快速静脉尿路造影及血浆肾素活性在肾血管性高血压诊断中的价值

本文对23例肾动脉狭窄性高血压患者作肾动脉造影,快速静脉尿路造影和血浆肾素活性(包括外周静脉、肾静脉、下腔静脉),并有肾动脉正常的原发性高血压15例进行对比分析,显示快速静脉尿路造影是安全而可靠的筛选检查方法之一,如果以二项或二项以上阳性作标准,则可减少假阳性。血浆肾素活性测定,单项指标阳性意义不大,假阳性与假阴性都很多。若二项或二项以上阳性,则可减少假阳性,因此,如与快速静脉尿路造影结果合并考虑,则诊断意义更大。     

L''''ANGINE DE POITRINE PRECEDENT L''''INFARCTUS DU MYOCARDE:RELATION AVEC LES LESIONS CORONAIRES ET LA CIRCULATION COLLATERALE

To determine the relationship between angina pectoris before myocardial infarction (MI) and the extent of coronary artery disease and collateral circulation, 28 patients with (group Ⅰ)and 22 patients without (group Ⅱ) angina one month prior to acute MI underwent left ventriculography and coronary arteriography within 6 months of a first transmural MI. 23 patients in group Ⅰbut only 6 patients in group Ⅱhad multivessel disease. Despite a similar incidence of total occlusion of infarct-related artery, the collateral score in group Ⅰwas significantly higher than that in group Ⅱ. Abnormal regional left ventricular motion score was lower in group Ⅰthan in group Ⅱ. The study suggests that a history of angina before MI may predict the presence o f multivessel disease and the formation of collateral circulation in patients with MI.     

经皮球囊导管法顺序扩张二尖瓣和三尖瓣狭窄

二尖瓣和三尖瓣同时狭窄较少见,常需手术治疗,本文报告用Inoue球囊导管治疗的体会.患者,沈某某,女性,21岁.因“胸闷一年余,加重5个月伴下肢浮肿和夜间不能平卧”而入院.体检:二尖瓣面容,颈静脉轻度怒张.呼吸25次/分.心率82次/分,律齐,心尖部第一心音亢进,闻及开瓣音及舒张期滚简样杂音Ⅲ级.三尖瓣区可闻及Ⅱ级舒张期杂音.腹软,肝肋下2cm.下肢轻度凹陷性浮肿.心胸比例>0.50,右心房、右心室和左心房增大.两肺淤血.心电图示左、右心房肥大.超声多普勒检查示:左、右心房及右心室内径增大.二尖瓣轻度钙化,瓣口面积为0.72cm~2.三尖瓣轻度增厚,瓣口面积为1.50cm~2,轻度返流.肺动脉收缩压为7.2kPa(54mmHg).     

颅外颈动脉超声检查对冠状动脉粥样硬化的预测价值

颈动脉粥样硬化(Cmotid Atherosclerois，CAS)与心脑血管疾病有着密切的联系。CAs是脑实质缺血性病变的主要原因之一，对CAS斑块与脑中风的关系已有较系统的报道。近年来，国外有文献报道冠状动脉粥样硬化(Coronuary Artery Atherosclerosis,CAAS)程度与超声测得的颅外CAS程度相关密切，从而开始了CAS与冠状动脉疾病（Coronuary Artery Disease,CAD)关系的研究。     

Structural alterations of resistance vessels of spontaneously hypertensive rats and protective effects of captopril.

ＳＴＲＵＣＴＵＲＡＬＡＬＴＥＲＡＴＩＯＮＳＯＦＲＥＳＩＳＴＡＮＣＥＶＥＳＳＥＬＳＯＦＳＰＯＮＴＡＮＥＯＵＳＬＹＨＹＰＥＲＴＥＮＳＩＶＥＲＡＴＳＡＮＤＰＲＯＴＥＣＴＩＶＥＥＦＦＥＣＴＳＯＦＣＡＰＴＯＰＲＩＬＣｈｅｎＹｉｈａｎ陈义汉，ＧｏｎｇＬａｎｓｈｅ...     

多普勒超声评价MI患者左室舒张功能动态改变及其意义

为了观察AMI患者住院期和出院早期左室舒张功能的动态改变,了解其与冠状动脉病变和梗塞后心绞痛的关系,本文采用二维PDE结合冠脉造影,对40例AMI患者进行了平均6个月的随访观察,结果显示,AMI组无论在住院期和出院早期,其多普勒左室舒张功能指标明显异常于正常组,表现在前者的E峰速度减低,A峰速度增加,E/A和Ei/Ai比值减小(p<0.01)。值得注意的是,梗塞平均6个月后,多项     

氨氯地平对异常血压昼夜节律的逆转作用

目的观察氨氯地平短期治疗非杓形高血压患者对异常血压昼夜节律与左心室舒张功能的逆转作用。方法２８例患者口服氨氯地平５～１０ｍｇ，１／ｄ，治疗前和疗程第６周时进行动态血压监测和超声心动图检查。结果２５例完成治疗随访的患者中，异常血压节律逆转１５例，未逆转１０例，逆转患者左心室舒张功能显著改善。结论氨氯地平治疗后，约６０％原发性高血压异常血压昼夜节律患者可改善血压昼夜节律。     

FACTORS RELATED TO THE LEFT VENTRICULAR ANEURYSM FORMATION AFTER ANTERIOR MYOCARDIAL INFARCTION

To examine the factors related to left ventricular (LV) aneurysm formation after transmural anterior myocardial infarction (MI), 22 patients with a first attack of anterior MI who underwent left ventriculography and coronary angiography within 6 months of infarction were divided into two groups on the basis of presence (10 patients, Group Ⅰ) or absence (12 patients, Group Ⅱ) of a LV aneurysm. Group Ⅰpatients were shown to have larger infarct and poorer LV function. Single vessel disease and total occlusion of the left anterior descending (LAD) artery were more common and collateral blood supply in the presence of an occluded LAD was significantly less adequate in Group Ⅰcompared with Group Ⅱ. Age, sex and risk factors for coronary artery disease were found to have no correlation with aneurysm formation. It is indicated in this study that total occlusion of the LAD in association with inherent poor collateral blood supply is an important determinant of aneurysm formation after anterior MI.     

VERAPAMIL TREATMENT OF TORSADES DE POINTESVENTRICULAR TACHYARRHYTHMIA IN PARTICULAR PATTERN

This paper reports two cases of "Torsades depointes" ventricular tachyarrhythmia (TPVT) in particular form. The electrocardiographic characteristicsshowed the presence of abnormally short couplingintervals of premature ventricular contractions(PVCs)as well as the PVCs initiating tachycardias in the set-ting of normal QT intervals. The tachycardias weresusceptible to verapamil and refractory to other an-tiarrhythmic agents. Either triggered activity or re-entry due to slow inward current is considered forthe mechanism of this type of tachyarrhythmia.