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1.
Chinese Journal of Postgraduates of Medicine ; (36): 305-308, 2019.
Article in Chinese | WPRIM | ID: wpr-753263

ABSTRACT

Objective To evaluate the clinical efficacy of the simplified strategy in the treatment of diffuse long lesions in the elderly. Methods Two hundred and forty patients over 75 years old with diffuse long coronary artery disease and successfully implanted stents were divided into two groups according to whether the stent placement was completed or limited. The clinical features, pathological features, percutaneous coronary intervention (PCI) status and long-term prognosis of the two groups were observed. The success rates of angiography and surgery were compared between the two groups. The medication was followed up. The major adverse cardiovascular events (MACE) and all-cause mortality were compared between the two groups at 1 year after surgery. Results There was no significant difference between the two groups in cardiac death [1.56% (2/128) vs. 1.87% (2/107)], non-lethal acute cardiac muscle infarction (AMI) [1.56% (2/128) vs. 2.80% (3/107)], all-cause death [4.69% (6/128) vs. 4.67%(5/107)], revascularization of target vessels [2.34%(3/128) vs. 5.61%(6/107)] and angina pectoris recurrence [4.69% (6/128) vs. 7.47% (8/107)], P > 0.05. The difference between the two groups was statistically significant only in the follow-up of coronary angiography [18.75%(24/128) vs. 8.41%(9/107)], P < 0.05. Conclusions The long diffuse coronary artery lesions in the elderly can be implanted with point stents by simplified strategy. The long-term clinical effect is generally satisfactory.

2.
The Journal of Practical Medicine ; (24): 1468-1471, 2018.
Article in Chinese | WPRIM | ID: wpr-697800

ABSTRACT

Objective To investigate correlation between QT interval(QT),corrected QT interval(QTc) and metabolic syndrome(MS). Methods Residents who participated in our survey concerning atherosclerosis and related diseases conducted in Shenyang were included. They accomplished questionnaire,physical examination, laboratory tests and electrocardiography test. We divided them into MS group and non-metabolic syndrome (NMS)group according to International Diabetes Federation(IDF)diagnostic criteria for MS. QT interval was measured from the standard 12-lead electrocardiogram. QTc was calculated by using Bazett and Fridericia equations. We analyze correlation of QT ,QTc and MS. Results A total of 739 residents who were 35~64 years old were included. Individuals with MS had longer QTcB and QTcF than NMS group[(415.8 ± 31.9)ms vs.(410.1 ± 32.1)ms, (407.2± 29.1)ms vs.(402.6 ± 28.8)ms,P<0.05]. The more the number of abnormal MS parameters they had, the longer the QT,QTcB and QTcF they had. Regression analysis showed that QT was associated with serum potassium,smoking,blood glucose,and LDL,and QTcB and QTcF were associated with hypertension,waist circumference and blood potassium. Conclusions MS is associated with corrected QTc. Careful ECG monitoring among persons with MS for early detection of a long corrected QT interval may prevent severe and often fatal arrhythmias or sudden death.

3.
Chinese Journal of Interventional Cardiology ; (4): 261-265, 2017.
Article in Chinese | WPRIM | ID: wpr-609146

ABSTRACT

Objective By comparing the efficacy and complication rates of the 8-mm-tip cryoablation catheter with the normal electrode ablation catheter in the treatment of atrioventricular nodal reentrant tachycardia,this study investigated the efficacy and feasibility of ablation with the 8-mm-tip cryoablation catheter.Methods This is a retrospective case-control study including 122 patients with AVNRT treated with CRYO (n =56) using an 8-mm-tip cryoablation catheter or RF ablation (n =66) from June 2014 to May 2016.The procedure success rate,the recurrence rate,atrioventricular block incidence,procedure time and the difference between the X-ray fluoroscopy dose were compared between the 2 groups.Results The procedure success rate was comparable between the 2 groups(100% for CRYO vs.98.5% for RF,P >0.999)and no AVB was found in both groups.The CRYO group needed shorter procedural time [(66.29±4.72)min vs.(70.00 ± 7.50) min,P =0.001] and less X-ray exposure [(674.14 ± 126.12) mSv vs.(837.52 ± 138.38) mSv,P > 0.001] than the RF group.Conclusions 8-mm-tip cryoablation catheter cryoablation for atrioventricular nodal reentrant tachycardia is as safe and effective as compared to conventional radiofrequency ablation with potential advantages.

