、发热、体重下降及多尿。 | [
{
"indices": [
15,
16,
17,
18,
19
],
"label": "dis",
"score": 1,
"text": "急性TIN"
},
{
"indices": [
21,
22,
23,
24,
25
],
"label": "dis",
"score": 1,
"text": "眼色素膜炎"
},
{
"indices": [
27,
28,
29,
30,
31
],
"label": "dis",
"score": 1,
"text": "骨髓肉芽肿"
},
{
"indices": [
36,
37
],
"label": "sym",
"score": 1,
"text": "虚弱"
},
{
"indices": [
39,
40
],
"label": "sym",
"score": 1,
"text": "厌食"
},
{
"indices": [
42,
43
],
"label": "sym",
"score": 1,
"text": "发热"
},
{
"indices": [
45,
46,
47,
48
],
"label": "sym",
"score": 1,
"text": "体重下降"
},
{
"indices": [
50,
51
],
"label": "sym",
"score": 1,
"text": "多尿"
},
{
"indices": [
51
],
"label": "bod",
"score": 1,
"text": "尿"
}
] |
眼部有流泪、眼痛及眼色素膜炎。 | [
{
"indices": [
0,
1,
2,
3,
4
],
"label": "sym",
"score": 1,
"text": "眼部有流泪"
},
{
"indices": [
0,
1
],
"label": "bod",
"score": 1,
"text": "眼部"
},
{
"indices": [
6,
7
],
"label": "sym",
"score": 1,
"text": "眼痛"
},
{
"indices": [
6
],
"label": "bod",
"score": 1,
"text": "眼"
},
{
"indices": [
9,
10,
11,
12,
13
],
"label": "dis",
"score": 1,
"text": "眼色素膜炎"
}
] |
在小儿时期最多见于各种尿路梗阻（UTO）和重度的膀胱输尿管反流（VUR）。 | [
{
"indices": [
11,
12,
13,
14
],
"label": "dis",
"score": 1,
"text": "尿路梗阻"
},
{
"indices": [
16,
17,
18
],
"label": "dis",
"score": 1,
"text": "UTO"
},
{
"indices": [
21,
22,
23,
24,
25,
26,
27,
28,
29,
30
],
"label": "dis",
"score": 1,
"text": "重度的膀胱输尿管反流"
},
{
"indices": [
32,
33,
34
],
"label": "dis",
"score": 1,
"text": "VUR"
}
] |
在小儿时期慢性TIN还可由代谢病引起，如①胱氨酸病：见本章第四节。 | [
{
"indices": [
5,
6,
7,
8,
9
],
"label": "dis",
"score": 1,
"text": "慢性TIN"
},
{
"indices": [
13,
14,
15
],
"label": "dis",
"score": 1,
"text": "代谢病"
},
{
"indices": [
21,
22,
23,
24
],
"label": "dis",
"score": 1,
"text": "胱氨酸病"
}
] |
②草酸盐过度产生或小肠过度吸收，造成肾排出草酸盐增多，则肾小管内草酸钙结晶沉积，受累小管萎缩，周围炎症细胞浸润和纤维化。 | [
{
"indices": [
1,
2,
3
],
"label": "bod",
"score": 1,
"text": "草酸盐"
},
{
"indices": [
1,
2,
3,
4,
5,
6,
7
],
"label": "sym",
"score": 1,
"text": "草酸盐过度产生"
},
{
"indices": [
9,
10
],
"label": "bod",
"score": 1,
"text": "小肠"
},
{
"indices": [
9,
10,
11,
12,
13,
14
],
"label": "sym",
"score": 1,
"text": "小肠过度吸收"
},
{
"indices": [
18
],
"label": "bod",
"score": 1,
"text": "肾"
},
{
"indices": [
18,
19,
20,
21,
22,
23,
24,
25
],
"label": "sym",
"score": 1,
"text": "肾排出草酸盐增多"
},
{
"indices": [
21,
22,
23
],
"label": "bod",
"score": 1,
"text": "草酸盐"
},
{
"indices": [
28,
29,
30
],
"label": "bod",
"score": 1,
"text": "肾小管"
},
{
"indices": [
28,
29,
30,
31,
32,
33,
34,
35,
36,
37,
38
],
"label": "sym",
"score": 1,
"text": "肾小管内草酸钙结晶沉积"
},
{
"indices": [
32,
33,
34
],
"label": "bod",
"score": 1,
"text": "草酸钙"
},
{
"indices": [
40,
41,
42,
43,
44,
45
],
"label": "dis",
"score": 1,
"text": "受累小管萎缩"
},
{
"indices": [
47,
48,
49,
50,
51,
52,
53,
54,
55,
56,
57,
58
],
"label": "sym",
"score": 1,
"text": "周围炎症细胞浸润和纤维化"
},
{
"indices": [
47,
48,
49,
50,
51,
52
],
"label": "bod",
"score": 1,
"text": "周围炎症细胞"
}
] |
③高钙血症。 | [
{
"indices": [
1,
2,
3,
4
],
"label": "dis",
"score": 1,
"text": "高钙血症"
}
] |
④钾不足：严重钾不足时主要为近曲小管受累（上皮空泡变性）。 | [
{
"indices": [
1,
2,
3
],
"label": "sym",
"score": 1,
"text": "钾不足"
},
{
"indices": [
1
],
"label": "bod",
"score": 1,
"text": "钾"
