电针联合骨质疏松治疗仪对脊髓损伤患者骨代谢指标的影响

ObjectiveTo observe the effect of electroacupuncture combined with low-frequency pulsed electromagnetic field on bone metabolism in patients with spinal cord injury (SCI).MethodsThe 60 SCI patients who met the inclusion criteria were randomly divided into 2 groups by means of a random number table. In the control group, 30 patients were treated with osteoporosis treatment apparatus. In the observation group, 30 patients were treated with osteoporosis treatment apparatus and electroacupuncture at the foot-shaoyangacupoints [Yánglíngquán (阳陵泉GB 34) and Xuánzhōng (悬钟GB 39) of both sides].The treatment was applied once a day, 5 days a week, for 8 weeks.Before and after treatment, the changes of indexes in the two groups, including the bone mineral density (BMD), bone gla-containing protein (BGP), serum alkaline phosphatase (ALP), procollagen type I C-peptide (PICP), and 25‑hydroxy-vitamin D [25(OH)D], were observed for comparison.ResultsAfter treatment, in the two groups, the BMD and 25(OH)D indexes of the femoral neck, greater trochanter, and Ward's triangle region were not significantly changed in comparing with those before treatment (P>0.05), while the BGP, ALP, and PICP indexes were significantly higher than those before treatment (P<0.05). After treatment, in the observation group, the BGP and ALP indexes were significantly increased in comparing with those of the control group, and the difference was statistically significant (P<0.05), whilst the BMD, PICP, and 25(OH)D indexes of the femoral neck, greater trochanter, and wards triangle region, were not significantly different in comparing with the control group (P>0.05).ConclusionThe osteoporosis treatment apparatus can improve bone metabolism in SCI patients, and the curative effect can be enhanced when combined with electroacupuncture at foot-shaoyangacupoints.     

BNP与NT—proBNP诊断急性呼吸窘迫综合征的价值

目的：探讨脑钠肽（BNP）和 N末端B型利钠肽前体（NT-proBNP）对急性呼吸窘迫综合征患者诊断中的意义以及对治疗的指导作用。方法：对124例有明确器质性心脏病或者突发呼吸窘迫患者（检测组）进行 BNP和NT-proBNP检查,判断心衰与否。另选110例发生急性呼吸窘迫但未做BNP、NT-proBNP检查的患者作为未检测对照组,收集所有患者诊断时间、住院时间、住院费用、死亡率等相关资料。结果：与未检测对照组比较,检测组诊断时间[（24.2±6.4）min比（16.3±5.2）min]、住院时间显著缩短[（12.5±3.5）d比（8.5±4.5）d],死亡率显著降低（8.18％比4.84％）,P均＜0.05;两组平均住院费用无明显差异（P＞0.05）。结论：脑钠肽和N末端B型利钠肽前体的检测对于早期诊断急性呼吸窘迫综合征,提高疗效和改善预后有重要价值。     

冠心病预后与冠状动脉侧支循环的关系

目的：研究冠心病（CHD）预后与冠状动脉侧支循环的关系。方法：依据冠状动脉造影结果98例患者被分为CHD无侧支循环组（62例）、CHD有侧支循环组（20例）、正常对照组（16例）,分析各组患者的临床资料。结果：CHD组（无论有无侧支循环）与正常对照组相比,除糖尿病发病率较高外（P〈0.01）,其他CHD易患因素差异均无显著性（P〉0.05）;有侧支循环与无侧支循环CHD患者相比,主要CHD易患因素、不稳定型心绞痛的发生率差异均无显著性（P〉0.05）;但无侧支循环患者左室射血分数〈50%患者比率（29.0%比10.0%）,心肌梗死（61.3%比30.0%）、室壁瘤（22.6%比0）的发生率较有侧支循环患者显著增加（P〈0.01）。结论：侧支循环存在与否与冠心病患者预后有关。     

急性冠状动脉综合征患者血清高敏C反应蛋白和新蝶呤的检测及意义

目的研究急性冠状动脉综合征（ACS）患者血清中炎症反应标记物高敏C反应蛋白（HS-CRP）和免疫反应标记物新蝶呤的变化。方法同时选取ACS患者和慢性稳定型心绞痛（SAP）患者各80例，采用酶联免疫法测定上述患者血中HS-CRP、新蝶呤浓度。结果与SAP患者相比，HS-CRP、新蝶呤的浓度在ACS患者血清中显著增高（均P〈0．05）。结论HS-CRP和新蝶呤可以作为诊断和预测ACS发生的敏感指标，炎症反应和免疫反应均参与了ACS的发生。     

多重动脉粥样硬化危险因素与冠状动脉病变特征

目的：研究多重动脉硬化危险因素与冠状动脉病变严重程度的关系。方法：根据病史询问、体格检查和血脂、血糖测定情况确定冠状动脉危险因素,并根据危险因素分为多重危险因素组及对照组。用冠状动脉造影术确定冠状动脉病变严重程度。结果：多重危险因素组较对照组冠状动脉病变严重,其冠状动脉多支病变率和平均病变支数明显高于对照组（P〈0．05～〈0．01）。结论：多重危险因素聚集往往导致冠状动脉的病变,并影响其病变范围。     

非ST段抬高型急性冠脉综合征肌钙蛋白Ⅰ水平对危险分层的评估

目的:探讨血清肌钙蛋白Ⅰ(cTnI)对非ST段抬高型急性冠状动脉综合征(NSTEACS)患者危险分层的判断价值。方法:对82例NSTEACS患者、50例健康者分别进行血清cTnI测定,并观察NSTEACS患者住院1个月内心脏事件发生情况。结果:NSTEACS组血清cTnI值明显高于正常对照组(P0.01)。NSTEACS组内,心肌梗塞者(cTnI阳性亚组)血清cTnI值明显高于不稳定型心绞痛者(cTnI阴性亚组)(P0.01)。正常对照组无一例发生心脏事件;cTnI阳性亚组心脏事件发生率为17.3%,显著高于cTnI阴性亚组的5.5%(P0.05)。结论:血清cTnI水平对NSTEACS患者危险分层有较好的价值。     

氟桂嗪对蛛网膜下腔出血血管痉挛的预防及治疗

目的：研究氟桂嗪对蛛网膜下腔出血（SAH）血管痉挛（CVS）的预防和治疗作用。方法：对34例未用氟桂嗪组（对照组）与38例用氟桂嗪预防组，和24例已发生CVS用氟桂嗪治疗组，于3－4周后分别进行经颅多普勒（TCD）及临床观察。结果：未用氟桂嗪组脑血管血流速度明显加快，与预防组相比有显著差异（P＜0．01），已发生CVS患者用药治疗后脑血管血流速度明显降低，痉挛缓解（P＜0．05）。结论：氟桂嗪预防和治疗SAH后CVS安全有效。