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蛋白尿和心电图左心室肥厚程度的减轻可独立地改善高血压的预后:LIFE研究

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世界核心医学期刊文摘（心脏病学分册） 2006年第9期2卷 55-56页

作者： Olsen M.H. Wachtell K. Ibsen H. 韩瑞娟 Department M of Internal Medicine Copenhagen University HospitalRingvejenDK-2600 GlostrupDenmark.Dr

Background: In the Losartan Intervention For Endpoint reduction in hypertensio n(LIFE) study, reduced urine albumin/ creatinine ratio(UACR) as well as regressi on of left ventricular hypertrophy have been associated with lower incidence of cardiovascular events. We wanted to investigate whether these prognostic improve ments were independent. Methods: In 6679 hypertensive patients included in the L IFE study,we measured UACR, left ventricular hypertrophy by electrocardiography, serum cholesterol, plasma glucose and blood pressure after 2 weeks of placebo t reatment and again after 1 year of anti-hypertensive treatment with either an a tenolol-or a losartan-based regimen. During this first year of treatment, 77 p atients encountered a non-fatal stroke or myocardial infarction and were exclud ed to avoid bias. During the next 3-4 years, 610 composite endpoints[cardiovasc ular death(n=228), fatal or non-fatal myocardial infarction or stroke] were rec orded. Results: In Cox regression analyses, the composite endpoint was after adj ustment for treatment allocation predicted by baseline logUACR[hazard ratio(HR)= 1.16 per 10-fold increase, P< 0.05], 1-year logUACR(HR=1.29 per 10-fold incre ase), baseline Sokolow-Lyon voltage(HR=1.01 per mm, both P< 0.001) and 1-year Cornell product(HR=1.01 per 100 mm x ms, P< 0.01). Cardiovascular death was pred icted by 1-year logUACR(HR=1.59, P< 0.001), baseline Sokolow-Lyon voltage(HR=1 .01, P=0.06) and 1-year Cornell product(HR=1.02, P< 0.001). Both were predicted independent of age, Framingham risk score, current smoking, history of cardiova scular disease and diabetes. Gender, serum cholesterol, plasma glucose and blood pressure did not enter the models. Conclusions: Baseline UACR and Sokolow-Lyon voltage, as well as in-treatment UACR and Cornell product, added to the risk p rediction independent of traditional risk factors, indicating that albuminuria a nd left ventricular hypertrophy reflect different aspects of cardiovascular dama

关键词：高血压患者左心室肥厚肥厚程度心电图预后减轻致死性心肌梗死蛋白尿

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探讨左心室肥厚程度与脑梗死面积大小的关系

中原医刊 2006年第3期33卷 62-62页

作者：程浩黄河贾海芹河南省南阳油田总医院急诊科南阳473132

左心室肥厚是心脏对高血压的适应性改变,能反映出高血压存在的时间和血压升高的幅度.高血压是脑梗死的独立危险因素,高血压与脑梗死的关系早已肯定,而有关左心室肥厚与脑梗死的关系资料较少。

关键词：脑梗死面积左心室肥厚肥厚程度超声心动图检查适应性改变高血压血压升高心脏急诊科预防

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孤立性房颤与高血压房颤患者左心重塑对比

中国临床医学 2005年第2期12卷 199-200页

作者：徐泽昌张艳玲刘星张桂珍北京军区总医院心内科北京100700

目的:探讨高血压伴发的房颤和孤立性房颤患者左室质量等重塑状况异同及其意义。方法:房颤和(或)原发性高血压患者,排除对心脏有影响的其他疾病,分为原发性高血压无房颤组(EH组)、原发性高血压伴房颤组(EHAF组)和孤立性房颤组(LAF组)。... 详细信息

