实时三维超声心动图在冠心病中的应用进展

实时三维超声心动图（Real-time three—dimensional echocardiography，RT3DE）是近年来超声心动图领域中新技术。随着计算机速度的进一步提高，心脏三维超声图像重建技术由过去的数十分钟缩短为近乎实时状态，引起了心脏超声工作者和临床医生的兴趣与重视。三维超声心动图是一次质的飞跃，它使超声心动图的诊断能力跨上一个新的台阶。二维超声心动图（2DE）只能提供心脏的断面图像；重建三维超声心动图，可以直观显示心脏的立体结构和功能，作出较准确的定量分析，     

厄贝沙坦氢氯噻嗪片对血压晨峰及左心室质量相关参数的影响

Objective To investigate the influence of combined irbesartan/hydrochlomthiazide on morning blood pressure surge(MBPS)and left ventricular mass(LVM) in essential hypertension.Methods After 4-8 weeks' run-in period,if blood pressure wagn't up to the standard,the 120 patients were given irbesartan/hydrochlorothiazide once daily from 150 mg/12.5 mg for 12 months to 300 mg/25mg for another 12 months.MBPS was conducted by arnbuhry blood pressure monitoring(ABPM)and LVM was determined by echocardiography at the end of placebo baseline and 12 months later.Results (1)After treatment the patients with MBPS(+)decreased and patients with MBPS(-) increased.(2)After treatment the extents of MBPS were reduced in MBPS(+)patients[systolic blood pressure(SBP)difference(16.1±1.8)mm Hg(1mm Hg=0.133 kPa)vs(29.4±2.8)mm Hg,diastolic blood pressure(DBP)difference(10.2±2.3)mm Hg vs(21.2±2.2)mm Hg,P<0.01]with little change in MBPS(-)patients[SBP difference(11.2±2.4)mm Hg vs(10.1±1.2)mm Hg,DBP difference(5.9±1.9)mm Hg vs(6.8±3.2)mm Hg]compared with before treatment.(3)LVM indexes of all patients were significantly reduced.Conclusion Irbesartan/hydrochlorothiazide can effectively attenuate the extent of MBPS, and has advantages on reversing left ventricular hypertrophy.     

厄贝沙坦氢氯噻嗪片对血压晨峰及左心室质量相关参数的影响

目的　对结缔组织病 (CTD)伴间质性肺疾病 (ILD)患者进行治疗研究。方法　 13例CTD伴ILD患者治疗半年后复查。结果　 12例患者血沉 (ESR)下降 ,肺功能、一氧化碳弥散量 (DLCO)、PO2 有明显改善 ,且P <0 .0 5。胸片检查 :1例毛玻璃样改变和 1例斑片网格状阴影基本消失。 1例网格状阴影形成蜂窝状影。HRCT检查 :9例毛玻璃样改变中 ,7例有改善 ,2例形成索条蜂窝样改变 ;2例胸膜下结节和 2例胸膜边缘不规则消失 ;3例小叶间隔增厚消失。其余的网状、索条、蜂窝状和肺大泡基本无改变。 1例SLE患者因合并肺部感染而死亡。结论　对急性ILD早期强的松或强的松加免疫抑制剂治疗 ,对慢性ILD可不予特别治疗。对ILD合并肺部感染者 ,要严格掌握激素用量 ,同时加强综合治疗     

厄贝沙坦氢氯噻嗪片对血压晨峰及左心室质量相关参数的影响

目的观察厄贝沙坦氢氯噻嗪片对中老年原发性高血压患者血压晨峰（MBPS）及左心室质量（LVM）相关参数的影响。方法选择120例轻中度原发性高血压患者,口服厄贝沙坦氢氯噻嗪片150mg／12.5mg,4-8周不达标者剂量加倍,治疗12个月,应用动态血压监测（ABPM）评价治疗前后MBPS的变化,应用超声心动图评价LVM相关参数的变化。结果（1）经厄贝沙坦氢氯噻嗪片治疗后,MBPS（＋）的患者减少,MBPs（-）的患者增多,与治疗前比较差异有统计学意义（P〈0.01）。（2）治疗后MBPS（＋）患者晨峰程度较治疗前明显降低[收缩压（SBP）差值（16.1±1.8）mmHg（1mmHg=0.133kPa）比（29.4±2.8）mmHg,舒张压（DBP）差值（10.2±2.3）mmHg比（21.2±2.2）mmHg,P〈0.01],而MBPS（-）患者晨峰程度较治疗前无明显下降[SBP差值（11.2±2.4）mmHg比（10.1±1.2）mmHg,DBP差值（5.9±1.9）mmHg比（6.8±3.2）mmHg]。（3）MBPs（＋）和MBPS（-）患者治疗后LVM相关参数较治疗前均明显减小,且MBPs（＋）患者治疗后左心室后壁厚度、LVM、LVM指数与MBPS（-）患者治疗后比较差异有统计学意义（P〈0.05）。结论厄贝沙坦氢氯噻嗪片能有效遏制MBPS的发生,降低晨峰程度,并能逆转左心室肥厚。     

