Objective:To observe the acute hemodynamic response of iloprost in secondary pulmonary hypertension of congenital heart disease.Method:Fifteen cases with secondary pulmonary hypertension of congenital heart disease(10 patients with ventricle septal defect, 3 patient with atrium septal defect, 1 patient with patent ductus arteriosus, 1 patient with endocardial cushion defect). All of them sequentially inhaled oxygen 15 min and following 20 μg of iloprost, and the response on hemodynamic and blood gases were monitored.Result:All patients displayed a significant reduction in mean pulmonary arterial pressure (PAP) and total pulmonary resistance (TPR)(P0.001)immediately after inhaled iloprost. There was no seriously decrease in the left cadiac index (CI)(P=0.244). There was no major adverse effects during this test. Conclusion:during acute drug testing, inhaled iloprost lowered PAP safely and efficaciously. Iloprost selectively dilated pulmonary vascular and is no more effect on systemic circulation.

Objective:To explore the clinical features of acute coronary syndrome (ACS) without ST-segrnent elevation in the aged with impaired glucose tolerance (IGT). Methods:Depending on blood glucose and oral glucose tqlerance test (OGTT), 96 aged ACS patients without ST-segment elevation were assigned to three groups:diabetes mellitus (DM) group (32 cases) , impaired glucose tolerance (IGT) groups (32 cases) , normal glucose tolerance (NGT) group (32 cases). All patients had coronary angiography (CAG) examined. Results:The levels of blood glucose and trigly- ceride (TG) in DM group and IGT group were higher than those in NGT group (P0.05-0.01) ;The blood glucose level in DM group more increased than those in IGT group (P0. 05-0. 01). The extents of myocardial ischemia of electrocardiogram and the coronary stenosis showed by CAG in DM group and IGT group were more severe than those in NGT group (P0. 01). Conclusion: The levels of blood glucose and TG, severe extents of myocardial ischemia and coronary artery stenosis in IGT group and DM group increased compared with those of NGT group, so must pay attention to coronary artery disease for the aged with IGT.

对50例安置永久性起搏器的病人进行术中心率、血压、心电监测并与术前比较.结果:术中心率比术前快(67.60±10.9 vs 56.24±7.9次/分,P<0.01),收缩压较术前升高(128.44±20.1 vs 122.44±11.2 mmHg,P<0.05).心绞痛发作4例,频发性室性早搏二联律2例,短阵室性心动过速3例,呼吸停止1例.结论:安置永久性起搏器手术中应避免电极过多刺激心肌导致心律失常发生,心绞痛发作.同时注意监测病人心率、血压及呼吸,防止发生意外.

目的 评价单侧肺动脉异常起源于主动脉的影像学诊断。方法 回顾性分析了９ 例单侧肺动脉异常起源于主动脉患者的临床表现、Ｘ线征象、诊断方法和手术治疗资料，所有病人均做了Ｘ线平片、彩色多普勒超声心动图及心血管造影检查。结果 ９ 例Ｘ线平片均有肺血增多，心脏增大。多普勒超声心动图检查６ 例漏诊，３ 例术前确诊。９ 例心血管造影均清楚显示该症的解剖畸形。结论 心血管造影是诊断单侧肺动脉异常起源于主动脉最可靠的手段。