脉搏波传导速度与心脑血管事件和死亡率的队列研究

目的:研究自然人群中颈-股脉搏波传导速度(C-FPWV)与心脑血管事件和全因死亡的关系。方法:在包头医学院第二附属医院体检科连续收集556例体检者的基本资料,并对体检者进行C-FPWV测定,平均随访5年,观察其终点事件的发生率。结果:动脉硬化组的心血管事件发生率(16.1%∶6.4%)和全因病死率(7.7%∶2.4%)均高于正常组,且差异有统计学意义。在重度动脉硬化组、轻度动脉硬化组和正常组的心血管事件发生率(分别为22.7%,10.7%和6.4%)和全因病死率(分别为10.5%,5.6%和2.4%)差异有显著统计学意义(P<0.001)。经Logistic回归分析后,重度动脉硬化组发生心脑血管事件的OR为4.609(95%CI:2.288～9.285),全因死亡的OR为4.763(95%CI:1.653～13.719)。轻度动脉硬化组发生心脑血管事件的OR为1.717(95%CI:0.822～3.586),全因死亡的OR为2.320(95%CI:0.777～6.920)。分别作C-FPWV与心脑血管事件和全因死亡的ROC曲线,得到预测心脑血管事件和全因死亡的最佳临界点分别为10.85m/s和11.05m/s...     

急性心血管事件院前急救的应急策略及流程探讨

Objective To study the strategy and process of out-hospital emergency care of acute cardiovascular events. Methods One hundred and eighty-three patients in the Second Affiliated Hospital of Baotou Medical College were prospectively studied. The patients were divided into two groups according to the different ways of out-hospital care, one group consisted of patients who received first-aid care after calling " 120" (94 cases), another was self-aid group consisting of patients sent to hospital by relatives (89 cases). The proportion of persons with higher than high school education and better knowledge for emergency care of patients with heart disease in first-aid group was higher than self-aid group (50. 0% vs. 29. 2%, 83.0% vs. 60. 7%, both P<0. 05). When the patients were brought to the emergency room, they were all treated according to our standard procedure and then registered. All patients were followed up at the end of first and third month after illness. Results Cardiovascular events were mainly myocardial infarction (61.7%) among 183 patients. There were statistically significant differences between two groups in self-aid response time, first disposal time and out-hospital rescuing time [(32.3 ± 5.6) minutes vs. (89.6±8.4) minutes, (47.3±7.3) minutes vs. (149.8±13.5) minutes, (61.7±8.3) minutes vs. [(149.8±13.5) minutes, all P<0. 01], but no difference was found in in-hospital rescuing time [(29. 9±5.3) minutes vs. (31.1±4.5) minutes, P>0. 05]. Morbidity rate was lower in first-aid group than self-aid group in 1st and 3rd month, respectively (2.1% vs. 9. 0%, 4. 2% vs. 12.4%, both P<0. 05). Conclusion Excellent emergency system and procedure can shorten initial disposal time and out-hospital rescuing time, thus improve patients' prognosis. The education level and health knowledge of patients and their raletives directly affect their mode of arriving hospital and prognosis.     

急性心脑血管事件院前急救模式与预后的关系

我国是心脑血管疾病高发国家.心脑血管疾病的主要风险集中在发病早期,而发病后能否得到及时救治是决定死亡、残疾的关键[1-3].因此,建立完善的急诊救治体系已势在必行.本研究采用前瞻性队列研究,评价不同就诊模式对心脑血管事件预后的影响.     

急性心血管事件院前急救的应急策略及流程探讨

Objective To study the strategy and process of out-hospital emergency care of acute cardiovascular events. Methods One hundred and eighty-three patients in the Second Affiliated Hospital of Baotou Medical College were prospectively studied. The patients were divided into two groups according to the different ways of out-hospital care, one group consisted of patients who received first-aid care after calling " 120" (94 cases), another was self-aid group consisting of patients sent to hospital by relatives (89 cases). The proportion of persons with higher than high school education and better knowledge for emergency care of patients with heart disease in first-aid group was higher than self-aid group (50. 0% vs. 29. 2%, 83.0% vs. 60. 7%, both P<0. 05). When the patients were brought to the emergency room, they were all treated according to our standard procedure and then registered. All patients were followed up at the end of first and third month after illness. Results Cardiovascular events were mainly myocardial infarction (61.7%) among 183 patients. There were statistically significant differences between two groups in self-aid response time, first disposal time and out-hospital rescuing time [(32.3 ± 5.6) minutes vs. (89.6±8.4) minutes, (47.3±7.3) minutes vs. (149.8±13.5) minutes, (61.7±8.3) minutes vs. [(149.8±13.5) minutes, all P<0. 01], but no difference was found in in-hospital rescuing time [(29. 9±5.3) minutes vs. (31.1±4.5) minutes, P>0. 05]. Morbidity rate was lower in first-aid group than self-aid group in 1st and 3rd month, respectively (2.1% vs. 9. 0%, 4. 2% vs. 12.4%, both P<0. 05). Conclusion Excellent emergency system and procedure can shorten initial disposal time and out-hospital rescuing time, thus improve patients' prognosis. The education level and health knowledge of patients and their raletives directly affect their mode of arriving hospital and prognosis.     

