目的 探究螺内酯治疗射血分数中间值心力衰竭(heart failure with mid-range ejection fraction,HFmrEF)的临床疗效与安全性.方法 选取就诊于吉林省一汽总医院心内科的射血分数中间值的心力衰竭患者作为本研究对象,收集时间为2017年7月—2019年7月,将收集到的80例患者随机分组,分为两组,对照组共40例患者,观察组共40例患者.对照组给予心力衰竭的常规药物治疗;观察组在心力衰竭的常规药物治疗同时给予螺内酯口服(20 mg/d).共随访6个月,比较两组治疗后的临床疗效与安全性.结果 经过6个月的随访,观察组的治疗总有效率85.00％;对照组的治疗总有效率62.50％,两组间的临床治疗总有效率差异有统计学意义(P<0.05).观察组的患者治疗后6 min步行距离较对照组延长;血清N末端B型利钠肽原水平较对照组下降,差异有统计学意义(P<0.05).但治疗后两组患者的心脏超声指标(包括左心室射血分数和左室舒张末期内径)差异无统计学意义(P>0.05).观察组治疗后血钾水平较对照组升高明显,差异有统计学意义(P<0.05);但两组患者均未发生高钾血症.结论 临床使用螺内酯治疗射血分数中间值的心力衰竭,能够提高患者的活动耐量,改善患者的心功能;其临床疗效明显,具有较好的安全性.

目的:探讨下肢动脉病变(LEAD)应用无创周围血管配合下肢动脉彩超检测的诊断价值.方法:选取2019年1月-2020年9月在本院确诊为糖尿病的149例患者为研究对象,发生下肢血管病变的81例为病变组,未发生下肢血管病变68例为健康对照组.均采用动脉造影检查、无创周围血管配合下肢动脉彩超检测,比较两种检查方式下的周围血管弹性、血管功能、检出情况以及检测灵敏度和特异性.结果:病变组两种检测方式的PWV、ABI、脉压指数比较,差异均无统计学意义(P>0.05).病变组两种检测方式的病变检出率比较,差异均无统计学意义(P>0.05).无创周围血管配合下肢动脉彩超检测的准确率为97.99％(146/149),漏诊率2.47％,误诊率1.47％,灵敏度为97.53％,特异度为98.53％.结论:无创周围血管配合下肢动脉彩超检测具有较高的检出率、灵敏度以及特异度,可代替动脉血管造影,作为临床诊断LEAD的重要依据,值得临床推广.

目的 研究并对比冠心病采用瑞舒伐他汀与阿托伐他汀治疗的效果.方法 2017年12月—2019年12月,选取我院收治的冠心病患者110例,按照随机数字表法进行分组,每组各55例,观察组给予瑞舒伐他汀治疗,对照组实施阿托伐他汀治疗,对比治疗效果、血脂、不良反应.结果 观察组有效率、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)高于对照组,观察组不良反应发生率、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、甘油三脂(triglyceride,TG)均低于对照组(P＜0.05).结论 冠心病患者采用瑞舒伐他汀治疗效果显著优于阿托伐他汀,可有效降低不良反应,控制血脂水平,值得应用.

左心室室壁瘤（LVA）是指急性心肌梗死后,心脏局部室壁呈瘤样膨出于心室表面的病理改变[1],心室壁出现矛盾运动,致使心肌运动减弱或消失,从而产生心室射血分数降低的区域[2],其形成主要与局部心肌组织坏死、变薄,导致局部心肌收缩力减弱、心肌重构有关[3,4],可导致恶性室性心律失常、室间隔穿孔、心力衰竭、左心室附壁血栓等并发症,若出现心脏破裂死亡率达到100%[5,6]。LVA在急性心肌梗死存活患者中发生率为10%-38%[7],现将本院收治的1例急性心肌梗死并发巨大室壁瘤病例报道如下。

