稳心颗粒联合美托洛尔治疗冠心病室性心律失常疗效观察

目的观察稳心颗粒联合关托洛尔治疗冠心病室性心律失常的疗效。方法将115例冠心病合并室性心律失常患者随机分为治疗组（A组）40例,口服稳心颗粒和美托洛尔治疗;对照组75例[其中关托洛尔组（B组）37例。口服美托洛尔治疗,胺碘酮组（C组）38例,口服胺碘酮治疗]。结果治疗组在动态心电图疗效上优于单用美托洛尔组（P〈0．05）,与胺碘酮组疗效比较差异无统计学意义（P〉0．05）。在临床症状改善上效果优于单用美托洛尔组和胺碘酮组（P〈0．05）。结论稳心颗粒联合美托洛尔能有效治疗冠心病室性心律失常,不良反应小,患者耐受性良好,具有临床应用价值。     

稳心颗粒联合胺碘酮治疗室性期前收缩的临床观察

目的观察稳心颗粒联合胺碘酮治疗室性期前收缩的临床疗效。方法将入选病例60例随机分为2组,治疗组（A组）口服稳心颗粒及胺碘酮片,对照组（B组）口服胺碘酮片,疗程均为4周。结果总有效率A组为93％,B组为87％,二组比较无显著性差异（P〉0．05）,胺碘酮应用总量A组比B组减少1／2,二组比较有显著性差异（P〈0．05）。结论稳心颗粒对室性期前收缩有一定的疗效作用,并可减少胺碘酮的用量。     

稳心颗粒与比索洛尔联用治疗老年冠心病室性早搏的疗效

目的：观察稳心颗粒与比索洛尔联用治疗老年冠心病室性早搏的疗效。方法：95例老年冠心病患者被随机分为稳心颗粒加比索洛尔组（A组,36例）、比索洛尔组（B组,31例）、稳心颗粒组（c组,28例）,观察治疗前后临床症状和心律失常改善情况及不良反应。结果：治疗前后动态心电图观察对比：A组总有效率为91．67％（33例）,显著高于B组的70．97％（22例）,C组的71．43％（20例）,P均〈0．05,B组的总有效率与C组的比较无显著性差异（P〉0．05）;治疗后临床症状改善情况：A组（94．44％）显著高于B组（77．42％）、C组（78．57％）,P均〈0．05;B组的与C组的比较则无显著性差异（P〉0．05）。结论：稳心颗粒与比索洛尔联用治疗老年冠心病室性早搏的疗效明显优于各自单用的疗效。     

胺碘酮联合稳心颗粒治疗急性心肌梗死后心律失常65例临床观察

目的观察胺碘酮联合稳心颗粒治疗急性心肌梗死后心律失常的临床疗效。方法选取急性心肌梗死后心律失常130例,分为观察组（65例）~NN（65例）,观察组采用胺碘酮联合稳心颗粒治疗,对照组给予单纯利多卡因药物治疗;对两组治疗效果进行比较。结果观察组患者临床治愈率和临床受益率明显高于对照组,P〈0．05。结论胺碘酮联合稳心颗粒治疗急性心肌梗死后心律失常效果显著,是一种可行的治疗方案。     

稳心颗粒治疗房颤临床疗效研究

目的观察稳心颗粒治疗房颤的不良反应及疗效,并与胺碘酮作比较。方法选择非瓣膜性房颤患者139例,随机分为A组（稳心颗粒组）71例,服用稳心颗粒5g/次,3次/d。B组（胺碘酮组）68例,服用胺碘酮600mg/d,连服2周后,减量为400mg/d,再服两周后减量为200mg/d,8周后观察疗效及不良反应。结果 A组和B组转律率差异无统计学意义（P〉O.05）。A组心室控制率明显高于B组（P〈0.05）。A组症状改善明显高于B组（P〈0.05）。不良反应则少于B组（P〈0.05）。结论稳心颗粒转律率小于胺碘酮,心室率的控制基本等同于胺碘酮,且不良反应小,可以作为治疗房颤的一线用药。     

米力农与胺碘酮治疗重度心衰伴快速心律失常的疗效分析

目的探讨米力农与胺碘酮治疗重度心力衰竭（CHF）伴快速心律失常的作用机制及安全性的比较。方法对156例因各种心血管疾病引发CHF合并快速心律失常住院者，随机分为治疗组（A组）86例：应用米力农静脉制剂＋胺碘酮片剂。对照组（B组）70例：单用米力农，方法同A组。结果两组在用药前后血流动力学各项参数表明，无论心脏收缩功能及舒张功能均有明显改善（P值均〈0．05）。但治疗后两组间比较无显著性差异（P值〉0．05）。A组用药后7d内，各项快速心律失常临床指标均有明显好转，与B组比较差异有显著性（P〈0．05）。结论米力农作为新一代治疗CHF的药物，不仅适用于收缩性心衰，亦能在舒张性心衰中发挥一定疗效。但不能避免本身有致心律失常的不良反应，及CHF引发快速心律失常时的治疗，而胺碘酮有显著的抗心律失常作用，且能够在一定程度上减轻心脏前、后负荷。在CHF合并快速心律失常时，二者联用疗效确切、安全性好。     

