尼群地平及卡托普利治疗高血压肥厚左室后的功能变化

已形成左室肥厚的１４ｗｋ龄自发性高血压大鼠（ＳＨＲ）经用尼群地平或卡托普利治疗１４ｗｋ后，左室肥厚消退。肥厚消退后的左室收缩力无明显改变，但异丙基肾上腺素灌注后左室压力最大上升速度的增量（Δｄｐ／ｄｔ－ｍａｘ）增加并接近年龄配对的正常血压鼠；左室被动弹性系数数Ｋｍ值亦相应降低。结果表明左室肥厚消退后，左室舒张功能改善，收缩速度储备力恢复，左室收缩力不变     

通过聚合酶链反应对DMD相关基因外显于缺失的研究

通过聚合酶链反应对ＤＭＤ相关基因外显于缺失的研究［英］／Ｋｉｔｏｈ、Ｙ．．．／／ＡｍＪＭｅｄＧｅｎｅｔ．－１９９２，４２．－４５３～４５７ＤＭＤ是一种常见的致死疾病，与少见且病情较轻的ＢＭＤ有相同位点、两者都为Ｘ染色体上至少由７０个外显子组成的相关基...     

儿童用IABP导管的开发

儿童用ＩＡＢＰ导管的开发［日］／渡边弘…／／人工脏器．－１９９５，２４（２）．－２５１主动脉内气囊反搏（ＩＡＢＰ）由于简便有效，在成人中已广泛应用，但由于儿童主动脉的弹性大，不容易提高舒张压，气囊导管直径细，驱动抵抗大等而效果不佳，目前应用还没有普及...     

美蓝与消炎痛对高血压大鼠内脏血管内皮依赖性舒张弱的影响

本文应用双标本微量生物测定法观察大鼠（ＳＨＲ）及其常压对照（ＷＫＹ）大鼠肠系膜动脉Ａｃｈ内皮依赖性舒张（ＥＤＲ）的变化，并对其机制进行初步探讨。结果发现：ＳＨＲ的Ａｃｈ ＥＤＲ显著弱于ＷＫＹ者；岛甙不化酶抑制剂美蓝（５×１０＾－５ｍｏｌ／Ｌ）可明显减弱ＳＨＲ与ＷＫＹ的Ａｃｈ ＥＤＲ，此时ＳＨＲ的舒张仍明显弱于ＷＫＹ。灌流消炎痛（５×１０＾－５ｍｏｌ／Ｌ）后，座中易感型自发高血压大鼠（ＳＨＲｓｐ）增     

双腔主动脉内气囊反搏的血流动力学影响的研究

我们的实验结果表明双腔主动脉内气囊（ＤＩＡＢ）反搏的效果要优于单腔主动脉内气囊（ＳＩＡＢ）反搏的。它明显地改善血流动力学参数,进而提高了反搏的功效。也未发现双腔主动脉内气囊进行反搏会对肾脏的血流动力这参数产生不良影响。在对比肾动脉去神经前后主动脉内气囊反搏的结果,发现反搏时产生的脉动会对血管神经系统产生刺激,从而降低肾血管局部的阻力。这是当气囊进行反搏时,使肾脏血液循环得以改善的最重要因素。     

美蓝与消炎痛对高血压大鼠内脏血管内皮依赖性舒张减弱的影响

本文应用双标本微量生物测定法观察自发高血压大鼠（ＳＨＲ）及其常压对照（ＷＫＹ）大鼠肠系膜动脉Ａｃｈ内皮依赖性舒张（ＥＤＲ）的变化，并对其机制进行初步探讨，结果发现：ＳＨＲ的ＡｃｈＥＤＲ显著弱于ＷＫＹ者；鸟苷酸环化酶抑制剂美蓝（５×１０－５ｍｏｌ／Ｌ）可明显减弱ＳＨＲ与ＷｋＹ的ＡＣｈＥＤＲ，此时ＳＨＲ的舒张仍明显弱于ＷＫＹ。灌流消炎痛（５×１０－５ｍｏｌ／Ｌ）后，卒中易感型自发高血压大鼠（ＳＨＲｓｐ）的ＡｃｈＥＤＲ增强，ＷＫＹ的舒张反应几乎不变。此时ＳＨＲｓｐ与ＷＫＹ的肠系膜动脉的ＡｃｈＥＤＲ的差异消失。以上结果支持高血压的内脏血管ＥＤＲ减弱的结论，并且可以认为乙酰胆碱（Ａｃｈ）激发的血管内皮舒张因子（ＥＤＲＦ）通过ｃＧＭＰ环节的功能发生变化。以及血管内皮细胞释放的收缩因子（ＥＤＣＦ）增多是这一减弱的原因之一。     

