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1.
目的:分析急性冠脉综合征(ACS)患者早期B型钠尿肽(BNP)水平的差异,评估BNP在早期诊断中的作用。方法:入选末次症状发作至就诊时间均〈6h的ACS患者221例.分为ST段抬高心肌梗死(STEMI)组(n=83)、非ST段抬高心肌梗死(NSTEMI)组(n=69)和不稳定性心绞痛(UA)组(n=69)。所有患者在入院即刻测定BNP水平,发病12h内测定肌钙蛋白Ⅰ(TnⅠ)。比较不同组间BNP的差别及BNP与TnⅠ的相关性。结果:UA、NSTEMI和STEMI患者基础血浆BNP浓度依次升高(分别为13.9pg/ml、34.9pg/ml和64.2pg/ml)(组间比较P〈0.01),且STEMI和NSTEMI患者BNP水平与TnⅠ正相关(叫分别为0.724和0.675,P均〈0.01)。BNP≥100pg/ml对NSTEMI诊断阳性预测值达83.3%。结论:ACS患者早期BNP水平升高.对早期鉴别NSTEMI和UA有一定价值.  相似文献   

2.
目的:探讨ST段抬高型急性心肌梗死(STEMI)溶栓治疗后患者血浆脑利钠肽(BNP)水平与临床预后的关系。方法:连续性入选189例行急性溶栓治疗的STEMI患者。测定症状发作平均(30.2±16.0)h的血浆BNP水平,随访患者住院期间,30天,3个月病死率及主要心脏不良事件(MACE)(心源性死亡,再次心肌梗死,继发性心衰和再入院的复合终点)发生率。结果:189例STEMI患者根据血浆BNP水平分为四组:BNP≤100ng/L组;100〈BNP≤300ng/L组;300〈BNP≤600ng/L组和BNP〉600ng/L组。随血浆BNP水平的升高,各组病死率及MACE发生率呈明显递增趋势:3个月时,各组病死率分别为0%、1.4%、7.7%、48.3%,MACE发生率分别为7.9%、57.7%、79.3%。在多变量的Logistic回归分析中,BNP独立于年龄、吸烟史、高血压、糖尿病、高脂血症及LVEF等危险因素,预测30天(r=0、8515,P〈0.01)和3个月(r=0.9201,P〈0.01),病死率及30天(r=0.7066,P〈0.01)和3个月(r=0.7090,P〈0.01)MACE发生率。结论:BNP能够很好地对STEMI患者行急症溶栓治疗后进行危险分层,预测近期病死率和MACE发生率。  相似文献   

3.
目的判定脑钠素水平在评价急性非sT段抬高型心肌梗死和急性ST段抬高型心肌梗死患者行急诊冠状动脉介入治疗后心功能与临床结果的关系。方法研究入选急诊PCI的NSTEMI患者20例、STEMI患者40例,于PCI后采集血液检测血浆BNP水平,根据BNP中位数将患者分为两组,高BNP组(BNP≥160ng/L)和低BNP组(BNP〈160ng/L)。比较两组患者特征、左室收缩功能、STEMI心电图ST段回落和住院期间主要并发症。结果高BNP组较低BNP组左室收缩功能降低(左室射血分数,P〈0.01)、左室舒张末期容积减少(P〈0.01)、长期大量吸烟和糖尿病患者多(60%:40%,P〈0.05;65%:45%,P〈0.05)、STEMIST段回落减少(P〈0.01)、住院期间急性左心衰发生增多(25%:5%,P〈0.01)。结论急性心肌梗死急诊PCI患者,血浆BNP的升高水平可作为评价PCI术后近期心功能及心肌再灌注的敏感指标。  相似文献   

4.
目的:研究急性ST段抬高型心肌梗死(STEMI)患者中医证型与N端脑钠肽前体、超敏C反应蛋白水平关系。方法:纳入STEMI患者167例作为实验组,确定中医辨证分型,另外选择健康体检者50例为对照组,实验组和对照组均采集静脉血检测NT-pro BNP,hs-CRP水平。结果:STEMI组患者血清NT-pro BNP为(1 636.62±538.90)pg/m L,明显高于对照组(46.72±24.64)pg/m L(P〈0.05);STEMI组患者血清hs-CRP为(16.45±3.64)mg/L,明显高于对照组(2.47±0.74)mg/L(P〈0.05)。心血瘀阻证患者血清NT-pro BNP(2 801.52±732.87)pg/m L、hs-CRP(30.67±5.77)mg/L水平明显高于其他证型患者,差异有显著性(P〈0.05),NTpro BNP与hs-CRP呈正相关性(r=0.503,P=0.034 P〈0.05)。结论:NSTEMI患者血清NT-pro BNP,hsCRP明显升高,且心血瘀阻证中医证候与NT-pro BNP、hs-CRP密切相关。  相似文献   

