冠心病秽浊痰阻证与血管性血友病因子的相关性研究

目的 探讨血浆血管性血友病因子(vWF)水平与冠心病秽浊痰阻证之间的关系.方法 应用酶联免疫吸附测定 (ELISA)检测85例冠心病秽浊痰阻证患者、93例冠心病非秽浊痰阻证患者及89名健康对照者的血浆vWF水平.结果 血浆vWF水平冠心病秽浊痰阻证组高于冠心病非秽浊痰阻证组,亦明显高于健康对照组,3组vWF水平差异有统计学意义(P<0.05或P<0.01).结论 冠心病秽浊痰阻证与血浆vWF水平升高密切相关.     

辛伐他汀对冠心病患者纤溶参数的影响

目的了解冠心病患者纤溶参数的变化,并观察辛伐他汀对冠心病患者纤溶参数的影响。方法测定87例正常对照者和108例冠心病患者血浆组织型纤溶酶原激活物(t-PA)活性和纤溶酶原激活物抑制物-(1PAI-1)活性,随后108例冠心病患者被随机分成常规治疗组和常规治疗+辛伐他汀40mg每日一次(辛伐他汀组)。治疗14d后复测t-PA活性和PAI-1活性。结果与正常对照组相比较,冠心病患者纤溶参数异常,t-PA活性下降,PAI-1活性上升(P<0.01)。常规治疗组治疗后纤溶参数无显著变化(P>0.05)。辛伐他汀组纤溶参数明显改善,表现为t-PA活性上升,PAI-1活性下降(P<0.01)。结论冠心病患者纤溶参数明显异常,辛伐他汀能改善冠心病患者纤溶参数。     

冠心病秽浊痰阻证与血浆同型半胱氨酸的相关性研究

目的 探讨冠心病秽浊痰阻证病人血浆同型半胱氨酸水平与冠心病秽浊痰阻证之间的关系.方法 选择住院及门诊确诊为冠心病病人101例,根据秽浊痰阻证诊断标准分为秽浊痰阻证组47例,非秽浊痰阻证组54例.并选择健康体检者50名作为正常对照组.结果 冠心病秽浊痰阻证病人血浆同型半胱氨酸水平为(22.78±10.12) μmol/L,明显高于冠心病非秽浊痰阻证病人的(16.09±8.92) μmol/L以及健康体检者的(12.46±5.31) μmol/L(P<0.05或P<0.01).结论 冠心病秽浊痰阻证与血浆同型半胱氨酸水平升高密切相关.     

急性冠脉综合征病人的纤溶系统与血管内皮功能关系

目的 研究血管内皮功能与急性冠脉综合征病人纤溶指标的关系.方法 以健康体检者(42例)为对照组,稳定型心绞痛(SAP)组43例,急性冠脉综合征(ACS)组52例,分别采用高分辨超声技术检测血流介导和硝酸甘油介导的肱动脉舒张功能,并测定血浆组织型纤溶酶原激活物(t-PA)、血浆纤溶酶原激活物抑制剂(PAI-1).结果 ACS组的PAI-1(69.40±5.73) ng/mL明显高于对照组及SAP组(P<0.05), t-PA明显低于对照组及SAP组(P<0.05).ACS病人的血管内皮功能(FMD)为(7.57±6.30)%,明显低于对照组(12.26±4.33)%及SAP组(11.25±3.08)%(P<0.05).ACS病人的FMD与PAI-1水平显著负相关,相关系数r=-0.811 5 (P＜0.05).结论 PAI-1可能是反映急性冠脉综合征病人血管内皮功能的血液标志物.PAI-1含量增高也可为临床诊断ACS提供依据.     

培哚普利对慢性心力衰竭患者血浆t-PA和PAI-1水平的影响

目的评价培哚普利对慢性心力衰竭(CHF)患者血浆组织型纤溶酶原激活物(t-PA)和纤溶酶原激活物抑制物-1(PAI-1)水平的影响。方法采用酶联免疫吸附法测定60例CHF患者(CHF组)及20例健康人(正常对照组)血浆t-PA、PAI-1水平。CHF组患者又随机均分为常规治疗亚组和培哚普利亚组。培哚普利亚组在常规治疗基础上加用培哚普利2~4mg,每日1次。所有CHF患者治疗2周后复测血浆t-PA、PAI-1水平。结果CHF患者血浆t-PA、PAI-1水平比正常对照组明显增高(P<0.01)。治疗后,培哚普利亚组血浆PAI-1水平比常规治疗亚组明显降低(P<0.01),血浆t-PA水平比常规治疗亚组明显升高(P<0.01)。结论培哚普利不仅可降低PAI-1水平,而且可升高t-PA水平,改善内源性纤溶功能。     

慢性肝病患者血浆中凝血酶激活的纤溶系统检测的临床意义

目的:探讨慢性肝病患者血浆凝血酶激活的纤溶抑制物活性(TAFI:A)、纤溶酶原激活物抑制剂(PAI-1)及组织型纤溶酶原激活物(t-PA)水平变化的临床意义。方法:收集84例临床肝病患者的血液标本,同时选取52例体检健康者为对照组,TAFI:A测定采用发色底物法,PAI-1、t-PA含量测定采用ELISA法,并统计分析上述3项指标与不同类型慢性肝病间的相关性。结果:与对照组比较,病例组血浆TAFI:A水平均显著降低(P<0.05);血浆PAI-1水平显著增加(P<0.05);血浆t-PA水平亦显著增加(P<0.05,原发性胆汁性肝硬化除外)。结论:慢性肝损伤患者血浆TAFI:A水平降低,导致纤溶活性增加,是提示慢性肝病患者呈出血倾向的一项指标。     

