老年冠心病介入术后的药物治疗研究进展

冠状动脉粥样硬化性心脏病简称冠心病,指冠脉粥样硬化而导致血管腔变窄或堵塞,引发心肌缺氧缺血,甚者发生心肌坏死,是临床上常见的心血管疾病,多见于中老年人群,被WHO认为是老年人的首位死因[1].据国外相关数据统计,老年人群中有25％患者因冠心病出现各种类型临床症状,甚至超过50％患者因冠心病死亡[2].     

经导管射频消融治疗快速性心律失常

经导管射频消融术自 1 987年应用于临床以来 ,已成为房室折返性心动过速 (ＡＶＲＴ)、房室结折返性心动过速 (ＡＶＮＲＴ)、房性心动过速、心房扑动、阵发性心房颤动及特发性室性心动过速 (ＩＶＴ)等快速性心律失常的首选根治方法[1 ,2 ] 。我院心内科于 2 0 0 0年 5月于临床应用此项新技术 ,现报告如下。1　资料与方法1 .1　病例资料　全组共 5 0例心动过速患者 ,男 2 2例 ,女 2 8例 ,平均年龄 ( 4 0 .5 4± 1 7.91 )岁 ,年龄 1 1～75岁。均有明确心动过速发作史并有心电图记录 ,或经食管心房调搏电生理检查诱发心动过速。合并冠心病 1例 ,…     

慢性心力衰竭患者心型脂肪酸结合蛋白与超敏C-反应蛋白的变化及其相关性

Objective To examine clinical significance and relativity of heart-type fatty acid binding protein (H-FABP) and high-sensitivity C-reactive protein (hs-CRP) in patients with chronic heart failure. Methods Ser-um concentrations of H-FABP and hs-CRP were measured in 60 patients with chronic heart failure and 30 control subjects. Left ventricular ejection fraction (LVEF) was examined by Doppler echocardio graphic in all subjects. Re-sults Serum concentrations of H-FABP and hs-CRP were higher in patients with chronic heart failure than in con-trol subjects[(6.11±1.49)μg/L vs (4.24±1.40)μg/L,and (12.77±3.65)mg/L vs(4.85±1.35) mg/L,t=5.746 and 7.543,P<0.01] but LVEF was lower in patients with chronic heart failure than in control subjects [(42.13±6.55) % vs (61.50±3.89) %,t=-14.902,P<0.01]. In CHF subgroups,H-FABP and hs-CRP lev-el increased with advancing NYHA class (F=26.288 and 351.784,P<0.01) but LVEF decreased (F=252.834,P<0.01). The serum H-FABP concentrations had a positive correlation with serum hs-CRP concentrations (r=0.801,P<0.01),and a negative correlation with LVEF (r=-0.718,P<0.01) ;serum hs-CRP concentrations had a negative correlation with LVEF(r=-0.881,P<0.01). Conclusion Serum H-FABP and hs-CRP levels are in-creased with the worsening of CHF. H-FABP and hs-CRP level are pnsitiviely related. The quantitative determination of serum concentrations of H-FABP and hs-CRP is valuable for risk stratification in patients with chronic heart fail-ure.     

利钠肽类激素在心律失常后的变化

目的观察心房利钠肽（atrial natriuretic peptide，ANP）、脑钠肽（brain natriuretic peptide，BNP）和C-型利钠肽（C-type natriuretic peptide，CNP）在心律失常后的变化，并探讨3者是否具有相关性。方法各种病因导致心律失常患者22例（NYHA心功能分级〈Ⅱ级），并设正常对照组20例，用竞争性放射免疫分析法测定血浆中ANP、BNP和CNP浓度。结果心律失常组血浆BNP较正常对照组明显升高，差异具有显著性（p〈0．01），而血浆ANP和CNP差异不具有显著性（p〉0．05）。心律失常组患者血浆ANP、BNP与CNP不具有相关性。结论无心力衰竭患者发作心律失常后血浆BNP可能明显升高，而血浆ANP与CNP浓度无明显变化。     

