L''''ANGINE DE POITRINE PRECEDENT L''''INFARCTUS DU MYOCARDE:RELATION AVEC LES LESIONS CORONAIRES ET LA CIRCULATION COLLATERALE

To determine the relationship between angina pectoris before myocardial infarction (MI) and the extent of coronary artery disease and collateral circulation, 28 patients with (group Ⅰ)and 22 patients without (group Ⅱ) angina one month prior to acute MI underwent left ventriculography and coronary arteriography within 6 months of a first transmural MI. 23 patients in group Ⅰbut only 6 patients in group Ⅱhad multivessel disease. Despite a similar incidence of total occlusion of infarct-related artery, the collateral score in group Ⅰwas significantly higher than that in group Ⅱ. Abnormal regional left ventricular motion score was lower in group Ⅰthan in group Ⅱ. The study suggests that a history of angina before MI may predict the presence o f multivessel disease and the formation of collateral circulation in patients with MI.     

经皮冠状动脉腔内硬化斑块旋磨术治疗严重冠心病的临床价值

对不适合行经皮冠状动脉腔中内球囊成形术（ＰＴＣＡ）的１９例冠状动脉狭窄具有复杂形态的冠心病患者施行冠状动脉腔内硬化斑块旋磨术（ＣＲＡ），其成功率与ＰＴＣＡ相似，单独ＣＲＡ或ＣＲＡ加补充ＰＴＣＡ后的残余狭窄低，提示ＣＲＡ治疗严重冠心病比ＰＴＣＡ更优越。     

心肌缺血预适应在PTCA中的临床价值

将１００例冠心病患者分为Ａ，Ｂ两组，Ａ组先行心肌缺血预适应症再行经皮冠状动脉球囊成形术（ＰＴＣＡ），Ｂ组仅行ＰＴＣＡ。结果显示，两组扩张效果相似，但Ａ组在ＰＴＣＡ中出现心绞痛，缺血型心电图ＳＴ段改变时间均比Ｂ组明显延迟且较轻，术中低血压，室速发生率较低（Ｐ〈０．０５），因此认为，ＰＴＣＡ中采用预适应方法对减少并发症和病死率有重要意义。     

FACTORS RELATED TO THE LEFT VENTRICULAR ANEURYSM FORMATION AFTER ANTERIOR MYOCARDIAL INFARCTION

To examine the factors related to left ventricular (LV) aneurysm formation after transmural anterior myocardial infarction (MI), 22 patients with a first attack of anterior MI who underwent left ventriculography and coronary angiography within 6 months of infarction were divided into two groups on the basis of presence (10 patients, Group Ⅰ) or absence (12 patients, Group Ⅱ) of a LV aneurysm. Group Ⅰpatients were shown to have larger infarct and poorer LV function. Single vessel disease and total occlusion of the left anterior descending (LAD) artery were more common and collateral blood supply in the presence of an occluded LAD was significantly less adequate in Group Ⅰcompared with Group Ⅱ. Age, sex and risk factors for coronary artery disease were found to have no correlation with aneurysm formation. It is indicated in this study that total occlusion of the LAD in association with inherent poor collateral blood supply is an important determinant of aneurysm formation after anterior MI.     

电刺兔下丘脑背内侧核诱发S-T段下移的范围及可能机理

为探讨电刺激下丘脑背内侧核(DMH)诱发心表面电图(EECG)S-T段下移的范围与冠状动脉走行的关系及S-T 段下移时,左心室跨壁血流比值的变化,用35只家兔进行了实验,结果表明电刺激家兔DMH 可诱发LADA 供血区,LVA 和LCA 某些末梢供血区S-T 段下移;诱发左心室壁内膜下心肌缺血,其缺血程度与S-T 段下移程度呈正相关。     

老年冠状动脉钙化病变与PTCA夹层形成

冠状动脉 (冠脉 )粥样硬化斑块钙化不但是严重冠脉病变的标志 ,也是决定介入治疗成功率、并发症和再狭窄率的重要因素 [1～ 2 ] 。因此 ,如何准确诊断冠脉硬化斑块内钙化病变的存在及严重程度 ,对提高手术成功率、减少术中并发症及降低再狭窄率具有重要意义。为此 ,我们对 1 989年 1 0月～ 1 998年 3月收治的 1 3 2 2例老年冠心病患者行左心室及左、右冠状动脉造影 ,旨在探讨老年人冠脉病变钙化的影响因素及其对介入治疗的影响。1　资料与方法1 .1　对象　取同期冠心病患者 1 3 3 2例 ,其中老年(>6 0岁 )冠心病患者 784例 (男 5 86例 ,女 1 …     

粒细胞集落刺激因子动员自体骨髓干细胞移植对心梗大鼠慢性心力衰竭的治疗作用

目的探讨粒细胞集落刺激因子动员自体骨髓干细胞移植对心梗大鼠慢性心力衰竭的治疗作用。方法建立Wistar大鼠心肌梗死后心衰模型,随机分为移植组、动员组和对照组各10只。移植组于梗死区内注射经标记后的骨髓间充质干细胞,动员组皮下注射粒细胞集落刺激因子,对照组未行任何处理。4周后采用超声和生理记录仪描记左室收缩压（LVSP）、左室舒张压（LVEDP）、左室压力最大上升或下降速率（±LVdp／dtmax）等指标。取心脏组织做病理检查,观察移植细胞分化、促血管生成、细胞凋亡情况。结果细胞移植4周后,移植组及动员组心脏功能较对照组显著改善（P均〈0．05）,梗死区血管密度明显高于对照组,心肌细胞凋亡指数低于对照组（P均〈0．05）。结论骨髓干细胞动员可能为慢性心力衰竭的治疗提供一种新的无创性手段。     

血脂康对慢性心力衰竭患者心功能、血清C-反应蛋白和血脂的影响

目的探讨血脂康对慢性心力衰竭（CHF）患者心功能和血清C-反应蛋白（CRP）的影响。方法68例患者随机分为两组,对照组（30例）应用血管紧张素转换酶抑制剂、B受体阻滞剂、利尿剂和洋地黄制剂治疗,血脂康组（38例）在对照组基础上加用血脂康治疗0．5年,治疗前后采用超声心动图和酶联免疫法分别测定心功能和CRP水平。结果（1）NYHA心功能分级、左室舒张期末内径和左室收缩期末内径治疗后两组均显著下降（P〈0．05）,且血脂康组显著低于对照组（P〈0．05）;左室射血分数和E／A峰比值显著上升（P〈0．05）,且血脂康组显著高于对照组（P〈0．05）。（2）CRP：治疗后血脂康组较治疗前显著降低（P〈0．01）,且显著低于对照组（P〈0．05）;对照组治疗前后比较差异无显著性。结论血脂康在改善心功能的同时能降低血清CRP水平。     

冠心病介入治疗的现状及展望

概述冠心病（ＣＡＤ）介入治疗的临床应用，使ＣＡＤ、心绞痛及心肌梗塞（ＭＩ）的治疗取得了突破性进展，急性ＭＩ患者的病死率明显降低，生存率明显提高。ＣＡＤ介入治疗的特点是手术创伤小，患者痛苦少，危险性低，康复快，疗效可靠而彻底；但所需设备复杂，费用高，约...