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1.
目的回顾性分析冠心病合并代谢综合征(MS)患者的远期预后.方法对1995年10月~ 2002年12月,经冠状动脉造影证实冠心病的458例住院患者进行了随访.按美国国家胆固醇教育计划成人治疗组第三次报告的修改标准,分为合并MS(MS+)和不合并MS(MS-)两组.随访患者的治疗经过和心脑血管事件的发生情况.采用Kaplan-Meier法分别计算两组患者的生存率和无心脑血管事件生存率.结果 458例患者随访20 ~ 108月(中位时间52.5月),冠心病合并MS的发生率为45.41%.MS+组患者的腰围、体重指数、空腹血糖、收缩压、舒张压、甘油三酯、尿酸和肌酐均显著高于MS-组患者,而高密度脂蛋白胆固醇显著低于MS-组患者.MS+患者得到更多的调脂和降压治疗.两组心脑血管事件的发生率相似.随访期间,两组的总生存率和无心脑血管事件生存率无显著差异.结论通过积极的综合干预,合并与不合并MS冠心病患者的远期预后相似.  相似文献   

2.
目的:观察冠状动脉临界病变合并糖调节异常的冠心病患者行介入治疗的预后。方法入选51例冠状动脉临界病变合并糖调节异常的冠心病患者,根据治疗方法不同分为单纯药物治疗34例(对照组)和介入治疗(药物+经皮冠状动脉介入治疗)17例(观察组),术后随访12个月,观察两组患者主要临床症状(再发心绞痛、心力衰竭)及主要心血管事件[靶血管再次介入治疗、远期(12个月)生存率]发生情况。结果观察组再发心绞痛、心力衰竭明显少于对照组(35.29%vs.73.53%、11.76%vs.44.12%,P=0.020、0.030);而两组在靶血管再次介入治疗以及远期(12个月)生存率比较,差异无统计学意义(11.76%vs.26.47%、5.88%vs.8.82%,P=0.297、1.000)。结论冠心病临界病变合并糖调节异常介入治疗虽可以改善部分临床症状,但不能明显降低主要心血管事件发生率。  相似文献   

3.
目的 评价多巴酚丁胺负荷超声心动图(DSE)期间心电图(DECG)的阳性变化对冠心病(CAD)患者预后的意义。方法 DECG采用多巴酚丁胺(DOB)负荷分级方法,分析DECG变化与心血管事件之间的关系。结果 DSE(+)-DECG(+)组、DSE(+)-DECG(-)组、DSE(-)-DECG(+)组与DSE(-)-DECG(-)组4组中,除后两组之间免于全部心脏事件的累积生存率无统计学差异(P>0.05)以外,其余属组间均有显著性差异(P<0.05)。结论 DECG(+)可以提供长期长期随访观察CAD患者发生心脏事件的预后信息,对CAD患者预后评价有一定的参考作用。  相似文献   

4.
目的 评估冠心病合并2型糖尿病患者冠状动脉内植入雷帕霉素洗脱支架的临床疗效。方法155例冠心病合并2型糖尿病患者接受冠状动脉内支架术,其中81例植入雷帕霉素洗脱支架(SES组),74例接受普通金属裸支架(BMS组),比较两组的临床一般情况、冠脉造影、支架植入术和远期综合心脏事件发生率。结果两组患者冠脉病变特点和支架植入术情况无统计学差异(P〉0.05),住院期间均无严重并发症发生。平均随访1年中,SES组远期心脏不良事件发生率显著低于BMS组(P〈0.001)。结论冠心病合并2型糖尿病患者植入雷帕霉素洗脱支架安全有效;与普通金属裸支架相比,雷帕霉素洗脱支架能显著降低心脏不良事件发生率。  相似文献   

5.
目的探讨老年冠心病合并糖尿病患者经皮冠状动脉介入(PCI)置入雷帕霉素洗脱支架(SES)治疗的远期疗效。 方法回顾性随机入选2003年1月至2007年12月住院期间老年冠心病合并糖尿病患者行PCI 100例,并入选同时期100例无糖尿病的冠心病患者行PCI为对照组。随访5年,随访包括心绞痛复发、死亡、心肌梗死、卒中和再次血运重建的主要不良心脑血管事件。结果 两组支架术成功率均为100%。随访率100%,随访5年,糖尿病组与非糖尿病组术后并发症发生率(8.0%、7.0%)、卒中发生率(5%、3.0%)、心源性死亡率(0%、0%)差异无显著性(均为ρ〉0.05)。再次血运重建率(30.0%、14.0%)、非致死性心肌梗塞(6.0%、2.0%)心绞痛复发率(42%、20%)、全因死亡率(10%、2.0%)糖尿病组高于非糖尿病组;但心源性病死率均为0%。结论:老年患者选择性冠脉内置入药物洗脱支架安全,成功率高,远期疗效尚好,但糖尿病仍是远期不良预后的独立预测因素。  相似文献   

