通心络治疗冠心病心绞痛的临床观察

目的 :探讨通心络治疗心绞痛的临床疗效。方法 :选择 80例心绞痛患者随机分成治疗组和对照组 ,治疗组在内科常规治疗的基础上加用通心络口服 ,观察两组患者症状缓解情况以及停药后复发情况。结果 :治疗组的心绞痛疗效、复发率分别为 95 %和 16.7% ,对照组分别为 62 .5 %和 5 2 % ,有显著差异(P <0 .0 5 )。结论 :通心络在治疗心绞痛中疗效显著 ,复发率低 ,使用方便 ,是较理想的药物。     

祛瘀消斑胶囊治疗不稳定型心绞痛及对其血浆Fib、DD的影响

目的　观察祛瘀消斑胶囊治疗不稳定型心绞痛及对其血浆Fib和DD水平的影响。方法　对 4 0例不稳定型心绞痛患者随机分为常规西药加祛瘀消斑胶囊治疗组 (治疗组 )和常规西药治疗组 (对照组 ) ,治疗组与对照组各 2 0例。采用相应药物治疗 4周后 ,观察 2组患者的临床疗效、心电图改善及硝酸酯类药物的停减率 ,以及血浆Fib、DD水平变化 ,并进行比较分析。结果　治疗组可显著改善心绞痛症状 ,与对照组比较有显著性差异 (P <0 .0 5 ) ,2组患者心电图改善情况及硝酸酯类药物减停率无显著性差异 (P >0 .0 5 )。治疗组降低Fib、DD水平 ,与对照组比较有显著性差异 (P <0 .0 5 )。 2组均未出现明显不良反应。结论　祛瘀消斑胶囊可显著降低不稳定型心绞痛患者Fib、DD水平 ,联合西药治疗不稳定型心绞痛 ,疗效优于单用西药 ,且安全可靠。     

葛根素注射液治疗不稳定性心绞痛疗效分析

目的　观察葛根素注射液治疗不稳定性心绞痛 (UA)的临床疗效。方法　将 6 8例不稳定性心绞痛患者随机分为治疗组和对照组。对照组 :服用肠溶阿司匹林 10 0～ 30 0mg/d ,10 %葡萄糖 5 0 0ml加 10 %氯化钾 15ml+2 5 %硫酸镁 10ml加普通胰岛素 12U ;治疗组 :在上述基础上加用葛根素注射液 4 0 0mg加 5 %葡萄糖 4 0 0ml。两组均静脉滴注 ,1次 /d ,15d为 1疗程。结果　心绞痛缓解情况 :治疗组总有效率为 85 .3% ,对照组为 6 1.8%(P <0 .0 5 ) ;心电图改善情况 :治疗组总有效率为 82 .4 % ,对照组为 5 5 .9% (P <0 .0 5 )。结论　在常规治疗基础上加用葛根素注射液 ,能有效地控制心绞痛发作。     

非角度稳定性钢板固定治疗桡骨远端关节内背侧移位骨折的结果

Objective Intra-articular fractures of the distal radius in young adults comprise a distinet fracture pattern that is diffficuh to manage and associated with a high frequency of post-traumatic arthritis.Restoration of articular congruency and alignment should improve the outcome.Methods In this study we prospectively re- viewed the results of 21 consecutive cases of dorsally displaced intra-articular distal radius fractures which were treated with internal fixation after failing to achieve articular congruency with closed reduction.Results 3 patients were lost to follow-up.For the rest of 18 patients,follow-up time ranges from 18 to 75 weeks the fractures had healed with highly satisfactory radiographic and functional results.The final volar tilt averaged 4.9°;radial inclination 23.9°;radial length 14mm;and articular incongruity,0.1 mm.Wrist motion at final follow-up examination aver- aged flexion 62°,extension 60°,radial deviation 16°,ulnar deviation 27°,pronation 77°and supination 74°.Grip strength averaged 83% of the uninjured side.The overall outcome of 18 patients(94.4%)had a good or excellent result according to the system of Gartland and Werley and 18 patients(72.2%)had a good result according to the modified system of Green and O'Brien at the most recent evaluation.The only complication in this series was a superficial pin tract infection,which was rapidly resolved with removal of pins at 5th week of external fixation. Conclusion Thus restoration of articular congruency and alignment is possible with minimal complication using modern non-angular stable methods of internal fixation.     

