青年维持性血液透析患者心血管疾病调查及危险因素分析

目的调查青年维持性血液透析（MHD）患者心血管疾病的发病情况和病变特点，并探讨其危险因素。方法采用横断面研究。MHD患者98例，以45岁为界分为青年组（47例）和中老年组（51例）。收集患者临床资料和生化指标。心脏超声检查测量心脏腔径及心功能参数。分析青年组患者心脏结构和功能异常的患病率、病变特点及其影响因素。结果（1）47例青年患者中有30例（63．8％）存在心脏结构异常，主要表现为左心室肥厚、左心房增大和瓣膜反流，患病率分别为61．7％、38．3％和34．0％。（2）青年组患者向心性肥厚的患病率为86．2％，离心性肥厚的患病率为13．8％，与中老年组相比，差异有统计学意义（P〈0．05）。（3）与无心脏病变青年MHD患者相比，伴心脏病变者的超滤量、收缩压、血磷和甲状旁腺激素明显增高，而Kt／V、血红蛋白和血清白蛋白明显降低，差异有统计学意义（P〈0．05）。Logistic回归分析结果显示，超滤量、收缩压、血红蛋白和血甲状旁腺激素是青年MHD患者并发心脏病变的独立危险因素。结论青年MHD患者心血管疾病的患病率较高，主要表现为左心室肥厚、左房增大和瓣膜反流。超滤量、收缩压、血红蛋白和血甲状旁腺激素水平可能是影响青年MHD患者并发心脏病变的独立危险因素。     

踝肱指数异常增高的糖尿病患者心血管病危险因素研究

目的 分析踝肱指数（ABI）增高的糖尿病患者的心血管病危险因素。方法采用多普勒血流探测仪测定解放军第306医院2003--2005年门诊及病房收治的493例2型糖尿病患者的ABI，以ABI〈0．90为低ABI组（n=39），0．90≤ABI≤1．40为正常组（n=353），ABI〉1．40为高ABI组（n=101）；同时对心血管病危险因素进行分析。结果高ABI与正常ABI组比较，腰围、腰臀比、C反应蛋白、尿酸显著增高，吸烟率及高血压合并症发生率显著增加。结论ABI〉1．40的糖尿病患者有更多的动脉硬化危险因素，需要将这些患者与ABI〈0．90的患者同样重视。     

糖尿病是一种心血管疾病和心身疾病的观点探讨

本文就糖尿病患者最早就诊的是心血管内科医师,以及负性情绪可明显影响糖尿病的发展进行了分析,并提出改善心境可明显增加自我控制糖尿病的能力。     

Cardiovascular autonomic dysfunction in normotensive awake subjects with obstructive sleep apnoea syndrome

Cardiovascular autonomic function in normotensive awake patients with obstructive sleep apnoea syndrome was studied in 21 normotensive (mean age 48 ± 14 years), drug-free men with obstructive sleep apnoea syndrome. Cardiovascular reflex tests with continuous blood pressure monitoring and biochemical indices were performed the morning after a standard polygraphic sleep recording. A group of 20 agematched (mean age 49 ± 19 years) normal subjects was used as controls. The obstructive sleep apnoea syndrome patients showed higher heart rate and noradrenaline plasma levels (p < 0.05) at rest and a higher blood pressure response to head-up tilt (p < 0.01), suggesting sympathetic overactivity. Respiratory arrhythmia, baroreflex sensitivity index and Valsalva ratio were significantly lower in the obstructive sleep apnoea syndrome group (p < 0.01) whereas the decrease in heart rate induced by the cold face test was significantly higher (p < 0.05) showing a blunting of reflexes dependent on baroreceptor or pulmonary afferents with normal or increased cardiac vagal efferent activity. These abnormalities in autonomic regulation may predispose obstructive sleep apnoea syndrome patients to cardiovascular complications like hypertension and cardiac arrhythmias.     

