共查询到20条相似文献，搜索用时 31 毫秒
1.
Aside from the important role of brain natriuretic peptide (BNP) in diagnosis, and differential diagnosis of heart failure,
this biological peptide has proved to be an independent surrogate marker of rehospitalization and death of the fatal disease.
Several randomized clinical trials demonstrated that drugs such as beta blocker, angiotensin converting enzyme inhibitor,
spironolactone and amiodarone have beneficial effects in decreasing circulating BNP level during the management of chronic
heart failure. The optimization of clinical decision-making appeals for a representative surrogate marker for heart failure
prognosis. The serial point-of-care assessments of BNP concentration provide a therapeutic goal of clinical multi-therapy
and an objective guidance for optimal treatment of heart failure. Nevertheless new questions and problems in this area remain
to be clarified. On the basis of current research advances, this article gives an overview of BNP peptide and its property
and role in the management of heart failure. 相似文献
2.
目的：探讨在监测血清脑钠肽水平下,短期使用注射用重组人脑利钠肽治疗急性心力衰竭或慢性心力衰竭急性发作的临床效果。方法：48例急性心力衰竭患者根据是否使用注射用重组人脑利钠肽分为常规组和注射用重组人脑利钠肽组,对比两组治疗的临床效果和超声心动图情况,并监测BNP水平。结果：治疗7d后,注射用重组人脑利钠肽组临床有效率明显好于常规组（81．7％vs61．6％,P〈0．05）,左室射血分数明显高于常规组（51±6）％vs（46±5）％,（P〈0．01）,且血清脑钠肽水平明显降低（498±209）pg／mL vs（642±318）pg／mL,（P〈0．01）,血清脑钠肽下降水平和左室射血分数提高水平差异有统计学意义（P〈0．05）,有效者治疗后左室射血分数提高及血清脑钠肽下降均强于无效者（P〈0．01）。结论：在血清脑钠肽指导下短期应用注射用重组人脑利钠肽有助于改善急性心力衰竭患者的临床症状和心功能。 相似文献
3.
We observed in a pilot study that there was a transient elevation of brain natriuretic peptide （BNP） level shortly after the transplantation in the patient with ischemic heart failure, which is unexplainable by the simultaneous increase of the cardiac output and six-minute walk distance. Similar findings were observed in the phase I trial. We postulated on the basis of the finding of Fukuda in vitro that this transient elevation of BNP level against the improvement of cardiac function and exercise capacity might indicate cardiomyogenesis in patients after mesenchymal stem cell transplantation. Further study is warranted to verify the hypothesis. 相似文献
4.
Yuan Gao Ling Xia Ying-lan Gong Ding-chang Zheng 《Journal of Zhejiang University. Science. B》2018,19(1):49-56
Left anterior fascicular block (LAFB) is a heart disease identifiable from an abnormal electrocardiogram (ECG). It has been reported that LAFB is associated with an increased risk of heart failure. Non-specific intraventricular conduction delay due to the lesions of the conduction bundles and slow cell to cell conduction has also been considered as another cause of heart failure. Since the location and mechanism of conduction delay have notable variability between individual patients, we hypothesized that the impaired conduction in the ventricular myocardium may lead to abnormal ECGs similar to LAFB ECG patterns. To test this hypothesis, based on a computer model with a three dimensional whole-heart anatomical structure, we simulated the cardiac exciting sequence map and 12-lead ECG caused by the block in the left anterior fascicle and by the slowed conduction velocity in the ventricular myocardium. The simulation results showed that the typical LAFB ECG patterns can also be observed from cases with slowed conduction velocity in the ventricular myocardium. The main differences were the duration of QRS and wave amplitude. In conclusion, our simulations provide a promising starting point to further investigate the underlying mechanism of heart failure with LAFB, which would provide a potential reference for LAFB diagnosis. the angulation of impaction having little effect on facture risk. 相似文献
5.
介绍了临床应用β-阻滞剂治疗慢性充血性心力衰竭(CHF)的发展.应用β-阻滞剂治疗CHF可显著改善临床症状,降低死亡率,特别是对特发性DCM的疗效最为显著.β-阻滞剂治疗CHF应当在病情稳定后开始使用.介绍了不同β-阻滞剂的作用特点以及具体应用方法,并针对可能发生的药物不良反应提出了防治方法. 相似文献
6.
