阻塞性睡眠呼吸暂停综合征对肥胖病人肺功能的影响分析

目的 探讨阻塞性睡眠呼吸暂停综合征(obtructive sleep apnea,OSAHS)对肥胖病人肺功能的影响。方法 选取2018年9月至2022年4月徐州医科大学附属医院睡眠中心就诊的160例肥胖病人,行多导睡眠监测(polysomnography,PSG)、肺功能检查及血液相关化验,依据呼吸暂停低通气指数(apnea hypopnea index,AHI)分为四组：单纯肥胖组(33例)、肥胖合并轻度OSAHS组(31例)、肥胖合并中度OSAHS组(32例)、肥胖合并重度OSAHS组(64例),分析年龄、身体质量指数(BMI)、Epworth嗜睡量表(epworthsleepiness scale,ESS)、AHI、平均血氧饱和度(MSaO₂)、最低血氧饱和度(LSaO₂)、最长呼吸暂停时间(LAT)、各项肺功能指标。结果 与单纯肥胖组相比,肥胖合并重度OSAHS组肺总量(TLC)[(82.27±13.89)L比(91.30±8.94)L]、重度组肺活量、用力肺活量(FVC)、补呼气容积(ERV)显著减低(P<0.05)。校正B...     

冠状动脉狭窄对应左室心肌纵向运动速度的定量研究

目的 探讨定量组织速度成像(QTVI)技术与冠状动脉狭窄程度之间局部心肌运动速度变化的定量关系.方法 应用定量组织速度成像技术对31例冠状动脉造影证实的冠状动脉狭窄患者(狭窄组)和21例正常人(对照组)左室心肌的12个节段测量QTVI曲线的收缩期峰值速度(Vs)、舒张早期峰值速度(Ve)和舒张晚期峰值速度(Va).结果 Vs、Ve在左室基底段和中间段与正常组比较均具有显著性差异(P＜0.01或P＜0.05),Va则无统计学意义.轻、中、重度狭窄组之间各指标相比均无显著性差异(P＞0.05).结论 定量组织速度成像的Vs和Ve能较准确地检出冠心患者静息状态下的异常心肌节段,但对区分冠状动脉的狭窄程度似无显著作用.     

高血压合并阻塞性睡眠呼吸暂停综合征患者的动脉硬化程度比较

目的 比较高血压病3级合并不同程度阻塞型睡眠呼吸暂停低通气综合征（OSAHS）患者的动脉粥样硬化及炎症水平。方法 选择2013年8月至2016年8月在安徽医科大学第三附属医院治疗的高血压3级患者169例,依据呼吸暂停低通气指数（AHI）分为对照组（无OSAHS）、轻度OSAHS组（AHI为5～14）、中度OSAHS组（AHI为15～30）和重度OSAHS组（AHI>30）,比较分析患者总胆固醇、高密度脂蛋白和动脉粥样硬化指数（AI）、超敏C反应蛋白（hs-CRP）、颈动脉内中膜厚度（IMT）及踝肱指数（ABI）。结果 4组患者的IMT、hs-CRP、AI及ABI差异有统计学意义（P<0.05）,但对照组与轻度OSAHS组的IMT、hs-CRP、ABI及AI差异无统计学意义（P>0.05）,而中度、重度OSAHS组的IMT、hs-CRP、AI较对照组明显升高,ABI明显下降,差异有统计学意义（P<0.05）。结论 高血压病3级合并OSAHS,随着睡眠呼吸暂停低通气程度的加重,其动脉粥样硬化及炎症水平的指标明显升高。     

超声心动图评价心肌梗死后的右心室功能

目的研究急性心肌梗死(AMI)后右心室功能,共40例.方法在二维切面心尖四腔图上用脉冲多普勒组织成像技术(PW-DTI),在右室游离壁测量三尖瓣环的运动,同时用M型曲线记录三尖瓣环运动.结果下壁、前壁心肌梗死(MI)后三尖瓣环收缩期峰值速度与对照组相比下降(12.0 vs 16.3 cm/s,P＜0.01;14.5 vs 16.3cm/s,P＜0.05).下壁MI后三尖瓣环运动幅度比对照组下降(19.4 vs 24 mm,P＜0.01).下壁合并右心室梗死者三尖瓣环峰值速度下降(P＜0.01),舒张早期速度下降(P＜0.01或P＜0.05),三尖瓣环运动幅度下降(P＜0.01).结论分析三尖瓣环运动和速度可评价下壁心肌梗死后的右心室功能.     

