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81.
冠心病行为模式与心理状态的相关性探讨 总被引:8,自引:1,他引:7
目的为探讨A型行为在冠心病(CoronaryHeartDisease,CHD)中的作用及与心理状态的相关性。方法对114例CHD及37例非CHD应用心理测验方法对照调查。结果发现A型行为的人易患CHD。CHDA型行为者在焦虑、抑郁、人际关系、认识、敌对性症状因子分较CHD非A型行为者有明显增高。CHD非A型行为者也具有一些特有的心理症状。结论CHD病人的行为模式与病后的某些心理表现呈正相关。 相似文献
82.
Bruce F. Waller Charles M. Orr James Van Tassel Thomas Peters Edward Fry James Hermiller Larry D. Grider 《Clinical cardiology》1997,20(1):67-74
Catheter balloon angioplasty is a well accepted form of nonsurgical treatment of acutely and chronically obstructed coronary artery vessels. It is also the centerpiece for various new intervention techniques. Their morphologic effect on the site of obstruction has been termed “remodeling.” Part V of this six-part series focuses on remodeling effects of balloon angioplasty on obstructed young (≤ 1 year) and old (> 1 year) saphenous vein bypass grafts. 相似文献
83.
Fumitaka Nakamura Jan Kvasnicka Micheline Levame Franoise Lange Hassan Bousbaa Herbert J. Geschwind 《Lasers in surgery and medicine》1993,13(4):412-420
This study was designed to examine the acute response of normal arterial wall to pulsed laser irradiation. Irradiation with an Excimer or a Holmium YAG laser was performed in 15 normal iliac sites of 8 male New Zealand white rabbits. The excimer laser was operated at 308 nm, 25 Hz, 50 mj/mm2/pulse, and 135 nsec/pulse and the Ho:YAG laser was operated at 2.1 μm, 3.5 Hz, 400 mj/ pulse, 250 μsec/pulse. The excimer and Ho:YAG laser were coupled into a multifiber wire-guided catheter of 1.4 and 1.5 mm diameter, respectively. The mean luminal diameter increased similarly from 2.01 ± 0.29 to 2.46 ± 0.27 mm (P < 0.0005) and from 2.09 ± 0.53 to 2.45 ± 0.30 mm (P < 0.005) after excimer and Ho:YAG laser irradiation, respectively. Perforation occurred in 3 of 15 Ho:YAG irradiated sites and 0 of 15 excimer laser irradiated sites. The sites irradiated with excimer or Ho:YAG laser had similar histologic features, consisting of shedding of the endothelium, disorganization of internal elastic lamina, localized necrosis of vascular smooth muscle cells, and fissures in the medial layer. However, the sites irradiated with excimer laser had lower grading scores than those irradiated with the Ho:YAG laser (P<0.05). Irradiation with excimer or Ho:YAG laser of normal arteries results in: (1) vasodilation of the irradiated artery; (2) localized mechanical vascular injury, and (3) Ho:YAG laser induces more severe damage to the arterial wall than excimer. © 1993 Wiley-Liss, Inc. 相似文献
84.
Life satisfaction in patients with chest pain subsequently diagnosed as coronary heart disease – connection through depressive symptoms? 总被引:3,自引:0,他引:3
Valkamo M. Koivumaa-Honkanen H.-T. Hintikka J. Niskanen L. Honkalampi K. Viinamäki H. 《Quality of life research》2003,12(8):1099-1105
The aim of this study was to investigate factors associated with life dissatisfaction in symptomatic patients (n = 144) with chest pain subsequently diagnosed as coronary heart disease (CHD) by coronary angiography. Life dissatisfaction was assessed with a four-item life satisfaction scale (LS), depression with the 21-item Beck Depression Inventory (BDI) and other psychiatric symptoms with the symptom check list (SCL). DSM-III-R Axis I and Axis II psychiatric diagnoses were performed by means of the Structured Clinical Interview. All assessments took place one day before angiography. Twenty-four per cent of CHD patients were dissatisfied with their lives. Life dissatisfaction was associated with being unmarried. Dissatisfied patients had Axis I mental disorders and Axis II personality disorders more frequently than others. Psychiatric and depressive symptoms according to the SCL and BDI, respectively, were also higher among dissatisfied patients. In multiple logistic regression analyses, mental disorders were related to life dissatisfaction when age, sex, employment status, New York Heart Association class, duration of chest pain symptoms and work load were controlled in the model. Married subjects had a lower probability of being dissatisfied with their lives than other subjects (Odds Ratio, OR: 0.23). When BDI scores were included in the model, the only factor independently associated with life dissatisfaction was the severity of depressive symptoms (OR: 1.81). To conclude, life dissatisfaction is not primarily determined by the severity of CHD but by the existence of depressive symptoms. 相似文献
85.