5.
摘要目的通过研究急性ST抬高型心肌梗死(acute ST elevation myocardial infarction,STEMI)者血浆脑钠肽(brain natri-uretic peptide,BNP)水平与血管病变及近期预后的关系来探讨其临床价值。方法选择STEMI者126例,据入院BNP水平由低到高由4个百分位数分为4组:A组(BNP≤105ng/L)、B组(BNP105.1-339.Ong/L)、c组(BNP339.1-1188.0ng/L)和D组(BNP〉1188ng/L)。90min内进行冠状动脉造影(coronary angiography,CAG)和经皮冠状动脉介入术(percutaneous coronary inter-vention,PCI),测定Gensini积分,记录1个月内并发症。结果①与A组、B组比较,D组多支冠脉病变比例显著增高(P〈0.01),与c组比较,D组多支冠脉病变比例有增高趋势(P〉0.05);②与前一组比较各组Gensini积分显著增高(P〈0.01);③血浆BNP水平与Gensini积分呈正相关(r=0.673,P〈0.01);④与A组、B组比较,D组心血管事件发生率显著增高(P〈0.01);与c组比较,D组心血管事件发生率有增高趋势(P〉0.05)。结论①STEM]者血浆BNP水平可能与冠状动脉病变支数及程度呈正相关;②AMI早期血浆BNP水平显著升高提示心血管事件发生率高,可作为心血管事件的预测因子。  相似文献   

6.
目的:通过分析急性心肌梗死患者血浆B型利钠肽(B-type Natriuretic Peptide,BNP)水平与相关临床因素的关系,探讨BNP在急性心肌梗死临床诊治中的作用及意义。方法:回顾性分析冠病患者159例临床资料,急性心肌梗死98例,包括ST段抬高型心肌梗死(STEMI)54例,非ST段抬高型心肌梗死(NSTEMI)44例,同期不稳定型心绞痛35例,稳定性心绞痛26例。所有入选病例均为入院24 h内测定血浆BNP浓度、心肌标志物测定,进行超声心动图检查,记录患者心功能Killip分级等。结果:(1)急性心肌梗死组患者血浆BNP水平显著高于不稳定型心绞痛组及稳定型心绞痛组(P<0.01);STEMI患者血浆BNP水平明显高于NSTEMI组,差异有统计学意义;不稳定型心绞痛组与稳定型心绞痛组血浆BNP水平,差异无统计学意义。(2)急性心肌梗死组患者血浆BNP水平随着心功能Killip分级(Ⅰ~Ⅳ)升高和左室射血分数(LVEF)降低而梯次升高,差异均有统计学意义(P<0.05),血浆BNP水平与Killip分级呈正相关(r=0.851,P<0.01),与LVEF呈负相关(r=-0.714,P<0.01),与LVEDs、LVEDd均呈正相关(分别为r1=0.427,r2=0.482,P<0.01),与Gensini积分呈正相关(r=0.452,P<0.01),与冠脉病变支数呈正相关(r=0.332,P=0.002)。(3)STEMI和NSTEMI亚组患者血浆BNP与LVEF均呈负相关,与LVEDs、LVEDd、Gensini积分均呈正相关。结论:血浆BNP水平可作为反映急性心肌梗死患者病情轻重的指标之一,与心梗后心功能状态、左室重构情况及冠脉病变程度相关,有助于心梗后心功能及预后判断,可参与急性心肌梗死患者的危险分层并发现心梗后高危人群。  相似文献   

7.
目的:探讨血浆脑钠肽(BNP)在急性冠脉综合征(ACS)中的变化及与冠脉病变范围的关系。方法:66例经冠状动脉造影证实的ACS患者作为研究组,其中急性心肌梗死(AMI)患者35例,不稳定型心绞痛(UAP)17例,稳定型心绞痛(SAP)14例,32例冠脉造影阴性作为对照组。检测患者血浆BNP浓度,比较各组间BNP的差异。结果:AMI组平均BNP明显高于UAP组、SAP组和对照组(P〈0.01),STEMI组平均BNP明显高于STEMI组和对照组(P〈0.01),NSTEMI组高于对照组(P〈0.05)。结论:不同临床类型冠心病患者的血浆BNP浓度存在差异,其水平高低与冠心病的病变范围关系密切。  相似文献   

8.
李志华 《当代医学》2010,16(31):51-52
目的探讨血浆脑钠肽(BNP)测定对急性冠脉综合征(ACS)诊断和判断预后的重要意义。方法检测健康对照组26例,ACS患者116例,其中ACS组再分为不稳定型心绞痛(UAP)组45例和ST段抬高性心肌梗死(STEMI)组31例,非ST段抬高性心肌梗死(NSTEMI)组40例,应用化学发光法分别测定其BNP浓度。结果四组受检者BNP间差异均有统计学意义(P〈0.05)。其中AMI组BNP浓度高于UAP组(P〈0.05),STEMI组BNP浓度高于NSTEMI组P〈0.05,各疾病组血浆BNP浓度明显高于健康对照组(P〈0.05)。结论 ACS患者血浆BNP浓度明显升高,检测ACS患者血浆BNP水平对疾病的预后观察具有重要的临床意义。  相似文献   

