乌鲁木齐地区58例老年重症肺炎临床分析

目的总结老年重症肺炎临床及诊治特点。方法对我院收治的乌鲁木齐地区58例老年重症肺炎的临床资料进行分析。结果临床治愈：9例，占15．5％，好转：19例，占32．8％，死亡：30例，占51．7％。结论老年重症肺炎的临床症状不典型，死亡率高，早期诊断和及时给予经验性用药是有效治疗的关键。     

Cohn‘sF-Ⅳ沉淀中人血高密度脂蛋白的溶解试验及载脂蛋白A-I的含量观察

国内外大量研究表明,高密度脂蛋白(HDL)与冠心病(CHD)的发生呈负相关[1,2],作为从根本上防治CHD的新药,HDL已经显示出良好的开发前景.笔者研究的从人血浆中直接提取人血HDL的工艺已经成熟[1,3].但由于受工艺限制,继续开发有一定难度,而且国内外广泛采用Cohn‘s低温乙醇法及其改良法分离血浆蛋白.为有效利用血浆资源,笔者考察了从Cohn‘s法废弃组分中提取HDL的可行性.本文以测定人血HDL的主要载脂蛋白A-I(apoA-1)为指标,对Cohn‘s法组分四(F-Ⅳ)沉淀中人血HDL的溶解条件及apoA-I的含量进行了研究.……     

HLA组织配型实验室送排风问题

随着中华骨髓库各个分库的建立和发展,在中国红十字会和各地红十字会的积极努力下,很多地区建立了HLA组织配型实验室。各地的HLA组织配型实验室均参照卫生部《临床基因扩增检验实验室管理暂行办法》、《临床基因扩增检验实验室工作规范》进行设计。在实验室的建立过程中,无论是利旧改造,还是异地重建,整个实验室的送排风问题都是一个至关重要的问题,如何解决好这个问题,既关系到     

The relationship between left ventricular hypertrophy, diastolic function and ambulatory blood pressure in patients with borderline hypertension

Objective To estimate the effect of borderline hypertension on the left ventricular hypertrophy and left ventricular diastolic function.Methods Doppler echocardiography was performed and ambulant blood pressure (ABP) was monitored in 92 borderline hypertensive (BH) patients and 36 normotensive subjects, and the following parameters were detected: left ventricular end-diastolic dimension (LVDd), interventricular septal thickness (IVST), posterior wall thickness (PWT), rapid filling phase and late diastolic filling phase peak flow velocity (E and A), the ratio of E/A, isovolumic relaxation time (IVRT), decelerating time (DT) of E peak and internal dimension of left atrium (LAD). Left ventricular mass (LVM) was calculated by Devereux equation: LVM(g)=0.8×1.04［(LVDd+IVST+PWT)(3) -LVDd(3) ］+0.6. Left ventricular mass index (LVMI, g/m(2) ) was calculated by dividing the value of LVM by body surface area. The upper limits of normal of LVMI were 125 g/m(2) for men and 120 g/m(2) for women. The ABP’s parameters were calculated according to the original readings: (1) average 24-hour blood pressure; (2) daytime and nighttime blood pressure; (3) blood pressure load values (the percentage of SBP >140 mm Hg and DBP >90 mm Hg during daytime or SBP >120 mm Hg and DBP >80 mm Hg during night-time); and (4) the ratio of nighttime and daytime blood pressure.Results The left ventricular hypertrophy was found in 17 of 92 BH patients (18.5%). In the study group, 76 cases presented a 'dipper pattern' ABP curve, and only 12 of them (15.8%) had LVH, however, 5 (31%) of the other 16 cases with 'no-dipper pattern' had LVH.The LVMI in BH group was significantly higher than in normotensives (107.2±13.5 g vs 92.5±11.6 g, P<0.01), and it was closely correlated with daytime SBP and load value of daytime’s SBP (r=0.30 and 0.28,respectively,P<0.01), it also correlated to the 24-hour SBP and night/day SBP ratio (r=0.25 and 0.22, respctively, P<0.05). The left ventricular diastolic function was obviously damaged in BH group, compared with those in the normotensive group, all items which reflect the LVDF except IVRT were significantly higher in BH group (P<0.05-P<0.01), which reveals that BH patients have developed insufficient LVDF.Conclusions The study suggests that left ventricular structure and function are impaired in BH patients. SBP level and the day-night rhythm disorder are responsible for the left ventricular involvement. Since BH patients can develop LVH and insufficiency of LVDF which has increased the risk of cardiovascular diseases, it is necessary for us to strengthen the medical care of the BH population to stratify the risk factors and give them adequate directions and reasonable treatments.     