4.
Chinese Journal of Tissue Engineering Research ; (53): 4409-4415, 2017.
Article in Chinese | WPRIM | ID: wpr-607614

ABSTRACT

BACKGROUND: Most of evidence-based studies include both adult degenerative scoliosis and adult idiopathic scoliosis, which lead to indirectness in the results, and suppress the promotion of the evidence.OBJECTIVE: To systematically analyze the current clinical researches, and to review the curative efficacy of lateral lumbar interbody fusion for adult degenerative scoliosis.METHODS: A computer-based research of Medline, EMBASE, CENTRAL, WanFang and CNKI databases from December 2015 to December 2016, was performed with the key words of lateral lumbar interbody fusion, direct lumbar interbody fusion, extreme lateral interbody fusion, minimal invasive surgery, adult scoliosis. The articles were screened based on the inclusion criteria, and the clinical symptom improvement and radiological changes were analyzed.RESULTS AND CONCLUSION: Totally 13 articles were included. In the treatment of adult degenerative scoliosis, lateral lumbar interbody fusion shows less blood loss, short hospitalization time, significantly improved symptoms, satisfactory correction at the coronal plane, and low incidence of long-term complications. However, it has the poor correction at the sagittal plane and high incidence of short-term postoperative complications. Therefore, intraoperative neurologic monitoring is necessary and the combination with internal fixation has obtained good effectiveness.

5.
Osteoporosis and Sarcopenia ; : 82-89, 2017.
Article in English | WPRIM | ID: wpr-27195

ABSTRACT

Osteoporotic vertebral fracture is a disease condition with high morbidity and mortality, whose prevalence rises with mean increase in the life span. Conventional treatments for an osteoporotic vertebral fracture include bed rest, pain medication and brace implementation, but if the patient's pain is severe, cement augmentation procedures, including vertebroplasty and kyphoplasty, are performed. Vertebroplasty and kyphoplasty are relatively easy procedures that have been reported to be effective in controlling acute pain. But, the risk of complication and additional adjacent segment fracture and their superiority over conventional treatment remain debatable. Therefore, the authors have summarized the procedures, complications, and clinical evidence of vertebroplasty and kyphoplasty in this review.


Subject(s)
Acute Pain , Bed Rest , Braces , Kyphoplasty , Mortality , Prevalence , Vertebroplasty
6.
Chinese Journal of Postgraduates of Medicine ; (36): 196-198, 2016.
Article in Chinese | WPRIM | ID: wpr-490712

ABSTRACT

Objective To observe the therapeutic effect of balloon dilation in acute thrombus disease. Methods After coronary angiography, 137 patients with acute thrombus disease who were performed percutaneous coronary artery interventional therapy (PCI) from August 2010 to August 2012 were enrolled. In them, 53 patients (control group) didn′t undergo balloon dilation after PCI, and 84 patients(observation group)underwent balloon dilation after PCI. The intraoperative complications and the major adverse cardiac events (MACE) rate were observed. Results The rate of residue stenosis in observation group was lower than that in control group:(6.7 ± 1.3)% vs. (17.1 ± 1.8)%, and there was significant difference (P0.05). The follow-up time was (0.9 ± 0.2) years. In control group, myocardial infarction occurred in 2 patients, 7 patients reviewed coronary angiography, and 2 patients underwent revascularization. In observation group, there was no MACE. Five patients reviewed coronary angiography, and no patient underwent revascularization. Conclusions The method of balloon dilation after PCI in acute thrombus disease is safe and feasible. It can reduce the incidence of MACE, and did not increase the rate of no-reflow or slow flow.

