中药槲寄生对冠心病患者血小板聚集率和心功能的影响

观察槲寄生注射液对48例陈旧性心肌梗塞患者治疗后的效应,血小板聚集率明显下降,由平均65014%max下降至平均39.15%max,p<0.001。甲皱微循环显示微循环障碍明显改善,血细胞解聚,微血流流速增加,由云絮状流改为直线流者占64～86%。心搏量(SV)、心输出量(CO)、心脏指数(CI)明显增加,与治疗前相比,P值均<0.01。说明槲寄生注射液对冠心病的血瘀状态及心功能有明显改善作用。     

Is laser speckle contrast analysis (LASCA) the new kid on the block in systemic sclerosis? A systematic literature review and pilot study to evaluate reliability of LASCA to measure peripheral blood perfusion in scleroderma patients

Objectives

A reliable tool to evaluate flow is paramount in systemic sclerosis (SSc). We describe herein on the one hand a systematic literature review on the reliability of laser speckle contrast analysis (LASCA) to measure the peripheral blood perfusion (PBP) in SSc and perform an additional pilot study, investigating the intra- and inter-rater reliability of LASCA.

Nailfold capillaroscopy in systemic lupus erythematosus: A systematic review and critical appraisal

Nailfold capillaroscopy is an easy, non-invasive technique to assess microvascular involvement in rheumatic diseases. Multiple studies describe capillaroscopic changes in systemic lupus erythematosus (SLE), including a wide range of non-specific findings. On behalf of the European League Against Rheumatism (EULAR) study group on microcirculation in rheumatic diseases, a systematic review was done to obtain all original research studies (in English) in which SLE patients had capillaroscopy. Forty such studies are identified. This article firstly provides a résumé of the results of these studies according to capillaroscopic parameters (density, dimensions, morphology, haemorrhages), semi-quantitative assessment and qualitative assessment of capillaroscopy in SLE patients. Secondly, the correlations between capillaroscopic parameters in SLE patients and clinical and laboratory parameters (including auto-immune parameters) are outlined. The following capillaroscopic parameters are found to be significantly more prevalent in SLE patients compared to healthy controls: tortuous capillaries, abnormal morphology and haemorrhages. Hairpin-shaped capillaries are significantly less prevalent than in healthy persons. The semi-quantitatively determined nailfold capillaroscopic score (NFC score) in SLE patients is also higher than in healthy controls. Several correlations between clinical and laboratory parameters and capillaroscopic parameters are identified in the review. Disease activity is correlated with NFC score in seven studies, with abnormal morphology (i.e. “meandering”) in one study and with haemorrhages in one study. Frequent attacks of Raynaud's phenomenon (RP) and gangrene are significantly correlated with dilated capillaries. In two studies a possible correlation between anti-SSA antibodies and lower density of capillaries is withheld. About other immune parameters conflicting results are found. In one study a significant negative correlation is found between 24-hour proteinuria and abnormal morphology (i.e. “meandering”). For the first time, an overview of the nailfold capillaroscopic changes that have been described in SLE and their correlations with clinical and laboratory findings is given. Further large-scale research on the identification of capillaroscopic changes in SLE and their correlations with standardised clinical and laboratory parameters, is ongoing at the EULAR study group on microcirculation in rheumatic diseases.     

艾灸对甲襞微循环的影响的研究

目的　研究健康人甲襞微循环对艾灸的效应。方法　选健康人30名,年龄2 1±3岁,采用江西协达公司生产的XDM Ⅰ型微循环仪,专人操作,于艾灸前及艾灸后测试甲襞微循环变化。结果　艾灸八邪及三阴交后,甲襞微循环各指标有明显变化,血流速度有非常显著性差异(P <0 .0 1)。红细胞聚集程度、流态积分、管周积分均有显著性差异(P <0 .0 5 )。结论　艾灸八邪及三阴交可明显改善甲襞微循环,红细胞积聚性下降,血流速度加快。     

银杏叶提取物改善微循环治疗亚健康的临床研究

目的 探讨银杏叶提取物治疗亚健康的疗效及其治疗机制.方法 选择已确诊的100例亚健康人,其中男50例,女50例,平均年龄 36.87±12.46岁.采用银杏叶提取物注射液17.5mg,每日一次,静点,每15d一个疗程.采用WX-9型微循环显微镜及微循环图像处理系统,观测100例亚健康人治疗前当天和一个疗程后第一天的足甲襞微循环,对治疗前后的观测结果 进行对比分析,同时比较治疗前后的症状,判断治疗效果.观测指标包括微血管形态、微血流动态、微血管周围状态共三方面17项.结果 治疗后与治疗前比较,治疗后微血管清晰度升高,管襻数增加,输入枝及输出枝长度增长,输入枝、输出枝和襻顶直径增加,血流速度加快,红细胞聚集性降低,襻周渗出和出血减少,亚健康症状减轻,有效率98%.结论 银杏叶提取物对亚健康有良好的治疗作用,其治疗机制是通过改善微循环,提高机体组织器官血液灌流来实现的.     

