高原地区血尿酸水平与慢性心力衰竭的相关性研究

目的 分析高原地区慢性心功能不全患者血尿酸水平与心力衰竭发生风险的相关性.方法 选取2015年6月至2016年6月拉萨市人民医院慢性心功能不全患者121例,依据临床症状,按纽约心脏协会(New York Heart Association,NYHA)心功能分级分为非心力衰竭组(70例)与心力衰竭组(51例),比较两组血尿酸及年龄、血脂、同型半胱氨酸(homocysteine,Hcy)等指标,采用多因素logistic回归分析血尿酸与慢性心力衰竭的关系,并绘制ROC曲线评估尿酸水平对心力衰竭的预测价值.结果 与非心力衰竭组相比,心力衰竭组患者平均年龄更高、心率增快、血尿酸及Hcy水平升高,差异有统计学意义(P＜0.05).Logistic回归分析显示,年龄(OR= 1.059,95％CI:1.016～1.105,P = 0.007)、血尿酸(OR = 1.008,95％CI:1.003～1.012,P = 0.001)为高原地区心力衰竭的预测因子.ROC曲线显示,年龄与尿酸联合预测心力衰竭的敏感度为64.0％,特异度为83.6％,AUC为0.837(95％CI:0.764～0.909,P＜0.001).进一步按照年龄≤60岁和＞60岁、血尿酸水平≤400 μmol/L和＞400 μmol/L进行分层后,logistic回归分析显示,年龄＞60岁的OR值为8.27(95％CI:2.53～27.11,P＜0.001),血尿酸＞400 μmol/L的OR值为 17.37(95％CI:5.40～55.92,P＜0.001).结论 高原地区慢性心力衰竭患者血尿酸水平要高于非心力衰竭患者,高尿酸血症可增加心力衰竭的风险.     

血清可溶性ST2水平在心力衰竭患者预后评估中的临床价值

目的 探讨血清可溶性ST2水平在心力衰竭患者预后评估中的临床价值.方法 对我院收治的169例心力衰竭患者的血清sST2及随访1年期间再发心衰住院和心源性死亡等心血管事件资料进行回顾性分析,采用Cox回归模型探讨影响患者预后的相关因素,并采用ROC曲线分析血浆sST2对心力衰竭患者出院后1年期心血管事件的预测价值.结果 169例心力衰竭患者随访1年期间共有39例发生心血管事件(23.1％),其中25例因心衰加重再住院,14例发生心源性死亡,发生时间为出院后3～12月,中位时间为9个月.心血管事件组患者血清sST2水平显著高于无心血管事件组患者[55.1 (36.0～104.6) ng/ml vs 33.5 (24.2～47.5) ng/ml],P＜0.05.单变量和多变量Cox回归分析均显示血清sST2水平增高为心力衰竭患者出院后1年内发生心血管事件的危险因素(P＜0.05).血浆sST2预测心力衰竭患者中期发生心血管事件的曲线下面积为0.750(S(x)=0.039,P＜0.001,95％CI:0.674～0.826),血浆NT-proBNP预测心力衰竭患者中期发生心血管事件的曲线下面积为0.790(S(x)=0.035,P＜ 0.001,95％CI:0.720～0.859),两项指标在预测心力衰竭患者中期发生心血管事件价值方面差异无统计学意义(P＞ 0.05).结论 血清sST2水平高低能够有效评估心力衰竭患者的心血管事件风险,预后预测价值较高,值得在临床上推广利用.     

聚ADP核糖聚合酶抑制剂治疗复发性卵巢癌的系统评价

目的 研究聚ADP核糖聚合酶(PARP)抑制剂治疗复发性卵巢癌的疗效和安全性.方法 采用Cochrane系统评价方法,检索Medline、Embase、Central和中国生物医学文献数据库,检索时限为建库至2017年9月,手工检索相关参考文献,纳入PARP抑制剂治疗复发性卵巢癌的随机对照试验(RCT).应用RevMan5.3软件进行Meta分析.结果 纳入5个RCT,试验组患者1 160例,对照组患者679例.PARP抑制剂治疗较安慰剂明显改善无进展生存[HR =0.34,95％CI(0.30,0.40),P＜0.01]和总生存结局[HR=0.73,95％CI(0.55,0.96),P=0.025],增加客观反应率[RR=2.56,95 ％CI(1.17,5.59),P=0.020].与单用化疗相比,PARP抑制剂+化疗明显降低疾病进展风险[HR=0.51,95％CI(0.34,0.77),P=0.001],但总生存结局[HR=1.17,95 ％CI(0.79,1.73),P=0.440]和客观反应率[RR=1.11,95％CI(0.86,1.42),P=0.420]在两组间的差异无统计学意义.PARP抑制剂治疗明显增加严重贫血、疲劳、恶心及呕吐的发生率.结论 现有证据表明PARP抑制剂能改善复发性卵巢癌的无进展生存结局.     