心肌顿抑时红细胞变形性变化机理及其意义初探

目的和方法：本文通过一次性阻断兔冠脉左室支１５ｍｉｎ后再灌注复制在体心肌顿抑（ＭＳ）模型，动态观察心肌缺血前后红细胞变形指数（ｄｅｆｏｒｍａｂｉｌｉｔｙｉｎｄｅｘ，ＤＩ）、红细胞超氧化物歧化酶（ｓｕｐｅｒｏｘｉｄｅｄｉｓｍｕｔａｓｅ，ＳＯＤ）活力、红细胞ＡＴＰ、红细胞丙二醛（ＭＤＡ）含量和心功能参数（左室舒张末压、左室收缩压±ｄｐ／ｄｔｍａｘ）变化。结果：缺血末心功能下降最显著（Ｐ＜００１）；再灌注０５ｈ时ＭＤＡ明显升高，而ＤＩ、ＳＯＤ明显下降（Ｐ＜００１）。随继续再灌注上述指标逐渐恢复。各时点ＡＴＰ无明显变化。再灌注０５ｈ时红细胞ＭＤＡ与ＤＩ、ＳＯＤ均呈显著负相关（Ｐ＜００１），ＤＩ与＋ｄｐ／ｄｔｍａｘ正相关（Ｐ＜００５）。结论：ＭＳ早期红细胞变形性降低与暂时性氧化－抗氧化失衡有关；再灌注早期红细胞变形性降低可能参与ＭＳ早期发生机制     

10例阿尔茨海默型老年痴呆事件相关电位的初步研究

对１０例临床诊断为阿尔茨海默型老年痴呆（ＳＤＡＴ）的患者及１９例正常人进行听觉事件相关电位（ＥＲＰ）检测，同时还观察ＳＤＡＴ患者体外反搏治疗前后ＥＲＰ的变化。发现患者组Ｎ１波潜伏期明显延长，Ｐ３波出现率低仅４％（正常青年组１００％，老年组８０％）。Ｐ３潜伏期显著延长，波幅明显降低。体外反搏治疗后，患者组Ｎ１波潜伏期明显缩短，Ｐ３波出现率升至８０％。     

用移动平均幅值微分算法检测胎儿R波

用移动平均幅值微分算法检测胎儿Ｒ波［英］／Ｐａｒｋ　ＹＣ…／／ＩＥＥＥＴｒａｎｓＢＭＥ．－１９９２，３９（８）．－８６８胎儿ＥＣＧ信号处理问题包括从腹导ＥＣＧ信号中去除母体ＱＲＳ复合波增强胎儿ＱＲＳ复合波，检测胎儿Ｒ波计算胎儿心率。ＡＭＤＦ（ａｖｅｒ...     

急慢性应激时热休克蛋白的表达与血压的关系

０６２　急慢性应激时热休克蛋白的表达与血压的关系［英］／ＢｌａｋｅＭＪ…／／Ｈｙｐｅｒｔｅｎｓｉｏｎ，一１９９５，２５（４１１ｔ１）．一５３９～５４４作者曾报道约束应激诱导主动脉热休克蛋白７０ＫＤ（ＨＳＰ７０）的表达，且被特异性ａ１肾上腺素能受体桔抗...     

吸氧对高原动物心和肺功能的影响

我们观察了9只高原猪吸氧后的心肺功能变化。高原猪吸入纯氧后,右室收缩压、右室dp/dt max、肺动脉压和肺血管阻力明显降低,但左室dp/dt max、心指数、主动脉压和外周阻力无明显变化。这些结果提示肺血管收缩在慢性缺氧性肺动脉高压的发生中起重要作用。吸入纯氧后右室dp/dtmax下降,这表明慢性缺氧可致右室功能增加而肺分流率下降,提示高原幼猪存在肺通气/灌流不均。     

Comparative study of the effect of pacing mode on the interaction of the right and left ventricles