},
{
"indices": [
5,
6,
7,
8,
9
],
"label": "sym",
"score": 1,
"text": "严重钾不足"
},
{
"indices": [
7
],
"label": "bod",
"score": 1,
"text": "钾"
},
{
"indices": [
14,
15,
16,
17
],
"label": "bod",
"score": 1,
"text": "近曲小管"
},
{
"indices": [
21,
22,
23,
24,
25,
26
],
"label": "sym",
"score": 1,
"text": "上皮空泡变性"
},
{
"indices": [
21,
22,
23,
24
],
"label": "bod",
"score": 1,
"text": "上皮空泡"
}
] |
⑤尿酸盐：尿酸负荷致肾受损，不定形尿酸盐结晶沉于肾间质引起周围巨噬细胞反应，与此同时，在小管及集合管中也有其结晶，最终导致间质纤维化、小管扩张及萎缩，此种损害只发生于血尿酸持续＞595～773μmol/L（10～13mg/dl）时。 | [
{
"indices": [
1,
2,
3
],
"label": "sym",
"score": 1,
"text": "尿酸盐"
},
{
"indices": [
5,
6
],
"label": "sym",
"score": 1,
"text": "尿酸"
},
{
"indices": [
10,
11,
12
],
"label": "dis",
"score": 1,
"text": "肾受损"
},
{
"indices": [
14,
15,
16,
17,
18,
19,
20,
21,
22,
23,
24,
25,
26
],
"label": "sym",
"score": 1,
"text": "不定形尿酸盐结晶沉于肾间质"
},
{
"indices": [
17,
18,
19,
20,
21
],
"label": "bod",
"score": 1,
"text": "尿酸盐结晶"
},
{
"indices": [
24,
25,
26
],
"label": "bod",
"score": 1,
"text": "肾间质"
},
{
"indices": [
29,
30,
31,
32,
33,
34
],
"label": "bod",
"score": 1,
"text": "周围巨噬细胞"
},
{
"indices": [
29,
30,
31,
32,
33,
34,
35,
36
],
"label": "sym",
"score": 1,
"text": "周围巨噬细胞反应"
},
{
"indices": [
44,
45,
46,
47,
48,
49,
50
],
"label": "bod",
"score": 1,
"text": "小管及集合管中"
},
{
"indices": [
44,
45,
46,
47,
48,
49,
50,
51,
52,
53,
54,
55
],
"label": "sym",
"score": 1,
"text": "小管及集合管中也有其结晶"
},
{
"indices": [
54,
55
],
"label": "bod",
"score": 1,
"text": "结晶"
},
{
"indices": [
61,
62,
63,
64,
65
],
"label": "sym",
"score": 1,
"text": "间质纤维化"
},
{
"indices": [
61,
62
],
"label": "bod",
"score": 1,
"text": "间质"
},
{
"indices": [
67,
68,
69,
70,
71,
72,
73
],
"label": "sym",
"score": 1,
"text": "小管扩张及萎缩"
},
{
"indices": [
67,
68
],
"label": "bod",
"score": 1,
"text": "小管"
},
{
"indices": [
77,
78
],
"label": "dis",
"score": 1,
"text": "损害"
},
{
"indices": [
83,
84,
85
],
"label": "ite",
"score": 1,
"text": "血尿酸"
},
{
"indices": [
83,
84,
85,
86,
87,
88,
89,
90,
91,
92,
93,
94,
95,
96,
97,
98,
99,
100,
101,
102,
103,
104,
105,
106,
107,
108,
109,
110,
111,
112,
113
],
"label": "sym",
"score": 1,
"text": "血尿酸持续＞595～773μmol/L（10～13mg/dl）"
}
] |
可表现为急性肾衰竭及肾小管功能障碍，偶见肾病综合征。 | [
{
"indices": [
4,
5,
6,
7,
8
],
"label": "dis",
"score": 1,
"text": "急性肾衰竭"
},
{
"indices": [
10,
11,
12,
13,
14,
15,
16
],
"label": "dis",
"score": 1,
"text": "肾小管功能障碍"
},
{
"indices": [
20,
21,
22,
23,
24
],
"label": "dis",
"score": 1,
"text": "肾病综合征"
}
] |
起病时乏力、厌食、体重下降、腹痛、头痛、苍白及呕吐。 | [
{
"indices": [
3,
4
],
"label": "sym",
"score": 1,
"text": "乏力"
},
{
"indices": [
6,
7
],
"label": "sym",
"score": 1,
"text": "厌食"
},
{
"indices": [
9,
10,
11,
12
],
"label": "sym",
"score": 1,
"text": "体重下降"
},
{
"indices": [
9,
10
],
"label": "ite",
"score": 1,
"text": "体重"
},
{
"indices": [
14,
15
],
"label": "sym",
"score": 1,
"text": "腹痛"
},
{
"indices": [
14
],
"label": "bod",
"score": 1,
"text": "腹"
},
{
"indices": [
17,
18
],
"label": "sym",
"score": 1,
"text": "头痛"
},
{
"indices": [
17
],
"label": "bod",
"score": 1,
"text": "头"
},
{
"indices": [
20,
21
],
"label": "sym",
"score": 1,
"text": "苍白"
},
{
"indices": [
23,
24
],
"label": "sym",
"score": 1,
