Reconstruction of laryngeal function in subtotal laryngectomy with preservation of monoarytenoid cartilage

Objective: To evaluate subtotal laryngectomy with preservation of monoarytenoid cartilage to re-construct laryngeal function in the treatment of advanced laryngeal cancer. Methods: We retrospectively re-viewed 48 patients with advanced laryngeal cancer (T3 or T4 on the primary site) treated by subtotal laryngec-tomy with preservation of monoarytenoid cartilage to reconstruct laryngeal function. Eighteen of them under-went neck dissection. Ipsilateral recurrent laryngeal nerve was preserved during this surgery. The cricoid cartilage was anastomosed to hypopharynx accordingly. Results: The overall 3- and 5-year survival rates were 81.25% (39/45) and 66% 67% (32/48), respectively. All patients had good phonation and swallowing function after surgery. Decannulation rate was 93. 75%. Conclusion: Subtotal laryngectomy with preserva-tion of monoarytenoid cartilage is satisfactory for treatment of elected advanced laryngeal cancers. The effect of this surgery is more satisfactory than that of the near-total laryngectomy (Pearson‘‘s technic).     

Relationship between the Expression of CD44v6 and Development,Progress, Invasion and Metastasis of Laryngeal Carcinoma

The expression of CD44v6 and its relationship with the development, progress, invasion and metastasis of laryngeal carcinoma was investigated. The expression and content of CD44v6 mRNA in tissuess were detected by both RT-PCR and FCM which were respectivelyextracted from normal laryngeal mucosa, leukoplakia of larynx, laryngeal papilloma, polyp of vocal cord, tissues of laryngeal carcinoma, metastatic and nonmetastatic lymph nodes of neck, and tissues close to carcinoma. The outcome of RT PCR indicated that the expression rate of CD44v6 mRNA involved in tissues of laryngeal carcinoma and metastatic lymph nodes of neck was the highest (90 %- 100%) compared with that of leukoplakia of larynx, laryngeal papilloma, tissues close to carcinoma by 0.5cm (55.56%--60.00%) and that of normal laryngeal mucosa, polyp of vocal cord, nonmetastatic lymph nodes and tissues close to carcinoma by 1.0 cm was the lowest (13.33%--20%). The result from FCM was highly consistent with that from RT-PCR. It was suggested that CD44v6 was closely related with the development, progress, invasion and metastasis of laryngeal carcinoma. The outcome from the tissues close to carcinoma by different distance could do help to the determination of incisal edge in surgery abstractly.     

Tumors of the heart. An analysis of 79 cases.

There were 79 cases of cardiac tumors seen from 1957 to July 1988. 49 (62.0%) of them were benign and 30 (38.0%) malignant. All the 49 benign tumors except 2 were surgically excised and found to be myxoma. Of them, 18 patients were male and 31 female. 85.7% of the tumors were located in the left atrium, 12.2% in the right atrium and 2.0% in the left ventricle. Palpitation, dyspnea, chest oppression, fever, episodes of syncope and hemiplegia, cough, diastolic and systolic murmurs at the apical or tricuspid area were the common symptoms and signs. Atrial fibrillation was found only in 2 cases. Echocardiographic findings were diagnostic while ECG and X-ray findings were nonspecific. Four patients died after operation. Of the 30 cases of malignant tumors, 15 were secondary tumors metastasized mainly from the lung or mediastinal malignancies. Of 11 primary tumor cases (7 males and 4 females), 3 were malignant lymphoma, 2 mesothelioma of pericardium, 2 malignant myxoma, 1 angiosarcoma, 1 leiomyosarcoma, 1 fibrosarcoma and 1 rhabdomyosarcoma. Another 4 cases were not studied histopathologically. The clinical manifestations, ECG and X-ray findings of the 11 primary tumors were nonspecific but echocardiography was helpful to the diagnosis. Six patients were operated on and 1 died during hospitalization.

