老年退行性心脏瓣膜病与鼾症相关研究

目的　探讨鼾症对老年退行性心脏瓣膜病 (DCVD)的影响和对心脏瓣膜结构和功能损害的特征。方法　对 4 5 2例老年鼾症患者与 4 5 2例非鼾症老人进行队列研究 ,采用彩色多普勒超声心动图检查心脏瓣膜的结构与功能。结果　老年鼾症组DCVD的发病率及严重程度与非鼾症组DCVD的发病率及严重程度相比 ,差别有非常显著性意义(P <0 0 1)。结论　鼾症可能是导致DCVD的原因之一 ,是加重心脏瓣膜结构损害与功能障碍的因素     

负压对缺血肢体血流动力学影响的实验研究

目的：观察负压对肢体动脉闭塞犬患肢血流动力学的影响。方法：犬15只，随机分治疗组10只和对照组5只。两组均采用切断犬后肢股动脉分支、动脉腔内置入螺旋状金属丝的方法，制作肢体缺血模型。在模型制作后2wk，治疗组行患肢负压治疗10d，对照组不做负压治疗。两组均于模型前、模型后2wk及治疗结束后，用彩色多普勒观察患肢股动脉血流动力学指标：收缩期最大流速(Vmax)、平均流速(Vmean)、阻力指数(R1)、搏动指数(P1)的变化。结果：治疗组在治疗后患肢股动脉Vmax、Vmean显著增加(P＜0．001)，RI、PI显著降低(P＜0.01)；对照组各指标无明显变化(P＞0．05)。结论：负压对缺血肢体血流动力学表现为流速增加，阻力下降。     

彩色多普勒超声在精索扭转诊断和鉴别诊断中的价值

目的 :应用彩色多普勒超声鉴别精索扭转和急性睾丸炎。　方法 :回顾性分析 13例急性睾丸疼痛病人的彩色多普勒血流显像 (CDFI)表现和治疗情况。　结果 :8例显示睾丸内血流信号稀疏或消失 ,诊断为精索扭转 ,其中 1例手法复位成功 ,7例手术探查并得以证实。其余 5例显示患侧睾丸血流信号丰富 ,诊断为急性睾丸炎或睾丸附睾炎 ,经抗生素治疗后症状好转 ,超声复查显示血流减少。　结论 :CDFI在精索扭转诊断和鉴别诊断中具有重要意义 ,可作为急性睾丸疼痛病人的首选检查方法     

Intensity-dependent regional cerebral blood flow during 1-Hz repetitive transcranial magnetic stimulation (rTMS) in healthy volunteers studied with H215O positron emission tomography: I. Effects of primary motor cortex rTMS.

BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) affects the excitability of the motor cortex and is thought to influence activity in other brain areas as well. We combined the administration of varying intensities of 1-Hz rTMS of the motor cortex with simultaneous positron emission tomography (PET) to delineate local and distant effects on brain activity. METHODS: Ten healthy subjects received 1-Hz rTMS to the optimal position over motor cortex (M1) for producing a twitch in the right hand at 80, 90, 100, 110, and 120% of the twitch threshold, while regional cerebral blood flow (rCBF) was measured using H(2)(15)O and PET. Repetitive transcranial magnetic stimulation (rTMS) was delivered in 75-pulse trains at each intensity every 10 min through a figure-eight coil. The regional relationship of stimulation intensity to normalized rCBF was assessed statistically. RESULTS: Intensity-dependent rCBF increases were produced under the M1 stimulation site in ipsilateral primary auditory cortex, contralateral cerebellum, and bilateral putamen, insula, and red nucleus. Intensity-dependent reductions in rCBF occurred in contralateral frontal and parietal cortices and bilateral anterior cingulate gyrus and occipital cortex. CONCLUSIONS: This study demonstrates that 1-Hz rTMS delivered to the primary motor cortex (M1) produces intensity-dependent increases in brain activity locally and has associated effects in distant sites with known connections to M1.     

正常人肺静脉管径及其血流频谱的研究

肺静脉血流和肺静脉管径的变化与左房压力及左心室舒张功能密切相关 [1 ,4 ] 。超声心动图可以直接、动态观察肺静脉内径及血流频谱变化 ,但是目前超声尚无健康人肺静脉内径正常值。我们应用彩色超声多普勒技术对正常人及孕周 2 4周以上的妊娠妇女进行肺静脉内径及血流频谱研究 ,以探索正常人肺静脉的显示率、内径正常值、血流频谱特点。观察高动力状态及呼吸对肺静脉管径和血流频谱的影响。1　材料与方法1.1　研究对象　 16 9例排除心肺疾患的健康人分组进行研究。其中成年男性组 4 4例、成年女性组 4 6例、儿童组 14例、中期妊娠组 (中妊 …     

Transcranial doppler ultrasonography for the evaluation of shunt malfunction in pediatric patients

