急性右室心肌梗塞的临床特点及诊治

Clinical features,diagnosis and treatment of acute right ventricular infarction

目的 探讨急性右室心肌梗塞的临床特点、诊断及治疗。方法 对 16例急性右室心肌梗塞的临床资料进行回顾性分析。结果 多合并有下壁心肌梗塞 ,临床表现主要是右心功能不全、低血压、肺清晰。右胸导联ST段抬高。治疗的特殊性在于扩容。

Objective To discuss the clinical features, diagnosis and therapy of right ventricular infarction. Methods We analyzed the informat ion of 16 patient s with right ventricular infarction. Results Right ventricular infarction freque ntly accompanies inferior left ventricular infarction. Main manifestations are r ight ventricular failure, hypotension and shock. Most patients have ST segment e levation in right precardial electrocardiographic V4R V6R. Specific management i s on a combination of expanding plasma volume. Conclusions The diagnosis should be considered when patients with acute inferior infarction have manifestations d escribed above. Key words myocardial infarction; right ventricle; clinica l featuresr failure, hypotension and shock. Most patients have ST segment elevation in right precardial electrocardiographic V4R V6R. Specific management is on a combination of expanding plasma volume. Conclusions The diagnosis should be considered when patients with acute inferior infarction have manifestations described above. myocardial infarction; right ventricle; clinical featuresical University, Chongqing 400038, China ) Abstract The effect of Rhizoma Paridis s ap onins (RPS)on acute analgesia tolerance to morphine in complete Freund's adj uvant induced arthritic(AIA)rats in warm water tail flick test was observed, th e changes of β endorphin (β EP) and adrenocorticotropic hormone (ACTH) level in the brain of rats were also assayed with radioimmunoassay methods. The rat m odels of acute analgesia tolerance to morphine were established when the AIA rat s received an intermittent injection of morphine every 2 h , the ACTH and β E P levels in the hippocampus , β EP level in the hypothalamus were found sign ificantly decreased. When the rats had orally taken RPS (60 mg/kg), the pain beh avior scores were decreased markedly and the warm water tail flick latency was increased significantly. Meanwhile, the ACTH levels in the hippocampus and hypot halamus,β EP level in the hypothalamus were increased significantly. The corre lation between the effect of RPS on the level of ACTH in the hypothalamus and th e pain behavior scores of morphine tolerance in AIA rats were significant at 0.0 1 level. The results suggest that RPS attenuate the development of acute analges ia tolerance to morphine in AIA rats by reversing the decline of ACTH level in t he hypothalamus .