埃他卡林对大鼠尾动脉平滑肌细胞［Ca2+］i， PKA和PKC活性的影响埃他卡林对大鼠尾动脉平滑肌细胞［Ca2+］i， PKA和PKC活性的影响

细胞内钙参与了对几乎所有类型细胞的各种生理活动的调节[1],并通过影响PKA和PKC等大分子蛋白,进一步调控细胞的分裂和增殖。以ATP敏感型钾通道(KATP)为靶点的钾通道开放剂(KCO)是一类新型的抗高血压药物[2,3]。KCO激活血管平滑肌KATP,间接抑制钙通道的开放,从而使[Ca2 ]i降低,     

Paradoxical emboli: demonstration using helical computed tomography of the pulmonary artery associated with abdominal computed tomography

We report the case of a 60-year-old woman with a recent history of a cerebrovascular accident. Because of clinical suspicion of pulmonary embolism and negative Doppler ultrasound findings of the lower limbs, spiral computed tomography of the pulmonary artery was performed and demonstrated pulmonary emboli. We emphasize the role of computed tomography of the abdomen, performed 3 min after the thoracic acquisition, which showed an unsuspected thrombus within the abdominal aorta and the left renal artery with infarction of the left kidney. Paradoxical embolism was highly suspected on computed tomography data and confirmed by echocardiography which demonstrated a patent foramen ovale. Received: 23 April 1999; Revised: 17 August 1999; Accepted: 18 August 1999     

血管紧张肽转换酶抑制药在冠心病治疗中的应用

血管紧张肽转换酶抑制药可通过改善心肌供氧耗氧平衡、改善血管内皮功能、抑制交感神经兴奋性、抑制血管平滑肌迁移和增殖、抑制血小板聚集和促进纤维蛋白溶解、抑制低密度脂蛋白氧化修饰、抑制心肌肥厚、延迟心脏重构等机制在动脉粥样硬化和冠心病的治疗中发挥重要作用     

急性冠脉综合征预防进展

预防动脉粥样硬化斑块破裂是预防急性冠脉综合征的最主要手段。动脉粥样硬化斑块破裂有其内在的和外在的因素。 3 羟基 3 甲基 戊二酰辅酶A(HMG CoA)还原酶抑制药、过氧化物酶体增殖激活受体α激动药、血管紧张肽转换酶 (ACE)抑制药、抗感染药物等是目前预防急性冠脉综合征的主要治疗方法。     

二乙酰基莲心碱对猪冠状动脉条的影响

目的:观察二乙酰基莲心碱拮抗氯化钾、乙酰胆碱(Ach)和组胺(His)所致猪冠状动脉条收缩的作用.方法:离体平滑肌实验方法,观察二乙酰基莲心碱对氯化钾,Ach,His所致猪冠状动脉条收缩曲线的影响以及在无钙克氏液中,对His引起猪冠状动脉条第一相收缩和钙引起第二相收缩的影响.结果:不同剂量二乙酰基莲心碱可使氯化钾,Ach,His所致冠脉条收缩量效曲线呈非竞争性拮抗作用,对冠脉条第一相和第二相收缩都有明显的抑制作用结论:二乙酰基莲心碱具有扩张冠脉的作用,此作用与拮抗细胞内钙的释放和抑制外钙内流有关.     

异丙酚、异氟醚及其联合应用在冠脉搭桥术中对心肌的保护作用

目的 :通过动态观察心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶 (CK MB)、超氧化物歧化酶 (SOD)和丙二醛 (MDA)的变化 ,比较麻醉剂异丙酚、异氟醚以及它们联合用药在心内直视手术中对心肌保护的影响。方法 :将 6 0例择期行冠脉搭桥术患者随机分为对照组、异丙酚组、异氟醚组和联合用药组。麻醉诱导和维持异丙酚组用异丙酚等 ,异氟醚组用异氟醚等 ,联合用药组异丙酚复合异氟醚等。分别于麻醉后转流前 (T0 )、开放升主动脉后 30min(T1)以及停机后 4h(T2 )、2 4h(T3 )、4 8h(T4)测定血浆cTnI、CK MB、SOD、MDA浓度。结果 :各组患者血浆cTnI、CK MB及MDA自T1均不同程度升高 ,异丙酚组、异氟醚和联合用药组cTnI及MDA值分别于T2 、T3 时显著低于对照组 ,联合用药组血浆cTnI于T3 时显著低于异丙酚组 (P <0 .0 5 ) ,联合用药组的心脏自动复跳率显著高于其它各组 (P <0 .0 5 )。结论 :在冠脉搭桥术中 ,麻醉剂异丙酚、异氟醚的应用均在一定程度上减轻由脂质过氧化反应介导的心肌缺血再灌注损伤 ,尤以异丙酚、异氟醚联合应用效果更佳     