Congestive heart failure (CHF) has emerged as a major worldwide epidemic and its main causes seem to be the aging of the population and the survival of patients with post-myocardial infarction. Cardiomyocyte dropout (necrosis and apoptosis) plays a critical role in the progress of CHF; thus treatment of CHF by exogenous cell implantation will be a promising medical approach. In the acute phase of cardiac damage cardiac stem cells (CSCs) within the heart divide symmetrically and/or asym-metrically in response to the change of heart homeostasis, and at the same time homing of bone marrow stem cells (BMCs) to injured area is thought to occur, which not only reconstitutes CSC population to normal levels but also repairs the heart by dif-ferentiation into cardiac tissue. So far, basic studies by using potential sources such as BMCs and CSCs to treat animal CHF have shown improved ventricular remodelling and heart function. Recently, however, a few of randomized, double-blind, pla-cebo-controlled clinical trials demonstrated mixed results in heart failure with BMC therapy during acute myocardial infarction. 相似文献
7.
Although the management of chronic heart failure (CHF) has made enormous progress over the past decades, CHF is still a tremendous medical and societal burden. Metabolic remodeling might play a crucial role in the pathophysiology of CHF. The characteristics and mechanisms of metabolic remodeling remained unclear, and the main hypothesis might include the changes in the availability of metabolic substrate and the decline of metabolic capability. In the early phases of the disease, metabolism shifts toward carbohydrate utilization from fatty acids (FAs) oxidation. Along with the progress of the disease, the increasing level of the hyperadrenergic state and insulin resistance cause the changes that shift back to a greater FA uptake and oxidation. In addition, a growing body of experimental and clinical evidence suggests that the improvement in the metabolic capability is likely to be more significant than the selection of the substrate. 相似文献
8.
Cell therapy in congestive heart failure 总被引：5，自引：0，他引：5
Congestive heart failure （CHF） has emerged as a major worldwide epidemic and its main causes seem to be the aging of the population and the survival of patients with post-myocardial infarction. Cardiomyocyte dropout （necrosis and apoptosis） plays a critical role in the progress of CHF; thus treatment of CHF by exogenous cell implantation will be a promising medical approach. In the acute phase of cardiac damage cardiac stem cells （CSCs） within the heart divide symmetrically and/or asymmetrically in response to the change of heart homeostasis, and at the same time homing of bone marrow stem cells （BMCs） to injured area is thought to occur, which not only reconstitutes CSC population to normal levels but also repairs the heart by differentiation into cardiac tissue. So far, basic studies by using potential sources such as BMCs and CSCs to treat animat CHF have shown improved ventricular remodelling and heart function. Recently, however, a few of randomized, double-blind, placebo-controlled clinical trials demonstrated mixed results in heart failure with BMC therapy during acute myocardial infarction. 相似文献
9.
Assessing the dynamics of heart rate fluctuations can provide valuable information about heart status. In this study, regularity of heart rate variability （HRV） of heart failure patients and healthy persons using the concept of singular value decomposition entropy （SvdEn） is analyzed. SvdEn is calculated from the time series using normalized singular values. The advantage of this method is its simplicity and fast computation. It enables analysis of very short and non-stationary data sets. The results show that SvdEn of patients with congestive heart failure （CHF） shows a low value （SvdEn： 0.056±0.006, p 〈 0.01） which can be completely separated from healthy subjects. In addition, differences of SvdEn values between day and night are found for the healthy groups. SvdEn decreases with age. The lower the SvdEn values, the higher the risk of heart disease. Moreover, SvdEn is associated with the energy of heart rhythm. The results show that using SvdEn for discriminating HRV in different physiological states for clinical applications is feasible and simple. 相似文献
10.
目的探讨慢性阻塞性肺疾病合并左心衰竭的诊断方法,并分析使用无创呼吸治疗的临床价值。方法总结31例患者诊断的经验,并使用无创呼吸机治疗,比较治疗前后血气分析结果,并统计呼吸机治疗前后患者临床症状改善情况。结果治疗后患者pH恢复正常,显著高于治疗前（P〈0.05）,且PO2和PCO2均恢复正常,均优于治疗前（P〈0.05）,治疗后患者存在端坐呼吸、精神萎靡和呼吸困难的比率均显著低于治疗前（P〈0.05）。结论 COPD合并左心衰竭较易漏诊,使用无创正压通气治疗,提高患者血氧含量,减轻呼吸机做功,纠正低氧血症,避免有创通气的并发症及脱机困难。 相似文献
11.