老年单纯收缩期高血压患者左心收缩功能的评价

目的研究探讨老年单纯收缩期高血压(EISH)血流动力学改变。方法应用彩色超声多普勒检测30例EISH患者及28例老年健康对照组左心收缩功能及相关血流动力学参数。结果EISH组左心收缩功能指标SV、CO、EF、CI明显高于对照组,直线相关分析显示EISH组脉压差水平与上述各参数呈显著正相关,r值分别为0.43,0.56,0.46,0.45,同时研究组心率水平明显高于对照组(P<0.05)。结论EISH存在显著的血流动力学异常,主要表现在左室收缩功能亢进,长期处于高心排血量及高负荷状态。     

肺隐球菌病免疫缺陷相关性临床研究

[目的]研究肺隐球菌病免疫缺陷相关性及临床特征,以提高对该病的认识.[方法]将60例患者随机分为外科治疗组35例,内科治疗组25例;分别给予外科及内科治疗,对两组患者的预后进行评价并统计学分析.同时还对免疫缺陷及非免疫缺陷患者预后进行评价并统计学分析.[结果160例肺隐球菌病患者中：内科治疗组有效率为76.0％、治愈率为32.0％、死亡率为16.0％;外科治疗组有效率97.1％、治愈率60.0％、死亡率0％与内科治疗组差异有显著性（P＜0.05）.非免疫缺陷与免疫缺陷组比较：非免疫缺陷组有效率为97.1％、治愈率为75.0％,死亡率为0％,免疫缺陷组有效率75.0％、治愈率17.9％、死亡率14.3％与非免疫缺陷组比较差异有显著性（P＜0.05）.[结论]本研究显示肺隐球菌病治疗外科手术治疗效果优于内科治疗,非免疫缺陷人群预后优于免疫缺陷人群.     

应用脉冲多普勒血流对晚孕妇女正常胎儿与宫内发育迟缓胎(IUGR)脐动脉血流指数(S/D)波形的比较

目的:比较妊娠晚期正常胎儿与宫内发育迟缓(IUGR)胎儿脐动脉多普勒血流波形的差异.方法:采用彩色多普勒超声诊断仪对35例超声诊断IUGR胎儿以及60例正常胎儿测定脐动脉(UmA)的多普勒血流波形,随访至分娩.35例IUGR中有19例出生体重符合低体重儿,60例正常胎儿均健康.对19例IUGR及60例正常胎儿的多普勒脐动脉血流指数进行比较.结果:IUGR组多普勒脐动脉血流指数S/D3.94/2.06大于正常对照组S/D2.68/1.73(P＜0.05),两组脉冲多普勒脐血流指数有统计学意义.结论:脐动脉(UmA)的多普勒血流监测是早期发现IUGR胎儿多普勒血流波形改变的安全、简便、快速的较好方法.     

立体定向术治疗精神障碍11例

目的 探讨立体定向术治疗精神障碍的疗效.方法 回顾性分析经立体定向术治疗的11例精神障碍病人的临床资料,其中难治性强迫症7例,抽动秽语综合征3例,双相情感障碍1例.分析手术前后耶鲁-布朗强迫量表(Y-BOCS)、汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)分值、脑白质纤维束变化及脑葡糖代谢情况.结果 术后6个月病人的各量表分值较术前均明显下降(均P<0.05),无严重并发症.大脑MR/弥散张量成像显示内囊前肢的横行纤维被毁损,大脑18F-FDG PET显示眶额皮质、运动区、运动前区、基底核、丘脑和边缘系统的高代谢区在术后明显降低.结论 立体定向术是治疗难治性精神障碍的有效方法.     

经鼻蝶窦入路显微手术治疗垂体腺瘤疗效分析

目的:评价经鼻蝶窦显微手术治疗垂体腺瘤的疗效及并发症.方法:回顾性分析2005年7月至2012年7月间,在我科接受经鼻蝶窦显微手术治疗的144例垂体腺瘤患者的临床资料.术后复查鞍区增强MRI和血液内分泌激素,并门诊随访.结果:肿瘤全切共119例,次全切18例,部分切除7例,全切率82.6％.截至最后一次随访,临床症状消失76例,明显改善51例,改善不明显17例,临床症状缓解率88.2％.91例功能性垂体腺瘤,激素水平测定恢复正常率45.1％,明显改善率为86.1％.术后脑脊液鼻漏发生率为3.5％,垂体及靶腺激素功能低下发生率9.0％,一过性尿崩及电解质紊乱发生率为22.9％,颅内感染2例,无死亡病例.结论:经鼻蝶窦显微手术能有效地治疗垂体腺瘤,手术创伤及术后并发症少,是垂体腺瘤手术治疗的有效选择.