     

Preservation of laryngeal function in treatment of hypopharyngeal carcinoma

Objective To study the surgical technique and results of laryngeal function preservation in treatment of hypopharyngeal carcinoma.Methods A retrospective review of 305 patients with malignant neoplasms of the hypopharynx (279 males, 26 females, age ranging from 14 to 77 years) was performed from 1978 to 1996 In the 305 patients (stage Ⅰ, n=6; stage Ⅱ, n=12; stage Ⅲ, n=82; stage Ⅳ, n=205), the sites of origin were pyriform sinus (n=234), postcricoid (n=21), posterior pharyngeal wall (n=35) and superior hypopharynx (n=15). Of the 305 patients, 206 (67. 54%, stage Ⅰ, n=6; stage Ⅱ, n=12; stage Ⅲ, n=65;]stage Ⅳ, n=123) were surgically treated with laryngeal function preserved and 99 (32. 46%, stage Ⅲ, n=17; stage Ⅳ, n=82) had no laryngeal function preserved. All had 55-75 Gy radiotherapy according to their need. Results A total of 206 patients (67. 54%) were surgically treated with laryngeal function preserved, totally (voice, respiration and deglutition) in 139 (67. 5%) and partially (voice and deglutition) in 67 (32. 5%). 99 patients (32. 46%) had no laryngeal function preserved. The overall 5-year survival rate of the 305 patients was 44. 8%, which segregated to 83% (stage Ⅰ), 71% (stage Ⅱ), 58% (stage Ⅲ), and 36% (stage Ⅳ). ]The 5-year survival of the laryngeal function preserved group was 48% (n=66), the rate of complications 28% (n=58) and the rate of residual tumor 5. 8% (n=12), compared with the no laryngeal function preserved group 37% (n=20), 31. 3% (n=31), and 6% (n=6) (P>0. 05). Conclution Only a small proportion of patients (31/305, 10%) with hypopharyngeal carcinoma who require total laryngectomy and preservation of the laryngeal function is feasible for eradication of tumor and preservation of laryngeal function.     

Evaluation of speech function on repairing defects of maxilla and palate with temporalis muscle flap

Objective： To evaluate the speech function on repairing defects of maxilla and palate with temporalis muscle flap after benign or malignant turmor resection. Methods： The lateral cephalogram and speech intelligibility were detected in 19 cases with the operations of repairing defects of maxilla and palate by temporalis muscle flap, and their recovery of the speech function were analyzed. Results： Among the 19 patients, there were 15 cases （78.00%） with complete velopharynx, 3 cases （15.80%） with mafiginal velopharynx, and 1 case （5.26%） with insufficient velopharynx. The average speech intelligibility was 94.3%, close to the normal speech intelligibility. Conclusion： The operation of repairing defects of maxilla and palate with temporalis muscle flap can reconstruct the phonatory structure, preserve the palate function and restore the speech function after operation.     

Expression of Vascular Endothelial Growth Factor and Cyclooxygenase-2 in Laryngeal Squamous Cell Carcinoma and Its significance

n order to study the expressions of vascular endothelial growth factor （VEGF） and cyclooxygenase-2 （COX-2） in human laryngeal squamous cell carcinoma （LSCC） and its significance, the expression of VEGF mRNA and COX-2 mRNA in 62 cases of LSCC and 54 adjacent noncancerous laryngeal tissues and 9 normal human laryngeal mucous tissues was detected by using techniques of semi-quantitative RT-PCR. It was found that the expression level of VEGF and COX-2 mRNA was significantly increased in LSCC as compared with that in the normal human laryngeal mucous tissues （both P〈0. 01）, and the expression level of VEGF and COX-2 mRNA were significantly increased in stage Ⅲ＋ Ⅳtissues of LSCC as compared with the stage Ⅰ ＋ Ⅱ tissues of LSCC （P 〈0.01）. There was a high positive correlation between VEGF and COX-2 expression in LSCC （r= 0. 756,P〈0.01）. These data raise the possibility that VEGF and COX-2 may play key roles in the growth, invasion and metastasis of LSCC.     

