肌钙蛋白与肿瘤坏死因子α在病毒性心肌炎急性期检测的临床意义

目的 :探讨心肌损伤指标肌钙蛋白T(cTnT)与非特异细胞炎症因子肿瘤坏死因子 α(TNF α)在急性病毒性心肌炎 (VMC)患者中检测的临床意义。 方法 :实验组为 36例诊断为急性VMC患者 ,检测 36例VMC患者发病 1周内血清cTnT及TNF α ,并与对照组 4 0例的检测结果进行比较。 结果 :cTnT平均值 :VMC组为 (0 .6 0 2 5± 0 .5 36 9) μg/L ,对照组为 (0 .0 12 1±0 .0 0 0 2 ) μg/L ,两组比较差异有非常显著性意义 (P <0 .0 1) ;TNF α平均值 :VMC组为 (45 .12± 2 9.0 1)ng/L ,对照组为 (3.2 4± 3.17)ng/L ,两组比较差异有非常显著性意义 (P <0 .0 1)。 结论 :与对照组比较 ,VMC患者在急性期中 ,cTnT及TNF α均有明显升高 ,而且二者密切相关 ,说明TNF α在心肌损伤过程中起着重要作用。     

异丙肾上腺素成功抢救心室电风暴2例

心室电风暴（ventficularelectricalstorm,VES）是心室电活动极不稳定所导致的危重恶性心律失常,及时诊断和治疗是挽救患者生命和改善预后的关键。本文报道2例VES患者通过应用异丙肾上腺素（Isoproterenol,Iso）成功终止了VES。     

情绪障碍要治疗吗

在门诊,常会见到这样一群患者,他们穿梭于综合性医院的各个临床科室,尤其是心血管科、消化科、神经科、中医科、妇科、急诊科等,希望医生能帮助解决身体上的各种不适。其实这些患者并没有器质性疾病,而是情绪障碍患者。     

血清心肌肌钙蛋白Ⅰ判断病毒性心肌炎炎性损伤及预后的探讨

目的探讨心肌肌钙蛋白I(cTnI)判断急性病毒性心肌炎炎性损伤程度及预后。方法采用抗人cTnI单抗,应用酶联免疫法测定52例急性病毒性心肌炎患者血清cTnI,同时作肌酸磷酸激酶及其同工酶(CK,CK-MB)检测,血清cTnI>7μg／L为阳性。第1次cTnI阳性者第2次复查仍然阳性者归入cTnI持续阳性组(18例),复查cTnI阴性者归入cTnI阴性组(20例)。结果cTnI阴性组与cTnI持续阳性组临床症状好转率、心律失常治愈率比较均有极显著性差异(P<0．01)。cTnI持续阳性组中,有2例患者发展为心肌炎后心肌病。52例急性病毒性心肌炎患者中第1次检测cTnI有38例患者cTnI阳性(73．1％),有3例CK-MB异常(5．8％)。cTnI持续阳性组柯萨奇B病毒中和抗体转阴率明显低于cTnI阴性组,两者比较P<0．05。结论cTnI可作为急性病毒性心肌炎炎性损伤及预后判断的指标。     

非ST段抬高急性冠脉综合征患者二尖瓣反流机制探讨

在急性Q波心肌梗化急性期，患者常并发功能性二尖瓣反流（mitral regurgitation，MR）。已有研究证实，MR是急性心肌梗死（AMI）患者的北亡预测岗子，并对充血性心力衰竭的发展起重要作用，但对急性非ST段冠脉综合征（non-ST-segment elevation acute Coronary syndrome，NSTSEACS）患者MR临床意义的研究甚少。本研究拟探讨NSTSEACS急性期功能性二尖瓣反流的机制。     

Observation on Therapeutic Effects of Shengmai Powder (生脉散)in Treating Acute Viral Myocarditis

Objective: To evaluate the clinical efficacy of Shengmai Powder (SMP, 生脉散) in treating a-cute viral myocarditis objectively. Methods: One hundred and twenty-four patients with acute viral myocarditis were randomized into the treated group (SMG, n = 64) and the control group(CG, n = 60 ). Such myo-cardial nutrient medicine as ATP, CoA , Vit-C, were given to both groups. And to the treated group, 40 ml of Shengmai Injection per day was given intravenously for 2 weeks, which was followed by oral intake of Shengmai granule, one package three times daily for another 2 weeks in total. The same anti-arrhythmia agents were applied to both groups, and no fructose-1, 6-diphosphate (FDP) for either. Semi-quantitative scoring method was adopted to observe such symptoms as chest stuffiness, palpitation and chest pain before treatment and four weeks after treatment. Meanwhile, EGG, dynamic ECG by Holter monitor, left ventricular end-diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF), serum neut     

