目的 观察超声心动图联合血清心脏型脂肪酸结合蛋白(H-FABP)、肌钙蛋白(cTnI)检测评估慢性心力衰竭(CHF)病人左心功能的效果.方法 选取2016年10月—2019年4月本院收治的72例确诊为CHF的住院病人,纽约心脏病协会(NYHA)心功能分级Ⅰ级17例,Ⅱ级22例,Ⅲ级18例,Ⅳ级15例.采用超声心动图检测受试者左心功能指标,主要包括左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)、每搏输出量(SV)、心脏指数(CI)及二尖瓣舒张早期与舒张晚期血流峰值速度比值(E/A).采用酶联免疫吸附试验(ELISA)检测血清H-FABP、cTnI水平,采用Spearman法分析超声心动图参数、血清H-FABP、cTnI水平与心功能分级的相关性.采用多元回归分析超声心动图参数联合血清H-FABP、cTnI水平对CHF病人心功能分级的预测价值.结果 不同心功能分级病人LVEDV、SV、CI参数比较,差异无统计学意义(P>0.05).与心功能Ⅰ级、Ⅱ级比较,心功能Ⅲ级、Ⅳ级CHF病人LVEF降低,LVEDD、LVESD、LVESV、E/A水平升高(P<0.05).CHF病人血清H-FABP、cTnI水平随心功能分级增加升高(P<0.05).Spearman分析结果显示,LVEF与心功能分级呈负相关(P<0.05),LVEDD、LVESD、LVESV、E/A、血清H-FABP、cTnI水平与心功能分级呈正相关(P<0.05).LVEF、E/A、H-FABP、cTnI是预测CHF病人心功能分级的独立因素(P<0.05).结论 超声心动图可有效评估CHF病人左心功能,联合检测血清H-FABP、cTnI对CHF病人心脏分级有一定预测价值.

目的 探讨阿托伐他汀钙联合阿司匹林对高血压伴冠状动脉粥样硬化性心脏病患者心钠素、心率及心肌酶谱的影响.方法 110例高血压伴冠状动脉粥样硬化性心脏病患者,随机分为观察组与对照组,每组55例.对照组患者给予阿司匹林治疗,观察组在对照组基础上联合阿托伐他汀钙治疗.比较两组患者治疗前后心钠素、心率及心肌酶谱变化情况.结果 治疗前,两组患者心率、心钠素比较差异无统计学意义(P>0.05);治疗后,两组患者心率、心钠素均较本组治疗前降低,且观察组患者心率(90.1±5.4)次/min、心钠素(420.4±20.7)ng/L明显低于对照组的(95.7±8.6)次/min、(702.6±30.7)ng/L,差异具有统计学意义(P<0.05).治疗前,两组患者肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)及肌钙蛋白I(cTnI)水平比较差异无统计学意义(P>0.05);治疗后,两组患者CK、CK-MB、cTnI水平均较本组治疗前降低,且观察组患者CK(100.3±10.3)IU/L、CK-MB(14.3±1.4)IU/L、cTnI(0.7±0.1)μg/L明显低于对照组的(201.4±18.6)IU/L、(20.2±3.7)IU/L、(1.6±0.2)μg/L,差异有统计学意义(P<0.05).结论 阿托伐他汀钙联合阿司匹林可显著改善高血压伴冠状动脉粥样硬化性心脏病患者心钠素、心率,减轻炎症及心肌细胞损伤程度,可作为首选药物使用.

目的 探讨胺碘酮联合厄贝沙坦治疗高血压合并阵发性心房颤动(房颤)的临床效果.方法 108例高血压合并阵发性房颤患者,随机分为对照组(53例)和观察组(55例).对照患者应用胺碘酮治疗,观察组患者在对照组基础上联合应用厄贝沙坦治疗.比较两组患者治疗3及6个月后的转复维持效果、血压、心率、左心房舒张末期容积(LAEDV)、左心房内径(LAD)、左心房射血分数(LAEF).结果 治疗3个月后,两组转复维持率比较差异无统计学意义(P>0.05);治疗6个月后,观察组转复维持率高于对照组,差异有统计学意义(P<0.05).治疗3、6个月后,观察组舒张压、收缩压及心率均显著低于对照组,差异有统计学意义(P<0.05).治疗3个月后,两组LAEDV、LAD、LAEF比较差异均无统计学意义(P>0.05);治疗6个月后,观察组患者LAEDV(142.3±69.4)ml、LAD(32.4±1.8)mm小于对照组的(178.6±63.2)ml、(37.5±2.6)mm,LAEF(0.35±0.40)％ 大于对照组的(0.25±0.20)％,差异有统计学意义(P<0.05).结论 胺碘酮联合厄贝沙坦治疗高血压合并阵发性房颤效果显著,可降低心脏负荷,延缓心肌重构,对阵发性房颤患者窦性心律维持效果优于单独应用胺碘酮治疗.

目的 探讨对肝阳上亢型高血压患者采取加味天麻钩藤汤联合硝苯地平治疗的效果.方法 选取2016年4月到2017年4月期间来我院就诊的肝阳上亢型高血压患者64例.按照计算机表法将其均分2组,各32例.对参照组采取硝苯地平治疗,对实验组采取加味天麻钩藤汤联合硝苯地平治疗.分析2组临床疗效、舒张压和收缩压.结果与实验组相比较,参照组临床疗效较差,行卡方检验,统计学意义存在(P<0.05);治疗后实验组的舒张压和收缩压相比于参照组均明显较低,组间数据对比差异显著(P<0.05).结论 肝阳上亢型高血压患者采取加味天麻钩藤汤联合硝苯地平治疗,临床疗效显著,患者的舒张压和收缩压明显下降.

