TCD、CDFI对头晕、眩晕患者检测的临床意义

目的分析头晕、眩晕患者的TCD、CDFI检测资料,探讨引起头晕、眩晕症状的血管性病因。方法采用RIMED公司生产的Trans-Link9000型TCD检测仪,以2MHz、4MHz探头分别检测颅内外各血管;采用PHILIPS公司生产的IU22彩色多普勒超声,分别用线阵探头和凸阵探头观察椎动脉颅外段（VAE）的走行、内径、内膜、血流充盈、血流方向等情况。结果 320例头晕、眩晕患者中,46例存在血管狭窄,占14.5%;双侧椎动脉管径不对称112例,占35.0%;椎动脉走行扭曲12例,占3.75%。头晕患者血管狭窄的发生率为12.25%,眩晕患者为17.85%,两者比较差别显著（P〈0.01）。头晕患者中椎-基底动脉狭窄发生率为3.85%,眩晕患者为14.28%,两者比较差别显著（P〈0.01）。结论 TCD、CDFI可以为临床探求头晕、眩晕患者的血管性病因提供线索,并能为治疗及预后提出建议。     

眩晕中医证型与椎动脉系统多普勒超声相关性研究

眩晕是以头晕和旋转感为主要特征的急性常见症状,多见于梅尼埃病、高血压病、脑动脉硬化和椎基底动脉供血不足。为了探讨不同中医证型之间血流动力学变化,我们应用多谱勒超声的方法对199例患者进行了比较分析,现报告如下。1资料与方法1·1资料与分组:199例患者均为我院住院和门     

飞行员颈性眩晕与椎动脉先天发育异常的关系

目的探讨飞行员颈性眩晕与椎动脉先天发育异常之间的关系。方法利用二维超声及彩色多普勒超声回顾性分析71例颈性眩晕飞行员患者的椎动脉走行、内径及血流动力学变化等,总结颈性眩晕飞行员患者中椎动脉先天发育异常的比例。结果根据椎动脉异常的超声诊断标准,本组71例患者142条椎动脉中,85条椎动脉起始段清晰显示,显示率为59.9%(85/142),椎间段均清楚显示,显示率为100%;椎动脉纤细者20例,占28.2%(20/71),共包括21条椎动脉(左侧8条,右侧13条),其中1例为双侧椎动脉纤细,均为均匀性纤细;椎动脉走形变异22例,占31.0%(22/71),共包括椎动脉37条;同时存在椎动脉纤细和椎动脉走行异常者12例,占16.9%(12/71)。血流动力学参数异常者13例,28例患者合并颈椎X线片改变;椎动脉纤细者左右侧椎动脉内径、收缩期峰值流速(Vmax)及血流量之间差异无统计学意义。结论椎动脉发育异常是飞行员颈性眩晕的主要原因之一,椎动脉超声检查可作为招飞检查项目。     

短期进驻高原地区人体脑血流的变化

目的：观测短期进驻高原地区人体脑血流动力学的变化;方法：设立短期进驻高原组与对照组(平原组),观察其脑动脉的收缩峰值血流速度(Vp)及舒张末血流速度(Vd),进行分析对比;结果：短期进驻高原组脑动脉的收缩峰值血流速度(Vp)及舒张末血流速度(Vd)均增快。结论：缺氧可引起脑血流速度加快,脑血流量增加。     

老年颈源性眩晕患者椎-基底动脉血流状况的研究

目的:应用经颅多普勒超声(TCD)探讨老年颈源性眩晕与椎-基底动脉的血流动力学变化的关系.方法:选择行TCD检查的48例颈源性眩晕患者(眩晕组)及同期行TCD检查的36例患者(对照组)纳入研究.记录并分析椎动脉、基底动脉的收缩期峰值流速(Vs)、舒张末期流速(Vd)、搏动指数(PI)及RI.结果:2组椎动脉或基底动脉血...     

眩晕症的诊断与治疗研究

目的:研究并分析眩晕症的临床诊断与治疗方式。方法:我院2007-12-01～2012-10-01期间一共收治了眩晕症患者33例,对其临床资料进行回顾性分析。结果:本组33例患者经过病因和药物治疗之后,临床症状均有所缓解。其中,7例患者药物保守治疗无效,分别给予其前路减压椎体间植骨融合术和后路螺钉内固定联合植肾融合术等进行治疗,全部治愈。结论:眩晕症的临床治疗方式主要为药物治疗和手术治疗等两种,查询病因并给予患者适合的治疗方式极为重要。     