"text": "呕吐"
}
] |
疾病后期表现慢性肾衰竭，伴显著高血压、高血压眼底改变及左心室肥厚，此时常难于区别原发病为肾小球疾病或间质炎症改变。 | [
{
"indices": [
6,
7,
8,
9,
10
],
"label": "dis",
"score": 1,
"text": "慢性肾衰竭"
},
{
"indices": [
15,
16,
17
],
"label": "dis",
"score": 1,
"text": "高血压"
},
{
"indices": [
19,
20,
21,
22,
23,
24,
25
],
"label": "dis",
"score": 1,
"text": "高血压眼底改变"
},
{
"indices": [
27,
28,
29,
30,
31
],
"label": "sym",
"score": 1,
"text": "左心室肥厚"
},
{
"indices": [
27,
28,
29
],
"label": "bod",
"score": 1,
"text": "左心室"
},
{
"indices": [
44,
45,
46,
47,
48
],
"label": "dis",
"score": 1,
"text": "肾小球疾病"
},
{
"indices": [
50,
51,
52,
53
],
"label": "dis",
"score": 1,
"text": "间质炎症"
}
] |
因此时病理上多兼有肾小球硬化和间质纤维化。 | [
{
"indices": [
9,
10,
11,
12,
13
],
"label": "dis",
"score": 1,
"text": "肾小球硬化"
},
{
"indices": [
15,
16,
17,
18,
19
],
"label": "dis",
"score": 1,
"text": "间质纤维化"
}
] |
尿沉渣瑞氏染色可检见嗜酸粒细胞，此对本症诊断有助；正常时尿中无嗜酸细胞，当其占尿白细胞中1%～5%，即有诊断意义，由药物引起之急性TIN患者中50%～90%为阳性。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6
],
"label": "pro",
"score": 1,
"text": "尿沉渣瑞氏染色"
},
{
"indices": [
10,
11,
12,
13,
14
],
"label": "bod",
"score": 1,
"text": "嗜酸粒细胞"
},
{
"indices": [
28
],
"label": "bod",
"score": 1,
"text": "尿"
},
{
"indices": [
31,
32,
33,
34
],
"label": "bod",
"score": 1,
"text": "嗜酸细胞"
},
{
"indices": [
39,
40,
41,
42
],
"label": "bod",
"score": 1,
"text": "尿白细胞"
},
{
"indices": [
63,
64,
65,
66,
67
],
"label": "dis",
"score": 1,
"text": "急性TIN"
}
] |
对有造成TIN的病因存在、发生肾功能减退以及肾小管功能障碍者应疑及本症，确诊依赖肾活体组织检查。 | [
{
"indices": [
4,
5,
6
],
"label": "dis",
"score": 1,
"text": "TIN"
},
{
"indices": [
15,
16,
17,
18,
19
],
"label": "sym",
"score": 1,
"text": "肾功能减退"
},
{
"indices": [
15
],
"label": "bod",
"score": 1,
"text": "肾"
},
{
"indices": [
22,
23,
24,
25,
26,
27,
28
],
"label": "dis",
"score": 1,
"text": "肾小管功能障碍"
},
{
"indices": [
40,
41,
42,
43,
44,
45,
46
],
"label": "pro",
"score": 1,
"text": "肾活体组织检查"
}
] |
在一回顾性研究中，应用泼尼松4～6周者，其ARF恢复时间虽与未用者相似，但8周时治疗组血肌酐水平较对照组为低。 | [
{
"indices": [
11,
12,
13
],
"label": "dru",
"score": 1,
"text": "泼尼松"
},
{
"indices": [
21,
22,
23
],
"label": "dis",
"score": 1,
"text": "ARF"
},
{
"indices": [
43,
44,
45,
46,
47
],
"label": "ite",
"score": 1,
"text": "血肌酐水平"
}
] |
先天性甲状腺功能减低症和急性淋巴细胞性白血病的发生率明显高于正常人群，免疫功能低下，易患感染性疾病。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6,
7,
8,
9,
10
],
"label": "dis",
"score": 1,
"text": "先天性甲状腺功能减低症"
},
{
"indices": [
12,
13,
14,
15,
16,
17,
18,
19,
20,
21
],
"label": "dis",
"score": 1,
"text": "急性淋巴细胞性白血病"
},
{
"indices": [
35,
36,
37,
38,
39,
40
],
"label": "sym",
"score": 1,
"text": "免疫功能低下"
},
{
"indices": [
44,
45,
46,
47,
48
],
"label": "dis",
"score": 1,
"text": "感染性疾病"
}
] |
如存活至成人期，则常在30岁以后即出现老年性痴呆症状。 | [
{
"indices": [
19,
20,
21,
22,
23
],
"label": "dis",
"score": 1,
"text": "老年性痴呆"
}
] |
因此，对怀孕早、中期的孕妇开展21-三体综合征筛查，及早采取积极预防措施，对保证妇幼健康水平有一定意义。 | [
{
"indices": [
15,
16,
17,
18,
19,
20,
21,
22
],
"label": "dis",
"score": 1,
"text": "21-三体综合征"
}
] |
产前筛查血清标志物HCG及AFP测定有一定临床意义，因为它能够减少羊膜穿刺进行产前诊断的盲目性，提示高危孕妇群的存在，使这些孕妇得以作进一步的产前检查和咨询，最大限度地防止21-三体综合征患儿的出生。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6,
7,
8,
9,
10,
11,
12,
13,
14,
15,
16,
17
],
"label": "pro",
"score": 1,
