冠心病患者不同导联,电压及性别间JT,JTc间期和JTC／QTC值的分析

为探讨ＪＴ及其变量与冠心病（ＣＨＤ）的关系和最佳测量方法，我们对１５２例ＣＨＤ患者和２１０例正常（Ｎ），进行了不同电压、导联和性别间的ＪＴ、ＪＴｃ、ＪＴｃ／ＱＴｃ值的比较分析。结果显示：ＣＨＤ２的ＪＴ及其变量可在常规心电图Ⅱ、Ⅴ３导联进行测量和计算；ＣＨＤ组ＪＴ及其变量的值均显著或极显著长于Ｎ组，且女性显著或极显著长于男性。在除外其它因素的影响，ＪＴ及其变量的在ＥＣＧ中明显延长可作为诊断ＣＨＤ的参     

A comparison of the in vivo antibacterial effects of 'OpSite', 'Tegaderm' and 'Ensure' dressings

Three semi-permeable polyurethane dressings, 'Ensure', 'OpSite' and 'Tegaderm', were tested for their ability to prevent the increase in bacterial population under naturally hydrated, occluded volar forearm skin. Only 'OpSite' inhibited the bacterial multiplication in these tests. It is concluded that in the practical situation, 'OpSite' could well confer a greater margin of safety.     

Comparative Study of Cefamandole versus Ampicillin plus Cloxacillin: Prophylactic Antibiotics in Cardiac Surgery

A randomized, prospective study of the efficacy of cefamandole naftate versus a combination of ampicillin and cloxacillin was undertaken in 109 adult patients operated on in Leeds during 1979. Sixty patients underwent valve replacement, and 49 had either aortocoronary bypass grafts or other forms of open-heart operation. The two groups matched well in age, sex, and type of operation. One gram of either antibiotic was given intravenously during the induction of anesthesia and every 6 hours thereafter for 48 hours. Two additional grams of antibiotic were placed in the prime of the heart-lung machine.The overall rate of infection was 7.5% for the entire series, with 1.7% for the group given cefamandole and 13.7% for the group given ampicillin plus cloxacillin (p < 0.05). The only patient with infection in the former group (1.7%) had sternal wound involvement. Major sternal wound infection occurred in 3 (5.9%) patients in the latter group. All wound infections were caused by Staphylococcus aureus. In 2 of these patients (ampicillin plus cloxacillin group) the infection proceeded to endocarditis. Urinary and respiratory tract infections occurred in 1.9% and 5.9%, respectively, of patients given ampicillin plus cloxacillin. The duration of hospital stay was shorter in the cefamandole group. The results of this study demonstrated that cefamandole confers effective prophylaxis in cardiac operations.     

急性颅脑损伤患者心电图QT离散度的特点与意义

目的探讨急性颅脑损伤（ABI）患者心电图QT、JT间期变化对其轻重程度的判断及预后评估的意义。方法根据格拉斯哥昏迷评分,将101例ABI患者分为轻、中、重型三组;根据患者有无蛛网膜下腔出血（SAH）,分为SAH组及无SAH组。检测各组伤后24h内心电图的QT间期及JT间期,计算QT离散度（QTd）、校正的QT离散度（QTcd）、JT离散度（JTd）及校正的JT离散度（JTcd）;根据格拉斯哥预后评分判断预后,对其不同组间的各值进行统计学分析。结果轻、中、重型ABI患者的心电图QTd、QTcd、JTd、JTcd存在显著性差异,且SAH组各指标均升高,较无SAH组有显著统计学差异（P〈0．01或〈0．05）,并与预后有明显的相关性（P均〈0．01）。结论QTd、QTcd、JTd、JTcd对判断ABI程度及其预后评估有重要参考价值,可作为预测患者临床转归的指标,并且有助于早期临床干预。     

卡维地洛对急性心肌梗死病人QT、JT离散度及心率变异性的影响

目的 研究卡维地洛对急性心肌梗死病人QT、JT离散度及心率变异性的影响.方法将115例急性心肌梗死病人随机分为卡维地洛组（65例）与对照组（50例）,两组均予常规治疗,卡维地洛组加用卡维地洛12.5 mg,2次/日,疗程4个月,并随访至半年.检测两组治疗前后QT离散度、JT离散度、心率变异性变化,并记录半年内的不良心血管事件发生情况.结果 经过4个月的治疗,两组QT离散度、JT离散度、心率变异性的时域及频域指标较治疗前均明显改善（P＆lt;0.01）,但卡维地洛组更为明显（P＆lt;0.01）.卡维地洛组半年内不良心血管事件发生率较对照组显著减少（P＆lt;0.05）.结论卡维地洛可显著减小急性心肌梗死病人QT、JT离散度及提高慢性心率变异性,减少心血管不良事件.     

Novel indices of ventricular repolarization to screen post myocardial infarction patients

We propose novel indices of ventricular repolarization intervals, the JTp/JT, Tpe/JTp and Tpe/JT ratios. These indices have been compared with the duration of the ventricular repolarization intervals and other ratios in 17 normal subjects and 17 patients with old myocardial infarction. In the intervals and other ratios, the best separation between groups is obtained with the Tpe/QTp and Tpe/QT ratios with 94% sensitivity and 82% specificity, the proposed ratios increased sensitivity to 100% and specificity to 94%. These indices should be further tested to determine their usefulness in discriminating between OMI patients with and without susceptibility to ventricular arrhythmias.     

急性心肌梗死QT间期及JT离散度变化的临床意义

目的：探讨急性心肌梗死（AMI）早期QT间期离散度（QTd）与JT间期离散度（JTd）的变化及其临床意义。方法：测定61例AMI患者及70例正常对照组的QTd、JTd及校正后的QT与JT间期离散度（QTcd、JTcd）。结果：（1）AMI组QTd、JTd较对照组显著增大（均P＜0．001）。（2）不同梗死部位的QTd、JTd无明显差异（P＞0．05）。（3）合并严重室性心律失常者明显大于无室性心律失常者（P＜0．001）,（4）心源性死亡组显著大于未死亡者。（5）EF≤45％组大于EF＞45％组（P＜0．01）。结论：AMI早期QTd、JTd显著增大,与严重室性心律失常的发生、心源性死亡及心功能状况密切相关,提示QTd的测定对预测心脏事件和猝死有重要参考价值。