浅谈垂体后叶素与硝酸甘油联用治疗上消化道出血

上消化道出血是内科常见的急危重病，本文介绍垂体后叶素联用硝酸甘油治疗上消化道出血，既能有效控制出血，又能降低重体后叶素的副作用，且价格低廉．适用于基层医院。     

硝酸甘油-多巴酚丁胺负荷超声心动图评价心肌梗死部位存活心肌的研究

目的　探讨硝酸甘油 多巴酚丁胺负荷超声心动图识别心肌梗死部位存活心肌的可靠性和安全性。方法　对 2 9例接受冠状动脉血运重建术的陈旧性心肌梗死患者 ,术前行多巴酚丁胺及其合用硝酸甘油超声心动图了解术前室壁运动情况 ,术后 3个月复查室壁运动改善情况 ,以术后相应节段运动改善为标准 ,分析比较术前多巴酚丁胺及其合用硝酸甘油超声心动图判定存活心肌的准确性并评价其安全性。结果　多巴酚丁胺合用硝酸甘油超声心动图判定存活心肌的敏感性、特异性和准确性分别为 90 .9%、95 .6%和 96.2 % ,其敏感性与单用多巴酚丁胺比较虽无统计学差异 (P >0 .0 5 ) ,但已表现出增高趋势 ,而特异性和准确性则不受影响。术前室壁节段运动指数分析提示多巴酚丁胺 10 μg·kg-1·min-1与多巴酚丁胺 5 μg·kg-1·min-1间差异无显著性 (P >0 .0 5 ) ,而多巴酚丁胺 10 μg·kg-1·min-1合用硝酸甘油较多巴酚丁胺 5 μg·kg-1·min-1级明显降低 (P <0 .0 5 )。且多巴酚丁胺合用硝酸甘油无诱发心肌缺血副作用。结论　硝酸甘油 多巴酚丁胺负荷超声心动图识别心肌梗死部位存活心肌比单用多巴酚丁胺更敏感而且更安全     

夜的眼睛

我正在单位值班,手机响了。凌晨一点的手机铃声格外刺耳,是老家的号码,我的心一阵紧缩,有一种不祥的感觉。那端传来母亲急急的声音:"小军,你爸爸又犯病了,赶快回家吧!"父亲有心绞痛的毛病,我忙问:"需要我买硝酸甘油吗?"母亲说:"不用了,我已经给尚大夫打了电话了,他很快就过来了!"听母亲这样说,我稍微放心了点。尚伯和我家是世交,他医术高超,最熟     

芎麻汤药效部位对硝酸甘油诱导偏头痛大鼠三叉神经颈髓复合体内CGRP-CRLR/RAMP1信号通路的影响

目的用硝酸甘油型偏头痛大鼠模型,观察芎麻汤药效部位(乙酸乙酯及正丁醇提取部位)对偏头痛发作时三叉神经颈髓复合体(TCC)内降钙素基因相关肽-降钙素受体样受体-活性修饰蛋白受体1(CGRP-CRLR/RAMP1)信号通路的干预作用。方法 36只雄性SD大鼠随机分为6组(空白对照组,模型组,芎麻汤药效部位低、中、高剂量组,琥珀酸舒马普坦对照组),每组6只。皮下注射硝酸甘油(10mg/kg)复制偏头痛模型,给药后乙醚麻醉,其中18只(每组3只)心脏灌注后取全脑剥离TCC部位,采用免疫组化染色检测CGRP、CRLR、RAMP1阳性表达;余18只直接取全脑剥离TCC部位并平分两份,一份组织采用qPCR检测CGRP、CRLR、RAMP1mRNA表达,另一份组织采用Western blot检测CGRP、CRLR、RAMP1蛋白表达。结果与空白对照组比较,偏头痛大鼠TCC内CGRP、CRLR、RAMP1阳性细胞数、mRNA及蛋白表达均明显增加,差异具有统计学意义(P<0.05),模型复制成功;与模型组比较,芎麻汤药效部位能降低偏头痛大鼠TCC内CGRP、CRLR、RAMP1阳性细胞数,下调CGRP、CRLR、RAMP1mRNA和蛋白表达,差异具有统计学意义(P<0.05)。结论芎麻汤药效部位能降低偏头痛大鼠TCC内CGRP-CRLR/RAMP1信号通路的活性。     

硝酸甘油贴剂对充血性心力衰竭的血液动力学效应

报道10例扩张型心肌病心力衰竭(HF)患者,对硝酸甘油贴剂(瑞士CIBA—GEIGY公司)的急性血液动力学效应。贴药后右房平均压(MRAP)较前有非常明显下降(P<0.01),持续8h。心脏指数(CI)明显升高(P<0.05),持续12h。提示局部敷贴硝酸甘油是一种治疗HF可取的给药途径。     

Nitroglycerin reduces augmentation index and central blood pressure independent of effects on cardiac preload

Objective To determine whether reduction In central pressure augmentation and central systolic blood pressure by nitroglycerine (NTG) results from effects on pre-lead or is due to arterial dilation. Methods We compared effects of NTG with these of lower body negative pressure (LBNP). Hemodyunmic measurements were made at rest, during LBNP (10, 20 and 30 mmHg, each for 15 min) and after NTG (10, 30 and 100μg/min, each dose for 15 min) in ten healthy volunteers. Cardiac pre-lead, stroke volume and cardiac output were assessed by echacardiography. Central pressure an mnentation and central systolic pressure were obtained by radial tonometry using a transfer function. Results LBNP (20 mmHg) and NTG (30μg/min) reduced pre-lead (as measured by the peak velocity of the S wave in the superior vena eava) to a similar degree [by (26. 8 ± 3.8) % and (23.9 ± 3. 4) %, respectively]. Compared to LBNP, NTG reduced systemic vascular resistance [by (32. 9 ± 7.5) %, p< 0. 01], decreased peripheral and central pressure augmentation [by (20. 8 ± 3. 4)% units and (12. 9±2. 9)% units, respectively, each P< 0. 01]. Conclusion These results suggest that a reduction in pre-load does not explain reduction in pressure augmentation and central systolic blood pressure by NTG and that these effects are mediated through arterial dilation.