7.
Journal of China Medical University ; (12): 468-471, 2015.
Article in Chinese | WPRIM | ID: wpr-463117

ABSTRACT

Objective To evaluate the efficacy and safety of direct stenting technique in emergent percutaneous coronary intervention(PCI)for pa?tients with acute myocardial infarction(AMI). Methods Totally 460 consecutive patients with acute myocardial infarction who underwent emergent PCI during August 2010 to July 2013 were involved,among whom 346 patients were assigned to the control group(traditional balloon dilation and stenting),114 patients were assigned to the experiment group(direct stenting). The safety and efficacy of direct stenting technique was observed. Results In the control group,7 cases had no reflow during operation,2 cases had reflow after the pre?expansion and 5 cases after stent implanta?tion,no similar cases in the experiment group(P=0.125 9). The follow?ups showed the control group had 2 cases of major adverse cardiac events including 1 case of acute stent thrombosis who required urgent revascularization,and 1 case of cardiac death at four days after operation;the experi?ment group had 1 case of stent thrombosis,there was no statistically significant difference(P=0.730 7). Conclusion Direct stenting technique may be performed selectively for certain coronary diseases when performing emergent PCI for AMI.

8.
Journal of Korean Society of Spine Surgery ; : 186-191, 2015.
Article in Korean | WPRIM | ID: wpr-118121

ABSTRACT

STUDY DESIGN: Literature review. OBJECTIVES: To present updated information on the conservative treatment of osteoporotic spinal fractures (OSFs). SUMMARY OF LITERATURE REVIEW: The treatments of osteoporotic spinal fractures are bed rest, pain medication, bracing, exercise and rehabilitation, and osteoporosis medication. However, there is disagreement about the outcomes of these treatments. MATERIALS AND METHODS: Review of the relevant literature. RESULTS: In the case of osteoporotic spinal fractures, analgesic administration, bracing, physical therapy, and exercise should be conducted. In order to prevent secondary fractures, bisphosphonates, selective estrogen receptor modulators, strontium ranelate, or parathyroid hormone, which has proven efficacy with respect to the prevention of secondary fractures, should be prescribed. CONCLUSIONS: We should actively prevent the occurrence of secondary fractures with fracture healing by implementing a proven effective treatment for osteoporotic spinal fractures.


Subject(s)
Bed Rest , Braces , Diphosphonates , Fracture Healing , Osteoporosis , Parathyroid Hormone , Rehabilitation , Selective Estrogen Receptor Modulators , Spinal Fractures , Strontium
9.
Chinese Journal of cardiovascular Rehabilitation Medicine ; (6): 476-480, 2015.
Article in Chinese | WPRIM | ID: wpr-478288

ABSTRACT

Objective:To study the relationship between neutrophil to lymphocyte ratio (N/L) and traditional cardio‐vascular risk factors among community 35~64‐year‐old residents .Methods :A total of 1884 residents (548 males and 1336 females) from urban Shenyang city received baseline condition questionnaire on cardiovascular diseases and re‐lated diseases from Apr 2011 to Feb 2012. According to presence of cardiovascular risk factors or not ,subjects were divided into healthy control group (n=675) and risk factor group (n=1209);according to number of risk factors , risk factor group was further divided into one risk factor group (n=491) ,two risk factors group (n=263) and ≥3 risk factors group (n=455) .Morning blood sample and urine sample were retained to measure blood and urine rou‐tine ,blood glucose and blood lipid profile etc in all subjects .N/L was compared and analyzed among all groups .Re‐sults:Among patients with only one of following risk factors [hypertension ,diabetes mellitus (DM) ,dyslipidemia and obesity] ,N/L levels of patients with hypertension or DM were significantly higher than that of healthy control group [1.55(1.15 ,1.95) ,1.60(1.21 ,2.07) vs .1.45(1.09 ,1.91)] , P0.05 all .Among risk factor sub‐groups ,N/L level of ≥3 risk factors group was significantly higher than that of two risk factors group [1.57(1.16 , 2.04) vs .1.41(1.07 ,1.89) ,P0.05) .Conclusion:N/L significantly related to hypertension or DM ,and N/L level of ≥3 risk factors group was sig‐nificantly higher than that of two risk factors group ,N/L is helpful to assess risk of cardiovascular diseases .

