蝮蛇抗栓酶伍用刺五加冠心病心率变异性的影响

目的 探讨蝮蛇抗栓酶伍用刺五加对冠心病心率异性的影响。方法 观察蝮蛇抗栓酶伍用刺五加对冠心病为异性的影响，并与对照组对比。结果 治疗组ＳＤＮＮ、ＨＦ、ＬＦ／ＨＦ改变较对照组有显著差异性（Ｐ〈０．０１）。结论 该方法能显著提高冠心病患者的心率变异性，对冠心病源性猝死的预防有着重要意义。     

蝮蛇抗栓酶伍用低强度He—Ne激光血管内照射治疗脑梗死50例

目的探讨蝮蛇抗栓酶伍用低强度Ｈｅ－Ｎｅ激光血管内照射治疗脑梗死。方法用蝮蛇抗栓酶静滴伍用低强度Ｈｅ－Ｎｅ激光血管内照射（ＩＬＩＢ）治疗一疗程。结果治疗后临床效果明显（总有效率９４．００％）,血流变学值和脑动脉平均血流速度（Ｖｍ）均有显著或非常显著性差异（Ｐ＜０．０５或Ｐ＜０．０１）。结论该方法治疗脑梗死效果满意。     

蝮蛇抗栓酶治疗冠心病86例疗效分析

蝮蛇抗栓酶治疗冠心病８６例疗效分析解放军３５０３厂医院（２１０００３）郑集树,马根埏我院自１９９０年１２月至１９９３年１１月收治冠心病８６例,病程１——１５年,多种方法检查确诊。治疗组加用蝮蛇抗栓酶治疗。以血流变、血糖、血脂、心功能、心律失常等项目观...     

蝮蛇抗栓酶及阿斯匹林防治缺血性中风发作630例疗效观察（摘要）

蝮蛇抗栓酶及阿斯匹林防治缺血性中风发作６３０例疗效观察（摘要）中国蛇协８１１０１部队医院血栓病防治中心付征友,王宇敏,何艳本文报告用蝮蛇抗栓酶（清栓酶）伍用阿斯匹林防治缺血性中风发作６３０例,其中男性Ａ１８例,女性２１２例,年龄３６～７２岁,合并脑动...     

蝮蛇抗栓酶伍用中药治疗顽固性痛经26例疗效观察

蝮蛇抗栓酶伍用中药治疗顽固性痛经２６例疗效观察黑龙江省五常市血栓病专科医院金松山黑龙江省五常市血栓病专科医院妇产科杜熙月,张玉华我院妇产科一九八七年开始应用蝮蛇抗栓酶治疗２６例顽固性痛经患者,得到了满意的效果如下：临床资料２６例均为中青年女性,年龄１...     

两种蝮蛇抗栓酶与传统方法治疗缺血性脑卒中146例的疗效分析

采用东北白眉蝮蛇抗栓酶、江浙蝮蛇抗栓酶、丹参加低右治疗缺血性脑卒中,以一般对症处理治疗作为对照组结果显示东北白屑蝮蛇抗栓酶治疗缺血性脑卒中与对照组比较 P 值有显著性差异,而其他两组与对照组比较 P 值无显著性差异.     

蝮蛇抗栓酶伍用丹参川芎注射液治疗血栓96例疗效分析（摘要）

蝮蛇抗栓酶伍用丹参川芎注射液治疗血栓９６例疗效分析（摘要）十堰市第二人民医院罗会常,梁佑平本文报告：用蝮蛇抗栓酶０．５单位加入１０％葡萄糖静液脉滴注与丹参川芎注射液（每毫升含生药丹参１ｇ川芎０．１ｇ）１４──２０ｍｌ加入１０％葡萄糖液静脉滴注１４──...     

蝮蛇抗栓酶在儿科神经系统疾病中的应用

蝮蛇抗栓酶在儿科神经系统疾病中的应用解放军总医院小儿内科神经组钟炎皋,藤燕,王考庆蝮蛇抗栓酶在临床已得到广泛的应用。在治疗脑血栓、脑梗塞、冠心病等方面取得了较好的疗效。用于治疗小儿神经系统疾病文献报道甚少。我科自１９８８年以来,应用蝮蛇抗栓酶治疗个儿...     