"text": "产前筛查血清标志物HCG及AFP测定"
},
{
"indices": [
33,
34,
35,
36
],
"label": "sym",
"score": 1,
"text": "羊膜穿刺"
},
{
"indices": [
86,
87,
88,
89,
90,
91,
92,
93
],
"label": "dis",
"score": 1,
"text": "21-三体综合征"
}
] |
亦称心室双入口。 | [
{
"indices": [
2,
3,
4,
5,
6
],
"label": "dis",
"score": 1,
"text": "心室双入口"
}
] |
动脉干发自原始心球，前者以后发育为主动脉、肺动脉。 | [
{
"indices": [
0,
1,
2
],
"label": "bod",
"score": 1,
"text": "动脉干"
},
{
"indices": [
7,
8
],
"label": "bod",
"score": 1,
"text": "心球"
},
{
"indices": [
17,
18,
19
],
"label": "bod",
"score": 1,
"text": "主动脉"
},
{
"indices": [
21,
22,
23
],
"label": "bod",
"score": 1,
"text": "肺动脉"
}
] |
最常见的单心室为左心室型单心室、主动脉位于肺动脉左侧、主动脉起自左侧的残余右心室，与纠正型大血管转位相似。 | [
{
"indices": [
4,
5,
6
],
"label": "dis",
"score": 1,
"text": "单心室"
},
{
"indices": [
8,
9,
10,
11,
12,
13,
14
],
"label": "dis",
"score": 1,
"text": "左心室型单心室"
},
{
"indices": [
16,
17,
18,
19,
20,
21,
22,
23,
24,
25
],
"label": "sym",
"score": 1,
"text": "主动脉位于肺动脉左侧"
},
{
"indices": [
16,
17,
18
],
"label": "bod",
"score": 1,
"text": "主动脉"
},
{
"indices": [
21,
22,
23,
24,
25
],
"label": "bod",
"score": 1,
"text": "肺动脉左侧"
},
{
"indices": [
27,
28,
29,
30,
31,
32,
33,
34,
35,
36,
37,
38,
39
],
"label": "sym",
"score": 1,
"text": "主动脉起自左侧的残余右心室"
},
{
"indices": [
27,
28,
29
],
"label": "bod",
"score": 1,
"text": "主动脉"
},
{
"indices": [
32,
33,
34,
35,
36,
37,
38,
39
],
"label": "bod",
"score": 1,
"text": "左侧的残余右心室"
},
{
"indices": [
42,
43,
44,
45,
46,
47,
48,
49
],
"label": "dis",
"score": 1,
"text": "纠正型大血管转位"
}
] |
有一种特殊的少见类型的单心室称Holmes心，表现为单一左心室双流入道及肺动脉狭窄但不伴有大动脉转位。 | [
{
"indices": [
11,
12,
13
],
"label": "dis",
"score": 1,
"text": "单心室"
},
{
"indices": [
15,
16,
17,
18,
19,
20,
21
],
"label": "dis",
"score": 1,
"text": "Holmes心"
},
{
"indices": [
26,
27,
28,
29,
30,
31,
32,
33,
34
],
"label": "sym",
"score": 1,
"text": "单一左心室双流入道"
},
{
"indices": [
28,
29,
30,
31,
32,
33,
34
],
"label": "bod",
"score": 1,
"text": "左心室双流入道"
},
{
"indices": [
36,
37,
38,
39,
40
],
"label": "dis",
"score": 1,
"text": "肺动脉狭窄"
},
{
"indices": [
45,
46,
47,
48,
49
],
"label": "dis",
"score": 1,
"text": "大动脉转位"
}
] |
患儿如不伴有肺动脉狭窄，在婴儿期随着胎儿期肺血管阻力的退化，肺血流逐渐增加，最终形成充血性心力衰竭而往往无法存活。 | [
{
"indices": [
6,
7,
8,
9,
10
],
"label": "dis",
"score": 1,
"text": "肺动脉狭窄"
},
{
"indices": [
21,
22,
23
],
"label": "bod",
"score": 1,
"text": "肺血管"
},
{
"indices": [
30,
31,
32
],
"label": "bod",
"score": 1,
"text": "肺血流"
},
{
"indices": [
42,
43,
44,
45,
46,
47,
48
],
"label": "dis",
"score": 1,
"text": "充血性心力衰竭"
}
] |
单心室患儿如伴有肺动脉闭锁，在生后即出现青紫。 | [
{
"indices": [
0,
1,
2
],
"label": "dis",
"score": 1,
"text": "单心室"
},
{
"indices": [
8,
9,
10,
11,
12
],
"label": "dis",
"score": 1,
"text": "肺动脉闭锁"
},
{
"indices": [
20,
21
],
"label": "sym",
"score": 1,
"text": "青紫"
}
] |
如果伴有严重的肺动脉狭窄，则由于明显的青紫而发现更早。 | [
{
"indices": [
7,
8,
9,
10,
11
],
"label": "dis",
"score": 1,
"text": "肺动脉狭窄"
},
{
"indices": [
16,
17,
18,
19,
20
],
"label": "sym",
"score": 1,
"text": "明显的青紫"
}
] |
通常需在生后6个月至1岁内再次进行心导管造影检查以判定前期处理的效果并确定进一步外科手术纠治的指征。 | [
{
"indices": [
17,
18,
19,
20,
21,
22,
23
],
"label": "pro",
"score": 1,
"text": "心导管造影检查"
},
{
"indices": [
40,
41,
42,
43
],
"label": "pro",
"score": 1,
"text": "外科手术"