10.
Journal of China Medical University ; (12): 214-216, 2015.
Article in Chinese | WPRIM | ID: wpr-460800

ABSTRACT

Objective To explore effect of irregular chemotatic factor fractalkine(FKN),phosphatidyl inositol 3 kinase and nuclear factor?κB(NF?κB)on interleukin?6(IL?6)expression in peripheral blood monocytes and the effect of valsartan intervention,so as to research the signal conduc?tive mechanism of FKN impacting on IL?6. Methods Peripheral blood monocytes were isolated from fresh blood of healthy volunteers by the densi?ty gradient centrifugation. The extractive peripheral blood monocytes were divided into seven groups:the control group,the FKN group,the LY294002 group(PI3K inhibitors),the PDTC group(NF?κB inhibitors),the FKN+valsartan group,the FKN+LY294002 group,and the FKN+PDTC group,the latter two were pretreated by LY294002 and PDTC respectively before FKN inducing PBMC cells. The IL?6 expression in cell me?dium was measured in each group by ELISA at 12 hours and 24 hours after PBMC treatment. Results After 12 hours of culture,compared with the control group,the expression of IL?6 in the FKN group was decreased(P0.05). Compared with the FKN group,the expression of IL?6 was decreased in the FKN+valsartan group(P0.05). Conclusion FKN can adjust the expression of peripheral blood PBMC IL?6 in a two?way pattern, inhibiting the expression of IL?6 by PI3K pathway and promoting the expression of IL?6 by NF?κB pathway,overall,FKN can inhibit the expression of IL?6. Valsartan can increase FKN to inhibit the expression of IL?6.

11.
Journal of China Medical University ; (12): 538-542, 2015.
Article in Chinese | WPRIM | ID: wpr-468286

ABSTRACT

Objective To study the independent risk factors of relapse of smoking among current smokers of different ages who underwent percuta?neous coronary intervention(PCI). Methods Totally 197 current smokers who received PCI from January 2007 to December 2009 in the Fourth Affiliated Hospital of China Medical University were enrolled. Information about relapse of smoking was collected through the medical records and the telephone follow?up. Discrepancy of risk factors of smoking resumption was compared in different age groups. Results Totally 112 patients re?sumed smoking after PCI. There were 87 patients in the non?elderly group and 25 in the elderly group. According to the correlation analysis,more than one stents(P=0.025),severe nicotine dependence(P=0.001)and long time for daily passive smoking(P=0.000)were related with relapse in the non?elderly group,and there was a negative correlation between more than one stents and relapse. But in the elderly group,relapse was associ?ated with history of hypertension(P=0.034). According to the logistic regression analysis in different age groups,independent predictors of smoking relapse in the non?elderly group were severe nicotine dependence(OR:3.914,P=0.003)and long time for daily passive smoking(OR:1.352,P=0.000). And in the elderly group,independent risk factors of smoking relapse were male(OR:17.325,P=0.027),history of hypertension(OR:13.185,P=0.005),long time for daily passive smoking(OR:1.273,P=0.045)Conclusion Independent risk factors of smoking relapse were different in the elderly group and the non?elderly group. In the non?elderly group,these factors were severe nicotine dependence and long time for dai?ly passive smoking. And in elderly group,these factors were male,history of hypertension,long time for daily passive smoking.

