目的:探讨术前负荷量的替格瑞洛对急性ST段抬高性心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)中无复流的影响。方法:将STEMI患者120例随机分为替格瑞洛组(n=60)和氯吡格雷组(n=60)。比较两组患者PCI后无复流。观察术前、术后心肌梗死溶栓血流分级(TIMI)、校正TIMI计帧数(CTFC)、心肌灌注分级(TMPG)、心电图ST段回落指数(STR)及心肌型肌酸激酶同工酶(CK-MB)峰值及峰值时间。结果:替格瑞洛组术后IRA TIMI3级血流、TMPG 3级明显增加(均P<0.05),CTFC明显改善(P<0.01),无再流发生率较氯吡格雷组低20.0%(P<0.01)。术后2 h STR、CK-MB峰值及酶峰值时间均优于氯吡格雷组(P<0.05)。结论:术前高负荷量的替格瑞洛,可减少术中无复流的发生率,改善心肌灌注。
目的:探讨在轻中度原发性高血压患者中腹型肥胖与临床不同动脉硬化指标之间的相关性。方法:以209例轻中度原发性高血压患者为研究对象,按腹围分组,分析一般临床数据、血生化指标和各动脉硬化指标在腹围正常组与腹型肥胖组之间的差异,及腹围与各个临床动脉硬化指标之间的相关性,最后用逐步回归分析动脉硬化的独立危险因素。结果:腹型肥胖组体质指数(BMI)、甘油三酯、血清尿酸、肱踝脉搏波传导速度(baPWV)和颈动脉内膜中层厚度均显著高于腹围正常组(P Objective: To explore the correlation between abdominal obesity and different clinical arteriosclerosis indexes in patients with mild to moderate essential hypertension. Methods: 209 patients with mild to moderate essential hypertension were divided into different groups according to the abdominal circumference. The differences of general clinical data, blood biochemical indexes and arteriosclerosis indexes between the normal and increased abdominal circumference groups were analyzed, and the correlation between abdominal circumference and each clinical arteriosclerosis index was analyzed. Finally, the independent risk factors of arteriosclerosis were analyzed by stepwise regression. Result: The body mass index (BMI), triglyceride, serum uric acid, brachial-ankle pulse wave velocity (baPWV) and carotid intima-media thickness in the abdominal obesity group were significantly higher than those in the group with normal abdominal circumference (P < 0.05). Ankle brachial index (ABI), carotid plaque and other indexes had no statistical difference between the two groups. At the same time, Pearson correlation analysis showed that there was a positive correlation between abdominal circumference and baPWV, end diastolic interventricular septal thickness and carotid intima-media thickness. The correlation was the highest with baPWV and the lowest with end diastolic ventricular septal thickness. Stepwise regression analysis sh