胺碘酮治疗心律失常40例临床体会

目的探讨胺碘酮治疗急性心肌梗死(AMI)后顽固性心律失常的疗效。方法将我院2010年7月—2012年7月收治的AMI后顽固性心律失常患者80例随机分为胺碘酮组与普萘洛尔组,2组入选患者除按AMI常规治疗外,胺碘酮组每日3次,每次0.25 g,7 d~9 d后每日1次,每次0.3 g静脉注射;普萘洛尔组每日2次,每次30 mg静脉注射。疗程均为5周。结果住院期间2组患者均出现不同程度并发症,胺碘酮组患者出现心力衰竭、心律失常等频率明显少于普萘洛尔组(P<0.05)。结论静脉注射胺碘酮治疗AMI后顽固性心律失常,可明显降低并发症发生率,改善患者预后。     

稳心颗粒联合胺碘酮治疗急性心肌梗死合并心律失常疗效观察

目的：观察稳心颗粒联合胺碘酮治疗急性心肌梗死合并心律失常的疗效。方法：将入选患者随机分为两组,治疗组给予稳心颗粒9 g,3次/d,胺碘酮0.2 g,1次/d。对照组给予胺碘酮0.2 g,3次/d,每周减0.2 g,最后以0.2 g/d维持,两组疗程均为4周。治疗前后行24 h动态心电图及血常规,肝、肾功能检查。结果：两者均可减少心律失常的发生,治疗组总有效率为92.9%,对照组总有效率为75.0%,治疗组优于对照组,差异有统计学意义（P〈0.05）。结论：稳心颗粒联合胺碘酮可有效缓解症状,疗效优于单用胺碘酮组,不良反应轻,安全可靠。     

胺碘酮治疗急性心肌梗死伴高危快速型心律失常临床观察

目的：探讨胺碘酮对急性心肌梗死（AMI）伴高危快速型心律失常患者的临床疗效。方法：80例AMI并高危快速型心律失常患者随机分为两组,在AMI常规治疗基础上,胺碘酮组首次0.15g静注,继之应用5mg/kg静脉维持,2～3天起改为口服0.2g,每日1次;心律平组70mg静注,继之应用3～4mg/kg静脉维持,日量〈350mg,起效后改为口服0.15g,日3次;疗程4周。结果：住院期间治疗组心肌梗死后心绞痛发作次数,静脉硝酸甘油剂量,恶性心律失常较心律平组少（P〈0.05,P〈0.01）。结论：胺碘酮治疗急性心肌梗死伴高危快速型心律失常患者,作用可靠,效果明显,不良反应轻。     

胺碘酮和索他洛尔治疗心房颤动的随机对比研究

目的 比较胺碘酮和索他洛尔对心房颤动（房颤）的疗效及其不良反应。方法102例房颤患者随机分为胺碘酮组（51例）和索他洛尔组（51例）。胺碘酮组服胺碘酮600mg／d，7d，400mg／d再服用7d，再减为200mg／d，转为窦律后200mg／d维持。索他洛尔组服索他洛尔40～80mg／a，7d，第2周增至160mg／a，转为窦律后40～80mg／a维持。两组患者服用3周转窦律均停用药物。随访12～24个月，分别测定治疗前后超声心动图、心电图和24h动态心电图判断疗效。结果（1）胺碘酮组房颤复律成功40例，有效率78．4％；索他洛尔组房颤复律成功36例，有效率70．6％。（2）胺碘酮组在1周内转复窦律34例，索他洛尔组1周内转复窦律10例。（3）随访12个月，胺碘酮组27例（67．5％）仍维持窦律、索他洛尔组15例（41．7％）；24个月，胺碘酮组12例（44．4％）维持窦律，索他洛尔组为4例（26．7％）。（4）随访6～12个月，索他洛尔组（80mg／d）10例患者因发生房室传导阻滞、严重心动过缓停药，而胺碘酮组未出现严重的心律失常。（5）房颤持续时间〉12个月是窦律不易维持的预测因素。结论胺碘酮转复房颤有效率和索他洛尔相当，但维持窦律疗效优于索他洛尔．对心脏毒副作用小于索他洛尔。     

比索络尔与胺碘酮合用对急性心肌梗死预后及安全性的影响

目的　评价比索洛尔与胺碘酮合用对AMI的疗效及安全性。方法　对 82例AMI随机分组 ,治疗组用比索洛尔、胺碘酮 ;对照组用美托洛尔。以两组心律失常发生例次、心功能、死亡率、治病前后QTcd为观察指标。结果　治疗组的心律失常发生率、死亡率均低于对照组 ,QTcd明显缩小 (P <0 0 1) ,心功能两组无变化。讨论　比索洛尔与胺碘酮合用不影响患者心功能 ,可明显减少心律失常发生率。QTcd的显著变化提示两者合用 ,无致心律失常作用     