多普勒组织成像和脉冲多普勒技术在评价高血压病患者左心室舒张功能中的应用

目的探讨多普勒组织成像和脉冲多普勒技术在评估原发性高血压病患者左心室舒张功能的应用价值。方法选取高血压病患者58例作为应用多普勒组织成像（DTI）及脉冲多普勒（PWD）技术检测2组二尖瓣环舒张期运动速度（Ve、Va）及二尖瓣口血流频谱,并进行对比研究。结果舒张早期血流速度（E）及E/A（舒张晚期血流速度）比值小于对照组,差异均有统计学意义（P〈0.05）。舒张早期峰值速度（Ve）及Ve/Va（舒张晚期峰值速度）比较,高血压组均小于对照组,差异均有统计学意义（P〈0.05）;且与二尖瓣血流频谱E/A比值高度成正相关,对照组与高血压组r值分别为0.81和0.74。结论高血压患者在发生左心室肥厚前已有心室舒张功能异常;DTI技术与PWD技术结合,可以为评估左室舒张功能提供更客观的诊断依据。     

参龙宁心胶囊联合索他洛尔治疗室性早搏的临床研究

目的 探讨参龙宁心胶囊联合盐酸索他洛尔片治疗室性早搏的临床疗效。方法 选取2018年8月—2021年4月在郑州市中心医院就诊的108例室性早搏患者,按照随机数字表法将全部患者分为对照组和治疗组,每组各54例。对照组口服盐酸索他洛尔片,80 mg/次,1次/d。治疗组在对照组治疗的基础上口服参龙宁心胶囊,2.0 g/次,3次/d。两组患者连续治疗3个月。观察两组的临床疗效,比较心电图指标、心功能指标和血清指标。结果 治疗后,治疗组总有效率92.59%高于对照组总有效率77.78%(P<0.05)。治疗后,两组的QT离散度、Tp-e间期、室早总数均显著降低（P<0.05）;治疗组的QT离散度、Tp-e间期、室早总数低于对照组,差异有统计学意义（P<0.05）。治疗后,两组的左室射血分数（LVEF）显著升高,左心室收缩末内径（LVESD）、左心房内径（LAD）显著降低（P<0.05）;治疗后治疗组的LVEF高于对照组,LVESD、LAD低于对照组,差异有统计学意义（P<0.05）。治疗后,两组的N前端脑钠肽（NT-pro BNP）、抗心磷脂抗体（ACA）水平显著...     

Elevated plasma Pim‐1 and its clinical significance in patients with pulmonary arterial hypertension

This study was aimed to determine plasma Pim‐1 levels in patients with pulmonary arterial hypertension (PAH) and to estimate the clinical value of Pim‐1 as a biomarker of PAH. This was a single‐centre retrospective study in 111 patients with congenital heart disease (CHD) and idiopathic PAH (IPAH). Those CHD patients were divided into two groups: PAH associated with CHD (PAH‐CHD) and CHD without PAH (nPAH‐CHD). Plasma Pim‐1 levels were measured by enzyme‐linked immunosorbent assay. (a) Plasma Pim‐1 levels were significantly increased in patients with PAH‐CHD and IPAH compared with the healthy control group (27.81 ± 11.34 ng/mL vs 13.02 ± 5.30 ng/mL; 32.81 ± 12.28 ng/mL vs 13.02 ± 5.30 ng/mL, P < 0.05) and nPAH‐CHD (27.81 ± 11.34 ng/mL vs 17.33 ± 7.99 ng/mL; 32.81 ± 12.28 ng/mL vs 17.33 ± 7.99 ng/mL, P < 0.05). Pim‐1 levels were substantially increased in patients with severe PAH‐CHD compared with mild‐to‐moderate PAH‐CHD (19.12 ± 6.70 ng/mL vs 8.54 ± 3.71 ng/mL, P < 0.05). (b) Pim‐1 levels were correlated positively with the mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) (r = 0.582, 0.516; P < 0.001, respectively), while negatively with tricuspid annular plane systolic excursion (TAPSE), tricuspid annular plane systolic velocity (S’) and right ventricular fractional area changes (RVFAC) (r = ?0.375, ?0.354, ?0.507; P < 0.05, respectively). (c) PAH‐CHD and severe PAH‐CHD was identified by plasma Pim‐1 with a cutoff value of 16.8 ng/mL (P < 0.001) with a sensitivity of 87.3% and a specificity of 65%, and a cutoff value of 20.53 ng/mL (P < 0.001) with a sensitivity of 87.3% and a specificity of 52%, respectively. Plasma Pim‐1 levels were significantly higher in patients with PAH‐CHD and IPAH. Plasma Pim‐1 may represent an effectively biomarker in patients with PAH.     

