体外反搏对改善心肌缺血的作用

为研究体外反搏对心肌缺血的作用，我们应用99mTC－MIBI负荷心肌灌注断层显像，观察冠心病患者体外反搏前后心肌缺血的改变。对象与方法一、对象冠心病19例，为我科1990年至1994年住院病人，诊断按照1979年WHO标准。男15例，女4例，年龄40～73岁，平均60.4±9.6岁。其中劳力型心绞痛18例，心肌梗塞1例。心绞痛病程1～120个月，平均22．5±35．9个月。二、方法1．心肌血流灌注断层显像患者入院后应用SeimensZLC－3700型单光子发射计算机断层扫描（SPECT）仪进行99mTC—MIBI踏车运动心肌灌注断层显像，体外反掉后再行SPECT心肌灌…     

增强型体外反搏治疗慢性左心衰竭60例观察

目的探讨体外反搏治疗慢性左心力衰竭的疗效及适应证。方法体外反搏治疗心功能Ⅱ、Ⅲ级左心力衰竭病人与单纯药物治疗对照进行疗效比较。采用6rain步行实验及LVEF值检测,对心功能改善情况及疗效进行观察,治疗时间为6个月。结果体外反搏组心功能改善、6min步行实验及LVEF值检测均明显优于对照组（P〈0．05）。6个月随访心血管住院率及发病率明显低于对照组。结论体外反搏治疗慢性左心力衰竭效果明显,费用低廉,值得进一步探讨其适应证及疗效并大力推广。     

增强型体外反搏联合药物治疗冠心病不稳定型心绞痛

<正>增强型体外反搏(EECP)是一种无创的体外辅助循环装置。它不仅能改善心绞痛症状,还能增加运动耐量、增强左室功能、持久提高心绞痛患者的生活质量。本文目的旨在探讨观察在药物治疗基础上联合应用EECP对减少不稳定型心绞痛(UA)患者心绞痛发作频率,缓解心绞痛的疼痛程度,提高生活质量及降低病死率的效果。1资料与方法1.1一般资料选择2010-05～2011-12在笔者所在医院治疗的不稳定型心绞痛患者80例,随机分为两组。治疗组40     

体外反搏治疗对老年人心功能影响的观察

体外反搏治疗对老年人心功能影响的观察太原市妇幼保健院（０３００１２）张凤兰山西中日友好康复医学中心张宏德本文对缺血性脑血管病患者４７例，其中２０例进行体外反搏治疗，２７例常规药物治疗，两组于治疗前后作心功能检查对照，现报道如下。１资料和方法１．１对象...     

增强型体外反搏治疗失眠 41例

目的探讨增强型体外反搏治疗失眠的疗效及机制。方法选取 2013年 3月至 2019年 3月在遂宁市中心医院就诊的失眠病人 81例,采用随机数字表法分为观察组 41例和对照组 40例,对照组给予失眠常规药物治疗及护理,观察组在此基础上给予增强型体外反搏治疗。分别于病人入院当天及治疗后 30 d采用匹兹堡睡眠质量指数量表(PSQI)对两组睡眠质量进行评估。比较两组各时间段 PSQI总分、各维度得分。结果观察组 PSQI总分治疗前为(14.8±1.93)分,治疗后 30 d为(7.85±1.74)分,对照组治疗后 30 d PSQI总分为(11.4±4.06)分,观察组治疗后 30 d PSQI总分及各维度得分均低于治疗前,且低于对照组,差异有统计学意义(P＜0.05)。结论体外反搏治疗能有效减轻病人失眠症状,改善病人睡眠质量。     

体外反搏治疗的护理体会

我科自1988年3月开展体外反搏治疗缺血性心脑疾病。由于护理工作做得较好,反搏疗效满意。现介绍如下: 一般情况我们使用广州出品的WFB-Ⅱ型四肢序贯式正压反搏器,对脑梗塞后遗症22例;脑动脉硬化或脑供血不足23例;冠心病3例;     

增强型体外反搏治疗冠心病不稳定型心绞痛疗效观察

目的观察增强型体外反搏治疗冠心病不稳定型心绞痛的临床疗效。方法将82例冠心病不稳定型心绞痛患者随机分为对照组和治疗组,对照组常规给予硝酸盐制剂、β受体阻滞剂、钙拮抗剂、双联抗血小板(阿司匹林和硫酸氯吡格雷)、他汀类调脂药物及低分子肝素等;治疗组在常规药物治疗基础上加用增强型体外反搏治疗,观察两组临床疗效及心电图变化。结果治疗后总有效率治疗组85.7%,对照组65.0%;心电图改善率分别为76.2%和52.5%,治疗组无严重不良反应发生。结论增强型体外反搏治疗冠心病不稳定型心绞痛安全有效。     

