Therapeutic Consequences of Variation in Intraarterial Pressure Measurements After Iliac Angioplasty

Purpose: To assess the accuracy of intraarterial measurement of transstenotic pressure gradients for the detection of hemodynamically suboptimal iliac angioplasty. Methods: In 14 patients, referred for diagnostic angiography, mean pressure gradients in the aorta and iliac artery were obtained twice, using a double-sensor pressure catheter. Additional iliac measurements were performed during pharmacologically induced flow augmentation. Repeatability was assessed by calculation of the mean difference plus standard deviation (MD ± SD) and repeatability coefficient (2 × SD). These results were extrapolated to 137 iliac angioplasty procedures with secondary stenting where there was a residual pressure gradient > 10 mmHg. Results: MD ± SD for repeated measurements at rest and during flow augmentation were 0 ± 2 mmHg and 1 ± 3 mmHg, respectively. Repeatability coefficients were 3 and 6 mmHg. Mean pressure gradients after hemodynamically insufficient angioplasty were 8 ± 7 mmHg at rest and 17 ± 5 mmHg following vasodilatation. Inaccurate pressure recordings may have led to inappropriate stent placement in less than 2.5%, and inappropriate denial of stent placement in less than 5% of the lesions. Conclusion: Variability of intraarterial pressure measurements has little consequence in the detection of hemodynamically significant stenosis after angioplasty. Received: 0/00/00/Accepted: 0/00/00     

Evaluation of the influence of the aqueous phase bioconstituent environment on the F-19 T1 of perfluorocarbon blood substitute emulsions

Oxygen-sensitive F-19 magnetic resonance imaging of perfluorocarbon compounds requires that fluorocarbon T1 changes correlate with the local Po₂ and not with the composition of the surrounding aqueous phase. The influence of various bioconstituents and paramagnetic ions within the aqueous phase on the F-19 fluorocarbon phase T1 for PFC emulsions was evaluated at 0.14 and 0.66 T. T1 was measured for FC-43, perflubron, and a fluorinated surfactant. Controlled variables introduced in the aqueous phase included annex solution constituents, blood, pH changes, and Gd-DTPA. For a constant Po₂, the F-19 T1s were independent of the emulsion constituents, blood concentration, and pH. For FC-43 and perflubron, F-19 T1 was independent of the Gd-DTPA concentration, while the aqueous phase T1 decreased by more than an order of magnitude. XMO-10 (smallest emulsion particle size) showed a slight decrease in F-19 T1 with increasing Gd-DTPA concentration at 0.66 T.     

Effect of norethisterone acetate on serum lipid and lipoprotein parameters as well as on blood coagulation in female monkeys (M. fascicularis)

The effects of daily oral administration of a high dose of 10 mg norethisterone acetate (NET-Ac.)/kg/day over 14 weeks on serum lipid and lipoprotein parameters as well as on blood coagulation were investigated in female monkeys (M. fascicularis). Measurements of lipids and lipoprotein cholesterol were performed in weeks —5 and — 1 before treatment and in weeks 4, 8 and 12 after treatment. In addition, various blood coagulation and fibrinolytic parameters were determined in weeks 11–14 after treatment with NET-Ac. Furthermore, the serum levels of norethisterone (NET) were determined in order to monitor the real systemic compound exposure and revealed that C_max and AUC (0–3 h) values reached for norethisterone in this experiment in monkeys were about 25 times higher than those obtained after an oral contraceptive dose of NET-Ac. in women.

The results of lipid and lipoprotein cholesterol determinations showed decreases in serum total lipids, phospholipids, triglycerides and total cholesterol associated with similar decreases in HDL-, LDL- and VLDL-cholesterol fractions after NET-Ac.-treatment in monkeys. These effects were observed from week 4 onwards and maintained their magnitude up to week 12 after treatment. Since both HDL- and LDL-cholesterol fractions decreased, the HDL/LDL-ratio remained almost unchanged. Thus, the results obtained in this study after high-dose treatment with NET-Ac. in monkeys did not indicate any changes of lipid and lipoprotein parameters which in humans are supposed to be associated with an increased risk of cardiovascular lesions, namely a decrease in HDL- and increase in LDL-cholesterol fractions.

The results of blood coagulation and fibrinolytic parameters showed increased antithrombin-III and plasminogen levels besides minor changes in other parameters, thus indicating that NET-Ac. -treatment does not contribute to an increased risk of cardiovascular thrombotic events in the cynomolgus monkey.     

初诊T2DM短期胰岛素强化治疗40例分析

目的观察初诊T2DM短期胰岛素强化治疗的疗效。方法对40例初诊T2DM患者采用三餐前皮下注射短效胰岛素和睡前注射中效胰岛素2wk，并检测治疗2wk前后FPG、PPG、GHbA1C及血脂等值进行比较。结果两组治疗后FPG、PPG、GHbA1C及血脂各值均显著低于治疗前p〈0．05（x^2=4．940—11．544）。结论胰岛13细胞功能异常和（或）胰岛素抵抗是T2DM发病的基本环节，早期强化胰岛素治疗能获得血糖的有效控制，减少或延缓并发症的发生。     

