排尿诱发急性心肌缺血2例

例1:男,48岁,因发作性心前区痛、视物不清,于1993年12月25日入院。查体:P80次/min, Bp22/34kPa。心律整,S_1↓,可闻及S_3,A_2=P_2,无病理性杂音。肝、脾、肺(-)。双下肢无浮肿。查血胆固醇6.24mmol/L,甘油三酯1.29mmol/L。尿常规、血糖、胸片及心脏B超均正常。心电图示窦性心律,心率75次/min,T波V_3、V_4低平。临床诊断冠心病心绞痛。10天做动态电图(DCG)     

脉冲式多普勒超声心动图诊断心脏瓣膜病的初步研究

脉冲式多普勒超声心动图(简称PDE)是用超声技术测定心脏及大血管内血流的一种新方法,这方面的研究国内报道较少,现将我们的初步研究小结如下。资料与方法一、资料:我们于1985年1～4月应用PDE频谱分析了33例心瓣膜病患者,其中男12例,女21例,年龄16～72岁,均经临床、X线及心电图诊断为风湿性心瓣膜病。     

中西医结合治疗闭塞性动脉硬化笔谈

闭塞性动脉硬化是常见的周围血管疾病之一,由于肢体动脉闭塞,引起肢体缺血,严重时可发生肢体坏疽。还常可并发高血压病、冠心病和糖尿病等。因此,该病的截肢率和病死率都比较高。随着人类平均年龄增大,人民生活不断提高和饮食结构的改变,该病在我国日益增多。为此,我部特请本刊编委尚德俊副教授组织有关专家、教授笔谈防治该病的经验体会,以供临床研究参考。     

干预高血压、高血脂、高黏滞血症对心脑血管疾患发生率的影响

Background:According to American Heart Association's report,death composition of cerebrovascular and cerebrovascular disease was increased to 29％ in 1996,and now 33％ from 25％ in 1992.Now,atherosclerosis seriously endanger human's health.Hypertension,hyperlipemia and hyperviscosity syndrome are main risk factors of cardiovascular and cerebrovascular diseases.There conditions often existed simultaneously in elders.Intervention to these diseases can prevent cardiovascular and cerebrovascular events,which is feasible. Objective:To investigate impact of hypertension,hyperlipemia and hyperviscosity syndrome on incidence of cardiovascular and cereborvascular events. Design:Random,controlled study. Unit:Department of Senile Diseases, Qianfoshan Hospital of Shandong. Subjects:In study group, 52 senile subjects with complete hospitalizing data were recruited from 1995～ 2000.Patients with hypertension,hyperlipemia ,hyperviscosity syndrome were included in the current study.13 subjects asked medical help due to hypertension,25 due to hyperlipemia and 14 due to hyperviscosity syndrome.Sometimes blood pressure of hypertension patients was 140～ 160/90～ 100 mmHg.Patients' mean age was 65.21.Ratio of male to female was 13:1.In control group,50 outpatients were included who had similar diseases those in study group.Mean age was 62.34 and ratio of male to female was 17.33:1. Intervention:In study group,calcium antagonist such as adalatcc, nitrendipine, plendil and/or ASCE inhibitor such as perindopril and captopril were given o.s.Blood pressure was con trolled to normal level.Blood lipid regulating drugs such as pravastatin, ticlopidine,and lipanthy were given for hyperlipemia patients.For patients with hyperviscosity syndrome,enteral aspirin or persantine was given,50～ 75 mg/day.Interval of drugs was 1 day to 2 months.Detailed data was unavailable.Red sage root or its compound form injecto was given i.v.,70 mg/day,pueraria root was given i.v.300～ 500 mg/day;astraglaus root was given 20～ 214 g/day,ginkgo leaf,70 mg/day.10～ 15 days was a disease course.Drugs were given for once in 17 subjects and twice 35 subjects.No subjects received 3 times of therapy.In control group,patients received no described treatment during 5 years.Outpatients' medical records as well as discharge record for inpatients were read to study conditions during five 5 years retrospectively. Main prognosis indexes:Collection point for statistical analysis was determined as begging phase of obervation and end point after 5 years.Cardiovascular events such as heart infarction,cerebrovascular disease such as cerebral infarction,cerebral hemorrhage and TIA were evaluated. Result: Incidence of cardiovascular and cerebrovascular events was markedly lower in study group compared with that in control group.In study group,2 subjects developed acute heart infarction(3.84％ ),11 subejcts developed heart infarction in control group(22.00％ )(P< 0.01).Ischemic cerebrovascular disease occurred in 1 subject(1.92％ ) in study group and 7 in control group(14.00％ ).Amount of cerebral hemorrhage showed no significant decrease in 1 subject (1.92％ )in study group and 3 subjects in control group(6.00％ )(P >0.05). Conclusion:Risk factors of cardiovascular and cerebrovascular disease in elders should be actively intervened to reduce development of cardiovascular and cerebrovascular disease.     