不同病因肺动脉血流加快的彩色多普勒分析

本文对 12 2例不同病因所致肺动脉血流速度 (Ｖｐ)加快的病因和彩色血流 (ＣＤＦＩ)对比分析 ,探讨其意义。1　资料和方法本组 12 2例中男 47例 ,女 75例 ,年龄 1～ 48岁 ,平均 19 9岁。其中窦性心动过速 (窦速 ) 15例 (心率 10 0～ 130次 /ｍｉｎ)、甲状腺功能亢进症 (甲亢 )     

上肢无脉症的血流动力学研究

目的:探讨不同病因所致的无脉症在二维超声、彩色多普勒血流显像及频谱多普勒,尤其是在血流动力学等方面的特点,以评价超声对无脉症病因的诊断价值。方法:上肢无脉症患者35例。采用HP-5500型Acuson-128xp/10 A.R.TCDFI诊断仪检测,并记录相关数值。结果:狭窄远端肱动脉PSV值明显下降(患侧37.943±5.892 cm/s,健侧90.311±10.528 cm/s,P<0.05);动脉硬化闭塞症、多发性大动脉炎及胸廓出口综合征是上肢无脉症的主要病因。三种疾病在性别、年龄、好发部位及血流动力学参数(SCA非狭窄段PSV值ASO 80.57±16.050 cm/s,TA 104.83±18.866 cm/s,TOS 106.54±18.586 cm/s,P<0.05)等方面均有明显差异。结论:超声检查可以显示病变部位、范围、程度及其周围组织,提供形态学和血流动力学信息,从而明确无脉症的病因及狭窄程度,是上肢无脉症的首选检查方法。     

龙氏正骨手法联合高压氧治疗椎动脉型颈椎病引发眩晕的疗效观察

目的:观察龙氏正骨手法联合高压氧（HBO）治疗椎动脉型颈椎病（CSA）引发眩晕的疗效。方法:前瞻性纳入2019年4月至2020年7月在山西医科大学第二医院康复医学科就诊的143例CSA伴眩晕患者为研究对象,依据随机数字表法将患者分为对照组（72例）与研究组（71例）,对照组接受龙氏正骨手法治疗,研究组接受龙氏正骨手法联...     

颈性眩晕患者的血管影像学研究

目的：分析颈性眩晕的影像学特点,并评价彩色超声多普勒(CDUS)联合 CT 血管成像(CTA)、增强磁共振血管成像(CE-MRA)在颈性眩晕中的应用价值。方法62例临床诊断为颈性眩晕患者作为病例组,其中39例行颈部血管超声和颈部 CTA检查,23例行颈部血管超声和颈部 CE-MRA。选取30例正常志愿者作为对照组,其中18例行颈部血管超声和颈部 CTA 检查,12例行颈部血管超声和颈部 CE-MRA。评价2组间椎动脉血流动力学及形态学的情况。比较 CDUS 与 CTA/CE-MRA 对椎动脉形态学检测的差异。结果①在形态学方面：颈性眩晕组中椎动脉狭窄率(46.77%)及变异率(29.03%)均高于对照组椎动脉狭窄率(23.33%)及变异率(6.67%),差异有统计学意义(均 P <0.05)。颈性眩晕组椎动脉迂曲发生率(11.29%)与对照组(13.33%)比较,差异无统计学意义(P >0.05)。②在血流动力学方面：CDUS 显示颈性眩晕组血流下降发生率(66.13%)高于对照组(10.00%),差异有统计学意义(P<0.05)。颈性眩晕组椎动脉狭窄(86.21%)及变异者(72.22%)血流速度下降发生率明显高于椎动脉迂曲(28.57%)及椎动脉正常者(12.50%)。结论应用 CDUS 联合 CTA/CE-MRA,可从责任血管形态学、血流动力学方面综合评价颈性眩晕的病因,对颈性眩晕的诊治具有重要意义。     

高性能战斗机飞行员脑应激疲劳时脑平均血流速度变化特征与立位耐力关系研究

目的 为飞行员心脑功能鉴定提供试验方法和依据.方法 测试45名男性飞行员(平均年龄27.5±2.6岁)在完成5 h"连续操作"任务期间,大脑前动脉(ACA)、大脑中动脉(MCA)和大脑后动脉(PCA)的脑平均血流速度(Vm),同步分析Vm、立位耐力与心脑功能指标间的变化关系,并对持续认知操作活动诱发的脑应激疲劳(CFS)进行斯坦福嗜睡量表(SSS)评定.结果 从第4 h以后,PCA的Vm先于ACA、MCA显著下降(t=9.254、11.918,P<0.05),出现晕厥前症状(PSS)时,ACA、MCA、PCA的Vm和立位耐力同时降低(t=9.314、11.654、15.120、20.545,P<0.05).脑电功率指数、心率变异性、连续操作能力指数测试及SSS主观评定表明心脑功能出现了严重抑制.结论 CFS末期,出现PSS时,ACA、MCA、PCA的Vm与立位耐力同步下降.CFS可诱发PSS或立位耐力降低.     