目的:探讨高血压伴发的房颤和孤立性房颤患者左室质量等重塑状况异同及其意义。方法:房颤和(或)原发性高血压患者,排除对心脏有影响的其他疾病,分为原发性高血压无房颤组(EH组)、原发性高血压伴房颤组(EHAF组)和孤立性房颤组(LAF组)。进行超声心动图检测左房横径、左房前后径、左房长径、左房面积、左室室间隔厚度(IVST)、左室后壁厚度(PWT)和左室舒张末期内径(EDD),计算室间隔/左室后壁厚度比值和左室质量指数(LVMI)。结果: EH组入选446 例,EHAF组78例,LAF组38例。EHAF组IVST和PWT均明显大于EH组和LAF组(p肥厚程度明显重于不伴房颤者。左房扩大、左室肥厚性重塑与孤立性房颤的关系不如与高血压房颤密切,孤立性房颤发生的危险因子不同于高血压房颤。

关键词：孤立性房颤房颤患者左心重塑原发性高血压患者左室舒张末期内径左室后壁厚度超声心动图检测左室质量指数 IVST LAF 室间隔厚度其他疾病左房面积 0.05 LVMI 肥厚程度左房扩大危险因子 PWT 其意义前后径 EH

同位素^(90)锶-^(90)钇[^(90)Sr-^(90)Y]敷贴治疗慢性肥厚性鼻炎27例临床观察

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新医学 2005年第5期36卷 281-282页

作者：耿建王胜利计学理刘建国肖来华北京铁路局大同铁路中心医院核医学科 037005 北京铁路局大同铁路中心医院耳鼻喉科 037005

目的:探讨同位素90锶-90钇[90Sr-90Y]敷贴治疗慢性肥厚性鼻炎的有效性。方法:慢性肥厚性鼻炎患者55例,随机分为两组,同位素治疗组(治疗组)27例采用90锶-90钇[90Sr-90Y]敷贴器敷贴于肥大的下鼻甲黏膜表面进行照射,照射时间视患者下鼻甲... 详细信息

目的:探讨同位素90锶-90钇[90Sr-90Y]敷贴治疗慢性肥厚性鼻炎的有效性。方法:慢性肥厚性鼻炎患者55例,随机分为两组,同位素治疗组(治疗组)27例采用90锶-90钇[90Sr-90Y]敷贴器敷贴于肥大的下鼻甲黏膜表面进行照射,照射时间视患者下鼻甲的肥厚程度而定,每次吸收剂量800cGy,每日或隔日1次,3次为1疗程,每疗程总吸收剂量不超过2400cGy;对照组28例采用下鼻甲黏膜下硬化剂(50%葡萄糖液1～2mL)注射治疗,隔日1次,5次为1个疗程。两组治疗两疗程后评定近期疗效,随访1年后评定远期疗效。结果:两疗程后,治疗组和对照组的近期治愈率分别为78%和54%;随访1年,治疗组和对照组的远期治愈率分别为70%和43%,两组的近期和远期治愈率比较差异均有统计学意义(均为P肥厚性鼻炎的新方法。

关键词：慢性肥厚性鼻炎 ^90钇 ^90锶敷贴治疗同位素临床观察 50%葡萄糖液吸收剂量远期治愈率下鼻甲治疗组对照组肥厚程度照射时间注射治疗近期疗效远期疗效敷贴器疗程硬化剂黏膜下 1年后统计学患者随访

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高血压左心室肥厚及构型与脉压的关系

现代医院 2005年第4期5卷 24-25页

作者：曾繁芳林泽鹏赵有生深圳市孙逸仙心血管医院广东深圳518121

目的　探讨高血压患者左心室肥厚及构型与脉压的关系。方法　回顾性分析171例有或无左心室肥厚(LVH)的高血压病病人的脉压与左心室肥厚及构型的相关性。结果　①高血压病患者LVH的程度与其脉压的相关系数为r =0 . 5 9(P <0 .0 5 ) ,表... 详细信息