Previous studies have demonstrated a high correlation between hydrocephalus and the resistive index (RI), as determined by transcranial Doppler ultrasonography. Measurements of RI, calculated by dividing the difference between the peak systolic velocity and the enddiastolic velocity by the peak systolic velocity, were attempted in 55 pediatric patients during evaluations for ventriculoperitoneal shunt malfunctions; values were obtained in 52. Indications of shunt malfunction included both clinical and radiographic evidence of increased intracranial pressure. Eleven patients, determined to have functional shunts both by clincal criteria and subsequent outcome, had RIs of 47±5 (average±1 standard deviation). Shunt malfunctions were confirmed in 41 patients. Prior to shunt revisions, these 41 patients has RIs of 71±10%; following revision, the RIs fell to 53±12%. Nine patients had had pre-malfunction RIs of 48±11% obtained during routine follow-ups; when they subsequently had shunt malfunctions, their RIs had significantly increased. Four of the 41 patients with shunt malfunctions had essentially normal RIs (52±7%), but had fluid tracking along the shunt; in these, RIs were essentially unaffected by shunt revision. For comparison, 119 pediatric patients with clinically functional ventriculoperitoneal shunts had RIs of 50±9%. The data, statistically significant with a P value of <0.001, showed a correlation between elevated RIs and shunt malfunction; thus, transcranial Doppler ultrasonography is a practical, non-invasive technique useful in the diagnosis of ventriculoperitoneal shunt malfunction.Presented at the Annual Meeting of the Pediatric Section of the American Association of Neurological Surgeons, Washington D.C., November 1989     

大脑中动脉狭窄的TCD与DSA检查比较研究

目的 :通过大脑中动脉狭窄的TCD检查与DSA检查方法比较 ,为临床提供方便可靠的检查方法。方法 :对经TCD检查确诊为大脑中动脉狭窄 6 0例做DSA检查 ,对两种检查结果进行比较分析。结果 :经TCD确诊为大脑中动脉狭窄病例 ,病变侧狭窄处的血流速度(Vm)均明显高于健侧一倍以上 ,在动脉硬化性狭窄中多伴有“海鸥鸣”或“铁锅炒沙”样杂音 ,且频谱形态呈圆钝或脉动指数值增高的阻力波形。该 6 0例在DSA的检查中均出现不同部位的不同狭窄。结论 :TCD检查具有快速方便、安全、经济、确诊率高的优点 ,可作为脑血管病首选检查手段     

Effect of prostaglandin E1 on graft function of kidneys from living related donors

Prostaglandin E₁ (PGE₁) was used in renal transplant recipients with living related donors. The drug was given intravenously from day 1 to day 7 after transplantation at a dose of 40 µg/kg twice a day. A total of 45 patients were studied divided into two groups: 25 patients were treated with PGE₁ (group B) and the remaining 20 patients did not receive the drug (group A). In group B, 24-h creatinine clearance (Ccr) was 66 ± 12.8 ml/min compared with 40.3 ± 13.4 ml/min in group A on the fifth postoperative day (P < 0.05). Urinary levels of N-acetyl-β-d -glucosaminidase (NAG) and serum levels of platelet factor 4 (PF4) in group B were significantly lower than in group A. On the fourth postoperative day, the urinary excretion of thromboxan B₂ (TxB₂) in group A was higher than in group B, but not significantly (5.1 ± 3.0 ng/day and 2.8 ± 1.1 ng/day, respectively). Acute rejection occurred in four patients in group B and in 10 patients (40%) in group A. The percentage of Leu2a-positive lymphocytes in group B was higher than in group A. We conclude that postoperative administration of PGE₁ improves graft function in kidneys from living related donors.     

彩色多普勒超声诊断先天性心脏病

彩色多普勒超声和二维超声心动图并用,不仅可观察和了解心脏解剖、形态及腔室大小,又能观察血流动力学改变。我们从1991年11月至1992年11月间应用上述方法诊断先天性心脏病共18例,均经我院和外院手术证实:室间隔缺损7例;房间隔缺损6例;动脉导管未闭5例,其中1例误诊为肺动脉瓣狭窄,诊断准确率达94.4％。我们认为彩色多普勒诊断先天性心脏病方法安全,准确无损伤,为临床及术前提供了较可靠的诊断依据,但检查者必须了解心脏及大血管的解剖关系,结合临床才能提高诊断准确率,减少漏、误诊的发生。     

右美沙芬对兔急性脑外伤后脑血流速度的影响

目的 :应用经颅多普勒超声 (TCD)技术研究右美沙芬治疗兔颅脑急性损伤后脑血流速度的变化及其意义。方法 :健康雄性白家兔 2 0只 ,随机分为 2组。A组 (n =1 0 )为脑外伤组 ,B组 (n =1 0 )为脑外伤后右美沙芬治疗组。应用TCD分别测定外伤前、伤后 5min、6h、72h、1 6 8h兔大脑中动脉 (MCA)脑血流速度。观察指标为收缩期血流速度 (vS) ,舒张期血流速度 (vD)和脉动指数 (PI)。结果 :A组伤前、后 5min、1 6 8hvS 与B组比较 ,差异无统计学意义 ;A组伤后 6h、72hvS((39.4 5± 7.5 )cm/s,(4 1 .2 0± 5 .94 )cm/s)与B组 ((5 1 .6 8± 1 0 .32 )cm/s,(5 2 .4 1± 8.5 6 )cm/s)比较差异有统计学意义 (P <0 .0 5 ) ;A组伤前、后 5min、1 6 8hvD 与B组比较 ,差异无统计学意义 ;A组伤后 6h、72hvD((2 6 .33± 3.4 6 )cm/s,(2 5 .84± 5 .6 9)cm/s)与B组 ((33.6 4± 4 .2 7)cm/s ,(34.86± 7.4 8)cm/s)比较差异有统计学意义 (P <0 .0 5 ) ;A组伤前、后 5minPI值与B组比较差异无统计学意义 ,A组伤后 6h、72h、1 6 8hPI(2 .0 6±0 .5 8,2 .2 5± 0 .36 ,1 .5 3± 0 .39)与B组 (1 .2 6± 0 .2 9,1 .38± 0 .2 9,0 .96± 0 .1 7)比较差异有统计学意义 (P <0 .0 5 )。结论 :提示右美沙芬可通过改善脑血流速度、降低脉动指