曲美他嗪联合阿托伐他汀治疗原发性高血压伴阵发性心房颤动的疗效观察

Objective To study the efficacy of trimctazidine combined with atorvastatin for primary hypertension with paroxysmal auricular fibrillation,and its effects on LAD and CRP. Methods 160 patients of pri-mary hypertension with paroxysmal auricular fibrillation were randomly divided into 4 groups. Forty patients were treated with amiodarone (control group),600 mg/d for the first week,400 mg/d for the second week and 200 mg/d later;40 patients were treated with atorvastatin (20 mg/d,3 times per day) in addition to amiodarone (the atorvasat-in group);40 patients were treated with trimetazidine (20 mg/d,3 times per day) in addition to armiodarone (the trimetazidine group);40 patients were treated with combination of trimetazidine and atorvastatin in addition to amiod-atone (the combination group),and the dose was the same as the above groups. The treatment was started within 24 hours of recovering from paroxysmal auricular fibrillation and lasted for 1 year. Results After 1 year there was 1 pa-the control group,and 62.5% (25/40) for the atorvasatin group,64.1% (25/39) for the trimetazidine group,and 84.6% (33/39) for the combination group. Compared to the control group,the effective rate of the 3 treatment groups were all significantly higher (X2=4.56、5.13、17.55,P<0.05). The effective rate of the combination group was significantly higher than that of the atorvasatin group and the trimetazidine group (X2=4.95、4.30,P<0.05),and there was no significant difference of effective rate between the atorvasatin group and the trimetazidine group(X2= >0.05). After treatment LAD was (40.96+1.81) mm in the control group,(38.65±1.90) mm in the atorvasatin group,(39.15±1.85)mm in the trimetazidine group,and (37.22±1.74) mm in the combination group. LAD of the 3 treatment groups were all significantly different from the control group(F=3.42,P<0.05). LAD of the combina-tion group was significantly smaller than that of the atorvasatin group and the trimetazidine group (P<0.05),and there was no significant difference of the LAD between the atorvasatin group and the trimetazidine group(P>0.05). There was no significant difference between the 4 groups on CRP before treatment (F=0.96,P>0.05). After treat-ment CRP was (8.85±1.45) mg/L in the control group,(5.96±1.26) mg/L in the atorvasatin group,(6.81± 1.37) mg/L in the trimetazidine group,and (3.75±1.15) mg/L in the combination group. CRP of the 3 treatment groups were all significantly different from the control group (F=3.63,P<0.05). CRP of the combination group was significantly lower than that of the atorvasatin group and the trimetazidine group (P<0.05),and there was no signif-icant difference of CRP between the atorvasatin group and the trimetazidine group (P>0.05). Conclusion The treatment with trmetazidine combined with atorvastatin could prevent recurrence of paroxysmal auricular fibrillation though anti-inflammatory and inhibiting the remodeling of left atrial.     

曲美他嗪联合阿托伐他汀治疗原发性高血压伴阵发性心房颤动的疗效观察

Objective To study the efficacy of trimctazidine combined with atorvastatin for primary hypertension with paroxysmal auricular fibrillation,and its effects on LAD and CRP. Methods 160 patients of pri-mary hypertension with paroxysmal auricular fibrillation were randomly divided into 4 groups. Forty patients were treated with amiodarone (control group),600 mg/d for the first week,400 mg/d for the second week and 200 mg/d later;40 patients were treated with atorvastatin (20 mg/d,3 times per day) in addition to amiodarone (the atorvasat-in group);40 patients were treated with trimetazidine (20 mg/d,3 times per day) in addition to armiodarone (the trimetazidine group);40 patients were treated with combination of trimetazidine and atorvastatin in addition to amiod-atone (the combination group),and the dose was the same as the above groups. The treatment was started within 24 hours of recovering from paroxysmal auricular fibrillation and lasted for 1 year. Results After 1 year there was 1 pa-the control group,and 62.5% (25/40) for the atorvasatin group,64.1% (25/39) for the trimetazidine group,and 84.6% (33/39) for the combination group. Compared to the control group,the effective rate of the 3 treatment groups were all significantly higher (X2=4.56、5.13、17.55,P<0.05). The effective rate of the combination group was significantly higher than that of the atorvasatin group and the trimetazidine group (X2=4.95、4.30,P<0.05),and there was no significant difference of effective rate between the atorvasatin group and the trimetazidine group(X2= >0.05). After treatment LAD was (40.96+1.81) mm in the control group,(38.65±1.90) mm in the atorvasatin group,(39.15±1.85)mm in the trimetazidine group,and (37.22±1.74) mm in the combination group. LAD of the 3 treatment groups were all significantly different from the control group(F=3.42,P<0.05). LAD of the combina-tion group was significantly smaller than that of the atorvasatin group and the trimetazidine group (P<0.05),and there was no significant difference of the LAD between the atorvasatin group and the trimetazidine group(P>0.05). There was no significant difference between the 4 groups on CRP before treatment (F=0.96,P>0.05). After treat-ment CRP was (8.85±1.45) mg/L in the control group,(5.96±1.26) mg/L in the atorvasatin group,(6.81± 1.37) mg/L in the trimetazidine group,and (3.75±1.15) mg/L in the combination group. CRP of the 3 treatment groups were all significantly different from the control group (F=3.63,P<0.05). CRP of the combination group was significantly lower than that of the atorvasatin group and the trimetazidine group (P<0.05),and there was no signif-icant difference of CRP between the atorvasatin group and the trimetazidine group (P>0.05). Conclusion The treatment with trmetazidine combined with atorvastatin could prevent recurrence of paroxysmal auricular fibrillation though anti-inflammatory and inhibiting the remodeling of left atrial.     