}
] |
异丙肾上腺素是最后可用的方法。 | [
{
"indices": [
0,
1,
2,
3,
4,
5
],
"label": "dru",
"score": 1,
"text": "异丙肾上腺素"
}
] |
除了有明显可逆性原因外，一般均应作电生理检查。 | [
{
"indices": [
17,
18,
19,
20,
21
],
"label": "pro",
"score": 1,
"text": "电生理检查"
}
] |
如为WPW综合征，应予消融。 | [
{
"indices": [
2,
3,
4,
5,
6,
7
],
"label": "dis",
"score": 1,
"text": "WPW综合征"
},
{
"indices": [
11,
12
],
"label": "pro",
"score": 1,
"text": "消融"
}
] |
如为原因不明或为非可逆性原因引起，应予安置AICD预防猝死。 | [
{
"indices": [
19,
20,
21,
22,
23,
24
],
"label": "pro",
"score": 1,
"text": "安置AICD"
},
{
"indices": [
27,
28
],
"label": "dis",
"score": 1,
"text": "猝死"
}
] |
多发生于皮肤、软组织、肝和脾等处。 | [
{
"indices": [
4,
5
],
"label": "bod",
"score": 1,
"text": "皮肤"
},
{
"indices": [
7,
8,
9
],
"label": "bod",
"score": 1,
"text": "软组织"
},
{
"indices": [
11
],
"label": "bod",
"score": 1,
"text": "肝"
},
{
"indices": [
13
],
"label": "bod",
"score": 1,
"text": "脾"
}
] |
肿瘤以皮肤的发生率最高，其他依次为软组织、乳房、肝、脾、心脏等处。 | [
{
"indices": [
0,
1
],
"label": "dis",
"score": 1,
"text": "肿瘤"
},
{
"indices": [
3,
4
],
"label": "bod",
"score": 1,
"text": "皮肤"
},
{
"indices": [
17,
18,
19
],
"label": "bod",
"score": 1,
"text": "软组织"
},
{
"indices": [
21,
22
],
"label": "bod",
"score": 1,
"text": "乳房"
},
{
"indices": [
24
],
"label": "bod",
"score": 1,
"text": "肝"
},
{
"indices": [
26
],
"label": "bod",
"score": 1,
"text": "脾"
},
{
"indices": [
28,
29
],
"label": "bod",
"score": 1,
"text": "心脏"
}
] |
皮肤肿瘤多见于头颈部，其次为上下肢、躯干，表现为高出皮肤的结节，直径1～2cm，表面常见坏死破溃。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "dis",
"score": 1,
"text": "皮肤肿瘤"
},
{
"indices": [
7,
8,
9
],
"label": "bod",
"score": 1,
"text": "头颈部"
},
{
"indices": [
14,
15,
16
],
"label": "bod",
"score": 1,
"text": "上下肢"
},
{
"indices": [
18,
19
],
"label": "bod",
"score": 1,
"text": "躯干"
},
{
"indices": [
24,
25,
26,
27,
28,
29,
30,
31,
32,
33,
34,
35,
36,
37,
38
],
"label": "sym",
"score": 1,
"text": "高出皮肤的结节，直径1～2cm"
},
{
"indices": [
26,
27
],
"label": "bod",
"score": 1,
"text": "皮肤"
},
{
"indices": [
29,
30
],
"label": "bod",
"score": 1,
"text": "结节"
},
{
"indices": [
40,
41,
42,
43,
44,
45,
46,
47
],
"label": "sym",
"score": 1,
"text": "表面常见坏死破溃"
},
{
"indices": [
40,
41
],
"label": "bod",
"score": 1,
"text": "表面"
}
] |
病理诊断上本瘤易与癌及血管丰富的转移性癌、上皮细胞型滑膜肉瘤、高分化的纤维肉瘤及血管内乳头状内皮增生症等相混淆。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "pro",
"score": 1,
"text": "病理诊断"
},
{
"indices": [
6
],
"label": "dis",
"score": 1,
"text": "瘤"
},
{
"indices": [
9
],
"label": "dis",
"score": 1,
"text": "癌"
},
{
"indices": [
11,
12,
13,
14,
15,
16,
17,
18,
19
],
"label": "dis",
"score": 1,
"text": "血管丰富的转移性癌"
},
{
"indices": [
21,
22,
23,
24,
25,
26,
27,
28,
29
],
"label": "dis",
"score": 1,
"text": "上皮细胞型滑膜肉瘤"
},
{
"indices": [
31,
32,
33,
34,
35,
36,
37,
38
],
"label": "dis",
"score": 1,
"text": "高分化的纤维肉瘤"
},
{
"indices": [
40,
41,
42,
43,
44,
45,
46,
47,
48,
49,
50
],
"label": "dis",
"score": 1,
"text": "血管内乳头状内皮增生症"
}
] |
免疫组织化学染色有助于其鉴别诊断，如：Ⅷ因子相关抗原由内皮细胞合成及其来源肿瘤的特异标记物。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6,
7
],
"label": "pro",
"score": 1,
"text": "免疫组织化学染色"
},
{
"indices": [
19,
20,
21,
22,
23,
24,
25
],
"label": "bod",
"score": 1,
"text": "Ⅷ因子相关抗原"
},
{
"indices": [
