先天性心脏病患儿肺动脉,上腔静脉血一氧化氮含量检测及意义

目的:探讨一氧化氮(NO)与先天性心脏病(CHD)引起的肺动脉高压(PH)发病间的关系。方法:应用NO试剂盒检测了CHD患儿肺动脉及上腔静脉血浆中NO含量。结果;(1)伴PH组肺动脉血浆NO含量明显高于不伴肺动脉高压组(37.58±9.99μmol/L:19.03±15.25μmol/L,P<0.01);(2)在PH组中,肺动脉血浆NO含量明显高于上腔静脉血(P<0.01);而不伴PH组,肺动脉和上腔静脉血浆NO含量无显著性差异(P>0.05)。结论:(1)伴PH的先心患儿肺动脉血浆NO含量升高;(2)NO可能介入了CHD引起的PH发病过程。     

原发性高血压病在平衡法核素心血池显像中的表现(与超声心动图及心机械图比较)

用44例原发性高血压(EH)患者及15例健康人对照组(N)的平衡法心血池显像(MGBP)心功能参数,对比分析了EH组多普勒超声心动图(UCG)及心机械图(MCG)的心脏检测指标.结果示,MGBP检测中 EH 组的左室高峰充盈率(PFR)、右室射血分数(RVEF)、局部射血分数_4(EF_4)及局部轴缩短率_4(RS_4)明显低于对照组(P<0.05～0.01).反映左室舒张功能的PFR与E/A峰比值(UCG)之间呈正相关(r=0.44,P<0.05),PFR与a/Eo(MCG)之间呈负相关(r=-0.87 P<0.01),PFR与左房内径(UCG)之间呈负相关(r=-0.48 P<0.05),反映左室间隔部位改变的EF_4,RS_4与室间隔厚度(UCG)均呈负相关(r=-0.3 P<0.05,;γ=-0.47 P<0.05).     

小剂量倍他乐克治疗晚期扩张性心肌病疗效及安全性观察

目的 :评价小剂量倍他乐克治疗晚期扩张性心肌病 (DCM )的疗效及安全性。方法 :2 0例晚期扩张性心肌病患者 ,经充分抗心衰治疗后 ,按入院顺序 ,随机分为A组 (倍他乐克治疗组 )和B组 (常规治疗组 ) ,比较各组治疗前后及两组间临床指标及生活质量改善情况。结果 :两组临床症状、生活质量均较入院时明显改善。A组左室射血分数(LVEF)、6分钟步行距离 (D)较B组提高 ;心率 (HR) ,心率、平均动脉压 (MBp)乘积较B组下降 ,差异有显著性 (P <0 .0 1) ;A组再住院率、住院日数较B组低 ,所有患者均能良好耐受倍他乐克 ,无心功能恶化。结论 :在充分使用血管紧张素转换酶抑制剂 (ACEI)、利尿剂和洋地黄的基础上 ,采用小剂量倍他乐克治疗晚期扩张性心肌病 ,疗效及安全性均肯定     

Ten-year stability of cardiovascular responses to laboratory stressors

In this study we examined test-retest stability of cardiovascular stress responses over a decade of the life span. Participants were 55 male college undergraduates. 19 years of age at initial testing, and 29 years of age at follow-up testing Stressors were a foot cold pressor and an aversive reaction time task. Cardiovascular measures included systolic and diastolic blood pressure, heart rate, and preejection period. For cold pressor, the magnitude and pattern of cardiovascular responses remained unchanged at the 10-year follow-up. For the reaction time task, the characteristic cardiovascular response patterns was preserved but with significant attenuation of magnitude. The present findings are consistent with previous observations of temporal stability but over a substantially longer test-retest interval. The long-term stability of stress responses is discussed in the context of stress test methodology, behavioral response demands, and maturation of the physiological systems involved in cardiovascular response expression.     

基于混合遗传算法的心脏病决策支持系统研究

将遗传算法和 BP算法相结合 ,建立了一个基于混合遗传算法的心脏病决策支持系统来鉴别诊断五种常见心脏病 (冠心病 ,高血压性心脏病 ,风湿性心脏病 ,慢性肺原性心脏病和先天性心脏病 )。一个含有 35 2份心脏病的数据库用来构建和测试了该系统。实验结果表明 ,构建的系统对这五种心脏病均有较好的诊断识别率 ,系统的平均识别准确性达 90 .6 % ,各疾病的用户准确性和程序准确性均大于 85 .0 % ,表现出良好的心脏病的临床诊断决策支持能力     