非诺贝特抑制兔脂肪组织纤溶酶原激活物抑制剂-1表达的机制

目的：观察非诺贝特对高胆固醇喂养兔脂肪组织纤溶酶原激活物抑制剂-1（PAI-1）mRNA表达的影响，并阐明其可能机制。方法：15只兔随机分为对照组、高胆固醇血症组和非诺贝特治疗组。实验的第12周末取兔皮下脂肪组织，并分离培养脂肪细胞，应用半定量逆转录多聚酶链式反应（RT-PCR）测定脂肪组织和细胞PAI-1、PPAR7和PPARα mRNA的表达。结果：高胆固醇血症组脂肪组织PAI-1 mRNA表达高于对照组（P〈0．01）。非诺贝特治疗后脂肪组织PAI-1 mRNA表达明显低于高胆固醇组（P〈0．01）。高胆固醇组脂肪组织PPARγmRNA表达高于对照组（P〈0.05），非诺贝特能降低高胆固醇饲养兔脂肪组织PPARγmRNA表达（P〈0．05），并呈剂量依赖性的降低脂肪细胞PAH和PPARγmRNA表达。3组兔脂肪组织PPARαmRNA表达差异无显著性。结论：非诺贝特能抑制高胆固醇饲养兔脂肪组织PAI-1 mRNA表达，其机制可能与下调脂肪细胞PPARγRNA表达有关。     

脑病便秘中医护理浅识

脑部疾病(脑梗死、脑出血等)简称脑病,脑病患者便秘是多种疾病的一个症候群,中医在药物治疗的同时注重饮食护理、心理护理、辨证施护、推拿按摩、生活护理,因此可有效的防治脑病便秘。     

脑中风辨证分型施护浅析

脑中风分肝阳暴亢、痰热腑实、风痰阻络、气虚血瘀四型。指出:发病七日内,及时治疗,护理措施得当,预后较好。     

慢性心力衰竭患者心型脂肪酸结合蛋白与超敏C-反应蛋白的变化及其相关性

Objective To examine clinical significance and relativity of heart-type fatty acid binding protein (H-FABP) and high-sensitivity C-reactive protein (hs-CRP) in patients with chronic heart failure. Methods Ser-um concentrations of H-FABP and hs-CRP were measured in 60 patients with chronic heart failure and 30 control subjects. Left ventricular ejection fraction (LVEF) was examined by Doppler echocardio graphic in all subjects. Re-sults Serum concentrations of H-FABP and hs-CRP were higher in patients with chronic heart failure than in con-trol subjects[(6.11±1.49)μg/L vs (4.24±1.40)μg/L,and (12.77±3.65)mg/L vs(4.85±1.35) mg/L,t=5.746 and 7.543,P<0.01] but LVEF was lower in patients with chronic heart failure than in control subjects [(42.13±6.55) % vs (61.50±3.89) %,t=-14.902,P<0.01]. In CHF subgroups,H-FABP and hs-CRP lev-el increased with advancing NYHA class (F=26.288 and 351.784,P<0.01) but LVEF decreased (F=252.834,P<0.01). The serum H-FABP concentrations had a positive correlation with serum hs-CRP concentrations (r=0.801,P<0.01),and a negative correlation with LVEF (r=-0.718,P<0.01) ;serum hs-CRP concentrations had a negative correlation with LVEF(r=-0.881,P<0.01). Conclusion Serum H-FABP and hs-CRP levels are in-creased with the worsening of CHF. H-FABP and hs-CRP level are pnsitiviely related. The quantitative determination of serum concentrations of H-FABP and hs-CRP is valuable for risk stratification in patients with chronic heart fail-ure.     

慢性心力衰竭患者心型脂肪酸结合蛋白与超敏C-反应蛋白的变化及其相关性

目的 观察慢性心力衰竭(CHF)患者血清心型脂肪酸结合蛋白(H-FABP)和超敏C-反应蛋白(hs-CRP)的浓度变化,并探讨其相关性及临床意义.方法 选择不同心功能级别的CHF患者60例及同期健康体检者30例,测定其血清H-FABP及hs-CRP的浓度,同时用彩色多普勒超声测定左心室射血分数(LVEF).结果 CHF组H-FABP[(6.11±1.49)μg/L]及ks-CRP[(12.77±3.65)mg/L]的浓度均较对照组[分别为(4.24±1.40)μg/L和(4.85±1.35)mg/L]升高(t值分别为5.746和7.543,P均<0.01),而LVEF明显降低[(42.13±6.55)%比(61.50±3.89)%],差异有统计学意义(t=-14.902,P<0.01).在CHF各亚组,H-FABP及hs-CRP的浓度均随着心功能级别的增加而升高(F值分别为26.288和351.784,P均<0.01),而LVEF降低(F=252.834,P<0.01).线性相关分析H-FABP的浓度与hs-CRP的浓度呈正相关(r=0.801,P<0.01),与LVEF呈负相关(r=-0.718,P<0.01);ks-CRP的浓度与LVEF呈负相关(r=-0.881,P<0.01).结论 血清H-FABP和hs-CRP的浓度随着CHF患者的病情加重而升高,两者的浓度变化呈正相关,与LVEF呈负相关;定量测定血清H-FABP和hs-CRP有助于CHF患者的危险分层.