老年OSAHS患者多导睡眠监测结果分析及临床意义

目的 探讨老年阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome, OSAHS)患者多导睡眠监测的临床意义.方法 随机抽取2003年2月至2005年12月期间,我科收治的经多导睡眠监测仪(polysomnography,PSG)确诊的老年OSAHS和非老年OSAHS患者(对照组)各42例,分析两组患者PSG监测结果以及临床特征.结果 老年组OSAHS患者微觉醒指数(Microarousal index, MAI)和呼吸暂停低通气指数(apnea hypopnea index, AHI)低于非老年组,差异具有显著性(P＜0.05);老年组OSAHS患者平均血氧饱和度和最低血氧饱和度(lowest arterial oxygen saturation, LSAT)与非老年组相比,差异无显著性(P＞0.05);老年组重度OSAHS患者明显少于非老年组(P＜0.05).结论 老年OSAHS患者病情较非老年患者轻,易受OSAHS引起的低氧血症和高碳酸血症的影响,导致并发症的发生,增加死亡率,要重视老年OSAHS的早期诊断与治疗.     

老年阻塞性睡眠呼吸暂停低通气综合征患者睡眠监测特点分析

目的:研究老年阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者睡眠监测的特点。方法:回顾进行睡眠监测的88例诊断为OSAHS的患者,分为老年组(≥60岁)和中青年组(<60岁),比较两组在体重、病情严重程度、呼吸暂停低通气指数(AHI)在不同睡眠分期的差别。结果:老年组患者体重指数(BMI)与青中年组比较差异具有统计学意义[(26.9±3.1)(28.5±3.4)kg/m2];老年组患者AHI与青中年比较差异具有统计学意义[(31.6±20.6)(46.9±28.8)次/h];最低血氧饱和度(LSaO2)老年组患者与青中年组差异具有统计学意义[(79.8±6.8)(75.2±11.7)%]。结论:老年OSAHS患者病情较轻,其治疗以保守治疗为主。     

老年与中青年阻塞性睡眠呼吸暂停低通气综合征患者临床表现和多导睡眠特征的差异

目的探讨中国老年阻塞性睡眠呼吸暂停低通气综合征（OSAHS）与中青年OSAHS临床特点和多导睡眠特征的差异。方法分析37例老年OSAHS和294例中青年OSAHS的临床表现和多导睡眠图特点,并按体重指数（BMI）匹配比较两组多导睡眠指标差异。结果老年OSAHS的症状除夜尿频率更高外（P=0．01）,其他与中青年组差异无统计学意义。老年组体重指数更低（P=0．018）,颈围更小（P=0．003）,合并糖尿病（P=0．001）和高血压病（P〈0．001）更多。老年组I、Ⅱ期睡眠时间（P〈0．001）和占总睡眠时间比例更高（P〈0．001）。两组之间睡眠呼吸暂停低通气指数差异无统计学意义（P=0．082）。老年组的夜间最低血氧饱和度较中青年组高（P=0．009）,但调整体重影响后这种差异消失（P=0．114）。结论老年组OSAHS主要临床表现与中青年组相似,老年OSAHS患者比中青年组体重更轻,并发症更多,夜尿更频繁。中青年组比老年组夜间最低血氧饱和度更低可能与BMI更高有关。     

阻塞性睡眠呼吸暂停低通气综合征患者睡眠状态下脑氧饱和度观察

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者睡眠期间脑组织氧合变化.方法 选取因夜间睡眠时打鼾并疑有睡眠呼吸障碍就诊行睡眠监测患者73例,受试者进行多导睡眠呼吸监测同时行脑局部氧饱和度(rSO2)监测,持续时间7h.依据整晚睡眠监测所得呼吸暂停低通气指数(apnea hypopnea index,AHI)将受试者分为4组,分析清醒与睡眠期及不同睡眠时相rSO2是否存在差异.结果 共49例受试者完成研究.①所有受试者脉搏氧饱和度(SpO2)和rSO2在清醒状态下分别为(96.44± 1.07)％、(66.32±1.65)％,睡眠期间分别降至(93.74±2.86)％、(64.98±2.00)％,P＜ 0.001,各组从清醒到睡眠期,SpO2、rSO2呈现出相似的降低趋势.②中度OSAHS组睡眠期SpO2低于AHI正常组、轻度OSAHS组(P＜ 0.05、P＜O.01);重度OSAHS组清醒期SpO2及睡眠期SpO2、rSO2均低于其他3组(P均＜0.05).③中、重度OSAHS患者SpO2、rSO2下降幅度在快动眼睡眠期大于非快动眼睡眠期(中度OSAHS组P＜0.05,重度OSAHS组P＜0.001).④各睡眠时相脑氧饱和度下降幅度与脉搏氧饱和度下降幅度显著相关(非快动眼睡眠期r=-0.911,P＜0.001;快动眼睡眠期r=0.872,P＜0.001).结论 因反复发生呼吸暂停及低通气致OSAHS患者睡眠期脑氧饱和度低于清醒期.近红外线光谱技术为评价OSAHS患者睡眠期间脑组织氧供需平衡提供了无创、有效的监测方法.     

