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1.
建立门控99mTc-甲氧基异丁基异腈心肌灌注断层显像的定量分析方法.方法:计算室壁收缩分数(WCF)和功能低下面积(DFA),直接反映心脏整体和局部的心肌收缩功能,并以WCF功能曲线及其靶心图显示.结果:WCF和DFA的测定重复性很好,CV分别为3.30%和3.6%.WCF、几何法测量的EF和DFA呈负相关(r分别为-0.8563和-0.8390).门控心肌断层显像法与心室显像计数法测量的EF值相关性好(r=0.8907).正常人、冠心病和心肌梗塞患者的WCF值分别为0.438±0.030、0.306±0.081和0.289±0.095.左前降支、右冠状动脉、左冠状动脉回族支和多支冠状动脉分布区灌注低下患者的WCF值分别为0.281±0.077、0.319±0.071、0.303±0.066和0.248±0.106.前三者之间差异无显著性(P>0.05),但后者低于前三者(P<0.05).平衡心室显像测量EF值、门控心肌显像测量EF值和WCF值对冠心病的诊断灵敏度分别为72.4%、48.3%和82.8%.结论:门控心肌断层显像测量WCF值、WCF功能曲线及其靶心图能全面客观地评价心脏收缩功能.  相似文献   

2.
目的:为探讨加强营养支持对高原地区肺心病缓解期营养不良患者呼吸和免疫功能的作用;方法:对30例高原(海拔2260~3200m)慢性肺心病缓解期营养不良(ND)患者在加强营养支持前后作了肺功能、吸气肌功能、动脉血气、血清免疫球蛋白和补体测定,并与本地肺心病营养正常(NN)患者对比;结果:ND组三头肌皮肤皱褶厚度(TSF)、上臂中部周径(MAMC)、口腔最大吸气压(PImax)、最大跨膈压(Pdimax)、PaO2、IgA、C3、C4均明显低于NN组(P均<0.01),膈肌张力—时间指数(TTdi)和PaCO2明显高于NN组(P均<0.01),两组FEV1.0、IgG、IgM无差异性。ND组加强营养支持6周后,体重明显增加,TSF、MAMC、PImax、Pdimax、PaO2、IgA、C3、C4明显提高(P<0.01或<0.05),TTdi,PaCO2明显下降(P<0.01);结论:加强营养支持治疗能明显改善高原地区肺心病营养不良患者的呼吸功能和增强其免疫功能。  相似文献   

3.
颅脑损伤后肌酸磷酸激酶活性和循环血内皮细胞变化   总被引:1,自引:1,他引:0  
目的:寻找有利于颅脑外伤早期诊断的指标.方法:制作大鼠颅脑撞击损伤模型.伤后测定循环血内皮细胞(CEC)数和BB型肌酸磷酸激酶(CK-BB)活性,24小时活杀后测脑含水量.结果:伤后损伤组血浆CK总活性明显高于对照组,尤以伤后0.5、2、24小时最为显著(P<0.01).脑脊液(CSF)中CK-BB活性于伤后0.5小时即有显著升高,但血浆CK-BB此时未见升高.伤后2小时无论CSF和血浆CK-BB均达峰值,CSF-CK-BB较血浆CK-BB升高更为明显(P<0.01).伤后8小时和24小时CSF-CK-BB虽稍有回落,但仍高于正常值(P<0.01),而血浆CK-BB已回至正常水平.CEC计数在伤后各时相点均显著高于正常(P<0.01).脑水含量伤后显著增加(P<0.05).结论:CEC计数和C-BB活性测定在脑损伤早期诊断中具有重要的作用,其中CSF-CK-BB活性变化敏感性更高.  相似文献   

4.
目的:探讨高原老年肺心病夜间睡眠减氧饱和及与呼吸功能的关系。方法:对34例高原老年肺心病缓解期患者作了白天觉醒时的血气、1秒钟用力呼气容积(FEV1)、75%、50%和25%肺活量大呼气流量[V75/Ht(m)、V50/Ht(m)、V25/Ht(m)]、最大跨膈压(Pdimax)和夜间睡眠时的脑电图、眼动图、血氧饱和度(SaO2)连续监测。结果:高原老年肺心病患者夜间睡眠时快动眼睡眠(REM)和非REM(NREM)期平均(MSaO2)和最低SaO2(MmSaO2)较白天觉醒SaO2(DSaO2)明显降低,均为P<0.01,以REM期最明显,高碳酸血症组较正常碳酸血症组降低明显(P<0.01或0.05)。MSaO2与DSaO2、FEV1、V75/Ht(m)、V50/Ht(m)、V25/Ht(m)Pdimax和MmSaO2与DSaO2呈明显正相关,r=0.738、0.687、0.771、0.889、0.568、0.876、0.822,均为P<0.01。结论:高原老年肺心病患者夜间睡眠有明显减氧饱和,尤以REM期最明显,且与肺和肺膈肌功能损害程度正相关。  相似文献   