己酮可可碱改善微循环灌流治疗亚健康的临床研究

目的探讨己酮可可碱治疗亚健康的疗效及其治疗机制。方法选择已确诊的100例亚健康人,其中男50例,女50例,平均年龄35．32±13．28岁。采用已酮可可碱葡萄糖注射液0．2g（首日0．1g）,每日一次,静点,每15d一个疗程。采用WX-9型微循环显微镜及微循环图像处理系统,观测100例亚健康人治疗前当天和一个疗程后第一天的足甲襞微循环,对治疗前后的观测结果进行对比分析,同时比较治疗前后的症状,判断治疗效果。观测指标包括微血管形态、微血流动态、微血管周围状态共三方而17项。结果治疗后与治疗前比较,治疗后微血管清晰度升高,管襻数增加,输入枝及输出枝长度增长,输入枝、输出枝和襻顶直径增大,血流速度加快,红细胞聚集性降低．襻周渗出和出血减少,亚健康症状减轻,有效率99％。结论己酮可可碱对亚健康有良好的治疗作用,其治疗机制是通过改善微循环,提高机体组织器官血液灌流来实现的。     

健康成人足甲襞微循环观测方法及结果

目的探讨健康成人足甲襞微循环（FNM）的观测方法、指标及正常参考值。方法采用WX-9B型多部位微循环显微镜及微循环图像分析系统,观测200名健康成人FNM的形态、血流动态及管周状态,并计算FNM各项指标的正常值,同时对观测前准备、观测体位、观测方法进行探讨。结果观测指标及正常值：清晰度（清晰）、管襻数目（7．99±4．06条／mm）、输入枝长度（98．85±54．52μm）、输出枝长度（115．81±68．16μm）、输入枝直径（7．01±4．60μm）、输出枝直径（9．10±4．32μm）、襻顶直径（11．54±4．28μm）、管襻形状（发卡型和交叉型）、血流速度（线粒流及粒线流）、红细胞聚集（无）、血色（玫瑰红色）、白细胞计数（1～30个／15s）、血管运动性（0～1次／min）、白微栓（无）、渗出（无）、出血（无）、乳头下静脉丛（16．5％可见）、皮肤乳头（波纹状及浅波纹状）、汗腺导管（0～2个／一趾甲襞）。结论足甲襞是健康成人微循环观测的良好部位,其各项指标与青春期青少年和儿童有所不同,建立健康成人FNM正常参考值,对规范FNM检测标准有重要意义。     

Human microvascular imaging: a review of skin and tongue videomicroscopy techniques and analysing variables

Imaging techniques are increasingly important in clinical diagnostic work. Microcirculation is essential for function and survival of all tissues, but imaging techniques for microvascular monitoring of patients have only been used to a limited extent in clinical practice. The microcirculation is complex with its static and dynamic feature, and only skin and oral mucosa are readily accessible for microscopic examination. In addition, there is a no general agreement on which microvascular parameters and analysing techniques that could be useful. The aim of this article is to give an overview of techniques for human intra‐vital microscopy and to describe software and variables used to analyse pictures and film sequences of human microcirculation. We also present clinical examples where microvascular examinations have been shown to be of diagnostic value. Improved techniques for assessing microvascular morphology and physiology will probably become important tools in clinical work in many disciplines in the near future.     

2型糖尿病周围神经病变患者甲襞微循环变化特点

目的探讨2型糖尿病(T2DM)周围神经病变(DPN)患者甲襞微循环的变化特点。方法住院T2DM患者600例,根据肌电图结果分为DPN组488例和无DPN(NDPN)组112例,另选择30例正常人作为健康对照组,检查3组的甲襞微循环形态、流态、血管周围状态等指标,并进行比较。结果 (1)微循环特征:与健康对照组比较,DPN组和NDPN组甲襞微循环形态和袢周积分明显升高(P<0.01);与NDPN组比较,DPN组袢周积分和总积分升高(P<0.01)。(2)甲襞微循环表现:与健康对照组比较,2组患者袢周渗出、出血积分升高,DPN组管袢数、乳头积分升高,袢顶直径减小(P<0.05,P<0.01),且DPN组袢顶直径和乳头积分与NDPN组比较差异亦有统计学意义(P<0.05)。(3)病变程度:2组患者甲襞微循环正常者比例明显低于健康对照组(P<0.01),DPN组中度异常的比例高于NDPN组(52.9%vs 19.6%,P<0.01),正常者和轻度异常者比例低于NDPN组(分别为13.5%vs 31.2%,25.0%vs 43.8%,P<0.01)。结论 T2DM患者均存在甲襞微循环异常,DPN患者甲襞微循环异常更为严重,可能是DPN的病因之一。