脑梗死患者急性期血浆PAI-1与t-PA比值的变化及临床意义

目的研究脑梗死患者急性期(发病7 d内)血浆纤溶酶原激活物抑制物-1(PAI-1)与血浆组织型纤溶酶原激活物(t-PA)比值的变化及其临床意义。方法采用酶联免疫吸附法检测67例脑梗死患者急性期血浆PAI-1t、-PA、计算PAI-1/t-PA(P/t)值,并与50名健康对照组作对照。结果脑梗死患者急性期血浆t-pA活性及PAI-1活性均升高,与正常对照组比较有统计学意义(P0.05),P/t值较正常对照组降低(P0.05)。结论脑梗死患者急性期体内纤溶活性相对亢进。在判定体内纤溶活性指标中,P/t值较t-PA、PAI-1稳定可靠。P/t值与纤溶活性呈反比关系。     

伊贝沙坦对原发性高血压患者纤溶功能的影响

目的:探讨高血压患者纤溶功能的变化以及伊贝沙坦对其影响。方法:原发性高血压(EH)2级患者42例(EH组),健康对照者30例(对照组);EH患者服用伊贝沙坦150 mg/d,观察对照组及EH组用药前后对纤溶功能的影响。结果:用药前EH组纤溶酶原激活物抑制剂1(PAI-1)活性明显高于对照组,组纵型纤溶酶原激活物(t-PA)活性明显低于对照组;用药后纤溶指标PAI-1显著降低(P<0.01),t-PA水平增高(P<0.05)。结论:EH患者存在血纤溶功能异常,伊贝沙坦可改善EH患者纤溶功能失调,对PAI-1作用明显。     

氯沙坦对原发性高血压患者纤溶功能的影响

目的观察氯沙坦对原发性高血压(EH)患者纤溶功能的影响。方法观察34例EH患者应用氯沙坦治疗4周后收缩压(SBP)、舒张压(DBP)、心率、血浆组织型纤溶酶原激活物(t-PA)、内皮细胞型纤溶酶原激活物抑制剂(PAI-1)水平的变化,并与30例健康人作比较。结果治疗前EH患者血浆t-PA水平明显低于对照组,而PAI-1水平明显高于对照组(均P<0.01)。氯沙坦治疗4周后,血压明显下降,心率无明显变化,血浆t-PA水平增加,但无统计学意义,而PAI-1水平明显降低,t-PA/PAI-1比值升高(均P<0.01)。结论EH患者存在着内源性纤溶功能紊乱,氯沙坦可以改善EH患者的纤溶功能。     

急性脑梗死患者血浆t-PA、PAI-1水平及血液流变学指标变化的相关性分析

目的研究急性脑梗死患者治疗前后血浆中组织型纤溶酶原激活物(t-PA)和纤溶酶原激活物抑制剂-1(PAI-1)的水平及血液流变学指标变化的意义。方法应用酶联免疫吸附试验(ELISA)测定急性脑梗死患者血浆t-PA和PAI-1的水平,常规方法测定血液流变学指标。结果①脑梗死患者急性期血浆t-PA含量明显低于对照组(P<0.01),而PAI-1含量则明显高于对照组(P<0.01),恢复期PAI-1水平趋于正常,而t-PA水平与对照组比较仍存在一定差异(P<0.05)。②t-PA和PAI-1的水平与多项血液流变指标相关。结论急性脑梗死患者存在不同程度的凝血纤溶系统失衡,并与血液流变学指标异常密切相关。     

ERCP and MRCP--when and why

Since the introduction of endoscopic retrograde cholangiopancreatography (ERCP) in the 1970s, gastroenterologists have a wide spectrum of diagnostic and therapeutic options in the biliopancreatic ductal system at their disposal. With its arrival in the 1990s, magnetic resonance cholangiopancreatography (MRCP) developed as a potent diagnostic tool in biliopancreatic pathology. Currently, MRCP is widely replacing diagnostic ERCP and thereby avoiding complications related to endoscopic technique.We summarize evidence-based data and demonstrate indications and differential indications for MRCP and ERCP in pancreatic disease. Complications related to the procedures and possible medical prevention are discussed. The feasibility of interventional endoscopy in pancreatic disease is reported in detail. The role of gastroenterologists in performing MRCP is outlined on the basis of practical examples.     

Convection and permeation and albumin between plasma and interstitium.

Nonequilibrium thermodynamics is combined with compartmental analysis to interpret albumin sieving and tracer experiments in terms of a permeability-surface product PS (permeation) and a solvent drag reflection coefficient σ_f (convection) for various blood-tissue barriers. The human whole-body albumin data of Lassen, Parving, and Rossing (Lassen, Parving, and Rossing, Microvasc. Res.7, i–iv (1974)), modified for nonliver tissues by Johnson and Levitt (Johnson &; Levitt, Microvasc. Res.9, 141 (1975)) lead to P ～ 1.8 × 10^?8 cm sec^?1 (based on a surface area per unit plasma volume of 700 cm^?1) and to σ_f ～ 0.9, which imply, in agreement with Johnson and Levitt, that permeation is the dominant nonliver blood-tissue transport mechanism for albumin in the normal resting human. Similar values are derived from the dog paw muscle data of Garlick and Renkin (Garlick and Renkin, Amer. J. Physiol.219, 1595–1605 (1970)). The Casley-Smith (Casley-Smith, Microvasc. Res.9, 43–48 (1975)) mechanism of uphill albumin transport is verified as possible. It is tentatively inferred that lymph formation in resting tissue does not result from a small difference between a large fluid (volumetric) filtration and an almost equally large fluid reabsorption, either in the same capillary (Starling) or between different capillaries (Zweifach) (Zweifach, Circ. Res.34, 858–866 (1974)). Rather, reabsorption is negligibly small relative to filtration, and lymph flow is comparable to volumetric filtration.