肝素、酚妥拉明、多巴胺治疗慢性肺心病、顽固性心衰26例临床观察

目的:使用肝素、酚妥拉明、多巴胺治疗慢性肺心病、顽固性心衰的临床效果.方法:对比患者使用肝素、酚妥拉明、多巴胺前后的一般状况及临床症状的变化.结果:26例中:4～9d症状减轻好转4例,症状体征均无好转2例.有效率92.1%.结论:肝素、酚妥拉明、多巴胺对治疗慢性肺心病、顽固性心衰临床效果较好.     

肝素、酚妥拉明、多巴胺治疗慢性肺心病、顽固性心衰26例临床观察

目的:使用肝素、酚妥拉明、多巴胺治疗慢性肺心病、顽固性心衰的临床效果.方法:对比患者使用肝素、酚妥拉明、多巴胺前后的一般状况及临床症状的变化.结果:26例中:4～9d症状减轻好转4例,症状体征均无好转2例.有效率92.1%.结论:肝素、酚妥拉明、多巴胺对治疗慢性肺心病、顽固性心衰临床效果较好.     

硝酸甘油治疗慢性肺心病心衰两例分析

目的通过典型慢性肺心病心衰治疗时加用硝酸甘油,探索硝酸甘油作为血管扩张剂治疗慢性肺心病心衰的疗效。方法在抗感染、氧疗、纠正酸碱平衡及电解质紊乱、纠正心率失常、利尿的基础治疗上加用硝酸甘油微泵推注。结果 2例慢性肺心病心衰患者在常规综合治疗基础上加用硝酸甘油,咳嗽、呼吸困难、胸闷、心慌症状得以缓解,紫绀、水肿消退,肺部啰音减轻或消失,心功能也得以改善。结论硝酸甘油能有效控制心衰,改善症状。     

硝酸甘油和多巴胺治疗全心衰竭61例疗效分析

1995年至1997年间,我们共收治慢性阻塞性肺气肿一肺心病合并左右两侧心功能衰竭患者61例,其中用例在常规治疗的基础上加用硝酸甘油和多巴肢静脉用药方法,为治疗组,30例病人采用常规治疗,为对照组．结果,对照组的死亡率、无效率均高于治疗组．经统计学处理,两组痊愈率存在显著差异（P＜0．05）,治疗组治疗效果优于对照组．1临床资料1．1一般资料对照组30例：男性18例,女性12例;年龄51～60岁7例,61～70岁16例,71岁以上7例．治疗组31例：男性17例,女性14例;45岁1例,51～60岁6例,61～70岁18例,71岁以上6例．两组性别、年龄无…     

硝普钠联合多巴胺治疗心力衰竭108例临床观察

本临床观察的目的：探讨硝普钠联合多巴胺治疗心力衰竭的临床疗效。方法：心力衰竭患者108例,心功能为（NYHA）Ⅱ—Ⅳ级,在常规治疗的基础上随机分为治疗组和对照组。结果：治疗组54例,显效34例,有效16例,无效4例,总有效率92.6%;对照组54例,显效16例,有效18例,无效20例,总有效率63.0%。两组疗效差异有统计学意义（P〈0.01）。结论：硝普钠与多巴胺联合治疗心力衰竭有明显疗效。     

心衰康煎液对实验心衰大鼠左心室内压的影响

目的 :观察中药复方心衰康煎液抗心衰的作用。方法 :取 4 0只成年Wistar大鼠 ,利用腹腔注射盐酸阿霉素的方法 ,连续 6周 ,复制心衰大鼠模型 ,再用心衰康煎液连续治疗 2 8d。利用北京微信达设计制造的Pclab实验记录分析系统观察和分析各组大鼠左心室内压、心电图 ,并观察心肌细胞的病理变化。结果 :心衰康煎液大、小剂量组和模型对照组比较左心室收缩内压显著性升高 (P <0 .0 1) ,病理学观察可见大、小剂量组心肌细胞的变性坏死均有明显减轻。结论 :心衰康煎液可减轻阿霉素对心肌的毒性作用 ,可明显改善心衰大鼠的心功能 ,表明该方有良好的抗心衰作用。     

依沙佐米治疗难治性/复发性多发性骨髓瘤临床试验效果的Meta分析

目的:评价依沙佐米治疗难治性/复发性多发性骨髓瘤(RRMM)的疗效及安全性。方法:计算机检索依沙佐米治疗RRMM的临床试验,手工检索纳入查询到的所有文献,提取数据后,使用R软件3.5.0进行Meta分析。结果:共纳入8篇文献,包括1096例RRMM患者,含依沙佐米三联方案的疗效优于单联方案或双联方案,以依沙佐米联合来那度胺和地塞米松(IRD)方案疗效最佳;IRD方案腹泻,恶心,皮疹,血小板减少,呕吐,腹泻≥3级,低血压≥3级,恶心≥3级高于来那度胺和地塞米松(RD)方案,而失眠,贫血≥3级低于RD方案,差异有统计学意义(P<0.05)。结论:含依沙佐米三联方案治疗RRMM的疗效较依沙佐米单联方案或二联方案显著。IRD方案疗效最佳,其不良反应较RD方案增多。     