27,
28,
29,
30
],
"label": "bod",
"score": 1,
"text": "内皮细胞"
},
{
"indices": [
37,
38
],
"label": "dis",
"score": 1,
"text": "肿瘤"
}
] |
该肿瘤因局部广泛扩散或远处转移，死亡率高。 | [
{
"indices": [
1,
2
],
"label": "dis",
"score": 1,
"text": "肿瘤"
}
] |
肿瘤常见转移到肺和肝，也可至区域淋巴结，对放疗敏感度低。 | [
{
"indices": [
0,
1
],
"label": "dis",
"score": 1,
"text": "肿瘤"
},
{
"indices": [
7
],
"label": "bod",
"score": 1,
"text": "肺"
},
{
"indices": [
9
],
"label": "bod",
"score": 1,
"text": "肝"
},
{
"indices": [
16,
17,
18
],
"label": "bod",
"score": 1,
"text": "淋巴结"
},
{
"indices": [
21,
22
],
"label": "pro",
"score": 1,
"text": "放疗"
}
] |
只有早期局限的四肢、躯干肿瘤可能获得根治手术和切除。 | [
{
"indices": [
7,
8,
9,
10,
11,
12,
13
],
"label": "dis",
"score": 1,
"text": "四肢、躯干肿瘤"
},
{
"indices": [
20,
21
],
"label": "pro",
"score": 1,
"text": "手术"
},
{
"indices": [
23,
24
],
"label": "pro",
"score": 1,
"text": "切除"
}
] |
除畸胎瘤有完整包膜，为局限性非侵袭性生长，其余肿瘤大多呈侵袭性生长，并可沿脑脊液发生播散性种植或远处转移如骨、肝及淋巴结等。 | [
{
"indices": [
1,
2,
3
],
"label": "dis",
"score": 1,
"text": "畸胎瘤"
},
{
"indices": [
7,
8
],
"label": "bod",
"score": 1,
"text": "包膜"
},
{
"indices": [
23,
24
],
"label": "dis",
"score": 1,
"text": "肿瘤"
},
{
"indices": [
37,
38,
39
],
"label": "bod",
"score": 1,
"text": "脑脊液"
},
{
"indices": [
53
],
"label": "bod",
"score": 1,
"text": "骨"
},
{
"indices": [
55
],
"label": "bod",
"score": 1,
"text": "肝"
},
{
"indices": [
57,
58,
59
],
"label": "bod",
"score": 1,
"text": "淋巴结"
}
] |
辅助检查MRI是诊断该部位肿瘤最有效的检查，由于肿瘤易沿脑脊液播散，因此，必要时还应作脊柱MRI检查及脑脊液细胞学检查。 | [
{
"indices": [
4,
5,
6
],
"label": "pro",
"score": 1,
"text": "MRI"
},
{
"indices": [
13,
14
],
"label": "dis",
"score": 1,
"text": "肿瘤"
},
{
"indices": [
24,
25
],
"label": "dis",
"score": 1,
"text": "肿瘤"
},
{
"indices": [
28,
29,
30
],
"label": "bod",
"score": 1,
"text": "脑脊液"
},
{
"indices": [
43,
44,
45,
46,
47,
48,
49
],
"label": "pro",
"score": 1,
"text": "脊柱MRI检查"
},
{
"indices": [
51,
52,
53,
54,
55,
56,
57,
58
],
"label": "pro",
"score": 1,
"text": "脑脊液细胞学检查"
}
] |
由于肿瘤位于脑重要部位，手术死亡率高，因此除畸胎瘤要求完整切除外，其余肿瘤手术目的是部分切除肿瘤，解除脑积水并了解肿瘤性质，或仅做立体定向活检，以利放疗或化疗。 | [
{
"indices": [
2,
3
],
"label": "dis",
"score": 1,
"text": "肿瘤"
},
{
"indices": [
6
],
"label": "bod",
"score": 1,
"text": "脑"
},
{
"indices": [
12,
13
],
"label": "pro",
"score": 1,
"text": "手术"
},
{
"indices": [
22,
23,
24
],
"label": "dis",
"score": 1,
"text": "畸胎瘤"
},
{
"indices": [
27,
28,
29,
30
],
"label": "pro",
"score": 1,
"text": "完整切除"
},
{
"indices": [
35,
36,
37,
38
],
"label": "pro",
"score": 1,
"text": "肿瘤手术"
},
{
"indices": [
42,
43,
44,
45,
46,
47
],
"label": "pro",
"score": 1,
"text": "部分切除肿瘤"
},
{
"indices": [
51,
52,
53
],
"label": "dis",
"score": 1,
"text": "脑积水"
},
{
"indices": [
57,
58
],
"label": "dis",
"score": 1,
"text": "肿瘤"
},
{
"indices": [
65,
66,
67,
68,
69,
70
],
"label": "pro",
"score": 1,
"text": "立体定向活检"
},
{
"indices": [
74,
75
],
"label": "pro",
"score": 1,
"text": "放疗"
},
{
"indices": [
77,
78
],
"label": "pro",
"score": 1,
"text": "化疗"
}
] |
放疗是主要治疗手段，松果体区恶性肿瘤如生殖细胞瘤等对放疗敏感，许多作者认为应常规行全脑和脊髓放疗，以防播散。 | [
{
"indices": [
0,
1
],
"label": "pro",
"score": 1,
"text": "放疗"
},
{
"indices": [
10,
11,
12,
13,
14,
15,
16,
17
],
"label": "dis",
"score": 1,
"text": "松果体区恶性肿瘤"
