经皮穿刺桡动脉冠状动脉造影30例分析

冠心病介入性诊治的常规路径是经皮穿刺股动脉，但国外如日本已较早采用经皮穿刺桡动脉的方法，国内如北京阜外医院近年来也已采用此方法。与经皮穿刺股动脉相比，经皮穿刺桡动脉具有损伤小、恢复快、患者无需卧床休息、周围血管并发症少、抗凝药物可连续使用等优点。目前国内尚未广泛应用此种方法，现将笔者使用该法的经验报告如下。     

30例难治性慢性心力衰竭患者心脏再同步治疗疗效分析

心脏再同步治疗(CRT)通过心脏同步性的改善,包括房室同步性、左心室内同步性和左、右心室间的同步性,改善左心室收缩功能,增加左心室充盈时间,减少二尖瓣反流,逆转慢性心脏重构,是近期慢性充血性心力衰竭(CHF)治疗的重大进展[1-2].现将我院30例已完成的CRT治疗患者的临床及随访资料进行分析,探讨CRT治疗CHF的疗效.     

药物涂层支架治疗冠状动脉分叉病变临床结果观察

PCI中，分叉病变治疗占4％～16％，因边支血管存在着闭塞的风险，PCI术后，边支血管≥2．0mm闭塞的主要并发症是急性心肌梗死，故其介入治疗极具挑战性。     

心脏再同步治疗慢性心力衰竭的疗效评价及无反应原因分析

Objective To investigate the effect of cardiac resynchronization therapy (CRT) and the problem of non-response to CRT in patients with chronic heart failure. Methods Twenty patients[(64±10.9) yrs,5 women, 15men] underwent CRT. Conventional echocardiography was performed in each patient before implantation and at 6 months post implantation. Results The clinical response rate was 60% and echocardio-graphic response rate was 55% at 6 month follow-up. Average EF increased 10%. Three patients died and 1 pa-tient was found to have increased left electrode thresholds. One electrode dislocation occurred and recannulation was required. Four patients had no response to CRT. The response rate to CRT was lower in patients with a nar-row QRS or ischemic cardiomyopathy. Conclusion CRT is an effective treatment for chronic heart failure pa-tients. Non-response to CRT may berelated to the cause of heart failure and narrow QRS.     

心脏再同步治疗慢性心力衰竭的疗效评价及无反应原因分析

Objective To investigate the effect of cardiac resynchronization therapy (CRT) and the problem of non-response to CRT in patients with chronic heart failure. Methods Twenty patients[(64±10.9) yrs,5 women, 15men] underwent CRT. Conventional echocardiography was performed in each patient before implantation and at 6 months post implantation. Results The clinical response rate was 60% and echocardio-graphic response rate was 55% at 6 month follow-up. Average EF increased 10%. Three patients died and 1 pa-tient was found to have increased left electrode thresholds. One electrode dislocation occurred and recannulation was required. Four patients had no response to CRT. The response rate to CRT was lower in patients with a nar-row QRS or ischemic cardiomyopathy. Conclusion CRT is an effective treatment for chronic heart failure pa-tients. Non-response to CRT may berelated to the cause of heart failure and narrow QRS.     

葛根素对心肌缺血再灌注损伤保护作用的研究进展

急性心肌梗死是临床上常见心血管系统危急重症,但再灌注过程往往导致心肌缺血再灌注损伤。葛根素是一种从葛根中提取的异黄酮化合物,药理作用广泛,可通过抗氧化应激、抗炎、抑制自噬反应、抑制铁死亡等机制减轻心肌缺血再灌注损伤。总结了葛根素保护心肌缺血再灌注损伤的作用机制,以期为葛根素临床治疗急性心肌梗死提供参考。     

心脏再同步治疗慢性心力衰竭的疗效评价及无反应原因分析

Objective To investigate the effect of cardiac resynchronization therapy (CRT) and the problem of non-response to CRT in patients with chronic heart failure. Methods Twenty patients[(64±10.9) yrs,5 women, 15men] underwent CRT. Conventional echocardiography was performed in each patient before implantation and at 6 months post implantation. Results The clinical response rate was 60% and echocardio-graphic response rate was 55% at 6 month follow-up. Average EF increased 10%. Three patients died and 1 pa-tient was found to have increased left electrode thresholds. One electrode dislocation occurred and recannulation was required. Four patients had no response to CRT. The response rate to CRT was lower in patients with a nar-row QRS or ischemic cardiomyopathy. Conclusion CRT is an effective treatment for chronic heart failure pa-tients. Non-response to CRT may berelated to the cause of heart failure and narrow QRS.     

冠状动脉心肌桥研究现状

冠状动脉(冠脉)在正常情况下走行于心外膜下的脂肪组织中或心外膜下,如果冠脉或其分支的某一段被心肌包绕,那么这段心肌被称为心肌桥(myocardial bridge,MB),造影显示在心脏收缩期,心肌收缩会导致冠脉狭窄,但是不会明显产生血流动力学变化,认为心肌桥只是一种良性的先天性冠脉畸形。随着近几十年来的医学技术的发展,对那些有症状的患者进行进一步检查,发现有些症状的罪魁祸首正是心肌桥的存在。本文就心肌桥的发病率、病理生理、临床表现、诊断和治疗做一综述。     

氟伐他汀联合普罗布考对急性冠脉综合征患者血脂及血清hs-CRP水平的影响

目的:探讨氟伐他汀联合普罗布考对急性冠脉综合征(ACS)患者血脂及血清超敏C-反应蛋白(hs-CRP)水平的影响。方法:收集ACS住院患者60例,随机分为A、B、C3组,每组20例,A组给予氟伐他汀40mg,1次/晚;B组给予氟伐他汀80mg,1次/晚;C组给予氟伐他汀40mg,1次/晚,并加用普罗布考250mg,2次/d。3组患者均于治疗前清晨空腹取血,测定hs-CRP和血脂水平,包括总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)。结果:治疗前3组间各项血脂指标及hs-CRP水平差异均无统计学意义(P0.05)。治疗后C组血脂指标和hs-CRP水平较A组均降低(P0.05),TC及HDL-C水平较B组均低(P0.05),而TG及LDL-C水平与B组比较差异无统计学意义(P0.05)。治疗后B、C组中TC、TG、LDL-C水平较治疗前降低(P0.05或P0.01);各组hs-CRP水平治疗前后差异均有统计意义(P0.05)。结论:氟伐他汀联合普罗布考或大剂量氟伐他汀均能明显降低ACS患者血脂及hs-CPR水平,尤以氟伐他汀联合普罗布考效果更为显著。     

心脏再同步治疗慢性心力衰竭的疗效评价及无反应原因分析

Objective To investigate the effect of cardiac resynchronization therapy (CRT) and the problem of non-response to CRT in patients with chronic heart failure. Methods Twenty patients[(64±10.9) yrs,5 women, 15men] underwent CRT. Conventional echocardiography was performed in each patient before implantation and at 6 months post implantation. Results The clinical response rate was 60% and echocardio-graphic response rate was 55% at 6 month follow-up. Average EF increased 10%. Three patients died and 1 pa-tient was found to have increased left electrode thresholds. One electrode dislocation occurred and recannulation was required. Four patients had no response to CRT. The response rate to CRT was lower in patients with a nar-row QRS or ischemic cardiomyopathy. Conclusion CRT is an effective treatment for chronic heart failure pa-tients. Non-response to CRT may berelated to the cause of heart failure and narrow QRS.