妊娠相关血浆蛋白A水平与不稳定心绞痛患者冠状动脉狭窄病变形态的关系

[目的]探讨不稳定型心绞痛患者妊娠相关血浆蛋白(PAPP-A)水平与高敏C-反应蛋白(hs-CRP)及动脉粥样硬化斑块稳定性的关系.[方法]不稳定型心绞痛组患者42例,稳定型心绞痛组38例.冠状动脉造影前检测PAPP-A和hs-CRP,根据造影结果将冠状动脉病变分为复杂狭窄和光滑狭窄.[结果]稳定型心绞痛组有28例(74%)患者至少有1支血管狭窄≥70%,多于不稳定型心绞痛组的24例(57%),P＜0.05;不稳定型心绞痛组中33例(79%)有1处以上的复杂狭窄,多于稳定型心绞痛组(22例,58%,P＜0.05);PAPP-A与hs-CRP正相关(r=0.44,P＜0.001);不稳定型心绞痛组与稳定型心绞痛组相比,hs-CRP(4.40 mg/L±0.003 mg/L vs 0.48 mg/L±0.016mg/L,P＜0.001)和PAPP-A(18.40×10-3 U/L±0.002×10-3U/Lvs 7.79×10-3 U/L±0.001×10-3 U/L,P＜0.001),差异均有统计学意义;两组中有复杂狭窄者的PAPP-A和hs-CRP水平显著高于无复杂狭窄者.[结论]PAPP-A可作为评估冠状动脉斑块稳定性的血清学指标之一.     

Quality of life on enalapril after acute myocardial infarction

Quality of life was assessed 4–6 months after an acutemyocardial infarction in a randomized double-blind study ofenalapril versus placebo. Quality of life was evaluated usingthe Nottingham Health Profile (NHP), the Physical Symptoms DistressIndex (PSDI), the Work Performance Scale (WPS) and the LifeSatisfaction Index (LSI). The study comprised 36 women (aged46–85 years, mean 68) and 96 males (aged 39–81 years,mean 62). Quality of life did not differ significantly between patientstreated with enalapril versus placebo. The scores were (enalaprilvs placebo, mean± SE): average NHP 15.4 ± 2.3vs 17.1 ± 2.3; PSDI 9.5± 1.0 vs 10.8 ±0.9; WPS 19.8 ± 2.0 vs 19.4 ± 1.4; LSI 24.1 ±1.0 vs 22.5 ±1.4. Men reported a better quality of lifethan women on most assessments, and non-smokers and ex-smokersbetter than smokers. Patients with moderate or severe anginapectoris had a worse quality of life measured by PSDI and NHPthan patients with minimal or no angina pectoris. Patients withcongestive heart failure had a higher PSDI than those without(13.6 ± 1.7 vs 9.4 ± 0.7, P<0.05), while nosignificant differences were observed in the NHP scores. In conclusion, quality of life was similar in enalapril andplacebo- treated patients after an acute myocardial infarction.However, it was reduced in patients with angina pectoris orheart failure and in those who continued smoking.     

Nutritional Aspects of Breath Testing Based on Stable Isotopes

Stable isotope methodologies offer a number of possibilities for the nutritional assessment of many different processes and metabolic pathways. The application of stable isotopes has been boosted by the development of new mass spectrometers, lower costs of probes, and the risks associated with radioactive tracers. The use of ¹³C as a tracer offers all the advantages of stable isotopes and has been widely applied for measuring various types of metabolic processes. This review is focused on clinical and nutritional assessments using ¹³C breath tests.     

葛根素注射液治疗不稳定型心绞痛疗效观察

目的:评价葛根素对不稳定型心绞痛的临床疗效。方法:85例不稳定型心绞痛患者随机分为2组,均常规口服消心痛,同时治疗组葛根素注射液400mg/d,对照组极化液500mL/d。结果:2周后心绞痛缓解,总有效率对照组为70%,治疗组为88.9%,差别不显著(P>0.05);心电图疗效比较,治疗组心肌缺血改善的总有效率71.1%,对照组40%,差别显著(P<0.05);血液流变学比较,治疗组全血粘度、血浆粘度及血小板聚集率均有明显改善(P<0.05),而对照组无此作用。结论:葛根素能有效地改善不稳定型心绞痛患者的症状,抗心肌缺血,降低血液粘度。     

低分子肝素治疗不稳定型心绞痛41例临床观察

目的:探讨低分子肝素治疗不稳定型心绞痛(UA)的临床疗效。方法:对41例不稳定型心绞痛病例,治疗前均常规治疗。在此基础上低分子肝素(体重≤60 kg为5 000 U,体重>60 kg为7 500 U),12 h 1次皮下注射,连用7~14 d,分别于用药前30 min,用药后48 h采血测定活化部分凝血活酶时间(APTT),凝血酶原时间(PT)。结果:显效9例,有效24例,总有效率80.5%。结论:低分子肝素具有高比例的抗因子Xa和抗因子Ⅱa活性,由于其分子量小,与血浆蛋白和内皮细胞结合减少,所以生物利用度高,血浆半衰期长。疗效可取得与肝素同样甚至更高抗凝血酶效果,并且有发生严重出血事件低的优点。     

红花注射液治疗冠心病心绞痛、心肌缺血临床观察

目的:观察红花注射液治疗冠心病心绞痛、心肌缺血的临床疗效。方法:选择126例冠心病心绞痛、心肌缺血的病例,分红花组及丹参组,疗程两周,详细记录治疗前后的临床表现、心电图、血糖、血脂、血液流变学检查的变化。结果:红花、丹参均可明显改善冠心病心肌缺血相应的临床症状和心电图改变,以红花较显著。红花还有降血糖、血脂作用,显著改善血液流变指标。结论:红花注射液是治疗冠心病心绞痛、心肌缺血的理想药物。