VENTRICUAL ECTOPY IN PATIENTS WITH HYPERTENSIVE LEFT VENTRICULAR HYPERTOPHY

ＶＥＮＴＲＩＣＵＡＬＥＣＴＯＰＹＩＮＰＡＴＩＥＮＴＳＷＩＴＨＨＹＰＥＲＴＥＮＳＩＶＥＬＥＦＴＶＥＮＴＲＩＣＵＬＡＲＨＹＰＥＲＴＯＰＨＹＤｈａｉｆａｌｌａｈ（缀福）；ＧｏｎｇＬａｎｓｈｅｎｇ（龚兰生）；ＺｈａｎｇＷｅｉｚｈｏｎｇ（张维忠）；ＹａｎｇＬｉ...     

ASSESSMENT OF CORONARY FLOW RESERVE IN PATIENTS WITH ANGINA PECTORIS

ＡＳＳＥＳＳＭＥＮＴＯＦＣＯＲＯＮＡＲＹＦＬＯＷＲＥＳＥＲＶＥＩＮＰＡＴＩＥＮＴＳＷＩＴＨＡＮＧＩＮＡＰＥＣＴＯＲＩＳＳｈｅｎｇＷｅｉｆｅｎｇ（沈卫峰）；ＣａｉＸｕ（蔡煦）；ＺｈａｎｇＤａｄｏｎｇ（张大东）；ＺｈａｎｇＸｉａｎ（张宪）；ＺｈｅｎｇＡｉ...     

EFFECT OF SHENG MAI SAN ON LEFT VENTRICULAR PERFORMANCE IN CORONARY HEART DISEASE

The present study aims at ascertaining thenature of Xin Qi Xu (XQX,deficiency of Heart-Qi) and the effect of the drug Sheng Mai San 生脉散(SMS) on heart performance,using systolicand diastolic time intervals as criteria in CHDassociated with XQX patients.The results ascompared with normal subjects showed increa-ses in QA_2,PEP,ICT,IRP,SFP,RFP,a/H%,PEP/LVET and SFP/RFP and a reduction ofLVET,suggesting that the patients have a la-tent cardiac insufficiency possibly relating tothe nature of XQX.The changes in systolic anddiastolic time intervals after intravenous ShengMai San were prolongation of MST and LVET,shortening of PEP and PEP/LVET,and slowingof heart rate.These changes are statisticallysignificant (P<0.05-0.001).The blood pressurewas not significantly changed.These changesand their degree suggest a positive inotropic ac-tion on myocardium and a reduction of myo-cardial oxygen consumption by Sheng Mat San.Its effects compared with Cedilanid-D showedthat the action of both drugs on systolic anddiastolic time intervals was similar.We ten-tatively suggest,therefore,that the inotropicaction of SMS simulates that of digitalis glycosi-des.Further studies are needed to determinewhether SMS affects the heart in the same wayas digitalis glycosides,for current work indica-tes that SMS may have other effects on theheart.     

CHANGES OF SERUM TYROSINE IN YIN-DEFICIENT PATIENTS WITH CORONARY HEART DISEASE

The mean serum tyrosine concentrationswere 1.14 mg/dl for normal control group(17cases)and 1.43 for patients with coronary heartdisease(CHD)(67 cases),a significantly higherfigure in the latter.No significant differencewas found between male and female patients.Averages of the serum tyrosine levels of Yin-deficient(43 cases)and Yang-deficient(24 cases)groups were 1.50 and 1.29 mg/dl respectively.The differences were statistically significantbetween the two deficiency groups and betweenthe Yin-deficient and normal control groups.The values of male or female Yang-deficientpatients were not however significantly differentfrom the normal.We considered the increaseof serum tyrosine level in CHD patients possiblyto be one of the important pathologic biochemi-cal changes of Yin-deficiency.We found nosuch relationship between the tyrosine level andthe CHD as reported by some foreign investiga-tors.     

