白花前胡甲素对心肌缺血再灌注大鼠血清IL-6水平的影响

目的　探讨白花前胡甲素 (Pd Ia)抗缺血再灌注损伤的机制 ,为寻找高效、低毒及安全的防治缺血再灌注损伤的药物提供理论基础。方法　采用放射免疫分析测定血清IL— 6水平 ,并通过常规HE染色比较中性粒细胞等炎性细胞的心肌浸润情况。结果　Pd Ia低、中、高三个剂量组IL— 6水平分别由对照组的 (15 2 88±15 2 5 ) pg/ml降至 (12 8 45± 18 37)pg/ml、 (119 6 6± 15 72 ) pg/ml和 (116 13± 10 45 )pg/ml (P <0 0 1) ,其作用强度与硝苯地平相近 (12 3 5 5± 18 6 2 )pg/ml。 结论　Pd Ia明显抑制缺血再灌注大鼠血清IL— 6水平 ,提示Pd Ia可能通过抑制NF—kB途径实现再灌注性损伤的防治     

Electrocardiographic Changes in Spontaneous Left Pneumothorax

ABSTRACT. Keller N, Szaff M, Sykulski R (Department of Internal Medicine, Sundby Hospital, Copenhagen, Denmark). Electrocardiographic changes in spontaneous left pneumothorax. Acta Med Scand 1987; 221:499–501. A 25-year-old man was admitted with severe chest pain and an electrocardiogram suggestive of anterior myocardial infarction. Echocardiogram was normal, but chest X-ray showed left-sided pneumothorax. The electrocardiogram showed increasing R-wave amplitude in the days after correction of pneumothorax. Taken in the supine position the electrocardiogram can be misleading in case of pneumothorax or mediastinal emphysema, but the electrocardiogram should be normal if taken in the erect position.     

大豆总皂甙对培养心肌细胞自发性搏动与动作电位的影响

培养Wistar大鼠乳鼠的心室肌细胞,向培养基中分别加入浓度为1.56μg/ml至50μg/ml的大豆皂甙,可使心肌细胞群落的自发性搏动呈剂量依赖性抑制。洗脱大豆皂甙或向培养基中再加入10μg/ml肾上腺素均能使自发性搏动恢复。向培养基中加入大豆皂甙5μg/ml使心肌细胞动作电位的波幅、波宽、超射、最大舒张电位、阈电位、最大除极速度等各电参数立即减小。Ca~(2+)80μg/ml能使动作电位的抑制逆转。上述结果表明大豆皂甙对培养的鼠心肌细胞具有钙通道阻滞用。     

PLASMA PHOSPHOLIPASE A2 ACTIVITY IN CLINICAL ACUTE MYOCARDIAL INFARCTION

1. Phospholipase A2 (PLA2) cleaves phospholipids to produce a lyso-phospholipid and free fatty acid and, in view of the biological activity of the products, PLA2 may play a role in many disease states. Lyso-phospholipids and free arachidonic acid increase in ischaemic myocardium, indicating that ischaemia activates the enzyme. 2. Plasma PLA2 activity was measured in patients with acute myocardial infarction, based on the release of labelled arachidonic acid from Escherichia coli cell membrane. Fourteen males (peak serum creatine phosphokinase (CK) above twice upper normal) were studied on day 1 (within 6 h of chest pain onset), days 2-4, and days 6-9. Normal age matched males (n = 13) were also studied. 3. Plasma PLA2 in patients with uncomplicated myocardial infarction (n = 12) was, initially, 1.14 +/- 0.10 (s.e.m.) nmol/min per mL plasma, similar to that in the normal group (1.52 +/- 0.14). On days 2-4, PLA2 activity increased to 1.94 +/- 0.18 (P less than 0.001) and this activity was correlated with the earlier peak CK level (P less than 0.02). On days 6-9, PLA2 activity was 1.49 +/- 0.13 while in two patients who developed complications and underwent open-heart surgery between the last two measurements, there were further increases to 4.22 and 4.04 nmol/min per mL. 4. The increase in plasma PLA2 in uncomplicated myocardial infarction is likely to be due to release from the damaged myocardium; whether it contributes to pathophysiology is uncertain.     

左旋硝基精氨酸诱导高血压大鼠心肌肥大

一氧化氮合酶（ＮＯＳ）抑制剂Ｎ－左旋硝基精氨酸（Ｎ－ＬＮＡ）诱导持续性高血压大鼠１２只，随机分成２组测右颈动脉压，ＮＯ代谢物亚硝酸盐（ＮＯ２）浓度，心肌组织胶原蛋白含量及丝裂活化蛋白激酶（ＭＡＰＫ）活性，观察左心室心肌病理变化，发现与高血压比较，自然归组大鼠动脉血完全逆转（Ｐ〈０．０１）；ＮＯ２水平及ＭＡＰＫ活性轻度逆转，但均未达到正常对照组水平（Ｐ〈０．０１），胶原蛋白含量，心脏及左心室相对重量     

老年急性心肌梗塞37例临床分析

对３７例老年急性心肌梗塞与５０例老年前期急性心肌梗塞病人进行临床对比分析．结果显示：部分老年急性心肌梗塞病人发病不典型，并发症多，死亡率高，这可能与并发室颤、房室或束支传导阻滞、心衰等有关．     

过敏性紫癜的心肌损害

目的观察儿童过敏性紫癜并心肌损害的发生率及临床特点。方法回顾性分析93例过敏性紫癜患儿并心肌损害的临床资料，对其发生率、临床表现及其他系统损害的关系和预后进行分析。结果497例过敏性紫癜患者中有93例（18．71％）有心肌受损，主要表现为心肌酶学异常和（或）心电图异常。所有病例应用肾上腺皮质激素治疗后均治愈。结论过敏性紫癜合并心肌损害是临床较常见的表现，早期识别并及时应用激素治疗及对症处理可避免严重并发症的发生，提高治疗效果。     

Prognostic value of supine scintigraphic heart function and simultaneous conventional exercise response in patients after myocardial infarction

A total of 240 survivors of one or more myocardial infarctions were consecutively admitted to perform supine exercise radionuclide ventriculography. Within 3 years after the test, 22 died; this group was compared to an age-matched control group of 22 survivors for left and right ventricular function during rest, exercise, and simultaneously assessed exercise performance as well as ECG variables. Evaluation of 3-year survival by linear discriminant analysis revealed an accuracy of 82% for discriminant models using ECG and exercise performance variables. Implementation of resting left ventricular ejection fraction and change of right ventricular ejection fraction during exercise, as well as scintigraphic presence or absence of dyskinesia, improved the accuracy of the model to 91% of correctly classified patients.