5.
目的:了解观察伤后输注纤维结合蛋白(Fn)对大鼠血管内皮细胞(VEC)损伤修复的作用.方法:用大鼠尾静脉损伤及左股骨粉碎性骨折模型,实验分Fn治疗组和等渗盐水对照组,Fn治疗组于伤后2小时,输注Fn1.7mg/100g体重.结果:输注Fn可使血浆Fn和腹腔巨噬细胞(P-Mψ)表面Fn水平增高、P-Mψ吞噬功能增强、循环内皮细胞(CEC)数量减少、内皮损伤区网格状支架增多、槽状结构变浅且有EC爬行现象.结论:伤后输注Fn促进损伤内皮的修复有一定作用.  相似文献   

6.
认间无创伤通气在慢性阻塞性肺疾病缓解期患者中的应用   总被引:1,自引:0,他引:1  
目的 探讨认间无创伤通气在慢性阻塞性肺疾病(COPD)缓解期的应用及其机理。方法 将50例COPD缓解期患随机分为治疗组与对照组,每组25例,观察夜间无创伤通气治疗前后12分钟步行距离(12MWD),血气分析、肺功能、膈肌移动度和夜间最低氧饱和度(SaO2)的变化。结果 夜间无创伤通气治疗组治疗后12MWD、FVC%、FEV1%、膈肌移动度夜间最低SaO2均较对照组增高,PaCO2较对照组降低2  相似文献   

7.
目的探讨减轻周围神经在缓慢牵拉过程中的损伤,增加神经延长率的方法。方法采用改良的组织扩张器,对大白兔坐骨神经行扩张延长的同时,辅以脉冲电磁场(PEMF)及碱性成纤维细胞生长因子(bFGF)处理。最后,测定神经延长率(NER)、运动传导速度(MCV)及组织病理观察。结果NER在PEMF组及bFGF组均显著高于对照组,而MCV的降低却显著较轻。组织病理显示,PEMF及bFGF组的神经变性轻,雪旺氏细胞增殖,新生毛细血管及髓鞘却较明显。结论PEMF及bFGF可减轻神经在扩张期间的损伤,增加延长率  相似文献   

8.
对34例急性脑外伤病人脑脊液(CSF)心钠素(ANF)、精氨酸加压素(AVP)的含量进行放射免疫测定。结果表明,脑外伤后48h和6~10dCSF中ANF含量均明显低于对照组(P<0.01);AVP含量较对照组明显升高(P<0.01)。伤后2~3周CSF中ANF水平升高,与对照组相比无明显差异(P>0.05);AVP水平降低,但仍明显高于对照组(P<0.01)。GCS≤8分者CSF中AVP含量高于GCS>8分者(P<0.05);CSF压力≥1.96kPa者AVP含量高于CSF压力<1.96kPa者(P<0.05)。ANF的含量变化与GCS计分和CSF压力无关。提示,ANF和AVP可能参与了颅脑损伤的发病机制,ANF的分泌减少与AVP的释放增加可能是导致脑外伤后继发脑水肿的重要因素。动态观察CSF中ANF和AVP的含量变化,对于探讨颅脑损伤后的病理机制,判断脑水肿的严重程度,指导临床治疗具有重要意义。  相似文献   

