颅脑肿瘤手术行急性等容血液稀释的临床研究

目的：研究急性等容血液稀释对颅脑肿瘤病人血流动力学、氧转运及凝血纤溶方面的影响,探讨该方法的安全性。方法：选择颅脑肿瘤手术病人12例,麻醉后从右颈内静脉放置Swan～Ganz导管,从桡动脉放血8ml/kg,同时等速从静脉输入等量的海脉素。分别测定血液稀释前后的血流动力学,氧转运及凝血纤溶方面的指标。结果：CO、SV、DO2显著增加(P＜0.05);PT延长(P＜0.05);PLT较血液稀释前减少,其余指标无明显改变。结论：急性等容血液稀释对颅脑肿瘤病人的血流动力学及凝血纤溶功能影响小,而氧供增加,是一安全有效的血液保护方法。     

彩色多普勒速度能量图对肝癌肝动脉栓塞术前后肝血流改变的探讨

目的 :研究原发或转移性肝癌肝动脉栓塞术治疗前后肝脏血流动力学改变。方法 :采用彩色多普勒速度能量图分别测量肝癌肝动脉栓塞治疗前后肝动脉、门静脉血管内径及血流速度。结果 :门静脉内径及平均血流速度无明显改变 ,肝动脉内径无明显变化 ,但收缩期峰值明显降低 (P <0 0 5)。结论 :肝癌肝动脉栓塞术治疗后门静脉血流无明显变化 ,对肝脏本身供血无影响。肝动脉收缩期峰值流速明显降低 ,主要依靠肝动脉供血的肿瘤血供明显下降     

扑热息痛所致狗急性肝功能衰竭时血浆5-羟色胺变化及肝脏血流动力学改变的实验研究

目的;通过扑热息痛所致急性肝功能衰竭的动物模型,以期探讨门静脉,肝静脉,腹主动脉,下腔静脉血浆５－羟色胺浓度变化和肝脏血流动力学改变。方法：成年杂种狗１２只,在戊巴比妥钠静脉麻醉下,作上腹正中切口,从门静脉,肝静脉,腹主动脉,下腔静脉各采血２ｍｌ,作血浆５－羟色胺含量检测,作楔形肝组织活检,关腹。     

异氟醚分娩镇痛对母体血液动力学的影响

目的：前瞻性研究异氰醚分娩镇痛对母体血液动力学的影响。方法：应用国产无创性血液动力学测试仪,对分娩活跃期异氟醚分娩镇痛和对照组产妇共３０例的血液动力学状况进行检测。结果：;实验前后,各组母体血液动力学参数;心率（ＨＲ）,每搏量（ＳＶ）,每搏指数（ＳＩ）,心输出量（ＣＯ）,心脏指数（ＣＩ）,左室有效泵力（ＶＰＥ）,平均动脉压（ＭＡＰ）和总外周阻力（ＴＰＲ）均无显著差异;两组间无显著差异。     

Effects of DPI 201-106, a novel cardiotonic agent,on hemodynamics,cardiac electrophysiology and arrhythmias induced by programmed ventricular stimulation in dogs with subacute myocardial infarction: A comparative study with dobutamine

Summary DPI 201-106 (DPI), a novel and potent cardiotonic agent, exhibits its effects by prolonging the open state of Na⁺ channels, resulting in an increase in action potential duration, and thus, is supposed to share the class III antiarrhythmic activity. The effects of DPI on the hemodynamics, intraventricular conduction and refractoriness of heart, and the incidence of arrhythmias induced by programmed electrical ventricular stimulation (PES) were compared with (±)-dobutamine. Dogs which survived for 5 to 7 days after the induction of myocardial infarction were used as the model. The presence of sub-acute myocardial infarction caused by occluding the left anterior descending coronary artery elicited a mild left ventricular dysfunction represented by a significant decrease in peak LV dp/dt by about 20%.Both i.v. bolus injection of DPI (1, 3 and 5 mg/kg) and i. v. continuous infusion of dobutamine (3, 5 and 10 g/kg/min), which were administered in a cumulative manner, dose-dependently improved the hemodynamic parameters. At the higher doses of both DPI (3 and 5 mg/kg) and dobutamine (5 and 10 g/kg/min) the control values were reached or even exceeded. DPI dose-dependently increased the effective refractory period (ERP) of both non-infarcted and infarcted ventricular myocardia to a similar degree, but the conduction time showed a frequency-dependent increase in the infarcted myocardium to a greater degree than in the non-infarcted myocardium after DPI. In contrast, dobutamine decreased the ERP in both non-infarcted and infarcted myocardia, and slightly increased the difference of refractoriness between the non-infarcted and infarcted zones with no effect on the intraventricular conduction. In the PES study, DPI (3 and 5 mg/kg) produced a significant decrease in the incidence of ventricular tachycardia, whereas dobutamine (5 and 10 g/kg/min) tended to worsen the arrhythmias. These findings suggest that cardiotonic agents with a class III antiarrhythmic property such as DPI may be potentially useful for the management of heart failure accompanied by ischemic heart disease.Abbreviations DPI, DPI 201-106; PES programmed electrical ventricular stimulation - LV dp/dt the rate of rise of left ventricular pressure - ERP effective refractory period - RVOT right ventricular outflow tract - VT ventricular tachycardia - LAD left anterior discending coronary artery Send offprint requests to T. Uematsu at the above address     