急性冠脉综合征经皮冠状动脉介入术中不同给药途径应用替罗非班的疗效与安全性的meta分析

目的 评价我国急性冠脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)时替罗非班经冠状动脉(IC)或经静脉(IV)不同给药途径的有效性及安全性.方法 检索从2006年1月至2012年1月纳入的国内外文献中公开发表的我国ACS[包括急性ST段抬高心肌梗死(STEMI)和非ST段抬高型ACS(NSTE-ACS)]患者PCI术中IC与IV不同给药途径应用替罗非班的临床随机对照试验(RCT)的所有学术论文35篇.根据文献异质性检验结果行meta分析,对不同纳入标准的结果进行了敏感性分析,并评价发表性偏倚.结果 经筛选后纳入meta分析的文献16篇,共计1314例患者,其中IC组658例,IV组656例.meta 分析结果显示:与替罗非班IV组比较,IC组PCI术后达心肌梗死溶栓治疗(TIMI)3级血流的比率{RR=1.13,95％ CI[1.05,1.23],P＜0.01}、TMP心肌灌注(TMP)达3级的比率{RR=1.28,95％ CI[1.12,1.46],P=0.0002}明显增加;术后7 d心脏超声左室射血分数(LVEF)值平均增加2.33％{WMD=2.33％,95％ CI[0.88％,3.78％],P=0.002},与IV组比较有统计学差异(P＜0.05),但长期临床意义尚需进一步研究观察;出血{RR=0.99,95％ CI[0.76,1.30],P=0.96)和血小板减少症{RR=0.79,95％ CI[0.42,1.51],P=0.48}的发生率与IV组比较无统计学差异(P＞0.05).结论 与单纯静脉注射比较,冠状动脉内注射替罗非班可能对改善我国ACS患者PCI术后心肌血流灌注有一定的意义,且不增加出血和血小板减少的风险.     

腹膜透析患者AAC与钙磷代谢相关性及预测CVD价值研究

目的 探讨腹膜透析患者腹主动脉钙化(AAC)与钙磷代谢的关系及其判断预测心血管疾病(CVD)的价值.方法 选择该院肾内科2018年8月至2020年3月收治的腹膜透析患者80例,采用AAC评分(AACS)记录AAC程度.比较不同钙化程度患者钙磷代谢水平,分析AACS与钙磷代谢指标的关系;治疗结束后对患者均行12个月随访,采用受试者工作特征曲线(ROC)分析AACS预测CVD的价值.结果 80例患者中无AAC 36例,轻度钙化18例,中度钙化12例,重度钙化14例.不同钙化程度患者血磷、全段甲状旁腺激素(iPTH)及钙磷乘积(CPP)比较,差异均有统计学意义(P＜0.001).Pearson线性相关分析显示,AACS与血磷、iPTH、CPP呈正相关(r=0.318、0.387、0.506,P＜0.001).中位随访时间为(10.24±1.77)个月,失访3例,77例患者发生CVD 14例(18.18％).Cox风险回归分析显示,AACS(HR=1.822,95％ CI:1.308～2.538,P＜0.001)、高血压肾损害(HR=1.690,95％ CI:1.325～2.156,P＜0.001)、CPP(HR=1.752,95％CI:1.332～2.304,P＜0.001)及iPTH(HR=1.449,95％ CI:1.023～2.052,P=0.037)是腹膜透析患者发生CVD的独立影响因素.ROC分析显示,AACS[曲线下面积(AUC)=0.806,95％ CI=0.694～0.918]、高血压肾损害(AUC=0.685,95％ CI:0.526～0.844)、CPP(AUC=0.671,95％ CI=0.506～0.836)及iPTH (AUC=0.703,95％ CI=0.548～0.859)对判断CVD风险具有一定价值.AACS判断CVD的AUC明显高于高血压肾损害、CPP及iPTH(P＜0.05).结论 腹膜透析患者AAC与钙磷代谢相关,监测AACS有助于判断CVD风险.     