Objective： To evaluate the surgical clinical results of hypertrophic obstructive cardiomyopathy. Methods： We retrospectively collected data on 24 patients who underwent surgical management in the past ten years in two hospitals in China and Madras Medical Mission in India. Myomectomy was carried out on all patients. Among them 3 patients underwent mitral valve replacement; 2 patients underwent mitral valve repair （anterior mitral leaflet plication）; 2 patients underwent aortic valve replacement; 1 patient underwent aortic valve repair; 2 patients underwent aortic root replacement; 1 patient underwent Bentall＇s procedure and 1 patient underwent coronary artery bypass grafting because of a breached muscle bridge, Results： One patient died of post-operative heart failure. The mean follow-up time was 4.3 years, There was significant improvement in the symptomatic status. Sixteen patients were asymptomatic with good effort tolerance and only four patients had New York heart association （NYHA） Classes Ⅰ-Ⅱ due to associated valvular lesions, Conclusion： Our experience proved that symptomatic hypertrophic obstructive cardiomyopathy or non-symptomatic hypertrophic obstructive cardiomyopathy with combined heart disease is indication for surgery as surgical intervention could get better clinical results in this kind of patients compared with other non-surgical method because it beneficially reduces the systolic anterior motion （SAM） of the mitral valve leaflet, which could not be avoided by other non-surgical treatment. 相似文献
12.
心电图在临床诊断心脏疾病中起着极其重要的作用,随着人们生活水平的提高,保健意识的增强,对便携式心电监护仪的需求也越来越大。文中设计了基于C8051F340的便携式心电信号采集系统,按照系统设计原则,提出了系统总体结构及功能,并采用余弦离散变换DCT对心电数据进行压缩,方便了数据存储和传输。 相似文献
13.
目的：探讨肺栓塞的诊断方法,分析常见误诊原因,提高对肺栓塞的认识,降低误诊、误治。方法：收集了30例肺栓塞患者的临床表现、实验室资料及误诊情况,对误诊原因进行分析。结果：肺栓塞临床表现缺乏特异性,临床医生,尤其是部分外科医生对该病认识不足,故误诊率高。30例病例误诊肺炎11例,肺结核4例,胸膜炎3例,慢性阻塞性肺病2例,肺心病2例,急性冠脉综合征5例,急性左心衰2例,腰椎间盘突出症1例。结论：肺栓塞早期临床诊断有一定困难,临床医生应提高对病症的认识,对有高危因素患者新近出现气促、胸痛、咯血、呼吸困难和新发肺部浸润影,经治疗症状无缓解,应考虑肺栓塞可能,尽早完善CT肺动脉造影检查,减少误诊、误治。 相似文献
14.
Qiang Liu Xiao-jia Su Yan Yu Yong-lin Liu 《Journal of Zhejiang University. Science. B》2013,14(8):749-753
In our study, 50 patients with dilated cardiomyopathy (DCM) were selected to investigate the correlation between virus persistent infection and cardic function. We found that 44% of patients with DCM were coxsackie virus B-RNA (CVB-RNA) positive, significantly different from that (20%) of the normal control group (P<0.05). The expression levels of coxsackie adenovirus receptor (CAR) in patients with DCM were significantly higher than those in the normal control group (P<0.01). In CVB-RNA-positive patients, expression levels of CAR were significantly higher than those in CVB-RNA-negative patients (P<0.01). There was a positive correlation between CAR expression and brain natriuretic peptide (BNP) level in patients with DCM, but no significant correlations between the CAR expression level and left ventricular ejection fraction (LVEF) or left ventricular end diastolic diameter (LVEDd). These results showed that expression levels of CAR on the surface of white cells can be used as an indicator for detecting persistent virus infection. We found that expression levels of CAR and heart function in patients with DCM were highly correlated. 相似文献
15.