12.
Journal of Chinese Physician ; (12): 1346-1348, 2013.
Article in Chinese | WPRIM | ID: wpr-442561

ABSTRACT

Objective To compare the difference in ischemic heart disease (IHD) incidence between left and right breast cancer treated with post-op radiation therapy.Methods We retrospectively reviewed electronic database of breast cancer patients treated in our cancer center from October 2006 to December 2011.Clinical data were recorded including clinical features,radiation fraction,and IHD.Statistical analysis was performed to compare the difference in IHD incidence between left and right breast cancer.Results Age on diagnosis was significantly associated with IHD (P < 0.05).Compare to younger patients (≤60),the increased hazard ratio of IHD in older patients (>60) was 3.84.The left breast cancer patients had greater incidence of IHD with the increased hazard ratio of 1.57 although this difference did not reach statistical power (P > 0.05).No patients got IHD in the intensity-modulated radiation therapy group.Conclusions Left-side breast cancer patients may have more probability to get IHD after thoracic radiation therapy compared to right-side patients.We recommend that left-side breast cancer patients should be treated with intensity-modulated radiation therapy to spare heart if they receive prophylactic radiation therapy after surgery.

13.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery ; (24): 1219-1220, 2013.
Article in Chinese | WPRIM | ID: wpr-747145

ABSTRACT

UNLABELLED@#Patients with cervical painless mass for 3 months with swallowing not feeling a week for the chief complaint.@*PHYSICAL EXAMINATION@#top right sternocleidomastoid before hitting a 7.0 by 3.0 cm size, lower limb reached 2.0 cm x 1.8 cm, the size of the mass on the left side of the supraclavicular reached 3.0 cm x 2.5 cm of the size of the mass, the three homogeneous medium hard, focally border and clear, the activity can be puncture cytological examination in return for: left supraclavicular see more protein and blood samples and a small amount of sample are arranged heap of fiber cells. Nuclear magnetic resonance (NMR): on the right side of the neck, with three at the left supraclavicular neoplasm, between 2.5-5.5 cm in size, high in T2, T1 low mixed signals, lesion boundaries clear.


Subject(s)
Humans , Clavicle , Deglutition Disorders , Head and Neck Neoplasms , Pathology , Magnetic Resonance Imaging , Meningeal Neoplasms , Pathology , Meningioma , Pathology , Neck , Neurilemmoma , Pathology , Sensation Disorders , Tumor Burden
14.
Clinical Medicine of China ; (12): 113-116, 2009.
Article in Chinese | WPRIM | ID: wpr-396467

ABSTRACT

Objective To define the effect and mechanism of hyperkalemic solution on atrial natriuretic peptide (ANP) secretion in rabbits. Methods Eighteen rabbits were selected and the chest was opened under anes-thetization to remove the heart. The left atrium was isolated and fixed in the atrial perfusion system with proper electric stimulation for beating. The following experiments were carried out on beating rabbit atria: ①The atrium was perfused for 60 min to stabilize parameters of ANP secretion and atrial dynamics. The control period (12 min as an experimental cycle) was followed by an infusion of hyperkalemic solution (K+ concentration of hyperkalemic solution was 5.64 mmol/L and the osmolarity of hyperkalemic solution was unchanged) for three cycles, then normal K+ cancentration was recovered for two cycles;②The control period was followed by an infusion of L type Ca2+ channel blocker nifedipine (1.0 μmol/L) for three cycles;③L type Ca2+ channel inhibitor nifedipine (1.0 μmol/L) was infused for 36 rain prior (three cycles) to infusion of hyperkalemic solution. Atrial stroke volume was determined and the ANP secretion was measured by radioimmtmoaasay. Results (1)Hyperkalemic solution increased atrial ANP secretion (P<0.01) and reduced the atrial stroke volume,hut the difference was not statistically significant as compared with that of the control cycle(P>0.05). The recovery trend was to the normal level of ANP secretion and atrial stroke volume was to become normal gradually when solution level recovered to normal ,which was not significantly different from that of the control cycle (P>0.05) ;②Nifedipine (1.0 μmol/L) also increased the atrial ANP secretion (P<0.01 or P <0.05) while decreasing atrial stroke volume (P<0.01 or P < 0.05 ) ; ③Nifodipine (1.0μmol/L) completely blocked the effect of hyperkalemic solution so to increase the ANP secretion (P <0.01 ). Conclusion Hyperkalemic solution significantly increases atrial ANP secretion via extracellular high K+ competitive inhibition of extracellular Ca2+ inflow in beating rabbit atria.

