卡托普利及抗内皮素抗体对自发性高血压大鼠血压的急性作用

卡托普利及抗内皮素抗体对自发性高血压大鼠血压的急性作用１００８５３北京解放军总医院张丽萍，范英鲜，曾强，余霞君关键词内皮素；高血压；血管紧张素Ⅱ；大鼠中国图书资料分类号　Ｒ５４４．１内皮素（ＥＴ）是一种含２１位氨基酸的活性肽，有极强的缩血管作用，尤其...     

非洛地平与卡托普利对老年高血压病的疗效比较

目的比较非洛地平和卡托普利对老年高血压病的降压效应和安全性。方法60例老年高血压病采用非洛地平(5mg／d-10mg／d)和卡托普利(375mg／d～75mg／d)治疗4周。结果 非洛地平和卡托普利均能有效地降低血压．非洛地平对舒张压效果更优。结论非洛地平对老年高血压安全有效。     

腹主动脉瘤患者手术治疗前后心理因素的变化

为探讨腹主动脉瘤患者手术前后心理因素的变化及其对患者生活质量的影响，选择1999年1月－2000年4月经手术治疗的腹主动脉瘤患者中能理解并独立完成答卷者24例，在入院当天和出院前1天分别利用SCL－90心理测试表进行问卷调查。结果发现，术前与术后患者在综合情况、抑郁、焦虑、强迫症状和恐怖等方面均存在显著差异（P＜0．05）。说明腹主动脉瘤的手术治疗不仅能达到预防腹主动脉瘤破裂的目的，而且可以缓解患者的精神压力，使腹主动脉瘤患者的生活质量大大提高。     

腹主动脉瘤血管内修复术前后血流动力学变化的MSCT分析

目的 :模拟、评价和分析肾动脉以下腹主动脉瘤行血管内修复术前后血流压力的变化。方法 :自 1996年 3月～ 2 0 0 1年 5月 ,13例腹主动脉瘤患者行血管内介入治疗。所有病例均行多排螺旋CT检查 ,采用计算机辅助流体动力学分析软件 (CFD) ,对主动脉病变介入治疗前后血流动力学进行     

主动脉瘤腔内修复术一期治愈Stanford A型主动脉夹层并腹主动脉瘤一例

Stanford A型主动脉夹层是一种灾难性疾病,病死率极高[1]。治疗主要以手术为主,即升主动脉或主动脉弓置换术,但手术创伤大,手术病死率达14%～21.6%[2]。自1991年     

腹主动脉腔内修复术治疗腹主动脉瘤合并冠心病患者临床疗效

目的 评价腹主动脉腔内修复术(EVAR)治疗腹主动脉瘤(AAA)合并冠心病(CHD)患者的临床疗效。方法 选取自2008年12月至2021年10月于北部战区总医院心血管内科行EVAR的51例AAA合并CHD患者为研究对象。收集并记录患者基线资料,围术期及随访情况等。观察随访期间临床事件的发生情况。结果 腹主动脉计算机断层扫描血管造影显示,瘤体最大直径(54.24±12.48)mm,瘤体长度(95.14±20.89)mm,合并附壁血栓21例(41.18%);同台行冠状动脉造影示：单支血管病变19例(37.25%),两支血管病变11例(21.57%),三支血管病变21例(41.18%);合并左主干病变7例(13.73%)。51例患者均成功植入腹主动脉覆膜支架;共14例(27.45%)行经皮冠状动脉介入治疗(PCI),1例同期PCI,13例分期PCI。平均植入冠状动脉支架(1.50±0.65)枚;37例(72.55%)冠心病药物治疗,无冠状动脉旁路搭桥术患者。30天随访结果：全因死亡2例(3.92%),其中1例(1.96%)主动脉源性死亡,1例(1.96%)因出血性脑卒中死亡;新发肾功能衰竭...     

卡托普利对缺氧大鼠心肌血管紧张素Ⅱ含量及右心室肥大的影响

观察了间断性缺氧大鼠血浆与右心室血管紧张素Ⅱ（AugⅡ）含量、右心室超微结构的变化及卡托普利对缺氧性右心室肥大的影响。结果表明，慢性缺氧引起右心室收缩压升高，右心室AugⅡ含量及右心室重量指数增加，心肌线粒体及肌原纤维变性。服用卡托普利后右心室收缩压、右心室重量指数和AugⅡ含量降低，心肌超微结构接近正常。说明AngⅡ在缺氧性右心室肥大发生中起着重要作用。     

葛根素对肾动脉狭窄患者内皮素及血管紧张素Ⅱ影响临床观察

目的：观察葛根素对动脉粥样硬化性肾动脉狭窄（ARAS）患者血浆内皮素（ET）及血管紧张素Ⅱ（AngⅡ）浓度的影响。方法：将动脉粥样硬化性肾动脉狭窄57例随机分为观察组30例，对照组27例。对照组采用常规治疗，观察组在常规治疗基础上加用葛根素，对照组加用丹参注射液，比较两组对ET及AngⅡ浓度的影响。结果：观察组治疗后ET及AngⅡ浓度均有显著下降（P〈0．05，P〈0．01）。结论：葛根素具有降低ET及AngⅡ浓度的作用。     

