急性下壁心肌梗塞胸前导联ST段压低临床意义的探讨

急性下壁心肌梗塞时伴有或不伴有胸前导联(V_1～V_4)ST段压低,其发生机理及临床意义仍有争论。本文总结了我院从1980年以来患急性下壁心肌梗塞住院的病人66例,现将结果报告如下。     

急性非特异性心包炎

急性非特异性心包炎是临床上最常见的心包疾患。在病理学上,是一种浆液纤维蛋白性心包炎。1854年Hodges首先对本病作了描述。1951年Christian提出本病可能由病毒引起。某些患者仅表现轻度的临床症状,可被漏诊。但是,有些可出现严重并发症;而且可与其他临床疾病混淆,因此,提高对本病的认识具有一定的重要意义。急性非特异性心包炎多见于青壮年,但儿童和老年人也有发生。男性多见于女性。多数发病于春秋两季。     

首乌治疗早期肾脏损害血瘀型高血压患者28例

首乌治疗早期肾脏损害血瘀型高血压患者２８例上海市高血压研究所（上海２０００２５）唐树德，王宪衍，王崇行，钱珠，刘小苹，龚兰生上海第二医科大学科技中心实验室刘国明，张桂生高血压引起心、脑、肾靶器官损害，但临床上主要见于脑、肾损害，肾脏损害是表现为慢性肾...     

ROLE OF RESTING SYSTOLIC LOADING CONDITIONS IN DETERMINING LEFT VENTRICULAR FUNCTIONAL RESERVE IN CHRONIC AORTIC REGURGITATION''::

The relationship between systolic loading condi tioiis at rest and left ventricular (LV) functional response to exercise was assessed in 31 patients with aortic regurgitation (AR) and 10 controls. The peak and end systolic wall stress determined from echocar. diography and cuff systolic pressure at rest were used as indirect measures of LV systolic loading, and compared with LV ejection fraction response to handgrip and bicycle exercise by radionuclide ven triculography. Both peak and end systolic wall stress were significantly higher in asymptomatic (164+33 and 90+2sxl03 dynes/cm2) and symptomatic (196+33 and 134+17x103 dynes,/cm2) patients with AR than in the controls (125+22 and 61+14x103 dynes/cm2, p<0.01), and correlated in versely with the changes in LV ejection fraction dur. ing handgrip (r--0.63 and r= -0.73) and bicycle (r=.0.68 and r=.0.87) exercise. In patients with AR, resting systolic loading conditions appear to reflect LV functional reserve during exercise.     

31例急性心肌梗塞后经食道心房调搏结果分析

31例急性心肌梗塞后平均30天进行经食道心房调搏,其中14例作放射核素心室造影。结果:15/31患者(48%)调搏阳性(阳性标准①ST段呈水平型或下垂型压低≥0.1 mv,或ST段抬高≥0.1 mv;④心绞痛;③血压反应不足,上升<10mmHg或收缩压下降≥20mmHg;④室早>5次/分),当调搏时血压反应不足或2项阳性提示预后差,阳性组LVEF比阴性组低,P<0.05,平均随访25个月阳性组3例死亡,阴性组均存活。所有病人能耐受调搏,无并发症。     

高血压治疗进展

高血压治疗进展龚兰生，高平进随着高血压发病机制的深入研究，调控血压的机制及影响血压的各种因素已逐渐明朗化。针对这些环节积极采取措施，可以有效地控制血压，逆转靶器官损害，并为高血压防治提供广阔前景。一、关于高血压分类、分期的现代观点近年来由于治疗观念变...     

冠心病患者纤溶系统及5-羟色胺含量变化的观察

对39例冠心病患者的纤溶酶原及纤溶酶进行测定,并对其中的21例进行血浆中及血小板内5-HT含量测定,发现纤溶酶原明显升高(P<0.01);血浆中5-HT含量明显升高(P<0.001),血小板内5-HT含量明显降低(P<0.02),尤以急性心肌梗塞及不稳定型心绞痛组为明显。     

INFARCT ARTERY RECANALIZATION AND COLLATERAL CIRCULATION IN PATIENTS WITH MYOCARDIAL INFARCTION

To dctermiuc the effects of infarct artcry rcca nalization and collateral circulation on myocardial in farct size and left ventricular (LV) function, 44 pa- ticnts with first transmural myocardial infarction underwent left ventriculography and coronary arte riography. The QRS score was used to measure the Jnfarct size. Patients with patent infarct artery (Group l, 18 cases) and those with totally' obstructcd infarct artery with collateral vessdls (Group 11, 13 cases) had lower QRS score and less severe abnormal LV wall motion and higher LV cjection fraction than patients with totally occluded infarct artery without collateral vessels (Group 111, 13 cases). The study indicates that the residual blood flow by way of either infarct artery recanalization or coronary col latcrals may play an important role in the reduction of myocardial infarct size and prcscrvation of LV function in paticnts with myocardial infarction.     

LEFT VENTRICULAR DIASTOLIC FILLING CHARACTERIS. TICS AND NIFEDIPINE EFFECTS ON CHRONIC AORTIC REGURGITATION

To assess left ventricular (LV) diastolic fillingcharacteristics and nifedipine effects, 22 patients withchronic aortic regurgitation (AR) and 10 control sub-jects underwent radionuclide ventriculography. LVpeak filling rate (PFR) was lower in patients withAR than in normal subjects (1.83+0.51 vs 2.95+0.22end-diastolic volume/sec, p<0.01). After administration of nifedipine, PFR increased significantly in ARpatients (P相似文献