15.
Chinese Journal of Postgraduates of Medicine ; (36): 19-21, 2009.
Article in Chinese | WPRIM | ID: wpr-392600

ABSTRACT

Objective To investigate the efficacy of intracoronary tirofiban during percutaneous coronary intervention(PCI)for patients with acute myocardial infarction(AMI).Methods Seventy-six consecutive AMI patients,treated with primary coronary angioplasty in 12 hours were enrolled.They were randomly divided into two groups:tirofiban group(39 cases)and control group(37 cases).Tirofiban group was treated with intracoronary timfiban during PCI and after the operation for 48 hours.Both of them were given heparin in PCI and aspirin,clopidogrel before PCI.At the end of PCI procedure,angiographic features such as TIMI flow grade and TIMI myocardial perfusion grade(TMPG)were analyzed.The difference of two groups in complication and major adverse cardiac events(MACE) was investigated.Results The myocardial reperfusion of tirofiban group was better than that of control group[TIMI grade 3 flow 94.9%(37/39) vs 78.4%(29/37),P<0.05;TMPG 3 grade 89.7%(35/39)vs 67.6%(25/37),P<0.05].There was no significant difference between two groups in bleeding complication.The occurrence of MACE in tirofiban group was less than that in control group[7.7%(3/39)vs 18.9%(7/37),P<0.05].Conclusion Intracoronary tirofiban dunng primary PCI in patients with AMI can improve coronary flow and myocardial perfusion,and has no more bleeding and less MACE occurrence.

16.
Journal of Interventional Radiology ; (12)2004.
Article in Chinese | WPRIM | ID: wpr-572963

ABSTRACT

Objective We Observed the mobilization effects of autologous circulating blood stem cell by G-CSF in old patients(≥70 years old) with acute myocardial infarction (AMI).Methods 10 old patients with AMI were allocated to receive either inclusive type Granulocyte Colony-Stimulating Factor (G-CSF), or excrete type G-CSF to mobilize the stem cell, with either 300?g/day or 600?g/day. The patients received G-CSF by hypodermic injection, and the duration of applying G-CSF was 5 days. In the process of the mobilization of the circulating blood stem cell, the white blood cell (WBC) and CD34 + cell count in the circulating blood should be observed. Results Prior to applying G-CSF and the 3rd、4th、5th、6th、7th after applying G-CSF, the counts of WBC were 6.75?10 9/L、28.16?10 9/L、34.93?10 9/L、34.40?10 9/L、38.93?10 9/L、21.85?10 9/L; the counts of CD34+ cell were 6.25?10 6、51.10?10 6、92.60?10 6、109.65?10 6、134.69?10 6、45.09?10 6 The peak of curve that WBC and CD34 + cell count changed with applying days was at the 6th .The count of CD34 + cell in the circulating blood was positive referent with the count of WBC in the circulating blood(r=0.940)Conclusion In old patients with AMI, the mobilized peak of WBC and CD34 + cell counts changed with applying days was at the 6th, and the count of CD34 + cell in the circulating blood was positive referent with the count of WBC in the circulating blood.

