电针结合西药治疗冠心病心绞痛

目的：观察电针结合西药治疗冠心病心绞痛的临床疗效.方法：200例冠心病心绞痛患者分为2组，均采用西药阿斯匹林和5-单硝异山梨醇酯等治疗，综合组120例同时配合电针内关、郄门穴治疗。结果：经过6个疗程的治疗后，心绞痛和心电图总有效率综合组高于对照组；心绞痛缓解和消失时间综合组明显短于对照组。结论：电针有关穴位结合口服西药能明显提高冠心病心绞痛患者的治疗效果和改善临床症状及体征。     

Angina Pectoris: An Approach to Management

Angina may develop on a chronic pattern or in acute episodes, necessitating judgment on differential diagnosis and rapid institution of appropriate methods of management. This article lists all necessary steps from lab tests and drug therapy to long term management plans of diet and smoking habits.     

与嗜铬细胞瘤有关的心绞痛临床分析

目的 研究与嗜铬细胞瘤有关的心绞痛特点。方法 采用回顾分析方法,分析我院及我校一院自７０年代以来３０年间铬细胞瘤伴有较典型心绞痛患者２０例。结果 与嗜铬细胞瘤有关的心绞痛发病率占整个嗜铬细胞瘤鹗２的１６％,该心绞痛心电图可以是心肌劳损、心肌梗死或正常心电图。其血尿儿茶酚胺水平仅部分患者升高。结论 嗜铬细胞瘤伴有心绞痛的发生率较高;发生心绞痛的患者,血尿儿蔡酚胺水平及心电图均可以正常,术前诊断肾上腺     

依姆多治疗稳定劳力型心绞痛的疗效观察

近 3ａ来 ,我科对 40例稳定劳力型心绞痛应用依姆多治疗 ,连用 4周 ,通过观察心绞痛的发作次数、硝酸甘油含量及心电图的变化、2 4ｈ动态心电图、活动平板运动试验等 ,对其疗效、副反应进行了比较分析 ,结果如下。1　资料与方法1.1　入选标准　根据 1979年ＩＳＦＣ/ＷＨＯ命名的缺血性心脏病的诊断标准[1] ,选择了 40例稳定劳力型心绞痛病人 ,其中男2 4例 ,女 16例 ,年龄 46岁～ 70岁 ,平均年龄 5 6 .37岁。且具备下列条件[2 ] :①胸痛发作有明确的劳力或情绪诱因 ;②发作的持续时间和程度相对固定 ;③疼痛可经休息或含硝酸甘油后迅速缓解 ;…     

尿激酶联合低分子肝素治疗不稳定性心绞痛的临床疗效分析

目的：探讨尿激酶联合低分子肝素治疗不稳定性心绞痛(UAP)的临床疗效。方法：将63例UAP患者随机分为溶栓治疗组及常规治疗组，溶栓治疗组(33例)应用尿激酶联合低分子肝素治疗，观察心绞痛发作频率、发作问期、心电图ST段改变以及出凝血检测等，并与常规治疗组(30例)进行比较。结果：溶栓治疗组与常规治疗组的心绞痛发作频率、发作间期及心电图ST段均具有显著性差异，两组用药前、后KPlT、PLT及PT实验监测指标均无显著性差异。结论：尿激酶联合低分子肝素治疗不稳定型心绞痛简单、安全、临床疗效确切，值得在基层医院推广应用。     

加味栝蒌薤白汤治疗宁夏地区慢性稳定型心绞痛

慢性稳定性心绞痛多发生于老年人,与患者脏腑功能失调、气血阴阳亏损相关,致肝气郁结不舒,脾胃运化失职,初期以气结血热蕴为热毒,久之则气血失调,生湿蕴痰,气滞血瘀,痰浊内生,相互结于体内,使心脉气血不得运行,阻塞而成心痛。作者通过分析宁夏地区饮食习惯,总结其慢性稳定性心绞痛患者易化湿成痰成瘀的特点,综合加味栝蒌薤白汤的理法方药,认为其既可益气补血治疗本虚,又可化痰散瘀治疗标实,在改善胸闷、心痛症状的同时补益体虚,标本兼治,疗效确切。     

Mibefradil: A New Selective T-Channel Calcium Antagonist for Hypertension and Angina Pectoris

