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支架置入术后多支血管弥漫性痉挛1例

国际心血管病杂志 2016年第1期43卷 62-63页

作者：胡凯刘宗军上海市普陀区中心医院心内科 200062

1病例简介患者男性,68岁,因胸闷、胸痛2d伴发热入院。心电图提示窦性心律,Ⅰ、AVL、V4～V6导联ST段抬高0.1～0.25mV。胸片提示慢性支气管炎继发感染。血生化显示,肌钙蛋白T 17.6ng/mL（参考值〈0.75ng/mL）。既往史：慢性支气管炎病史1... 详细信息

1病例简介患者男性,68岁,因胸闷、胸痛2d伴发热入院。心电图提示窦性心律,Ⅰ、AVL、V4～V6导联ST段抬高0.1～0.25mV。胸片提示慢性支气管炎继发感染。血生化显示,肌钙蛋白T 17.6ng/mL（参考值〈0.75ng/mL）。既往史：慢性支气管炎病史10余年,吸烟史20年,已戒烟10年。

关键词：弥漫性支血管慢性支气管炎冠脉造影支架置入术肌钙蛋白继发感染窦性心律前降支胸痛

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肺结核咯血患者多支血管栓塞术后的护理

山东医药 2014年第24期54卷 108-109页

作者：刘琼邓小军黄小英南华大学附属南华医院湖南衡阳421002

肺结核咯血患者实施多支血管栓塞使止血成功率提高,术后复发减低,但增加了术后并发症的可能[1～4]。我院对15例多支血管参与供血的肺结核咯血患者进行多支血管栓塞治疗,效果良好。现将护理情况报告如下。临床资料：2009～2012年南华大... 详细信息

肺结核咯血患者实施多支血管栓塞使止血成功率提高,术后复发减低,但增加了术后并发症的可能[1～4]。我院对15例多支血管参与供血的肺结核咯血患者进行多支血管栓塞治疗,效果良好。现将护理情况报告如下。临床资料：2009～2012年南华大学附属南华医院收治肺结核咯血患者15例,均有支气管动脉之外的其他体循环动脉参与供血,男10例、女5例,

关键词：肺结核咯血血管栓塞止血成功率支气管动脉术后并发症甲状颈干动脉体循环动脉支血管动脉搏动穿刺口出血

在药物洗脱支架时代使用单支血管与分叉支架置入治疗冠状动脉左主干远端病变的比较:对RESEARCH(鹿特丹心脏病医院雷帕霉素洗脱支架评估)和T-SEARCH(鹿特丹心脏病变医院紫杉醇洗脱支架评估)注册研究的临床和血管造影认识

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世界核心医学期刊文摘（心脏病学分册） 2007年第4期3卷 9-10页

作者： Valgimigli M. Malagutti P. Rodriguez Granillo G.A. P.W.Serruys 马超 Erasmus Medical Center ThoraxcenterRotterdamNetherlands Dr.

背景:新近发现,常规药物洗脱支架(DES)置入可改善接受冠状动脉左主干(LM)经皮治疗患者的预后。然而,即使是在DES时代,远端LM的治疗仍是不良预后的独立预测因素。应使用单支血管支架(SVS)

关键词：冠状动脉左主干 RESEARCH T-SEARCH 支血管支架置入治疗紫杉醇洗脱支架药物洗脱支

血管造影、心肌血流储备分数与单光子发射计算机断层心肌灌注成像判定冠状动脉多支血管病变患者心肌病变的对比研究

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世界核心医学期刊文摘（心脏病学分册） 2007年第8期3卷 25-26页

作者： Ragosta M. Bishop A.H. Lipson L.C. 罗亮 Dr.Cardiovascular Division Department of Medicine University of Virginia Health System Charlottesville VA United States

推测在冠状动脉多支血管病变(MVD)患者中,心肌灌注成像(MPI)不能检测出具有潜在心肌缺血可能性的所有血管分布区域。MPI检查基于相对血流储备,其用于判断M VD中单个部分狭窄病变意义的价值仍存质疑。血流储备分数(FFR)可以检测单个血管... 详细信息

推测在冠状动脉多支血管病变(MVD)患者中,心肌灌注成像(MPI)不能检测出具有潜在心肌缺血可能性的所有血管分布区域。MPI检查基于相对血流储备,其用于判断M VD中单个部分狭窄病变意义的价值仍存质疑。血流储备分数(FFR)可以检测单个血管狭窄病变的意义。36例患者(涉及88支血管病变)接受了血管造影、FFR以及MPI。FFR是在冠状动脉内注射腺苷使之充血的情况下利用压力导丝进行测定。利用MPI进行定量分析,并将每一节段指定到特定的冠状动脉。确定每一个血管分布区域中FFR与灌注之间的关系。

