Coronary Flow Reserve in Patient with Essential Hypertension and Left Ventricular Hypertrophy

ＣｏｒｏｎａｒｙＦｌｏｗＲｅｓｅｒｖｅｉｎＰａｔｉｅｎｔｗｉｔｈＥｓｓｅｎｔｉａｌＨｙｐｅｒｔｅｎｓｉｏｎａｎｄＬｅｆｔＶｅｎｔｒｉｃｕｌａｒＨｙｐｅｒｔｒｏｐｈｙＣａｉＸｕ（蔡煦）；ＳｈｅｎＷｅｉｆｅｎｇ（沈卫峰）；ＺｈａｎｇＤａｄｏｎｇ（张大东）...     

中国人群2型糖尿病患者付氧酶基因多态性与冠心病关系的研究

探讨中国２型糖尿病患者付氧酶（ＰＯＮ）基因与并发冠心病（ＣＡＤ）的关系。方法利用聚合酶链反应一变性梯度凝胶电泳技术对４９例２型糖尿病合并ＣＡＤ患者,４９例未合并ＣＡＤ的２型糖尿病对照者和１０１例健康对照者进行ＰＯＮ基因外显子筛查。结果发现中国人群ＰＯＮ基因第１９１位密码子存在Ｇｌｎ＾１９１－Ａｒｇ多态性,等位基因以Ａ／Ｂ表示。ＣＡＤ患者ＰＯＮ基因的３种基因型（ＡＡ、ＡＢ和ＢＢ）的构成比与２型糖尿病     

卡托普利早期和长期治疗对老年急性心肌梗死患者生存率的影响

目的　比较早期和长期卡托普利治疗对≥65岁和＜65岁急性心肌梗死(心梗)患者生存率的影响。　方法　根据是否早期及长期卡托普利治疗,将822例首次心梗72h内入院患者分为＜65岁卡托普利组209例、≥65岁卡托普利组269例,＜65岁对照组131例、≥65岁对照组213例。　　结果　住院期(1～42d)＜65岁卡托普利组死亡8例(3.83%),＜65岁对照组死亡10例(7.63%),差异无显著性(P＞0.05);≥65岁卡托普利组死亡25例（9.29%）,≥65岁对照组死亡52例（24.41%）,差异有显著性(P＜0.0001)。卡托普利治疗患者住院期心原性死亡与年龄相关(P=0.0002),随访1.3～54.0个月表明,心原性死亡与年龄关系不密切;＜65岁卡托普利组158例中猝死3例(1.9%),＜65岁对照组97例猝死11例(11.4%,P＜0.01);≥65岁卡托普利终访192例中猝死7例(3.6%),≥65岁对照组终访128例中猝死25例(19.5%,P＜0.01)。≥65岁和＜65岁卡托普利组心源性事件发生也低于相应对照组(P＜0.01)。　结论　卡托普利治疗急性心梗作用住院期有年龄差异,而长期应用改善预后作用无年龄差异。     

冠脉内注射罂粟碱引起多形性室速三例

冠脉内注射罂粟碱已被广泛用于冠脉血流储备功能测定。该药于冠脉内注射后可产生一过性心脏电生理变化,偶可引起严重室性心律失常。本文报告98例用冠脉内注射罂粟碱作冠脉血流储备功能测定时,3例并发多形性室速的情况。     

急性心肌梗死后卡托普利早期和长期治疗五年随访结果

目的 急性心肌梗死（心梗）后５年随访期间比较各种因素对死亡率影响，探讨卡托普利早期长期治疗的预后意义。方法 ８２２例首次急性心梗后７２小时内入院且无心源性休克患者中，４７８例早期并长期持续应用卡托普利和常规治疗（治疗组），３４４例公常规治疗（对照组）。用Ｃｏｘ回归方法作多因素分析，ＫａｐｌａｎＭｅｉｅｒ法分析两组随访期累积生存率和心源性事件发生率。结果 年龄、Ｋｉｌｌｉｐ分级、前壁梗死、糖尿病、Ｃ     

Intracoronary stent implantation under intracoronary ultrasound guidance with aspirin and ticlopidine therapy

Objective To observe the immediate angiographic and intravascular ultrasound (IVUS) result s and their effects on one month clinical outcomes in forty-one patients who su bmitted to coronary stent deployment with IVUS guidance. Methods All patients were allocated to coronary stent implantation with high inflation p ressure. After good angiographic results (<20% residual stenosis), all patients underwent IVUS and higher-pressure dilatation would be necessary if criteria f or optimal coronary stent implantation were not met. The optimal criterion of I VUS for stent implantation was the ratio of intrastent lumen cross-sectional ar ea to the average of the proximal and distal reference lumen cross-sectional ar eas ≥80%. All patients had aspirin and ticlopidine therapy on the day of a ngioplasty and during the one month follow-up period. Results Optimal criteria of IVUS were obtained without any further intrastent dilatation in twenty-five patients but intrastent higher-pressure dilatation was perform ed in fourteen patients whose ultrasound results did not reach the criteria. In these patients, we increased the minimal intrastent lumen area 25.7% (P< 0.05). Thirty-five patients (90%) had good minimal intrastent lumen area of IVUS. There were no deaths, myocardial infarction, acute stent thrombosis or n eed for revascularization during the study and the one month follow-up. Conclusions Intracoronary stent deployment under IVUS guidance, including combining aspirin and ticlopidine therapy, had beneficial ultrasound results and good clinical out comes after one month follow-up.     

冠心病介入治疗后再狭窄因素分析

目的 探讨冠心病介入治疗后再狭窄与冠心病易患因素关系。方法 冠心病介入治疗４４０例中,选择连续８４例（１１５个狭窄病变）术后随访冠脉造影复查者,冠脉定量分析（ＱＣＡ）术前、术后和随访复查冠脉造影图象,并分析再狭窄与冠心病易患因素的关系。结果患者６个月再狭窄率为４０．００％,多元回归分析再狭窄发生时间与吸烟史、多个易患因素、多支病变、病变类型和前降支病变呈正性相关,与支架置入呈负性相关。结论 冠心     

57例腹腔镜辅助阴式全子宫切除术的手术配合与护理

通过对57例腹腔镜辅助阴式全子宫切除术的手术配合与护理,包括加强术前准备、麻醉配合、体位安置、术中配合等,手术均顺利,无术后并发病,随访恢复良好.     

血尿酸与冠心病的关系

冠心病发病机制复杂，近年来有证据显示血尿酸的改变与冠心病的发生、发展有关系。本通过对785例经冠状动脉造影证实的冠心病患血尿酸水平测定，探讨其与冠心病的关系。