老年充血性心衰患者地高辛药代动力学研究

目的 :探讨老年心衰患者地高辛维持量的合理应用。　 方法 :用荧光偏振免疫分析法测定了 14例老年心衰患者血清地高辛浓度 ,并计算出药代动力学参数。　 结果 :14例老年心衰患者地高辛 t1/ 2 β,β和 Vd分别为 72 .769± 2 9.768h、0 .0 11± 0 .0 0 6h-1和 3.190± 3.30 0 L/ kg,与非老年心衰患者 ( t1/ 2 β 36.1± 2 .0 h,56.3± 12 h,β 0 .0 19± 0 .0 0 1h-1,Vd 7.37± 1.65L / kg)相比差异显著。　 结论 :老年心衰患者地高辛维持量以小量分次给药为宜 ,且更应注意个体化     

Cell transplantation to improve ventricular function in the failing heart

Current therapies for congestive heart failure are limited in efficacy or in applicability. Cardiac cell transplantation offers a novel therapeutic approach to improve heart function. Although significant progress has been made over the past decade in the development of cell transplantation, only recently have investigators studied the changes in ventricular function following cell transplantation. This review article describes the latest research developments, evaluates recent studies of ventricular function after cell transplantation, and discusses the future directions of cell transplantation as a new therapy to ‘repair broken hearts’.     

黄芪注射液治疗充血性心力衰竭的临床观察

目的 :观察黄芪注射液对充血性心力衰竭 (CHF)的治疗效果。方法 :将 12 7例心衰病人随机分为 2组。对照组 5 5例 ,给予传统治疗心衰药物洋地黄、利尿剂及休息、低盐饮食、吸氧等治疗 ;治疗组 72例 ,在对照组病人用药的基础上加黄芪注射液 40ml ,静脉滴注 ,每日 1次 ,2组均连续用药 15天。结果 :总有效率治疗组 91 7%,对照组 6 7 3%,治疗组效果明显优于对照组 (P <0 0 1) ,且 2组自身对照 ,治疗后好转程度 ,治疗组优于对照组 ,左室射血分数 (LVEF)明显好于对照组。结论 :在常规治疗CHF的同时加用黄芪注射液可显著提高疗效。     

167例老年人心力衰竭的循证治疗实践

目的:探讨老年人充血性心力衰竭(CHF)的循证医学(EBM)标准化治疗。方法:167例确诊为CHF的住院患者,年龄60￣90岁,平均(74.38±6.84)岁,按照循证医学的基本原理,在病因、诱因和改善心衰症状的基础上,强调能改善预后的神经内分泌拮抗剂的应用。结果:本组167例CHF患者,显效96例(57.5%),有效62例(37.1%),总有效率94.6%,死亡9例(5.4%)。神经内分泌拮抗剂践行率分别为:ACEI类119例(71.3%),β受体阻滞剂69例(41.32%),醛固酮拮抗剂88例(52.7%);随访6￣36个月,平均(16.25±9.30)个月;107例(67.7%)再入院1￣5次,院外死亡6例。结论:按照EBM原理对老年CHF患者制定的个体化治疗方案,效果理想。在老年CHF患者中,神经内分泌拮抗剂践行率较低,可能是再住院次数多的原因之一。     

温阳健心灵口服液治疗充血性心力衰竭的临床与实验研究

以煎剂形成筛选治疗CHF的处方，发现温阳益气方改善泵血功能的效果优于单纯益气和养阴益气的处方。根据前方制备的温阳健心灵口服液保持了原煎剂的疗效，并被毒理学试验证明毒性极低。动物药效学及临床试验发现该药不仅能改善心衰犬和病人的左室收缩功能，还能改善其舒张功能。除此，它还具有利尿作用和使PAWA、SVR和PVR下降的作用，这也是它抗心衰的机理之一。90例的临床观察（疗程2周）表明该药总有效率、近期治愈率和显效率分别达88．9％、7．4％和18．5％，其效与开搏通组无明显差异。     

Changes over 6-months in health-related quality of life in a matched sample of hispanics and non-hispanics with heart failure

Hispanics are a growing ethnic minority in the United States and one at significant risk for heart failure. Health-related quality of life (HRQL) is poor in individuals with heart failure, especially during and immediately following hospitalization. No prior research into the HRQL of Hispanics with heart failure was located. A sample of 80 individuals with heart failure, evenly divided by primary language and matched on functional status using the New York Heart Association classification system and age, was studied for 6 months following hospital discharge. Data on HRQL were collected using Spanish and English versions of the Minnesota Living with Heart Failure Questionnaire. Scores improved over time in both groups but significantly more so in the Hispanics when compared to the non-Hispanics. Group differences in HRQL could not be explained by demographics, clinical characteristics, treatment received, perceived support, or instrument response characteristics. Further exploration of this naturally occurring phenomenon may provide insight into how HRQL can be improved in the general heart failure population.     

雅施达治疗老年人充血性心力衰竭的临床疗效观察

目的 :观察雅施达 (培哚普利 )治疗老年人充血性心力衰竭 (CHF)的临床疗效。方法 :5 9例经常规洋地黄、利尿剂、血管扩张药等治疗效果欠佳的CHF老年患者 ,给予口服雅施达 2mg/d4mg/d ,治疗 4周 6周。观察治疗前后心率、心胸比、血压、左室舒张末期内径、左室射血分数以及心功能变化。结果 :治疗后心率、血压、心胸比以及左室舒张末期内径与治疗前比较均明显下降 (P <0 .0 5 )。左室射血分数增加 (P <0 .0 5 ) ,心功能改善 1级 2级。药物副作用少 ,患者耐受性好。结论 :雅施达治疗老年人CHF疗效好 ,副作用少 ,是理想的治疗药物     

Atrial natriuretic peptide in human urine

Summary A highly sensitive radioimmunoassay to measure atrial natriuretic peptide (ANP) concentration in urine has been established, and its clinical usefulness is presented. ANP in urine was stable at 4° C for several days and was easily measured by our radioimmunoassay. The average ANP excretion in 65 healthy persons was 25.0±1.4 ng/day (mean ± SEM) and the fractional excretion of ANP was 0.7±0.05%. In 14 patients with congestive heart failure, the average ANP excretion was 119.2±29.4 ng/day, which decreased to 53.3±11.0 after successful treatment.Abbreviations ANP atrial natriuretic peptide - hANP human atrial natriuretic peptide - RIA radioimmunoasay - NSB non specific bound - FE_ANP the fractional excretion of atrial natriuretic peptide - FE_Na the fractional excretion of sodium - SIADH the syngrome of inappropriate secretion of antidiuretic hormone     

肌钙蛋白T试纸条预测充血性心力衰竭预后的意义

目的探讨肌钙蛋白T(TNT)试纸条在预测充血性心力衰竭(CHF)预后的价值。方法将CHF患者64例,按心功能分级分为轻、重度心功能不全组各34例,30例,用试纸条检测TNT,阳性判断临界值为0.1μg/L。结果轻、重度心功能不全组TNT阳性数各为0例,8例,有显著差异(P＜0.05);TNT阳性死亡率50%较阴性死亡率3.57%高(P＜0.05);TNT阳性住院日数(36.36±14.64)d较阴性住院数(23.82±11.29)d长(P＜0.05);TNT阳性预测患者死亡率特异性为93.01%,敏感性为66.67%。结论用试纸条测试TNT对CHF预后具有一定的预测价值。