通阳散结方对球囊损伤大鼠血管内膜转化生长因子-β1的影响

目的探讨通阳散结法及其组方射心通胶囊对血管球囊损伤实验大鼠术后血管内膜增生的干预作用。方法将30只SD大鼠随机分为假手术组、球囊损伤模型组和中药复方干预组，每组10只。连续给药并饲养8周，各组于6周末行颈动脉内膜剥脱术，分离出颈外动脉，结扎其远端，在近端作一切口，逆行插入球囊导管，造成颈动脉内膜损伤；假手术组只分离出颈外动脉，结扎其远端，未行球囊损伤。术后继续喂养2周后处死各组实验大鼠，取颈动脉损伤血管段，标本经相应处理后观察其形态学变化及转化生长因子-β1（TGF-β1）免疫组化和逆转录-聚合酶链反应（RT—PCR）结果。结果①模型组动脉内膜增生较假手术组明显，而中药复方干预后内膜增生面积明显减少，差异均有统计学意义（P均〈0．01）；②模型组TGF-β1的蛋白及mRNA表达较假手术组明显增加，而中药复方干预组能明显减少模型动物TGF-1β的蛋白及mRNA表达，差异有统计学意义（P均〈0．01）。结论通阳散结法及其组方可通过抑制TGF-β1的表达，阻止新生内膜的形成，从而干预球囊损伤术后的血管重构。     

三维标测指导下心房颤动环肺静脉线性消融的效果评价

目的探讨三维标测系统指导下行心房颤动(房颤)环肺静脉线性消融的安全性和有效性。方法2003年4月至2006年3月对首都医科大学附属北京安贞医院收治的410例房颤患者进行三维标测系统(CARTO系统或EnSiteNavXTM系统)指导下的环肺静脉线性消融,消融的主要终点为肺静脉电学隔离。随访成功的定义为经3个月的洗脱期无症状性快速性房性心律失常发生。结果394例实现肺静脉电隔离(96%),平均随访(12.4±6.8)个月,阵发性房颤单次消融成功率为77.3%(221/286),持续性、永久性单次房颤消融成功率69.4%(86/124),后者成功率显著低于前者(P=0.006)。103例复发患者中41例接受再次消融,再次消融成功率为75.6%(31/41)。严重并发症包括心脏压塞4例(0.97%),心包穿刺引流后痊愈;脑卒中3例(0.73%),治疗后无肢体运动障碍,日常生活无影响;无死亡病例。结论三维标测指导下心房颤动环肺静脉线性消融是安全、有效的。     

房间隔缺损经导管封堵术后房间隔穿刺一例

房间隔缺损封堵术后通常被认为是房间隔穿刺的禁忌证,但有经验的医生仍可对这样的患者安全地进行房间隔穿刺,现报道一例.     

冠心病血清胆红素的测定及临床意义

观察分析 2 94例冠心病患者血清总胆红素 (TBIL)与血脂的关系。方法 :统计了近 3年我科住院的冠心病患者不同血清总胆红素水平组间血脂的变化情况。结果 :血清总胆红素水平与总胆固醇 (TC)和低密度脂蛋白胆固酶 (LDL -C)水平呈明显负相关。结论 :胆红素影响脂质代谢 ,认为血清总胆红素的水平对预测冠心病的危险性有临床价值。     

第12次中国心脏起搏与电生理学术会议纪要

由中国生物医学工程学会心律分会主办的第12次中国心脏起搏与电生理学术会议于2005年11月3—6日在北京国际会议中心召开，这也是中国生物医学工程学会心脏起搏与电生理分会更名为中国生物工程学会心律分会后举办的第一次会议。大会共收到学术论文300余篇。来自全国20多个省、市、自治区、直辖市、香港特别行政区和美国、英国、意大利、法国、日本、韩国、新加坡、瑞典、荷兰、比利时等国的代表参加了这次学术盛会。会议日程包括心房颤动（简称房颤）导管消融治疗演示及高级讲习班，     

射心通胶囊抗球囊损伤术后再狭窄作用的实验研究

冠状动脉介入治疗近十余年取得了迅速发展,其对冠心病的治疗价值已得到众多随机临床试验的证实.     