目的　探讨高血压患者左心室肥厚及构型与脉压的关系。方法　回顾性分析171例有或无左心室肥厚(LVH)的高血压病病人的脉压与左心室肥厚及构型的相关性。结果　①高血压病患者LVH的程度与其脉压的相关系数为r =0 . 5 9(P 程度与其脉压间有较密切的关系。②三型肥厚组的脉压与无肥厚组相比,有明显的差别,对称性室间隔肥厚(CH)和扩张性肥厚(DH)较大(P均肥厚(DH)较甚。结论　高血压患者左心室肥厚及构型与脉压具有一定的联系,因此,对于肥厚程度较重、扩张性肥厚(DH) ,要给予高度的重视;在降压治疗的同时,应缩小增大的脉压。

关键词：高血压左心室肥厚脉压构型高血压患者高血压病患者回顾性分析室间隔肥厚扩张性相关系数肥厚程度降压治疗 LVH 相关性对称性

对比增强谐波彩色多普勒超声与核磁共振测定左室质量的对照研究

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心血管病学进展 2005年第4期26卷 453-454页

作者：李小清程亚沙成都市第三人民医院心研所

伴左室肥厚的心脏病患者心脏事件发病率增加,其治疗也与无此危险因素心脏病患者不同。M型和二维超声心动图是临床应用最广泛的技术,通过测定左室质量来确定左室肥厚程度。超声心动图无创、相对便宜,但当左室腔畸形时测量受到限制。核磁... 详细信息

伴左室肥厚的心脏病患者心脏事件发病率增加,其治疗也与无此危险因素心脏病患者不同。M型和二维超声心动图是临床应用最广泛的技术,通过测定左室质量来确定左室肥厚程度。超声心动图无创、相对便宜,但当左室腔畸形时测量受到限制。核磁共振(MRI)是比较理想的测定左室质量的方法,但因其昂贵,对植入电子仪器(如起搏器、除颤器等)患者和心律不齐患者的限制以及对严重肥胖病人测得图像质量欠佳而不被广泛使用。最近,经胸超声心动图技术的发展提示超声心动图能在所有病人构建高分辨率的心脏三维图像。本文目的是评价对比增强谐波造影彩色多普勒超声(contrastenhancedcol ourDopplerechocardiography,CECDE)测定左室质量的可行性以及与精标准MRI测定左室质量对照。方法:采用Simpson’s法和面积长度法计算左室质量。MRI获取心脏的短轴观和倾斜角的冠状观及矢状观。使用美国AcusonC256Sequoia超声仪,探头频率1.75/3.5MHz。在45s内静脉注射声学造影剂levovist2.5g,调节低于正常的尼奎斯特频率,约20cm/s,使谐波彩色多普勒充满心腔,增强心肌对比度和增加心内膜边界的显...

关键词：左室质量核磁共振彩色多普勒超声对照研究测定对比增强二维超声心动图超声心动图技术心脏病患者谐波心脏事件左室肥厚危险因素临床应用肥厚程度电子仪器图像质量肥胖病人心律不齐三维图像高分辨率

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心脏磁共振成像在肥厚型心肌病诊断中的应用

世界核心医学期刊文摘（心脏病学分册） 2006年第1期2卷 40-41页

作者： Rickers C. Wilke N. M. Jerosch-Herold M. B.J. Maron 刘少伟 Dr. Minneapolis Heart Institute Foundation 920 E 28th St. Minneapolis MN 55407 United States

Background-Two-dimensional echocardiography is currently the standard test for the clinical diagnosis of hypertrophic cardiomyopathy(HCM). The present study was undertaken to determine whether cardiac MRI(CMR) affords greater accuracy than echocardiography in establishing the diagnosis and assessing the magnitude of left ventricular(LV) hypertrophy in HCM. Methods and Results-Forty-eight patients(age 34±16 years) suspected of having HCM(or with a confirmed diagnosis) were imaged by both echocardiography and CMR to assess LV wall thickness in 8 anatomic segments(total n=384 segments) and compared in a blinded fashion. Maximum LV thickness was similar by echocardiography(21.7±9.1 mm) and CMR(22.5±9.6 mm; P=0.21). However, in 3(6%) of the 48 patients, echocardiography did not demonstrate LV hypertrophy, and CMR identified otherwise undetected areas of wall thickening in the anterolateral LV free wall(17 to 20 mm), which resulted in a new diagnosis of HCM. In the overall study group, compared with CMR, echocardiography also underestimated the magnitude of hypertrophy in the basal anterolateral free wall(by 20±6%; P=0001), as well as the presence of extreme LV wall thickness(≥30 mm) in 10%of patients(P< 0.05). Conclusions-CMR is capable of identifying regions of LV hypertrophy not readily recognized by echocardiography and was solely responsible for diagnosis of the HCM phenotype in an important minority of patients. CMR enhances the assessment of LV hypertrophy, particularly in the anterolateral LV free wall, and represents a powerful supplemental imaging test with distinct diagnostic advantages for selected HCM patients.