APPLICATION OF TRANSVAGINAL CDFI IN THE DISTIN- GUISHMENT BETWEEN BENIGN AND MALIGNANT OVARIAN TUMOR

Objective To assess the value of transvaginal CDFI in the diagnosis of malignant ovariantumors and to discriminate the benign from malignant ovarian tumors. Methods 96 patients pelvic masses were studied by transvaginal ultrasonograph mass scoring, and by CDFI through pulsatility index (PI) and resistance index (RI) of peripheral blood flow of mass analyses. Results Mass ultrasonic scoring : scoring >9, 91.9% masses were malignant tumors. Scoring ≤<9, 91.5% masses were benign tumors. PI and Rl of peripheral blood flow of masses were detected by CDFI: Pl< 1 .0 . 92.5% cases; RI<0.5, 97.4% cases were malignant tumors. The diagnosis match rate of malignant ovarian tumors was 97.0% . The diagnosis match rate of benign ovarian tumor was 96 .2% . The diagnosis match rate was improved. Conclusion Ovarian mass ultrasonic scoring>9 and PI< 1 .0 , RI<0 .5 of mass peripheral blood flow are the special ultrasonic features of malignant ovarian tumor and the better methods to distinguish the benign ovarian tumor fro     

THE ROLE OF HYSTERECTOMY IN THE THERAPY OF GESTATIONAL TROPHOBLASTIC TUMOR

Objective. To evaluate the role of hysterectomy for patients with gestational trophoblastic tumor. Methods. We retrospectively analyzed 68 cases of gestational trophoblastic neoplasia treated by hys-terectomy from 1985～1997 at PUMC hospital. Thirty-eight cases were diagnosed of choriocarcinoma and 30 were invasive mole. Results. Twenty-three elder patients who didn‘t desire to preserve fertility were selected for hysterec-tomy after shorter courses of chemotherapy, 22 of them had a complete remission (95.6 % ), the total aver-age courses of chemotherapy was 4.2. Of twenty-seven chemorefractory cases who were suspected of a re-fractory isolated lesion in the uterus, delayed hysterectomy as an adjunct to chemotherapy was performed, 20 of them got a complete remission (74.1% ), the total average courses of chemotherapy were 9. 4. Emer-gency hysterectomy is indicated in 18 patients with uterine perforation or life-threatening hemorrhage, 17 cases had a complete remission (94.4 % ), the total average courses of chemotherapy were 7.6. Conclusion. Although the development of effective chemotherapy has resulted in improved survival of patients with gestational trophoblastic tumor, hysterectomy remains an important adjuncts in the treatment of a selected subset of patients; in order to operate more completely and prevent recurrence, it‘s better to perform extended hysterectomy for the indicated patients.     

Expression of phosphorylated-STAT3 and osteopontin and their correlation in melanoma

The expressions of p-STAT3 and osteopontin in 22 cases of normal nevi and 43 cases of malignant melanoma were immunohistochemically detected, and the correlation between p-STAT3 and osteopontin in malignant melanoma and the correlations of p-STAT3 （or osteopontin） with invasion, metastasis and thickness of malignant melanoma were examined. The results showed p-STAT3 was expressed in 2 of 22 cases of normal nevi and 30 of 43 cases of malignant melanoma, while osteopontin was expressed in 3 cases of normal nevi and 29 cases of malignant melanoma. The expressions of p-STAT3 and osteopontin in melanoma were significantly higher than that in benign nevi. There existed significant correlations between the expression of p-STAT3 and that of osteopontin in melanoma. Furthermore, the expression rates of p-STAT3 were significantly higher in invasive or metastatic melanomas than that their non-invasive or non-metastatic counterparts, and the expression rates of osteopontin were significantly higher in invasive melanomas than that in non-invasive ones. It is concluded that p-STAT3 and osteopontin may play important roles in the pathogenesis of malignant melanoma.     