体外反搏治疗帕金森病疗效观察

我院于1990年4月至1996年6月，对帕金森病患者进行了体外反博治疗，并与药物治疗对照。报告如下。临床资料一、52例患者均为老干部，年龄60～76岁，病程1～7年。按1964年全国锥体外系疾病讨论会修订的帕金森病及帕金森综合症的诊断标准，排除甲亢、老年性震颤，排除吩摩唤类等药物及其它中毒史，诊断明确。二、分组反搏组26例，其中男25例，女1例。采用广州医疗器械厂产WFB－IV增强型体外反搏装置。每日1次，每次1小时，12次为1疗程，疗程间休息3天，共3个疗程。服药组26例，其中男24例，女2例。口服左旋多巴500mg，每日3次；安坦Zing，…     

通过测量血压对体外反搏疗效的观察

通过３８例病人的血压测量及用ＸＸＧ－Ｅ型心功能测试仪对５例病人的心功能测试，疗效均为满意，本文仅举２例病人为证。     

Nicotine in High Concentration Causes Contraction of Isolated Strips of Rabbit Corpus Cavernosum

It is well known that cigarette smoke can cause erectile dysfunction by affecting the penile vascular system. However, the exact effects of nicotine on the corpus cavernosum remains poorly understood. Nicotine has been reported to cause relaxation of the corpus cavernosum; it has also been reported to cause both contraction and relaxation. Therefore, high concentrations of nicotine were studied in strips from the rabbit corpus cavernosum to better understand its effects. The proximal penile corpus cavernosal strips from male rabbits weighing approximately 4 kg were used in organ bath studies. Nicotine in high concentrations (10^-5~10^-4 M) produced dose-dependent contractions of the corpus cavernosal strips. The incubation with 10^-5 M hexamethonium (nicotinic receptor antagonist) significantly inhibited the magnitude of the nicotine associated contractions. The nicotine-induced contractions were not only significantly inhibited by pretreatment with 10^-5 M indomethacin (nonspecific cyclooxygenase inhibitor) and with 10^-6 M NS-398 (selective cyclooxygenase inhibitor), but also with 10^-6 M Y-27632 (Rho kinase inhibitor). Ozagrel (thromboxane A2 synthase inhibitor) and SQ-29548 (highly selective TP receptor antagonist) pretreatments significantly reduced the nicotine-induced contractile amplitude of the strips. High concentrations of nicotine caused contraction of isolated rabbit corpus cavernosal strips. This contraction appeared to be mediated by activation of nicotinic receptors. Rho-kinase and cyclooxygenase pathways, especially cyclooxygenase-2 and thromboxane A₂, might play a pivotal role in the mechanism associated with nicotine-induced contraction of the rabbit corpus cavernosum.     

研究EECP联合药物治疗CHD对患者血浆Lp-PLA2及hs-CRP水平的影响

目的 探讨增强型体外反搏(EECP)对冠心痛(CHD)患者血浆超敏C反应蛋白(hs-CRP)、脂蛋白相关磷脂酶A2(Lp-PLA2)水平的影响.方法 选取2012年1月至2015年8月本院心血管内科收治的90例CHD患者,其中47例患者仅采用常规药物治疗(常规组)、43例患者采取常规疗法+EECP治疗(EECP组),疗程5周,观察两组患者血浆hs-CRP、Lp-PLA2的水平变化.结果 治疗前,EECP组和常规组患者的Lp-PLA2、hs-CRP测定值差异均无统计学意义(P＞0.05);治疗3周、5周后,EECP组患者的Lp-PLA2、hs-CRP水平均显著低于常规组患者(P＜0.05),EECP组患者的Lp-PLA2水平与治疗前比较均显著降低(P＜0.05),两组患者的hs CRP水平与治疗前比较均显著降低(P＜0.05).结论 EECP能显著降低CHD患者血浆hs-CRP、Lp-PLA2的水平.     