胃内胆汁反流与上消化道症状关系的研究

目的　探讨胃内胆汁反流与上消化道症状之间的关系。方法　使用Bilitec 2 0 0 0型便携式胆汁监测仪 ,分别对无症状对照组(2 2例 )及上消化道症状组 (4 4例 )进行胃内胆汁反流监测 ,观察胃内胆汁反流与上消化道症状之间的关系。结果　无症状对照组与上消化道症状组胃内胆汁反流 ,总时间百分比、总反流面积及反流次数 ,分别为 1 5 6 %± 1 4 0 %、2 0 6± 1 8 7、2 2 3± 1 3 6次 ,及 2 6 4 %±2 1 3%、4 8 7± 6 0 8、4 2 9±4 4 5次。结论　上消化道症状组胃内胆汁反流监测结果明显高于无症状对照组 ,提示胃内胆汁反流的程度对上消化道症状的发生有一定影响     

MR-based coronary artery blood velocity measurements in patients without coronary artery disease

To evaluate the feasibility of MR-based coronary blood velocity measurements (MRvenc) in patients without coronary artery disease (CAD). Eighty-three patients with angiographically excluded CAD received MRvenc of the proximal segments of both coronary arteries (CAs). Using a retrospectively ECG-gated breath-hold phase-contrast FLASH sequence with high temporal resolution, flow data were technically acquirable in 137/166 (83%) CAs. Quantification and analysis of blood velocities in systole and diastole of both CAs were performed. Biphasic velocity profiles were found in 83/100 CAs. Median systolic and diastolic velocities differed significantly in LCA (19 cm/s, 24 cm/s; P<0.0001) and RCAs (14 cm/s, 16 cm/s; P<0.01). The diastolic/systolic velocity ratio was calculated in LCAs and RCAs with a median of 1.3 and 1.1, respectively. The velocity profiles of the remaining CAs were monophasic (17 CAs) or revealed severe alterations of the physiologic velocity profile with reduced flow undulations and steady velocities (37 CAs). Optimized clinical MRvenc is feasible to quantify blood velocities in the CAs. Potential indications are (1) non-invasive monitoring of patients after aortic valve reconstruction as well as (2) detection of asymptomatic CAD patients.     

The application of breath hold phase velocity mapping techniques to the measurement of coronary artery blood flow velocity: Phantom data and initial in vivo results

A segmented k-space breath hold phase velocity mapping technique has been developed for the study of coronary artery blood flow velocity. In vitro validation has been performed using a number of pulsatile flow phantoms and the accuracy of the technique for determining the velocity increase at the site of a stenosis demonstrated in several phantom models. Examples of both in-plane and through-plane velocity maps of the left anterior descending and right coronary arteries of normal subjects in early diastole are presented. In one subject, through-plane velocity maps were obtained in the right and left anterior descending arteries throughout the cardiac cycle in order to generate flow velocity time curves. The problems associated with coronary artery velocity mapping are discussed.     

高压氧治疗与血脑屏障通透性的实验研究

目的探讨常规治疗压力（0．25MPa）的高压氧增强血脑屏障开放、促进神经保护剂（神经节苷脂，GM-1）进入脑组织的作用。方法30只Wistar雄性大鼠，随机分为对照组、实验-1组、实验-2组、实验-3组、实验-4组；利用HPD 1700流体撞击仪，建立颅脑损伤动物模型，经毛细管电泳仪测定各组脑组织匀浆中GM-1相对浓度。结果各HBO治疗实验组GM-1浓度较无HBO治疗组和对照组有一定程度的提高，但对照组与各实验组、各实验组之间q检验均没有显著差异（P〉0．05）。结论常规治疗压力的高压氧无明显促进BBB通透性作用，但有增加BBB开放的趋势，促进神经保护剂进入脑组织。     

胃脘疾患胃镜征象与中医证型关系初探

<正> 为运用胃镜检查来探讨西医诊断与中医辨证分型之间的相关性,现将我院消化内科按中医辨证分型的596例胃脘疾患患者与胃镜检查诊断结果分析如下。     

MR phase-contrast velocity mapping methods for measuring venous blood velocity in the deep veins of the calf

Purpose:

To evaluate the feasibility of using un‐gated, real‐time MRI for venous blood velocity mapping in the calf, comparing an interleaved spiral k‐space sequence (ISP) against a standard segmented gradient echo sequence (GRE).