胸腔内置管并甘露聚糖肽联合白细胞介素-2注药治疗肺癌致恶性胸腔积液34例

目的 观察胸腔内置管并甘露聚糖肽联合白细胞介素-2注药治疗肺癌致恶性胸腔积液的疗效.方法 将我院收治的恶性胸腔积液患者34例,尽量排尽胸腔积液后胸腔内注入药物,治疗组为甘露聚糖肽60 mg/次、白细胞介素-2 100～200万U/次,每周1～2次,连用4次,无效停止治疗;对照组为甘露聚糖肽60 mg/次,每周1～2次,连用4次无效停用,随访3个月.结果 甘露聚糖肽+白细胞介素-2组有效率为82.35%;甘露聚糖肽组有效率为41.18%,两组有效率比较差异有统计学意义(P＜0.05).结论 中心静脉导管行胸腔闭式引流术操作简单,创伤小,无痛苦,带管活动方便,引流效果满意.甘露聚糖肽和白细胞介素-2联合用于胸膜腔内注射可充分发挥协同作用,迅速促进癌性渗出液的吸收,值得临床上进一步研究和推广. Abstract： Objective To discuss the clinical value of closed drainage of pleural cavity with central venous catheterand to evaluate the effect of mannatide and interleukin-2 in the treatment of the patients with pulmonary neoplasm combined with malignant pleural effusion by thoracic cavity perfusion drainage.Methods Thirty-four patients with pulmonary neoplasm combined with malignant pleural effusion were randomly divided into two groups.In group A, injection of mannatide (60 mg) and interleukin-2(10-20 million U) each time.In group B, injection of mannatide (60 mg)each time.The procedures were performed at an interval of a week for 1-2 times.The course of treatment was 4 weeks and the follow-up period was 3 months.Results The total efficiencies in groups A and B were 82.35% and 41.18%, respectively; the difference was considered significant (P ＜ 0.05).Conclusions The closed drainage of pleural cavity with central venous catheter is easy to manipulate, with minor trauma, no complaints, convenience in patient activity and satisfactory drainage effect.Mannatide and interleukin-2were effective and safe on patients with pulmonary neoplasmcombined with malignant pleural effusion, and they take effect synergetically.This method worth being studied and extended clinically.     

重组改构人肿瘤坏死因子治疗恶性胸腔积液疗效观察

目的 评价重组人改构肿瘤坏死因子(rmh-TNF)治疗恶性胸腔积液的疗效和不良反应.方法 38例恶性胸腔积液患者排尽胸水后,注入单药rmh-TNF 2×106 IU,2次/周,观察其疗效、生活质量和不良反应.结果 38例中完全缓解12例,部分缓解23例,无效3例,总有效率92%;不良反应发生率有发热76%(29/38),胸痛44%(17/38).结论 rmh-TNF局部治疗恶性胸腔积液疗效可靠,不良反应少,生活质量提高,是治疗恶性胸腔积液的有效药物,尤其是治疗因恶性胸腔积液不能耐受全身静脉化疗的患者. Abstract： Objective To evaluate the effect and side effect of recombinant mutant human tumour necrosis factor (rmh-TNF) in the treatment of malignant hydrothorax. Methods Thirty-eight patients with malignant hydrothorax were observed rmh-TNF 2×106 IU were injected intrapleurally after complete drainage, two times a week,until the malignant effusion no longer appeared,to observe the effect,quality of life and side effect.Results Among 38 patients with malignant hydrothorax,12 patients obtained complete response(CR),23 patients partial response (PR)and 3 patients no change (NC), the overall response rate was 92%. The adverse reactions were fever 76%(29/38), and chest pain 44%(17/38).Conclusions The rmh-TNF is effective with minor side effect in the treatment of malignant hydrothorax,improve the quality of life.Therefore it is a favorable treatment of choice,especilly to that who can't tolerant chemotherapy.     