血糖水平对18F-FDG PET/CT图像质量的影响

目的 研究血糖水平对18F-脱氧葡萄糖(FDG) PET/CT图像质量的影响.方法 80例行体格检查或评价肿瘤性质的受检者,按空腹血糖水平分为9组(组间距为1mmol/L),第1组为血糖正常组,即血糖＜6.0mmol/L(10例);第2～9组血糖水平高于正常,分别为6.0～6.9mmol/L(11例),7.0～7.9mmol/L(13例),8.0～8.9mmol/L(11例),9.0～9.9mmol/L(11例),10.0～10.9mmol/L(8例),11.0～11.9mmol/L(6例),12.0～12.9mmol/L(5例),≥13.0mmol/L(5例).受检者做完PET/CT检查后,图像质量由2位有经验的医师独立判断.同时根据肝不同层面的标准摄取值(SUV)最大值(SUVmax)及SUV平均值(SUVavg)分别计算肝图像噪声.采用SPSS 12.0软件进行统计学处理.结果 (1)9组之间图像质量评分、肝噪声差异有统计学意义(P均＜0.05).将第2～9组图像质量评分、肝噪声分别与第1组进行比较,第2～7组与第1组差异无统计学意义(P均＞0.05);第8,9组与第1组比较差异有统计学意义(P均＜0.05),且评分低于第1组.(2)血糖水平与图像质量评分呈负相关(r=-0.52,P＜0.05);血糖水平与肝噪声呈正相关(SUVmax、SUVavgr值分别为0.33和0.60,P均＜0.05);SUVavg所算噪声与血糖水平的相关性优于SUVmax.结论 图像质量随血糖水平的升高而下降,血糖＜12.0mmol/L时与血糖正常者PET/CT图像质量差异无统计学意义,但当血糖水平≥12.0mmol/L时图像质量将显著下降.     

空腹血糖——急性心肌梗死患者早期死亡的独立预测因子

目的研究急性心肌梗死(AMI)患者空腹血糖的预后价值。方法本研究入选257例无糖尿病病史AMI患者。测量患者入院时血糖(AG)和禁食至少8h后的血糖(FG)。随访患者30d,分析AG和FG与患者预后之间的关系。结果共24(9.3%)例无糖尿病病史患者在AMI后30d内死亡。FG正常组死亡2例(1.5%),FG升高者的第一、第二、第三个三分位数组分别死亡4例(9.8%)、5例(12.2%)、13例(31%)。和FG正常组患者相比,校正后的30d死亡的相对危险比(OR)随FG三分位数的增加而增加,第一、第二和第三个三分位数组分别为:2.5(95%CI,0.71～8.5;P=0.011),8.6(95%CI,3.2～23.5;P=0.0005),12.7(95%CI,4.5～36.4;P<0.0003)。同FG和AG都正常的患者相比,AG升高FG正常预测患者30d死亡的OR为0.69(95%CI,0.25～3.80;P=0.59);AG正常FG升高者为3.6(95%CI,2.1～11.5;P=0.04);FG和AG都升高者为10.6(95%CI,4.3～25.6;P<0.0001)。镶嵌模型的比较显示AG并不能增加FG模型预测30d死亡(2=5.2,3df,P=0.20)或预测30d死亡和心力衰竭(2=4.8,3df,P=0.31)的价值。相反,FG却能增加AG模型预测30d死亡(2=24.5,3df,P=0.0001)或预测30d死亡和心力衰竭(2=24.7,3df,P=0.0001)的价值。结论无糖尿病病史AMI患者30d死亡率随AG和FG浓度的增加而增加,FG比AG的预测价值更大。     

应用电子计算机计算血液流变学的正常值及分析

为评价血流粘滞诸因素生理与病理的异常,对济南地区338例正常人血液流变学的各项指标进行了检测,统计了血液流变学各项指标的总平均及男女的平均值和正常范围,并计算了血液流变学各项指标间的相关系数。     

内脏器官激光多谱勒血流灌注图象的显示

目的显示内脏器官血流灌注和分布的图象,探讨激光多谱勒血流成像技术在内脏微循环检测中的价值。方法应用激光多谱勒血流灌注成像仪(LDPI),对大鼠和家兔腹部脏器(肝、脾、肾、膀胱、胃、大小肠和肠系膜等)的血流灌注进行扫描和血流图显示。结果在体内脏器官显像清晰,肝、肾、脾、膀胱等微循环血流的整体分布较均匀;而胃、肠系膜、回盲肠等激光多谱勒血流图上大血流线状显示极其显著;大鼠与家兔两种动物之间相同脏器血流图上的差异并不明显。结论LDPI能将内脏器官的微循环状态以图象的形式显示,该新技术方法在检测内脏血流方面将有一定的应用价值。     

2型糖尿病患者血清抵抗素浓度与血脂代谢水平的临床意义

目的了解2型糖尿病患者血清抵抗素浓度与空腹血糖、血脂的关系。方法选择52例2型糖尿病患者和40例健康中老年人,分别分为糖尿病组和非糖尿病组,用竞争性酶联免疫吸附法测定各组空腹血浆抵抗素水平,同时检测空腹血糖、血脂各项指标。结果糖尿病空腹血浆抵抗素水平显著高于对照组(p<0.05)。抵抗素与甘油三脂、空腹血糖呈正相关关系(r=0.687,p<0.05,r=0.849,p<0.05),而抵抗素与其余各项血脂指标、性别之间无明显相关性。结论血清抵抗素水平与2型糖尿病关系密切,抵抗素水平可能影响体内能量代谢和平衡,与糖、脂代谢的关系更为密切。