体检人群甲襞微循环检测结果分析

目的:观测体检人群的甲襞微循环,分析其异常结果的临床意义。方法:采用徐州产WX-753B型微循环多参数测量仪,对3430例体检者的甲襞微循环管袢形态、血流状态、管袢周围状态等三类16项指标进行检测,分析其异常结果人群的年龄、性别分布和吸烟对微循环的影响。结果:甲襞微循环检测异常者占总检测例数的31.55%,其异常结果中不同性别间、各年龄组间以及吸烟和未吸烟组间的甲襞微循环形态、流态、袢周状态积分值有明显差异(P<0.05～0.01),且与增龄有明显正相关(r=0.99)。结论:甲襞微循环检测对辅助疾病诊断和临床用药、疗效判断等提供有一定临床意义的相关信息,为疾病的防治,健康宣教提供较客观的依据。     

高强度手部作业人群甲襞微循环的远期观察

目的:检测高强度手部作业人群甲襞微循环的远期变化。方法:使用ZL104型微循环检测仪及图像分析系统检测224例参加地震救援者(观察组)左手甲襞微血管形态、微血流流态和袢周状态,并对照正常参考值(正常组)进行比较分析。结果:观察组甲襞微循环异常者占全部受检者的36.16%,其甲襞微血管形态积分、流态积分、袢周状态积分及总积分分值均显著高于正常组(P<0.05)。结论:高强度手部作业对部分人群甲襞微血管形态及功能有远期影响。     

24例室间隔缺损患者的微循环变化

本文报道24例单纯室缺不合并肺功脉高压患者手术前后甲襞、球结膜微循环变化,评分标准按田牛教授提出的甲襞、球结膜微循环综合定量积分法进行评定。结果表明:室缺组甲襞微循环改变主要是管袢输入枝,袢顶直径变细,交叉畸形管袢发生增高。室缺组的总积分、形态积分、袢周积分均高于对照组(P<0.05)。手术后甲襞     

雷诺现象患者的区域血流量及微循环变化

目的:探讨雷诺现象(RP)患者甲襞区域血流量和微循环的变化。方法:对30例RP患者和34例健康对照者进行甲襞区域血流量和甲襞微循环(NFM)检测。结果:RP患者的甲襞区域血流量明显低于健康对照组(P<0.01)。RP患者NFM检测中见管袢模糊不清,管袢缩短,交叉管袢增多,出现宽大畸形管袢,血流速度减慢,多呈粒流、粒线流,血管运动性增强,红细胞聚集多呈中、重度,乳头浅平,汗腺导管增多,血色暗红,严重者袢周有渗出、出血;管袢数减少,输入枝、输出枝、袢顶均增宽;与健康对照组相比有显著性差异(P<0.01)。RP患者NFM积分值明显高于健康对照组(P<0.01)。结论:甲襞区域血流量检测和微循环检查有助于判断RP患者的病情和预后。     

不同危险分层原发性高血压病患者甲襞微循环改变

目的:观察原发性高血压病不同危险分层患者甲襞微循环变化。方法:115例原发性高血压病患者,根据心血管危险分层分为低危组(n=7)、中危组(n=28)、高危组(n=34)和极高危组(n=46),以同期20例年龄、性别匹配的健康志愿者为健康对照组。采用ZL-104型微循环检测仪和微循环图像分析系统检测各组甲襞微血管视野清晰度、管袢长度、管袢数、畸形管袢数、交叉管袢数、输入支管径、输出支管径、袢顶直径、血流速度、红细胞聚集程度、白细胞数、白微栓、袢周渗出、出血、甲襞微血管乳头及乳头下静脉丛的统计学差异。结果:低危组甲襞微循环各项指标与健康对照组比较均无统计学差异(P0.05),中危组到极高危组甲襞微循环渐次出现明显的形态、流态和袢周状态的变化,且与低危组差异均有统计学意义(P0.05)。形态上主要表现为:视野清晰度变差、微循环管袢数减少、畸形管袢数占比增加、输入支管径变细;流态上主要表现为:微血管内血流速度减慢、红细胞聚集增多;在袢周状态上主要表现为:微血管袢周渗出增多。且有高血压危险分层越高,上述改变越严重的趋势。结论:高血压病患者出现与危险分层相关的甲襞微循环改变。甲襞微循环变化对高血压病患者病情评估、治疗与预后判断有重要临床意义。     