无创正压通气治疗急性左心衰的临床研究

目的：观察机械通气治疗急性左心衰的疗效。方法：60例急性左心衰患者,随机分为常规治疗组和无创通气组,无创通气组在常规治疗基础上加用机械通气治疗,观察通气前后心率（HR）、呼吸频率（RR）,平均动脉压（MAP）及血气分析（pH、PaO2、SaO2、PaCO2）的变化及临床症状的改善情况。结果：机械通气治疗后,患者呼吸困难明显改善,生命体征很快稳定,血气分析指标明显好转。结论：对各种不同原因引起的急性左心衰,机械通气能及时有效的改善患者的临床症状及低氧血症,是抢救急性左心衰的有效措施。     

从谜米角度分析字母词的流行

通过运用谜米的相关理论,对字母词诞生的方法、成为谜米的原因、传播的途径以及成为谜米的心理因素等方面进行了分析,使人们理解和掌握并熟练地使用字母词。     

分析冠脉造影心肌桥患者的治疗方法及治疗效果

目的:研究分析冠脉造影心肌桥患者的治疗方法与治疗效果.方法:回顾性分析我院2011年6月-2013年4月期间通过冠脉造影检测出的82例心肌桥患者的临床资料、治疗方法与治疗效果.结果:82例心肌桥患者中有2例肌桥处于回旋支,其余80例都位于左前降支.有7例心肌桥近端出现冠状动脉狭窄,有5例心肌桥所处部位合并冠状动脉狭窄,有3例心肌桥远端存在冠状动脉狭窄.治疗心肌桥主要以药物治疗为主,有30例患者口服"合贝爽(盐酸地尔硫卓缓释胶囊)90mg每天一次",同时接受β受体阻滞剂与钙离子拮抗剂两种药物辅助治疗,结果显效7例,有效20例,无效3例,治疗总有效率高达90.0%.结论:心肌桥可能会引发心肌缺血、心绞痛等,冠脉造影是目前诊断心肌桥的金标准,治疗方法为多采用β受体阻滞剂与钙离子拮抗剂治疗,效果较好;如有必要可以采用冠状动脉支架安置术、外科手术治疗.     

Cell therapy in congestive heart failure

Congestive heart failure （CHF） has emerged as a major worldwide epidemic and its main causes seem to be the aging of the population and the survival of patients with post-myocardial infarction. Cardiomyocyte dropout （necrosis and apoptosis） plays a critical role in the progress of CHF; thus treatment of CHF by exogenous cell implantation will be a promising medical approach. In the acute phase of cardiac damage cardiac stem cells （CSCs） within the heart divide symmetrically and/or asymmetrically in response to the change of heart homeostasis, and at the same time homing of bone marrow stem cells （BMCs） to injured area is thought to occur, which not only reconstitutes CSC population to normal levels but also repairs the heart by differentiation into cardiac tissue. So far, basic studies by using potential sources such as BMCs and CSCs to treat animat CHF have shown improved ventricular remodelling and heart function. Recently, however, a few of randomized, double-blind, placebo-controlled clinical trials demonstrated mixed results in heart failure with BMC therapy during acute myocardial infarction.     

Review:Cell therapy in congestive heart failure

Congestive heart failure (CHF) has emerged as a major worldwide epidemic and its main causes seem to be the aging of the population and the survival of patients with post-myocardial infarction. Cardiomyocyte dropout (necrosis and apoptosis) plays a critical role in the progress of CHF; thus treatment of CHF by exogenous cell implantation will be a promising medical approach. In the acute phase of cardiac damage cardiac stem cells (CSCs) within the heart divide symmetrically and/or asym-metrically in response to the change of heart homeostasis, and at the same time homing of bone marrow stem cells (BMCs) to injured area is thought to occur, which not only reconstitutes CSC population to normal levels but also repairs the heart by dif-ferentiation into cardiac tissue. So far, basic studies by using potential sources such as BMCs and CSCs to treat animal CHF have shown improved ventricular remodelling and heart function. Recently, however, a few of randomized, double-blind, pla-cebo-controlled clinical trials demonstrated mixed results in heart failure with BMC therapy during acute myocardial infarction.     