OSAHS患者运动心肺功能及肾功能与病情严重程度关系

目的 研究OSAHS患者运动心肺功能及肾功能与病情严重程度关系.方法 回顾性分析2016年1月～2019年12月共收治的OSAHS患者80例作为研究对象,并将OSAHS患者睡眠呼吸暂停低通气指数(AHI)进行分组将AHI≥30次/h的患者分为重度组,共42例;将15≤AHI<30次/h分为中度组,共26例;5≤AHI<...     

亚临床甲状腺功能减退与甲状腺功能减退患者心脏结构及功能的改变

目的 观察亚临床甲状腺功能减退（SCH）和甲状腺功能减退（甲减）患者的超声心动图,分析其心脏结构与功能的改变。方法 选取2011年3月至2017年3月北京朝阳医院收治的58例SCH患者为SCH组,21例甲减患者为甲减组,选择同期甲状腺功能正常的健康体检者65例为对照组进行回顾性研究。比较3组对象超声心动图参数如左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）、左室射血分数、主动脉窦内径等的变化,并分析甲状腺功能状态对3组研究对象心脏结构与功能的影响。结果 对照组、SCH组及甲减组患者的LVEDD分别为（47.69±4.13）、（45.33±4.45）和（42.81±4.26）mm,3组差异有统计学意义（P<0.05）。对照组、SCH组及甲减组患者的LVESD分别为（29.69±3.34）、（27.45±4.16）和（26.48±3.89）mm,3组差异有统计学意义（P<0.05）。结论 SCH患者与甲状腺功能减退患者的LVEDD和LVESD减小,左心室功能降低。     

右心室间隔部起搏对心功能影响的临床研究

目的 比较右室间隔（RVS）和右室心尖（RVA）起搏对心功能的影响。方法 选择天长市人民医2014年7月至2015年11月收治的需要置入永久起搏器的患者54例,随机分A组（RVS起搏,26例）和B组（RVA起搏,28例）,比较两组患者的起博参数、术后1个月、3月和6月心功能指标和NT-proBNP差异。结果 两组患者起博参数差异无统计学意义（P>0.05）。A组术后3个月和6个月的QRS时限和左室舒张末期内径低于B组,而左室射血分数高于B组,差异有统计学意义（P<0.05）。两组术后1周、1个月、3个月和6个月的NT-proBNP差异无统计学意义（P>0.05）。结论 与RVA起博相比,RVS起博能够改善患者的左室功能和重构。     

Transgenerational left ventricular hypertrophy and hypertension in offspring after uteroplacental insufficiency in male rats

Epidemiological studies have shown an association between low birthweight and adult disease development with transmission to subsequent generations. The aim of the present study was to examine the effect of intrauterine growth restriction in rats, induced by uteroplacental insufficiency, on cardiac structure, number, size, nuclearity, and adult blood pressure in first (F1) and second (F2) generation male offspring. Uteroplacental insufficiency or sham surgery was induced in F0 Wistar‐Kyoto pregnant rats in late gestation giving rise to F1 restricted and control offspring, respectively. F1 control and restricted females were mated with normal males, resulting in F2 control and restricted offspring, respectively. F1 restricted male offspring were significantly lighter at birth (P < 0.05), but there were no differences in birthweight of F2 offspring. Left ventricular weights and volumes were significantly increased (P < 0.05) in F1 and F2 restricted offspring at day 35. Left ventricular cardiomyocyte number was not different in F1 and F2 restricted offspring. At 6 months‐of‐age, F1 and F2 restricted offspring had elevated blood pressure (8–15 mmHg, P < 0.05). Our findings demonstrate the emergence of left ventricular hypertrophy and hypertension, with no change in cardiomyocyte number, in F1 restricted male offspring, and this was transmitted to the F2 offspring. The findings support transgenerational programming effects.     

