甘糖酯对缺血性脑血管病患者红细胞变形能力及甲襞微循环的影响

观察了４０例缺血性脑血管病患者应用甘糖酯治疗前后红细胞滤过指数和甲襞微循环的改变。结果显示：治疗前患者红细胞滤过指数明高于正常人（Ｐ＜０．００１），治疗后红细胞滤过指数明显低于治疗前（Ｐ＜０．００１），且治疗２０天后红细胞滤过指数与正常人无明显差异（Ｐ＞０．０５）；治疗前甲襞微循环血管形态血液流态、袢周状态及总积分值均明显高于正常人（Ｐ＜０．００１），治疗后各项指标均有不同程度的改善。     

甘糖酯联合针刺治疗血管性痴呆32例临床观察

目的 评价甘糖酯联合针刺治疗对血管性痴呆（VD）患者的临床疗效。方法 将VD病人随机分为甘糖酯治疗组与对照组，治疗组接受甘糖酯治疗，对照组接受雏脑路通治疗，此外两组均给予针刺治疗，采用Barthel指数和简易精神状态检查表（MMSE）评定治疗前后的日常生活活动能力以及认知功能。结果 两组病人治疗后康复评定积分较治疗前都有明显提高．甘糖酯治疗组较对照组提高尤为显著（P〈0．05）。结论 甘糖酯合并针刺对VD具有显著的康复治疗效果，值得临床推广。     

2型糖尿病患者应用甘糖酯治疗前后血脂、血流变的变化

目的 探讨甘糖酯对2型糖尿病治疗前后的血脂、血流变的变化。方法用LG-R-80检测37例2型糖尿病患者的血液流变学各项指标，血脂用贝克曼全自动生化分析仪检测。结果37例2型糖尿病患者经过甘糖酯治疗后，血脂、血液流变学结果均较治疗前有好转。结论甘糖酯具有降低甘油三酯的明显特点，是一种适用于2型糖尿病患者的理想调脂药物。     

冠心病红细胞变形能力的测定

采用核孔膜滤筛法,对30例急性心肌梗塞(AMI)和30例心绞痛患者、41例健康者测定红细胞变形能力(RCD).结果发现:AMI和心绞痛组RCD较对照组显著降低;AMI组RCD较心绞痛组明显降低;RCD降低阳性率AMI组较心绞痛组明显增高.     

断肢大鼠红细胞变形性的改变及利多卡因对其的影响

以核孔滤膜法测定断肢大鼠红细胞的变形性，用滤过指数（ＩＦ）作为红细胞变形性的指标。结果发现断肢大鼠（ｎ＝６６）ＩＦ的改变与断肢严重程度、内毒素血症有密切关系。给断肢大鼠腹腔内注射２％利多卡因０．５ｍｌ／１００ｇ体重，１ｈ后的ＩＦ比用药前，明显下降。将断肢大鼠的红细胞与利多卡因共同体外孵育，结果发现，与孵育前比，孵育３０ｍｉｎ后ＩＦ明显下降，因而提示：断肢能引起红细胞变形性减小，利多卡因能直接改善断肢大鼠红细胞变形性。     

高胆固醇血症患者红细胞变形能力的测定

用对Hanss改良的初始流量法仪器系进行改进的装置及5μ孔经的滤膜,对32名高胆固醇血症患者红细胞的变形能力进行测定。结果表明患者红细胞的变形能力明显低于正常人,此为患者微循环不畅的一个原因。     

补心气、滋心阴口服液对冠心病患者红细胞变形能力的影响

应用DXC—400核孔滤膜细胞变形能力测定仪,对57例冠心病患者合并红细胞变形能力低下时,在常规治疗冠心病药物基础上,据中医辩证论治给予补心气或滋心阴口服液,20—30天为一个疗程,进行红细胞变形能力的测定观察。结果表明:显著改善了红细胞变形能力。提示补心气、滋心阴口服液对冠心病兼备扩冠和改善其血液流变障碍的作用。     