阻塞性睡眠呼吸暂停患者持续气道正压通气治疗中复杂性睡眠呼吸暂停的发生及其特点

目的 调查阻塞性睡眠呼吸暂停患者接受持续气道正压通气压力滴定时复杂性睡眠呼吸暂停综合征的发生率及其多导睡眠监测的特点.方法 回顾性分析2010年1月至2012年12月在四川大学华西医院睡眠医学中心诊断为阻塞性睡眠呼吸暂停并接受整夜持续气道正压通气压力滴定的420例成年患者的临床资料,分析其多导睡眠监测记录,对呼吸事件、氧减事件、睡眠分期数据进行对比分析.结果 复杂性睡眠呼吸暂停综合征的发生率为7.9％ (33/420),中枢性呼吸暂停指数为(9.0±5.1)次/h.复杂性睡眠呼吸暂停与非复杂性睡眠呼吸暂停患者在年龄、性别、体质指数及持续气道正压通气滴定压力上差异均无统计学意义(均P＞0.05).与非复杂性睡眠呼吸暂停患者相比,复杂性睡眠呼吸暂停患者中位呼吸暂停低通气指数(12.8比3.6次/h)、氧减指数(10.3比3.8次/h)均显著增高(均P＜0.05),且以非快速眼动期增高为主.复杂性睡眠呼吸暂停患者的总睡眠时间[(365 ±96)比(402±77)min]及快速眼动期比例(16％±8％比20％±10％)显著减少,但入睡后觉醒时间[(108±93)比(79±61) min)]、非快速眼动1期睡眠比例(24％±17％比15％±13％)以及微觉醒指数[(28±15)比(20±12)次/h]均显著增高(均P＜0.05).结论 阻塞性睡眠呼吸暂停患者持续气道正压通气治疗中复杂性睡眠呼吸暂停的发生率并不低,患者睡眠时间和质量均降低.     

阻塞性睡眠呼吸暂停低通气综合征不同年龄PSG睡眠结构特点

目的 分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者不同年龄PSG睡眠结构的特点,以上指导对OSAHS的诊断与治疗.方法 对因睡眠打鼾就诊、整夜多导睡眠图检查诊为OSAHS的患者603例,按年龄将其分为四组儿童组(8～14岁)、青年组(15～40岁)、中年组(41～59岁)、老年组(＞60岁)进行PSG的特点比较分析.结果 在打鼾就诊人群中OSAHS患病率为89.60%,年龄、肥胖、颈围、体重指数(BIM)均为高危因素.老年组绝大多数以1、2期睡眠为主,其分别占睡眠时间(45.6±2.8)%、(31.3±8.5)%,且觉醒的次数多达(123.3±32.5)次,总的睡眠时间/记录时间(63.9±23.6)%、快速动眼睡眠时间/总睡眠时间(1.6±0.5)%、非快速动眼睡眠时间/总睡眠时间(55.8±21.4)%,显示明显减少(P＜0.05).儿童的3、4期睡眠明显高于老年组分别占[(30.4±14.6)%、(48.6±17.5)%],觉醒次数(65.8±34.5)次,明显减少(P＜0.05).结论 不同的年龄组OSAHS患者的睡眠结构有着显著不同的特点,可以根据这些不同的特点指导临床诊断和治疗.     

阻塞性睡眠呼吸暂停低通气综合征患者日间嗜睡与夜间血氧的相关研究

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者日间嗜睡与夜间低氧血症的关系。方法90例OSAHS患者根据嗜睡评分分组,比较嗜睡组与非嗜睡组的一般状况和夜间多导睡眠监测参数,并将日间嗜睡评分与夜间多导睡眠监测参数进行相关分析。结果嗜睡组与非嗜睡组相比,嗜睡评分[(16.37±4.19)分vs(2.7±2.26)分,P<0.01]、睡眠呼吸暂停低通气指数[(44.81±22.04)次/hvs(20.24±13.56)次/h,P<0.05]、氧减指数[(49.87±24.03)次/hvs(24.88±14.22)次/h,P<0.05]高于非嗜睡组,最低血氧饱和度[(68.21±10.93)%vs(77±6.32)%,P<0.05]低于非嗜睡组。多元逐步回归日间嗜睡评分仅与氧减指数相关(R2=0.303,P<0.05)。结论OSAHS患者日间嗜睡与氧减指数密切相关,夜间低氧血症是OSAHS患者出现日间嗜睡的主要原因。     

