Effect of Different Styles of Coronary Heart Disease and Its Risk Factors on Cardiac Remodeling and Dysfunction

Objectives To evaluate the effect of different styles of coronary heart disease (CHD), different regions of acute myocardial infarction (AMI), its risk factors and branches of coronary stenosis on left ventricular remodeling and dysfunction by applying echocardiography. Methods 251 patients with CHD and 96 patients without CHD (NoCHD) were verified by selective coronary angiography. CHD patients were divided into stable angina pectoris(SAP) 26, unstable angina pectoris(UAP) 53, acute myocardial infarction (AMI) 140 and old myocardial infarction (OMI) 30 based on clinical situation, cTnT, cardiac enzyme and EGG. AMI patients were further divided into subgroups including acute anterior myocardial infarct (Aa,n = 53), acute inferior myocardial infarction (Ai, n,=54) and Aa Ai(n=33) based on ECG. Cardiac parameters: end-diastolic interventricular septum thickness (IVSd) , end-diastolic left ventricular internal diameter (LVd ), left ventricular mass(LM) , end-diastolic left ventricular volume ( EDV) , end-systolic left ventricular volume (ESV) and left ventricular ejection fraction(LVEF) were measured by ACUSON 128XP/10 echocardiography. Multiples linear regression analyses were performed to test statistical associations between LVEF and the involved branches of coronary stenosis, blood pressure, lipids, glucose and etc after onset of myocardial infarction. Results EDV and ESV were increased and LVEF decreased on patients with AMI, OMI and UAP (P<0.05-0.0001). LM was mainly increased in patients with OMI (P<0.01) and LVd was mainly enlarged in patients with AMI. EF was significantly decreased and EDV, ESV, LM and LVd were remarkably increased in AMI patients with Aa and Aa Ai. With the multiple linear regression analyses by SPSS software, we found that LVEF was negatively correlated to the involved branches of coronary stenosis as well as to systolic blood pressure after onset of myocardial infarction while there was no significant correlation between LVEF and other factors. LVEF was significantly decreased, and LVd and LM increased in AMI patients with antecedent hypertension, compared to patients without hypertension (P<0.001). Conclusions Effects of different styles of CHD and different regions of AMI on left ventricular remodeling and cardiac function are different. Myocardial infarction, especially Aa and Aa Ai, is one of the most important causes of left ventricular remodeling and cardiac dysfunction. Multiple vessel stenosis and systolic blood pressure at the onset of myocardial infarction reduce LVEF in AMI patients. Antecedent hypertension may accelerate the effect of AMI on cardiac remodeling and dysfunction. Therefore primary and secondary preventions of CHD are critical for protecting heart from remodeling and dysfunction.     

89Sr治疗骨质疏松性骨折的临床研究

目的 :探讨89Sr(锶 )治疗骨质疏松性骨折及其引起顽固性疼痛的疗效。方法 :对12例骨质疏松性骨折患者静脉注射89Sr,比较治疗前后患者疼痛程度及骨质量 (BMD)的改变 ,并与对照组比较。结果 :静脉注射 89Sr5～10天后 ,11例疼痛完全缓解(Ⅰ级) ,1例明显好转、仅轻度疼痛(Ⅱ级) ,总有效率100 %。治疗前后腰椎BMD百分率变化:显效4例 ,有效5例 ,无效3例 ,总有效率75 %。与对照组比较效果明显(P<0.05)。结论 :静脉注射 89Sr能有效治疗骨质疏松性骨折及其引起的顽固性疼痛。     

肝复康口服液的实验研究

研究了肝复康口服液对大鼠实验性肝硬化的防治作用。结果表明,剂量4g/100g体重能明显减轻肝细胞脂肪变性或坏死、抑制肝细胞纤维增生、抑制假小叶形成,能防止白/球比值降低,对肝硬化病变有一定的预防作用。急性毒性低,小鼠灌胃给药LD_(50)>300g生药/kg体重。亚急性毒性实验表明对各脏器均无毒性反应。     

《伤寒论》泻心汤煎液中黄连素和黄芩甙含量变化的实验研究

<正> 中药复方煎液化学成分含量对中药疗效有重要意义,中药化学成分在煎液中含量受许多因素影响,配伍药物间的相互作用是一个重要因素。按现代药理研究认为某些有效的成分,     

