粗大冠状动脉瘘误诊为冠心病

[病例] 男,55岁.因反复心前区疼痛伴胸闷2周,加重2天,于1999年11月1日入院.有高脂血症9年,无高血压病史,1985年曾因"冠心病、阵发性房颤"住院治疗.本次入院前2周劳累后出现心前区疼痛,呈针刺样并向左肩放射,每次发作时间2～15分钟不等,服用麝香保心丸无效.同时伴有心跳漏搏感,以平卧时尤甚.急诊查心电图示:室性早搏,STⅡ、Ⅲ、aVF压低0.5 mv,STv5～6压低1.0 mv,低电压.查体:血压130/80 mmHg,心率78/min,心音有力,各瓣膜区未闻及杂音,心界在正常范围.     

Influence of Shengmai Capsule (生脉胶囊) on recovery of living capacity in patients after myocardial infarction

ABSTRACT Objective： To observe the effect of long-term application of Shengmai Capsule （生脉胶囊, SMC） on recovery of patients after myocardial infarction. Methods： A total of 120 myocardial infarction patients were assigned into two groups. Changes of angina pectoris, electrocardiogram （ECG）, living capacity and heart function in patients were observed after 6-month treatment. Results： The total effective rate in alleviating angina pectods was 90.0% and that in improving ECG figure was 93.3% in the treatment group, both were significantly higher than those in the control group, 73.4% and 70.0% respectively （P〈0.05）. The Karnofsky Performance Status scores of heart function were increased and the Activity of Daily Living scores in living capacity decreased in both groups, but the improvements were better in the treatment group （P〈0.01 and P〈0.05）. The parameters of cardiac function, including cardiac output, stroke volume, cardiac index and ejection fraction, were increased in both groups, but the increments in the treatment group were more significant （P〈0.01 or P〈0.05）. Conclusion： Long-term application of SMC could effectively prevent and treat angina pectoris, improve the living capacity and accelerate the recovery of heart function in patients after myocardial infarction.     

CLINICAL SIGNIFICANCE OF VITAMIN C TO AMELIORATE LIPID PEROXIDATION DAMAGE IN CORONARY ARTERY DISEASE

ＣＬＩＮＩＣＡＬＳＩＧＮＩＦＩＣＡＮＣＥＯＦＶＩＴＡＭＩＮＣＴＯＡＭＥＬＩＯＲＡＴＥＬＩＰＩＤＰＥＲＯＸＩＤＡＴＩＯＮＤＡＭＡＧＥＩＮＣＯＲＯＮＡＲＹＡＲＴＥＲＹＤＩＳＥＡＳＥＬｕＢａｑｉｎｇ（吕宝经）；ＲｏｎｇＹｅｚｈｉ（荣烨之）；ＺｈｕＸｉａｎｇ...     

静脉硝酸酯对冠状动脉支架术后胸痛和微梗死的影响

目的 :在冠状动脉支架术后静脉滴注硝酸酯 ,观察其对术后胸痛和微梗死的影响。方法 :以行经皮冠状动脉腔内成形术及支架置入术的心绞痛 (稳定型、不稳定型 )患者 5 6例为入选对象 ,术后随机分为硝酸酯组(A组 ,2 8例 )和非硝酸酯组 (B组 ,2 8例 )。比较两组临床一般特征、冠状动脉病变、置入支架数及术后两组胸痛和微梗死的发生率。结果 :两组在临床一般特征方面、冠状动脉病变、置入支架数差异无显著性意义 (P >0 .0 5 ) ,硝酸酯对术后胸痛的发生率无影响 (A组 2 5 .0 % ,B组 2 8.6 % ,P >0 .0 5 ) ,但可显著减少术后微梗死的发生率 (A组 3.6 % ,B组 2 5 .0 % ,P <0 .0 1)。结论 :选择性支架术后静脉滴注硝酸酯可安全、有效地减少因支架术后并发冠状动脉微栓塞、分支闭塞等引起的微梗死 ,而对术后胸痛的发生无明显影响。     

糖尿病患者常见的无症状性心肌缺血

冠心病是糖尿病的主要并发症和死亡原因。据资料显示,糖尿病患者中的冠心病发病率比同年龄、同性别的非糖尿病患者高2倍(男性)至4倍(女性)。约43%～50%的糖尿病患者合并冠心病,且急性心肌梗死时的死亡率比非糖尿病患者高2～3倍。     

冠状动脉球囊成形术、粥样斑块切除术和腔内支承术之即时效果:造影定量比较

冠脉粥样斑块切除术和冠脉腔内支承术(endoluminal stenting)能有效地减轻冠脉狭窄的程度,但这二种方法与惯用的球囊成形术尚未直接进行比较。为了比较这三种手术的即时效果,18例接受冠脉粥样斑块切除术,21例接受冠脉腔内支承术,造影观察残余狭窄的形态并定量评价其程度。两组病人分别与接受冠脉成形术的病人配对比较,配对病人选自电子计算机化大型资料库。配对变量包括:病人的年龄和性别,病变的部位和程度,病变的复杂性。同球囊成形术相比,冠脉粥样斑块切除术和冠脉腔内支承术减轻冠状     

Hoffmann综合征一例报道

甲状腺机能减退症(以下简称甲减)可合并肌病已为众所周知。甲减合并假性肌肥大和强直性肌病者甚少见,临床上可分两类,并发于克汀病者称Kocher-Debré-Semélaigne综合征(KDSS);出现于成人者即Hoffmann综合征(HS),两者均有肌肥大、发硬和无力。我院     

多柔比星对乳鼠心肌细胞增殖周期与蛋白质含量的影响

多柔比星对乳鼠心肌细胞增殖周期与蛋白质含量的影响张亚臣荣烨之吕宝经赵美华黄国芳杨瑾文（上海第二医科大学附属新华医院心内科，上海２０００９２）多柔比星（ｄｏｘｏｒｕｂｉｃｉｎ）对心肌的毒性作用一直是多柔比星临床应用的一大障碍［１－３］，为防治其心肌毒性...