9.
张小乐  苏永才  邓斌  冯新武  苏良献 《吉林医学》2013,34(19):3754-3756
目的:分析初发急性ST段抬高型心肌梗死(STEMI)患者血浆B型脑钠肽(BNP)水平与住院期间左室射血分数(LVEF)、左室舒张末内径(LVEDd)、室壁瘤形成(LVA)及主要不良心脏事件(MACE)之间的关系,评价BNP与STEMI患者的临床关系。方法:选取非心衰初发STEMI患者86例,按照BNP水平分为BNP<100 ng/L组,100 ng/L≤BNP<200 ng/L组和BNP≥200 ng/L组,比较各组住院期间的LVEF、LVEDd、LVA发生率和MACE的发生率。采用SPSS 19.0统计软件进行数据分析,计量资料用均数±标准差表示,用t检验进行分析,多组均数比较采用单因素方差分析,计数资料采用χ2检验,以P<0.05为差异有统计学意义。结果:BNP≥200 ng/L组LVEF最低,LVEDd最大,MACE发生率最高(P=0.000),BNP<100 ng/L组LVEF最高,LVEDd最小,MACE发生率最低(P=0.000),而100 ng/L≤BNP<200 ng/L组的三个统计指标介于两者之间(P=0.000)。结论:STEMI患者住院期间的BNP水平越高,心功能越差,心肌重塑程度越高,LVA发生率和MACE发生率越高。  相似文献   

10.
目的:研究ST段抬高型急性心肌梗死(STEMI)患者早期脑钠肽(BNP)水平变化情况,分析各个时间点BNP水平对心力衰竭的诊断价值。方法:118例STEMI患者作为研究对象。根据Killip分级分为心力衰竭组(n=42)和非心力衰竭组(n=76)。分析两组患者不同时间点的BNP水平情况和STEMI患者BNP水平的影响因素,分析不同时间点BNP水平与Killip分级的关系。结果:心力衰竭患者在发病6、12、24、48 h时BNP水平分别为(52.96±10.12) pg/ml、(172.43±25.38) pg/ml、(471.24±51.72) pg/ml和(374.69±33.42) pg/ml,均明显高于非心力衰竭患者的(12.58±2.69) pg/ml、(75.82±12.36) pg/ml、(179.27±20.64) pg/ml和(118.42±19.76) pg/ml(均P<0.05)。发病6~24 h,所有患者BNP水平随着时间的延长而增高,发病24~48 h,所有患者BNP水平随着时间的延长而降低(均P<0.05)。等级Logistic回归分析显示,Killip分级较低、前壁心肌梗死、男性和发病至球囊扩张时间较短是STEMI患者BNP水平较低的影响因素(均P<0.05)。BNP浓度在发病6、12 h时与Killip分级呈较弱正相关,发病24、48 h时,BNP浓度与Killip分级呈较强正相关(均P<0.05)。结论:BNP水平随着STEMI患者发病时间的延长而升高,约24 h达峰值。BNP在STEMI患者发病≤12 h及>24 h对心力衰竭的诊断价值较低,STEMI患者发病12~24 h BNP对心力衰竭的诊断价值较高。  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.
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   

19.
Objective To measure Derpl and Blot5 allergen levels in asthmatics' homes in Hongkong.Methods Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derpl and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.Results The levels of Derpl allergens found in bed (geometric mean (GM) 3.43 μg/g of dust; 95%CI, 1.89-4.96 μg/g)and on the floor (GM 1.12 μg/g of dust; 95%CI, 0.71-1.53 μg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 μg/g of dust; 95%CI, 0.89-38.90 μg/g) and on the floor (GM 6.14 μg/g of dust; 95%CI, 0.40-11.90 μg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derpl and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 ≥ 10 μg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P< 0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 =0 μg/g of dust as compared with Derpl in bed and on the floor (4.3% and 14.5% respectively, P< 0.05).Conclusions Derpl and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.  相似文献   

20.
ANTI-PROLIFERATION EFFECT OF ORIDONIN ON HL-60 CELLS AND ITS MECHANISM   总被引:4,自引:0,他引:4  
Objcetive To investigate the anti-proliferation effect of oridonin on leukemic HL-60 cells and its mechanism. Methods HL-60 cells in vitro in culture medium were given different concentrations of oridonin. The inhibitory rate of cells were measured by microculture tetrazolium (MTT) assay, cell apoptotic rate was detected by flow cytometry (FCM), morphology of cell apoptosis was observed by hoechst 33258 fluorescence staining, and the activity of telomerase was detected using telomere repeat amplification protocol (TRAP) PCR-ELISA before and after apoptosis occurred. Results Oridonin could decrease telomerase activity, inhibit growth of HL-60 cells, and cause apoptosis significantly. The suppression was both in time- and dose-dependent manner. Marked morphological changes of cell apoptosis including condensation of chromatin and nuclear fragmentation were observed clearly by hoechst 33258 fluorescence staining especially after cells were treated 48-60 hours by oridonin. Conclusions Oridonin has apparent anti-proliferation and apoptotic effects on HL-60 cells in vitro, decreasing telomerase activity of HL-60 cells may be one of its most important mechanisms. These results will provide strong laboratory evidence of oridonin for clinical treatment of acute leukemia.  相似文献   

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