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不稳定性心绞痛治疗的新进展

德国医学 1999年第4期16卷 213-214页

作者： F.-J.Neum.nn A.Schm.g 赵华月 deutsches {1. m.chen Lazarettstr.36D-81636 MnchenGermany 同济医科大学附属同济医院

不稳定性心绞痛的临床综合征的定义为在近六周来经轻度活动后甚至在静息状态下即出现加剧性心绞痛但血浆肌酸激酶却无明显升高。病理生理不稳定心绞痛(IAP)的主要诱发因素为冠状动脉内斑块破裂促进血栓形成。斑块内含有富于胆固醇的脂... 详细信息

不稳定性心绞痛的临床综合征的定义为在近六周来经轻度活动后甚至在静息状态下即出现加剧性心绞痛但血浆肌酸激酶却无明显升高。病理生理不稳定心绞痛(IAP)的主要诱发因素为冠状动脉内斑块破裂促进血栓形成。斑块内含有富于胆固醇的脂质和单核细胞及巨噬细胞等,表面盖有纤维帽,破裂后流出血液接触动脉壁底层而产生附壁血栓。较少见的诱因为斑块表面的腐蚀,其表面产生的凝血酶可使细胞外的血小板粘附及聚集而产生冠状动脉内不稳定的血栓。早期血液尚能通过。

关键词：心绞痛不稳定性治疗

紫绀型先天性心脏病致红细胞极度增多患者中的铁缺乏症

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世界核心医学期刊文摘（心脏病学分册） 2007年第7期3卷 57-57页

作者： Braun S.L. Eicken A. Kaem.erer H. 韩瑞娟 Institut für Laboratorium.m.dizin Deutsches Herzzentrum München Germany

紫绀型先天性心脏病（CCHD）患者中的红细胞增多是改善氧运输的适应性反应。然而，血细胞比容水平高度增加的患者也许会出现血液高黏度症状。由于血红蛋白浓度的增加，CCHD患者中的铁缺乏症常被忽略。一例29岁CCHD男性患者予本院门诊部... 详细信息

紫绀型先天性心脏病（CCHD）患者中的红细胞增多是改善氧运输的适应性反应。然而，血细胞比容水平高度增加的患者也许会出现血液高黏度症状。由于血红蛋白浓度的增加，CCHD患者中的铁缺乏症常被忽略。一例29岁CCHD男性患者予本院门诊部再次人院。其红细胞（1.．65×1.^1.／L）、血红蛋白（257g／L）和血细胞比容（80％）极度增高。铁供给测量显示具有铁缺乏症的典型表现，即伴有低铁蛋白（1.．2μg／L）和高可溶性转铁蛋白受体（sTfR；20m.／L）。本文中展现了1.红细胞计数极高的铁缺乏症病例。为了适当的治疗并避免对铁状态的错误判断，应经常对CCHD患者进行铁蛋白和sTfR的实验室检查。

关键词：紫绀型先天性心脏病红细胞增多铁缺乏症可溶性转铁蛋白受体极度血红蛋白浓度血细胞比容 CCHD

用Am.latzer肌部室间隔缺损封堵器经导管治疗非限制性动脉导管未闭

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世界核心医学期刊文摘(心脏病学分册) 2007年第9期 48-48页

作者： Eicken A. Balling G. Gildein H.P. 郭俊 Departm.nt of Pediatric Cardiology and Congenital Heart Disease Deutsches Herzzentrum Mü nchen Technische Universitt Mü nchenGermany

本文报道对1.肺动脉高压成年患者的非限制性动脉导管未闭(PDA;口径大)的成功治疗。

关键词：动脉导管未闭先天性心脏病 Am.latzer 非限制性

关于bosentan治疗先天性心脏病合并肺动脉高压成年患者的首次开放性、前瞻性、多中心研究

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世界核心医学期刊文摘(心脏病学分册) 2006年第2期 31-31页

作者： Schulze-Neick I. Gilbert N. Ewert R. 任付先 Abteilung fü r Angeborene Herzfehler Deutsches Herzzentrum Berlin Augustenburger Platz 1 13353 Berlin Germany Dr.