姚素萍 《襄樊职业技术学院学报》2011,10(3):32+37-32,37
目的通过典型慢性肺心病心衰治疗时加用硝酸甘油,探索硝酸甘油作为血管扩张剂治疗慢性肺心病心衰的疗效。方法在抗感染、氧疗、纠正酸碱平衡及电解质紊乱、纠正心率失常、利尿的基础治疗上加用硝酸甘油微泵推注。结果 2例慢性肺心病心衰患者在常规综合治疗基础上加用硝酸甘油,咳嗽、呼吸困难、胸闷、心慌症状得以缓解,紫绀、水肿消退,肺部啰音减轻或消失,心功能也得以改善。结论硝酸甘油能有效控制心衰,改善症状。 相似文献
16.
The evolution in undergraduate medical school curricula has significantly impacted anatomy education. This study investigated the perceived role of clinical anatomy and evaluated perceptions of medical students' ability to apply anatomical knowledge in the clinic. The aim of this study was to develop a framework to enhance anatomical educational initiatives. Unlike previous work, multiple stakeholders (clinicians, medical students, and academic anatomists) in anatomy education were evaluated. Participants completed an eleven-point Likert scale survey written by the investigators. Responses from both clinical educators and medical students at Penn State Milton S. Hershey Medical Center and College of Medicine suggest that medical students are perceived as ill-prepared to transfer anatomy to the clinic. Although some areas of patient management differ in relevancy to anatomical education, there are areas of clinical care which were uniformly ranked as relying heavily on anatomical knowledge (imaging and diagnostic studies, physical examination, and arrival at correct diagnosis) by a variety of clinical specialists. Our results suggest a need for advanced anatomy courses to be taught coincidental with medical students' clinical education. Development of these courses would optimally rely on input from both clinicians and academic anatomists, as both cohorts rated clinical anatomy similarly (P ≥ 0.05). Additionally, we hypothesize that preclinical students' application of anatomy would be enhanced if clinical context was derived from areas of clinical care which rely heavily on anatomy, whereas courses designed for advanced medical students will benefit from anatomical context focused on specialty specific aspects of clinical care identified in this study. 相似文献
17.
Christine Szwed 《British Journal of Special Education》2007,34(2):96-104
This article considers the impact of recent policy designed to define the roles and responsibilities of special educational needs co-ordinators (SENCos). The international drive towards the inclusion of children with special educational needs within the mainstream has led many schools to reconsider their structures and practices. In the UK, the SENCo role lies at the heart of these structures and the Government has sought to define this role both within a revised Code of Practice for special educational needs and in a set of national standards. In this article, Christine Szwed, Director of Studies for Initial Teacher Education at the University of Birmingham, reports the findings of a survey examining the context of SENCo role management within a group of primary schools. The findings indicate that the role cannot be generalisd and that SENCos are operating in increasingly complex contexts within very different management structures. Christine Szwed argues that, to be effective, SENCos must be enabled to work at a whole-school level and that the co-ordination of special needs is a development issue for the whole staff. 相似文献
18.
Heart failure has become one of the biggest threats to human health. Transplantation remains the most effective therapy for heart failure, but because of the shortage of donors, it cannot meet the demand. Ventricular assist devices (VADs) were developed to treat heart failure, and have now been clinically applied worldwide. As the country with the largest population, China is also facing the threat of heart failure. However, the development of VADs in China is very slow and is seldom discussed. This paper first talks about the background for VAD development in China. Then several home-developed VADs in China are introduced. The current clinical application status of VADs in China is also presented. Finally the challenge and opportunity for VAD development in China are discussed. 相似文献
19.
目的：探讨癌基因C-erbB-2在周围型肺癌发生、发展中的作用。方法：采用免疫组化和流式细胞术、聚合酶链反应三种方法检测基因表达是否一致及与生物学行为、CT征象的关系。结果：癌基因C-erbB-2蛋白表达与患者的年龄、性别、TNM分期无关，在肺腺癌中的表达明显高于鳞癌（P（0．05），肺癌的分化程度低、有肺门或纵隔淋巴结转移C-erbB-2蛋白表达明显增高（P〈O．05）。C-erbB-2蛋白表达与深分叶征、棘突征有关；而与肿瘤的大小、短细毛刺征、胸膜凹陷征无关。三种方法检测C-erbB-2蛋白及mRNA表达水平一致．结论：癌基因C-erbB-2在肺癌发生、发展、CT征象中起重要作用，检测这种基因并结合CT征象可作为临床诊断及评估预后的有效指标。 相似文献
20.