择期非心血管手术术中失血对凝血功能的影响

目的 观察择期非心血管外科手术患者术中不同程度失血对凝血功能的影响.方法 随机选择拟行非心血管外科手术的患者20例,年龄23～57岁,ASA Ⅰ-Ⅱ级,术前凝血功能无异常.麻醉后在充分镇静、镇痛的基础上,给予37℃预温的林格液和羟乙基淀粉(晶胶比1∶2),维持心率、血压和中心静脉压的稳定.术中监测体温和动脉血气指标以排除低体温和酸中毒可能造成的干扰.监测失血量约占全血容量的10%、15%、20%、25%时患者的血常规、常规凝血功能指标以及Sonoclot分析仪测定的凝血和血小板功能参数.结果 手术前血细胞比容(Hct)为0.381±0.038,失血量10%、15%、20%、25%时下降为0.334±0.030、0.315±0.029、0.301±0.045和0.279±0.031.失血量达到或超过15%时血小板(PLT)计数较术前显著下降(P<0.01),但未超出正常值范围.失血量20%、25%时血浆凝血酶原时间(PT)、活化的部分凝血酶原时间(APTT)明显延长,与术前比较差异有统计学意义(P<0.05).纤维蛋白原定量(Fib)浓度也都明显降低,与术前比较差异有统计学意义(P<0.01).Sonoclot分析提示,失血20%时激活的凝血时间(ACT)、曲线达峰值时间(TP)均延长(P<0.05),失血25%时显著延长(P<0.01);失血15%时血小板功能(PF)下降(P<0.05),失血20%、25%时PF和血块凝结速率(CR)都显著下降(P<0.01).结论 在避免过度应激,最大程度地减少低体温、酸中毒对凝血功能影响的情况下,非心血管外科手术患者术中失血达20%以上者,凝血指标与术前比较均有统计学差异(P<0.05),出血量不足20%可忽略其对凝血功能的影响.Sonoclot分析技术灵敏、可靠,对于早期发现失血造成的凝血功能障碍,从而进行及时、有针对性地干预提供了有力的支持.     

肾水平以下主动脉血栓体积的测量和决定因素

腔内血栓可能是腹主动脉瘤发展过程中的一个影响因素。本研究目的包括评估CT测量主动脉血栓体积技术的重复性以及研究主动脉扩张病人肾水平以下主动脉     

Measurement and determinants of infrarenal aortic thrombus volume

Intra-luminal thrombus has been suggested to play a role in the progression of abdominal aortic aneurysm (AAA). The aims of this study were twofold. Firstly, to assess the reproducibility of a computer tomography (CT)-based technique for measurement of aortic thrombus volume. Secondly, to examine the determinants of infrarenal aortic thrombus volume in a cohort of patients with aortic dilatation. A consecutive series of 75 patients assessed by CT angiography with maximum aortic diameter >/=25 mm were recruited. Intra-luminal thrombus volume was measured by a semi-automated workstation protocol based on a previously defined technique to quantitate aortic calcification. Intra- and inter-observer reproducibility were assessed using correlation coefficients, coefficient of variation and Bland-Altman plots. Infrarenal aortic thrombus volume percentage was related to clinical, anatomical and blood characteristics of the patients using univariate and multivariate tests. Infrarenal aortic thrombus volume was related to the severity of aortic dilatation assessed by total aortic volume (r = 0.87, P < 0.0001) or maximum aortic diameter (r = 0.74, P < 0.0001). We therefore examined the clinical determinates of aortic thrombus expressed as a percentage of total aortic volume. Aortic thrombus percentage was negatively correlated with serum high density lipoprotein (HDL, r = -0.31). By ordinal multiple logistic regression analysis serum HDL below median (相似文献   

严重创伤患者术中大量输血的麻醉管理

目的：探讨创伤患者大量输血的麻醉管理。方法：回顾分析我院1996～2007年收治的33例术中输注RBC≥20U的患者的麻醉管理策略。结果：33例术前1SS评分（34．4±16．1），SOFA评分（13．0±3．1），S1（2．29±0．55），术中采取“目标靶向治疗”策略，采用输血加温、加压装置平均输注RBC（37±15）U，血浆（18±6）U，术毕Hot（24±5）％，体温（34．5±1．2）℃，PLT（42＋28）×10^12／L。术中5例死亡，余28例带管回ICU（术后11例死亡，17例存活）。结论：积极大量的液体复苏以及体温、凝血功能的维护是创伤患者救治的关键。     