国内外心脏康复模式的研究进展

随着社会经济的发展、人们生活方式的转变以及人口老龄化的加剧,我国心血管疾病发病的危险因素不断增加,心血管疾病患病率升高,带病生存的人群急剧增加。如何对该类人群进行健康管理、建立符合中国国情的心脏康复模式是近年研究的热点。该文介绍了国内外心脏康复模式的研究进展。     

肌钙蛋白T对急性心肌梗死的诊断与预后判断

在我国冠心病的发病率逐年增加。血清酶学测定是早期诊断急性心肌梗死（ＡＭＩ）和判断预后的重要方法之一。肌钙蛋白Ｔ（ＴｎＴ）是晚近发展起来的一种新型的、比ＣＫ、ＣＫＭＢ对心肌损伤有更高灵敏度和更高特异性的分子水平检测ＡＭＩ的方法［１～７］。本文通过观察ＡＭＩ血清ＴｎＴ浓度变化及与ＣＫ、ＣＫＭＢ比较，对其在ＡＭＩ的诊断敏感性及预后判断方面进行探讨。材料与方法一、病例选择自１９９７年５月至１９９７年１０月住院患者，依据国际心脏病学会和协会及ＷＨＯ的缺血性心脏病的命名及诊断标准［８］确诊ＡＭＩ３５例，…     

门冬氨酸钾镁口服液治疗老年心脏病人的便秘

目的：观察门冬氨酸钾镁口服液治疗老年心脏病人便秘的疗效。方法：伴有便秘的老年心脏病人３３例（男性２１例，女性１２例；年龄６７±ｓ８ａ），使用门冬氨酸钾镁口服液２０ｍＬ，ｂｉｄ，１５ｄ为一个疗程。结果：３３例便秘者中有２６例（７９％）大便通畅。结论：门冬氨酸钾镁口服液可缓解部分病人的便秘     

Observation on Therapeutic Effects of Shengmai Powder(生脉散)in Treating Acute Viral Myocarditis

Objective: To evaluate the clinical efficacy of Shengmai Powder (SMP, 生脉散) in treating acute viral myocarditis objectively. Methods: One hundred and twenty-four patients with acute viral myocarditis were randomized into the treated group (SMG, n=64) and the control group(CG, n=60 ). Such myocardial nutrient medicine as ATP, CoA, Vit-C, were given to both groups. And to the treated group, 40 ml of Shengmai Injection per day was given intravenously for 2 weeks, which was followed by oral intake of Shengmai granule, one package three times daily for another 2 weeks in total. The same anti-arrhythmia agents were applied to both groups, and no fructose-1, 6-diphosphate (FDP) for either. Semi-quantitative scoring method was adopted to observe such symptoms as chest stuffiness, palpitation and chest pain before treatment and four weeks after treatment. Meanwhile, ECG, dynamic ECG by Holter monitor, left ventricular enddiastolic dimension (LVEDD), left ventricular ejection fraction (LVEF), serum neutralizing antibody of virus Coxsackie B, cardiac troponin I (cTnl) and cardiac troponin T (cTnT) were examined. Results: (1) Compared with the control group, more significant improvement was got in SMG in respects of chest stuffiness, palpitation, chest pain and arrhythmia ( P＜0.05 or P＜0.01). (2) Negative converting rates of cTnl , cTnT in the two groups were 59.46% vs 35.48%, 68.75% vs 42.31% respectively (P＜0.05). (3) LVEDD before and after treatment in SMG was 52.44±3.40 mm and 48.81± 2.23mm respectively, while that in the control group was 52.31±3.74 mm and 49.92±2.67mm respectively; LVEF before and after treatment in SMG was 60.67±4.62 % and 65.02±4.16 % respectively, while that in the control group was 60.91± 4.26 % and 63.67±3.17 %. There was obvious improvement in the two parameters in both groups, but the improvement in SMG was superior to that in the control group (P＜0.05). Conclusion: SMP shows a good effect in improving clinical symptoms and signs, heart function, abnormal ECG and inflammatory injury inde xes in patients with acute viral myocarditis.