腹膜透析患者饮食成分与大动脉僵硬度的关系

目的 探讨持续性非卧床腹膜透析(CAPD)患者饮食营养成分与大动脉僵硬度的关系.方法 选取同一中心92例饮食状况稳定的CAPD患者为研究对象.采用自动脉搏波速度分析仪测定脉搏波速度(PWV),由专业的营养师计算患者饮食组成部分,与PWV进行相关和多元回归分析,筛选出大动脉僵硬度的影响因素.结果 Pearson分析发现PWV与尼克酸 (r=-0.148,P<0.05)、维生素C(r=-0.125,P<0.05)、维生素E(r=-0.181,P<0.05)、碳水化合物(r=-0.181,P<0.05)、能量(r=-0.147,P<0.05)、蛋白质(r=-0.154,P<0.05)相关.多元回归分析结果显示,饮食中维生素E(β=-0.163,P=0.022)及碳水化合物(β=-0.284,P=0.025)是PWV的独立相关因素,二者一起决定了PWV变化的5%.结论 腹膜透析患者饮食维生素E、碳水化合物与PWV密切相关.维生素E、碳水化合物是腹膜透析患者大动脉僵硬度的独立影响因素. Abstract： Objective To investigate the association between dietary nutritive composition and pulse wave velocity (PWV)in patients with continuous ambulatory peritoneal dialysis (CAPD). Methods CAPD patients (n=92) of stable dietary habits in one single center were included.Carotid-femoral PWV was measured with a validated automatic device and was used as an index of large arterial stiffness.Dietary nutritive composition of these patients were calculated by a professional nutritionist. Pearson's correlation and multiple regression analysis were performed to identify the relationship between nutritive composition and PWV.Results PWV was closely associated with nicotinic acid (r=-0.148,P<0.05),vitamin C(r=-0.125,P<0.05),vitamin E (r=-0.181,P<0.05),carbohydrates (r=-0.181,P<0.05),energy (r=-0.147,P<0.05),protein(r=-0.154,P<0.05), respectively.Multiple regression analysis showed that PWV was independently determined by vitamin E (β=-0.163,P=0.022)and Carbohydrates (β=-0.284,P=0.025).They accounted for 5% of the total variance.Conclusions Dietary vitamin E and carbohydrates is closely associated with PWV in CAPD patients.Dietary vitamin E and carbohydrates are independent influential factors for PWV in CAPD patients.Suggesting that the relationship may help to explain the possible protective effect of vitamin E and carbohydrates on cardiovascular risk and mortality through alleviating atherosclerosis in CAPD patients.     