紫外线照射和充氧自血回输加白眉蝮蛇抗栓酶治疗脑梗塞的临床实验研究

我们应用紫外线照射和充氧自血回输(简称自血回输)加白眉蝮蛇抗栓酶治疗急性脑梗塞,与单纯用自血回输及单纯用白眉蝮蛇抗栓酶治疗急性脑梗塞进行了临床实验研究.其结果自血回输加白眉蝮蛇抗栓酶疗法优于单纯自血回输疗法,更优于单纯白眉蝮蛇抗栓酶疗法.临床证明两者合用有协同作用,而且方法安全、简单、方便.     

蝮蛇抗栓酶对不稳定性心绞痛患者血中部分凝血及纤溶指标的影响

测定３８例不稳定性心绞痛（ＵＡＰ）患者血中纤维蛋白原（Ｆｇ）含量、组织型纤溶酶原激活物（ｔ－ＰＡ）活性、血管性假血友病因子（ｖＷＦ）活性和血小板聚集率水平（ＰＡｇＴ）并与２１名正常人对比。患者中１８例用蝮蛇抗栓酶治疗,２０例行常规治疗。结果显示：ＵＡＰ患者血中ＰＡＩ－１、ｖＷＦ以及ＰＡｇＴ水平明显增高,ｔ－ＰＡ水平明显降低;蝮蛇抗栓酶组治疗后血中Ｆｇ、ＰＡＩ－１、ＰＡｇＴ水平均明显下降,使ｔ－ＰＡ水平明显升高;常规治疗组治疗前后各项指标无明显变化。认为蝮蛇抗栓酶对ＵＡＰ有可靠疗效     

冠心病患者静息心率与血小板活性相关研究

目的:探讨冠心病患者静息心率与血小板活性的相关研究。方法:选择2013年1月至2014年9月于我院住院患者474例,按静息心率快慢分为三组,心率70 bmp为第一组(Q1)150例,心率位于70~85 bmp为第二组(Q2)265例,心率85 bmp为第三组(Q3)59例,三组患者均于病情稳定时行血栓弹力图(TEG)中MA值检测,同时随访3个月,观察和比较三组患者MA值变化及预后。结果:三组患者MA值分别为61.16±7.29 mm、62.02±7.46 mm、65.32±6.56 mm,第三组患者MA值与第一组或第二组患者MA值比较差异均存在统计学意义(P0.05),通过血栓弹力图检测三组经花生四烯酸(AA)途径的血小板抑制率和经二磷酸腺苷(ADP)途径的血小板抑制率发现,静息心率高低与抗血小板药物作用疗效无相关关系(P0.05)。随访3个月,三组患者心绞痛、再住院、脑血管病及死亡的总发生率分别为28%、28.68%、40.67%。结论:冠心病患者静息心率越快,MA值越大即血小板活性越高,静息心率的高低与抗血小板药物作用疗效无关。     

静息心率与慢性心力衰竭患者血清NT-proBNP的相关性分析

目的:探讨入院时静息心率与慢性心力衰竭患者血清N末端B型钠尿肽原(NT-pro BNP)相关性。方法:选取我院收治的242例慢性心力衰竭患者为研究对象,按静息心率将患者分为Ⅰ组(心率70次/min),Ⅱ组(心率:70%~90次/min),Ⅲ组(心率90次/min);测量患者入院时血清NT-pro BNP水平,按照其中位数分为两组:NT-pro BNP2087.63 pg/m L组和NT-pro BNP≥2087.63 pg/m L,比较各组相关指标的差异。用多元线性回归分析静息心率与血清NT-pro BNP的关系。结果:三组在收缩压、心功能分级、左室射血分数(LVEF)、左室舒张末内径(LVEDD)、空腹血糖(FPG)比较具有统计学差异(P0.05),与Ⅰ组及Ⅱ组比较,Ⅲ组患者收缩压、LVEDD、FPG,NYHA心功能分级Ⅲ~Ⅳ比例较高、LVEF偏低;三组在血清NT-pro BNP比较亦存在显著的统计学差异(P0.05),Ⅲ组高于Ⅰ组及Ⅱ组、Ⅱ组高于Ⅰ组;与NT-pro BNP2087.63 pg/m L组比较,NT-pro BNP≥2087.63 pg/m L组静息心率偏快,且患者中90(次/min)的比例较高(P0.05)。静息心率与与NT-pro BNP呈正相关(r=0.281,P=0.035);静息心率是影响NT-pro BNP水平的独立危险因素。结论:静息心率水平与慢性心力衰竭患者血清NT-pro BNP水平密切相关。     