Materials and Methods:

A flow phantom with a variable flow‐rate was scanned using both GRE and ISP sequences for an in vitro comparison. Seven subjects were scanned prone, performing metronome guided breathing, using the (externally triggered) segmented GRE and real‐time ISP sequences. The segmented GRE acquisition duration was 2.5 mins (22 guided respiratory cycles) and the ISP sequence ran continuously for 35s, 4 full guided respiratory cycles. Mean velocity from each of the deep veins was measured and peak mean velocity, peak flow rate and cumulative volume flow over a respiratory cycle compared between sequences.

Results:

The two sequences compared well both in vitro and in vivo. The real‐time ISP sequence showed short‐term variations in mean velocity superimposed on the respiratory induced flow, which were averaged out using the segmented GRE sequence.

Conclusion:

Real‐time ISP provides comparable time‐averaged flow results to the standard sequence with additional information on real‐time flow variations and so could be used for further investigation into venous blood flow in the lower leg. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc.     

临床生物样本库血液样本的可控性采集和质量管理

目的建立医疗过程中血液样本可控性采集模式,保证样本的采集、处理过程可回溯,为肿瘤、自身免疫性疾病、心脑血管疾病及代谢性疾病的研究提供高质量的血液样本。方法通过建立网络化样本采集管理流程,将样本采集电子申请、项目管理以及样本处理中涉及血液样本的各项前处理因素整合到电子工作程序中,保证标准流程的执行情况处于可控状态,形成规范化的血液采集、前处理、保存和管理办法。结果仁济医院血液样本库有临床疾病20余种,含有完整的临床及随访资料。血液样本与相应的组织样本、临床信息相匹配;系统记录每份样本采集时间、到库时间、入库时间等;可通过组合查询筛选相应质量要求的样本。共采集血液样本40 000余份,抽样检查90%的样本分子生物学指标稳定。结论仁济医院可控性血液采集、处理模式和管理模式为综合性医院血液生物样本库建设提供管理经验,为血液样本的规范化、高质量采集、前处理、保存提供详细操作经验参考,为肿瘤、自身免疫性疾病、心脑血管疾病及代谢性疾病的研究提供高质量的血液样本及信息资源。     

High-resolution blood flow velocity measurements in the human finger.

MR phase contrast blood flow velocity measurements in the human index finger were performed with triggered, nontriggered, and cine acquisition schemes. A strong (G(max) = 200 mT/m), small bore (inner diameter 12 cm) gradient system inserted in a whole body 3 Tesla MR scanner allowed high-resolution imaging at short echo times, which decreases partial volume effects and flow artifacts. Arterial blood flow velocities ranging from 4.9-19 cm/sec were measured, while venous blood flow was significantly slower at 1.5-7.1 cm/sec. Taking into account the corresponding vessel diameters ranging from 800 microm to 1.8 mm, blood flow rates of 3.0-26 ml/min in arteries and 1.2-4.8 ml/min in veins are obtained. The results were compared to ultrasound measurements, resulting in comparable blood flow velocities in the same subjects. Magn Reson Med 45:716-719, 2001.     

Modeling the relationship between velocity and time to fatigue in rowing

INTRODUCTION: Several mathematical models describe the relationship between velocity and time to fatigue. PURPOSE: The purposes of this study were to evaluate different critical velocity (V(critical)) models applied to rowing ergometry and to investigate prediction of performance time in a 2000-m race based on results from shorter trials. METHODS: Sixteen men performed seven rowing ergometer tests. Velocity and time to fatigue data from the 200-m (approximately 0.5 min) to 1200-m (approximately 3 min) trials and from the 200-m to 2000-m (approximately 6.5 min) trials were fit to a two-parameter hyperbolic model, a three-parameter hyperbolic model, and a three-parameter exponential model. RESULTS: Including data from the 2000-m trial generally resulted in higher R2 and smaller SEE. V(critical) from the three versions of the two-parameter model were 4.71 +/- 0.28 m x s(-1), 4.80 +/- 0.27 m x s(-1), and 5.04 +/- 0.24 m x s(-1) (P < 0.001). The two three-parameter models had high R2 (0.991 and 0.990, respectively) and generated parameter estimates that appeared reasonable. Time for a 2000-m race was predicted better using the two-parameter model (r > 0.974) than using the three-parameter models (r = 0.820-0.870). CONCLUSION: It is necessary to include the relatively long 2000-m predicting trial to describe accurately the velocity-time relationship in rowing. The two-parameter model may be useful in predicting time for a 2000-m race but is not otherwise appropriate for modeling when predicting trials of <1 min duration are included. Choice of model and duration of trials must be considered when using mathematical modeling to derive V(critical) and other parameters in rowing.