腹膜透析患者脉压的影响因素及其与患者病死率的关系

目的 探讨腹膜透析(腹透)患者脉压的影响因素及其与病死率的关系.方法 以腹透超过6个月且年龄在18周岁及以上的患者作为研究对象.收集患者相关临床资料,以腹透开始6个月内的血压平均值计算脉压作为基线值,所有患者随访至死亡、退出腹透、转其他中心、失访或研究终止日期(2010年12月31日).采用多元线性回归分析腹透患者脉压的独立影响因素,以多因素Cox风险比例模型分析脉压及其影响因素与患者病死率的关系.结果 共入选腹透患者498例.多元线性回归分析结果显示:年龄(β=2.34,P＜0.001)、血清白蛋白(β=-0.235,P=0.004)、糖尿病(β=4.93,P＜0.001)是腹透患者脉压的独立影响因素.单因素分析结果显示:脉压与患者的全因死亡(HR=1.017,95％ CI 1.007 ～1.027,P＜0.001)和心血管死亡(HR=1.016,95％CI 1.003～ 1.030,P=0.019)密切相关;进一步的多因素Cox风险比例模型分析结果显示:老龄(HR=1.065,95％ CI1.047～1.082,P＜0.001)、低血清白蛋白(HR =0.945,95％CI 0.909 ～ 0.983,P=0.005)和低血红蛋白(HR =0.981,95％ CI0.971 ～0.991,P＜0.001)是腹透患者全因死亡的独立危险因素;老龄(HR=1.041,95％CI 1.016～1.066,P=0.001)、低血红蛋白( HR =0.983,95％CI 0.969 ～0.996,P=0.014)是腹透患者心血管死亡的独立危险因素;多因素校正后的分析并未显示脉压是腹透患者全因死亡(HR=1.019,95％CI 0.996 ～ 1.043,P=0.104)和心血管死亡(HR=0.988,95％CI 0.860～1.136,P=0.870)的独立危险因素.结论 年龄、血清白蛋白、糖尿病是腹膜透析患者脉压的独立影响因素;脉压与腹透患者病死率的关系尚有待深入研究.     

健康教育对社区中老年入骨质疏松干预效果的Meta分析

目的 综合评价对社区中老年人群进行骨质疏松干预的效果,为该人群的骨质疏松防治提供理论依据.方法 计算机检索中国科技期刊全文数据库、中国学术期刊网全文数据库、万方数据库等2000～2011年公开发表的、且为随机对照试验的关于社区中老年人骨质疏松干预的文献,按照Cochrane系统评价员手册对纳入文献质量进行评价,采用Cochrane协作网提供的RevMan 5软件进行Meta分析,计算加权均方差(WMD)及95％可信区间(95％ CI).结果 纳入分析的随机对照试验文献6篇,健康教育组累计321例,对照组累计424例.健康教育组骨密度值高于对照组[WMD=0.08,95％ CI(-0.00,0.15),P=0.05],骨质疏松知识高于对照组[WMD=1.75,95％ CI(0.78,2.72),P =0.000 4],健康信念高于对照组[WMD =4.11,95％ CI(0.72,7.50),P=0.02],自我效能高于对照组[WMD=7.28,95％ CI(-0.03,14.59),P=0.05],生活质量优于对照组[WMD=12.50,95％ CI(7.41,17.59),P＜0.00001].结论 健康教育对社区中老年人骨质疏松干预是有效的.因本分析仅纳入6项研究,病例较少,尚需多中心、大样本随机对照研究验证.     

胶质母细胞瘤放疗结合替莫唑胺治疗对比单独放疗的Meta分析

目的 评价胶质母细胞瘤患者放疗结合替莫唑胺治疗方案的有效性和安全性.方法 按Cochrane系统评价方法,分别检索Pubmed、Cochrane library、Medline、OVID数据库,对纳入的文献进行质量评估,提取数据后进行Meta分析.结果 纳入的研究中替莫唑胺组对比单独放疗组汇总显示:12个月总生存率[RR 1.22,95％CI(1.01,1.47),P=0.04]、24个月总生存率[RR 2.65,95％CI(1.86,3.78),P＜0.01],差异均有统计学意义.12个月无进展生存率[RR 2.59,95％CI(1.53～4.40),P=0.000 4]、24个月无进展生存率[RR 6.77,95％CI(2.82～16.26),P＜0.01],差异也有统计学意义.血液毒性反应:替莫唑胺组中同步治疗期对比放疗期[RR 3.21,95％CI(1.89,5.46),P＜0.01];替莫唑胺组中辅助治疗期对比放疗组[RR 6.11,95％CI(3.70,10.09),P＜0.01];替莫唑胺组中同步治疗期对比辅助治疗期[RR 0.48,95％CI(0.36,0.65),P＜0.01],差异均有统计学意义;非血液毒性反应事件[RR 1.11,95 ％CI(0.72,1.70),P=0.64],差异无统计学意义.结论 放疗结合同步和随后辅助替莫唑胺治疗提高了胶质母细胞瘤患者的总生存期和无进展生存期,较高血液毒性反应发生率与替莫唑胺治疗药物相关.     