STUDIES ON ERYTHROCYTE INSULIN RECEPTOR IN PATIENTS WITH CORONARY HEART DISEASE

Erythrocyte insulin binding studies were performed in 30 patients with coronary heart disease (CHD) and 29 healthy subjects. The results showed that the patients with CHD had decreased concentration of insulin receptors on erythrocytes as compared with the controls, 111.3±25.1 versus 198.6±24.9 sites/RBC, and increased receptor affinity resulting in insulin binding (B/T) within normal value. These findings may explain the phenomenon found by a number of researchers that a decreased glucose tolerance and an elevated insulin response to oral glucose are present in patients with CHD. Furthermore, the relationship of plasma lipids to serum insulin and insulin receptor was examined. Among the controls, the influence of sex and age on insulin receptor was also evaluated. A hypothesis about the pathogenesis of atherosclerosis was suggested from the results of the present studies.     

THE EFFECTS OF MASSAGE ON THE LEFT HEART FUNCTIONS IN PATIENTS OF CORONARY HEART DISEASE

Since 1987 the authors have treatedcoronary heart disease with massage andobserved its effects on the clinical manifesta-tions, left heart functions,electrocardiograms, blood pressure andblood lipids, as reported in the following.GENERAL DATA50 cases of coronary heart disease were     

COMPARATIVE OBSERVATION ON EFFECT OF ELECTRIC ACUPUNCTURE OF NEIGUAN (P 6) AT CHEN TIME VERSUS XU TIME ON LEFT VENTRICULAR FUNCTION IN PATIENTS WITH CORONARY HEART DISEASE

Paired experimental design was adopted in this experiment for comparative observation on effect of electric acupuncture (EA) of Neiguan (P 6) at Chen Time (7 a.m. to 9 a.m.) versus Xu Time (7 p.m. to 9 a.m.) on left ventricular function in patients with coronary heart dis-ease (CHD). The results show that EA performed at Chen Time could improve the left ventricular function of CHD patients as indicated by shortening of PEPI and decrease of PEPI/LVETI ratio; on the contrary, EA performed at Xu Time prolonged PEPI and raised PEPI/LVETI ratio in CHD patients, suggesting impairment of left ventricular function.     

COMPARATIVE STUDY ON THE MECHANISM OF FORMATION OF PULSE MANIFESTATIONS IN CORONARY HEART DISEASE AND HEMATOPATHIC PATIENTS

Most patients suffering from coronary heart disease have string-like pulse due mainly to disorder of cardiac function, lowered arterial compliance and increased total peripheral resistance. The common type of pulse in hematopathy patients is rapid, thready, string-like and slippery, due mainly to increased compensatory pumping action of heart, shortening of ejection time of left ventricle, relatively better vessel compliance and blood rheology as well as low total peripheral resistance.     

ABNORMAL CORONARY FLOW RESERVE IN PATIENTS WITH LEET VENTRICULAR HYPERTROPHY DUE TO HYPERTENSION

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经食管超声技术评价左室心肌肥厚患者冠脉血流储备功能

应用多平面经食管多普勒超声心动图(TEE)潘生丁负荷试验,探讨左室心肌肥厚患者的冠脉循环特点及血流储备(CFR)功能。方法53例受试者分为A组(对照组)、B组(冠心病组)、C组(左室心肌肥厚组)。应用TEE测定冠脉前降支血流参数,以基础状态(R)和潘生丁负荷后(D)冠脉舒张期最大流速比值(D／R PDV)为CFR的指标。结果B组和c组与A组比较,D／R PDV明显减低[(1.55土0.43)cm／s vs(3.43±0.71)cm／s P     

高血压病合并左室肥厚的临床意义

目的探讨左室肥厚对高血压病人预后的影响。资料和方法对７７例高血压病并左室肥厚的患者和１３１例高血压病无左室肥厚的患者进行急性心、脑血管事件发生情况的比较。结果左室肥厚组心肌缺血、心律失常、心衰、心肌梗塞及脑卒中发生率明显增高（Ｐ＜０．０５、０．０１）。结论左室肥厚是心、脑血管疾病的危险因素，应尽早防治。     