普伐他汀对高胆固醇血症患者纤溶活性的影响

目的:研究高胆固醇血症患者降脂治疗后体内纤溶活性的变化并探讨其作用机制。方法:正常对照组30例。120名高胆固醇血症患者随机分成两组,普伐他汀60例,10 mg,每晚顿服;辛伐他汀60例,20 mg,每晚顿服,疗程8周。观察治疗前后血清总胆固醇(TC)、低密度脂蛋白(LDL-C)、纤溶酶原激活抑制剂-1(PAI-1)活性、组织型纤溶酶原激活剂(t-PA)和纤维蛋白原(Fib)等指标。结果:试验组治疗前后比较:①血清TC由6.58± 0.57,显著下降到4.86±1.36 mmol·L~(-1)(P<0.001);LDL-C由4.08±0.53显著下降到2.75±0.73 mmol·L~(-1)(P<0.01);②血浆PAI-1活性由0.91+0.14显著下降到0.69±0.13 AU·mL~(-1)(P<0.01);③t-PA活性由0.27±0.12显著增高到0.36±0.11 U·mL~(-1)(P<0.05);④Fib由3.91±0.22下降到3.13±0.16gL~(-1)(P<0.05)。试验组与对照组比较,治疗后各项指标的改变无显著差异(P>0.05);⑤血清TC与LDL-C水平及PAI-1活性显著正相关(P<0.001)。结论:普代他汀与辛伐他汀有相似的降脂和改善纤溶活性的作用。     

淫羊藿苷对家兔阴茎海绵体cGMP浓度的效果

目的　观察淫羊藿苷对家兔阴茎海绵体组织中cGMP浓度的影响。方法　应用12 5I放射免疫法 ,测定不同浓度的淫羊藿苷对阴茎海绵体内PDE5酶底物cGMP浓度的影响 ,并以西地那非和罂粟碱作为阳性对照。结果　淫羊藿苷能提高阴茎海绵体内cGMP浓度 ,具有浓度依赖性 (P<0 0 0 1) ,其半数有效浓度 (EC50 )为 5 13μmol·L-1,而西地那非 0 31为 μmol·L-1,罂素碱为 3 15 μmol·L-1。结论　淫羊藿苷对阴茎勃起的作用机制与其能提高海绵体平滑肌cGMP浓度而增强阴茎海绵体平滑肌松弛作用有关     

枸橼酸西地非尔对兔海绵体组织作用及其机制的离体研究

目的　研究枸橼酸西地非尔对兔海绵体组织舒张功能的影响及其作用机制。方法　 37℃温孵兔海绵体组织(RCC) ,用放射免疫方法监测在硝普钠存在下 ,西地非尔10、10 0、10 0 0nmol·L-1对cGMP水平的影响 ;采用离体器官水浴技术 ,将RCC用苯丙肾上腺素 (PE)收缩 ,观察西地非尔对NO供体硝普钠 (SNP)及促内皮依赖性NO释放剂氯化乙酰甲基胆碱介导RCC舒张作用的影响。结果　SNP可提高RCC中cGMP水平 ,西地非尔 10、10 0、10 0 0nmol·L-1可剂量依赖性使之升至更高水平。西地非尔使SNP、氯化乙酰甲基胆碱 (MCH)作用IC50 显著减小。结论　以上结果表明枸橼酸西地非尔通过NO/cGMP呈剂量依赖性增强MCH和SNP对RCC的舒张作用 ,对动物阴茎海绵体组织舒张功能有显著性改善作用 ,从而大大提高动物性功能。     

Effect of Atorvastatin Versus Rosuvastatin on Levels of Serum Lipids,Inflammatory Markers and Adiponectin in Patients with Hypercholesterolemia

Purpose  To compare the short-term effect of treatment with atorvastatin and rosuvastatin on levels of serum lipids, inflammatory markers and adiponectin in patients with hypercholesterolemia. Methods  Sixty-nine patients with hypercholesterolemia were randomly assigned to receive 10 mg/day of atorvastatin or rosuvastatin for 12 weeks. Inflammatory biomarkers, including highsensitivity C-reactive protein (hs-CRP), tumor necrosis factor (TNF)-alpha, matrix metalloproteinase-9 (MMP-9), and endothelin (ET-1), plasminogen activator inhibitor type 1 (PAI-1) and plasma tissue plasminogen activator (tPA), adiponectin, and lipid profiles were measured before and after statin therapy. Results  Atorvastatin and rosuvastatin both lowered levels of hs-CRP, MMP-9, PAI-1, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) from baseline values, with rosuvastatin lowering TC and LDL-C to a greater extent than atorvastatin (P < 0.05). Adiponectin level increase was 15% higher than that at baseline with atorvastatin (P > 0.05) but 67% higher with rosuvastatin (P < 0.05). Conclusions  Therapy with both statins not only significantly improved lipid profiles but also decreased levels of vascular biomarkers hs-CRP, MMP-9, and PAI-1; however, only rosuvastatin increased serum adiponectin levels significantly in patients with hypercholesterolemia, which could imply a beneficial effect in coronary artery disease.     