以急性心肌梗死为首发表现的血小板增多症一例

一、临床病例资料：患者，男，70岁。因突发剑突下剧痛20小时于2003年7月20日入院。既往8年前因头晕，左侧肢体活动受限曾诊为高血压病、脑梗塞，当时测血常规未见异常，经治疗后左侧肢体活动功能恢复正常，平时使用卡托普利、心痛定等药物治疗。偶有牙龈出血及鼻衄，因症状不重未诊治，亦未再测血常规。体检：体温36．4℃，     

2型糖尿病合并高血压的研究进展

最近几十年,全球糖尿病患者人数以惊人的速度迅速增长,糖尿病特别是2型糖尿病目前已成为严重影响人类身心健康的主要公共卫生问题。随着我国经济的快速发展,糖尿病的发病率也飞速增长。根据国际糖尿病组织报告,2003年中国约有糖尿病患者2260万,目前中国已成为仅次于印度的世界第二糖尿病大国,以目前的增长趋势,预计到2025年,中国的糖尿病患者将达到5000万。更为危险的是,有证据表明,     

TTM和DCG对心律失常诊断价值和效价的对比

对间歇出现的以不规律心悸、头晕、黑朦或晕厥为主诉的患者,普通心电图很难捕捉到心律失常。电话传输心电监测系统(TTM)和动态心电图(DCG)的出现增加了其检出的机会。但何者效价好,尚缺资料现介绍如下。     

动态血压与脂蛋白(a)的关系

目的 :探讨高血压患者动态血压 (ABP)与脂蛋白 (a) [L p(a) ]。方法 :测定 15 7例高血压患者及 4 5例正常对照者的 ABP及 L p(a)浓度。结果 :高血压患者 L p(a)浓度为 2 86± 4 2 mg/ L,对照组为 183± 38mg/ L,二者差异具有统计学意义 (P<0 .0 1)。在高血压患者中 ,L p(a)高者其动态血压中 2 4小时平均收缩压、夜间平均收缩压、收缩压负荷及舒张压负荷均高于 L p(a)浓度正常者。结论 :高血压患者 L p(a)浓度高于正常人群 ,且脂蛋白 (a)浓度与动态血压参数有关     

急性心肌梗死早期溶栓治疗对QT离散度及恶性室性心律失常的影响

研究急性心肌梗死（ＡＭＩ）后溶栓治疗对ＱＴ离散度（ＱＴｄ）及恶性室性心律失常（ＭＶＡ）事件的影响。回顾性选择分析ＡＭＩ患者７５例（溶栓治疗组４３例、未溶栓组３２例）,通过测量入院时及入院后２４ｈ常规心电图计算ＱＴｄ、校正ＱＴｃ（ＱＴｃｄ）,并在入院后一周内心电监护观察ＭＶＡ事件发生情况。溶栓再通组ＱＴｄ、ＱＴｃｄ较溶栓前显著缩短（４２．６±１４．３ｍｓｖｓ７１．７±１６．９ｍｓ,４５．９±１７．４ｍｓｖｓ７４．８±１８．５ｍｓ,Ｐ均＜０．０１）;溶栓未通组、未溶栓组入院２４ｈ期间ＱＴｄ、ＱＴｃｄ无明显变化（Ｐ＞０．０５）。ＱＴｄ、ＱＴｃｄ≥９０ｍｓ者ＭＶＡ事件明显高于＜９０ｍｓ者（７０．６％ｖｓ１０．２％,Ｐ＜０．０１）,溶栓再通组ＭＶＡ事件与溶栓未通组比较趋于减少（１１％ｖｓ２８％）。结论：ＡＭＩ后成功的溶栓治疗可以缩短心室复极的ＱＴｄ,从而可能减少ＡＭＩ后早期ＭＶＡ的发生;无效的溶栓治疗对ＡＭＩ近期预后无任何影响。