目的 探究半量替格瑞洛对高龄急性冠脉综合征(ACS)介入治疗患者的临床疗效.方法 120例行经皮冠状动脉介入治疗(PCI)的高龄急性冠脉综合征患者,依据使用P2Y12受体抑制剂的不同分成对照组(61例)和观察组(59例).对照组给予氯吡格雷75 mg,1次/d口服,观察组给予替格瑞洛45 mg 2次/d口服.两组同时给予患者常规药物治疗方案.随访12个月,比较两组治疗后的临床疗效、主要不良心脑血管事件(MACCE)发生率及大出血发生率.结果 治疗7 d后,观察组血小板聚集抑制率(70.1±6.2)％明显高于对照组的(64.6±5.3)％,差异具有统计学意义(t=5.229,P<0.05).治疗12个月后,观察组MACCE发生率为11.9％,明显低于对照组的26.2％,差异具有统计学意义.治疗12个月后,两组大出血发生率比较差异无统计学意义(χ2=0.175,P>0.05).结论 临床使用半量替格瑞洛能够有效抑制血小板聚集,其作用优于标准剂量氯吡格雷;高龄ACS介入治疗患者使用半量替格瑞洛治疗,临床疗效明显,MACCE发生率降低,且不增加大出血发生率,长期使用有较好的安全性.

Objective To find how to avoid stent malappsition in coronary artery stent implantation through study many factors that maybe have something to do with stent malappsition.Methods The number of patients of experimental groub is 503 and the number of stents of this group is 708.To control group the two numbers are 579 and 753.Stents of experimental groub are released at 120％ of its named pressure.Stents are released at its named pressure in control group.Three experienced doctors take part in this study.The role of SB Subtract, OCT and post expansion are studied at the same time.Results There is no significant difference of lesion vessel, stent diameter, rear diffuser and pressure of post expansion between the experimental groub and the control group.There is significant difference of the number of stents that need post expansion between the two groups by evaluation of the three doctors, SB Subtract and OCT.Conclusion Stents released by high pressure and post expansion may be beneficial to avoid stent malappsition in coronary artery stent implantation.OCT is the best method for the evaluation of stent adherence of the three methods in our study.To evaluation the stent adherence SB Subtract is a better methods than the three doctors.

Objective To regard the patients with coronary heart disease who were treated with PCI as the objects of study,the research analyzes and compares&nbsp;patients'postoperative effects by using clopidogrel and ticagrelor as wel as the potential adverse events.Methods It selects 150 patient cases with coronary heart disease who were treated with PCI in the hospital from August 2014 to August 2015,and divides them randomly into folowing two groups: the group of clopidogrel and the group of ticagrelor with the same patient number. Then it respectively analyzes and compares the clinical effects of these two medicines as wel as MACE.ResultsThe total effective rate of the clopidogrel group is 76.0%,while that of the ticagrelor group is 93.3% ,Patients with a postoperative MACE of the clopidogrel group is a total 30 cases,while that of the other group is a total 10 cases. Compare the two groups of patients in curative effects and MACE,the differences have statistical significance. (P<0.05) . Conclusion The patients with coronary heart disease who were treated with PCI wil have better curative effects when using ticagrelor,and the patients with a postoperative MACE is less.

Objective To explore the early acute myocardial infarction patients with serum potassium concentrations associated with coronary angiography in vascular and ventricular arrhythmias in relation, for reference by clinical research.MethodsFrom November 2014 to December 2015, 74 patients with acute myocardial infarction, through early serum potassium concentrations in acute myocardial infarction patients were divided into 2 groups, namely early group of low blood potassium (potassium concentration is less than 3.5 mmol/L) and normal blood potassium (potassium concentration between 3.6~5.5 mmol/L), Observation of 74 cases of acute myocardial infarction patients with serum potassium concentration associated with coronary angiography in vascular and the relationship of ventricular arrhythmias.Results Through this research can be seen, when the anterior descending artery lesion, associated with hypokalemia, also were susceptible to ventricular arrhythmia cases, the number of cases was signiifcantly higher than normal potassium blood, signiifcant difference (P<0.05).Conclusion Early serum potassium concentration in patients with acute myocardial infarction and coronary angiography in vascular and has some relationship of ventricular arrhythmias, can be used to promote.