慢性阻塞性肺疾病患者血清瘦素水平与炎性反应相关性

目的 探讨慢性阻塞性肺疾病(COPD)患者血清瘦素水平变化及其与炎性反应的关系,了解瘦素在COPD患者炎症反应过程中的作用及其意义.方法 选择COPD患者共58例,COPD急性加重期(Ⅰ组)30例,COPD缓解期(Ⅱ组)28例,正常对照组28例.测定和计算各组的多项营养指标,包括身高、体重、体重指数(BMI)、理想体重百分比(NM%)、体脂百分比(fat%).用酶联免疫吸附试验法(ELISA)测定58例COPD患者和28例正常人的血清瘦素、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、超敏C-反应蛋白(hs-CRP)水平及肺功能,分析瘦素与各项参数的相关性.结果 ①COPD患者的各营养指标:BMI、NM%、fat%均显著低于正常对照组(P<0.01).②COPD I组血清瘦素、TNF-α、IL-8、hs-CRP均显著高于正常组与COPDⅡ组(P<0.01);COPDⅡ组血清瘦素低于正常组(P<0.01),TNF-α、IL-8、hs -CRP高于对照组(P<0.01);③COPD患者的瘦素含量与BMI、NM%、fat%、TNF-α、IL-8、hs -CRP水平显著正相关.结论 血清瘦素在COPD急性加重期明显高于缓解期,并与营养参数、TNF-α、IL-8、hs -CRP呈显著正相关,提示瘦素可能与COPD的疾病本身和全身炎症反应有关,可作为COPD急性加重期的炎症标志物. Abstract： Objective To investigate the expression and significance of serum leptin in patients with chronic obstructive pulmonary disease(COPD). Methods Thirty COPD patients in acute exacerbations phase (group I), 28 COPD patients in stationary phase(group Ⅱ) and 28 healthy controls were studied. Body height, body mass,body mass index (BMI), percentage of normal body mass (NM%), percentage of body fat(fat%) were determined.The serum leptin、TNF-α、IL-8、hs-CRP levels were examined by ELISA. The correlation between leptin and other parameters was analysed. Results ①BMI,NM% fat% in COPD patients significantly lower than those in healthy controls (P<0.01). ②Serum leptin、TNF-α、IL-8、hs-CRP level was significantly higher in group I than that in healthy controls and in group II (P<0.01); Serum leptin level was significantly lower in group II than that in healthy controls (P<0.01); Serum TNF-α、IL-8、hs-CRP level was higher in healthy controls (P<0.01). ③The leptin level was associated positively with BMI,NM%, fat%. TNF-α、IL-8、hs-CRP level of COPD. Conclusions The leptin level of COPD in acute is higher than that in stationary, and the levels were correlated to nutritional parameters,TNF-α,IL-8,hs-CRP.The result suggests that leptin may play a role in systemic inflamination of COPD, the leptin is an inflaming mark of the actue exacerbation phase in patients with COPD.     

全腔静脉肺动脉连接术治疗复杂先天性心脏病

目的 总结全腔静脉肺动脉连接术治疗复杂先天性心脏病的经验,并对心内隧道和心外管道两种全腔静脉肺动脉连接术术式进行比较.方法 全组32例复杂先天性心脏病,12例行心内隧道全腔静脉肺动脉连接术,20例行心外管道全腔静脉肺动脉连接术.结果 全组患者死亡2例,发生低心排出量综合征8例,10例出现胸腔积液(均治愈),血流动力学满意,术后随访心功能Ⅰ～Ⅱ级,紫绀消失,无心律失常发生.结论 全腔静脉肺动脉连接术是治疗复杂先天性心脏病的一种有效方法,临床效果好,优于传统的Fontan手术;心外管道全腔静脉肺动脉连接术较心内隧道全腔静脉肺动脉连接术操作更简单. Abstract： Objective To summary the experience of total cavopulmonary connection (TCPC) with different methods and study the operative indication, design and therapeutic efficacy. Methods Thirty-two cases of complex cyanotic congenital heart disease were reviewed: 12 cases underwent lateral tunnel and 20 cases extra-cardiac conduit TCPC.Results Two cases were died, and low heart output syndrome occurred in 8 cases, pleural effusion in 10 cases were cured at last. Cyanosis were abscised in all patients and no arrhythmogenesis occured and the heart function improved too. Conclusions The surgical procedures of TPCP is a modus operandi to treat the complex cyanotic congenital heart disease and outweigh the orthodox Fontan procedure. The operating performance of extra-cardiac conduit TCPC is reducing to the lateral tunnel.     