稳心颗粒与胺碘酮联用治疗急性冠状动脉综合征合并室性心律失常的疗效及安全性研究

目的评价稳心颗粒与胺碘酮联用治疗急性冠状动脉综合征合并室性心律失常的疗效及安全性。方法将我院收治的急性冠状动脉综合征合并室性心律失常患者72例随机分为两组,对照组（35例）采用胺碘酮治疗,观察组（37例）采用稳心颗粒与胺碘酮联用治疗,比较两组患者的疗效及不良反应发生情况。结果观察组的总有效率为97.3%,对照组为82.9%,组间比较差异有统计学意义（P〈0.05）;观察组的不良反应发情况与对照组比较差异无统计学意义（P〉0.05）。结论稳心颗粒与胺碘酮联用治疗急性冠状动脉综合征合并室性心律失常临床疗效满意且无明显不良反应,值得临床推广应用。     

稳心颗粒治疗冠心病心律失常30例临床观察

目的　观察稳心颗粒和胺碘酮对冠心病心律失常治疗的效果和安全性。方法　将 88例冠心病并发早搏病人随机分为 3组 ,稳心颗粒组 (n =3 0 )口服稳心颗粒 ,每次 9g ,每天 3次 ;胺碘酮组 (n =2 9)口服胺碘酮 ,每次 0 .2 g ,每天 3次 ,两周后逐渐减为每天 0 .2 g ;对照组 (n =2 7)只给予常规治疗。观察用药前后 3组病人常规心电图及 2 4h动态心电图早搏次数变化情况及不良反应。结果　稳心颗粒组和胺碘酮组与对照组比较早搏次数及有效率无统计学意义 (P <0 .0 5 ) ,而稳心颗粒组与胺碘酮组比较早搏次数及无效率无统计学意义 (P >0 .0 5 )。结论　稳心颗粒治疗冠心病心律失常疗效与胺碘酮作用相当 ,且副反应轻微。     

稳心颗粒联合胺碘酮治疗室性期前收缩的疗效观察

目的观察稳心颗粒联用胺碘酮治疗室性期前收缩的疗效及安全性。方法选择室性期前收缩患者84例,随机分为稳心颗粒加胺碘酮组（A组）43例,胺碘酮组（B组）41例。A组给予稳心颗粒9g加胺碘酮0.2g,1次/d,饭后服用。B组给予胺碘硐0.2g,3次/d,饭后服用。两组均以4周为1个疗程。治疗前及疗程结束后行24h动态心电图及血常规、肝、肾功能检查。结果两组均可显著减少室性期前收缩的发生。两组患者临床疗效间差异有统计学意义（P〈0.01）。结论稳心颗粒联用胺碘酮可显著减少室性期前收缩的发生,疗效优于单用胺碘酮,同时可以减少胺碘酮等抗心律失常药物的剂量。     

稳心颗粒对冠心病快速心律失常病人的临床疗效及甲襞微循环的影响

目的研究稳心颗粒对冠心病快速心律失常病人的临床疗效和对甲襞微循环的影响。方法90例冠心病心律失常病人,随机分为两组,治疗组予稳心颗粒3粒,每日3次;对照组予胺碘酮0.2g,每日3次,1周后改为0.2g,每日2次,再1周后改为0.2g,每日1次,疗程皆为4周。治疗前后分别对临床症状、Holter心律失常进行等级评定,并检查三大常规、肝肾功能、心电图、胸片及甲襞微循环。结果冠心病心律失常病人的相关临床症状缓解总有效率治疗组为95.7%,优于对照组的83.7%（P〈0.01）,Holter心律失常的总有效率治疗组为68.9%,与对照组的76.6%比较差异无统计学意义（P〉0.05）,改善甲襞微循环治疗组优于对照组（P〈0.01或P〈0.05）。治疗组未见副反应。结论稳心颗粒对冠心病快速心律失常的控制率与胺碘酮相当,改善相关临床症状及甲襞微循环方面优于胺碘酮;且毒副反应少,安全性高于胺碘酮。     

肿瘤病人弓形虫感染分析

在肿瘤的发生和发展进程中 ,多伴有免疫功能低下或缺陷 ,从而极易遭受各种感染。弓形虫是机会感染因子 ,当患者免疫功能受损时 ,易于感染 ,还会使隐性感染激活 ,引起低热不退、淋巴结肿和脑神经系统的反应 ,此现象尚未引起临床医师的重视。近年来 ,我们对 4 0 9例肿瘤病人进行了弓形虫感染及弓形虫病的分析观察 ,报告如下 :1　材料与方法1 1　材料　 30 4例病人血清取自江西省肿瘤医院住院或门诊病人 ,随机抽样后低温保存待检 ,10 5例取自其他医院送检样品 ,有急性症状者随到随检 ,以便及时做病原学检测。1 2　弓形虫病诊断方法1 2 1　免疫…     