重度阻塞性睡眠呼吸暂停低通气综合征患者的负性情绪状况研究

目的探讨重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的心理状况,分析与其负性情绪相关的因素。方法选取2013年1月至2014年12月在北京市昌平区中西医结合医院就诊的OSAHS患者168例,根据睡眠呼吸暂停低通气指数及最夜间最低血氧饱和度将患者分为轻中组度(n=95)和重度组(n=73)。分析两组患者症状自评量表(SCL-90)、汉密尔顿抑郁量表(HAMD)和焦虑自评量表(SAS)评分结果,分析与OSAHS患者负性情绪相关的因素。结果重度组患者SCL-90量表中躯体化、强迫、人际关系、抑郁、焦虑、精神疾病的评分及总分均高于轻中度组患者,差异有统计学意义(P<0.05或P<0.01)。重度组HAMD及SAS评分均高于轻中度组患者[(23±4)分比(18±4)分,(55±9)分比(48±10)分],差异有统计学意义(P<0.01)。OSAHS患者的HAMD评分与体质指数、吸烟指数、睡眠呼吸暂停低通气指数、睡眠呼吸低通气指数、睡眠呼吸暂停指数呈正相关(r=0.281,0.263,0.298,0.430,0.362,P<0.05),与夜间最低血氧饱和度、夜间平均血氧饱和度呈负相关(r=-0.394,-0.384,P<0.05),SAS评分与体质指数、吸烟指数、睡眠呼吸暂停低通气指数、睡眠呼吸低通气指数、睡眠呼吸暂停指数呈正相关(r=0.293,0.211,0.352,0.159,0.327,P<0.05),与夜间最低血氧饱和度、夜间平均血氧饱和度呈负相关(r=-0.329,-0.315,P<0.05)。结论重度OSAHS患者处于中等焦虑抑郁状态,控制体质量、戒烟及改善多导睡眠仪相关指标可能有助于缓解OSAHS患者的负性情绪。     

单纯型鼾症与混合型睡眠呼吸暂停低通气综合征多导睡眠检测分析

目的 探讨单纯鼾症和混合型睡眠呼吸暂停低通气综合征睡眠结构、血氧饱和度(SaO2)、呼吸紊乱指数(AHI)的差异及其这些差异可能的原因.方法 分别对30例混合型睡眠呼吸暂停低通气综合征患者和62例单纯型鼾症患者进行多导睡眠监测,包括浅睡眠、深睡眠、快速动眼(REM)睡眠、SaO2、AHI,并将其结果进行对比.结果 与单纯型鼾症患者比较,混合型睡眠呼吸暂停低通气综合征组Ⅰ、Ⅱ期睡眠(37.66±19.04、14.05±14.21)增多,Ⅲ、Ⅳ期、REM睡眠(3.31±5.69、0.87±1.37、41.67±23.36)减少;混合型睡眠呼吸暂停低通气综合征组患者的AHI指数(70.89±18.14)升高(P<0.01)、而SaO2减低(66.00±10.48)(P<0.01).结论 对于构成睡眠结构的各期所占之百分比,混合型睡眠呼吸暂停低通气综合征组与单纯型鼾症组比较差异无统计学意义(P>0.05),但前者存在Ⅰ、Ⅱ期睡眠增多和Ⅲ、Ⅳ期、REM睡眠减少的趋势;混合型睡眠呼吸暂停低通气综合征组患者的AHI指数明显升高、而SaO2却明显减低.     

睡眠呼吸暂停/低通气综合征体重指数与睡眠结构及呼吸紊乱关系探讨

目的探讨阻塞性睡眠呼吸暂停/低通气综合征(OSAHS)患者不同体重指数(BMI)与睡眠结构和呼吸紊乱的关系。方法经多导睡眠仪监测确诊为OSAHS的患者100例,比较BMI<25kg/m2(正常)、25≤BMI<30kg/m2(超重)和BMI≥30kg/m2(肥胖)三组患者的睡眠结构和呼吸紊乱指标。结果不同BMI组的OSAHS患者,其觉醒时间、觉醒指数、快速动眼睡眠(REM)、REM/总睡眠时间(TST)%存在统计学差异(P<0.05),以BMI≥30kg/m2组的患者睡眠结构改变显著。BMI高者,呼吸暂停低通气指数、呼吸紊乱最长时间显著增加,夜间基础氧饱和度、最低氧饱和度显著下降,氧饱和度低于90%时间及占总睡眠时间延长,呼吸暂停低通气指数(AHI)和呼吸紊乱最长时间(BDLon)升高(P<0.05)。结论不同BMI对OSAHS患者睡眠结构、AHI、BDLon和动脉血氧饱和度的影响不同。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.