新正天丸对偏头痛血瘀证甲襞和球结膜微循环的影响

目的 :探讨偏头痛血瘀证病人甲襞和球结膜微循环的改变及新正天丸治疗后的影响。方法 :对照观察 3 6例偏头痛血瘀证病人发作期、治疗后和 2 8例正常人甲襞微循环 ,检测 2 8例偏头痛病人球结膜微循环 ,并与 2 6例正常人相比较 ,重点观察甲襞和球结膜微循环的形态、流态及血管袢周围状态等多项指标 ,并以加权积分法计算其积分值。结果 :与对照组相比 ,发作期存在明显的甲襞和球结膜微循环改变 ,主要表现在毛细血管管径缩小 ,管袢形态异常 ,袢周出血。经新正天丸治疗后 ,管袢清晰度增强 ,血流速度加快 ,红细胞聚集性下降 ,加权积分法示治疗前后甲襞和球结膜微循环有显著性改变 (P <0 .0 5～ 0 .0 1)。结论 :甲襞和球结膜微循环障碍可能是偏头痛血瘀证的重要病理特征 ,新正天丸对其微循环障碍可能有改善作用。     

中风患者的甲襞微循环

利用全军微循环专业组所制定的临床甲襞微循环加权积分标准,观察了75例脑中风患者甲襞微循环的变化。发现甲襞管袢内血液流态的变化出现较早且较明显。62例患者甲襞管袢内血流呈粒流,粒缓流(积分值为0.64±0.43),69例出现不同程度的红细胞聚集(积分值为0.58±0.49),血浆柱亦较明显。病程在一个月以内者     

吸、戒烟对人体甲襞微循环的影响

对３０例吸烟者、３０例有吸烟史现戒烟者以及３０例无吸烟史者行甲襞微循环观测。结果表明，吸烟组甲襞微循环有明显改变，总积分值高于戒烟组和无吸烟的对照组（Ｐ＜００１）。其主要改变为：管袢输入枝、输出枝管径增宽，管袢扭曲、分叉，血流速度减慢，红细胞聚集度增加。戒烟组各项指标均明显改善，但与吸烟组比较差异显著（Ｐ＜００１）。与对照组比较，其形态改变尚未完全恢复（Ｐ＜００１）。以上结果提示，吸烟可引起机体的慢性微循环障碍，戒烟可对其造成的损害有所改善     

中国北方地区健康成人甲襞微循环之特点

目的 :探讨年龄因素及地区因素对甲襞微循环的影响。方法 :按田牛甲襞微循环综合评分方法 ,对按不同年龄分组的 142例中国北京地区健康成人甲襞微循环进行观察、测量、计分、分析 ,同时将部分指标与国内报道的正常参考值进行对比分析。结果 :北方地区各年龄组健康成人甲襞微循环积分值分别为 2 0～ 39岁组 1.17± 0 .7、 40～ 5 9岁组1.74± 1.0 8、6 0～岁以上组 2 .48± 0 .6 1。各组的管袢形态、流态及袢周状态积分值及总积分值均随年龄增加呈递增趋势 ,组间比较有极显著差异 (P <0 .0 1)。各年龄组积分值均明显高于国内报道的同年龄组的正常参考值 (P <0 .0 1)。微循环的管袢数、输入枝、输出枝、袢顶管径随年龄增加呈递减趋势 (P <0 .0 5 )。积分值增高主要表现在管袢清晰度下降、畸形管袢率增加、血流缓慢、红细胞聚集、出血、乳头变浅、乳头下静脉丛可见。其中血流缓慢、红细胞聚集、乳头变浅、乳头下静脉丛可见出现率随年龄增加呈递增趋势。结论 :北方地区健康成人甲襞微循环加权积分值偏高且受年龄因素的影响 ,随着增龄积分值增高。     