6.
目的对冠心病合并代谢综合征(metabolicsyndrome,MS)的患者脂质和载脂蛋白水平进行分析。方法选择于2011年5月-2012年10月在我院心内科行冠状动脉造影术并确诊为冠心病的患者119例,分为合并Ms组(53例)和未合并MS组(66例),比较两组相关危险因素,测定血清脂质水平和载脂蛋白谱,分析冠心病合并MS患者血脂的特点。结果与未合并MS组比较,冠心病合并MS组甘油三酯(TG)、载脂蛋白B(ApoB)、载脂蛋白C2(ApoC:)、载脂蛋白C3(ApoC3)水平均增高(P〈0.05—0.01);高密度脂蛋白胆固醇(HDL—C)、载脂蛋白A1(ApoA1)水平低于未合并MS组(P〈0.05~〈0.01);两组冠心病患者总胆固醇(TC)、低密度脂蛋白胆固醇(LDL—c)、载脂蛋白A2(ApoA2)、载脂蛋白E(ApoE)水平比较无统计学差异(P〉0.05);冠心病合并MS组冠脉病变严重程度明显增加(P〈0.01)。结论冠心病患者合并MS存在多种脂质代谢紊乱,并可加重冠状动脉病变严重程度。  相似文献   

7.
陈祖鹏  张昕  黄李法  李徐  徐震  竺国充 《浙江医学》2015,38(22):1816-1819
目的分析自发性小脑出血昏迷患者的生存情况,探讨影响远期预后的相关因素。方法回顾性随访分析82例小脑出血后格拉斯哥评分(GCS)≤8分的患者,对研究对象10项基线特征进行生存分析,采用Kaplan-Meier法计算,单因素患者生存率比较采用log-rank检验,多因素分析采用Cox比例风险模型。结果随访期内死亡患者53例,4例失访,中位生存期(四分位数间距)为22.0(38.0)个月。单因素分析表明,原发性心脑血管事件(P=0.013)、脑室积血(P=0.019)和GCS评分≤5分(P=0.013)为预后的危险因素。采用Cox比例风险模型进行多因素分析,同样表明原发性心脑血管事件(HR=1.959,95%CI1.082~3.545)、脑室积血(HR=2.019,95%CI1.165~3.948)、GCS评分≤5分(HR=1.813,95%CI1.008-3.261)对生存率有显著影响。手术可以提高生存率和延长生存时间,但无统计学意义(P=0.812)。结论小脑出血昏迷患者的病死率仍较高,决定远期预后的影响因素为原发性心脑血管事件、脑室积血和GCS评分≤5分。  相似文献   

8.
目的探讨代谢综合征对仅行溶栓治疗的急性心肌梗死预后的影响。方法筛选2007年的初发急性心肌梗死后收治入我院的患者157例进行随访。随访结束后将资料完整的72例患者分为合并代谢综合征组(35例)和无代谢综合征组(37例)。通过比较两组患者的主要心脏事件发生率和病死率,来分析代谢综合征对急性心肌梗死患者预后的影响。结果在本研究的急性心肌梗死患者中代谢综合征的发病率为48.6%;在急性心肌梗死仅行溶栓治疗的患者中MS组病死率为31.4%,明显高于非MS组病死率10.8%(P=0.031);患者远期反复发作心绞痛为MS组28.6%,非MS组13.5%(P=0.116),差异无统计学意义。结论合并代谢综合征而仅行溶栓治疗的急性心肌梗死患者具有较高的病死率,应加强对代谢综合征的早期诊断及二级预防。  相似文献   

9.
聂晓莉  周世炳  赵思勤  李秋  吴涛  刘小蓉 《四川医学》2002,23(11):1143-1144
目的:探讨高血压病并存2型糖尿病对其心血管并发症及预后的影响。方法:对96例高血压合并2型糖尿病患者(A组)及274例高血压非糖尿病患者(B组)进行了血压,血脂的检测,以及发生冠心病,心力衰竭,肾功能衰竭,心肌梗死,脑座中和死亡的随访比较分析。结果:A组比B组血清总胆固醇,甘油三酯显著增高(P<0.05和<0.01),高密度脂蛋白明显降低(P<0.05),低密度脂蛋白A组与B组无明显差异(P>0.05)。A组收缩压和舒张压均比B组增高显著(P<0.01)。无论是冠心病,肾功能衰竭,脑卒中和死亡A组比B组发生都显著增加(P<0.05和<0.025),心力衰竭和心肌梗死两组无显著差异(P>0.05)。结论:高血压并存糖尿病对脂质代谢紊乱,血压升高和心血管事件的发生有一定影响。二者并存在是导致冠心病、肾功能衰竭、脑卒中和死亡发生的重要危险因素。提示早发现和早控制病人血糖和血压有利于防止或延缓心脑血管事件的发生和发展。  相似文献   

10.
目的探讨采用介入疗法(PCI)治疗老年冠心病患者的临床疗效。方法选取该院126例经PCI治疗的老年冠心病患者,为老年组,组内老年冠心病患者年龄均在75岁以上;118例年龄〈75岁的中青年冠心病患者为中青年组。对两组患者行PCI治疗并于术后6个月及1年后进行随访,比较两组患者手术成功率,术后1年内心脑血管事件及远期心功能改善状况。结果相比于中青年组的远期心功能情况,老年组患者在1年之后的心脑血管改善方面效果显著,两组差异有统计学意义(P〈O.05)。结论高龄患者PCI治疗成功率及术后不良反应与中青年相当,且远期心功能改善比后者更加明显。  相似文献   

11.
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.  相似文献   

12.
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.  相似文献   

13.
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.  相似文献   

14.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

15.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

16.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

17.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

18.
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…  相似文献   

19.
Journal of Nanjing Medical University (English Edition) JNMU, sponsored by Nanjing Medical University, was established in 1987. It is a bimonthly comprehensive English medical journal published locally and abroad.Since 2007, Journal of Nanjing Medical University (English Edition )was granted Elsevier the full publishing and distribution rights worldwide for the Electronic Edition, excluding the People's Republic of China.  相似文献   

20.
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.  相似文献   

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