单纯环肺静脉前庭隔离术治疗持续性心房颤动:单中心三年随访结果

Objective To report the long-term outcome of catheter radiofrequency ablation treatment for patients with persistent atrial fibrillation (PerAF) and discuss the impact of PerAF duration and the termi-nation on the therapeutic outcome. Methods Eight-six consecutive PerAF patients underwent circumferential pulmonary vein antrum isolation (CPVAI) only were included in this study. Based on PerAF duration, patients were divided into two groups: short term (≤1 year, n =47) and long term (> 1 year, n =39). Results The mean follow-up period was 25-50 (36 ± 8) months. During the follow-up period, the success rate after single procedure was 30. 2% (26/86). Late recurrence phenomenon, defined as atrial tachyarrhythmias relapsed 1 year later, was observed in 9 patients (10.5%). The long-term success rate in the short term group was signifi-cantly higher than that in long term group (42.5% vs 15.4% ,P <0.01). During the first procedure, atrial fi-brillation converted into sinus rhythm or atrial tachycardia occurred in 29 patients (33.7%). Compared with the another 57 patients, the long-term outcome of these patients was much better (48.3% vs 21.1% ,P < 0.01). Redo procedures were pedormed in 24 patients (27.9%), which increased the total success rate at 3 years follow-up to 41.9% (36/86). Conclusion The long-term outcome treated with CPVAI in patients with PerAF is still unsatisfactory. In addition, the late recurrence is common. Shorter term of PerAF and terminated by ablation indicate that those patients might get more benefit from the CPVA1 treatment.     

单纯环肺静脉前庭隔离术治疗持续性心房颤动:单中心三年随访结果

Objective To report the long-term outcome of catheter radiofrequency ablation treatment for patients with persistent atrial fibrillation (PerAF) and discuss the impact of PerAF duration and the termi-nation on the therapeutic outcome. Methods Eight-six consecutive PerAF patients underwent circumferential pulmonary vein antrum isolation (CPVAI) only were included in this study. Based on PerAF duration, patients were divided into two groups: short term (≤1 year, n =47) and long term (> 1 year, n =39). Results The mean follow-up period was 25-50 (36 ± 8) months. During the follow-up period, the success rate after single procedure was 30. 2% (26/86). Late recurrence phenomenon, defined as atrial tachyarrhythmias relapsed 1 year later, was observed in 9 patients (10.5%). The long-term success rate in the short term group was signifi-cantly higher than that in long term group (42.5% vs 15.4% ,P <0.01). During the first procedure, atrial fi-brillation converted into sinus rhythm or atrial tachycardia occurred in 29 patients (33.7%). Compared with the another 57 patients, the long-term outcome of these patients was much better (48.3% vs 21.1% ,P < 0.01). Redo procedures were pedormed in 24 patients (27.9%), which increased the total success rate at 3 years follow-up to 41.9% (36/86). Conclusion The long-term outcome treated with CPVAI in patients with PerAF is still unsatisfactory. In addition, the late recurrence is common. Shorter term of PerAF and terminated by ablation indicate that those patients might get more benefit from the CPVA1 treatment.     

大蒜素对家兔窦房结动作电位的影响

大蒜(Allium sativum L.)是我国传统中药,已研究证实有良好的防治心血管系统疾病的作用。大蒜素是从大蒜中提取的一种稳定单体,对窦性心率有抑制作用。本实验应用玻璃微电极技术,对其进行深入研究。材料与方法1 动物 4月龄大耳白兔8只,雌雄不拘,体重(2.13±0.27)kg。由卫生部武汉生物制品研究所提供。2 药物及仪器大蒜素注射液:30mg/2ml,上海禾丰制药有限公司生产,批号9504011。改良台氏液(mmol/L):NaCl136.9,KCl 5.4,MgCl_2 1.05,CaCl_2 1.80,NaH_2PO_4 0.42,NaHCO_311.9,Glucose 5.55,以上药品从湖北省化学试剂公司购得,为分     

持续性心房颤动导管消融术强化间隔消融与术后左心耳激动延迟的关系

  目的  探讨持续性心房颤动(简称房颤)导管消融术后左心耳激动显著延迟与术中强化间隔消融的关系。  方法  对2007年6月至2009年2月在本科接受导管消融术的201例持续性房颤患者行步进式导管消融, 术后行左房激动标测并记录左心耳电活动, 术后1月行经胸心脏超声评估左房功能。  结果  术后23例出现左心耳激动显著延迟, 其中14例为初次消融病例, 9例接受了间隔线消融(OR 15.2, 95%CI 4.6~50.8, P < 0.001);另9例为第2次消融(包括2例左房隔离)病例, 9例患者也于初次消融中行广泛间隔复杂碎裂电位消融(P=0.002)。激动标测提示21例患者中18例(85.7%)左房最早激动部位转向冠状窦。术后1个月二尖瓣前向血流A峰为(18.2±17.0)cm/s, 与术前为窦性心律者比较显著下降, (20.2±19.1)cm/s vs.(58.2±17.9)cm/s(P=0.037)。随访(10.6±6.2)个月, 14例患者维持窦性心律。  结论  持续性房颤导管消融术行间隔线或广泛间隔复杂碎裂电位消融可导致左心耳激动显著延迟, 可能影响左房功能, 持续性房颤患者采用此术式应该慎重。