9.
蒺藜总皂甙对TNF-α及IL-1β诱导内皮细胞粘附的抑制作用   总被引:3,自引:0,他引:3  
目的:观察蒺藜总皂甙(grosssaponinsfrom TribulusterrestrisL,GSTT) 对肿瘤坏死因子- α(TNF- α) 、白细胞介素-1β(IL-1β) 诱导的培养新生牛脑微血管内皮细胞(CMEC) 粘附大鼠血单核细胞(MNC) 及中性粒细胞(PMN) 的影响。方法:用TNF-α和IL-1β分别诱导传代的CMEC,计粘附MNC及PMN的细胞数,并计算粘附率。结果:CMEC 经TNF- α处理4h 后,CMEC与MNC及PMN的粘附率,分别增加到31.3±0.5% 和32.1±0.5% (对照组分别为12 .5±0 .2% 和13 .8±0 .4 %) ,经IL-1β处理2h 后,则分别为44.5 ±1.0 % 和44.8 ±0.7 % ( 对照组分别为12 .9 ±0.6 % 和14.7 ±0.6% )。在TNF- α(IL- 1β) 处理前,用GSTT与CMEC共孵育,预处理2h,则GSTT可剂量依赖性地抑制TNF- α和IL- 1β的作用。结论:GSTT可抑制CMEC 与PMN及MNC的粘附。  相似文献   

10.
糖尿病、非糖尿病组(对照组)各23例,分别在人工晶体植入术(ECCE+IOL)前后进行角膜内皮显微镜观察和计算机图像分析。对照组术后3个月角膜内皮细胞(CEC)、形状系数(FC)和变异系数(CV)恢复正常(P>0.05),以后(至2年)CEC密度(D)未继续下降。而与对照组比较,糖尿病组术前CEC面积(A)正常,但周长(Pe)、长径(L)、CV增大,FC减小(P<0.01);术后2年内各形态定量指标较术前及同期对照组差异有显著性意义(P<0.05或0.01),D持续下降,表明形态定量检测可判断ECCE+IOL术后CEC预后状况,尤其对糖尿病患者十分重要。  相似文献   

11.
OBJECTIVE: The objective of our study was to illustrate the potential for phrenic nerve injury during percutaneous lung ablation, to discuss the importance of this complication, and to review the expected location of the phrenic nerve on chest CT. CONCLUSION: Knowledge of the expected location of the phrenic nerve-a structure that is usually not visible on imaging but is important-is essential for avoiding injury to the nerve during pulmonary ablation.  相似文献   

12.
目的:探讨恶性肿瘤经动脉介入治疗致脊髓损伤的发生率、影像及临床表现、处理原则及预防措施。方法:284例肺恶性肿瘤患者行420例次选择性支气管动脉介入治疗,63例肾癌患者行96例次经肾动脉介入治疗(部分例次经腰动脉介入治疗),肺恶性肿瘤和肾癌患者的介入治疗之和占同期恶性肿瘤经动脉介入治疗的2.0%。恶性肿瘤经动脉介入治疗后出现8例次脊髓损伤,对其临床资料进行回顾性分析。结果:肺恶性肿瘤经支气管动脉介入治疗,肾癌经肾动脉、腰动脉介入治疗,脊髓损伤发生率分别为1.2%、2.1%,1例次具有右膈动脉侧支供血的肝癌对右膈动脉行TACE术时出现脊髓损伤。同期的其他介入治疗(如腹腔动脉、肝动脉、脾动脉、肠系膜上动脉等)无脊髓损伤。血管造影仅1例次(1/8)显示脊髓根动脉及脊髓前动脉,造影即刻至数小时出现脊髓损伤症状。使用大剂量激素、血管扩张剂、脱水剂、神经营养剂等治疗,尽早进行康复训练,脊髓功能在0.5~3.5个月左右基本恢复。结论:恶性肿瘤经动脉介入治疗可导致脊髓损伤发生,血管造影脊髓根动脉及脊髓前动脉显示率低,术前及术中应以多种预防措施减少其发生率,术后积极治疗、尽早进行康复训练,脊髓功能可基本恢复。  相似文献   

13.
OBJECTIVE: To verify the reliability of quantitative computed tomography (CT) to estimate the postoperative lung function in patients with mild to severe chronic obstructive pulmonary disease (COPD) who underwent a lobectomy. METHODS: Nine COPD patients with lung cancer having a lung lobectomy with preoperative CT were enrolled. By applying a density mask technique and a specific equation, predicted postoperative forced expiratory volume in 1 second (FEV1) and vital capacity (VC) were calculated. Predicted values were correlated with postoperative measured values. RESULTS: Estimated FEV1 and VC were always significantly lower than the corresponding postoperative values; however, CT-estimated postresection FEV1 values were better than the postresection VC values (biases between estimated and measured values were -0.14 and -0.536 L, respectively, according to the Bland-Altman method). Quantitative CT predicted postoperative FEV1 (r = 0.97, P < 0.001) and VC (r = 0.93, P < 0.001) well in all patients, however. CONCLUSIONS: Quantitative CT may be an alternative tool to perfusion scan to predict postresection lung function, even in patients with borderline pulmonary function undergoing a lobectomy.  相似文献   

