血清胆红素与冠心病的关系

目的探讨血清总胆红素与冠心病的关系。方法对120例冠心病患者与120例健康者作对照,用改良J-G法检测血清总胆红素;用胆固醇氧化酶法(CHOD-PAP)检测总胆固醇(TC);用磷酸甘油氧化酶法(GPO-PAP)检测甘油三酯(TG);用直接匀相测定法检测高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),进行两组比较。结果冠心病组的总胆红素明显低于对照组(P<0.05)。结论血清胆红素的降低,可导致冠心病的发生。     

Cognitive disorders in patients with occlusive disease of the carotid artery: a systematic review of the literature

We present a systematic review of the literature on the prevalence, nature, severity, course, and causes of cognitive deficits in patients with occlusive disease of the carotid artery prior to surgery (if surgery was under discussion). Searches were carried out on Medline and Psychlit from 1980 to 1999 using neurovascular and psychological index terms, and papers and books were checked for further references. Studies describing neuropsychological assessment of groups of patients with carotid obstruction were included. Eighteen studies were found. We extracted from the papers data on study design, demographic characteristics of patients, clinical diagnosis, carotid obstruction, cerebral imaging, time interval between ischemic episode and neuropsychological assessment, neuropsychological asessment procedures, integration and interpretation of test performances, and conclusions of authors. Fourteen studies concluded that there are cognitive deficits both in patients with symptomatic and in those with asymptomatic carotid obstruction; four studies denied cognitive impairment. There were no differences in patient characteristics, study design, or neuropsychological assessment procedures between the 14 studies that found deficits and the 4 that did not. There are indications for a mild, diffuse, detrimental effect of carotid occlusive disease on cognitive functioning. However, methodological problems prevent a definitive conclusion. Further research is needed to confirm these findings and to ascertain the neurovascular risk factors for and the natural course of cognitive impairment in patients with carotid occlusive disease. Received: 12 July 1999/Received in revised form: 10 November 1999/Accepted: 26 January 2000     

经桡动脉和经股动脉途径行冠状动脉造影的对比分析

目的比较经桡动脉和经股动脉途径行冠状动脉造影的优缺点。方法同期158例临床疑诊冠心病拟行冠状动脉造影术的患者,随机分成经桡动脉组(51例)和经股动脉组(107例),对比观察其穿刺成功率、手术操作时间、X线曝光时间、术后住院天数和并发症的发生率,并进行统计学处理。结果桡动脉组的平均X线曝光时间、穿刺成功率分别为(5.97±4.52)min和96.08%,经股动脉组为(4.72±4.16)min和100%,两组比较差异无统计学意义(P>0.05);经桡动脉组的术后住院天数为(3.06±1.42)d,少于经股动脉组(4.97±3.07)d,P<0.01;两组局部血肿发生率分别为0和7.48%,差异有统计学意义,P<0.05;手术操作时间分别为(30.72±14.07)min和(24.96±9.62)min,两组比较差异有统计学意义,P<0.05;经桡动脉组动脉痉挛发生率为8.16%,经股动脉组无动脉痉挛发生,两组比较差异有统计学意义,P<0.05。结论经桡动脉径路行冠状动脉造影是安全有效的方法。具有止血容易、不需卧床、痛苦小、并发症少和住院时间短的优点,患者更易接受。     

子宫动脉栓塞治疗子宫腺肌病对卵巢功能的影响

目的:探讨子宫动脉栓塞治疗子宫腺肌病对卵巢功能的影响。方法:对27例子宫腺肌病患者采用聚乙烯醇微粒(PVA)进行子宫动脉栓塞治疗,在栓塞前、栓塞后3个月及6个月,评估所有病人的症状改善情况,并且采用经阴道彩色能量多普勒超声对子宫及病灶进行动态监测,监测子宫大小,子宫动脉和卵巢动脉血流动态改变,及基础性激素水平和基础体温情况。结果:子宫动脉栓塞术后3个月,子宫体积显著减小,平均缩小136.48(37.6%),子宫动脉的最大血流速度Vmax(cm/s)显著降低,由(27.27±6.03)cm/s降至(14.19±5.98)cm/s,P<0.05。子宫动脉阻力指数(RI)由0.54±0.03降至0.86±0.04,P<0.05;栓塞术前、后卵巢血流、卵泡刺激素(FSH)、雌二醇(E2)和月经周期无显著性差别。1例患者出现短暂卵巢功能急剧减退。结论:子宫动脉栓塞治疗子宫腺肌病是一种新颖、微创、安全、有效、并发症少且恢复快的治疗方法,可保留子宫的生育功能,对卵巢功能无明显损害,但应注意可能导致卵巢衰竭。     