前列地尔联合生长抑素治疗重症急性胰腺炎的Meta分析

目的 系统性评价前列地尔联合生长抑素治疗重症急性胰腺炎的疗效和安全性.方法 检索PubMed、Cochrane library、Web of Science、万方数据库、中国知网数据库、中国生物医学数据库,检索时限均设定为各数据库建库至2015年11月,收集所有前列地尔联合生长抑素治疗重症急性胰腺炎的随机对照试验,应用RevMan 5.3软件对数据进行Meta分析.结果 纳入11篇文献,共927例患者.Meta分析结果显示:与对照组相比,前列地尔联合生长抑素治疗组可以显著提高总有效率[OR=5.45,95 ％CI(3.48,8.52),P＜0.01],改善临床症状缓解时间[均数差(MD)=-15.20,95％CI(-18.17,-12.23),P＜0.01],血淀粉酶[MD=-26.59,95％CI(-29.85,-23.34),P＜0.01],血C反应蛋白[MD=-23.95,95％CI(-27.68,-20.22),P＜0.01],血白细胞介素-6[MD=-12.40,95％CI(-15.69,-9.11),P＜0.01],组间比较差异均有统计学意义.此外,不良反应发生率较低.结论 在传统治疗基础上加用前列地尔联合生长抑素可以有效提高重症急性胰腺炎的治疗效果,且安全性高,值得临床推广.     

CRT-P/D治疗射血分数降低的心力衰竭患者超反应发生的相关因素分析

目的 探讨心脏再同步化治疗(cardiac resynchronization therapy with pacemaker function / defibrillation function,CRT-P /D) 在射血分数降低的心力衰竭患者中发生超反应的预测因素及不良事件的影响因素.方法 回顾分析我科2015年1月至2017年1月收治的59例因心力衰竭采用CRT-P /D治疗并随访12个月以上的患者,采集一般临床资料、心电图、心脏超声、不良事件发生等临床数据.以术后12个月左室射血分数(left ventricular ejection fraction,LVEF) 升高幅度分3组: 超反应组(幅度≥ 15％,14例),中度反应组(5％≤幅度< 15％, 23例),轻度/无反应组(幅度< 5％, 22例) .采用方差分析及多因素Logistic回归分析筛选CRT-P /D治疗发生超反应的独立预测因素.采用Kaplan-Meier法进行预后分析,COX回归模型明确影响预后的危险因素.结果 超反应组术前心房颤动比例、右房内径(right atrial diameter,RA) 明显低于中度反应组及轻度/无反应组(P＜0. 05),双心室起搏比例明显高于中度反应组及轻度/无反应组(P＜0. 01) .多因素Logistic回归结果显示病程< 1. 5年(OR = 17. 54, 95％CI = 1. 41 ～ 216. 96,P = 0. 02) 、RA<35 mm(OR = 23. 70, 95％CI = 1. 60 ～ 349. 32,P = 0. 02) 、双心室起搏比例> 96％(OR = 36. 35, 95％CI = 12. 17 ～ 609. 03,P = 0. 01) 是术后发生超反应的独立预测因素.预后分析显示无事件(心衰再住院、恶性心律失常、全因死亡) 生存率超反应组高于中度反应组及轻度/无反应组(Log Rank: P＜0. 01),多因素Cox回归分析显示对于复合不良事件的发生,心房颤动是影响预后的独立因素(P＜0. 05,HR = 2. 35, 95％CI = 1. 067 ～ 5. 19) .结论 对于CRT-P /D治疗射血分数降低的心力衰竭患者,病程< 1. 5年、RA<35 mm,双心室起搏比率> 96％是发生超反应的重要预测因素,心房颤动是影响术后不良事件发生的独立因素.     

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.     

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.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.