关键词：多支血管病变单光子发射血管造影压力导丝支血管灌注成像血管分布灌注缺损血运重建动脉供

具有多支血管病变的心脏病患者的治疗:PRISMA研究

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世界核心医学期刊文摘（心脏病学分册） 2005年第2期1卷 17-18页

作者： Cournot M. Cambou J.-P. Ferrières J. 高登峰 INSERM U558 Departement d'Epidemiologie Facultéde Méde cine 37 allées Jules Guesde 31073 Toulouse Cedex France Dr.

Introduction: myocardial infarction (MI), peripheral vascular disease and isch aemic cerebral vascular accident (CVA) are three manifestations of the same dise ase, atherothrombosis, and they share the same pathophysiology and prognosis. Ob jective: the aim of this work was to describe the clinical characteristics and t he medical management of polyvascular patients in cardiology. Method: cardiologi sts from all over the country participated in a consultation register for 3 week s. The clinical characteristics and medical management for the first 3 patients on the register for each cardiologist were studied in a national multicentre stu dy and then compared according to whether the atherothrombotic disease was isola ted or polyvascular. Results: in total, 100 429 patients were examined during th e period of the register and 2 780 were included in the study. Polyvascular pati ents represented 7%of the register and 22%of the vascular patients. These pati ents with multiple manifestations were frequently diabetics. A lipid profile was available less often in the cardiac patients when they had another disorder (72 .4%) than in the case of an isolated disorder (78.9%). Whatever the initial di sorder, dyslipidaemia was less often controlled in the case of polyvascular dise ase (63%of LDL C ≥.3g/l in polyvascular cardiac patients vs 52%in cardiac pa tients with isolated disease). In cardiac patients, the presence of peripheral v ascular disease was associated with less prescription of beta blockers (OR=0.4 [ 0.3-0.6]), the presence of CVA was associated with less prescription of statin s (OR=0.7[0.5-0.9] ). Eight out of 10 polyvascular patients received anti pla te let aggregation treatment. The presence of multiple atherothrombotic manifestati ons was associated with greater prescription of ACEI, except in cardiac patients . Conclusion: these results improve our understanding of the specific management of polyvascular patients, for whom secondary prevention is paramount due to the higher risk of recurrence. They should

关键词： PRISMA 多支血管病变血管疾病患者支血管药物治疗情况他汀类药物周围血管疾病二级预防血脂障碍 β受体阻滞剂

锝-99m sestamibi心肌灌注成像肺心比增高与多支血管冠状动脉疾病之间的临床关系

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世界核心医学期刊文摘（心脏病学分册） 2005年第10期1卷 50-51页

作者： Kumar S. P. Brewington S. D. O' Brien K. F. Movahed A. 刘健 Section of Cardiology Department of Internal Medicine E. Carolina Univ. Brody Sch. of Med. Greenville NC 27858- 4354 United States

An increased lung to heart ratio(LHR) on thallium-201(Tl- 201) stress myocardial perfusion imaging(MPI) is a predictor of adverse cardiac events and identifies people with extensive coronary artery disease(CAD). The implications of increased LHR in patients undergoing stress technetium- 99m(tc- 99m) sestamibi are developing. Our aim is to evaluate the relationship between increased LHR and extent of CAD in patients undergoing tc- 99m sestamibi MPI. Methods: We reviewed the records and images of 530 consecutive subjects who underwent exercise or adenosine tc- 99 m sestamibi MPI. One hundred thirty-two had transient or partially reversible myocardial perfusion defects and 79(exercise=34, adenosine=45, male=43, female=36, mean age=61 years) of these underwent coronary angiography(study population). The average LHR of these 79 subjects was compared to 79 patients(control population) with normal scans(exercise=50, adenosine=29, male=34, female=45, mean age=60 years). Results: The mean LHR(± SE) in subjects with normal scans was 0.30± 0.01. The mean LHR for those with abnormal scans and single vessel CAD who underwent exercise was 0.32± 0.01 and pharmacological stress was 0.31± 0.01. There was no statistically significant difference between the LHR of those with a normal scan and those with single vessel disease and an abnormal scan. However, there was a statistically significant association between the elevated LHR and multi-vessel CAD. The mean LHR for subjects with multi-vessel CAD with exercise was 0.39± 0.01(p=0.000) and for adenosine was 0.39± 0.02(p=0.000). Conclusion: An elevated LHR in patients undergoing exercise or pharmacological tc- 99m MPI correlates with multi-vessel CAD.