17.
Chinese Medical Journal ; (24): 1283-1286, 2002.
Article in English | WPRIM | ID: wpr-340347

ABSTRACT

<p><b>OBJECTIVE</b>To assess the complications of percutaneous tansluminal septal myocardial ablation (PTSMA) for the treatment of hypertrophic obstructive cardiomyopathy (HOCM).</p><p><b>METHODS</b>Seventy-two patients with symptomatic left ventricular outflow tract obstruction were diagnosed by echocardiography or catheterization procedures. Absolute ethanol was injected into the target coronary artery branch (branches) for septal myocardial ablation. Documented complications were recorded.</p><p><b>RESULTS</b>Sixty-nine patients had severe chest pain, 19 developed different degrees of heart block during the periprocedural period, but only one developed a complete AV block, requiring permanent pace-maker implantation. Temporary right bundle branch block occurred in 50% of patients and permanent block occurred in 38.9% of patients. Acute inferior myocardial infarction occurred in six patients (8.3%) and acute anterior myocardial infarction occurred in one patient. During two-year follow-up of 24 cases, there were no deaths. All patients had improvement in heart function and none experienced heart failure.</p><p><b>CONCLUSION</b>The most common complication of PTSMA is right bundle branch block. The most significant complication of the procedure is heart block. PTSMA is a good technical, non-surgical treatment for HOCM.</p>


Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Arrhythmias, Cardiac , Cardiomyopathy, Hypertrophic , General Surgery , Catheter Ablation , Heart Block , Heart Septum , General Surgery , Myocardial Infarction , Postoperative Complications
18.
Chinese Journal of Practical Internal Medicine ; (12)2002.
Article in Chinese | WPRIM | ID: wpr-553025

ABSTRACT

Objective To access the clinical effectiveness and safety of the home-made coronary artery stent - Jin Xin stent. Methods Ten patients with coronary heart disease,from 39 to 70 years old (averaged 55 2yrs),male 7,female 3,were performed PTCA .Jin Xin stents were implanted in to left anterior descending arteries(2),left circumflex(3)and right coronary arteries (5). Results The stenosis was 80~100% before the stents implantation, and 0 after the implantation. There were no abrupt occlusion and thrombosis during the procedure,and no cardiac events during the 6~8 months follow-up. Conclusion Jin Xin Stent is very good at releasing and standing-support. And it can dilate completely. It is safe and effective as an interventional therapy for coronary heart disease.

19.
Chinese Journal of Practical Internal Medicine ; (12)2001.
Article in Chinese | WPRIM | ID: wpr-554945

ABSTRACT

Objective To observe the safety and feasibility of autologous peripheral blood stem cell (PBSC) transplantation by intracoronory infusion in patients with acute myocardial infarction (AMI).Methods Totally 27 patients with AMI were randomly allocated to receive either inclusive type granulocyte colony-stimulating factor (G-CSF),or excretory type G-CSF to mobilize the stem cells.They received the dose of G-CSF 300-600?g/d by hypodermic injection for 5 days.On the sixth day,PBSCs were separated by Baxter CS 3000 blood cell separator into 50ml suspending liquid.The suspending liquid without treatment was infused into the infarct-related artery (IRA)by occluding the over-the-wire balloon and infusing artery through balloon center lumen.During PBSC mobilization,the following side-effects should be paid attention to,such as bone pain,lethargy,tetter,fever,gastrointestinal effects (nausea,vomiting,constipation),angina or deteriorated heart failure,as well as some rare complications (spontaneous spleen rupture,severe purulent infection, hypercoagulable state,and autoimmune diseases).When the PBSCs were being separated and collected,some complications were observed,for example,low calcium effects (mouth numbness and spasm),pale and dizziness due to vagus reflect,pale and dizziness owing to low blood volume,deterioration of angina or heart failure.The complications should also be observed during the PBSC transplantation by intracoronary infusion:arrhythmia including bradycardia (because of balloon occlusion),sinus arrest or the third degree of atrial ventricular block (because of coronary spasm due to balloon stimulating stent), ventricular fibrillation or hypotension,etc.Results There were 22 cases with complications during the mobilization,separation,collection, and infusion of PBSCs.The incidence of complications during mobilization was 44.4%(12/27),during separation and collection is 25.9%(7/27),and during PBSC transplantation by intracoronary infusion 11.1%(3/27).Conclusion In patients with AMI,Intracoronary infusion of PBSC is feasible and safe.

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