B/M型超声心动图评定冠心病左室功能的临床价值

作者运用B/M型超声心动图在成人心脏形态观察以及各心腔内径测量研究基础上,提出了在二维超声显像(B型)引导下,用M型对左室功能进行测定的技术。通过对50例冠心病患者和62例正常成人左室功能进行对比分析,认为B/M型超声心动图测定左室功能的8个参数,对评定冠心病患者左室功能具有敏感性高、重复性好等优点,对临床有一定的实用价值。     

左室肥厚的高血压病患者的室性心律失常

对44例男性高血压病患者进行心电图、超声心动图、动态心电图检查,发现超声心动图对高血压左室肥厚的敏感性比心电图高。全部病例进行24小时连续动态心电医监测结果表明,超声心功图有左室肥厚者严重室性心律失常的发生率比无左室肥厚者显著增多(P<0.01)。     

Heather指数对冠心病左心室收缩功能的评定价值

应用心阻抗微分图的Heather指数(H1),评定冠心病、可疑冠心病及健康人(每组各60例)的左心室收缩功能。将三组中的HI值与射血前时间(PEP)、射血时间(LVET)、PEP/LVET、每搏输出量(SV)、每分输出量(CO)、心脏指数(CI)作了分析比较。结果表明:三组间的HI值差异有非常显著意义(P<0.01),与心排血功能有良好的相关性,比STI敏感。认为HI值可作为评定冠心病左心室收缩功能较敏感的指标。     

无心肌梗死冠心病患者心功能变化与室性心律失常的关系

目的：探讨冠心病心力衰竭对各种室性心律失常的影响。方法：选择381例冠心病住院患者，根据心功能分级标准（NYHA）分为4组，检测24h动态心电图（Holter），分析室性心律失常类型及发生率，进行统计分析。结果：各级心功能组其室性心律失常发生率经x^2检验示，室性心律失常的发生率除联律和持续性或非持续性室性心动过速外各组间差异无显著性（P＞0．05）。结论：非心肌梗死冠心病患者室性心律失常发作频率与心力衰竭的程度无关，但联律和持续或非持续性室性心动过速在重度心力衰竭患者发生率增加。     

应用组织多普勒成像技术评价冠心病病人左心室长轴功能的变化

目的应用组织多普勒成像(TDI)技术测定冠心病病人左心室长轴功能,并探讨其临床应用价值。方法选择在我院接受治疗的冠心病病人48例,应用TDI技术获得二尖瓣环沿左心室长轴的运动频谱,测量收缩期心肌峰值运动速度(SM)、收缩期位移(DS)及收缩前期时间(PCTM),舒张早期心肌峰值运动速度(EM),心房收缩期心肌峰值运动速度(AM),计算EM/AM比值及左心室射血分数(EF)。结果冠心病组与正常对照组比较,SM和DS显著减小(t=2.78、9.61,P<0.01);PCTM显著增加(t=2.49,P<0.05);EM显著减小(t=5.45,P<0.01);EM/AM比值显著减小(t=4.94,P<0.01);冠心病病人SM和DS与EF、EM呈明显正相关(r=0.58~0.72,P<0.01)。结论冠心病病人存在左心室长轴功能受损,TDI技术为准确评价左心室长轴功能提供了一条新途径。     

氯沙坦与氨氯地平治疗高血压病左室肥厚的临床对比研究

目的 以氨氯地平作对照,研究新型降压药物－血管紧张素受体拮抗剂氯沙坦治疗高血压病左室肥厚的临床疗效。方法 ４１例老年高血压病左室肥厚患者随机分为氯沙坦组２１例和氨氯地平组２０例,分别给予氯沙坦和氨氯地平口服,疗程结束前后行２４ｈ动态血压监测和心脏超声检查。结果 两组２４ｈ动态血压监测指标和心脏超声检查指标用药后均较用药前有显著下降（Ｐ〈０．０１）;两组治疗后各项指标相比无显著差异（Ｐ〉０．０５）。