沥青烟作业工人认知功能的观察

目的观察沥青烟作业工人认知功能的改变。方法选择某炭素厂生阳极车间接触沥青烟作业工人53名作为观察组,以该厂非沥青烟作业职工50名为对照,采用神经行为核心测试组合(neurobehavioral coretest battery,NCTB)中情感状态、数字跨度、数字译码测验、Benton视觉保留测验、目标追踪测验Ⅱ五项测试检测两组认知功能情况。结果 (1)观察组情感状态测试总分为(269.48±53.15)分,明显高于对照组[(217.54±41.41)分](P0.01)。观察组数字跨度总得分、视觉保留总得分、目标追踪测试总得分分别为(48.14±9.94)、(47.94±9.64)、(47.87±8.05)分,均低于对照组[分别为(52.82±9.57)、(53.45±9.74)、(53.19±11.80)分](P0.05)。(2)相关分析结果表明,数字译码测试总得分、数字跨度测试总得分及目标追踪测试总得分均与年龄呈负相关(分别r=-0.498,P0.01;r=-0.281,P0.05;r=-0.282,P0.05);数字译码测试总得分及目标追踪测试总得分均与接触工龄呈负相关(分别r=-0.476,P0.01;r=-0.269,P0.05)。结论沥青烟对作业工人认知功能可能产生潜在的损害。     

老年白内障的生化学改变

水晶体混浊致白内障,原因种种。水晶体老年化,代谢功能下降是老年白内障的生化基础。蛋白质晶体蛋白质(Crystallin)是水晶体所特有的蛋白质,蓄积于皮质和核中。分为4种α、β、γ、δ。前3种存在于哺乳动物中,后1种存在于爬虫类和鸟类。水晶体随年龄增长,蛋白质合成能力下降,不溶性成分增加。人类水晶体的构造蛋白质寿命比其它动物长,但随年龄变化也较明显。水晶体随年龄增长,蛋白质合成后修饰异常,使高分子重合增加,α、β、γ-晶体蛋白质混合呈不匀一状态。晶体蛋白质是高分子量(HMW)的可溶性旦白质,随年龄增长,渐聚合而由可溶性转变为不可溶     

脐部给药治老年高血压观察

老年高血压患者在使用口服降压药物时,往往发生低血压反应或体位性低血压,甚至可能引起心、脑、肾等器官的进一步缺血而导致严重并发症,故近年来十分重视给药新途径的研究。我们按中医脐疗法选择脐部皮肤给药,经临床使用有一定降压效果,且降压平稳,无低血压和体位性低血压反应,报告于下。     

骨盆骨折并发阴道损伤

骨盆骨折并发阴道损伤文献报道少见。早期常见于同时合并其它重要脏器损伤等原因而漏诊，导致晚期严重并发症。我院1982年1月～1995年1月收治11例，从妇产科和骨科角度对有关问题讨论如厂。亚临床资料1．1一般资料本组11例，占同期收治的146例女性骨盆骨折的75％。年龄12～61岁，平均34．7岁。伤因：10例车祸伤门例骑自行车或摩托车时发生车祸，1例拖拉机辗压伤），1例高空坠落伤。1.2伤情11例骨盆均有二处以上部位骨折，另伴耻骨联合分离及骶髂关节分离各2例。均为不稳定型骨折，其中压缩型4例，分离型5例，中间型2例。开放性骨折3例，开放…     

人本主义心理护理在冠状动脉介入治疗患者围手术期中的应用

目的探索人本主义心理学在冠状动脉介入治疗围手术期临床护理工作中的应用价值,探索针对冠状动脉介入治疗围手术期患者合理的心理护理模式。方法将120例患者随机分为对照组(60例)和实验组(60例),对照组采用常规护理,实验组由专职护士采取人本主义心理护理,比较2组患者围手术期SCL-90结果。结果入院时,2组患者10项因子比较,均无统计学意义(p>0.05),手术前1d,实验组较对照组在人际关系、抑郁、焦虑、敌对、恐怖因子方面得分低,2组比较差异有统计学意义(p<0.05),手术后第7d,实验组较对照组在强迫、人际关系、抑郁、焦虑、敌对、恐怖、偏执及其它方面得分低,2组比较差异有统计学意义(p<0.05)。结论人本主义心理护理比常规心理护理更能有效地缓解冠状动脉介入治疗患者围手术期的心理问题。