右小腿软组织及胫骨缺损修复一例

患者男，３０岁。车祸伤致右小腿软组织伤，胫骨开放性骨折，在院外以抗感染、小夹板外固定治疗７天后，于１９９５年５月入我院。检查：右小腿胫前有一１３ｃｍ×８ｃｍ皮肤及皮下组织缺损区，胫骨断端外露，创面有脓液，创缘皮肤部分坏死。Ｘ线片示：胫骨开放性骨折，缺...     

ST段抬高型心肌梗死患者冠状动脉血流灌注分级与围术期临床指标的关系

目的 探讨ST段抬高型心肌梗死（ST-segment elevation myocardial infarction,STEMI）患者冠状动脉血流灌注分级与围术期临床指标的相关性。方法 回顾性纳入2018年1月至2021年6月于聊城市第二人民医院行经皮冠状动脉介入（percutaneous coronary intervention,PCI）治疗的STEMI患者共159例，根据术前心肌梗死溶栓试验（thrombolysis in myocardial infarction,TIMI）血流分级分组，其中TIMI 0～1组和2～3级组分别为121例、38例。分析两组患者一般资料、冠状动脉造影指标及光学相干断层扫描技术（optical coherence tomography,OCT）相关指标，采用Logistic回归模型评价STEMI患者PCI治疗前冠状动脉血流灌注分级独立影响因素。结果 两组患者的年龄、左心室射血分数（left ventricular ejection fraction,LVEF）及氨基末端脑钠肽前体（N-terminal pro-brain natriuretic pe...     

吡格列酮对无胰岛素抵抗的高血压病患者左室肥厚及脑钠肽的影响

目的:探讨吡格列酮对无胰岛素抵抗(IR)的高血压病患者左室肥厚(LVH)及脑钠肽(BNP)的影响.方法:入选无IR的高血压病伴LVH患者60例,随机分成吡格列酮组与常规治疗组.常规治疗组给予依那普利治疗,吡格列酮组给予依那普利和吡格列酮治疗6个月.比较两组治疗前后左心室重量指数(LVMI)、血清BNP水平的变化.结果:吡格列酮组与常规治疗组治疗前后比较,LVMI、血清BNP均下降(P＜0.05),两组治疗后比较,吡格列酮组LVMI、血清BNP下降明显(P＜0.05).结论:吡格列酮能逆转高血压病LVH,并降低血清BNP浓度.     

伊布利特在房性心律失常中的临床应用

目的观察伊布利特转复心房颤动(atrial fibrillation,AF)和心房扑动(atrial flutter,AFL)的有效性及安全性。方法选取2016年1月~2017年12月在聊城市第二人民医院心内一科住院的持续时间≤3个月的AF、AFL患者32例,随机分为伊布利特组(17例)与胺碘酮组(15例)。伊布利特组首次剂量1mg伊布利特稀释于5%葡萄糖注射液10ml静脉推注,如无效10min后再给予1mg;胺碘酮组首次剂量150mg胺碘酮稀释于5%葡萄糖注射液10ml静脉推注,如无效10min后再给予150mg。结果伊布利特组的AF和AFL转复及总转复率分别为64.3%、66.7%和64.7%,胺碘酮组的AF和AFL转复及总转复率分别为41.7%、33.3%和40.0%,2组比较差异有统计学意义(P0.05)。伊布利特组平均转复时间为(29.28±12.57)min,胺碘酮组平均转复时间为(70.59±16.83)min,2组比较差异有统计学意义(P0.01)。治疗前后2组血压、心率比较无统计学差异(P0.05)。2组不良反应发生率比较无显著差异(17.6%vs 26.7%,P0.05)。结论伊布利特转复AF、AFL具有起效快,成功率高,安全性好的特点,其疗效优于胺碘酮。     

卡维地洛治疗原发性高血压疗效分析

目的评价卡维地洛对原发性高血压的临床疗效及安全性。方法60例原发性高血压患者，经过2周安慰剂洗脱期后随即分为治疗组和对照组，对照组30例给予美托洛尔25mg，2次／d，口服2周末血压下降未达到有效标准者增至50mg，2次／d，疗程8周；治疗组30例给予卡维地洛10mg，2次／d，服药2周末血压标准未达到有效标准者增至20mg，2次／d，疗程共8周。结果治疗组降压总有效率80.0％，显效率56，7％，对照组总有效率73．3％，显效率53．3％；2组疗效比较差异无统计学意义（P〉0．05），不良反应发生率差异无统计学意义（P〉0．05）。2组不良反应程度均较轻，可耐受。结论卡维地洛是治疗原发性高血压安全有效的药物。     

