目的分析血清脑钠肽、降钙素原变化与心力衰竭患者纽约心脏病协会(New York Heart Association,NYHA)分级的相关性。方法选取2019年5月—2023年2月云南省玉溪市第二人民医院收治的97例心力衰竭患者为研究对象,所有患者都进行NYHA心功能...目的分析血清脑钠肽、降钙素原变化与心力衰竭患者纽约心脏病协会(New York Heart Association,NYHA)分级的相关性。方法选取2019年5月—2023年2月云南省玉溪市第二人民医院收治的97例心力衰竭患者为研究对象,所有患者都进行NYHA心功能分级后分为3组,心功能Ⅱ级57例(Ⅱ级组),心功能Ⅲ级28例(Ⅲ级组),心功能Ⅳ级12例(Ⅳ级组),检测3组血清脑钠肽、降钙素原含量并进行相关性分析。结果随着NYHA分级的增加,患者的左室射血分数明显降低,左室舒张末期内径明显升高,差异有统计学意义(P均<0.05)。随着NYHA分级的增加,患者的血清脑钠肽、降钙素原含量明显升高,差异有统计学意义(P均<0.05)。Spearman分析显示NYHA分级与血清脑钠肽、降钙素原含量、左室射血分数、左室舒张末期内径存在相关性(r=0.714、0.746、-0.788、0.692,P均<0.05)。结论心力衰竭患者多伴随有血清脑钠肽、降钙素原的高表达,与患者的NYHA分级存在相关性,可作为判断患者病情的重要依据。展开更多
Objective: This case report aimed to highlight intersections of TB and Cardiovasular diseases which carry high morbidity and mortality rates. Methods: We are reporting the surgical management of forty seven years fema...Objective: This case report aimed to highlight intersections of TB and Cardiovasular diseases which carry high morbidity and mortality rates. Methods: We are reporting the surgical management of forty seven years female who had back ground history of IDDM (Insulin dependent diabetic Mellitus), ESRD (End stage renal disease) on HD (haemodialysis) also she had left subclavian artery stenosis, and paroxysmal atrial fibrillation. She was diagnosed with mitral valve infective endocarditis and found accidently to have an open pulmonary tuberculosis (TB) on the day before surgery. Results: She was started on first line anti-TB treatment. She was isolated in her private room and airborne precautions measures applied. The patient underwent a tissue Mitral Valve replacement and tricuspid valve repair annuloplasty. Special precautions were applied in Theatre and on cardiopulmonary bypass Machine guided by KAMC-J disinfection protocol. The patient made good recovery postoperatively. She was discharged well on day 7 post operatively. Conclusion: Intersections of TB and cardiovasular diseases carry high morbidity and mortality rates. Early diagnosis and early anti tuberculosis treatment can surely improve the patient prognosis. Our decontamination and disinfective procedures are recommended. Cases like this should be monitored long term for the development of further cardiovascular complication.展开更多
Congestive heart failure is a disease in which initially compensatory changes in cardiac , vascular, and renal functions become detrimental over time. The changes are mediated by a large number of neurohormones and cy...Congestive heart failure is a disease in which initially compensatory changes in cardiac , vascular, and renal functions become detrimental over time. The changes are mediated by a large number of neurohormones and cytokines. Counter-regulatory hormones also play a role, but are generally insufficient to offset the adverse effects of the neurohormones or progression of the disease. Symptoms of heart failure occurs in the 'presence of systolic dysfunction, usually documented by a decrease in ejection fraction, or can present with impaired diastolic function occasionally labeled as heart failure with preserved systolic function of the left ventricle. Heart failure and its treatment represent a medical problem of significant importance because of the high mortality associated with it despite the current therapy , which has substantial evidence of reduction in mortality and morbidity. Prevention or slowing of the progressive deterioration in function of the heart and other organs involved through utilizing new agents that affect more or different neurohormonal pathways may be beneficial and forms the focus of heart failure research and drug development. However , the multiplicity of hormonal effects mandate the use of complex therapy in the management of congestive heart failure(CHF). The new agents in addition to the conventional therapy used in the management of heart failure are; Human B-type nalriuretic peptide (in the treatment of decompensated CHF) , endothelin receptor antagonists, calcium sensitizers, neutral endopeptidase (NEP) and vasopeptidase inhibitors, vasopressin antagonists and cytokine inhibitors.展开更多
