Lysozyme and hypokalaemia

Serum potassium, lysozyme and urinary lysozyme measurements were made in 98 patients with tuberculosis, 18 with sarcoidosis and 30 with acute myeloid leukaemia. Serum K concentration fell below 3·5 mmol/l in 17 of the 30 leukaemic patients and only 7 of these had raised serum lysozyme concentrations. None of the patients in the tuberculosis-sarcoidosis group with lysozymaemia or lysozymuria developed hypokalaemia. This study suggests that raised lysozyme concentrations are not causally related to hypokalaemia.     

肺炎支原体感染并发心肌损伤6例临床观察

目的 :探讨小儿肺炎支原体感染并发心肌损伤的临床特征及治疗方法。方法 :对 6例诊断为肺炎支原体感染并发心肌损伤患儿的临床特点及治疗效果进行回顾性分析。结果 :6例均有发热、心电图异常和心肌酶谱增高 ,咳嗽 5例 ,鼻塞 3例 ,肺部改变 5例 ,乏力 4例。心动过速 6例 ,心律不齐 4例 ,心音低钝 2例。全部病例给予阿奇霉素 10mg·kg-1·d-1抗感染治疗 3周痊愈。结论 :肺炎支原体感染患儿可并发心肌损伤 ,对可疑病例应及早做心电图及心肌酶学检查 ,以及时诊断及治疗。使用阿奇霉素规则序贯治疗预后良好     

高血压性心脏病猝死者心肌连接蛋白43的表达

目的:探讨高血压性心脏病(HHD)猝死者心肌连接蛋白43(Cx43)表达及其与猝死的关系。方法:挑选我校基础医学院法医学教研室2009-2011年尸体解剖案例20例,分为两组,每组各10例。①HHD组:男性9例,女性1例;年龄为41-73岁,平均年龄56.5岁;均为高血压性心脏病猝死。②非心源性死亡对照组:男性7例,女性3例;年龄为40-53岁,平均年龄46.8岁。每例心脏进行常规病理学检查并取材后,运用免疫组织化学和图像分析技术,检测左心室肌的Cx43染色情况。结果:HHD组心肌Cx43阳性颗粒数量显著减少,着色明显减弱,部分呈颗粒状,且分布于心室肌细胞内或细胞侧-侧连接处;对照组的染色未见明显变化。定量检测并经统计分析发现,HHD组Cx43蛋白染色阳性的面积和平均光密度与对照组均有非常显著的差异(P<0.01)。结论:高血压性心脏病猝死者心室肌Cx43蛋白的表达明显减少,高血压性心脏病的猝死可能与Cx43的表达变化有一定的关系。     

心肌桥致急性前壁心肌梗死三例分析

冠状动脉心肌桥（心肌桥）导致急性心肌梗死在临床上较少见,为了提高对此病的认识,本文对3例冠状动脉左前降支心肌桥致急性前壁心肌梗死患者的资料进行分析,并探讨心肌桥的诊断和治疗。     

癫癎持续状态致急性肾功能损害及对策

观察癫$持续状态(SE)所致急性肾功能的损害,寻找治疗及预防对策.方法:34例患者急诊入院后,立即予地西泮、苯巴比妥等,并快速建立静脉通道,予甘露醇、呋塞米及碳酸氢钠、脑神经保护剂等,同时观测肾功能的变化.结果:18例(52.94%)出现不同程度的肾功能损害;5例(14.71%)出现急性肾功能衰竭,给予血液透析1～2次;病死2例(5.88%).结论:选择强有力、见效快、作用时间长、副作用小且首次足量的抗惊厥药,尽快控制SE是预防急性肾功能衰竭的关键.     

抗中性粒细胞胞浆抗体相关血管炎所致肺部损害的诊断和治疗

原发性系统性小血管炎是一组以小血管为主要侵犯对象的自身免疫性疾病，它主要造成所侵害血管的炎症与坏死，并影响相应器官的功能异常或衰竭，由于疾病可先后累及多种组织与器官，因此其临床表现呈多样性，给临床诊断与治疗带来了许多困难。1866年Kussmaul与Maier首先报道了原发性血管症候群病人后，陆续又发现了Wegener氏肉芽肿(WG)、Churg-Strauss综合征(CSS)、     

Thiazides and hypokalaemia in diabetic ketoacidosis

In a series of forty-one episodes of diabetic coma or pre-coma, three patients had plasma potassium values of less than 3.0 mEq/l. All three had been taking thiazide diuretics with only one receiving oral potassium supplements. None was previously known to be diabetic, representing 18% of the new diabetics in the series. The mean plasma potassium for the other new diabetics was 4·7 ± 0·2 mEq/l. These findings emphasize that adequate potassium supplements should be given with thiazide diuretics to diabetic subjects and to those with an increased risk of developing the disease.     

Myocardial infarction due to isolated left circumflex or right coronary artery occlusion.

The electrocardiographic (ECG) patterns related to clinical spectrum and angiographic features were assessed in 41 patients with first myocardial infarction due to isolated left circumflex coronary artery (LCX) occlusion, and compared to those in 45 patients with right coronary artery (RCA)-related infarction. The occurrence of inferior Q waves was similar in patients with LCX and RCA occlusion, but lateral Q waves and an abnormal R wave in lead V1 were more frequently seen in patients with LCX-related infarction (46% vs 7% and 51% vs 4%, respectively). Compared with patients with LCX-related infarction without an abnormal R wave in lead V1 and those with RCA occlusion, patients with LCX-related infarction and an abnormal R wave in lead V1 associated with inferior and/or lateral Q waves had larger left ventricular end-diastolic and end-systolic volumes, lower ejection fraction, higher incidence of total occlusion of a dominant LCX without collaterals, and more cardiac events during follow-up. The study suggests that the presence of lateral Q waves and an abnormal R wave in lead V1 after myocardial infarction may be a useful marker of LCX occlusion, and that patients with LCX-related infarction may have different status of left ventricular function depending on the size of circulation and the status of residual flow to the infarct region during LCX occlusion.

     

甲基苯丙胺所致大鼠心肌损伤及相关指标的变化

目的探讨甲基苯丙胺（MA）导致的大鼠心肌的形态学和心功能指标的变化。方法建立MA中毒模型组和对照组,检测两组大鼠心率、血压变化及HE染色观察大鼠心脏形态学变化,用EusA法测定大鼠血清肌钙蛋白（Tn—T）和脑利钠肽（BNP）浓度。结果与对照组相比,MA组大鼠心率、血压显著升高;MA组大鼠心肌HE染色可见心肌损伤性改变,血清中Tn—T、BNP浓度较对照组显著升高,差异有统计学意义（P〈0．05）。结论甲基苯丙胺可导致大鼠心肌损伤,引起心功能减退。