简介:为了从期刊文献的学科属性实现族性检索,为文章的分类统计创造条件,本刊2005起均对具有文献标识码的文章采用《中国图书馆分类法》(第四版)进行分类后。标识分类号文章一般标识1个分类号,多个主题的文章可标识2个或3个分类号;主分类号排在第一位,多个分类号之间应以分号分隔。希望有条件查询的作者在来稿时自行标明中图分类号。
简介:backgroundStudiesshowedthatarterialelasticitychangesappearearlierthananystructuralchanges,therefore,itsaccurateevaluationcouldbeappliedatearlystagetopreventdisease.Echo-tracking(E-tracking)techniquecantrackthewallmotiontrajectoryinreal-time,calculatethechangeinvasculardiameterautomatically,andassessmentofvascularstiffnessandflexibilitydirectly.Thisarticleaimstoassessthechangeofelasticityofcarotidarteryafterhormonetherapy(HT)usingEcho-trackingtechnology.MethodsEcho-trackingwasusedtoevaluatethecarotidelasticmoduli,suchasthepressure-strainelasticmodulus(Eρ),stiffnessparameter(β),arterialcompliance(AC),pulsewaveconductingvelocity(PWVβ)andaugmentationindex(AI)byAlokaα10colorDopplerultrasounddiagnosissystem.ResultsEρ,βandPWVβinHTgroupweresignificantlylowerthanthoseinthecontrolgroup(P<0.01),whileACwasobviouslyhigherthanthecontrolgroup(P<0.01).E2wasnegativelyrelatedtoβ,EρandPWVβ(r=-0.607,r=-0.573,r=-0.574,P<0.001),whilepositivelyrelatedtoAC(r=0.574,P<0.001);endothelial-dependentdilatation(EDD)wasnegativelyrelatedtoβ,EρandPWVβ(r=-0.521,r=-0.411,r=-0.456,P<0.001),whilepositivelyrelatedtoAC(r=0.443,P<0.001);ButIMTwaspositivelyrelatedtoβ,EρandPWVβ(r=0.553,r=0.444,r=0.529,P<0.001),whilenegativelyrelatedtoAC(r=-0.400,P<0.001).ConclusionsArterialstiffnessincreasesandcompliancedecreasesinmenopausalwomen.AsEDDdecreasesarterialelasticityrecedes,andHTcanimprovearterialelasticity.E-trackingtechnologycandiscovertheearlychangesinarterialstiffnesseffectivelyanditismoresensitiveinfindingoutthechangesofstiffnessinearlyatherosclerosisthanIMTofcarotidartery.
简介:BackgroundChronickidneydisease(CKD)patientsareathighriskofatherosclerosis.Structuralandelasticchangesofcarotidarterywallreflecttherangeanddegreeofatherosclerosisinperipheralarteries,whichcanbeacquiredbyultrasoundradiofrequency-datatechniqueautomaticallyandprecisely.MethodsAtotalof66CKDpatientswithnegativeresultsonroutinecarotidarteryultrasoundexaminationwereenrolled,and30healthyphysicalexamineeswereselectedascontrols.Patientsweredividedinto3groupsaccordingtoCKDstage:stage1-2,stage3-4andstage5.Clinicalcharacteristicsandthelaboratoryresultswereacquired.Intima-mediathickness(IMT)andcompliancecoefficient(CC)ofcommoncarotidarteryweremeasuredbyultrasoundradiofrequencydatatechnique(QIMTandQAS).PredictorsofIMTandCCwereanalyzedrespectively.ResultsAmongthe66patients,15wereonstage1-2,15onstage3-4and36onstage5accordingtoeGFR.ThecommoncarotidarteryIMT(CCIMT)ofalltheCKDgroupsexceptpatientsonstage1-2wassignificantlyincreasedwhencomparedwithcontrols.TheCCofcarotidarterysignificantlywasdecreasedineveryCKDgroupcomparedwithcontrols.AgeandCKDstageweresignificantpredictorsofCCIMTandCCinCKDpatients(P<0.05).AgingandadvancedCKDstagewereassociatedwithincreasedCCIMT(OR=4.855and4.969)anddecreasedCC(OR=32.178and14.068).ConclusionsRadiofrequency-datatechniquecandetectthesmallchangesofstructureandelasticityofcarotidarterywallinCKDpatients.CKDpatientshaveincreasedIMTanddecreasedelasticityofcarotidarterycomparedwithhealthysubjects.AgingandadvancedCKDstageareassociatedwithincreasedCCIMTanddecreasedCC.