Calcium antagonists are an established therapy for patients with hypertension and angina pectoris, but their current usage is often limited by their pharmacologic profilers and side effects. Mibefradil is a recently developed calcium antagonist with a unique chemical structure, site of action, and set of pharmacologic effects. Unlike currently available calcium channels as well as L-type channels. It is further distinguished from the other calcium antagonists in that it is the first member of a new class of calcium antagonists, the tetralol derivatives. With chronic oral dosing, mibefradil attains steady-state plasma concentrations within 3-4 days, has a bioavailability of approximately 90%, and a plasma half-life of 17-25 hours. It has a gradual onset of action and can be administered once daily without regard to food intake. It increases coronary blood flow and lowers peripheral vascular resistance. The vasodilatory effects of mibefradil are associated with a lack of inotropic effect on myocardium, lack of neurohormonal activation, and a reduction in heart rate. In clinical trials it has been demonstrated to be an effective agent in the treatment of patients with hypertension and angina pectoris, with a good safety and tolerability profile regardless of age, gender, or race.     

老年人带状疱疹误诊为心绞痛

1病例资料女,79岁。因反复发作性喘息40年,喘憋、胸闷、活动后喘息加剧,伴心慌、咳嗽,咳黄白黏痰10天入院。查体:体温36℃,脉搏100/m in,呼吸20/m in,血压120/82 mmHg。桶状胸。双肺听诊呼吸音粗,有较多哮鸣音及散在湿性啰音;心率100/m in,P2>A2,剑突下心尖搏动明显。诊断为支气管哮喘(急性发作期)、肺源性心脏病,予抗感染、解痉平喘、扩张血管及糖皮质激素等治疗。入院第5天患者感左胸胁部针刺样疼痛难忍,以夜间明显,皮肤未见异常改变。X线胸片除外气胸,心电图检查示ST-T段改变。考虑为不典型心绞痛,予硝酸甘油含化,疼痛缓解不明显,予布…     

国内近年来冠心病心绞痛的治疗现状

国内近年来冠心病心绞痛的治疗现状李秀才（青岛医学院附属心血管病医院，青岛２６６０７１）ＰｒｅｓｅｎｔＳｔａｔｕｓｏｎＴｈｅｒａｐｙｏｆＡｎｇｉｎａＰｅｃｔｏｒｉｓｉｎＣｈｉｎａＬｉＸｉｕｃａｌ（ＣａｒｄｉｏｖａｓｃｕｌａｒＤｉｓｅａｓｅｓＨｏｓｐｉｔ...     

Unstable Angina Pectoris as a Warning Symptom before Acute Myocardial Infarction

SUMMARY Four hundred patients who were admitted over the last threeyears with myocardial infarction were questioned about the presenceand pattern of angina before its onset. Two hundred and twenty-four(56 per cent) patients had angina before their infarction; 184(46 per cent) had the unstable pattern of angina. That sucha high proportion of patients experience unstable angina asa prodromal symptom makes it possible that myocardial infarctioncould be prevented in some of these patients. Patients withprevious angina had a higher incidence of subendocardial infarctionthan patients without angina (stable or unstable) (p<0. 01).In-hospital prognosis was better in patients with chronic orunstable angina than in patients without angina (p<0. 05).     

Efficacy and Safety of Bepridil in Chronic Stable Angina Pectoris Refractory to Nifedipine

The efficacy and safety of bepridil in chronic stable angina pectoris refractory to an extended-release preparation of nifedipine were evaluated in this open-label prospective study. Patients whose angina had not responded adequately to maximum tolerated doses of nifedipine received bepridil for 8 weeks after a 2-week baseline period at their established dose of nifedipine. Twenty-five patients entered the bepridil treatment period. Total exercise time (mean plus minus SD) was significantly increased at the end of bepridil therapy (9.3 plus minus 2.3 min) compared with the end of nifedipine baseline period (8.40 plus minus 2.3 min, p = 0.02). Time to the onset of angina increased from 6.1 plus minus 2.7 min to 8.1 plus minus 2.3 min, p < 0.01. Time to 1-mm ST depression increased from 7.0 plus minus 2.7 min to 8.4 plus minus 2.3 min, p < 0.01. Nitroglycerin consumption decreased from 3.01 plus minus 5.6 to 0.56 plus minus 1.3 tablets week(minus sign1), p < 0.05. The mean weekly angina attack rate decreased from 4.34 plus minus 5.3 to 1.33 plus minus 2.2, p < 0.01. Therapy with bepridil resulted in few adverse experiences. The mean QT(c) interval was significantly prolonged from 0.40 + 0.03 s at baseline to 0.45 + 0.045 s at the end of bepridil therapy (p < 0.001). There were no serious adverse events. The results of this study indicated that bepridil provides effective and safe treatment of stable angina pectoris in patients whose angina is not adequately controlled by nifedipine.     