关键词：肥厚型心肌病心脏磁共振临床诊断磁共振成像二维超声心动图室壁厚度解剖断面标准检测肥厚程度 MR检查

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经胸骨上窝小鼠心肌肥厚模型建立

中华实验外科杂志 2016年第3期33卷 840-840页

作者：安君李永财安康刘旭光高健王敬琦宁夏自治区人民医院西北民族大学附属医院心胸外科银川750021 宁夏自治区人民医院西北民族大学附属医院神经外科银川750021 上海交通大学医学院附属新华医院心胸外科 200092 吉林大学第一医院心脏外科长春130021

心肌肥厚模型目前有药物诱导、转基因及主动脉缩窄等，主动脉缩窄为最常用。我们通过胸骨上窝利用钽夹部分夹闭主动脉弓的方法使其模型形成时间相对固定，成功率得到提高，肥厚程度可控，模型制备相对简单，现报道如下。

关键词：心肌肥厚模型胸骨上窝主动脉缩窄小鼠药物诱导形成时间主动脉弓肥厚程度

肥厚型心肌病患者心电图形态与表型表现及临床预后的关系

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世界核心医学期刊文摘（心脏病学分册） 2006年第1期2卷 34-34页

作者： Montgomery J. V. Harris K. M. Casey S. A. B.J. Maron 王亭忠 Dr. Hypertrophic Cardiomyopathy Center Minneapolis Heart Institute Foundation Minneapolis MN United States

Twelve-lead electrocardiography, a traditional component in evaluations of patients with hypertrophic cardiomyopathy (HC), is often regarded as a marker for the magnitude of left ventricular(LV) hypertrophy, which in turn has been linked to sudden death risk. To determine whether electrocardiographic(ECG) patterns have clinical utility by accurately reflecting phenotypic expression or predicting clinical outcome, voltages and patterns were compared with LV wall thicknesses assessed by echocardiography and with clinical outcomes in 448 consecutive patients with HC. Significant but relatively weak correlations were evident between maximum LV wall thickness and ECG voltage: r=0.295(p< 0.01) for the sum of R-and S-wave voltages in all 12 leads, r=0.254(p< 0.01)for the maximum R or S wave in any lead, and r=0.210(p< 0.01) for the sum of SV1(or SV2) and RV5(or RV6). Of 55 patients with extreme LV hypertrophy(LV wall thickness ≥30 mm), only 24(44%) showed greatly increased ECG voltage≥30 mm in any lead. Of 102 patients with outflow gradients≥30 mm Hg at rest, only 43(42%) had ECG voltage ≥30 mm in any lead. Normal ECG results were uncommonly associated with HC-related death(1 of 40 patients, 2.5%) but had similar prevalence in surviving patients(17 of 376 patients, 4.5%; p=NS). In conclusion, in HC, 12-lead ECG voltages are not a reliable clinical marker for the magnitude of LV hypertrophy or outflow obstruction. Diverse ECG patterns, consistent with heterogenous expression of this disease, did not predict HC-related death. Scalar electrocardiography has selective but limited power in routine clinical assessments of patients with HC.

关键词：肥厚型心肌病临床预后心电图形态患者表型超声心动图检测室壁厚度导联心电肥厚程度