芪参益气滴丸联合尿激酶对心肌梗死患者血脂水平和左心室功能的影响

目的 研究芪参益气滴丸联合尿激酶对心肌梗死患者血脂水平和左心室功能的影响。方法 选择2015年1月—2017年12月新疆生产建设兵团第六师医院收治的120例心肌梗死患者,随机分为两组。对照组单纯静脉滴注尿激酶,观察组联合餐后服用芪参益气滴丸。两组均治疗8周。比较两组的血脂水平、左心室功能和预后情况。结果 观察组的有效率明显高于对照组,差异有统计学意义（P<0.05）。两组治疗后的三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）和总胆固醇（TC）水平均明显降低,高密度脂蛋白胆固醇（HDL-C）水平明显升高,同组治疗前后比较差异均有统计学意义（P<0.05）;且观察组血脂改善更为明显,组间差异有统计学意义（P<0.05）。两组的左心室射血分数（LVEF）、左心室舒张末期内径（LVDs）、左心室后壁厚度（LVPWT）均较治疗前明显改善,同组治疗前后比较差异有统计学意义（P<0.05）;且观察组更为明显,组间差异有统计学意义（P<0.05）。观察组的再梗死、心源性休克、心律失常和心绞痛发生率均明显低于对照组,差异有统计学意义（P<0.05）。结论 芪参益气滴丸联合尿激酶有助于提高心肌梗死患者的治疗效果,改善血脂水平、左心室功能和预后情况,值得应用推广。     

左西孟旦联合美托洛尔对老年慢性心力衰竭患者心功能、N端脑钠肽前体和心室重构的影响

目的 研究左西孟旦联合美托洛尔对老年慢性心力衰竭患者心功能、N端脑钠肽前体水平和心室重构的影响。方法 选取2015年1月-2017年12月新疆兵团第一师医院诊治的老年慢性心力衰竭患者81例,按治疗方法分为对照组41例、观察组40例。对照组口服美托洛尔片治疗,观察组联合给予左西孟旦注射液治疗。比较两组的治疗有效率,心功能指标以及N端脑钠肽前体水平。结果 观察组老年慢性心力衰竭患者的总有效率为92.50%,明显高于对照组的75.61%,差异有统计学意义（P<0.05）。治疗后两组患者的左心室射血分数、左心室舒张末期内径、左心室后壁厚度均显著改善,同组治疗前后比较差异有统计学意义（P<0.05）;且观察组更明显,组间比较差异有统计学意义（P<0.05）。两组治疗后的N端脑钠肽前体水平均明显降低,同组治疗前后比较差异有统计学意义（P<0.05）;且观察组更为明显,组间比较差异有统计学意义（P<0.05）。结论 左西孟旦联合美托洛尔可以有效改善老年慢性心力衰竭患者的心功能,降低N端脑钠肽前体水平,抑制心室重构,且具有较高的安全性。     

参松养心胶囊联合维拉帕米治疗室性心动过速的疗效观察

目的研究参松养心胶囊联合盐酸维拉帕米缓释片治疗室性心动过速的临床疗效。方法选取2016年8月—2017年7月荆州市第二人民医院接收的120例室性心动过速患者作为研究对象,将所有患者随机分为对照组和治疗组,每组各60例。对照组患者清晨口服盐酸维拉帕米缓释片,1片/次,1次/d。治疗组在对照组的基础上口服参松养心胶囊,3粒/次,3次/d。两组均持续治疗4周。观察两组患者的临床疗效,比较两组治疗前后的心率、PR间期、QT间期、复律时间和左心室功能。结果治疗后,对照组和治疗组的总有效率分别为88.33%、93.33%,两组比较差异具有统计学意义(P0.05)。治疗后,两组心率、QT间期、PR间期和复律时间均显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组各指标均显著低于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组左心室射血分数(LVEF)明显升高,左心室收缩末期内径(LVESD)和左心室舒张末期内径(LVEDD)均显著降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组左心室功能明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论参松养心胶囊联合盐酸维拉帕米缓释片治疗室性心动过速具有较好的疗效,能够显著改善患者心率和心功能,安全性较好,值得临床推广应用。     