络泰粉针剂对冠心病患者氧自由基及红细胞流变性的影响

目的 :观察冠心病患者MDA、SOD与红细胞变形性、聚集性的变化及药物络泰粉针剂对其影响。方法 :将 80例经选择性冠脉造影证实为冠心病的患者随机分为基础治疗的对照组和基础治疗加络泰粉针剂治疗的观察组 ,检测治疗前后动态心电图、常规 12导联心电图、血清MDA、SOD含量及红细胞变形性及聚集性的变化 ,并与 2 0例健康人比较。结果 :冠心病患者血清SOD降低 ,MDA含量增高 ,红细胞变形能力减低 ,聚集性增高。应用络泰粉治疗后MDA显著降低 ,SOD明显升高 ,红细胞变形能力增加 ,聚集性降低 ,心电图及临床症状改善。结论 :络泰粉具有抗氧化、清除氧自由基、改善红细胞流变性 ,扩张血管 ,改善心肌缺血等作用 ,对防治和延缓冠心病的发生和发展有积极治疗价值     

幽门螺杆菌感染及其毒力与心肌梗死的关系

目的探讨幽门螺杆菌(Hp)感染及不同毒力的Hp感染与冠心病心肌梗死的关系.方法本研究测定93例冠心病心肌梗死(MI)患者,包括51例急性心肌梗死(AMI)和42例陈旧性心肌梗死(OMI)患者的Hp特异性抗体(HpIgG、HpIgM)及其细胞毒素相关蛋白特异性抗体(CagA-HpIgG)浓度,并同步观察血浆纤维蛋白原(Fg)、血液流变特性指标变化及其与Hp感染的相关性;同时与31例冠脉造影正常者(NC)进行比较.结果AMI组HpIgG阳性率及平均浓度,HpIgM阳性率及OD值明显高于NC组,AMI组、OMI组和NC组之间CagA-HpIgG阳性率及平均浓度无显著差异.未校正冠心病危险因素时,HpIgG阳性与AMI具有相关关系(OR为3.047),校正后两者仍有相关关系(OR为3.262).AMI组Fg、血浆黏度、低切全血比黏度、红细胞聚集指数明显高于、红细胞变形指数明显低于NC组;Fg、低切全血比黏度显著高于OMI组;中切全血比黏度、血浆黏度、红细胞比容显著高于红细胞变形指数显著低于OMI组.AMI组中Hp( )组Fg明显高于Hp(-)组及OMI组中Hp( )组,并且IgG与Fg、低切全血比黏度、血浆黏度呈正相关,与红细胞变形指数呈负相关(P均＜0.05),调整与Fg相关的冠心病危险因素后,IgG与Fg仍呈正相关.治疗后AMI组HpIgG、CagA-HpIgG阳性率及平均浓度,HpIgM阳性率及OD值较治疗前差异不显著.结论Hp感染与CHD(AMI)之间存在明显的相关性,与Fg、血液流变特性指标也存在相关性.不同毒力的Hp感染与冠心病心肌梗死的关系无显著差异.     

单纯疱疹病毒感染与急性心肌梗死、纤维蛋白原、血液流变特性的相关性研究

测定51例急性心肌梗死(AMI)和42例陈旧性心肌梗死(OMI)患者及31例冠脉造影正常者(NC)的HSV-1抗体水平及DNA,同时观测纤维蛋白原(Fg)、血液流变特性指标变化及其与HSV-1感染的相关性.结果显示AMI组HSV-ngG阳性率及水平高于NC组,HSV-1DNA检测结果与之吻合.校正冠心病危险因素前、后,HSV-11gG阳性与AMI均有相关关系.AMI组中HSV-1(+)组IgG、Fg、血浆黏度、低/高切全血比黏度、红细胞压积、红细胞聚集指数高于,而红细胞变形指数低于HSV-1(一)组;且IgG与Fg、低/高切全血比黏度、血浆黏度、红细胞聚集指数呈正相关,而与红细胞变形指数呈负相关.表明HSV-1感染与AMI有明显的相关性,与Fg、血液流变特性指标也存在相关性.     

The effect of serum from patients with acute myocardial infarction on in vitro lymphocyte reactivity. II. Inhibition of IL-2 production.

