孕妇体位改变对胎儿脐动脉血流速度影响的研究

目的探讨妊娠晚期孕妇体位改变对脐动脉血流速度调节的影响。方法选择妊娠28周以上单胎孕妇105例,应用MFM-OBS型产科综合诊断监护系统(脐血流),对孕妇平卧位、左侧卧位、右侧卧位及坐位时进行脐动脉血流速度测定,以平卧位作基础,采用自身对照t检验方法分析体位改变后S/D值的变化。结果大于标准值下限者53例改变体位后S/D值显著下降(p<0.01),小于标准值下限者52例吸改变体位后S/D值显著升高(p<0.01)。结论孕妇侧卧位或坐位,有利于胎儿脐动脉血流供应,并且其调节方式为双向性,机理有待于进一步研究。     

Maximal longitudinal contraction velocity in assessment of left ventricular systolic function: a pulsed tissue Doppler and M-mode study

AIMS: During recent years the maximal longitudinal contraction velocity (MLCV), measured by either pulsed tissue Doppler or M-mode, has been suggested as an index of left ventricular (LV) systolic function. The aims of the present study were to compare MLCV with ejection fraction (EF) in consecutive patients with known or suspected heart failure and to compare measures from recordings by pulsed tissue Doppler with recordings by M-mode. METHODS AND RESULTS: Sixty-four consecutive patients with suspected or known heart failure, referred to echocardiography, were included. Twelve of these patients had decreased LV systolic function defined as EF < 50% calculated by the biplane Simpson's rule, while a significantly (P > 0.05) higher proportion of 23 had decreased function defined as decreased MLCV recorded by pulsed tissue Doppler. Measures from M-mode recordings were significantly lower (P < 0.001) than the corresponding measures from tissue Doppler recordings. CONCLUSIONS: The study shows that higher values of MLCV are obtained by pulsed tissue Doppler than by M-mode. Reference values can therefore not be used interchangeably. The results also suggest that MLCV is a more sensitive index of LV systolic function than EF.     

双功彩超诊断退行性主动脉瓣病变及心功测定

随着我国老龄化的进一步扩大,主A瓣的退行性病变日渐增多,应用二维彩色多普勒诊断技术对198例患者进行定性定量分析并测定其心功能,与对照组相比差异显著(P<0.01),对疾病的早期诊断及治疗有一定的价值.     

心导纳微分波测定健康儿童心缩间期

用导纳微分波测定心缩问期及心舒间期,并与阻抗法和颈动脉法比较,表明前者优于后者。以年龄、心率、身高、体重、胸围和性别等因素与心缩间期和心舒间期进行单因素和多因素相关分析,并用逐步回归建立各参数的最优回归方程。     

Longitudinal systolic shortening of the left ventricle: an echocardiographic study in subjects with and without preserved global function

Summary The atrioventricular (AV) plane displacement was studied by echocardiography in 79 subjects (45 healthy subjects and 34 patients with acute myocardial infarction or chronic congestive heart failure). From apical 4- and 2-chamber views the displacement of the AV plane towards the apex in systole was recorded at 4 sites in the left ventricle (LV) corresponding to the septal, anterior, lateral, and posterior walls and the mean value from the above 4 sites (AV-mean) was calculated. In addition, in healthy subjects, the AV plane displacement at right ventricular free wall was also recorded. The AV-mean correlated well with the echocardiographic ejection fraction determined by biplane area-length method (r= 0.96, P<0–001). The correlation was also high when the percentage of the left ventricular shortening along the long axis was used (r= 0–97, P<0–001). The correlation between ejection fraction and AV-mean was also good when separate analysis was made for the subjects with preserved ejection fraction (r= 0.86, P<0–001) and decreased ejection fraction (r= 0.82, P< 0.001). The right ventricle had a significantly higher AV plane displacement (P< 0.001) than the LV. The study also includes determination of the muscular excursions of the septal and posterior walls along the short axis of the left ventricle from the parasternal long axis view. The AV plane displacement of the respective walls was relatively greater (P<0.001) compared to concentric contractions. The septal and posterior wall excursions along the short axis correlated poorly with the AV plane displacement of the respective walls (r= 0.55, P<0.01 and r= 42, P<0.05).     