This study was designed to evaluate ventricular dyssynchrony from the viewpoint of the interaction of right and left ventricular contractions. Forty-three patients, 24 with sick sinus syndrome, 9 with complete atrioventricular block, and 10 with normal sinus rhythm were involved in this study. Microtip transducer catheters were advanced into both the left and right ventricles and ventricular pressure and the associated dp/dt were recorded simultaneously. Hemodynamic differences in various pacing modes were analyzed using pressure and dp/dt recordings obtained from the left and right ventricles. When an asynchrony between the right and left ventricular contractions existed, the right ventricular positive peak dp/dt developed a dual-peak waveform, the second peak corresponding in time to the peak of the left ventricular positive peak dp/dt. This dual-peak dp/dt waveform was seen with ventricular (VVI) and atrioventricular sequential (DVI) pacing, whereas a single-peak waveform was seen with atrial (AAI) pacing or sinus rhythm. In cases where DVI or VVI pacing modes are selected, an asynchronous effect between contractions of the right and left ventricles may occur, with dual-peak dp/dt of the right ventricle. Because the dual-peak dp/dt waveform indicates ventricular dyssynchrony, reducing the distance from peak I to peak II could maintain the synchronization of the right and left ventricles. It is considered particularly vital to give sufficient consideration to this point in chronic heart failure patients with left bundle branch block requiring biventricular pacing.     

增强型体外反搏增加心脏骤停犬颈总动脉血流量

目的: 探讨增强型体外反搏(EECP)干预对心脏骤停(SCA)犬颅内压(ICP)、脑灌注压(CPP)和右颈总动脉平均流量(MQ)的影响。方法: 12只犬制成SCA模型,经心肺复苏至自主循环恢复(ROSC)后随机分成对照组(4只)和EECP组(6只),2只建模未成功。EECP组分别行2次1 h EECP干预,观察致颤前后、ROSC后(每1 h)ICP、CPP和MQ的变化,ROSC 6 h后停止监测。结果: 平均动脉压(MBP)、收缩期血压峰值(MSP)、ICP、平均脑灌注压(MCPP)和收缩期脑灌注压峰值(SCPP)组间比较差异无统计学意义(P＞0.05);EECP时舒张期血压峰值(MDP)和舒张期脑灌注压峰值(DCPP)明显高于对照组(P<0.05)。EECP组颈总动脉血流阻力在EECP时明显低于对照组(P<0.05)。EECP时MQ明显高于对照组(P<0.05)。结论: EECP并不影响SCA-ROSC模型MBP、MSP、ICP、MCPP和SCPP而是通过增加MDP、DCPP和降低血流阻力等机制来增加颈总动脉的平均血流量。     

Use of non-invasive finger blood pressure monitoring in the estimation of aortic pressure at rest and during the Mueller manoeuvre.

The aim of this investigation was to evaluate whether reliable estimates of aortic pressure can be derived using non-invasive finger blood pressure monitoring. Finger blood pressure (Ohmeda 2300 Finapres device; Finapres, Englewood, CO) was compared with simultaneous ascending aortic pressure measured with a catheter-transducer system both at rest and during acute negative intrathoracic pressure (the Mueller manoeuvre). Thirty-eight patients aged 17-73 years were studied. All were undergoing routine diagnostic or therapeutic cardiac catheterization. Beat-to-beat values of systolic, diastolic and mean non-invasive finger and invasive aortic blood pressure were measured at rest and factors which might have an influence on the difference between methods were examined. The mean finger-aortic difference was +5 +/- 14 mmHg for systolic, -2 +/- 7 mmHg for diastolic, -5 +/- 8 mmHg for mean and +6 +/- 13 mmHg for pulse pressure. In multivariate linear regression analysis, the difference in systolic pressure was related to aortic systolic pressure (standardized coefficient beta = -0.33, P = 0.01), heart rate (beta = 0.49, P < 0.000), age (beta = -0.29, P < 0.025) and height (beta = 0.40, P < 0.005). The linear regression equations to derive resting aortic pressures from the non-invasive finger pressure readings had correlation coefficients between 0.83 and 0.87 and standard errors of estimate between 6 and 14 mmHg. During the Mueller manoeuvre, Finapres reproduced average pressure changes reliably compared with intra-aortic pressure. Due to moderate inter-individual variation in the finger-aortic differences the correlation coefficients ranged from 0.83 to 0.93 and the standard errors of estimate from 3 to 6 mmHg. Non-invasive finger blood pressure monitoring could be used to estimate central aortic mean and diastolic blood pressure fairly reliably at rest, but with respect to systolic pressure the variance in finger-aortic difference was marked. The average intra-aortic pressure changes caused by the Mueller manoeuvre were reliably reproduced by the Finapres device.     