Recombinant human-type SOD attenuates circulatory disorders after reperfusion of splanchnic organs in rats

Oxygen free radicals (OFRs) have been reported to play pivotal roles in the pathogenesis of cell damage induced by ischemia and reperfusion. The efficacy of recombinant human superoxide dismutase (rh-SOD) in the treatment of circulatory disorders after reperfusion of the splanchnic area was investigated in rats. All rats died within 3 hours after release of 60-min superior mesenteric artery occlusion (SMAO) when no treatment was given. Animals which received rh-SOD, 2mg·100g^–1BW, at reperfusion followed by a continuous infusion of rh-SOD 0.67mg·100g^–1BW·hr^–1, exhibited prolonged survival times compared with no treatment rats (231 ± 35min and 149 ± 43min, respectively). Mean blood pressure in rats treated with rh-SOD was higher than in controls after reperfusion, and was concomitant with improvement in splanchnic perfusion. The results suggest excessive activity of OFRs in reperfused organs and a possible scavenging effect of rh-SOD as a means of eliminating them.(Bitoh H: Recombinant human-type SOD attenuates circulatory disorders after reperfusion of splanchnic organs in rats. J Anesth 6: 247–254, 1992)     

罗氏促排卵汤加减对肾虚型无排卵性不孕症卵巢动脉血流动力学的影响

目的 观察“罗氏促排卵汤加减”对肾虚型无排卵性不孕症卵巢动脉血流动力学的影响，从“妇人以血为本”的角度探讨肾虚型无排卵性不孕症的发病机理和“罗氏促排卵汤加减”的作用机制。方法 用经阴道彩色多普勒超声测量30例正常妇女、30例肾虚偏肾阳虚型无排卵性不孕症患者治疗前后月经周期四时期最大卵泡平均直径(MFD)，卵巢动脉血流阻力指数(RI)和搏动指数(PI)。结果 健康组月经周期卵巢RI、PI有显著周期性变化。治疗组肾虚症状消失或缓解，卵泡增大，MFD与治疗前相比有显著差异，与健康组相比仍较低，仍有显著差异；RI值下降，与治疗前相比有非常显著差异，与健康组相比无显著差异，且有显著周期性改变；PI值下降，与治疗前相比有非常显著性差异，但与健康组相比仍有非常显著性差异，且无自身周期性变化。结论 “罗氏促排卵汤加减”作用机制是调整下丘脑-垂体-性腺轴，整体调节机体功能；对观察对象的影响是卵巢血管阻力降低，血供增加，血循环改善。     

卡维地洛对慢性心力衰竭患者神经内分泌和血流动力学的影响

目的　比较卡维地洛 (Carvedilol)与美托洛尔 (Metoprolol)对慢性心力衰竭 (CHF)患者神经内分泌激素和血流动力学的影响。方法　 80例 CHF患者 ,随机分为卡维地洛组和美托洛尔组。观察治疗前后脑钠素 (BNP)、去甲肾上腺素 (NE)和左室射血分数 (LVEF)、平均肺动脉压(MPAP)、肺楔压 (PCWP)的变化。结果　卡维地洛组较美托洛尔组显著降低 BNP、NE、MPAP和 PCWP(P<0 .0 5) ,较美托洛尔组明显提高 L VEF(P<0 .0 5)。结论　卡维地洛抗交感活性作用强于美托洛尔 ,能显著降低 BNP、NE水平 ,血流动力学改善优于美托洛尔     

Ⅱ型糖尿病和高血压患者血液动力学改变的相关因素分析

目的：探讨糖病和高血压血管并发症的发生机理。方法：分别测定高血压（ＨＴ）组、Ⅱ型糖尿病（ＮＩＤ－ＤＭ）组及Ⅱ型糖尿病合并高血压组和对照组的胰岛素水平、血脂、心脏彩超和血液流变学指标。结果：３个试验组的周围总阻（ＴＰＲ）、甘油三酯（ＴＧ）和胰岛素面积（ＩｎｓＳ）均明显增高,其中ＨＴ组和ＮＩＤＤＭ合并ＨＴ组的左室收缩期峰值室壁应力（ＰＳＳ）也明显增高：ＮＩＤＤＭ合并ＨＴ组ＩｎｓＳ明显高于其他三组,三试     

舌诊与血液流变学的研究

对２６６例慢性病患者以血液的红细胞压积、全血粘度等７项检测为指标，按舌诊中舌体、舌质、舌苔分类，比较舌象与血液流变学的关系。结果，胖大舌红细胞压积明显升高而全血粘度无明显改变，瘦小舌红细胞压积明显降低而全血还原粘度、全血粘度明显升高。发现暗淡舌、暗红舌、暗紫舌红细胞压积值及全血粘度均有不同程度的升高；随舌质由淡、红、紫色的加深，全血粘度质呈递增趋势。血液流变学的指标测定对阐明舌体、舌质的形成原理具有一定价值；舌象可以反映人体血液流变学的一些变化，为中医舌诊辨证的科学性提供了有力证据