术前低剂量胺碘酮预防非体外循环冠状动脉旁路移植术后心房颤动

Objective To assess the safety, tolerability and efficacy of preoperative low dose intravenous amiodarone in the prevention of atrial fibrillation (AF) after off-pump coronary artery bypass grafting (OPCAB). Methods Two hundred patients with coronary atheroselerotic heart disease underwent selected OPCAB and were randomly divided into two groups: control group (100 cases) and experimental group (100 cases). Patients in control group were given conventional medicines and placebo, and patients in experimental group were treated with low dose intravenous amiodarone daily for 4 days before surgery. They were given conventional medicines after surgery. Results After the off-pump coronary artery bypass grafting, the incidence of AF, ventricular rate and the duration of AF in the experimental group were lower than those in control group [15% vs. 41%, χ2=16.766, P=0.000; (126.0±20.8) times/ min vs. (150.0±25.6) times/ min, t=0.478, P =0. 017; (8. 0±8. 6) h vs. (12.0±9.6) h, t=0. 439, P=0. 019]. No significant difference were found in the incidence of side effect between low close amiodarone group and the control group. Conclusions Prophylactic application of low dose intravenous arniodarone before off-pump coronary artery bypass grafting can safely and effectively reduce the postoperative ventricular rate and the incidence of AF, shorten the duration of AF, promote the rehabilitation and slightly improve the clinical symptoms.     

术前低剂量胺碘酮预防非体外循环冠状动脉旁路移植术后心房颤动

目的 前瞻性的评估术前低剂量胺碘酮预防非体外循环冠状动脉旁路移植术后心房纤颤(房颤)的安全性、耐受性和有效性. 方法 将200例择期行非体外循环冠状动脉旁路移植手术(OPCAB)治疗的冠状动脉粥样硬化性心脏病患者随机分成研究组和对照组.对照组100例,术前给予常规药物和安慰剂;研究组100例,术前给予常规药物和低剂量胺碘酮,术后两组均用常规药物.结果 研究组的房颤发生率(15%)、房颤时最大心室率(126.0±20.8)次/min,房颤持续时间(8.0±8.6)h均低于对照组的房颤发生率((41%),(χ2=16.766,P=0.000]、房颤时最大心室率((150.0±25.6)次/min,t=0.478,P=0.017]以及房颤持续时间[(12.0±9.6)h,t=0.439,P=0.019].本实验结果 显示研究组药物不良反应的发生较对照组差异无统计学意义(P均0.05).结论 术前预防性应用低剂量胺碘酮能安全有效减少房颤发生率,缩短房颤持续时间,并能降低术后房颧最大心室率,减轻临床症状.     

间充质干细胞治疗心肌缺血性疾病的临床研究进展

<正>心肌缺血性疾病导致梗死区心肌细胞不可逆死亡,疤痕组织形成,心室重构,心功能降低最终导致心力衰竭。尽管现行心脏内外科治疗可以很大程度地降低了急性心肌梗死的病死率。然而并不能使梗死区梗死心肌细胞再生,导致心功能不可逆的降低。间充质干细胞(mesenchymal stem cells,MSC)是来源于骨髓和脐带,可以在体外被培养扩增,具有分     

超声弹性成像与全自动乳腺容积扫描诊断乳腺肿块价值研究

目的 探讨超声弹性成像（ultrasonic elastography,UE）与自动全乳腺容积扫描（automated breast volume scanning,ABVS）在乳腺良恶性肿块诊断中的应用价值.方法 收集自2012年6月至2013年7月行超声检查乳腺肿块67例,分别以UE及ABVS的良恶性标准判断肿块的性质,并与术后病理诊断作对照研究.结果 UE技术对乳腺肿块良恶性诊断的敏感性为92％,特异性为90％,准确性为91％;ABVS技术对乳腺肿块良恶性诊断的敏感性83％,特异性96％,准确性89％,两者差异具有统计学意义（P＜0.05）.结论 UE与ABVS在诊断乳腺肿块的性质上敏感性、特异性具有统计学意义,二者联合更具有应用价值.     

MR分子成像评价壁虎活性单体对人肺腺癌SPC细胞的作用

目的 利用前期制备的超微超顺磁性氧化铁(USPIO)标记的含有精氨酸-甘氨酸-天冬氨酸(RGD)序列的环肽探针(RGD-USPIO分子探针)进行MR成像,评价壁虎活性单体BH1273209对人肺腺癌SPC细胞的作用效果。方法 将SPC细胞接种于6孔板中培养24 h,分为实验组和对照组,分别加入1 mg/ml的BH1273209和培养液,培养48 h后加入含铁浓度25 μg/ml的RGD-USPIO培养1 h,进行普鲁士蓝染色。将细胞重悬于1%琼脂糖凝胶中,置于Eppendorf管内进行MR扫描。结果 随浓度增加,BH1273209对SPC细胞的抑制作用增强,1 mg/ml时抑瘤率最高;铁浓度为25 μg/ml时RGD-USPIO探针对SPC细胞活性无明显影响。对照组SPC细胞内可见较多蓝染颗粒,实验组SPC细胞内未见明显的蓝染颗粒。T2WI中,实验组的SNR(132.26±17.24)较对照组(4.89±3.35)明显增高(P<0.01)。结论 MR分子成像可简便、准确地评价BH1273209对SPC细胞的作用效果;BH1273209使SPC细胞结合RGD-USPIO明显减少,推测其通过抑制整合素配体-受体结合而发挥抗肿瘤作用。     