心电图预测慢性完全闭塞病变血运重建后心功能的恢复

<正> 1 资料与方法选择2005年1月～2007年6月在济南市第四人民医院和山东省立医院成功行PCI或冠状动脉旁路移植术(CABG)的冠状动脉慢性完全闭塞病变(CTO)患者59例。入选标准:(1)术前冠状动脉造影术证实为左前降支(LAD)或右冠状动脉(RCA)闭塞(排除回旋支闭塞患者);闭塞远端TIMI血流0～1级;(2)闭塞时间超过3个月为慢性闭塞;(3)PCI后残余狭窄<30%,TIMI血流2级判断为PCI成功;(4)术前行三维超声心动图(RT3DE)检查,提示存在闭     

中西医结合治疗病毒性心肌炎疗效观察

目的:观察在西医常规治疗基础上配合五参汤加味治疗病毒性心肌炎的临床疗效。方法:将120例病毒性心肌炎患者随机分为治疗组和对照组各60例,两组均给予西医常规治疗,治疗组另外配以五参汤加味治疗。比较两组的症状、体征及心电图血清心肌酶等方面治疗前后的变化。结果:中西医结合治疗病毒性心肌炎疗效明显。     

厄贝沙坦氢氯噻嗪片对血压晨峰及左心室质量相关参数的影响

Objective To investigate the influence of combined irbesartan/hydrochlomthiazide on morning blood pressure surge(MBPS)and left ventricular mass(LVM) in essential hypertension.Methods After 4-8 weeks' run-in period,if blood pressure wagn't up to the standard,the 120 patients were given irbesartan/hydrochlorothiazide once daily from 150 mg/12.5 mg for 12 months to 300 mg/25mg for another 12 months.MBPS was conducted by arnbuhry blood pressure monitoring(ABPM)and LVM was determined by echocardiography at the end of placebo baseline and 12 months later.Results (1)After treatment the patients with MBPS(+)decreased and patients with MBPS(-) increased.(2)After treatment the extents of MBPS were reduced in MBPS(+)patients[systolic blood pressure(SBP)difference(16.1±1.8)mm Hg(1mm Hg=0.133 kPa)vs(29.4±2.8)mm Hg,diastolic blood pressure(DBP)difference(10.2±2.3)mm Hg vs(21.2±2.2)mm Hg,P<0.01]with little change in MBPS(-)patients[SBP difference(11.2±2.4)mm Hg vs(10.1±1.2)mm Hg,DBP difference(5.9±1.9)mm Hg vs(6.8±3.2)mm Hg]compared with before treatment.(3)LVM indexes of all patients were significantly reduced.Conclusion Irbesartan/hydrochlorothiazide can effectively attenuate the extent of MBPS, and has advantages on reversing left ventricular hypertrophy.     

厄贝沙坦氢氯噻嗪片对血压晨峰及左心室质量相关参数的影响

Objective To investigate the influence of combined irbesartan/hydrochlomthiazide on morning blood pressure surge(MBPS)and left ventricular mass(LVM) in essential hypertension.Methods After 4-8 weeks' run-in period,if blood pressure wagn't up to the standard,the 120 patients were given irbesartan/hydrochlorothiazide once daily from 150 mg/12.5 mg for 12 months to 300 mg/25mg for another 12 months.MBPS was conducted by arnbuhry blood pressure monitoring(ABPM)and LVM was determined by echocardiography at the end of placebo baseline and 12 months later.Results (1)After treatment the patients with MBPS(+)decreased and patients with MBPS(-) increased.(2)After treatment the extents of MBPS were reduced in MBPS(+)patients[systolic blood pressure(SBP)difference(16.1±1.8)mm Hg(1mm Hg=0.133 kPa)vs(29.4±2.8)mm Hg,diastolic blood pressure(DBP)difference(10.2±2.3)mm Hg vs(21.2±2.2)mm Hg,P<0.01]with little change in MBPS(-)patients[SBP difference(11.2±2.4)mm Hg vs(10.1±1.2)mm Hg,DBP difference(5.9±1.9)mm Hg vs(6.8±3.2)mm Hg]compared with before treatment.(3)LVM indexes of all patients were significantly reduced.Conclusion Irbesartan/hydrochlorothiazide can effectively attenuate the extent of MBPS, and has advantages on reversing left ventricular hypertrophy.     

心电图预测冠状动脉慢性完全闭塞病变血运重建后心功能恢复的研究

目的 研究心电图对冠状动脉慢性完全闭塞病变(CTO)患者血运重建术后左室功能恢复的预测作用.方法 选择2005年1月至2007年6月济南市第四人民医院和山东省立医院58例CTO患者用静息12导联心电图来评价Q波及QT离散度等参数,应用实时三维超声心动图(RT-3DE)评价左室局部室壁运动情况.结果 在无病理性Q波(无Q波)的患者中,室壁运动记分指数(WMSI)由1.56±0.31降低至1.12±0.21(P<0.05).而存在病理性Q波(有Q波)的患者WMSI无明显变化(1.73±0.12和1.59±0.23,P>0.05).结论 对于血运重建的CTO患者,通过分析心电图的病理性Q波能可靠地预测局部室壁运动的恢复.