Objective: To investigate the change of serum omentin levels and the relationships between serum omentin and other adipocytokines in pregnancy obese subjects and GDM.Methods: Serum omentin,APN,RBP-4 levels were measured by Enzyme Linked Immuno Sorbent Assay(ELISA) in 38 cases of GDM with obesity(Group A),41 cases of GDM with normal weight(Group B),39 cases of obesity pregnant women without pregnancy complications(Group C),and 44 cases of normal weight pregnant women(Group D).Meanwhile,FINS,FPG,TC,TG,HDL-C,LDL-C were measured.Insulin resistance was estimated using the homeostatic model assessment-insulin resistance(HOMA-IR) index.Results:(1) TG,FPG,FINS levels and HOMA-IR in GDM were higher and HDL-C levels were lower than those in the control group(P < 0.05).FINS,HOMA-IR levels were higher in the group A,C than those in the group B,D respectively(P < 0.05).(2) Serum omentin,APN levels in GDM were lower than those in non-GDM group(P < 0.001).Serum omentin,APN levels in the group C were lower than those in the group D(P < 0.01).Serum RBP-4 levels were the highest in the group A(P <0.05).Serum RBP-4 levels in the group C were higher than those in the group D(P < 0.001).(3) Positive correlation was shown between omentin levels and HDL-C,APN.There was significant negative correlation between omentin levels and TG,FPG,FINS,HOMA-IR,and RBP-4(P <0.05).(4) In a multiple stepwise regression analysis,FINs,APN were independent variables of omentin.(P < 0.05).Conclusion: Pregnancy women with GDM and obesity were characterized by glucose,lipid metabolic disturbance.Serum omentin and APN levels were decreased and serum RBP-4 levels were increased in the GDM and the pregnancy obese subjects.Serum omentin levels were closely related with glucose,lipid metabolic indicators and other adipocytokines.Interactions between adipocytokines may be involved in the pathogenesis of obesity and GDM.

Objective:To investigate the change of serum omentin levels and the relationship among serum omentin levels and glucose,lipid metabolic indicators in GDM.Methods:Serum omentin levels were measured by enzyme-linked immuno sorbent assay(ELISA) in 35 cases of GDM with obesity(group A),32 cases of GDM with normal weight(group B),36 cases of normal weight pregnant women(group C).Meanwhile,FINS,FPG,TC,TG,HDL-C,LDL-C were measured.Insulin resistance was estimated using the homeostatic model assessment-insulin resistance(HOMA-IR) index.Results:(1)TG,FPG,FINS and HOMA-IR levels in GDM were higher and HDL-C level was lower than those in the control group(P<0.05).(2)Serum omentin level was higher in group B than that in group A,and serum omentin level was the highest in the group C(P<0.01).(3)Positive correlation was showed between omentin and HDL-C.There was significant negative correlation between omentin levels and TG,FPG,BMI,FINS levels and HOMA-IR(P<0.05).(4)In a multiple stepwise regression analysis,FINs,FPG,and prepregnant BMI were independent variables of omentin(P<0.05).Conclusion:GDM is characterized by glucose,lipid metabolic disturbance and insulin resistance.Serum omentin level is decreased in the GDM.The metabolic disturbanc and the insulin resistance are more serious,and the level of serum omentin is more lower in the GDM accompanied with obesity.Reducing omentin level may be involved in the occurrence and development of GDM.

高血压在冠心病的发生发展中起较大作用,且血压水平与冠心病发病率有密切关系.另外,有研究<'[1-3]>表明动脉脉压(主动脉脉压、肱动脉脉压)能够反映动脉弹性情况,与收缩压(SBP)和舒张压(DBP)相比能够更好地预测心血管事件的发生.但脉压(PP)本身具有一定的可变性,脉压指数(PPI)能够同时反映血管的固有和动态的顺应性,并且变化幅度小于PP<'[4]>.本研究通过24 h监测行冠脉造影的老年住院患者血压取其平均值,探讨肱动脉PP、PPI与冠状动脉关系.

Objective To study the rate of hemorrhaging at the puncture among acute myocardial infarction (AMI) patients who underwent emergency or elective percutaneous coronary intervention (PCI),and thus to provide some basis for formulating effective related nursing measures. Methods An analysis was made of the hemorrhage at the puncture among 65 AMI patients who underwent emergency PCI and 37 ones who underwent elective PCI. Results There were 31 cases of hemorrhaging in the emergency PCI group and 4 cases in the elective PCI group,with the rate of hemorrhaging of the former distinctly higher than that of the latter (P<0.01). Conclusion The rate of hemorrhaging of AMI patients who underwent emergency PCI is higher than that of the patients who received elective PCI. For those who underwent emergency PCI,the nursing personnel should strengthen the award touring and put right the poor body posture of the patient,if any,make sure that the patient is clear about the post-surgery points for attention,in order to minimize the hemorrhaging at the puncture.

Objective To observe the effect of Danggui Shaoyao powderAngelica sinensis and Radix paeoniae powder in preventing and treating hyperlipemia in rabbits and the primary mechanism. Methods The hyperlipemia in rabbit was induced by the breeding method. The influence of Danggui Shaoyao powder on the serum and liver lipid in hyperlipemia rabbit was observed. Results the Danggui Shaoyao powder could obviously decrease the serum TC,TG,LDL-C,AppoB100 level,increase the HDL-C and ApoA1,decrease the TC and TG of liver tissue and inhibit the liver lipid deposit in hyperlipemia rabbit. Conclusion The mechanism of Danggui Shaoyao powder in preventing and treating hyperlipemia maybe closely correlated with above factors.