非诺贝特和吡格列酮对压力过负荷大鼠心室重塑的影响及作用机制

目的： 探讨过氧化物酶体增殖物激活型受体（PPARs）的配体非诺贝特和吡格列酮对压力过负荷大鼠心功能、心室重塑的影响及其作用机制。方法： 取雄性Wistar大鼠腹主动脉缩窄致压力过负荷模型，术后48 h存活的40只随机分成：手术组（CAA组）、非诺贝特干预组（F组）、吡格列酮干预组（P组）及非诺贝特和吡格列酮联合干预组（F＋P组）。另以10只雄性Wistar大鼠为假手术对照。在给药处理12周后检测血流动力学参数、心室重塑指标、血浆和心肌肾素活性、血管紧张素Ⅱ、醛固酮及心肌的1型血管紧张素Ⅱ受体（AT1）mRNA表达变化。最终36 只大鼠获完整资料，上述各组分别为7、8、7、6和8只。 结果： F组、P组及F＋P组的左室湿重/体重、平均动脉压、左室收缩压、左室舒张末期压及心率低于CAA组，而左室压力上升、下降最大速率（±dp/dtmax）高于CAA组；F组、P组、F＋P组及CAA组间血浆和心肌肾素、血管紧张素Ⅱ、醛固酮活性无显著差异。P组和F+P组大鼠心肌AT1 mRNA 的表达水平低于F组。 结论： 尽管PPARα配体（非诺贝特）和PPARγ配体（吡格列酮）对血浆和心肌肾素活性、血管紧张素Ⅱ和醛固酮无明显影响，但PPARs信号通路激活能抑制压力过负荷大鼠心室重塑，降低前后负荷，并提高±dp/dtmax。PPARγ途径激活可抑制心肌AT1 mRNA的表达。     

甘氨酸对缺氧/复氧离体大鼠心脏功能的作用

目的：观察甘氨酸(glycine, GLY)对缺氧/复氧离体心脏功能的影响，探讨甘氨酸对心肌缺血-再灌注 (ischemia/reperfusion, I/R)损伤的防治作用及其机制。方法：利用Langendorff灌流装置复制心肌缺氧/复氧(hypoxia/reoxygenation, H/R)模型，观察不同浓度GLY处理后心脏左室收缩压（left ventricular systolic pressure, LVSP）、左室舒张末压（left ventricular end diastolic pressure, LVEDP）、左室发展压 (left ventricular developed pressure, LVDP=LVSP-LVEDP)、左室收缩压最大上升/下降速率(the maximum rising and dropping rates of left ventricular pressure, dp/dtmax and dp/dtmin)，并在相应的时点分别测定冠脉流出液中的超氧化物歧化酶(superoxide dismutase, SOD)活性和丙二醛(malondialdehyde, MDA)的水平。结果：H/R后各时点大鼠心功能各指标均低于缺氧前；GLY处理组复氧后心功能各指标均高于H/R组，并拮抗损伤导致的SOD减少和MDA升高。结论：一定浓度的GLY能显著改善缺氧/复氧心肌的舒缩功能，其机制可能与其提高SOD活性抑制脂质过氧化反应有关。     

链脲佐菌素诱导MSG大鼠糖尿病心脏病模型的研究

目的:探讨腹腔注射链脲佐菌素(Streptozotocin,STZ)诱导L-谷氨酸钠(Monosodium glutamate,MSG)肥胖大鼠建立糖尿病心脏病模型。方法:选用新生SD大鼠随机分为两组:MSG组和正常对照组(NS组)。MSG组新生大鼠自出生第2d起颈部皮下注射L-谷氨酸钠5g·kg-1,隔天一次,共三次;正常对照组于皮下注射等体积无菌注射用水。MSG组于6周龄时再随机分为4个小组,腹腔注射链脲佐菌素0mg·kg-1,20mg·kg-1,30mg·kg-1,40mg·kg-1。于注射STZ 4w后测定各心脏血流动力学相关指标,同时取血测定其胰岛素水平及血液脂质等指标。结果:注射STZ 4w后,MSG组大鼠Lee’s指数显著增加,心脏指数明显降低,血浆高密度胆固醇(HDL)、低密度胆固醇(LDL)升高,收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR)、左心室收缩压(LVSP)、左心室内压最大上升速率(+dp/dt)、下降速率(-dp/dt)均显著升高,心电图显示其Q-T间期缩短,与对照组比较有统计学差异。MSG+STZ 30mg·kg-1组大鼠SBP、DBP、MAP、HR、+dp/dt、-dp/dt均显著降低,与MSG组比较有统计学差异。MSG+STZ 40mg·kg-1组大鼠SBP、DBP、MAP、HR、LVSP、+dp/dt、-dp/dt均显著降低,Lee’s指数降低,胰岛素浓度降低,血糖水平及心脏指数升高,血浆LDL水平降低,Q-T间期延长,与MSG组比较有统计学差异。结论:研究表明MSG大鼠在6周龄时腹腔注射STZ 40mg·kg-1,有利于糖尿病心脏病模型的建立,为研究、开发防治2型糖尿病心脏病的新药提供了一种良好的动物模型。     