压缩雾化吸入可必特治疗慢性阻塞性肺疾病急性加重期35例疗效观察

目的 探讨压缩雾化吸入可必特对慢性阻塞性肺疾病急性加重期的疗效和不良反应.方法 将75例患者随机分为两组,对照组30例采用常规治疗,治疗组35例在常规治疗基础上加用雾化治疗,观察两组治疗效果和解除主要症状、体征的时间和住院时间.结果 治疗组住院时间和喘憋、肺部喘鸣音的持续时间均明显短于对照组(P＜0.05).结论 压缩雾化吸入可必特治疗慢性阻塞性肺疾病急性加重期疗效确切,方法简便,不良反应小,值得推广. Abstract： Objective To explore the effect of compressed nebulized inhalation combivent on chronic obstructive pulmonary disease with acute exacerbation. Mehods Seventy-five patients were randomly divided into two groups,the control group(30 cases) with conventional treatment, the treatment group (35 cases) on the basis of conventional therapy plus treatment with the spray were observed lifting of the main symptoms and signs of the time and hospital stay.Results The treatment group hospitalization time and asthmatic lungs duration of wheezing were significantly shorter than the control group (P<0.01). Conclusions Compression combivent aerosol inhalation treatment of chronic obstructive pulmonary disease with acute exacerbation is simple, side effects are little and are worth promoting.     

低分子量肝素在胸部肿瘤合并高凝血状态病人围术期的临床应用

目的 使用低分子量肝素(LMWH)预防胸部肿瘤合并高凝血状态病人的围术期血栓性疾病的发生.方法 对2006年1月至2007年10月我科收治的合并高凝血状态的食管癌、贲门癌、肺癌病人,在围术期皮下注射低分子量肝素,每日1次,从术前3～5 d开始直至病人下床,观察术中出血量及术后胸液量,并统计血栓性疾病发生率.结果 该组病人围术期血栓性疾病发生率得到了明显控制.结论 低分子量肝素对预防胸部肿瘤合并高凝血状态病人的围术期血栓性疾病的发生有明显效果,安全可靠. Abstract： Objective To evaluate the efficacy of low molecular weight heparin for preventing thromboembolism disease in perioperative of thoracic tumor with blood hypercoagulabale state. Methods From January 2006 to October 2007, we diagnosed and treated 72 patients with lung cancer and carcinoma of esophagus and cardia. All the patients were treated with LMWH qd from the 3 -5 days before operation until ambulation after operation. To observe the postoperative total amount effusion and to statistic of incidence of thromboembolism disease. Results Incidence of thromboembolism disease decreased more significantly of this group than usual. Conclusions Application of LMWH for preventing thromboembolism disease in periopetive of thoracic tumor with blood hypercoagulabale state is an effective, safe and reliable treatment.     

阿托伐他汀对冠心病合并充血性心力衰竭患者血管内皮功能的影响

目的 研究阿托伐他汀对冠心病(CHD)合并充血性心力衰竭(CHF)患者血浆中一氧化氮(NO)、降钙素基因相关肽(CGRP)和内皮素(ET)的影响.方法 将68例CHD并CHF患者随机分为两组,常规治疗组(地高辛、氢氯噻嗪、硝酸异山梨酯)34例,联用组常规用药加阿托伐他汀34例,另选34例健康体健者为正常对照组.采用Greiss法测定NO水平,放射性免疫法测定治疗前后血中CGRP和ET的水平.结果 CHD并CHF患者中NO和CGRP水平明显低于正常组(P＜0.01),ET显著高于正常组(P＜0.01),治疗后均显著改善(P＜0.01),且以联用组改善更为显著,与常规组治疗后比较差异有统计学意义(P＜0.05).结论 常规用药加阿托伐他汀能显著改善CHD合并CHF患者的NO、CGRP和ET的代谢失衡. Abstract： Objective To study the effect on levels of plasma calcitonin gene-related peptide (CGRP) and endothelin(ET) of atorvastatin in patients with coronary artery heart disease(CHD) complicated with congestive heart failure(CHF). Methods Patients with CHD complicated with CHF were divided into two groups usual medicine group(usual medicine) and atorvastatin group. The plasma CGRP and ET levels were observed before and after treatment. Results The levels of CGRP in patients with CHF were lower than that in normal group before treatment (P＜0.05),and the level of ET was higher (P＜0.05),the improvement of CGRP and ET in atorvastatin group was better than that in the usual medicine group(P＜0.05). Conclusions Atorvastatin had the action of improving the imbalance of CGRP and ET in Patients with CHD complicated with CHF.     