4303例不同年龄组冠状动脉旁路移植术早期疗效分析

目的 探讨不同年龄组冠状动脉旁路移植术手术效果及组间差异.方法采集单纯冠状动脉旁路移植术4 303例临床资料.按年龄分为青年组(≤45岁)、中年组(46～60岁)、低龄老年组(61～74岁)和高龄老年组(≥75岁),对各组患者术前、术中因素,术后死亡率及并发症进行比较.结果 青、中年组患者高血压史、合并轻度二尖瓣或主动脉瓣关闭不全比例、术前血清肌酐、大隐静脉与前降支吻合比例、呼吸机辅助时间、ICU停留时间低于老年组患者,而体外循环及全动脉化桥比例高于老年组患者.青、中年组患者术后死亡率(0.35%和1.52%)明显低于低龄(2.62%)和高龄老年组患者(5.45%).高龄老年组患者术后心房颤动(8.18%)和低心排综合征发生率(3.18%)最高.结论 大隐静脉与前降支吻合、年龄及体外循环是影响术后死亡的独立危险因素.冠状动脉病变支数、全动脉化桥比例、合并轻度二尖瓣关闭不全或主动脉瓣关闭不全比例及术前血清肌酐与死亡率有一定关系.术后肾功能不全可能与术前糖尿病史和术前血清肌酐水平有关.     

术前低剂量胺碘酮预防非体外循环冠状动脉旁路移植术后心房颤动

Objective To assess the safety, tolerability and efficacy of preoperative low dose intravenous amiodarone in the prevention of atrial fibrillation (AF) after off-pump coronary artery bypass grafting (OPCAB). Methods Two hundred patients with coronary atheroselerotic heart disease underwent selected OPCAB and were randomly divided into two groups: control group (100 cases) and experimental group (100 cases). Patients in control group were given conventional medicines and placebo, and patients in experimental group were treated with low dose intravenous amiodarone daily for 4 days before surgery. They were given conventional medicines after surgery. Results After the off-pump coronary artery bypass grafting, the incidence of AF, ventricular rate and the duration of AF in the experimental group were lower than those in control group [15% vs. 41%, χ2=16.766, P=0.000; (126.0±20.8) times/ min vs. (150.0±25.6) times/ min, t=0.478, P =0. 017; (8. 0±8. 6) h vs. (12.0±9.6) h, t=0. 439, P=0. 019]. No significant difference were found in the incidence of side effect between low close amiodarone group and the control group. Conclusions Prophylactic application of low dose intravenous arniodarone before off-pump coronary artery bypass grafting can safely and effectively reduce the postoperative ventricular rate and the incidence of AF, shorten the duration of AF, promote the rehabilitation and slightly improve the clinical symptoms.     

激光心肌打孔血运重建术的研究与应用现状

激光心肌打孔血运重建术的研究与应用现状屈正，张兆光，孙衍庆激光心肌打孔血运重建术（ＴＭＬＲ）是利用激光在心脏的缺血区域制造多个贯穿心外、内膜的心肌隧道，以便促使左室内动脉血于收缩期注入到缺血的心肌内，并通过心肌无数的窦状隙冠状动脉交通网提供给该区域氧...     

术前低剂量胺碘酮预防非体外循环冠状动脉旁路移植术后心房颤动

Objective To assess the safety, tolerability and efficacy of preoperative low dose intravenous amiodarone in the prevention of atrial fibrillation (AF) after off-pump coronary artery bypass grafting (OPCAB). Methods Two hundred patients with coronary atheroselerotic heart disease underwent selected OPCAB and were randomly divided into two groups: control group (100 cases) and experimental group (100 cases). Patients in control group were given conventional medicines and placebo, and patients in experimental group were treated with low dose intravenous amiodarone daily for 4 days before surgery. They were given conventional medicines after surgery. Results After the off-pump coronary artery bypass grafting, the incidence of AF, ventricular rate and the duration of AF in the experimental group were lower than those in control group [15% vs. 41%, χ2=16.766, P=0.000; (126.0±20.8) times/ min vs. (150.0±25.6) times/ min, t=0.478, P =0. 017; (8. 0±8. 6) h vs. (12.0±9.6) h, t=0. 439, P=0. 019]. No significant difference were found in the incidence of side effect between low close amiodarone group and the control group. Conclusions Prophylactic application of low dose intravenous arniodarone before off-pump coronary artery bypass grafting can safely and effectively reduce the postoperative ventricular rate and the incidence of AF, shorten the duration of AF, promote the rehabilitation and slightly improve the clinical symptoms.