青少年吸烟对甲襞微循环的影响

对16～18岁吸烟(烟龄≥1年,平均日吸烟量≥3支)与非吸烟青少年各40人进行甲襞微循环检查,结果显示吸烟组管襻数、输入枝管径、管襻长度各值低于非吸烟组,统计学处理有非常显著差异(P相似文献   

桂蜡膏对老年糖尿病微血管病变患者甲襞微循环的影响

目的:观察桂蜡膏足底穴位贴敷对老年2型糖尿病(T2DM)微血管病变患者甲襞微循环的影响。方法:选择老年T2DM微血管病变患者50例,予以桂蜡膏足底穴位贴敷,每天一次,连续4周为一疗程。治疗前后行甲襞微循环及血液流变性检查。结果:全部病例治疗后与治疗前比较甲襞微循环及血液流变学指标均有不同程度好转,差异具有非常显著性意义(P<0.01)。结论:桂蜡膏足底穴位贴敷治疗可明显改善老年T2DM微血管病变患者甲襞微循环。     

Triggers of Heavier and Lighter Cigarette Smoking in College Students

This preliminary study examined the relationship between cigarette smoking and several environmental and psychological cues to smoke in college students who were lighter (2–8 cigarettes per day) and heavier (greater than 10 cigarettes per day) smokers. Nineteen lighter and 16 heavier smokers monitored their smoking behavior and certain smoking cues, and reported this information daily to an interactive voice response (IVR) system over a 13-day period. Results indicated the lighter smokers consumed a significantly greater proportion of cigarettes when drinking alcohol and during the evening hours compared to heavier smokers. No differences were found between groups on smoking in the presence of negative affect or coffee, although heavier smokers smoked a greater proportion of cigarettes when experiencing low energy positive affect (e.g., calm). If a replication of this study produces similar results, there could be implications for public policy, particularly the regulation of smoking in venues where alcohol is served.     

茶色素对中老年人血脂和甲襞微循环的影响

目的：研究25例健康中老年人口服茶色素前后血脂、甲襞微循环的变化。方法：服茶色素每日3次，每次250mg，连服3个月。服药前后查血脂及甲襞微循环。仪器用日立7150型生化仪、XY－3型DOC显示器，BCAC教育型微循环显微镜按田氏加权积分进行检测。结果：25例中老年人口服茶色素前后各项指标均有显著性差异（P＜0．01）。结论：茶色素对中老年人有降低胆固醇，改善微循环的作用，对防治心脑血管疾病有效。     

Cigarette smoking and random serum cholesterol levels in a Northern Ireland general practice population of 18- to 20-year-old students and non-students.

BACKGROUND: Coronary heart disease is the commonest cause of death in Northern Ireland, but few data exist on the incidence of risk factors in young adult students and non-students. AIM: To gather data on the prevalence of cigarette smoking and raised serum total cholesterol in a population of 18- to 20-year-old students and non-students. METHOD: Subjects were patients are Mountsandel Surgery, Coleraine on 1 January 1989 and were 18-20 years of age inclusive on that date. Subjects were interviewed by a research nurse who recorded socio-demographic data, tobacco consumption and random serum total cholesterol. Smoking status validation was by serum thiocyanate and expired air carbonmonoxide estimations. RESULTS: Out of the 832 subjects surveyed, 570 were students and 262 were non-students. Cigarettes were smoked by 239 (28.7%) subjects, and a significantly greater proportion of non-students compared with students were smokers (36.6% and 25.1%, respectively; P < 0.001). The proportion of males compared with females who smoked cigarettes was not significantly different, but males smoked significantly more cigarettes per day than females (14 and 11 cigarettes, respectively; P = 0.005). The average age for commencing regular cigarette smoking was 15.3 years, and 49.9% of smokers had started regular smoking by the age of 16 years. A greater proportion of non-students (65.7%) compared with students (39.2%) had started smoking before the age of 16 years. Out of those sampled, 156 (19.2%) had random serum cholesterol levels above 5.2 mmol l-1. Mean total cholesterol for non-students was significantly higher than for students (4.61 and 4.45 mmol l-1, respectively; P = 0.01) and increased significantly with increasing age (P = 0.03). Three subjects recorded cholesterol levels above 7.8 mmol l-1. CONCLUSION: Cigarette smoking and raised serum total cholesterol were prevalent among an apparently healthy population of students and non-students. These young adults may be significantly more at risk from subsequent coronary heart disease than was previously suspected.     