A patient with rectal ulcer with severe stenosis presenting with perforated peritonitis

We report a patient with rectal ulcer with severe stenosis, who underwent urgent surgical treatment for perforated peritonitis. The 54-year-old man suddenly developed cramping abdominal pain and fever while hospitalized, with signs of peritoneal irritation. An emergency laparotomy was performed, and severe stenosis of the rectum and a perforated lesion on the oral side approximately 10 cm distant from the stenosis were found, with massive abdominal purulent fluid. He was treated by rectosigmoid colon resection with transverse colon loop colostomy. Histopathologically, the stenosis was caused by ulceration extending to all muscular layers of the rectum, with inflammatory changes. Benign rectal stenosis is so rare that differential diagnosis from malignancy may be difficult when there are inflammatory changes in the surrounding tissues. However, it is necessary to keep in mind the likelihood of this disease in differentiation from rectal cancer. Received: December 21, 1998 / Accepted: May 28, 1999     

Infection with Rhodococcus equi in a patient with sarcoidosis treated with corticosteroids

A 51-year-old female farmer was diagnosed as having sarcoidosis. During 4 years of observation, slow radiological progression was observed. Cough then developed, necessitating treatment with corticosteroids. After 28 months of continuous treatment with prednisolone in low doses (5-7.5 mg daily), she suffered fever episodes, recurrent haemoptyses, general malaise and loss of weight. A chest roentgenogram showed a left upper lobe infiltrate, which progressed and finally cavitated, and rib destruction. Despite efforts, including a thoracotomy, 22 months passed before a diagnosis could be made. Blood and sputum cultures and cultures from the destroyed rib showed growth of Rhodococcus equi, a common soil organism which can cause infections in foals and other animals. Treatment with rifampicin and erythromycin was successful. R. equi has been reported to cause infection in patients with neoplastic disease and/or immunosuppression, but the disease might be more common than is suggested by the sparse case reports in the literature, owing to lack of familiarity with the organism, which will tend to be overlooked as a contaminant.     

Evaluation of atrial vulnerability with transoesophageal stimulation in patients with atrioventricular junctional: Comparison with patients with ventricular pre-excitation and with normal subjects

The aim of our work was to evaluate the inducibility of atrialfibrillation in a group of patients with atrioventricular junctionalreentrant tachycardia and to compare it with that of patientswith a Kent-type ventricular pre-excitation (Wolff-Parkinson-Whitesyndrome) and a control group. One hundred and twenty-five subjects were separated into groups.Group 1 comprised 49 Wolff-Parkinson-White patients, with amean age of 26.4, range 10.66 years; group 2, 51 patients withatrioventricular junctional reentrant tachycardia inducibleby transoesophageal atrial stimulation andlor clinically documented,with a mean age of 43.4, range 16–78 years; group 3, 25control subjects with a mean age of2.64, range 13–76 years. Each subject underwent atrial transoesophageal stimulation withthe following protocol: programmed atrial stimulation with 1and 2 stimuli during atrial pacing of 100. min^–1 and 150.min^–1; atrial stimulation for 10 s at a rate of 200–300–400–500–600.min^–1 with intervals of 10 s between stimulations, fivesuccessive ‘ramp-up’ atrial stimulations for 9 swith the rate increasing from 100 to 800. min^–1 with intervalsof 10 s between stimulations. The end point was the completionof the protocol or induction of sustained atrial fibrillation(>1 min). The chi-square test was used for statistical analysis. Our resultsshowed that in group 1 atrial fibrillation was induced in 27149patients (55.1%); this was sustained in 13149 (26.5%) and non-sustainedin 14149 (28.5%); in group 2, atrial fibrillation was inducedin 22151 patients (43.0%); it was sustained in 7151 (13.7%)and non-sustained in 15151 (29.4%); in group 3, sustained atrialfibrillation was not induced in any subject and in only onesubject was a non-sustained atrial fibrillation (4 s) induced. The chi-square test showed that group 2 vs group 1 were non-significant,while group 2 vs group 3 and group 1 vs group 3 were significant(P<0.003 and P<0.0007, respectively). Therefore group 2 patients showed a greater atrial vulnerabilityin comparison to the control subjects and a similar vulnerabilityto group 1 patients. It is possible that the greater atrialvulnerability in the patients of group 2 was due to the doublenodal pathway.     

Treating patients with lupus with B-cell depletion

A new era in the treatment of systemic lupus erythematosus has dawned with the increasing introduction of monoclonal antibodies and other approaches, that target the key molecules involved in the pathogenesis of the disease. At present the ability to block the CD20 molecule on those B cells that carry this marker has proved the most effective way to treat patients resistant to conventional immunosuppressive drugs. However, these studies have all been open label and the results of double blind controlled studies are eagerly awaited.