曲美他嗪联合阿托伐他汀治疗原发性高血压伴阵发性心房颤动的疗效观察

Objective To study the efficacy of trimctazidine combined with atorvastatin for primary hypertension with paroxysmal auricular fibrillation,and its effects on LAD and CRP. Methods 160 patients of pri-mary hypertension with paroxysmal auricular fibrillation were randomly divided into 4 groups. Forty patients were treated with amiodarone (control group),600 mg/d for the first week,400 mg/d for the second week and 200 mg/d later;40 patients were treated with atorvastatin (20 mg/d,3 times per day) in addition to amiodarone (the atorvasat-in group);40 patients were treated with trimetazidine (20 mg/d,3 times per day) in addition to armiodarone (the trimetazidine group);40 patients were treated with combination of trimetazidine and atorvastatin in addition to amiod-atone (the combination group),and the dose was the same as the above groups. The treatment was started within 24 hours of recovering from paroxysmal auricular fibrillation and lasted for 1 year. Results After 1 year there was 1 pa-the control group,and 62.5% (25/40) for the atorvasatin group,64.1% (25/39) for the trimetazidine group,and 84.6% (33/39) for the combination group. Compared to the control group,the effective rate of the 3 treatment groups were all significantly higher (X2=4.56、5.13、17.55,P<0.05). The effective rate of the combination group was significantly higher than that of the atorvasatin group and the trimetazidine group (X2=4.95、4.30,P<0.05),and there was no significant difference of effective rate between the atorvasatin group and the trimetazidine group(X2= >0.05). After treatment LAD was (40.96+1.81) mm in the control group,(38.65±1.90) mm in the atorvasatin group,(39.15±1.85)mm in the trimetazidine group,and (37.22±1.74) mm in the combination group. LAD of the 3 treatment groups were all significantly different from the control group(F=3.42,P<0.05). LAD of the combina-tion group was significantly smaller than that of the atorvasatin group and the trimetazidine group (P<0.05),and there was no significant difference of the LAD between the atorvasatin group and the trimetazidine group(P>0.05). There was no significant difference between the 4 groups on CRP before treatment (F=0.96,P>0.05). After treat-ment CRP was (8.85±1.45) mg/L in the control group,(5.96±1.26) mg/L in the atorvasatin group,(6.81± 1.37) mg/L in the trimetazidine group,and (3.75±1.15) mg/L in the combination group. CRP of the 3 treatment groups were all significantly different from the control group (F=3.63,P<0.05). CRP of the combination group was significantly lower than that of the atorvasatin group and the trimetazidine group (P<0.05),and there was no signif-icant difference of CRP between the atorvasatin group and the trimetazidine group (P>0.05). Conclusion The treatment with trmetazidine combined with atorvastatin could prevent recurrence of paroxysmal auricular fibrillation though anti-inflammatory and inhibiting the remodeling of left atrial.     

吡格列酮联合厄贝沙坦对原发性高血压患者左心室肥厚及血清脑钠肽的影响

目的 探讨吡格列酮对原发性高血压患者左心室肥厚及脑钠肽的影响.方法 原发性高血压伴左心室肥厚患者80例完全随机分成2组,各40例.常规治疗组给予厄贝沙坦（150 mg/d）,吡格列酮组给予厄贝沙坦（150 mg/d）＋吡格列酮（15 mg/d）,均治疗6个月.比较2组治疗前后左心室质量指数（LV MI）、血清脑钠肽浓度的变化.结果 治疗后2组患者LVMI、血清脑钠肽浓度均下降（P＜0.05）,2组治疗后比较,吡格列酮组LVMI、血清脑钠肽浓度下降为[（126.2±10.4）g/m2、（113.6±42.9）ng/L,较常规治疗组[分别为（135.5±11.2）g/m2、（138.8±45.8）ng/L]明显（P＜0.05）.结论 吡格列酮能逆转高血压病患者的左心室肥厚,并降低血清脑钠肽浓度.     

曲美他嗪对高血压病伴阵发性房颤患者左房内径及血清CRP水平的影响

目的 探讨曲美他嗪治疗高血压病伴阵发性房颤的疗效及可能机制。方法 将同期收治的高血压病伴阵发性房颤患者80例随机分为观察组和对照组各40例,均予钙离子拮抗剂和（或）利尿剂降压,并于房颤复律后24h内开始口服胺碘酮,第1、2周分别为600、400mg／d,其后改为200mg／d;观察组在此基础上口服曲美他嗪20mg／次,每日3次。两组均服药18。观察两组治疗前后疗效及左房内径、血清CRP水平变化。结果 观察组有效率显著高于对照组（P〈0．05）;治疗后观察组左房内径显著小于对照组、血清CRP水平显著低于对照组（P〈0．05）。结论 曲美他嗪治疗高血压病伴阵发性房颤疗效确切,可能机制为抑制炎症反应及左房重构。