14.
目的 探讨64层螺旋CT肺容积扫描诊断慢性阻塞性肺疾病(COPD)的临床价值.资料与方法 COPD组87例,对照组29例,进行64层螺旋CT肺容积扫描和常规肺功能检查,两次检查时间间隔小于30d,研究CT肺容积参数与肺功能实验室指标之间的相关性,并采用ROC曲线分析CT肺容积参数对COPD诊断和分级的临床价值.结果 CT容积扫描获取的肺气肿容积比例与肺功能分级、RV(实际/预计%)、TLC(实际/预计%)、RV/TLC(%)、FEV1(实际/预测%)和FEV1/VC MAX(%)之间均存在显著相关(r分别为0.560,0.309,0.246,0.280,-0.522,-0.599,P均<0.01):ROC曲线分析结果显示,全肺肺气肿容积比例、右肺肺气肿容积比例和左肺肺气肿容积比例诊断COPD的曲线下面积分别为0.863、0.822和0.917(P均<0.01),差异有统计学意义.结论 CT测量的肺气肿容积与肺总容积之比和肺功能分级相关,对诊断COPD有预测意义.  相似文献   

15.
PURPOSE: The purpose of this work was to assess the accuracy of MRI for the determination of lung gas and tissue volumes. METHOD: Fifteen healthy subjects underwent MRI of the thorax and pulmonary function tests [vital capacity (VC) and total lung capacity (TLC)] in the supine position. MR examinations were performed at inspiration and expiration. Lung volumes were measured by a previously validated technique on phantoms. Both individual and total lung volumes and capacities were calculated. MRI total vital capacity (VC(MRI)) was compared with spirometric vital capacity (VC(SP)). Capacities were correlated to lung volumes. Tissue volume (V(T)) was estimated as the difference between the total lung volume at full inspiration and the TLC. RESULTS: No significant difference was seen between VC(MRI) and VC(SP). Individual capacities were well correlated (r = 0.9) to static volume at full inspiration. The V(T) was estimated to be 836+/-393 ml. CONCLUSION: This preliminary study demonstrates that MRI can accurately estimate lung gas and tissue volumes. The proposed approach appears well suited for functional imaging of the lung.  相似文献   

16.
髋臼骨折合并股神经损伤相关因素分析   总被引:3,自引:0,他引:3  
目的 分析髋臼骨折合并股神经损伤的原因,以期进一步提高临床诊治水平。方法 1996年1月-2004年11月,共手术治疗髋臼骨折146例,其中6例合并股神经损伤,根据临床表现、CT及三维重建分析股神经损伤的原因。按Letournel和Judet的髋臼骨折分类法进行分类,双柱骨折2例,横形伴后壁骨折1例,因骨折形成的巨大血肿压迫股神经,致股神经损伤;前壁骨折伴股骨头前脱位1例,髋臼前柱陈旧性骨折合并耻骨上支骨折1例,骨折端直接挫伤股神经;前柱骨折合并髂骨翼骨折1例,因术中牵拉损伤股神经。5例患者给予血肿清除、神经束减压、神经外膜松解去除病因,1例行保守治疗。结果本组6例患者随访1—3年,平均随访1.8年。5例患者股四头肌肌力从术前1—2级恢复至4—5级,1例从伤后2—3级恢复至5级,伸膝功能正常,可正常行走。4例患者感觉功能完全恢复,1例患者随访2年后仍有大腿下2/3前方及小腿内侧感觉减退;另有1例牵拉伤患者肌力恢复正常,随访1.2年后仍存在感觉障碍。结论 髋臼骨折合并股神经损伤临床上少见,复杂髋臼骨折应高度警惕有无股神经损伤;髂腰肌周围血肿形成及骨折块直接损伤是髋臼骨折合并股神经损伤的常见原因;医源性损伤需引起重视。  相似文献   