急性心肌梗死再灌注期间的心电变化特征 总被引:1,自引:1,他引:0
目的 探讨急性心肌梗死 (AMI)再灌注期间的心电变化特征。方法 46例经急诊冠状动脉造影明确为成功再灌注的AMI,其中 2 4例接受溶栓治疗和 2 2例接受直接经皮腔内冠状动脉成形 ,于发病的 6小时内以动态心电图技术持续2 4小时监测心电图变化 ,并与 1 5例无灌注者进行对比。结果 ①再灌注发生后 ,相应导联ST段迅速下降 ,约 2小时达较低水平 ;同时 ,T波正向振幅进行性降低 ,距再灌注 0~ 2 2 (2 7± 4 5)小时呈现T波倒置并逐渐加深。②再灌注后的 1小时内 ,室性心律失常明显增加 ,6~ 8小时后显著减少。结论 AMI早期再灌注发生后呈现特征性心电变化 ,及时识别这些特征将有助于临床评估再灌注状态和危险度分层 相似文献
86.
多巴酚丁胺负荷及运动试验~(99m)Tc-MIBI心肌断层显像与冠状动脉造影的对比研究 总被引:2,自引:0,他引:2
比较69例冠心病患者多巴酚丁胺负荷99mTc甲氧基异丁基异腈(MIBI)心肌断层显像与82例运动试验99mTcMIBI心肌断层显像的结果,以探讨它们对冠心病的诊断价值。结果表明:以冠状动脉造影结果为标准,多巴酚丁胺负荷诊断冠心病的敏感性和特异性分别为912%和800%,运动试验分别为894%和829%。多巴酚丁胺负荷检出冠状动脉病变的敏感性和特异性:左前降支为781%和913%,回旋支为667%和982%,右冠状动脉为100%和837%;运动试验分别为783%和911%,600%和968%,909%和850%,差异均无显著性(P>005)。提示两者结果相近,对于不能进行运动试验的病人,多巴酚丁胺试验是一种有价值的诊断冠心病的方法。 相似文献
87.
国产4环/7层PET仪初试 总被引:1,自引:0,他引:1
对我国1996年研制成功的4环/7层PET仪(轴向视野8cm)进行试用。先进行模型试验和动物实验,然后对1例正常志愿者和7例患者进行18F脱氧葡萄糖(FDG)PET显像。静脉注射18FFDG370MBq后约15小时显像,成人全身显像行11个床位采集,约15小时,心脑局部显像行2~3个床位采集,约半小时。直径1~3cm的阴模和阳模皆可显示。8例全身冠状和矢状断层影像清晰,正常志愿者(正常进食)可见脑和心肌显影,膀胱内放射性较多。2例恶性肿瘤患者的6处病变浓聚18FFDG。2例恶性肿瘤患者手术和化疗后无复发征,显像阴性。2例良性病变处未见18FFDG浓集。1例陈旧性心肌梗塞患者18FFDG心肌断层显像与99mTc甲氧基异丁基异腈心肌血流灌注显像匹配良好。正常心肌显影与否受葡萄糖负荷的影响。8例脑皮质横断影像良好,基底节和丘脑影像有时尚欠清晰。初试结果表明,该PET仪相当于至今尚在国外广泛使用的80年代中期4环/7层PET仪水平,但具有90年代PET仪全身整体冠状和矢状断层显像的功能,可用于全身肿瘤显像、心肌活性判断和功能性癫痫灶术前定位,但仪器操作性能和软件功能尚需进一步完善。 相似文献
88.