Enhanced external counterpulsation improves endothelial function and exercise capacity in patients with ischaemic left ventricular dysfunction

Enhanced external counterpulsation (EECP) therapy decreases angina episodes and improves quality of life in patients with left ventricular (LV) dysfunction (LVD). However, studies have not elucidated the mechanisms of action and overall effects of EECP in patients with LVD. The purpose of the present study was to investigate the effects of EECP on endothelial function in peripheral conduit arteries and exercise capacity (peak Vo ₂) in patients with LVD. Patients with ischaemic LVD (ejection fraction (EF) 34.5 ± 4.2%; n = 9) and patients with symptomatic coronary artery disease (CAD) and preserved LV function (EF 53.5 ± 6.6%; n = 15) were studied before and after 35 sessions (1 h) of EECP. Brachial and femoral artery flow‐mediated dilation (bFMD and fFMD, respectively) were evaluated using high‐resolution ultrasound. Enhanced external counterpulsation elicited similar significant improvements in the following FMD parameters in the CAD and LVD groups (P ≥ 0.05 between groups for all): absolute bFMD (+53% and +70%, respectively), relative bFMD (+50% and +74%, respectively), bFMD normalized for shear rate (+70% and +61%, respectively), absolute fFMD (+33% and +21%, respectively) and relative fFMD (+32% and +17%, respectively). In addition, EECP significantly improved plasma levels of nitrate/nitrite (+55% and +28%) and prostacyclin (+50% and +70%), as well as peak Vo ₂ (+36% and +21%), similarly in both the CAD and LVD groups (P ≥ 0.05 between groups for all). Despite reduced LV function, EECP therapy significantly improves peripheral vascular function and functional capacity in CAD patients with ischaemic LVD to a similar degree to that seen in CAD patients with preserved LV function.     

高同型半胱氨酸和高胆固醇血症联合作用对大鼠基因组DNA总甲基化状态的影响

目的:探讨高同型半胱氨酸血症(HHCY)和高胆固醇血症(HTC)联合作用对大鼠主动脉基因组DNA总甲基转移酶活力(DNMT)及总甲基化水平的影响.方法:44只健康清洁级成年Wistar雄性大鼠按2×2析因设计随机分为阴性对照组、高同型半胱氨酸(HCY)组、高总胆固醇(TC)组、高HCY+高TC组,每组11只.对照组给予普通大鼠饲料,其余各组给予相应的配方饲料.喂养3个月后心脏取血检测血清中HCY、TC等相关指标.提取主动脉基因组DNA检测基因组DNA总甲基化水平;提取主动脉核蛋白检测基因组DNA总甲基转移酶活力.结果:HHCY和HTC联合作用大鼠血清HCY较高,产生相可作用(P＜0.01),表现为协同作用,而对大鼠血清TC、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)无交互作用.HHCY和HTC联合作用主动脉基因组DNA总甲基转移酶活力较高,产生相互作用(P＜0.01),表现为协同作用,总基因组DNA甲基化水平降低,即去甲基化程度的增加,产生相互作用(P＜0.01),表现为协同作用.结论:HHCY和HTC联合作用使得大鼠主动脉基因组DNA总DNMT活力增高,基因组DNA总甲基化水平降低,可能是AS发生发展的重要机制之一.     

Enhanced external counterpulsation reduces indices of central blood pressure and myocardial oxygen demand in patients with left ventricular dysfunction

Enhanced external counterpulsation (EECP) therapy decreases angina episodes and improves quality of life in patients with left ventricular (LV) dysfunction. However, the underlying mechanisms relative to the benefits of EECP therapy in patients with LV dysfunction have not been fully elucidated. The purpose of this study was to investigate the effects of EECP on indices of central haemodynamics, aortic pressure wave reflection characteristics, and estimates of LV load and myocardial oxygen demand in patients with LV dysfunction. Patients with chronic stable angina and LV ejection fraction < 40% but > 30%, were randomized to either an EECP group (LV ejection fraction = 35.1 ± 4.6%; n = 10) or sham‐EECP group (LV ejection fraction = 34.3 ± 4.2%; n = 7). Pulse wave analysis of the central aortic pressure waveform and LV function were evaluated by applanation tonometry before and after 35 1‐h sessions of EECP or sham‐EECP. Enhanced external counterpulsation therapy was effective in reducing indices of LV wasted energy and myocardial oxygen demand by 25% and 19%, respectively. In addition, indices of coronary perfusion pressure and subendocardial perfusion were increased by 9% and 30%, respectively, after EECP. Our data indicate that EECP may be useful as adjuvant therapy for improving functional classification in heart failure patients through reductions in central blood pressure, aortic pulse pressure, wasted LV energy, and myocardial oxygen demand, which also suggests improvements in ventricular–vascular interactions.