},
{
"indices": [
19,
20,
21,
22,
23
],
"label": "dis",
"score": 1,
"text": "生殖细胞瘤"
},
{
"indices": [
26,
27
],
"label": "pro",
"score": 1,
"text": "放疗"
},
{
"indices": [
41,
42,
43,
44,
45,
46,
47
],
"label": "pro",
"score": 1,
"text": "全脑和脊髓放疗"
}
] |
大的、高度恶性的或有下丘脑浸润或转移的肿瘤预后极差，生存期不到1年。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6,
7,
8,
9,
10,
11,
12,
13,
14,
15,
16,
17
],
"label": "sym",
"score": 1,
"text": "大的、高度恶性的或有下丘脑浸润或转移"
},
{
"indices": [
10,
11,
12
],
"label": "bod",
"score": 1,
"text": "下丘脑"
},
{
"indices": [
19,
20
],
"label": "dis",
"score": 1,
"text": "肿瘤"
}
] |
本病患者近亲发病率也高，国外报道12%SLE患儿近亲中患有同类疾病，其他自身免疫性疾病发病率也高于人群总发病率。 | [
{
"indices": [
19,
20,
21
],
"label": "dis",
"score": 1,
"text": "SLE"
},
{
"indices": [
36,
37,
38,
39,
40,
41,
42
],
"label": "dis",
"score": 1,
"text": "自身免疫性疾病"
}
] |
感染诱发SLE也研究较多。 | [
{
"indices": [
0,
1
],
"label": "dis",
"score": 1,
"text": "感染"
},
{
"indices": [
4,
5,
6
],
"label": "dis",
"score": 1,
"text": "SLE"
}
] |
T细胞功能紊乱可能源自细胞内信号传递异常，如细胞黏附分子异常，引起细胞间相互识别，黏合，信号传递障碍等，可能在SLE发病机制中具有重要作用。 | [
{
"indices": [
0,
1,
2,
3,
4,
5,
6
],
"label": "dis",
"score": 1,
"text": "T细胞功能紊乱"
},
{
"indices": [
11,
12,
13
],
"label": "bod",
"score": 1,
"text": "细胞内"
},
{
"indices": [
11,
12,
13,
14,
15,
16,
17,
18,
19
],
"label": "sym",
"score": 1,
"text": "细胞内信号传递异常"
},
{
"indices": [
22,
23,
24,
25,
26,
27
],
"label": "bod",
"score": 1,
"text": "细胞黏附分子"
},
{
"indices": [
22,
23,
24,
25,
26,
27,
28,
29
],
"label": "sym",
"score": 1,
"text": "细胞黏附分子异常"
},
{
"indices": [
33,
34
],
"label": "bod",
"score": 1,
"text": "细胞"
},
{
"indices": [
33,
34,
35,
36,
37,
38,
39,
40,
41,
42,
43,
44,
45,
46,
47,
48,
49
],
"label": "sym",
"score": 1,
"text": "细胞间相互识别，黏合，信号传递障碍"
},
{
"indices": [
55,
56,
57
],
"label": "dis",
"score": 1,
"text": "SLE"
}
] |
近年已开始注意有患儿发生冠状动脉炎及心肌梗死的病例。 | [
{
"indices": [
12,
13,
14,
15,
16
],
"label": "dis",
"score": 1,
"text": "冠状动脉炎"
},
{
"indices": [
18,
19,
20,
21
],
"label": "dis",
"score": 1,
"text": "心肌梗死"
}
] |
可出现巩膜炎、虹膜炎及视网膜炎等眼部症状。 | [
{
"indices": [
3,
4,
5
],
"label": "dis",
"score": 1,
"text": "巩膜炎"
},
{
"indices": [
7,
8,
9
],
"label": "dis",
"score": 1,
"text": "虹膜炎"
},
{
"indices": [
11,
12,
13,
14
],
"label": "dis",
"score": 1,
"text": "视网膜炎"
},
{
"indices": [
16,
17,
18,
19
],
"label": "sym",
"score": 1,
"text": "眼部症状"
},
{
"indices": [
16,
17
],
"label": "bod",
"score": 1,
"text": "眼部"
}
] |
服免疫抑制剂期间尽量不到公共场所，减少感染机会，若发生感染应积极治疗，要避免使用诱发狼疮和肾损害的常用药物（磺胺、肼苯达嗪、普鲁卡因胺、对氨基水杨酸、青霉素及氨基甙类药物）；局部皮损若无继发感染，可涂泼尼松软膏。 | [
{
"indices": [
1,
2,
3,
4,
5
],
"label": "dru",
"score": 1,
"text": "免疫抑制剂"
},
{
"indices": [
19,
20
],
"label": "dis",
"score": 1,
"text": "感染"
},
{
"indices": [
27,
28
],
"label": "dis",
"score": 1,
"text": "感染"
},
{
"indices": [
42,
43
],
"label": "dis",
"score": 1,
"text": "狼疮"
},
{
"indices": [
45,
46,
47
],
"label": "dis",
"score": 1,
"text": "肾损害"
},
{
"indices": [
54,
55
],
"label": "dru",
"score": 1,
"text": "磺胺"
},
{
"indices": [
57,
58,
59,
60
],
"label": "dru",
"score": 1,
"text": "肼苯达嗪"
},
{
"indices": [
62,
63,
64,
65,
66
],
"label": "dru",
"score": 1,
"text": "普鲁卡因胺"
},
{
"indices": [
68,
69,
70,
71,
72,
73
],
"label": "dru",