笑气镇痛在人工流产中的临床应用

目的:探讨笑气吸入在人工流产中镇痛的效果。方法:将采用笑气吸入镇痛的人工流产患者80例作为观察组,与利多卡因宫颈注射麻醉80例为对照组。观察两组患者人工流产时疼痛程度、手术时间、宫颈松弛情况、子宫收缩、阴道流出血和手术后病人身体状况。结果:笑气吸入组人工流产镇痛效果较利多卡因组好。结论:笑气吸入镇痛简单易行,无副作用,是妇产科门诊人工流产一种比较理想的镇痛方法,值得推广应用。     

Reductions in Cardiac Structure and Function 24 Months After Spinal Cord Injury: A Cross-Sectional Study

ObjectiveTo determine the alterations in cardiac structure and function that occur in the months after spinal cord injury (SCI).Study DesignCross-sectionalSettingRehabilitation HospitalParticipantsVolunteers (N=29; 4 women, 25 men) between 3 and 24 months after SCI.Main Outcome MeasuresTransthoracic echocardiography was performed on each volunteer. The relationships between time since injury and neurologic and sensory levels of injury to cardiac structure and function were assessed via multiple linear regression.ResultsTime since injury was most strongly associated with reductions in left ventricular end diastolic volume (r²=0.156; P=.034), end systolic volume (r²=0.141; P=.045), and mass (r²=0.138; P=.047). These structural changes were paralleled by reduced stroke volume (r²=0.143; P=.043) and cardiac output (r²=0.317; P=<.001). The reductions in left ventricular structure and systolic function were not differentially affected by neurologic or sensory levels of injury (P=.084-.921).ConclusionsThese results suggest progressive reductions in left ventricular structure and systolic function between 3 and 24 months after SCI that occur independent of neurologic and sensory levels of injury.     

参附注射液对动物心律失常的影响

目的 :观察参附注射液对动物心律失常模型的影响。方法 :用结扎冠状动脉法造成犬心肌缺血性心律失常模型 ;用乌头碱造成大鼠心律不齐模型 ;用心得安造成犬心动过缓模型 ,然后分别给予参附注射液观察其对上述心律失常的影响。结果 :参附注射液能有效改善心肌缺血性心律失常的血流动力学指标 ,对室性早搏 (VP)的发作率由给药前 5min的 39.3± 5 .2次降为 11.2± 2 .7次 ;室性心动过速 (VT)由给药前 5min的 37.2± 3.9次降至9.1± 2 .5次 ;同时对乌头碱所致VP、VT有显著的对抗作用 ;并对心得安所致心动过缓有加快心率作用     

Myocardial velocity gradient imaging by phase contrast MRI with application to regional function in myocardial ischemia

Velocity-encoded phase contrast magnetic resonance imaging (MRI) has the potential to quantify regional myocardial contractile function with a sensitivity to motion comparable to implanted ultrasonic crystals. An MRI sequence and post-processing algorithm were developed to measure myocardial velocity gradients on a 1.5 T MRI scanner. These methods were validated on a rotating phantom and applied to dogs before (n = 11) and during prolonged coronary occlusion (n = 5). In phantom validation studies, the average absolute error corresponded to motion equivalent to 0.03 ± 0.04 mm (mean ± SD) during the repetition time of the experiment. Rigid body corrections during post-processing significantly simplified the interpretation of myocardial velocity vectors. In vivo, rigid body motion contributes substantially to the recorded myocardial velocities in systole and diastole and can give the false impression of regional wall motion abnormalities. After rigid body correction, normal systolic and diastolic velocity vectors in short-axis views of the left ventricle were primarily directed toward the center of the left ventricle. Transmural radial strain rate was 2.0 ± 0.6 sec⁻¹ during systole and −3.6 ± 1.1 sec⁻¹ during early diastole in normal canine hearts. Ischemic myocardium was easily discriminated from normal left ventricle by velocity-encoded phase contrast MRI both qualitatively and quantitatively (P < 0.01 in systole and P < 0.05 in early diastole). Although the myocardial velocity images have a spatial resolution on the order of a millimeter, the velocity encoding describes the mechanical consequences of focal myocardial ischemia with sensitivity to submillimeter displacement of the pixels. The three-dimensional nature of velocity-encoded MRI is particularly well suited to the study of the complex motion of the heart in vivo. Magn Reson Med 42:98–109, 1999. © 1999 Wiley-Liss, Inc.