17.
Pulmonary function evaluation during the Skylab and Apollo-Soyuz missions.   总被引:2,自引:0,他引:2  
Previous experience during Apollo postflight exercise testing indicated no major changes in pulmonary function. Pulmonary function has been studied in detail following exposure to hypoxic and hyperoxic normal gravity environments, but no previous study has reported on men exposed to an environment that was both normoxic at 258 torr total pressure and at null gravity as encountered in Skylab. Forced vital capacity (FVC) was measured during the preflight and postflight periods of the Skylab 2 mission. Inflight measurements of vital capacity (VC) were obtained during the last 2 weeks of the second manned mission (Skylab 3). More detailed pulmonary function screening was accomplished during the Skylab 4 mission. The primary measurements made during Skylab 4 testing included residual volume determination (RV), closing volume (CV), VC, FVC and its derivatives. In addition, VC was measured in flight at regular intervals during the Skylab 4 mission. Vital capacity was decreased slightly (-10%) in flight in all Skylab 4 crewmen. No major preflight-to-postflight changes were observed. The Apollo-Soyuz Test Project (ASTP) crewmen were studied using equipment and procedures similar to those employed during Skylab 4. Postflight evaluation of the ASTP crewmen was complicated by their inadvertent exposure to nitrogen tetroxide gas fumes upon reentry.  相似文献   

18.
AIMS: To document the presence and extent of air trapping on high resolution computed tomography (HRCT) in patients with pulmonary sarcoidosis and correlate HRCT features with pulmonary function tests. METHODS: Twenty-one patients with pulmonary sarcoidosis underwent HRCT and pulmonary function assessment at presentation. Inspiratory and expiratory HRCT were assessed for the presence and extent of air trapping, ground-glass opacification, nodularity, septal thickening, bronchiectasis and parenchymal distortion. HRCT features were correlated with pulmonary function tests. RESULTS: Air trapping on expiratory HRCT was present in 20/21 (95%) patients. The extent of air trapping correlated with percentage predicted residual volume (RV)/total lung capacity (TLC) (r = 0.499;P < 0.05) and percentage predicted maximal mid-expiratory flow rate between 25 and 75% of the vital capacity (r = -0.54;P < 0.05). Ground-glass opacification was present in four of 21 (19%), nodularity in 18/21 (86%), septal thickening in 18/21 (86%), traction bronchiectasis in 14/21 (67%) and distortion in 12/21 (57%) of patients; there were no significant relationships between these CT features and pulmonary function results. CONCLUSION: Air trapping is a common feature in sarcoidosis and correlates with evidence of small airways disease on pulmonary function testing.  相似文献   

19.
目的探讨大鼠坐骨神经牵拉伤后MRI变化以及损伤过程中转化生长因子β1(transforming growth factorβ1,TGF-β1)的表达和Ⅰ、Ⅲ型胶原蛋白(COL-Ⅰ、Ⅲ)含量的变化。方法将50只成年雄性SD大鼠随机分为对照组(仅暴露坐骨神经)和牵拉组(大鼠右侧后腿坐骨神经牵拉伤),分别于术后3d,2、4、6、8周,随机取两组大鼠各5只,切取牵拉段神经行MRI、组织形态学、免疫组织化学的观察及反转录酶-聚合酶链式反应(RT-PCR)、Western Blot定量测定TGF-β1的表达和COL-Ⅰ、Ⅲ含量。结果牵拉损伤后MRI表现为神经增粗,T1、T2时间延长;牵拉组大鼠坐骨神经TGF-β1的表达和COL-Ⅰ、Ⅲ含量明显高于对照组,两者差异有统计学意义(P0.05)。结论坐骨神经牵拉损伤后,周围神经发生纤维化病变,COL-Ⅰ、Ⅲ含量显著增加,TGF-β1表达有显著差异,提示TGF-β1在周围神经纤维化过程中具有一定的作用。  相似文献   

20.
人工髋关节置换术中的神经损伤并发症   总被引:4,自引:1,他引:3  
目的 探讨人工髋关节置换术中并发神经损伤的原因及其防治措施。方法 回顾性分析1991年1月~2001年12月所进行的人工髋关节置换术413例,发生神经损伤3例,发生率0.73%。其中坐骨神经损伤2例,股神经损伤1例。结果 3例神经损伤的原因分别为:过量使用抗凝药预防深静脉血栓形成而导致的低血容量性休克1例,血肿形成压迫1例,病因未明1例。经纠正休克、清除血肿和康复治疗后,神经功能均有不同程度的恢复。结论 人工髋关节置换术并发神经损伤的原因为直接损伤或间接的牵拉,压迫和缺血。了解神经损伤的原因并避免损伤的发生,及时而正确的应对措施对防治人工髋关节置换术中的神经损伤具有重要意义。  相似文献   

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