Impact of intervened hypertension,hyperlipemia,hyperviscosity syndrome in incidence of cardiovascular and cerebrovascular diseases

Background：AccordingtoAmericanHeartAssociation＇sre－port，deathcompositionofcerebrovascularandcerebrovasculardis－easewasincreasedto２９％in１９９６，andnow３３％from２５％in１９９２．Now，atherosclerosisseriouslyendangerhuman＇shealth．Hypertension，hyperlipemiaandhyperviscositysyndromearemainriskfactorsofcardiovascularandcerebrovasculardis－eases．Thereconditionsoftenexistedsimultaneouslyinel－ders．Interventiontothesediseasescanpreventcardiovascularandcerebrovascularevents，whichisfeasi…     

老年骨质疏松与骨质增生症并存病人骨代谢生化指标及骨密度研究

本文对３５例老年骨质疏松症合并骨质增生病人及４０例不伴增生病人血甲状旁腺激素（ＰＴＨ）、降钙素（ＣＴ）、骨钙素（ＢＧＰ）、碱性磷酸酶（ＡＫＰ）、Ｃａ、Ｐ、Ｍｎ、Ｚｎ、Ｍｇ、Ａｌ等及骨密度（ＢＭＤ）进行检测。结果显示增生组ＰＴＨ、ＣＴ及ＢＧＰ均显著高于非增生组，增生组血Ｃａ、Ｍｎ水平均高于非增生组。经直线相关分析，增生组ＰＴＨ与ＣＴ之间ＰＴＨ、ＣＴ与ＢＧＰ之间具显著正相关。本文认为老年骨质疏松症合并骨质增生病人存在继发性甲状旁腺机能亢进和ＣＴ代偿性上升，其ＢＧＰ升高示骨转换和成骨细胞活性增高。     

老年骨质疏松症肾功能不全患者血清锰、锌、镁、铝水平与内生肌酐清除率、甲状旁腺素、骨矿密度的关系

本文测定了72例老年骨质疏松症肾功能不全患者血清锰(Mn)、锌(Zn)、镁(Mg)、铝(Al)及内生肌酐清除率(Ccr)、甲状旁腺素(PTH)、骨矿密度(BMD),并分析其相互关系。结果显示,病人血清Mn、Zn、Mg显著降低,而Al增高;PTH亦升高;Mn、Zn与Ccr呈正相关,Al与Ccr呈负相关;Mg、Zn、Al与BMD亦有相关性。本文认为,老年骨质疏松症肾功能不全患者Mn、Zn、Mg缺乏及Al蓄积与其肾功损害和骨矿密度的关系密切,是否需要补充Mn、Zn、Mg治疗有待探讨。     

冠心汤Ⅰ号治疗冠心病30例近期疗效观察

目前国内中西医结合治疗冠心病已取得显著效果,应用“活血化瘀”法治疗该病正在进行深入的研究。我们自1977年5月至1978年5月,应用“冠心汤”治疗冠心病30例,取得较满意的效果,现总结报导如下:     

209例冠心病动态心电图分析

为研究冠心病病人心律失常及动态变化,我们对209例临床有典型或不典型心绞痛及心电图表现有心肌缺血的病人(按1980年全国第一届内科学会心血管专业组会议诊断标准)作了动态心电图(DCG)监测。对象与方法209例中,男151例,女58例,年龄为32～80岁。     

情绪诱发心肌缺血及心律失常的动态心电图观察

1992～1995年,我们对260例生气患者行动态心电图(DCG)检查,其中30例出现心肌缺血(25例诱发心律失常)。现报告如下。 资料与方法:本组年龄32～56岁,平均48±3.12岁。临床诊断为冠心病20例(下称Ⅰ组),其中陈旧性心肌梗塞6例;无器质性心脏病10例(下称Ⅱ组),其中晕厥2例,心悸8例。 先行12导联心电图检查,再行24小时DCG检测。导联采用MV_5和MV_1。仪器为美国惠普43400B系统。详细记录患者生气时的症状及时间。室性心律失常采用LOWN＇S分级法。 结果:两组共检出缺血47阵次,其中Ⅰ组35阵次ST段改变,Ⅱ组12阵次,两组心肌缺血发生率有明显差异(P<0.001)。Ⅰ组和Ⅱ组ST段下移的最大幅度分别为3.5和2.0mm,最长持续时间分别为9.8和3.6分钟(P<0.05)。说明器质性心脏病比无器质性心脏病患者的ST段下移幅度大(见表1)。本组生气时ST段下移1～1.5mm6例