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...     

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   

动态血压参数的短期重复性研究

我们观察了正常血压和高血压者各１０例在相隔４～１２周短期内的动态血压参数重复性，结果表明：各项参数重复检测时无显著性差异；重复检测的参数呈高度显著相关；非同日的血压随时间变动曲线相互之间呈交叉、重叠特征。结果提示，动态血压有良好的短期重复性，可作为评价降压疗效的可靠方法。     

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。     

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...     

Soluble cell adhesion molecules in patients with acute coronary syndrome

Objective To observe the changes in serum soluble intercellular adhesion molecule type-1(ICAM-1), vascular cell adhesion molecule type-1(VCAM-1), E-selectin and von Willebrand factor (vWf) in patients with acute coronary syndrome. Methods Serial venous blood samples were taken from 21 patients with acute myocardial infarction(AMI) before and 4, 8, 12, 24, 48 and 72 h after thrombolytic treatment or direct PTCA. One blood sample was drawn from 16 patients with unstable angina and 16 control subjects. Serum concentrations of ICAM-1, VCAM-1, E-selectin and vWf were determined using a double antibody sandwich enzyme-linked immunosorbent assay. Results Serum levels of ICAM-1, VCAM-1, E-selectin and vWf were higher in patients with acute coronary syndrome than in controls. Patients with AMI and successful reperfusion therapy had a significant reduction in the serum concentration of ICAM-1 and E-selectin at 24 and 48 h, VCAM-1 at 24 and 72 h and vWf at 12,　24,　48 and 72 h, but had peak in serum levels of ICAM-1 and E-selectin at 4 h. The number of diseased coronary arteries was not related to the levels of ICAM-1,　VCAM-1 and E-selectin. Conclusion The serum concentration of soluble cell adhesion molecules was elevated significantly in patients with acute coronary syndrome. Successful reperfusion therapy was associated with a reduction in the serum concentrations of soluble cell adhesion molecules in patients with AMI.     

挽救缺血心肌的最新治疗方法

冠状动脉急性或慢性阻塞引起的心肌严重缺血或不可逆性坏死,在临床上常表现为不稳定型心绞痛或急性心肌梗塞。为挽救缺血心肌,缓解心绞痛和缩小心肌梗塞面积,人们不断探索新的治疗措施。近几年来,对心肌缺血提出了几种新的治疗方法,本文复习近年有关文献,作一综述。经皮冠状动脉扩张术(percutaneous trans-luminal coronary angioplasty,PTCA)这是用非手术方法扩张狭窄的冠状动脉而改善心肌供血的新措施。1964年 Dotter 及Judkins 最早提出经皮插入导管以扩张因动脉硬化而致管腔阻塞的外周动脉,使血管再通,故称血管扩张术(transluminal angioplasty)。后因出血及血栓形成等并发症,临床应用受限。1976年 Gruntzig 对上述技术加以改进,制成双腔微型气囊导管,1977年首次为1例严重冠状动脉狭窄伴顽固性心绞痛的病人作了 PTCA,     

二维超声检测冠心病患者颈动脉粥样硬化病变

对103例经选择性冠状动脉造影的患者作双侧颈动脉超声检查，探讨了颈动脉超声检查的方法学以及颈动脉粥样硬化斑块的好发部位和超声分型，发现颈动脉粥样硬化斑块好发于颈动脉分叉处，以左侧多见，且多为扁平斑；颈动脉粥样硬化与冠状动脉粥样硬化之间有着密切的相关关系，冠状动脉病变支数越多，其颈动脉粥样硬化斑块积分也越高，不同冠状动脉病变组之间有非常显著的差异（P＜0．001）。