手部随意修复皮瓣甲襞微循环的观察

背景：随意皮瓣循环的观察多通过激光多普勒血液灌流仪来完成,但未曾有过对随意皮瓣甲襞微循环进行过观察研究,而甲襞微循环是一种最为常见的外周循环检测方法。 目的：通过对随意皮瓣的手指甲襞微循环进行观察,来了解皮瓣末梢微循环的变化情况。 方法：选择河北医科大学第一医院烧伤整形外科收治的手部有皮肤组织缺损的患者进行随意皮瓣修复而并未进行特殊药物治疗的患者共有23例按照皮瓣移植后受伤肢体及健康肢体指端的甲襞微循环分为皮瓣组和对照组,观察皮瓣移植后即刻、7,15 d共3个时相的微循环形态、流态及襻周。 结果与结论：皮瓣组移植后即刻微循环在清晰度、血流速度、红细胞聚集、渗出方面均有很大的变化,发生微循环障碍。移植后7 d,两组红细胞聚集比较差异无显著性意义(P > 0.05),而清晰度、血流速度及渗出比较差异有显著性意义(P < 0.05);移植后15 d,两组在清晰度、血流速度、红细胞聚集及渗出方面差异无显著性意义(P > 0.05)。提示,在临床治疗过程中,通过对指端微循环的观测,能够了解皮瓣血运建立情况,给临床皮瓣断蒂提供依据。     

Influence of smoking fewer cigarettes on exposure to tar, nicotine, and carbon monoxide

In the hope of reducing the adverse health consequences of smoking, physicians frequently advise their patients who cannot quit to smoke fewer cigarettes. Habitual smokers may compensate for the reduced number of cigarettes, however, by taking in more smoke per cigarette. We measured the intake of tar (estimated as mutagenic activity of the urine), nicotine, and carbon monoxide during short-term cigarette restriction. With a reduction from an average of 37 cigarettes to an average of 5 cigarettes per day, the intake of tobacco toxins per cigarette increased roughly threefold and daily exposure to tar and carbon monoxide declined only 50 percent. We conclude that smoking fewer cigarettes may reduce exposure to toxins and related adverse health consequences. However, consistent with a tendency to maintain intake of nicotine, the magnitude of the benefit is much less than expected. Whether "oversmoking" persists during long-term restriction of cigarettes requires further investigation.     

硬皮病患者甲襞微循环的特点

利用“甲襞微循环加权积分法”观测了11例硬皮病患者的甲襞微循环,发现硬皮病患者甲襞微循环的主要特点是管襻数目减少,畸形管襻增多,血流缓慢,出现不同程度的红血球聚集,以及乳头波纹浅平等。硬皮病患者甲襞微循环的总积分属于中度异常。     

