老年人心气虚证并心舒张功能不全中药治疗观察简报

老年人心气虚证并心舒张功能不全中药治疗观察简报汤益明黄惠生张庭玉万士荣肖大鹏（江西中医药研究所南昌３３０００６）关键词心气虚证心舒张功能不全中药疗法老年心气虚证并心功能不全，辨证方面既以气虚及血瘀为主要病机，自应以益气活血为治疗的主要原则。笔者实践中...     

诊治病毒性心肌炎及炎症性心肌病的最新进展

1 病原 　　心肌炎是心肌的一种炎症性病变,可分为感染性和非感染性两大类.非感染性包括过敏或变态反应性心肌炎,如风湿性心肌炎以及理化和药物引起的中毒性心肌炎等.感染可由各种病原体引起,但目前除个别国家尚有相当数量的白喉杆菌及南美洲锥虫病(Chagas)引起的心肌炎外,绝大多数属病毒性心肌炎类(VMC)[1]. 　　……     

快速心律失常治疗的现代概念

近年来心律失常的治疗有较大进展 ,主要在非药物治疗方面 ,包括除颤、起搏、消融 ,手术等。非药物治疗可以解决一部分心律失常的治疗 ,但大部分心律失常还是需要用药物治疗[1～ 3 ] 。尽管近五年来新上市的抗心律失常的新药仅有主要对房性心律失常的伊布利特 (ｉｂｕｔｉｌｉｄ     

中西医结合防治内皮功能不全的策略

动脉粥样硬化（AS）的始发及冠心病事件的主要机制中内皮功能不全（endothelial dysfunction．ED）、氧化物应激（0xidant stress，OS）及炎症均起关键作用。本文着重探讨ED发病机制的新进展及中西医结合抗氧化，改善内皮功能的防治策略。     

急性心肌梗死时新血清标记物的应用

１前言当冠状动脉发生急性血栓性堵塞时，相关区域内心肌遭受缺血性损伤，视血栓的性质、阻塞的程度及时间与侧支循环等因素，心肌损伤可以是可逆性的，如不稳定性心绞痛；也可以是不可逆性的，表现为急性心肌梗死（AMI）。AMI时因心肌细胞坏死，内膜完整性受损，细胞内巨分子（血清心肌标记物）释放进入血液。近年来检验技术的进步，少至１克心肌的坏死即可由新的心脏标记物如心肌肌钙蛋白（cardiactroporin，cTn）的升高而检测犤１犦。使微量心肌梗死（infarctlet）或微量心肌损害（minormyocar－dialdemage，MMD）的诊断成为可能犤１…     

内分泌高血压临床诊断的进展

<正> 尽管在为数众多的高血压病(原发性高血压)病人中继发性高血压只占较小比例。如我国北京地区联合调查,继发性只占1.1％。不同人群中继发性高血压所占的比例也有不同,例如1976年Berglund在47～54岁男性高血压人群中发现继发性者就占6％。基于高血压病患病人数的庞大,一位数百分比也不是一个小数目。何况多数继发性高血压病因治疗后,高血压可得到痊愈。相反,一旦漏诊后常给生命和健康带来很大的危害。因此提高继发性高血压的诊断水平还是具有较大的实际价值的。根据国内外资料,继发性高血压中除以肾实质性高血压最常见外,以内分泌高血压占最大比重。本文将简扼介绍其主要临床表现,重点探讨当前对这些疾病诊断方法及其概念的有关进展,希有助于临床医师诊断水平的提高。     

循证医学与中西医结合

1循证医学(evidence-based medicine,EBM)是医学临床实践的新模式过去30年来医学临床研究迅猛发展,其突出表现之一是随机对照试验(randomized controlled trial,RCT)作为研究的方法和标准已被医学界彻底接受,并被公认为临床试验的金标准[1,2],任何药物或疗法没有通过RCT试验均不可能被批准而合法地应用于临床。而多个RCT的高质量系统评价(systemic review,SR)即荟萃分析(meta-analysis)更被认为具有较高的指导意义。循证医学工作小组1992年在美国医学会杂志(JAMA)正式提出一种医学临床的新模式-EBM,要求临床医师的行医模式逐渐由以…     

慢性心力衰竭患者心脏再同步治疗疗效观察

Objective This study was designed to evaluate the clinical outcome of cardiac resynchro-nization therapy(CRT) during short and mid-long term follow-up. Methods Consecutive patients treated with CRT between 1999 and 2008 were registered. Clinical information was collected from baseline and last follow-up. Clinical information included survival, chnical cardiac function, echocardiography parameters and QRS wave width from surface ECG. Results Ninety-five patients who were treated with CRT successfully were included. These patients were divided into two groups: those with only short term follow-up and those with mid-long term follow-up. In the short term follow-up group,survival was 89.1% with follow-up of(18±10) month(median = 18 months). Survival was 66.6% in mid-long term group with follow-up of(57±17) months (median = 54 moths). While clinical cardiac function was significantly improved in both groups the intrinsic QRS wave width did not show significant change. Those patients' medical therapy for chronic heart failure has been changed dur-ing the period of follow-up. Conclusion CRT can improve clinical cardiac function in parts of patients with chronic heart failure and increased survival during mid-long term and short term follow-up. However, there re-mains a need for more sensitive indicators.     

慢性心力衰竭患者心脏再同步治疗疗效观察

Objective This study was designed to evaluate the clinical outcome of cardiac resynchro-nization therapy(CRT) during short and mid-long term follow-up. Methods Consecutive patients treated with CRT between 1999 and 2008 were registered. Clinical information was collected from baseline and last follow-up. Clinical information included survival, chnical cardiac function, echocardiography parameters and QRS wave width from surface ECG. Results Ninety-five patients who were treated with CRT successfully were included. These patients were divided into two groups: those with only short term follow-up and those with mid-long term follow-up. In the short term follow-up group,survival was 89.1% with follow-up of(18±10) month(median = 18 months). Survival was 66.6% in mid-long term group with follow-up of(57±17) months (median = 54 moths). While clinical cardiac function was significantly improved in both groups the intrinsic QRS wave width did not show significant change. Those patients' medical therapy for chronic heart failure has been changed dur-ing the period of follow-up. Conclusion CRT can improve clinical cardiac function in parts of patients with chronic heart failure and increased survival during mid-long term and short term follow-up. However, there re-mains a need for more sensitive indicators.     

中毒性休克综合征

中毒性休克综合征(toxic shock syndrome,TSS)是一种以发热、低血压、皮疹、皮肤脱屑和多器官系统功能损害为特征的临床症候群,1978年由 Todd 等首次描述并命名。近数年来,国外围绕该综合征进行有关研究的报告甚多,发病率亦有逐年上升的趋势,迄止1981年底,报道的确诊病例数已逾1,500例。本文综述国外文献,就 TSS 的病因、发病机理及临床学等诸方面的问题作一介绍,旨在引起国内医务工作者的重视。病因与易患因素现已查明,TSS 的病原体是血浆凝固酶阳性的化