Metabolic remodeling in chronic heart failure

Although the management of chronic heart failure (CHF) has made enormous progress over the past decades, CHF is still a tremendous medical and societal burden. Metabolic remodeling might play a crucial role in the pathophysiology of CHF. The characteristics and mechanisms of metabolic remodeling remained unclear, and the main hypothesis might include the changes in the availability of metabolic substrate and the decline of metabolic capability. In the early phases of the disease, metabolism shifts toward carbohydrate utilization from fatty acids (FAs) oxidation. Along with the progress of the disease, the increasing level of the hyperadrenergic state and insulin resistance cause the changes that shift back to a greater FA uptake and oxidation. In addition, a growing body of experimental and clinical evidence suggests that the improvement in the metabolic capability is likely to be more significant than the selection of the substrate.     

Brain natriuretic peptide and optimal management of heart failure

BRAIN NATRIURETIC PEPTIDE Several studies demonstrated that the heart is an endocrine organ (Henry and Pearce, 1956; Kisch, 1956; de Bold, 1985; de Bold et al., 1981; 1996; 2001). Atrial natriuretic peptide (ANP) was the first cardiac hormone identified in 1984 (Kangawa et al., 1984; de Bold et al., 1981). Later on, a new com- pound from pig brain was found, which had similar natriuretic and diuretic effects as ANP (Sudoh et al., 1988). This peptide was named brain (B-type) natr…     

Brain natriuretic peptide and optimal management of heart failure

Aside from the important role of brain natriuretic peptide (BNP) in diagnosis, and differential diagnosis of heart failure, this biological peptide has proved to be an independent surrogate marker of rehospitalization and death of the fatal disease. Several randomized clinical trials demonstrated that drugs such as beta blocker, angiotensin converting enzyme inhibitor, spironolactone and amiodarone have beneficial effects in decreasing circulating BNP level during the management of chronic heart failure. The optimization of clinical decision-making appeals for a representative surrogate marker for heart failure prognosis. The serial point-of-care assessments of BNP concentration provide a therapeutic goal of clinical multi-therapy and an objective guidance for optimal treatment of heart failure. Nevertheless new questions and problems in this area remain to be clarified. On the basis of current research advances, this article gives an overview of BNP peptide and its property and role in the management of heart failure.     

充血性心力衰竭与甲状腺激素的关系

目的 :研究充血性心力衰竭与甲状腺激素的关系。方法 :对 4 0例充血性心力衰竭患者及 16例正常患者分别测定三碘甲状腺原氨酸 ,四碘甲状腺原氨酸 ,反三碘甲状腺原氨酸以及促甲状腺激素水平。结果 :充血性心力衰竭程度越重 ,三碘甲状腺原氨酸水平下降越明显 ,反三碘甲状腺原氨酸水平升高越明显 ,促甲状腺激素水平正常 ,四碘甲状腺原氨酸变化不明显。结论 :三碘甲状腺原氨酸 ,反三碘甲状腺原氨酸对充血性心力衰竭的早期诊断有重要意义。     

从理论到实践探讨肺源性心脏病心力衰竭治疗的教学方法

慢性肺源性心脏病是临床上常见的多发病,因常并发慢性右心衰竭而倍受重视。这种心力衰竭和心脏病变(如冠心病)引起的慢性心力衰竭在病因和发病机制不尽相同的,治疗方法也不同。但是,对本病的病因、发病机制和治疗原则。目前中等职业医学生大多数未能很好地地理解。具体表现之一是,认为可以常规性地应用强心利尿剂治疗本症。为解决这个教学难点,我们需要从理论和实践两个方面进行分析。找出问题的症结,寻找到最佳教学方案。     

Roles of SIRT3 in heart failure: from bench to bedside

Heart failure (HF) represents the most common endpoint of most cardiovascular diseases (CVDs) which are the leading causes of death around the world. Despite the advances in treating CVDs, the prevalence of HF continues to increase. It is believed that better results of prognosis are obtained from prevention rather than additional treatment for HF. Therefore, it is reasonable to prevent the development of CVDs or other complications to HF. Most types of HF are attributed to contractile dysfunction, cardiac hypertrophy or remodeling, and ischemic injuries. SIRT3 is a mitochondrial nicotinamide adenine dinucleotide (NAD⁺)-dependent deacetylase whose substrates vary from metabolic biogenesis-associated proteins to stress-responsive proteins. In recent years, a number of studies have highlighted the cardio-protective role of SIRT3 and, as such, efforts have been made to induce over-expression or increased activity of this protein. In this review, we provide an overview of the roles of SIRT3 in cardiac hypertrophy induced by pressure overload or agonists and cardiomyocytes ischemic injuries. Moreover, we will introduce the application of SIRT3 agonists in the prevention of cardiac hypertrophy and ischemia reperfusion injury.