冠心病与血清高敏C反应蛋白、尿酸及血脂水平的检测与结果分析

目的 探讨冠心病患者血清高敏C反应蛋白(hs-CRP)、尿酸(UA)及血脂水平变化及临床意义.方法 抽取冠心病与健康对照组清晨空腹静脉血,应用全自动生化分析仪对血清hs-CRP、UA、血脂进行检测.结果 冠心病组高密度脂蛋白胆固醇(HDL-C)、载脂蛋白AI(apoAI)含量低于健康对照组;hs-CRP、UA、甘油三酯(TG)、胆固醇、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(apoB)浓度高于健康对照组.结论 血清hs-CRP、UA及血脂水平的联合检测对冠心病的诊断具有重要意义. Abstract： Objective Discussion coronary disease blood serum high sensitivity C-reactive protein (hs-CRP),the blood lipids and the uric level change and clinical significance. Methods Extraction coronary disease group with the healthy control group early morning the empty stomach venous blood, applied the whole blood to move the biochemistry analyzer to the blood serum hs-CRP, the uric acid, the blood lipids carries on the examination. Results The coronary disease group blood serum the high density lipoprotein cholesterol and carry the lipoprotein AI content were lower than that in the healthy control group. The hs-CRP, the uric acid, the triglyceride, the low density lipoprotein cholesterol, carry lipoprotein B were higher than that in the control group. Conclusions Combined determination of the patient blood serum hs-CRP, uric acid, blood lipids level is important for the diagnosis of coronary artery disease.     

D-二聚体与纤维蛋白原在冠心病中的临床意义

目的 研究D-二聚体(D-Dimer,DD)与纤维蛋白原(Fg)的含量在冠心病患者中的差异.方法 将入选的130例经冠状动脉造影(CAG)的患者分为确诊的冠心病组94例与正常对照组36例,其中冠心病组又分为急性心肌梗死(AMI)组25例、不稳定型心绞痛(UAP)组36例和稳定型心绞痛(SAP)组33例;再将冠心病组按CAG结果分为轻度病变组24例、中度病变组27例和重度病变组43例.用免疫透射比浊法分别测定DD、Fg含量进行比较.结果 AMI、UAP两组DD、Fg含量及阳性检出率明显高于SAP和对照组(P＜0.05),AMI组的DD、Fg含量明显高于UAP组(P＜0.05),重度病变组DD、Fg含量高于轻、中度病变组(P＜0.05).结论 联合检测DD与Fg在冠心病的诊断中具有重要的临床意义. Abstract： Objective To examine the diversity of D -dimer(DD) and fibrinogen (Fg)in the patients with coronary heart disease(CHD). Methods The 130 subjects were divided into CHD group(94 cases) which were confirmed by coronary artery angiography(CAG) and control group (36 cases). CHD group was divided into acute myocardial infarction (AMI) group (25 cases), unstable angina pectoris (UAP) group (36 cases) and stable angina pectoris (SAP) group ( 33 cases). In addition, CHD group was divided into slight (24 cases), moderate (27 cases)and severe (43 cases)lesion groups according to the outcome of CAG. The levels of DD and Fg were measured respectively and compared among all groups. Results The levels of DD, Fg in AMI and UAP groups were significantly elevated as compared with that of SAP and control groups ( P＜0.05), and DD, Fg in AMI group were higher than that of UAP group. The levels of DD and Fg in severe lesion group were higher than that of moderate and slight groups ( P＜0.05 ). Conclusions To measure the levels of DD and Fg simultaneously has important clinical significance in CHD.