潘生丁治疗病毒性疾病

随着对潘生丁药理研究的进展,其临床应用日益广泛,本文就潘生丁治疗病毒性疾病给予简述.1、治疗病毒性上呼吸道感染。李氏等用潘生丁治疗该病并与病毒灵比较,治疗组37例,3～5mg/kg·d,分2～3次服,连服3日;对照组33例,用病毒灵10～20mg/kg·d,分2～3次服,连服3日,均不用抗生素。结果治疗组有效率91.9%、对照组有效率51.5%(p<0.01)。刘氏用潘生丁、病毒灵及青霉素治疗上呼吸道感染70例作比较,结果2天内潘     

潘生丁试验与冠状动脉造影对诊断冠心病的对比研究

1991年2～12月我们对13例拟诊冠心病病人以潘生丁0.75mg/kg10分钟内静脉注射,观察注药前后心电图及有无心绞痛症状出现。全部病例均作选择性冠状动脉造影以进一步探讨潘生丁试验(DP—T)用于诊断冠心病的临床意义。结果冠状动脉造影1例为阳性,12例阴性;DP—T3例阳性,10例阴性,假阳性2例。本文试图从冠状动脉造影结果来证实DP—T的可靠性、完全性及其临床应用价值。     

潘生丁超声心动图试验诊断冠心病

选用了确诊的２５例冠心病进行潘生丁超声心动图试验（ＤＥＴ），以新出现节段性室壁运动异常（ＲＷＭＡ）为阳性指标。结果阳性率为６４％。对照组１６例均呈阴性。２例心绞痛患者ＰＴＣＡ前均可见与狭窄血管供血区相当的ＲＷＭＡ，术后５天复查均转为阴性。共２４例受试者出现副作用。大多数较轻，不需治疗自行缓解。但有１例患者诱发广泛心肌缺血并出现室颤，抢救无效死亡。本试验操作简便，特异性强，具有一定的敏感性，可用于不能进行运动试验的患者。但本试验亦非十分安全，故选择试验应从严掌握，试验过程需严密观察及备有急救措施。     

平板运动试验和潘生丁负荷试验对冠心病的诊断价值研究

目的 探讨潘生丁心电图负荷试验在冠心病诊断中的价值，旨在为不能耐受运动试验的特殊人群提供安全有效、简便易行的冠心病辅助诊断方法。方法 共选取临床疑似或确诊的男性冠心病住院患者52例，年龄41-75岁，在1个月内先后进行平板运动试验、潘生丁负荷试验及冠状动脉造影检查并分析比较结果。结果 ①平板运动试验和潘生丁负荷试验诊断冠心病的敏感性、特异性分别为100％，、78．95％和79．31％、65．22％。②当患者冠状动脉病变支数分别为0、1、2、3支时，平板运动试验与潘生丁负荷试验的阳性例数则分别为0、2、10、17例和0、6、10、15例。③在潘生丁负荷试验中，分别将患者的症状、心电图改变及两者相结合作为冠心病阳性诊断标准，其敏感性、特异性则分别为72．41％、65．22％，；65，52％、82．61％；及79．31％、65．22％。结论 潘生丁负荷试验与平板运动试验诊断冠心病的敏感性及特异性基本相同；随着患者冠状动脉病变支数的增多、病情的加重，上述两项负荷试验的阳性例数也相应增加；同时本研究表明潘生丁负荷试验适用于辅助诊断不能耐受运动的冠心病患者。     

潘生丁试验SPECT心肌血流灌注显像诊断冠心病

采用~(99m)Te—MIBI对16例正常人,59例冠心病人进行了潘生丁试验SPECT心肌血流灌注显像。结果证实:结合潘生丁试验可提高静息心肌灌注显像诊断冠心病的灵敏度及发现更多的心肌缺血节段;对可疑OMI的鉴别具有重要的价值。局限性心肌梗塞静息时可表现为缺血,潘生丁试验时可表现为散在“岛状”心肌血流灌注缺损灶。     

动态心电图,潘生丁试验对冠心病诊断价值的探讨

应用动态心电图(DCG)和潘生丁试验(DPT)对50例冠心痛(CHD)进行检查,结果提示DCG诊断CHD的敏感性为60％,特异性为97％,而DPT诊断CHD的敏感性为74％,特异性为97％,两者联合诊断CHD的敏感性为84.44％,特异性和阳性诊断价值达100％。DCG对心肌缺血的程度和发作频率,无痛性心肌缺血发作的监测有着重要意义,两者结合使诊断CHD简便而且较为可靠的方法。     