Myocardial metabolic imaging by means of fluorine-18 deoxyglucose/technetium-99m sestamibi dual-isotope single-photon emission tomography 总被引:2,自引:1,他引:1
Hans-Peter Stoll Nicola Hellwig Christof Alexander Cem Özbek Hermann Schieffer Erich Oberhausen 《European journal of nuclear medicine and molecular imaging》1994,21(10):1085-1093
The detection of preserved glucose uptake in hypoperfused dysfunctional myocardium by fluorine-18 deoxyglucose (FDG) positron emission tomography (PET) represents the method of choice in myocardial viability diagnostics. As the technique is not available for the majority of patients due to cost and the limited capacity of the PET centres, it was the aim of the present work to develop and test FDG single-photon emission tomography (SPET) with the means of conventional nuclear medicine. The perfusion marker sestamibi (MIBI) was used together with the metabolic tracer FDG in dual-isotope acquisition. A conventional SPET camera was equipped with a 511-keV collimator and designed to operate with simultaneous four-channel acquisition. In this way, the scatter of 18F into the technetium-99m energy window could be taken into account by a novel method of scatter correction. Thirty patients with regional wall motion abnormalities at rest were investigated. The results of visual wall motion analysis by contrast cine-ventriculography in nine segments/heart were compared with the results of quantitative scintigraphy. The scintigraphic patterns of MIBI and FDG tracer accumulation were defined as normal, matched defects and perfusion-metabolism mismatches. Spatial resolution of the system was satisfactory, with a full width at half maximum (FWHM) of 15.2 mm for 18F and 14.0 mm for 99mTe, as measured by planar imaging in air at 5 cm distance from the collimator. Image quality allowed interpretation in all 30 patients. 88% of segments without relevant wall motion abnormalities presented normal scintigraphic results. Seventy-five akinetic segments showed mismatches in 27%, matched defects in 44% and normal perfusion in 29%. We conclude that FDG-MIBI dual-isotope SPET is technically feasible with the means of conventional nuclear medicine. Thus, the method is potentially available for widespread application in patient care and may represent an alternative to the 201T1 reinjection technique. 相似文献
89.
潘生丁ECT显像诊断冠心病临床可行性研究:附110例冠脉造影对照报告 总被引:2,自引:0,他引:2
110例疑冠心病病人以冠状动脉造影为对照,研究潘生丁核素心肌断层显像在诊断冠心病中的临床可行性。73例冠脉造影阳性(50%以上狭窄)及37例造影阴性病例中,潘生丁心肌显像检出的敏感性为95.3%,特异性为89.2%。单支、双支及三支病变检出的敏感性分别为92.7%、100%、100%。受累血管检出的敏感性分别为左前降支84.2%,回旋支82.1%,右冠状动脉90.6%。 相似文献
90.
本文报道准分子激光冠脉成形术(ELCA)8例,均为男性,年龄平均61岁。心梗4例(2例有梗塞后心绞痛),4例仅表现为心绞痛。冠脉造影显示LAD狭窄6支,LCX狭窄4支,RCA狭窄4支。按ACC/AHA分型B型5例,C型3例。均用ELCA+PTCA。根据血管直径选用1.3mm(能量密度14.5mJ)和1.6mm(能量密度21.0mJ)激光导管,频率20Hz。1例导引钢丝未能通过狭窄,ELCA失败,另1例二次心梗,经旁路移植后仍有心绞痛发作,心功能较差,其ELCA虽获成功,但因病情严重死亡。8例中ELCA成功7例,手术成功6例。 相似文献