Vibration plethysmography: A method for studying the visco-elastic properties of finger arteries

Vibration plethysmography records changes in vascular volume produced by fast vibrations of cuff pressure. From these, waveforms of dynamic vascular compliance (DVC) are obtained. A total of 46 recordings of DVC, photo-electric plethysmogram (PG), cuff pressure (CP), and indirect blood pressure (BP) are performed on two adjacent fingers (third and fourth) in 23 healthy subjects. The shape and polarity of the DVC waveform markedly depends upon CP or transmural pressure (TP) (TP=BP-CP). The correlation coefficient between DVC and PG waveforms is nearly −1 at negative mean TP, near zero at zero TP, and approaches +1 at positive TP. For CP moving between systolic and diastolic BP, the DVC waveform shows a diastolic peak, with its maximum close to the zero value of instantaneous TP. xy-diagrams of PG against TP and of DVC against TP plotted for the diastolic phase of single pulses reveal a close coincidence of the DVC peak with the maximum slope of the PG/TP curve. A similar relationship appears when slow changes in PG and the amplitude of PG pulse waves are plotted against mean TP.     

Cardiovascular Function During Pre-Avoidance, Avoidance, and Post-Avoidance in Dogs

Four dugs, implanted with aortic blood flow probes and catheters, were trained to press a panel during signalled shock avoidance and switched to an hour of Sidman avoidance per day for a minimum of 10 days, Cardiovascular function (heart rate=HR; stroke volume=SV: blood pressure = BP; cardiac output = CO; total peripheral resistance =TPR; and maximum aortic (dp/dt) was determined during the hour preceding avoidance, during avoidance, and during a 10 min post-avoidance period, Data from 4 dogs were analyzed. Two behaviorally reactive dogs showed elevated BP due to increased TPR during pre-avoidance and increased CO during avoidance. Increases in SV. HR. and dp/dt, most pronounced at the beginning of avoidance, suggest a change in left ventricular function. Intercorrelations between HR and dp/dt revealed apparent influences of the Frank-Starting mechanism during pre-avoidance, and cardiac contractility during avoidance. The 2 remaining animals were less reactive and showed only some of the patterns consistently seen in the 2 more reactive dogs. The data were discussed in terms, of obtaining a model for early stages of human hypertension.     

二肾一夹和肾下主动脉缩窄模型对高血压大鼠右室纤维化的影响

目的探讨二肾一夹（2K1C）及肾下主动脉缩窄（INAC）高血压模型大鼠右室功能与结构的改变及其Ang（1-7）的影响。方法建立2K1C及INAC模型，并采用微渗泵植入技术，用Ang（1-7）进行体内干预，采用无创及有创方法检测动物血压及右心功能；定性及定量分析这两种高血压模型右室心肌细胞及纤维化程度的变化。结果在血压增高的过程中，2K1C模型右室的功能和结构均发生明显的变化，术后14d时其右室收缩及舒张功能均已受损；其心肌细胞无明显变化，但其胶原已明显增多，CVF及PVCA均明显增加；应用Ang（1-7）干预可明显改善2K1C大鼠右室功能并减轻心肌纤维化的发生。在INAC动物模型，14d时其右心功能并无明显变化，无心肌细胞的改变及心肌纤维化的发生，Ang（1-7）对其亦无明显影响。结论在这两种动物模型，其右心功能的改变与其是否发生心肌纤维化有关，而心肌纤维化的发生是RAAS激活的结果。Ang（1-7）可抑制2K1C模型右室心肌纤维化进而改善右心功能，其机制可能与直接抑制RAAS有关。