文摘目的分析血清脑钠肽、降钙素原变化与心力衰竭患者纽约心脏病协会(New York Heart Association,NYHA)分级的相关性。方法选取2019年5月—2023年2月云南省玉溪市第二人民医院收治的97例心力衰竭患者为研究对象,所有患者都进行NYHA心功能分级后分为3组,心功能Ⅱ级57例(Ⅱ级组),心功能Ⅲ级28例(Ⅲ级组),心功能Ⅳ级12例(Ⅳ级组),检测3组血清脑钠肽、降钙素原含量并进行相关性分析。结果随着NYHA分级的增加,患者的左室射血分数明显降低,左室舒张末期内径明显升高,差异有统计学意义(P均<0.05)。随着NYHA分级的增加,患者的血清脑钠肽、降钙素原含量明显升高,差异有统计学意义(P均<0.05)。Spearman分析显示NYHA分级与血清脑钠肽、降钙素原含量、左室射血分数、左室舒张末期内径存在相关性(r=0.714、0.746、-0.788、0.692,P均<0.05)。结论心力衰竭患者多伴随有血清脑钠肽、降钙素原的高表达,与患者的NYHA分级存在相关性,可作为判断患者病情的重要依据。
文摘Objective: This case report aimed to highlight intersections of TB and Cardiovasular diseases which carry high morbidity and mortality rates. Methods: We are reporting the surgical management of forty seven years female who had back ground history of IDDM (Insulin dependent diabetic Mellitus), ESRD (End stage renal disease) on HD (haemodialysis) also she had left subclavian artery stenosis, and paroxysmal atrial fibrillation. She was diagnosed with mitral valve infective endocarditis and found accidently to have an open pulmonary tuberculosis (TB) on the day before surgery. Results: She was started on first line anti-TB treatment. She was isolated in her private room and airborne precautions measures applied. The patient underwent a tissue Mitral Valve replacement and tricuspid valve repair annuloplasty. Special precautions were applied in Theatre and on cardiopulmonary bypass Machine guided by KAMC-J disinfection protocol. The patient made good recovery postoperatively. She was discharged well on day 7 post operatively. Conclusion: Intersections of TB and cardiovasular diseases carry high morbidity and mortality rates. Early diagnosis and early anti tuberculosis treatment can surely improve the patient prognosis. Our decontamination and disinfective procedures are recommended. Cases like this should be monitored long term for the development of further cardiovascular complication.
文摘Congestive heart failure is a disease in which initially compensatory changes in cardiac , vascular, and renal functions become detrimental over time. The changes are mediated by a large number of neurohormones and cytokines. Counter-regulatory hormones also play a role, but are generally insufficient to offset the adverse effects of the neurohormones or progression of the disease. Symptoms of heart failure occurs in the 'presence of systolic dysfunction, usually documented by a decrease in ejection fraction, or can present with impaired diastolic function occasionally labeled as heart failure with preserved systolic function of the left ventricle. Heart failure and its treatment represent a medical problem of significant importance because of the high mortality associated with it despite the current therapy , which has substantial evidence of reduction in mortality and morbidity. Prevention or slowing of the progressive deterioration in function of the heart and other organs involved through utilizing new agents that affect more or different neurohormonal pathways may be beneficial and forms the focus of heart failure research and drug development. However , the multiplicity of hormonal effects mandate the use of complex therapy in the management of congestive heart failure(CHF). The new agents in addition to the conventional therapy used in the management of heart failure are; Human B-type nalriuretic peptide (in the treatment of decompensated CHF) , endothelin receptor antagonists, calcium sensitizers, neutral endopeptidase (NEP) and vasopeptidase inhibitors, vasopressin antagonists and cytokine inhibitors.
