764-3对野百合碱性肺动脉高压大鼠肺动脉胶原沉积的影响

目的：观察７６４－３对野百合碱（ＭＣＴ）性肺动脉高压大鼠肺动脉胶原沉积的影响，探讨其可能的作用机制。方法：将雄性Ｗｉｓｔａｒ大鼠随机分为４组即正常组，正常给药组，ＭＣＴ对照组，ＭＣＴ给药组。给药大鼠从第１５天起，皮下注射７６４－３（４０ｍｇ／ｋｇ）１次／日。实验结束时，行血流动力学和病理形态学检查，并测定肺动脉羟脯氨酸（ＨＹＰ）和总蛋白含量。结果：ＭＣＴ性肺动脉高压大鼠肺动脉羟脯氨酸含量较正常组明显增高，平均分别为２４９．５±４９．９μｇ和１２４．２±２１．７μｇ（Ｐ＜０．００１），泡内肺肌型动脉中膜平滑肌细胞（ＳＭＣ）肥大、呈分泌型改变，细胞间胶原沉积；７６４－３能显著降低肺动脉羟脯氨酸含量（平均由２４９．５±４９．９μｇ降至１８６．８±３８．５μｇ，Ｐ＜０．０１），中膜ＳＭＣ结构逆转，胞体多细长，细胞间胶原减少。结论：７６４－３能部分抑制胶原在肺动脉壁的过度沉积，降低ＭＣＴ性肺动脉高压。而其减少胶原沉积、降低肺动脉高压的机制，很可能是通过逆转中膜ＳＭＣ表型改变     

肺功能和心血管病关系的研究进展

二十世纪中叶以来，心血管病日益成为最主要的死亡原因。一系列研究发现，肺功能降低不仅是总死亡的独立危险因素，而且与心血管病发病与死亡危险升高有关联，受到国际流行病学界的广泛重视。本文就肺功能对心血管病的影响及其可能的机制做简要综述，以期对相关研究工作有所帮助。     

原发性与栓塞性肺动脉高压的判别分析

原发性与栓塞性肺动脉高压在临床上难以鉴别。本文研究了71例原发性和55例栓塞性肺动脉高压,从78种临床资料中筛选出6种鉴别意义较大的指标,建立了用以鉴别这两种肺动脉高压的Bayes概率模型,回代检验证明其判断正确率为86.51%。     

EFFECT OF SALVIAE MILTIORRHIZAE COMPOUND ON PULMONARY ARTERY HYPERTENSION CAUSED BY CHRONIC PULMONARY THROMBOEMBOLISM

Sixteen patients (6 males and 10 females with a mean age of 38) were diagnosed as having pulmonary thromboembolism, except one case of pulmonary veno-occlusive disease. Baseline he- modynamic parameters were measured. Then after inhalation of 100% oxygen, measurements of the following hemodynamic parameters, e.g. pulmonary artery pressures (PAP), including systolic pulmonary artery pressure (SPAP), dias- tolic pulmonary artery press,ure (DPAP), mean pulmonary artery pressure (MPAP), pulmonary capillary wedge pressure (PCWP), cardiac output (CO), cardiac index (CI), and total pulmonary resistance (TPR) were repeated at 10: minutes and 20 minutes. When the hemodynamic changes returned to the baseline9 20 ml of Salviae mil- tiorrhizae compound was injected slowly through catheter and showed a direct vasodilator effect on the pulmonary arterioles. The vasodilator effect persisted over 20 minutes and was better in mild and moderate groups of pulmonary hy- pertension than in severe group, so it is impor- tant to diagnose and treat these patients, as early as possible in order to prevent or postpone the development of pulmonary hypertension. As for the long-term effect of Salviae miltiorrhizae further investigation is needed.     

VALUF OF THE PUMONARY VALVE ECHOGRAM IN ESTIMATING PULMONARY ARTERY PRESSURE

Pulmonary valve echoes are valuable in assessing pulmonary arterial pressure and right ventricular hemodynamics. With the present technic some indices have been already obtained such as a wave amplitude and right ventricular systolic time intervals, which can be utilized to estimate pulmortary arterial pressure to recognize the presence of severe pulmonary hypertension. However, it is still a qualitative or semi-quan- titative technic and this insufficiency needs fur- ther investigation to improve the accuracy of this noninvasive technic for estimating pul- monary arterial pressure.     

地高辛和电转复在休息时室率过缓及长R—R间期房颤的应用

本文观察了14例休息时室率过缓和长R—R间期心房颤动患者的地高辛和电转复疗效。地高辛0.16～0.48nmol(0.125～0.375mg/日),一周后可使活动时心室率显著下降。长R—R间期改变不明显。电转复后无一例出现严重心律失常。     

卡介苗的歷史及使用

遠在一九○一年法國羅卡德(Nocard)氏從牛奶中分離出一株牛型結核桿菌,保存在試驗室內。後經卡美德(Calmette)及介雲(Guerin)二氏用含牛胆汁的馬鈴署培養基進行培養,他們試驗的結果,認為牛型結核菌在此種培養基上生長時,其毒力漸漸消失。一九○七年他們發表了一篇論文,說明了此點。以後每間二、三星期,將此菌傳種一代,到第十五代時,該菌已不能使豚鼠發     

CLINICAL COMPLICATIONS AND SAFETY OF TRANSESOPHAGEAL ECHOCARDIOGRAPHY： A REPORT OF 1552 EXAMINATIONS

Background. Transesophageal eckocardiography(TEE) is an advanced technique. The purpose of this article is to discuss the complication and safety of the TEE. Method. Fifteen hundred and fifty-two patients with heart disease were examined with monoplane,biplane and omniplane TEE probe(including male 727, female 825;9～76 years old). During the same period, 113 307 precordial echocardiographic examinations were performed in our laboratory. The ratio between TEE and transthoracic Echo examines was 1 : 73. Reset. All different kinds of complication were occurred during TEE examination, including vomiting. minor mucus bleeding, laryngospasm, rnandibular dislocation, angina pectotis, arrhythmia, even ventricular fibrillation and death. The article suggested that there were five steps must be improved during TEE examination including instrument and patients preparation, local anesthesia, manipulation technique and TEE probes pattern. Conclusion. Although TEE is a semiinvasive technique and can cause some kinds of complication, it is a safe technique if the five steps are improved.     

肺动脉高压110例血液动力学分析

肺血流量、左—右分流量与肺动脉压之间虽有一定关系,但非关键因素;肺血管阻力与肺动脉高压之间呈正比关系;肺动脉高压对右心室收缩时间的影响主要是ICT时间;右室PEP/VET比值可作为衡量肺动脉压力的指标;重度肺动脉高压但其肺血管阻力在1000以上者,肺血管反应性差,而反应性良好者手术的近期疗效满意;39例尸检病例的肺血管改变程度与肺动脉压之间的符合率为66.6～86.9％。作者还探讨了肺动脉高压形成的机制。     

经食管双平面超声探头的临床应用评价

经食管双平面超声探头的临床应用评价中国医学科学院心血管病研究所，阜外医院超声科王国干，孟宪强，程克正，樊朝美，张辉，刘醒，刘汉英，蔡如升经食管超声（ＴＥＥ）避开了胸壁和肺组织的干扰，能更清晰地显示心脏和大血管结构，弥补了经胸超声（ＴＴＥ）的不足。我们...