Circulating CD36 and fractalkine levels are associated with vulnerable plaque progression in patients with unstable angina pectoris

The chemokine, fractalkine, independently enhances the vulnerability of coronary atherosclerotic plaques. The present study investigated the combined effects of CD36 and fractalkine on coronary plaque progression in patients with unstable angina pectoris. In the present study, 120 unstable angina pectoris patients undergoing coronary angiography and intravascular ultrasound were divided into two groups: an intermediate lesion group (lumen diameter stenosis 50–70%, 80 patients) and a severe lesion group (at least one lesion with lumen diameter stenosis > 70%, 40 patients). The control group consisted of 40 healthy age‐ and sex‐matched subjects. Concentrations of CD36 and fractalkine were measured by enzyme‐linked immunosorbent assay. Major adverse cardiovascular events were monitored over a 2‐year follow up. Intravascular ultrasound showed that patients with severe lesions had more calcified and mixed plaques, and a larger plaque area and plaque burden than patients with intermediate lesions (P < 0.05–0.01). More patients with severe lesions underwent stent deployment (P < 0.05) than those with intermediate lesions. CD36 and fractalkine concentrations were significantly higher in the severe lesion patients (P < 0.05), and both had significant positive correlations (P < 0.05) with the plaque burden of atherosclerotic lesions. Using the matched nested case–control study, we found that CD36 and fractalkine levels were higher in patients with recurrent major adverse cardiovascular events than controls (P < 0.05). In conclusion, CD36 and fractalkine both promote, and might synergistically enhance, the progression of coronary atherosclerotic plaques.     

益心酮软胶囊联合硝苯地平控释片治疗冠心病心绞痛的疗效观察

目的研究益心酮软胶囊联合硝苯地平控释片治疗冠心病心绞痛的临床疗效。方法选取2012年6月—2017年6月天津市第三中心医院分院收治的冠心病心绞痛患者100例为研究对象,将所有患者随机分为对照组和治疗组,每组各50例。对照组患者口服硝苯地平控释片,1片/次,1次/d。治疗组患者在对照组治疗的基础上口服益心酮软胶囊,3粒/次,3次/d。7d为1个疗程,两组患者均持续治疗4个疗程。观察两组的临床疗效和心电图疗效,比较两组的临床症状、左室收缩功能。结果治疗后,对照组和治疗组的临床疗效总有效率分别为82.00%、94.00%,两组比较差异有统计学意义(P0.05)。治疗后,对照组和治疗组的心电图疗效总有效率分别为78.00%、94.00%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者心绞痛持续时间和发作次数显著低于治疗前,同组治疗前后比较差异有统计学意义(P0.05);且治疗组心绞痛持续时间和发作次数明显低于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组患者每搏射血量(SV)、心脏指数(CI)和左心室射血分数(LVEF)均显著高于治疗前,同组治疗前后比较差异有统计学意义(P0.05);且治疗组左室收缩功能指标显著高于对照组,两组比较差异有统计学意义(P0.05)。结论益心酮软胶囊联合硝苯地平控释片治疗冠心病心绞痛具有较好的临床疗效,能改善临床症状、心电图情况和左室收缩功能,安全性较高,具有一定的临床推广应用价值。     

宁心宝胶囊联合普罗帕酮治疗室性心律失常的临床研究

目的观察宁心宝胶囊联合普罗帕酮治疗室性心律失常的安全性与有效性。方法选取2016年7月—2017年7月于重庆市巴南区人民医院治疗的室性心律失常患者151例,随机分成对照组(75例)和治疗组(76例)。对照组患者口服盐酸普罗帕酮片,6片/次,3次/d;治疗组患者在对照组基础上口服宁心宝胶囊,2粒/次,2次/d。两组患者连续治疗2个月。观察两组患者临床疗效,同时比较治疗前后两组患者动态心电图指标、心功能指标和不良反应情况。结果治疗后,对照组和治疗组临床有效率分别为85.33%和96.05%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者QRS波时限、室性早搏及短阵室速较治疗前显著降低(P0.05),且治疗组这些动态心电图指标明显低于对照组(P0.05)。治疗后,两组患者6min步行距离和左心室射血分数(LEVF)水平较治疗前显著升高(P0.05),脑尿钠肽(BNP)水平显著降低(P0.05),且治疗组这些心功能指标明显好于对照组(P0.05)。治疗期间,治疗组患者药物不良反应发生率为3.95%,显著低于对照组患者的14.67%,两组比较差异具有统计学意义(P0.05)。结论宁心宝胶囊联合普罗帕酮治疗室性心律失常效果显著、安全性高,且能够显著改善患者心功能,具有一定的临床推广应用价值。     