XIVth World Congress of Pharmacology San Francisco,CA, July 7–12, 2002 New Cardiovascular Drugs

The XIVth World Congress of Pharmacology took place July 7–12, 2002 in Moscone Convention Center, San Francisco, CA. Over 4,000 scientists, exhibitors and guests attended the Congress. It consisted of 40 symposia, 11 workshops, 18 plenary lectures and ca. 1,400 posters. The Congress was sponsored by the American Society for Pharmacology and Experimental Therapeutics, Inspire Pharmaceuticals and GlaxoSmithKline. The major financial donors were: Eli Lilly and Company, Servier, Johnson & Johnson, Merck, Novartis, Roche, Schering‐Plough, Wyeth and Yamanouchi Foundation. This report covers only presentations and posters on drugs that were attended or viewed by the author.     

肺静脉异常连接X线诊断 (附11例报告)

目的:提高X线对肺静脉异常连接的诊断准确性,为手术治疗提供可靠的依据。材料与方法:回顾性分析了11例肺静脉异常连接的X线胸片和病理生理改变,男3例,女8例,年龄8—34岁。从血液动力学变化分析了“8”字征,镰刀综合征等X线典型征象。结果:11例中完全性肺静脉异常连接4例,部分性7例。按部位分心上型6例;心内型4例;心下型1例。肺静脉异常连接或多或少合并房间隔缺损,法鲁氏三联症,以及右肺和肺动脉发育不全。结论:肺静脉异常连接的X线征象十分复杂而多变,因此,术前的仔细观察和精心判别对于手术治疗是非常重要的。     

日晒海盐工人机体内高镁反应

报道福建某盐场从事日晒海盐生产人工机体内高镁对心血管系统的影响，通过现场空气、饮水、主良的镁含量测定，并对进入机体途径进行分析，得出空气、卤水接触、饮水为机体镁增高的主要来源。不同对象头发镁含量测定结果显示，以接触卤水、劳动强度大的盐工最高，并随机体内镁含量增高，出现血压偏低、心率减慢、心电图Ｐ－Ｒ间期延长、ＱＲＳ波增宽、Ｔ波高尖等机体高镁反应，与临床高镁血症相似。     

Wnt-frizzled信号通路与心血管疾病关系的研究进展

Many researches have focused on the wnt- frizzled cascade in the recent years, while much work has been done in neoplastic diseases and embryology, the role of the wnt- frizzled signal transduction pathway in cardiovascular diseases has only recently begun to be explored. It plays a very important role in many physiological and pathophysiological processes, such as its transduction pathway, the healing after myocardial infarction, the proliferation, differentiation and orientation of cardiomyocytes, angiogenesis/neovascularization, cardiac hypertrophy and heart failure, the deposition of the extracellular matrix and so on. This article is aimed at its relation with myocardial infarction and the role of this pathway in cardiovascular diseases.     

美托洛尔预防老年围拔管期心血管反应的临床观察

目的探讨美托洛尔用于预防老年患者围拔管期心血管反应的方法。方法40例全身麻醉行择期手术的老年患者随机分为A组20例,B组20例,A组围拔管期分次静注美托洛尔0.06~0.1 m g/kg,B组以生理盐水分次静注。观察手术结束时、拔管前5分钟、拔管时、拔管后5、20分钟的心率(HR)、收缩压(SBP)、舒张压(DBP)及心率收缩压乘积(RPP)的变化。结果A组拔管时、拔管后5、20分钟的HR、RPP与手术结束时比较,差异无统计学意义,用药后最慢心率53次/m in,围拔管期血压维持平稳,RPP保持在较低值;B组拔管前5分钟、拔管时、拔管后5分钟的各参数与手术结束时比较明显升高(P<0.01);两组间比较,B组拔管前5分钟、拔管时、拔管后5分钟的HR、SBP、RPP明显高于A组(P<0.01)。结论老年患者小剂量分次静注美托洛尔可以安全地预防围拔管期心血管反应。     

雌激素及其受体对心血管系统保护作用实验研究进展

雌激素对心血管系统具有重要的保护作用。雌激素及其受体主要通过调节血管舒张功能、抑制血管平滑肌细胞增殖和迁移以及影响肾素 -血管紧张素等介导这一保护作用。但临床上雌激素替代治疗尚未得到肯定 ,需进一步研究