内皮祖细胞移植修复大鼠颈总动脉内皮损伤

 [目的]探讨内皮祖细胞修复动脉内皮损伤的作用.[方法]建立大鼠颈总动脉内皮损伤模型,16只大鼠随机等分为内皮祖细胞移植组和对照组.体外诱导大鼠外周血单个核细胞为内皮祖细胞.在动脉损伤后,将5-溴脱氧尿苷标记的内皮祖细胞注入损伤动脉段,14 d后取损伤动脉段和对侧正常动脉段.采用病理学方法、免疫组织化学和图像分析技术评价内皮祖细胞的修复效果.[结果]内皮祖细胞移植组的损伤动脉段5-溴脱氧尿苷免疫组化为阳性.内皮祖细胞移植组损伤动脉段的新生内膜厚度较对照组明显减轻（43.5±5.5）μm vs（90.7±12.7）μm,P＜0.05;内皮祖细胞移植组的再内皮化程度明显高于对照组77.8%±0.1%vs52.2%±0.1%,P＜0.05.[结论]内皮祖细胞具有修复动脉内皮细胞损伤的作用,内皮祖细胞可作为心血管疾病细胞移植疗法的种子细胞.     

血府逐淤汤治疗冠心病不稳定型心绞痛35例临床观察

①目的探讨血府逐淤汤加味治疗不稳定型心绞痛的临床疗效。②方法将入选70例患者随机分为观察组与对照组,每组35例。对照组采用西药抗心绞痛治疗方案。观察组在对照组治疗基础上联用血府逐淤汤加味。均以20天为一个疗程。一疗程后评定疗效。观察心绞痛症状改善情况、心电图变化、血流变变化情况及血脂水平的变化。③结果观察组显效22例,有效10例,无效3例,显效率62.9%,总有效率为91.4%;对照组组显效19例,有效9例,无效7例,显效率54.3%,总有效率为80.0%。④结论观察组治疗后心绞痛症状和心电图明显改善,、总胆固醇、甘油三酯明显下降。血府逐淤汤具有扩张冠状动脉、降低周围血管阻力、抑制血小板和红细胞聚集、改善微循环作用,对不稳定型心绞痛疗效明确、显著。     

Experimental study on inhibitory effect of bridgy duct of hepatic artery on apoptosis of liver and bile duct cells

Objective： To investigate whether the method of bridgy duct established between the recipient＇s spleen artery and the donor＇s gastroduodenal artery could inhibit the apoptosis of liver and bile duct cells caused by hepatic artery ischemia. Methods： Twenty-four mongrel dogs from Xi＇an area were used to establish simplified models of dog orthotopic liver transplantation and divided into three groups randomly： HAI group （hepatic artery ischemia group）,BBB group（bypassing the blood by a bridgy duct） and control group. After cold perfusion, The samples were collected from liver and bile duct in each group at different time and fixed in glutaraldehyde and 4% polyformaldehyde respectively. At last, the apoptosis of liver and bile duct cells were observed and the apoptotic indexes were calculated. Results： Two hours after cold perfusion, apoptotic phenomenon was common in HAI group, rare in BBB group, while no apoptotic phenomenon was observed in control group. TUNEL staining showed that there was no significant difference in apoptotic index among the three groups immediately after cold perfusion. However, with time going, the apoptotic cells were increased in three groups, and the difference in apoptotic index was significant among three groups （P 〈 0.01 ）. Conclusions： Bridgy duct of hepatic artery can inhibit the apoptosis of liver and bile duct cells caused by HAI significantly.     

Comparative study of graft flow between on-pump and off-pump coronary bypass surgery for patients with multivessel coronary artery disease

Objective： To Comparatively study grafts flow between on-pump and off-pump coronary bypass surgery for patients with triple coronary artery disease. Methods ： The grafts flow was studied in 100 patients of OPCAB and compared with 100 cases of CCABG by means of Medi-Stim Butterfly Flowmeter measurement intraoperatively. Results： The mean number of the distal anastomosis was 3.78＋ 1.11 in CCABG group, and 3.83 ＋ 0.93 in OPCAB group. The index of completeness of revascularization in CCABG group was 1.01 ＋ 0.08, and 1.10＋ 0.09 in OPCAB group. The flow of grafts was satisfied in all patients. The PI values were all under 5. There was no significant difference in the mean graft flow and PI value between two groups. Conclusion： OPCAB can provide the same grafts flow and similar completeness of revascularization when compared with CCABG which indicates the similar anastomosis quality of grafts in OPCAB and CCABG groups.     

P-选择素在急性冠脉综合征中的研究进展

P-选择素可反映体内血小板的功能状态,间接反映体内血管炎症及免疫状态,而炎症与免疫可能是导致斑块不稳定的主要因素,观察及干预P-选择素可能对急性冠脉综合征的预测和防治有帮助。     

Vascular ultrasound in obstetrics

The usefulness of the vascular ultrasound in the field of obstetrics is now well recognized. Intima-media thickness (IMT) and elastic property of the common carotid artery are affected by pregnancy and vary with complications. Flow-mediated vasodilation (FMD) of the brachial artery reflects the vascular endothelial function and is reported to be useful in the management of complicated pregnancy, especially pre-eclampsia. For the screening of deep vein thrombosis of the lower extremities in the perinatal period, compression ultrasonography (CUS) is useful.