卡维地洛联合厄贝沙坦治疗慢性心功能不全的疗效及对IL-6的影响

目的:探讨卡维地洛联合厄贝沙坦治疗慢性心功能不全的疗效及对血浆IL-6的影响。方法:选择64例慢性心功能不全患者采用平行对照法随机分为治疗组和对照组各32例,对照组给予血管扩张剂、利尿剂和强心剂等基础用药进行常规治疗,观察组在对照组的基础上加用卡维地洛联合厄贝沙坦进行治疗,疗程均为4周,观察两组患者的临床疗效、心功能分级和血浆IL-6水平变化情况。结果:4周疗程后,观察组总有效率为84.38%显著高于对照组的59.38%,差异有统计学意义(P0.05);心功能分级变化情况显示,治疗后两组患者心功能分级状况都有所变化,症状得到改善。与对照组相比观察组I级患者数量明显增加,III级数量减少,差异有统计学意义(P0.05);治疗后两组患者IL-6水平均下降,且左室射血分数(LVEF)值升高,与对照组相比观察组患者指标水平变化明显,差异有统计学意义(P0.05)。结论:在常规用药基础上加用卡维地洛和厄贝沙坦,可改善慢性心功能不全症状,降低IL-6水平,临床疗效显著。     

先天性心脏病相关综合征的遗传学研究

先天性心脏病(congenitalheartdisease,CHD)是儿科常见的疾病,现已发现约有300多种临床综合征伴有CHD.对Alagille综合征、CHARGE联合征、Holt-Oram综合征、Noonan综合征、Turner综合征、VACTERL联合征、Williams综合征、22q11缺失综合征和13、18、21三体综合征与CHD相关流行病学、临床表型、遗传病因和诊断及其再发风险进行了综述,为产前和产后临床诊断,了解疾病预后和再发概率提供资料.     

Implantation of Total Artificial Heart in Congenital Heart Disease

In patients with end-stage heart failure (HF), a total artificial heart (TAH) may be implanted as a bridge to cardiac transplant. However, in congenital heart disease (CHD), the malformed heart presents a challenge to TAH implantation. In the case presented here, a 17 year-old patient with congenital transposition of the great arteries (CCTGA) experienced progressively worsening HF due to his congenital condition. He was hospitalized multiple times and received an implantable cardioverter defibrillator (ICD). However, his condition soon deteriorated to end-stage HF with multisystem organ failure. Due to the patient''s grave clinical condition and the presence of complex cardiac lesions, the decision was made to proceed with a TAH. The abnormal arrangement of the patient''s ventricles and great arteries required modifications to the TAH during implantation.With the TAH in place, the patient was able to return home and regain strength and physical well-being while awaiting a donor heart. He was successfully bridged to heart transplantation 5 months after receiving the device. This report highlights the TAH is feasible even in patients with structurally abnormal hearts, with technical modification.     

Transfer of Heart Rate Feedback Training to Reduce Heart Rate Response to Laboratory Tasks

To examine whether transfer of heart rate (HR) feedback training to tasks not used during training could be improved by using multiple tasks during training, a modified multiple baseline across tasks, single subject design study was conducted using six high HR-reactive young adults. Participants received HR feedback training during the presentation of a videogame, and transfer of training was assessed to a mental arithmetic challenge and handgrip task. Transfer of training was next assessed following training with the mental arithmetic challenge and handgrip task. HR responses to each training task with no HR feedback were assessed during a pre-treatment session, an immediate post-training period following training on each task, a short delay (1–2 days) post-training session, and a long delay (1–2 weeks) post-training session. HR response to a novel speech task was assessed at pre-treatment and during short delay and long delay post-training sessions. Results revealed that participants reduced HR during training and generally maintained this reduction in HR during the immediate post-training assessment when HR feedback was not present. Participants were not able to reduce HR responses to tasks during short delay and long delay post-training sessions, and they were unable to transfer HR reduction skills to the speech task. Transfer of HR feedback training to new tasks was limited in nature and efforts to train across multiple stressors did not appear to improve transfer of training.     