阻塞性睡眠呼吸紊乱综合征有效治疗前后的心率变异性分析

目的通过观察OSAS患者经过有效治疗前后HRV的变化,评价患者的心率变异性变化情况。方法对51例OSAS病人在有效治疗前后同步进行PSG检查及动态心电监测,统计其HRV的时阈指标SDNN、rMSSD及频阈指标LF、HF及LF/HF,采用SPSS/PC统计软件中配对样本t检验进行处理。结果SDNN、LF、LF/HF等指标在治疗前后的差异有显著性(p<0·05),rMSSD、HF的变化无显著性差异(p>0·05)。结论有效治疗OSAS可使植物神经系统的功能得到恢复,降低心脏事件发生的危险性。     

CRRT治疗老年顽固性心力衰竭的疗效观察

顽固性心力衰竭(CHF)是临床常见而又难治的心脏疾病,其病死率一直居高不下,虽然国内外许多学者采用了多种综合性措施,如主动脉内气囊反搏、植入心脏起搏器等,然而其预后仍较差。近几年来国外学者采用血滤或血透的方法矫治顽固性CHF取得了一些进展。由于研究结果差异较大,已成为     

原位心脏移植30例临床分析

目的对30例心脏移植进行分析总结。方法30例患者中,24例的原发病为扩张型心肌病,4例为终末期瓣膜性心肌病,1例为终末期缺血性心肌病,1例为病毒性心肌炎行双心室辅助术后1个月。均在体外循环下行原位心脏移植术,3例采用标准心脏移植术式,27例采用双腔静脉吻合心脏移植术式,体外循环时间(75±24)min,主动脉阻断时间(72±8)min。术后采用环孢素A、霉酚酸酯和泼尼松预防排斥反应,根据血环孢素A的浓度调整CsA的用量。术后早期,每天行心肌内心电图及超声心动多普勒监测,以便早期发现急性排斥反应,必要时行心内膜心肌活检。结果30例患者中,术后死亡5例,3例死于低心排,1例死于感染所致的多器官功能衰竭,1例死于出血。术后并发症有低心排、心律失常、三尖瓣返流、右心衰竭、细菌和真菌感染、肾功能异常及血糖升高,上述并发症除导致死亡者外,其余经治疗好转;4例发生急性排斥反应,给予甲泼尼龙冲击治疗,并调整免疫抑制剂的用量后排斥反应逆转。结论术后并发症的预防和及时正确的处理,是心脏移植成功的关键,尤其是对感染、急性排斥反应、右心功能不全及肾功能异常的预防和处理。     

Heart rate fluctuations in diabetic patients with cardiac vagal dysfunction: a spectral analysis

The autonomic nervous control of cardiac function during active orthostatic load has been studied by measuring the power spectrum of heart rate fluctuations in 16 insulin-dependent diabetic patients and 14 age-matched control subjects. The patients were subdivided into two groups: 8 with normal respiratory sinus dysrhythmia (RSA+) and 8 with reduced respiratory sinus dysrhythmia (RSA-). In RSA- patients the total power (0.01-0.50 Hz) was significantly reduced compared with control subjects (4.7 versus 15.5 min-2, 2p less than 0.05) and the pattern of heart rate fluctuations was characterized by a relative increase in the low-frequency component (0.01-0.05 Hz) as compared with RSA+ patients and control subjects (45% versus 24% and 27%, both 2p less than 0.01). There was also a significant reduction in the high-frequency component (0.15-0.50 Hz) as compared with RSA+ patients and control subjects (17% versus 36% and 33%, both 2p less than 0.05). During standing, a significant increase in total power was found only in control subjects (2p less than 0.01) and the difference between control subjects, and RSA+ and RSA- patients reached significance (32.2 versus 15.1 and 12.7 min-2, 2p less than 0.02 and 2p less than 0.01). The pattern of heart rate fluctuations in RSA- patients showed no significant change on standing. These results suggest that the reduced overall heart rate variability in diabetic patients with cardiac autonomic neuropathy is associated with a typical heart rate fluctuation pattern.     

心率变异性与心肌梗塞范围关系的研究

报道７２例急性心肌梗塞患者的心率变异性（ＨＲＶ）值与心肌梗塞范围的关系，并与１２０例正常人的ＨＲＶ值进行对比，结果发现，心肌梗塞急性期ＨＲＶ值明显降低，与正常组对比有显著统计学意义，但ＨＲＶ值降低与心肌梗塞部位、范围无关，可能主要为心肌梗塞引起的应激反应所造成的体液及神经调节改变所致。