Background: Endothelin receptor antagonism.has been introduced as an effective oral therapy of patients with idiopathic pulm.nary arterial hypertension. In view of the pathophysiologic and histologic sim.larities between idiopathic pulm.nary arterial hypertension and pulm.nary arterial hypertension associated with congenital heart disease(PAH-CHD), there is a rationale for treating these patients with the oral dual(ETA/ETB) endothelin receptor antagonist bosentan. m.thods: Thirty-three patients with PAH-CHD(43± 1. years, 23 with Eisenm.nger syndrom.) were treated with bosentan for a m.an of 2.1. 0.5 years. Efficacy was assessed by a panel of tests, including New York Heart Association functional class, 6-m.nute walking distance, and echocardiographic and hem.dynam.c param.ters. Results: m.an 6-m.nute walking distance increased from.362± 1.5 to 434± 68 m.P=.001.. New York Heart Association class also im.roved significantly(3.1.to 2.4, P=.0001.. This was associated with slight trends in im.rovem.nts of transcutaneous oxygen saturation(86% ± 7% to 88% ± 7% , P=.1.) and m.xim.m.oxygen uptake(1..2± 4.0 to 1..9± 2.5, P=.1.). Right ventricular systolic pressure m.asured by echocardiographic decreased from.1.1. 32 to 1.6± 22 m. Hg(P=.001.. Bosentan treatm.nt was well tolerated by all patients. Conclusions: Long-term.bosentan treatm.nt in adult patients with PAH-CHD was well tolerated and im.roved functional status as well as exercise capacity. These findings have to be corroborated by controlled studies that are presently ongoing.

关键词：肺动脉特发性肺动脉高压先天性心脏病心脏先天畸形 bosentan 成年患者

用组织多普勒应变成像检测法洛四联症修补术后右束支传导阻滞患者的左心室不同步

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世界核心医学期刊文摘（心脏病学分册） 2005年第9期1卷 60-60页

作者： Abd El Rahm.n m.Y. Hui W. Yigitbasi m. H. Abdul-Khaliq 吴波 Dr.Klin. F. Angeborene Herzfehler/K. Deutsches Herzzentrum Berlin D-13353 Berlin Germany

OBJECTIVES: We aim.d to investigate whether patients after tetralogy of Fallot(TOF) repair with right bundle branch block have left ventricular(LV) asynchrony and to assess the influence of ventricular asynchrony on regional and global LV function. BACKGROUND: Patients after TOF repair usually have right bundle branch block. However, no data regarding LV asynchrony in this group are available. m.THODS: Twenty-five patients after TOF repair and 25 age-m.tched healthy control subjects were studied. The regional m.ocardial deform.tion of the interventricular septum.IVS) and the LV lateral wall were exam.ned using tissue-Doppler-derived strain. The tim. interval between the onset of QRS com.lex and the peak strain was m.asured for each wall. According to the difference between LV and septum.tim. intervals am.ng the norm.l subjects, a norm.l range(m.an±2 SD) was plotted, and TOF patients in whom.the difference was beyond the norm.l range were considered to have LV asynchrony. The Tei index was used to assess global LV function. RESULTS: Thirteen(52%) of the exam.ned patients after TOF repair had LV asynchrony. Patients after TOF repair with LV asynchrony had a significantly reduced regional septal systolic strain(p1. and significantly elevated Tei index(p1. com.ared with those without. CONCLUSIONS: Left ventricular asynchrony m.y exist in patients after TOF repair with right bundle branch block. This LV asynchrony is associated with a reduction of both regional and global LV function.

关键词：法洛四联症组织多普勒右束支传导阻滞左心室波群室间隔时间间隔指数评价收缩应变