简介:目的观察慢性心力衰竭(HF)患者的肾功能及相关临床特征.方法回顾性分析2009年9月至2011年9月在南京市胸科医院心内科住院的139例心衰患者,男性70例,女性69例,年龄(66±15)岁,根据NYHA心功能分级,Ⅰ级40例、Ⅱ级37例、Ⅲ级34例、Ⅳ级28例.入院后次日清晨空腹抽取静脉血,全自动生化分析仪测定血浆肌酐(Cr)、尿素氮(BUN)、尿酸(UA);根据简化的MDRD公式计算估计的肾小球滤过率(eGFR).心脏彩超Teich法测定患者左室射血分数(LVEF).结果心功能>Ⅱ级各组与Ⅰ级患者比较,患者年龄显著增高.随着心功能分级增高,LVEF逐渐降低;随着心功能分级的增高,患者BUN、Cr及UA水平逐渐增高;心功能Ⅳ级与其他各组比较eGFR水平显著降低.139例HF患者中心肾综合征(CRS)患者为96例(69%),其中轻度、中重度肾功能不全分别为49例和47例.在肾功能正常及轻度肾功能不全组,心功能Ⅰ级患者比例高;在合并中重度肾功能不全组,心功能Ⅳ级患者比例较高.中重度肾功能不全组2年内累计心血管死亡率高于肾功能正常和轻度肾功能不全组.结论HF患者随着心功能分级增高,年龄越大,肾功能越差;伴有中重度肾功能不全的CRS患者中心功能≥Ⅲ级比例显著增高,且预后较差.对于NYHA分级≥Ⅲ级的心衰患者,不仅需要积极强化药物治疗改善心功能,更要注意保护患者的肾功能.
简介:ObjectivesEndothelialdysfunctionistheearliestmarkerforatherosclerosisandplayskeyroleinthepathogenesisofcardiovasculardiseases.Thepresentstudywasperformedtoevaluateeffectofagingonarterialelasticitybyusingpulsewaveformanalysisandinvestigatewhetherthechangesinarterialelasticitycanbeusedasanon-invasivemeasureforearlydetectionofendothelialdysfunction.MethodsUsingmodifiedWindkesselmodelofthecirculationandpulsewaveformanalysis,C1largearteryandC2smallarteryelasticityindicesof204normalhealthysubjects(age15-80years)weremeasured.Amongthemtwenty-fourmalehealthysubjectsweredividedintoboththeyoung(age20-30years,n=12)andelderly(age60-70years,n=12)groups.Wedeliveredacethycholine(Ach),anendotheliumdependentvasodilator,andsodiumnitroprusside(SNP),anendothelium-independentvasodilator,todermalvesselsoftheforearmusingiontophoresis,respectively,andmeasuredbasalandpeakbloodflowusinglaserdopplerfluximetry.ResultsC1largearteryandC2smallarteryelasticityindiceswerereducedwithadvancingage.C1largearteryandC2smallarteryelasticityindiceswerenegativelycorrelatedwithage(r=-0.628,p<0.001;r=-0.595,p<0.001).Basalbloodflowwassimilarbetweentheyoungandelderlygroups(14.58±3.4vs13.52±3.41PU,p=NS).PeakbloodflowinducedbyAchwassignificantlyreducedintheelderlygroupcomparedwiththeyounggroup(83.4±11.9vs93.75±10.87PU,p<0.05).However,peakbloodflowinducedbySNPwassimilarinthetwogroups(119.17±16.76vs128.33±21.29PU,p=NS).Ach-inducedpeakbloodflowcorrelatedpositivelywithC1largearteryandC2smallarteryelasticityindices(r=0.56,p<0.01;r=0.53,p<0.01).ConclusionsAdvancingageleadstoimpairedarteryelasticityandendothelialdysfunction.Reducedarterialelasticityis,inparallel,associatedwithdiminishedendothelium-dependentvasodilation.Itisconcludedthata
简介:目的评价床边超声心动图在房间隔缺损(ASD)封堵术中的临床应用。方法25例ASD适合介入封堵的病人,术中床边超声心动图测量ASD最大直径,与测量球囊测量ASD直径比较,指导封堵器封堵、释放等过程,并观察有无残余分流及封堵器是否影响周围结构功能。结果25例患者ASD直径床边超声心动图测量值为(20.52±1.53)mm,球囊导管测量值为(21.41±1.52)mm,二者差异无统计学意义(P〉0.05)。25例患者全部一次堵闭成功,术后即刻超声心动图检查无残余分流,各瓣膜无病理性返流或原有返流加重,上、下腔静脉回流正常。结论床边超声心动图在ASD封堵术中能准确估测ASD直径,指导封堵过程,监测有无并发症发生,在ASD封堵术中具有重要指导作用。
简介:目的研究6小时内到达医院就诊的急性脑梗死患者未进行溶栓治疗的原因及对策。方法通过回顾性调查,对院内发生的或6小时内到院的急性脑梗死患者未进行溶栓治疗的原因统计,并对原因进行对策分析。结果174例缺血性脑卒中患者在发病6小时内到达医院就诊,42例接受溶栓治疗,占24.41%。溶栓患者平均到院时间(4.00±1.61)小时。发病6小时内就诊的132例脑梗死患者未接受溶栓治疗,其原因有醒后卒中,完成评估后超过时间窗,患方拒绝或犹豫,严重神经功能缺损,年龄不符等。结论加强对醒后卒中的研究,加强公众对脑卒中的了解,优化院内卒中流程,更新我国溶栓指南等有助于提高脑梗死溶栓治疗比例。