射血分数保留的老年心力衰竭患者的临床特征

目的:分析和比较射血分数保留的心力衰竭(HFp EF)、射血分数中间值(HFmr EF)及射血分数降低的老年心力衰竭(HFr EF)患者临床特征的差异。方法:选取2017年9月至2018年8月哈尔滨市第一医院收治的老年慢性心力衰竭患者共287例,根据心动超声所测左室舒张末期内径(LVEF)值将其分为3组:HFpEF组175例、HFmr EF组50例和HFr EF组62例。比较各组患者一般情况、心动超声检查结果、血清学指标的差异。结果:(1)与HFr EF组患者比较,HFpEF组患者年龄、性别、吸烟史、体重指数(BMI)、原发冠心病、高血压、2型糖尿病患者比例、房颤发生率及心功能分级构成比均具有统计学差异(P0.05);(2)与HFr EF组相比较,HFpEF组患者的E/A比值,左房内径、肺动脉内径、LVEDD较小,而室间隔厚度较厚(P0.05);(3)与HFr EF组患者相比,HFpEF组血清总胆固醇、甘油三酯较高;血肌酐、血尿素氮、血尿酸、超敏C反应蛋白、N-末端脑钠肽前体水平较低,具有统计学差异(P0.05)。结论:老年HFpEF心力衰竭患者以女性居多,体重指数较大,以向心性肥胖为主,血压水平较高,心功能II级者比例高,有明显的舒张功能不全,易发生房性心律失常,房颤发生率高,主要病因为高血压。     

肾脏去神经化在心力衰竭治疗中的研究进展

生理情况下,心脏和肾脏在血流动力学和神经激素等调节中相互作用,对于循环系统的稳态维持起重要作用。但在充血性心力衰竭的病理情况下,心脏和肾脏之间存在明显的调节紊乱。首先,急性失代偿性心力衰竭的患者住院治疗的研究结果证明其有一定程度的肾脏失调。其次,慢性充血性心力衰竭时肾脏交感神经系统也起到重要作用:肾脏交感纤维活性增强可导致肾素的释放、钠水潴留、肾血流的降低、血管阻力增加、左心室重塑、左心功能失调等。众所周知,肾脏交感神经切除术可以减低血压和改善心脏功能,但是由于有创的手术方式限制了其应用。过去两年间,随着新的导管消融肾脏去神经化技术的日益完善,其有望成为治疗高血压病和心力衰竭的手段。在此,本文综述了心力衰竭时肾脏交感传入神经和传出神经的发病机理,对目前进行的经导管肾脏去神经化治疗慢性心力衰竭的基础及临床试验进行安全性及有效性评价。提示我们经导管肾脏去神经化有望成为心力衰竭治疗的新靶点。     

Changes in Hemodynamic Response to Mental Stress with Heart Rate Feedback Training

This study was designed to examine underlying hemodynamic changes that accompany observed reductions in heart rate (HR) response to mental stress following HR feedback training. Twenty-five college males, assigned to either a HR feedback training group (FB+) or a control group (FB–), were presented with a videogame and mental arithmetic challenge, as HR, blood pressure, and impedance cardiography-derived measures of hemodynamic functioning were recorded. During training, the FB+ group received HR feedback and the FB– group was not provided with HR feedback while playing a videogame. At posttraining, results revealed that the FB+ group exhibited significantly lower HR, systolic blood pressure, stroke volume, and total peripheral resistance responses to the videogame compared to that at pretraining. There was no evidence that the acquired skills generalized to a mental arithmetic task. These results suggest that HR feedback training is an effective method for reducing cardiovascular and hemodynamic responses to a mental stressor; however, the generalizability of this effect remains questionable.     

Heart glycogen content and isoprenaline-induced myocardial lesions

The role of glycogen content in the heart for the development of isoprenaline-induced myocardial lesions (IML) was studied in Wistar rats and in two inbred rat strains: In IR rats (resistant to the development of IML) and in IS rats (sensitive to IML development).Glycogen content in the heart can be dramatically lowered or increased by various interventions. IML develop during the period of very low heart glycogen content (about 0.6 mg.g^–1) induced by isoprenaline administration. In animals with increased resistance to IML, either due to genetic factors or induced by isoprenaline pretreatment a high glycogen content in the heart is found (up to 7.5 mg.g^–1).The increase of resistance to IML development and increased glycogen content induced by isoprenaline pretreatment were accompanied by lower basal or ISO-, guanylylimidodiphosphate- (Gpp/NH/p) and forskolin-stimulated activities of adenylyl cyclase. On the other hand, these parameters did not differ between IR and IS rats in spite of the presence of significant differences in the resistance to the development of IML and in heart glycogen content in these two rats strains.These results suggest that genetically determined differences between two inbred rat strains in the resistance of the heart to the development of IML and in the heart glycogen content are caused by factors which are independent of the receptor-adenylyl cyclase complex and are therefore different from those involved in the increase of resistance and glycogen content due to isoprenaline pretreatment.