关键词：支血管 m sestamibi 临床关系灌注成像不良心脏事件受试组血管病图像资料

大脑中动脉临时阻断时长与症状性脑梗死的关系

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实用医学杂志 2022年第5期38卷 650-654页

作者：游慧超李文琦孙登江欧阳和平江汉大学附属湖北省第三人民医院神经外科武汉430000 江汉大学附属湖北省第三人民医院超声科武汉430000

载瘤动脉临时阻断是颅内动脉瘤夹闭术中常用的技术,明确脑动脉的安全可耐受阻断时长,对脑动脉瘤夹闭术的顺利进行具有重要作用,然而目前对于脑动脉的安全阻断时长尚无定论^([1-4])。大脑中动脉供应基底节区、中央前后回及语言中枢等重... 详细信息

载瘤动脉临时阻断是颅内动脉瘤夹闭术中常用的技术,明确脑动脉的安全可耐受阻断时长,对脑动脉瘤夹闭术的顺利进行具有重要作用,然而目前对于脑动脉的安全阻断时长尚无定论^([1-4])。大脑中动脉供应基底节区、中央前后回及语言中枢等重要功能区,远离Willis环,其分叉部动脉瘤较其他部位动脉瘤位置更为表浅,其远端无一级代偿血管,阻断后仅依靠同侧软脑膜支血管代偿供血^([5])。

关键词：语言中枢重要功能区分叉部脑动脉瘤夹闭术软脑膜支血管基底节区大脑中动脉

急性冠状动脉综合征患者多支血管不稳定的致死性同步

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世界核心医学期刊文摘（心脏病学分册） 2007年第4期3卷 38-38页

作者： Hansen P.R. 郭俊 Department of Cardiology P Gentofte University HospitalNiels Andersensvej 65DK-2900 HellerupDenmark

急性冠状动脉综合征患者可能表现为广泛的冠状动脉不稳定。本文报道1例ST段抬高型心肌梗死患者。

关键词：支血管血管造影检查

多支血管病变患者进行血流储备分数指导的经皮冠状动脉介入治疗后的远期临床预后

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世界核心医学期刊文摘（心脏病学分册） 2005年第12期1卷 59-59页

作者： Berger A. Botman K.-J. MacCarthy P. A. B. De Bruyne 武俊平 Cardiovascular Center Aalst OLV Clinic Moorselbaan 164 B-9300Aalst Belgium

OBJECTIVES: In the present study, we analyzed the clinical outcome of patients with multivessel coronary artery disease in whom at least one vessel was treated by percutaneous coronary intervention(PCI) and at least one other vessel was deferred on the basis of fractional flow reserve(FFR) measurements during the same session. BACKGROUND: Myocardial FFR is an established tool for assessing the severity of epicardial stenoses. It has been shown that it is safe to defer an intervention in single vessel disease patients when FFR >0.75. METHODS: One hundred two patients(66±10 years) with multivessel coronary artery disease were included in the study. In all patients, PCI of at least two vessels was contemplated. Yet in all of them at least one vessel was treated by PCI, whereas at least one other vessel was deferred based on an FFR >0.75. Major adverse cardiac events(MACE) were recorded during an average follow-up of 29±18 months. RESULTS: In 102 patients, 113 coronary arteries underwent PCI. In these arteries FFR was 0.57±0.13 and mean diameter stenosis was 68±14%. One hundred twenty-seven coronary arteries had an FFR >0.75 and PCI was deferred. In these arteries FFR was 0.86±0.06 and mean diameter stenosis was 47±12%. No death occurred during the follow-up. A MACE occurred in 9%and 13%of patients after 12 and 36 months, respectively. These MACE were related to 22(9.2%) arteries. Among them, 8(6.3%) MACE were related to one of the initially deferred vessels, whereas 14(12.3%) MACE were related to one of the initially treated coronary artery. CONCLUSIONS: In patients with multivessel disease, PCI of hemodynamically non-significant stenoses can be safely deferred, even if initially planned on the basis of the angiogram.

关键词：多支血管病变介入治疗支血管外膜血管不良心脏事件血管病血管造影