目的:研究氯吡格雷联合阿司匹林及低分子肝素钙对心肌梗死患者的疗效及其对血清巨噬细胞游走抑制因子(MIF)、白介素(IL)-10水平的影响.方法:我院的94例心肌梗死患者被随机均分为阿司匹林组(常规治疗基础上加用阿司匹林联合低分子肝素)和联合治疗组(阿司匹林组基础上加用氯吡格雷).两组均治疗3个月.观察比较两组治疗前后血清肌酸激酶同工酶(CK-MB)、cTnT、超氧化物歧化酶(SOD)、MIF、IL-10水平及不良心血管事件率.结果:治疗后,与阿司匹林组比较,联合治疗组血清CK-MB[(64.48±5.13) U/L比(45.30±5.34) U/L]、cTnT[(1.11±0.31) U/L比(0.66±0.11) U/L]、MIF[(1.16±0.25) ng/ml比(0.95±0.16) ng/ml]降低更显著,血清SOD[(156.97±10.04) U/L比(176.52±11.49) U/L]、血清IL-10水平[(341.88±30.20) pg/ml比(536.62±27.44) pg/ml]升高更显著,P均=0.001.联合治疗组不良心血管事件率显著低于阿司匹林组(4.26％比51.06％,P=0.001).结论:氯吡格雷联合阿司匹林及低分子肝素钙可显著改善心肌梗死患者心肌酶及炎症因子水平,安全性好.

目的 探讨琥珀酸美托洛尔联合胺碘酮对心律失常患者心功能及生活质量评分(QOL)评分的影响.方法 选取96例心律失常患者,按照治疗方式的不同分为两组.对照组患者应用胺碘酮进行治疗,研究组患者在对照组的基础上联合琥珀酸美托洛尔进行治疗.观察两组患者的治疗效果、药物不良反应、QOL以及心功能的差异.结果 研究组患者QT期间以及QT离散度(QTd)明显高于对照组(P＜0.05);研究组不良反应的发生率明显低于对照组(P＜0.05);QOL方面研究组患者的生活质量评分明显高于对照组患者(P＜0.05);心功能指标方面,研究组患者左心室射血最大分数比例、左心室舒张极限内径长度以及左心室收缩末期内径长度明显优于对照组患者(P＜0.05).结论 应用琥珀酸美托洛尔联合胺碘酮对心律失常患者进行治疗,能够明显改善患者的心功能且安全性较高.

目的：探讨早期胰岛素强化治疗对初诊2型糖尿病患者血糖及胰岛β细胞功能的影响。方法：将46例初诊2型糖尿病患者随机均分为观察组和对照组，观察组给予早期胰岛素强化治疗，对照组给予口服降糖药物治疗，观察两组患者胰岛β细胞功能改善情况。结果：观察组患者治疗后Homaβ及HomaIR均明显优于对照组（P＜0.05）。结论：早期胰岛素强化治疗可改善初诊2型糖尿病患者胰岛β细胞功能。

Objective To explore the safety,feasibility and efficacy of emergency bedside temporary pacing wire electrodes implanted via femoral veins.Methods Forty patients with severe bradycardia(26 men,14 women) aged(67±18.7) years(range,36-79 years) were selected from March 2005 to February 2010 in departments of cardiology and emergency,and emergency bedside temporary pacing wires were introduced via femoral veins in these patients under non-perspective conditions.After pacing,routine chest X-ray was performed to observe the location of pacemaker electrode tip,which was determined by perspective view in higher level hospitals.Results Temporary pacing was successful in all patients,with a success rate of 100%.The time spent in placing temporary pacing wires averaged(11.5±4.3) minutes(range,5-18 minutes).None of these patients had venous thrombosis,myocardial perforation,puncture site infection or other local complications.Conclusion Under non-perspective conditions,temporary pacing wire electrodes implanted via femoral veins is safe,convenient and feasible with a high success rate for emergency bedside temporary pacing,which can avoid life-threatening because of transportation,protect the puncture site and the approach to permanent pacemaker implantation and create the advantage conditions to save lives of transfer patients.

目的:探讨应用纤维支气管镜(纤支镜)介入微波并局部注药治疗支气管结核的疗效.方法: 将46例支气管结核患者随机分为治疗组和对照组;治疗组22例强化期采用纤支镜介入微波并局部注药加全身化疗,对照组24例只进行全身化疗.结果:22例共进行136人次治疗,治疗成功率100%,症状改善率为95.4%,痰菌阴转率83.3%,纤支镜下病灶吸收率86.4%,胸部CT所见病灶吸收率85.7%,与对照组相比有显著性差异(P＜0.01);无1例发生气胸、出血、结核播散、肺部继发性感染等并发症;治疗组远期疗效也较对照组有显著性差异(P ＜0.05).结论:该疗法效果显著,明显优于单纯全身化疗组,是一种安全、有效、易行的治疗支气管结核的综合性方法,能减少手术及各种并发症的发生.