"score": 1,
"text": "对氨基水杨酸"
},
{
"indices": [
75,
76,
77
],
"label": "dru",
"score": 1,
"text": "青霉素"
},
{
"indices": [
79,
80,
81,
82,
83,
84
],
"label": "dru",
"score": 1,
"text": "氨基甙类药物"
},
{
"indices": [
87,
88,
89,
90
],
"label": "dis",
"score": 1,
"text": "局部皮损"
},
{
"indices": [
95,
96
],
"label": "dis",
"score": 1,
"text": "感染"
},
{
"indices": [
100,
101,
102,
103,
104
],
"label": "dru",
"score": 1,
"text": "泼尼松软膏"
}
] |
轻者仅表现为红斑，水疱；重者表现为局部组织坏死、溃疡，可伴有皮肤或其他部位的黏膜损害。 | [
{
"indices": [
6,
7
],
"label": "sym",
"score": 1,
"text": "红斑"
},
{
"indices": [
9,
10
],
"label": "sym",
"score": 1,
"text": "水疱"
},
{
"indices": [
17,
18,
19,
20,
21,
22,
23,
24,
25
],
"label": "sym",
"score": 1,
"text": "局部组织坏死、溃疡"
},
{
"indices": [
19,
20
],
"label": "bod",
"score": 1,
"text": "组织"
},
{
"indices": [
30,
31,
32,
33,
34,
35,
36,
37,
38,
39,
40,
41
],
"label": "dis",
"score": 1,
"text": "皮肤或其他部位的黏膜损害"
}
] |
主要是去除致敏物质和抗过敏治疗。 | [
{
"indices": [
3,
4,
5,
6,
7,
8
],
"label": "pro",
"score": 1,
"text": "去除致敏物质"
},
{
"indices": [
10,
11,
12,
13,
14
],
"label": "pro",
"score": 1,
"text": "抗过敏治疗"
}
] |
抗过敏药物有盐酸苯海拉明及氯苯那敏。 | [
{
"indices": [
0,
1,
2,
3,
4
],
"label": "dru",
"score": 1,
"text": "抗过敏药物"
},
{
"indices": [
6,
7,
8,
9,
10,
11
],
"label": "dru",
"score": 1,
"text": "盐酸苯海拉明"
},
{
"indices": [
13,
14,
15,
16
],
"label": "dru",
"score": 1,
"text": "氯苯那敏"
}
] |
必要时可用泼尼松及地塞米松。 | [
{
"indices": [
5,
6,
7
],
"label": "dru",
"score": 1,
"text": "泼尼松"
},
{
"indices": [
9,
10,
11,
12
],
"label": "dru",
"score": 1,
"text": "地塞米松"
}
] |
对症治疗包括局部止痛和抗感染等。 | [
{
"indices": [
0,
1,
2,
3
],
"label": "pro",
"score": 1,
"text": "对症治疗"
},
{
"indices": [
6,
7,
8,
9
],
"label": "pro",
"score": 1,
"text": "局部止痛"
},
{
"indices": [
11,
12,
13
],
"label": "pro",
"score": 1,
"text": "抗感染"
}
] |
在第二肿瘤中，AML是一种较常见的类型，主要与先前烷化剂如环磷酰胺、氮芥、马利兰等暴露有关，常发生于第一肿瘤4～5年后，可先表现为骨髓增生异常综合征（MDS）再发展为AML，但在10～12年后AML的发病机会减少。 | [
{
"indices": [
1,
2,
3,
4
],
"label": "dis",
"score": 1,
"text": "第二肿瘤"
},
{
"indices": [
7,
8,
9
],
"label": "dis",
"score": 1,
"text": "AML"
},
{
"indices": [
25,
26,
27
],
"label": "dru",
"score": 1,
"text": "烷化剂"
},
{
"indices": [
29,
30,
31,
32
],
"label": "dru",
"score": 1,
"text": "环磷酰胺"
},
{
"indices": [
34,
35
],
"label": "dru",
"score": 1,
"text": "氮芥"
},
{
"indices": [
37,
38,
39
],
"label": "dru",
"score": 1,
"text": "马利兰"
},
{
"indices": [
50,
51,
52,
53
],
"label": "dis",
"score": 1,
"text": "第一肿瘤"
},
{
"indices": [
65,
66,
67,
68,
69,
70,
71,
72,
73
],
"label": "dis",
"score": 1,
"text": "骨髓增生异常综合征"
},
{
"indices": [
75,
76,
77
],
"label": "dis",
"score": 1,
"text": "MDS"
},
{
"indices": [
83,
84,
85
],
"label": "dis",
"score": 1,
"text": "AML"
},
{
"indices": [
96,
97,
98
],
"label": "dis",
"score": 1,
"text": "AML"
}
] |
除此以外，鬼臼毒素类药物VP-16的暴露与第二肿瘤性AML的发病有关，其发病时间常较烷化剂诱发者早。 | [
{
"indices": [
5,
6,
7,
8,
9,
10,
11
],
"label": "dru",
"score": 1,
"text": "鬼臼毒素类药物"
},
{
"indices": [
12,
13,
14,
15,
16
],
"label": "dru",
"score": 1,
"text": "VP-16"
},
{
"indices": [
21,
22,
23,
24,
25,
26,
27,
28
],
"label": "dis",
"score": 1,
"text": "第二肿瘤性AML"
},
{
"indices": [
42,
43,
44
],
"label": "dru",
"score": 1,
"text": "烷化剂"
}
] |