低分子量肝素治疗不稳定型心绞痛

不稳定型心绞痛 (ＵＡＰ)急性期用肝素和 (或 )口服小剂量阿斯匹林显著减少急性心肌梗死 (ＡＭＩ)和顽固性心绞痛的发生[1] 。低分子量肝素 (ＬＭＷＨ)是普通肝素通过解聚和分离所得[2 ] 。我们应用ＬＭＷＨ及 (或 )阿斯匹林治疗ＵＡＰ ,对比分析ＬＭＷＨ的疗效。1　资料与方法1.1　病例选择　选择 1998年 8月～ 1999年 12月收治住院的ＵＡＰ患者 4 2例 ,其中初发劳力性心绞痛 17例 ,恶化劳力性心绞痛 2 5例。上述对象同时符合以下各项 :(1) 48ｈ以内有 2次以上的心绞痛发作 ;(2 )较轻微体力活动可引起心绞痛 ,可有静息心绞痛 ;(3)有心肌缺…     

就神经病学观点谈心绞痛的误诊

文章从心脏神经的解剖、生理特点,分析颈胸神经病变误诊为心绞痛的原因。指出了颈椎慢性病变造成的刘永纯综合征以及侵袭颈交感神经或椎神经与颈４～７神经根的疾病所造成的非心源性心胸疼痛,易与心绞痛相混淆,须对此引起注意并做好鉴别诊断。     

降纤酶治疗不稳定型心绞痛的临床观察

目的 :探讨降纤酶 (Dfb)治疗不稳定型心绞痛 (UAP)的疗效。方法 :将 6 2例UAP患者随机分组 :A组 (32例 )给予口服阿斯匹林 (30 0mg·d-1)和抗心绞痛药 ,B组 (30例 )在A组治疗基础上 ,另加Dfb(10U·d-1共 3d)静脉点滴。结果 :A组和B组在住院 10d内每天心绞痛发作次数、非致死性     

老年不稳定型心绞痛与生物节律相关性的探讨

对２００例老年不稳定型心绞痛（ＵＡ）病人，进行了发病时间与生物节律相关性的探讨。结果显示：２００例在体力低潮期ＵＡ日平均发作人数最高，与体力高潮期和临界期日平均发生数相比，差异均有显著性（Ｐ＜０．０１）；２００例ＵＡ病人在情绪低潮期ＵＡ日平均发作人数最高，与情绪高潮期和临界期ＵＡ日平均发作人数相比，差异均有显著性（Ｐ＜０．０１）。提示：应予针对性的护理。     

不稳定型心绞痛患者血清同型半胱氨酸含量的变化

[目的]探讨血清同型半胱氨酸含量(HCY)在不稳定型心绞痛(UAP)发展过程中的变化.[方法]65例患者分为3组:UAP组(n=23)、稳定型心绞痛(SAP)组(n=22)和对照组(n=20).UAP组又分为有并发症组(n=17)和无并发症组(n=6)两个亚组.入院时取静脉血检查血糖、血脂(标准酶法) 、血清HCY (色谱法) 水平和肝、肾功能、C反应蛋白(CRP,化学发光法)等.UAP组48 h后重复检测HCY、CRP.[结果]①UAP组CRP、HCY血清水平明显高于对照组(p＜0.01);②SAP组CRP、HCY血清水平与对照组相比差异有显著性(P＜0.05);③入院时,有并发症组血清HCY和CRP水平高于无并发症组(P＜0.05);48 h后,有并发症组的HCY、CRP血清水平较入院时高(P＜0.05),而无并发症组较入院时差异无显著性(P＞0.05).[结论]48 h前后血清HCY和CRP水平的变化,可能反映了疾病的活动程度和预后.     

通心络治疗不稳定心绞痛的疗效和血液流变性变化

目的观察通心络胶囊治疗不稳定性心绞痛(UAP)的临床疗效和血液流变性变化.方法将80例UAP患者随机分为常规治疗组(对照组)及常规治疗加通心络组(治疗组),疗程为1个月.结果 1个月后总有效率:治疗组为92.5%,对照组为67.5%(P＜0.01);治疗组无一例发生心肌梗死,对照组有2例发生心肌梗死(5%).治疗组未发现明显不良反应.结论在常规治疗基础上加用通心络,能更有效地控制心绞痛发作,减少心肌梗死发生率.