胺碘酮治疗老年缺血性心力衰竭并心房颤动30例体会

目的 观察胺碘酮治疗老年缺血性心脏病(IHD)心力衰竭并心房颤动(房颤)的疗效及不良反应.方法 30例IHD心力衰竭合并心律失常的老年患者在应用强心苷、血管紧张素转换酶抑制剂、利尿剂、硝酸酯类药等常规治疗基础上,给予胺碘酮口服,80岁以下患者给予负荷量0.2 g,3次/d,1周后0.2 g,2次/d,再1周以后服用维持量0.2 g,1次/d.80岁以上患者给予负荷量0.2 g,2次/d,1周以后服用维持量0.2 g,1次/d,疗程均为4周.观察心衰症状和体征,房颤及左室射血分数(LVEF)等变化.结果 经胺碘酮等治疗,患者LVEF显著增加;阵发性房颤恢复窦律,持续性房颤转为阵发性房颤(有效率83.3%);心功能改善.结论 小剂量胺腆酮治疗老年缺血性心力衰竭并房颤患者安全有效.     

胺碘酮治疗急性冠脉综合征伴新发心房纤颤60例临床观察

目的观察静脉滴注胺碘酮治疗急性冠脉综合征（ACS）伴新发快速房颤（Af）患者的临床疗效。方法将60例ACS伴新近发生快速房颤患者随机分为2组（治疗组-胺碘酮组和对照组-索他洛尔组）,治疗组和对照组各30例,治疗组的患者予以胺碘酮进行治疗,对照组的患者给予索他洛尔治疗。观察2组患者的治疗情况以及Af转复的情况。并且对其进行分别判定疗效。结果治疗组与对照组对ACS伴新发快速Af有效率分别为93.3%与82.0%,治疗组的疗效明显高于对照组,有统计学意义（P〈0.05）。治疗组不良反应明显低于对照组,有统计学意义（P〈0.05）。结论与使用索他洛尔相比,胺碘酮治疗ACS伴新发快速心房纤颤,能增加有效率,减少不良反应。胺碘酮治疗ACS伴新发快速房颤是有效及安全的,可作为控制急性冠脉综合征伴新发心房纤颤的首选药物之一。     

胺碘酮联合索他洛尔救治快速室上性心律失常的临床疗效

目的：探讨胺碘酮联合索他洛尔救治快速室上性心律失常的临床疗效。方法：选取2010年8月至2013年10月广州市荔湾区第二人民医院收治的128例快速室上性心律失常患者作为研究对象,随机分为对照组(胺碘酮)和观察组(胺碘酮＋索他洛尔),每组各64例。观察两组患者的临床疗效及药物起效时间、治疗后心率、窦性心律复转率等指标。结果：观察组有效率为94％(60/64),高于对照组的80％(51/64);观察组药物起效时间及治疗后心率均显著低于对照组;窦性心律复转率明显高于对照组;上述指标比较,差异均有统计学意义( P<0.05)。结论：胺碘酮联合索他洛尔治疗快速室上性心律失常起效快、效果好。     

胺碘酮治疗老年心力衰竭合并心律失常的临床疗效及安全性

目的:观察胺碘酮治疗老年心力衰竭合并心律失常的临床疗效及安全性。方法:40例老年心力衰竭合并心律失常的患者在应用利尿剂、强心甙、ACEI等药物作常规治疗基础之上应用胺碘酮口服,80岁以下患者给负荷量0.2 g次/,3次/d,1周后,0.2 g次/,2次/d,再1周后服用维持量0.2 g次/,1次/d。80岁以上患者口服胺碘酮0.2g次/,2次/d,1周后服用维持量,0.2 g次/,1次/d,疗程均为4周。观察心衰症状及体征,心率失常及左室射血分数(LVEF)等变化。结果:经应用胺碘酮治疗后患者LVEF显著增加,室性早搏明显减少;阵发性房颤转复为窦性心律,持续性房颤转复为偶有发作的阵发性房颤(有效率为75%);心功能改善。结论:小剂量胺碘酮治疗对于老年心力衰竭合并心律失常的患者安全有效。     

两种用药方案治疗心律失常的临床药效-成本分析

目的研究索他洛尔和胺碘酮对心律失常患者的临床药效-成本分析,以期为临床用药提供参考。方法选取2008年12月～2010年12月确诊为心律失常的120例患者为研究对象,随机分为两组,分别为索他洛尔组和胺碘酮,每组各60例。对两组患者的药效-成本进行分析。结果两组的成本分别为1836和1380元,其治疗心律失常的总有效率分别为76.67%和73.33%,成本-效果比为23.95和18.81;其改善心功能的总有效率分别为93.33%和90.00%,成本-效果比为19.67和15.33。结论根据药物经济学分析,胺碘酮和索他洛尔在治疗心律失常和改善心功能方面作用相当,但胺碘酮比索他洛尔的花费小,更适合于治疗心律失常。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.