Culture supernatants from concanavalin-A (con-A)-activated peripheral blood lymphocytes from healthy controls grown in the presence of sera from 20 patients 24 hours and 1 week after acute myocardial infarction (AMI) were tested for their mitogenic activity and for the presence of interleukin-2 (IL-2). Binding of exogenous IL-2 to activated lymphocytes from 10 patients was also determined. In supernatants prepared in the presence of patients' as compared to control sera, a significantly decreased mitogenic activity and IL-2 content were found. The mitogenic activity and IL-2 content in culture supernatants prepared with patients' sera collected 24 hours after the AMI (AMI I) and one week thereafter (AMI II) were significantly suppressed, and the degree of suppression in the 24-hour sera was significantly higher than in those collected after one week. No significant differences were observed in the binding capacity to exogenous IL-2 of activated patients' and control lymphocytes. The possibility is that immunosuppressive factors in the patients' sera, including cortisol, may suppress the patients' immune response acting through inhibition of IL-2 production.     

血瘀症大鼠的血液流变性改变与脂质过氧化作用

本文对血瘀症大鼠体内脂质过氧化反应及清除氧自由基能力强弱与血液流变特性改变的关系进行了实验研究。结果表明：血瘀症大鼠血液流变指标较正常组增高（Ｐ＜０．０５—０．０１），同时，脂质过氧化产物丙二醛（ＭＤＡ）含量增加，超氧化物歧化酶（ＳＯＤ）活性降低（Ｐ＜０．０１）；而用药物藻酸双酯钠的血瘀症大鼠的血液流变指标明显低于不用药组（Ｐ＜０．０５—０．０１），ＭＤＡ和ＳＯＤ则相应降低和增强（Ｐ＜０．０５—０．０１）。分析认为：体内脂质过氧化反应增强，清除氧自由基能力减弱，造成体内自由基反应紊乱，可导致血液流变性异常。     

Decreased red cell filterability in patients with acute myocardial infarction

The red cell filterability was decreased in patients with acute myocardial infarction (AMI) when compared with healthy controls, 14.6 (12.2-16.3) units and 16.9 (15.6-17.4) units respectively, P50 (P25-P75), p less than 0.001). No significant correlations could be seen within the AMI group between the decrease in filterability and the levels of serum aspartate aminotransferase or serum lactate dehydrogenase. The erythrocyte filterability, however, correlated to the serum concentrations of hepatic enzymes in AMI. The addition of sodium lactate in vitro in physiological concentrations (0.9-3.6 mM/l final concentration) lowered the erythrocyte filterability markedly to 2.7 (0-9.8) units in a dose-dependent manner, supporting the hypothesis that the decrease in erythrocyte filterability in AMI might be caused by an increase in the lactate concentration.     

Impact of the COVID-19 Outbreak on Emergency Care Utilization in Patients with Acute Myocardial Infarction: a Nationwide Population-based Study

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has impacted various aspects of daily living and has influenced the life of every individual in a unique way. Acute myocardial infarction (AMI) is associated with high morbidity and mortality; thus, timely treatment is crucial to prevent poor prognosis. Therefore, an immediate emergency department (ED) visit is required; however, no domestic studies have reported the effect of COVID-19 on ED visits by patients with AMI. Therefore, this study aimed to assess the changes in the pattern of ED visits by patients with AMI by comparing visits during the COVID-19 outbreak period to those during two control periods.MethodsThis nationwide, retrospective study used registry data of the National Emergency Department Information System. The ‘outbreak period’ was defined as the period between February 21, 2020 and April 1, 2020, while the ‘control period’ was defined as the same time period in the preceding two years (2018 and 2019). The primary outcome of our study was the number of patients admitted to the ED owing to AMI during the outbreak and control periods. Secondary outcomes were time from symptom onset to ED visit, length of ED stay, and 30-day mortality following admission.ResultsDuring the outbreak period, 401,378 patients visited the ED; this number was lower than that during the control periods (2018: 577,548; 2019: 598,514). The number of patients with AMI visiting the ED was lower during the outbreak period (2,221) than during 2018 (2,437) and 2019 (2,591).ConclusionThe COVID-19 pandemic has caused a reduction in ED visits by patients with AMI. We assume that this could likely be caused by misinterpretation of AMI symptoms as symptoms of respiratory infection, fear of contracting severe acute respiratory syndrome coronavirus 2, and restrictions in accessing emergency medical care owing to overburdened healthcare facilities. This study sheds light on the fact that healthcare and emergency medical staff members must work towards eliminating hurdles due to this pandemic for patients to receive timely emergency care, which in turn will help curb the growing burden of mortality.     