The need for pharmaceutical care in the prevention of coronary heart disease: an exploratory study in acute myocardial infarction patients

AIM: To determine guideline-related pharmaceutical care issues for the prevention of coronary heart disease in hospitalised patients admitted for myocardial infarction (MI). METHODS: Consecutive patients admitted with a diagnosis of Q-wave MI to two large teaching hospitals were studied. Relevant patient medical and drug histories, co-morbidities and total cholesterol concentrations were recorded. Primary or secondary prevention treatment prior to admission was assessed using a data collection tool of 16 criteria developed from the Scottish Intercollegiate Guidelines Network (SIGN) guidelines. MAIN OUTCOME MEASURES: Frequency of adherence to defined clinical guideline criteria. RESULTS: There were 167 patients reviewed (mean age 65 years, 111 males), representing possible candidates for primary prevention (n = 98) or secondary prevention (n = 69) based on absence or presence of past history of coronary heart disease (CHD), respectively. Possible primary prevention candidates: eight guideline-based criteria were developed from the SIGN guideline. There were 85 (87%) patients with a total cholesterol concentration available on admission of whom 56 (66%) had a predicted CHD risk > or = 15% and 10 (12%) had CHD risk > or = 30%. Of those with CHD risk > or = 15% 6 (11%) had been receiving an anti-platelet agent and of those with CHD risk > or = 30% only 1 (10%) was recorded as taking a statin. Of known hypertensives with CHD risk > or = 15%, 21% (5/24) were not recorded as having received treatment. Secondary prevention candidates: a further eight guideline-based criteria were developed from the SIGN guidelines. There were 42/65 (65%) candidates for aspirin documented as receiving it. There were 22/47 (47%) of those who had a total cholesterol > or = 5 mmol/l and/or known history of hypercholesterolaemia receiving a statin (representing 76% of the known hypercholesterolaemic patients identified in the community). Of statin-treated patients with a cholesterol measured on admission, 44% (7/16) had cholesterol remaining > or = 5 mmol/l. Beta-blocker use was 27/62 (44%) and ACE inhibitors use was 11/31 (36%) of those eligible. Sublingual GTN was recorded in 36/69 (52%). CONCLUSION: The study has identified opportunities for improved pharmaceutical care in primary and secondary CHD prevention among those destined to suffer an MI. Candidates for secondary prevention are potentially identifiable from community pharmacy patient medication records from which the contribution of pharmacists in primary care might be targeted. The findings were obtained during a period of evolution of the evidence-base and so they establish a baseline for future work.     

莲心碱二乙醚对猪冠状动脉条的影响

OBJECTIVETo observe the antagonism of on contraction of porcine artery strips induced by KCl, acetyl choline (Ach) and histamine (Hist) respectively. METHODUsing experimental methol of smoth muscle. RESULTSDifferent dosage of O,O-Diethyl-liensinine had no     

年龄增加对人血管内皮依赖性舒张作用的实验研究及机制探讨

目的探讨年龄增加对人血管内皮依赖性舒张作用的影响及其初步机制。方法采用血管环张力测定法,在15例不同年龄段（51~83岁）胃癌患者手术切除的胃网膜动脉上,测定0.001~10 μmol/L乙酰胆碱（ACh）诱发的血管内皮依赖性舒张作用和内皮依赖性超级化因子（EDHF）样血管舒张作用的变化;采用实时荧光定量PCR（qRT-PCR）方法观察不同年龄人血管中的内皮型NO合酶（eNOS）、环氧合酶（COX）、胱硫醚γ裂解酶（CSE）以及C-型利钠肽（CNP）基因表达的改变。结果相同剂量下,ACh诱导出人动脉内皮依赖性的舒张作用会随着年龄的增加而减弱（P<0.05）,其EDHF样血管舒张作用也明显降低（P<0.05）;qRT-PCR发现随着年龄的增加,其血管eNOS、CSE和CNP mRNA表达降低(P<0.05),而COX mRNA表达的年龄趋势不明显。结论随年龄的增加,血管内皮依赖性舒张和EDHF样舒张作用降低,可能与内皮合成的NO和CNP等舒血管物质减少有关。