卡托普利治疗对海勤人员高血压患者生活质量的影响

目的：探讨卡托普利治疗对海勤人员高血压患者生活质量的影响。方法：对海勤人员Ⅰ、Ⅱ期高血压病77例进行卡托普利治疗前后生活质量变化的评定以及收缩压和舒张压变化的评定,与普奈洛尔组比较。结果：与治疗前比较海勤人员Ⅰ、Ⅱ期高血压病患者经卡托普利组治疗后血压下降了18.2/13.6 mmHg（P〈0.01）;自觉健康状况、情感积极性以及工作状况分值均明显增高（P〈0.01）;心理忧伤分值明显降低（P〈0.01）;性生活分值没有变化。普奈洛尔组治疗后血压下降了17.2/12.6 mmHg（P〈0.01）;其余分值没有变化。结论：卡托普利不仅能有效地降低海勤人员Ⅰ、Ⅱ期高血压病患者的血压水平,而且能提高其生活质量。     

择期手术患者术前焦虑状况及需求的问题调查

手术前帮助患者进行有效的应对,恰当地进行心理调适,保持心理状态的稳定非常重要。本研究以100例择期手术患者为研究对象,通过问卷调查,了解手术患者术前的心理状况及关心问题,以便为患者进行心理护理提供依据。     

Hospital costs for elective endovascular and surgical repairs of infrarenal abdominal aortic aneurysms

PURPOSE: To determine and compare the average in-hospital costs of elective open surgical and endovascular repairs of infrarenal abdominal aortic aneurysms. MATERIALS AND METHODS: Total actual cost data for patients undergoing elective endovascular (n = 181) or open surgical (n = 273) repair of abdominal aortic aneurysms between 1997 and 1999 were retrieved. The mean total hospital cost (including stent-graft costs and excluding attending physician fees) and mean postoperative length of stay were calculated for each treatment group. Costs were expressed in 1999 U.S. dollars. RESULTS: Endovascular repair yielded a shorter postoperative length of stay than did open surgery (mean stay, 3.4 vs 8.0 days; P <.001) and a lower proportion of patients who were admitted to the intensive care unit for 1 full day or longer (2.8% vs 36.3%; P <.001). The mean total hospital cost was significantly higher for endovascular repair than for open surgery ($20,716 vs $18,484; P <.001). CONCLUSION: Hospital costs were higher for endovascular repair than for open surgical repair. However, endovascular repair was associated with a decreased length of stay and fewer intensive care unit admissions. The increased mean hospital cost for endovascular repair was smaller than one would expect, considering the higher costs of endovascular grafts, as compared with those for surgical grafts (approximately $6,400 according to literature data).     

肾动态显像在多囊肾手术前后监测中的临床意义

目的：探讨SPECT对多囊肾诊断价值、对病程发展进行监测,以确定有效的治疗时机,同时可以对疗效进行观察。方法：用常规SPECT肾动态显像检测分肾功能,对58例临床确诊的多囊肾患者术前检测,并对其中的32例I、Ⅱ、Ⅲ期多囊肾患者术后复查,对动态图像、清除曲线、肾小球滤过率（GFR）进行综合分析。结果：多囊肾图像可见多个放射性减低区,曲线可呈多种类型,GFR随疾病程度不同而有不同程度的降低,GFR随病程不同在手术后也有不同的表现。结论：肾动态功能显像对了解分肾功能、了解病情进展、对选择有效的治疗时机与治疗方法有很大的价值。     

Ambulatory arterial blood pressure monitoring in patients before and after thyroidectomy

BACKGROUND/AIM: [corrected] Increased values of thyroid hormones in the clinical syndrome of hyperthyreosis affect blood pres sure values and its circadial variation. The aim of this study was to define the influence of hyperthyreosis on the values and circadial variations of arterial blood pressure, as well as to investigate the effect of thyroid surgery on blood pressure values. METHODS: We compared the 24-hour averages of systolic and diastolic blood pressure, their variations and their reduction during the night between 20 female patients with hyperthyroidism and hypertension de novo and 20 healthy females. We compared the values of 24-hour ambulatory monitoring performed before the surgery with the values gathered two weeks after the surgery. RESULTS: The 24-hour average systolic and diastolic blood pressure values were higher in the patients with hyperthyroidism than in the control group (p < 0.001). In the group of patients, the variations in blood pressure were significantly higher than they were in the group of healthy people (p < 0.001). The amplitude of the nocturnal reduction of blood pressure was also significantly lower in the patients with hyperthyroid status and hypertension, in comparison to the healthy persons (p < 0.001). Two weeks after the surgery, a significant reduction of blood pressure values (both for systolic and diastolic) appeared. CONCLUSION: The patients with hyperthyroidism caused hypertension had higher systolic and dia stolic blood pressure, higher variations in blood pressure and lower nocturnal reduction of blood pressure than healthy subjects. Thyroid surgery, as a control of thyroid function, optimised blood pressure very rapidly.     

MDCT angiography before and after thoracic endovascular aortic repair (TEVAR) in patients with thoracic traumatic aortic injuries

Objective

The objective of this study was to outline the role of multidetector computed tomography angiography (MDCTA) in the evaluation of patients with thoracic traumatic aortic injuries (TTAIs) pre- and post-thoracic endovascular aortic repair (TEVAR)