潘生丁试验82例临床分析

诊断冠心病的潘生丁试验(DET)是一种简单、安全、特异性高的方法。本院自1992年4月～1994年11月,对82例病人作了DET,现作一临床分析。     

潘生丁负荷首次通过法心肌显像诊断冠心病的价值

目的 为了在心肌灌注显像的同时获得心功能参数,提高冠心病诊断的准确率,我们采用首次通过法心肌显像对５１例冠心病患者和健康对照组进行了检查。方法：在负荷高峰时“弹丸”式静脉注射示踪剂,即刻以帧／５０ｍｓ速度连续采集。设立左室感兴趣区,以左室计数最高一帧为舒张末期,计数最低一帧为收缩末期应用计算机相应程序时其间１６帧～２０帧进行处理得出各项心功能参数。结果 潘生丁负荷下对照组ＬＶＥＦ值与冠心病组ＬＶＥ     

超声心动图潘生丁负荷试验诊断冠心病

超声心动图潘生丁负荷试验诊断冠心病与（９９ｍ）ＴＣ—ＭＩＢＩ心肌灌注显像结果对照。结果表明，以节段性室壁运动失调为标准诊断冠心病的敏感性和特异性分别为６８％和１００％。而当其结合多普勒二尖瓣血流参数后（Ｅ／Ａ＜１），敏感性则升至８４％，且特异性无任何降低。该结果与（９９ｍ）ＴＣ—ＭＩＢＩ心肌显像结果十分接近。两者在冠心病的诊断方面显示出良好的一致性。     

多巴酚丁胺多普勒超声心动图负荷试验对冠心病的诊断价值

用多普勒超声心动图观察３３例左室舒张功能正常的冠心病人和３８例正常人静脉滴注多巴酚丁胺前后左室舒张功能各指标的变化。用药后左室舒张功能各指标两组间差异有显著性（Ｐ值＜０．０５），用药前后左室舒张功能各主要指标变化量两组间差异非常显著（Ｐ值＜０．０００１），多巴酚丁胺多普勒超声心动图负荷试验诊断冠心病的敏感性、特异性、准确性分别为：１００％、９７．４％、９８．６％。因此认为该试验是诊断冠心病特异、敏感而安全可行的方法。     

平板运动试验在诊断女性冠状动脉疾病中的临床意义

目的：评价平板运动试验(treadmill exercise testing，TET)在诊断女性冠状动脉疾病(coronary artery disease，CAD)中的应用价值。方法：回顾性分析1995年3月-2002年11月在本院作冠状动脉造影(coronary arteriography,CAG)并同时行TET检查的104例女性患的临床资料。TET检查采用日本国立心血管疾病中心(NCVC)制定的方案，评价指标包括ST段压低程度、运动后3min收缩期血压(SBP)与运动高峰时SBP比值[SBP比(3’)]和是否发生心绞痛(angina pectoris，AP)。结果：单用ST段压低作为诊断指标，其灵敏度为98．2％，特异度为4．2％；ST段压低结合SBP比(3’)时，其灵敏度为83．9％，特异度为89．6％；ST段压低结合AP作为诊断指标，其灵敏度为89．3％．特异度为95．8％。结论：ST段压低与SBP比(3')及AP的综合评估可提高TET对女性CAD的临床诊断的准确性。     

Chronic Coronary Artery Disease: Diagnosis and Management

Coronary artery disease (CAD) is the single most common cause of death in the developed world, responsible for about 1 in every 5 deaths. The morbidity, mortality, and socioeconomic importance of this disease make timely accurate diagnosis and cost-effective management of CAD of the utmost importance. This comprehensive review of the literature highlights key elements in the diagnosis, risk stratification, and management strategies of patients with chronic CAD. Relevant articles were identified by searching the PubMed database for the following terms: chronic coronary artery disease or stable angina. Novel imaging modalities, pharmacological treatment, and invasive (percutaneous and surgical) interventions have revolutionized the current treatment of patients with chronic CAD. Medical treatment remains the cornerstone of management, but revascularization continues to play an important role. In the current economic climate and with health care reform very much on the horizon, the issue of appropriate use of revascularization is important, and the indications for revascularization, in addition to the relative benefits and risks of a percutaneous vs a surgical approach, are discussed.BMS = bare metal stent; CABG = coronary artery bypass grafting; CAD = coronary artery disease; CCS = Canadian Cardiovascular Society; CT = computed tomography; DES = drug-eluting stent; FFR = fractional flow reserve; LAD = left anterior descending artery; LBBB = left bundle branch block; LV = left ventricular; MI = myocardial infarction; MRI = magnetic resonance imaging; OMT = optimal medical therapy; PCI = percutaneous coronary intervention; SYNTAX = Synergy Between PCI With TAXUS and Cardiac SurgeryChronic coronary artery disease (CAD) is estimated to affect 16.8 million people in the United States; of these, 9.8 million have angina pectoris, and nearly 8 million have had a myocardial infarction (MI).¹ In 2005, CAD was the single most frequent cause of death in American men and women, causing 607,000 deaths (about 1 in every 5 deaths).¹ In 2006, 1.76 million patients were discharged from US hospitals with a diagnosis of CAD. The estimated direct and indirect economic cost of CAD in the United States for 2009 is $165.4 billion.¹ Worldwide, cardiovascular disease is becoming pandemic as developing countries experience the epidemiologic transition described by Omran from pestilence and famine to receding pandemics and degenerative diseases.² In 2002, out of 57 million deaths worldwide, approximately 16.7 million were due to cardiovascular disease (as compared with approximately 5 million due to tuberculosis, human immunodeficiency virus, and malaria combined), and 80% of these cardiovascular deaths were in the developing world.³ Coronary artery disease (including acute MI) is responsible for about half of these cardiovascular deaths.⁴ Mortality from cardiovascular disease is predicted to reach 23.4 million in 2030. Moreover, in the developing world, cardiovascular disease tends to affect people at a younger age and thus could negatively affect the workforce and economic productivity.⁵ The morbidity, mortality, and socioeconomic importance of CAD make its diagnosis and management fundamental for all practicing physicians.The article provides a state-of-the-art review of the literature on chronic CAD for interested physicians; appropriate articles were identified by searching the PubMed database for the following terms: chronic coronary artery disease or stable angina. This article highlights key points in diagnosis and risk stratification and delineates evidence-based management strategies for patients with chronic CAD, with particular emphasis on the indications for revascularization and the preferred method for each patient.     