Fasudil alleviates brain damage in rats after carbon monoxide poisoning through regulating neurite outgrowth inhibitor/oligodendrocytemyelin glycoprotein signalling pathway

Carbon monoxide (CO) poisoning can lead to many serious neurological symptoms. Currently, there are no effective therapies for CO poisoning. In this study, rats exposed to CO received hyperbaric oxygen therapy, and those in the Fasudil group were given additional Fasudil injection once daily. We found that the escape latency in CO poisoning group (CO group) was significantly prolonged, the T₁/T_total was obviously decreased, and the mean escape time and the active escape latency were notably extended compared with those in normal control group (NC group, P < 0.05). After administration of Fasudil, the escape latency was significantly shortened, T₁/T_total was gradually increased as compared with CO group (>1 week, P < 0.05). Ultrastructural damage of neurons and blood‐brain barrier of rats was serious in CO group, while the structural and functional integrity of neuron and mitochondria maintained relatively well in Fasudil group. Moreover, we also noted that the expressions of neurite outgrowth inhibitor (Nogo), oligodendrocyte‐myelin glycoprotein (OMgp) and Rock in brain tissue were significantly increased in CO group, and the elevated levels of the three proteins were still observed at 2 months after CO poisoning. Fasudil markedly reduced their expressions compared with those of CO group (P < 0.05). In summary, the activation of Nogo‐OMgp/Rho signalling pathway is associated with brain injury in rats with CO poisoning. Fasudil can efficiently down‐regulate the expressions of Nogo, OMgp and Rock proteins, paving a way for the treatment of acute brain damage after CO poisoning.     

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.     

左卡尼汀改善尿毒症血透患者营养不良和心功能的临床研究

目的 评价左卡尼汀对尿毒症维持血液透析患者营养不良及心功能的改善作用。方法 将2012年12月-2013年12月中国人民解放军海军总医院收治的尿毒症患者74例随机分成治疗组（37例）和对照组（37例）。对照组采用常规血液透析治疗,治疗组在常规血液透析的基础上,于每次透析结束后iv左卡尼汀注射液1 g,连续治疗3个月。观察治疗前后两组患者的血清总蛋白（TP）、白蛋白（Alb）、转铁蛋白（TRF）、前白蛋白（PA）和以及心功能情况。结果 治疗组患者治疗后血清营养学指标TP、Alb、TRF、PA均较治疗前有所升高,治疗前后比较差异有统计学意义（P<0.05）;治疗组总胆固醇（TC）水平较治疗前显著下降,治疗前后比较差异有统计学意义（P<0.05）,且显著低于对照组治疗后水平（P<0.05）;治疗后,治疗组TP、Alb、TRF、PA水平均显著高于对照组,两组比较差异有统计学意义（P<0.05）。治疗后两组患者的左心房内径（LAD）、左室后壁厚度（LVPWT）、室间隔厚度（IVST）较治疗前均有显著性减小,同组治疗前后差异有统计学意义（P<0.05）,且治疗组左室收缩末内径（LVDs）、左室舒张末内径（LVDd）较治疗前变化显著,治疗前后差异有统计学意义（P<0.05）。治疗后,治疗组LAD、LVDs、LVDd和LVPWT值均低于对照组,两组比较差异有统计学意义（P<0.05）。治疗后两组患者的舒张期始末血流速度E、A峰比值（E/A）、左室射血分数（EF）均较治疗前显著增加,治疗前后差异有统计学意义（P<0.05）,治疗组计算左房每搏量（SV）较治疗前显著性减小,治疗前后差异有统计学意义（P<0.05）。治疗后,治疗组E/A、EF均显著高于对照组,治疗组SV显著性低于对照组,两组差异具有统计学意义（P<0.05）。结论 iv左卡尼汀可明显改善尿毒症血液透析患者营养不良的状况,保护心肌细胞,延缓心脏结构及功能的进一步损害,值得临床推广应用。