Maximum oxygen uptake capacity of smokers of different age groups

Eighty-four healthy asymptomatic sedentary smokers and 92 healthy sedentary non-smokers of the age range 20-59 years were investigated for their maximum oxygen uptake capacity (VO2max) and related cardiorespiratory parameters at the level of maximal exercise by bicycle ergometry. The subjects were blocked into four age decades of 20-29, 30-39, 40-49, and 50-59 years to show the effect of smoking on VO2max of smokes of different age groups. The physical characteristics of smokers and non-smokers of comparable age groups did not show any significant difference. The smokers of each subsequent age group consumed 5.9 +/- 4.1, 6.3 +/- 5.7, 12.7 +/- 7.1, and 11.5 +/- 9.1 pack years of cigarettes, respectively (pack year = number of packets of cigarettes per day X number of years of smoking). VO2max of smokers (38.9 +/- 4.6 ml.kg-1.min-1) was significantly lower (p less than 0.05) than that of nonsmokers (42.1 +/- 3.2 ml.kg-1.min-1) only in the young age group of 20-29 years. VO2max expressed in per kg of the body weight (VO2max/BW) was found to be significantly (p less than 0.01) and negatively correlated with number of cigarettes smoked per day (-0.36, p less than 0.01), number of years through which smoked (-0.38, p less than 0.01), and pack years (-0.42, p less than 0.01). In other age groups, though non-smokers predominated over smokers in VO2max, the differences were not statistically significant. Also, in these age groups, smoking histories failed to reveal any significant correlation with VO2max. This suggests that smoking impairs VO2max only in the young ages. By increasing age, VO2max was diminished by 13% from 20 to 59 years in non-smokers and 15.5% from 20 to 59 years in smokers. Age also diminished HRmax and VEmax of smokers in the same manner as in the case of non-smokers. The VO2max of Indian sedentary non-smokers was found to be lower than those of Caucasians, Kurds, Yemenites, Europeans, and Africans. Values reported on Asians were found to be comparable with those of the present study.     

Relative and absolute excess risks of coronary heart disease among women who smoke cigarettes

We prospectively examined the incidence of coronary heart disease in relation to cigarette smoking in a cohort of 119,404 female nurses who were 30 to 55 years of age in 1976 and were free of diagnosed coronary disease. During six years of follow-up, 65 of the women died of fatal coronary heart disease and 242 had a nonfatal myocardial infarction. The number of cigarettes smoked per day was positively associated with the risk of fatal coronary heart disease (relative risk = 5.5 for greater than or equal to 25 cigarettes per day), nonfatal myocardial infarction (relative risk = 5.8), and angina pectoris (relative risk = 2.6). Even smoking 1 to 4 or 5 to 14 cigarettes per day was associated with a twofold to three-fold increase in the risk of fatal coronary heart disease or nonfatal infarction. Overall, cigarette smoking accounted for approximately half these events. The attributable (absolute excess) risk of coronary heart disease due to current smoking was highest among women who were already at increased risk because of older age, a parental history of myocardial infarction, a higher relative weight, hypertension, hypercholesterolemia, or diabetes. In contrast, former smokers had little, if any, increase in risk. These prospective data emphasize the importance of cigarette smoking as a determinant of coronary heart disease in women, as well as the markedly increased hazards associated with this habit in combination with other risk factors for this disease.     

Knowledge and attitudes of children towards cigarette smoking and its damage

The present study reports the results of knowledge and attitudes of 280 children (mean age = 6.9 +/- 0.75 years) towards cigarettes and smoking. Subjects were divided into two groups: (I) children of parents who smoked (n = 178) and (II) children whose parents did not smoke (n = 102). The scoring for knowledge in the topics of cigarettes, smoking and the consequences was similar in the two groups (6.2 +/- 2.2 vs 6.1 +/- 2) (N.S.). The differences between the two groups were obvious and significant (p = 0.001) in their attitude towards smoking and its damage; children in group I displayed tolerant attitudes towards smoking even though they knew its consequences in comparison with the children of group II (6.1 +/- 2.4 vs 7.0 +/- 2.2). Without any exceptions among the children of the two groups, 7.4% believe that even at this young age they will begin to smoke one day. In addition, 2.1% pointed out that it is possible they will belong one day to the smokers' group. Of the population study, 90.2% believe that instruction about smoking damage should be included starting from the first grade of elementary school, and certainly, it should be at the level which will be understandable for them. As the pupils' knowledge about the consequences of smoking was lacking, we could add that the important topic of smoking and the damage it can inflict should be taught in all schools from the level of the first grade and during all subsequent years of study. Pupils should be familiar with all aspects of negative consequences caused by cigarette smoking. This knowledge may have influence upon their attitude towards smoking and smokers. More studies should be done to find what may change the positive attitudes of these pupils towards cigarettes and smoking.