超声心动图对川崎病冠状动脉病变的诊断

目的方法结果（35．5％），结论评价超声心动图对川崎病造成的冠状动脉病变的诊断价值。利用彩色多普勒超声心动图技术检测川崎病患者冠状动脉的开口、内径、近段走行及其血流特点。本组109例患者，合并冠状动脉病变者31例（28．4％），其中左冠状动脉病变18例（58．1％），右冠状动脉病变11例左、右冠状动脉病变2例（6．5％）。治疗后，27例（87．1％）冠脉扩张者恢复正常。多普勒超声心动图技术可以比较准确地诊断川崎病患者的冠状动脉病变，但对远端损害的检出有一定的困难。     

维持性血透患者冠心病的诊断

近年来 ,各种心、脑血管事件成为维持性血透患者的主要死因。 1998年来自ＵＳＲＤＳ(ＵｎｉｔｅｄＳｔａｔｅｓＲｅｎａｌＤａｔａＳｙｓ ｔｅｍ)的数据显示 :透析患者的 5年存活率为 2 9.3% ,其中将近一半的死因为心血管疾病。在 2 0～ 44岁、45～ 6 4岁、6 5岁以上 3个年龄组 ,急性心肌梗死分别占死因的 7%、11%和 10 %。糖尿病患者的预后更差 ,2 7%患者在透析开始后1年内死亡 ,其中 45～ 6 4岁年龄组死因的 12 %是心肌梗死[1] 。早期发现维持性血透患者中存在的冠心病 (ＣＡＤ) ,有助于通过早期干预减少并发症的发生 ,提高患者对血透的耐…     

多层螺旋CT冠状动脉成像对冠状动脉病变的诊断价值

目的探讨多层螺旋CT(MSCT)冠状动脉成像诊断冠状动脉病变的价值。方法选择2007年3月～2009年2月我科住院疑似和确诊的冠心病70例,首先行MSCT检查,1个月内行冠状动脉造影(CAG)检查,对MSCT与CAG结果结果进行比较。结果 9例CAG正常,双支病变26例,单支病变18例,三支病变17例。MSCT示40例存在钙沉积。3例MSCT示冠状动脉旁路移植桥血管闭塞,与CAG结果符合;1例MSCT示支架内闭塞,CAG示血管内膜增生。以CAG结果为金标准,MSCT检测冠状动脉明显狭窄灵敏度84.67%,特异度94.57%,阳性预测值78.38%,阴性预测值96.37%,诊断符合率92.70%,MSCT和CAG诊断冠状动脉节段明显狭窄差异无统计学意义(P>0.05)。结论 MSCT冠状动脉成像可作为冠状动脉病变的初步诊断手段。     

Coronary Artery Disease

In the past 20 years or more the death rate from acute myocardial infarction has remained at 30 to 40 per cent in most large hospitals. It is obvious from reports now coming out in the literature that many progressive centers are decreasing their mortality rate primarily by saving the heart that is a good pump, that has a good myocardium, by preventing arrythmias and hence preventing cardiac arrest — a purely electrical abnormality. The resulting decrease in mortality rate is about one-third, or somewhat better. If we are to offer good coronary care in the future we should be working towards monitoring patients in medium and perhaps even smaller hospitals (wherever myocardial infarction patients are admitted), and lowering the death rate from myocardial infarction as a result.