Diagnostic value for acute myocardial infarction of creatine kinase and lactate dehydrogenase isoenzymes compared with total enzymes. Creatine kinase isoenzyme specificity for myocardial damage

The diagnostic value of creatine kinase (CK) and lactate dehydrogenase isoenzymes was investigated in a prospective study of 201 patients with suspected acute myocardial infarction (AMI). The isoenzymes were analyzed with a column chromatographic method. The patients' final diagnoses were made according to the WHO criteria without knowledge of the isoenzyme results. The prevalence of AMI was 50%. The diagnoses were predicted with significantly greater reliability with the isoenzyme than with the total enzyme determinations in most of the patients. However, the greater diagnostic reliability had sufficient therapeutic consequence to justify the extra analytical cost only in patients for whom the diagnosis must be based mainly on the enzyme results. The CK isoenzyme specificity for myocardial damage was studied in populations with low prevalence of heart disease. In a group of 39 patients who had elevated total CK due to noncardiac disease there were five with elevated isoenzyme values, but since among 69 young healthy persons none had elevated isoenzymes, this was taken to indicate that the isoenzymes may be leaked into the blood from other organs than the heart.     

Association of social support during emergency department evaluation for acute coronary syndrome with subsequent posttraumatic stress symptoms

We examined the associations of different aspects of social support during emergency department (ED) evaluation for an acute cardiac event with perceptions of threat in the ED and subsequent posttraumatic stress symptoms (PSS) in 484 patients. Participants were enrolled in the ED where they reported on their perceptions of threat in the ED. Social support in the ED and PSS were assessed at inpatient bedside or by telephone a median of 3 days later. Positive aspects of social support were not associated with subsequent PSS. Anxiety-provoking social support was significantly associated with increased PSS at follow-up. Greater ED threat perception partially mediated that relationship.     

早期血清ALB水平检测用于急性心肌梗死患者急性肾损伤预测的临床价值

目的 分析早期检测血清白蛋白（albumin,ALB）对急性心肌梗死患者急性肾损伤的预测价值。方法 纳入急性心肌梗死患者100例,其中有急性肾损伤患者48例,无急性肾损伤患者48例,探讨早期血清ALB对急性心肌梗死患者发生急性肾损伤的预测价值。结果 两组患者在性别、年龄和体质量指数上无统计学差异（P＞0.05）;有急性肾损伤患者的心率、收缩压、舒张压、尿量、白细胞、血糖、血肌酐水平更高,行冠状动脉支架治疗概率、左室射血分数、红细胞比容、ALB水平更低（P＜0.05）;多因素Logistic回归分析显示,肾损伤的危险因素包括ALB、白细胞计数和血肌酐（P＜0.05）;经校正混杂因素后,低ALB血症为肾损伤的危险因素(P＜0.05)。结论 早期检测血清ALB水平,可对急性心肌梗死患者发生急性肾损伤的风险进行预测。     

Effect of isosorbide dinitrate on enzymatically estimated infarction size and on clinical condition of the patients of acute myocardial infarction

With the aim of reducing myocardial infarction size, isosorbide dinitrate (ISDN) was tried in 27 patients of acute myocardial infarction (AMI). There was 11% reduction of infarction size, in the ISDN treated group, in comparison to that of non treated group, though the result was not statistically significant. But, many of the in-hospital complications were significantly less in the treated group. After a critical analysis of the result it was concluded that a statistically insignificant result, as regard reduction of infarction size in AMI, cannot always exclude the utility of a drug therapy in AMI.     

冠心病患者红细胞生物物理特性的改变及其临床意义

目的 :了解冠心病 (CHD)患者红细胞变形性 (ED)、膜胆固醇 (Ch)、磷脂 (PL)及膜脂微粘度 ( η)的改变。方法 :采用激光衍射法和DPH探针观察 2 7例CHD患者ED及 η的变化 ,并与 30例健康人对照。结果 :CHD患者膜Ch、Ch/PL及 η明显高于对照组 ,而PL及ED明显低于对照组。ED与膜Ch、Ch/PL及 η呈负相关 ; η与Ch/PL呈正相关 ;各变形参数间亦有正相关关系。结论 :CHD患者ED的降低与红细胞膜脂异常及膜微粘度的改变有关 ,且降低的ED与冠心病的发生和发展有一定关系