Video essentials of thoracolaparoscopy combined with esophagectomy / 中国胸心血管外科临床杂志

@#（正）Luketich 等[1]2000 年首次报道了胸腹腔镜联合食管癌微创手术（minimally invasive esophagectomy， MIE）病例。随着近 10 多年的发展，食管癌微创外科已经进入一个技术成熟的阶段，能使广大食管癌患者受益。2009 年美国国立综合癌症网络（NCCN）临床指南[2]已将 MIE 列为标准食管癌术式之一。

The level and clinical significance of soluble ST2 in heart failure patients with atrial fibrillation / 中华检验医学杂志

Objective@#To determine the level of Soluble Suppression of Tumorigenicity-2 (sST2) in patients with heart failure(HF) and atrial fibrillation (AF), and to explore its diagnostic and prognostic value in patients with HF and AF.@*Methods@#A prospective cohort study was carried out to investigate the data of 185 HF patients who were hospitalized between January 2018 and June 2018 in department of cardiology or department of cardiac care unit in TEDA International Cardiovascular Hospital. And according to whether they had atrial fibrillation before admission, we categorized patients into: HF with sinus rhythm (HF-SR, n=90) and HF with AF(HF-AF, n=95). Meanwhile, 40 healthy controls were collected. Baseline data of HF-SR and HF-AF groups and plasma sST2 levels in different ejection fraction groups were compared. Plasma sST2 level was determined by enzyme-linked immunosorbent assay(ELISA). Statistical methods such as nonparametric test and Spearman correlation analysis were used. The receiver operating characteristic curve was applied to evaluate the diagnostic value of sST2 in HF-SR and HF-AF groups. And by using the COX risk model, Multi-factor COX analysis was used to analyze the prognosis of patients.@*Results@#Compared with healthy controls, the median (P25, P75) of Plasma sST2 levels in HF patients increased remarkably [32.93 (20.31-51.39) ng/mL vs 15.99(7.97-22.69) ng/mL, Z=-4.373, P<0.001]. Patients with HF-AF group had significantly higher test results [39.86 (27.20-59.21)] ng/mL than HF-SR group [24.74 (14.83-44.11)] ng/mL, Z=-6.783, P<0.001].In the HFmrEF and HFpEF subgroups, the plasma sST2 level of patients in the HF-AF group was higher than that in the HF-SR group (Z=-2.381, P=0.017; Z=-3.701, P<0.001).Spearman correlation analysis showed that, in HF-AF patients, plasma sST2 level was positively correlated with diastolic blood pressure, Hypertension, New York Association (NYHA) cardiac function classification Ⅲ to Ⅳ, white blood count(WBC), and the level of Alanine Aminotransferase (ALT), Υ-glutamine transaminase (Υ-GT), B-type natriuretic peptide (BNP) (r>0, P<0.05).Also, there is a negative correlation between sST2, left ventricular ejection fraction (LVEF) and estimated Glomerular Filtration Rate (eGFR) (r<0, P<0.05). At ROC analysis, sST2 showed predictive value in both HF-AF and HF-SR group, with an optimal cut-off value of 25.33 ng/mL(AUC 0.872, 95%CI: 0.805-0.935, P<0.001, sensitivity 81.1%, specificity 87.5%) and 23.34 ng/mL(AUC 0.665, 95%CI: 0.570-0.761, P<0.001, sensitivity 55.6%, specificity 77.5%).The AUC of BNP and sST2 in differential diagnosis of HF-SR and HF-AF was 0.604 and 0.699, respectively, and the AUC of sST2 was higher than that of BNP. Multi-factor COX analysis indicated that plasma sST2 level, BNP, NYHA cardiac function grading could be risk factors for cardiac events in HF patients. Plasma sST2, left atrial diameter (LA-D), and associated cardiomyopathy are risk factors for cardiac events in patients with HF-AF. The incidence of cardiac events in HF patients with sST2≥20.31 ng/mL was significantly higher than that of patients with sST2<20.31 ng/mL (χ2=7.625, P=0.006). The incidence of cardiac events in HF-AF patients with plasma sST2≥39.86 ng/mL was significantly higher than that in patients with sST2<39.86 ng/mL (χ2=4.287, P=0.038).@*Conclusions@#The plasma sST2 level in patients with HF-AF is significantly higher than that both in HF-SR and healthy controls. The diagnostic value of plasma sST2 in patients with HF-AF is higher than that in patients with HF-SR. It is suggested that sST2 are more valuable for the differential diagnosis of HF-SR, HF-AF than BNP. HF-AF Patients with plasma sST2 ≥ 39.86 ng/mL are prone to cardiovascular events.

A potential role of plasma circulating microRNA-30d in acute coronary syndrome / 中华检验医学杂志

Objective To investigate the diagnosis and prognosis value of plasma microRNA-30d (miR-30d)in acute coronary syndrome(ACS)patients.Methods It retrospectively recruited 170 cases of ACS patients from TEDA International Cardiovascular Hospital between September 2011 to February 2012, including 70 STEMI(male 54,female 16), 52 NSTEMI(male 34,female 18),48 UAP(male 29,female 19).At the same time,41 healthy controls(male 24,female 17)were enrolled into the study.Plasma miR-30d levels were determined by real-time quantitative PCR.In order to evaluate the dynamic change of miR-30d and other cardiac biomarkers,20 plasma samples of AMI patients were collected at 0-3 h,4-6 h,7-9 h, 10-12 h after pectoralgia.ROC curves and Kaplan-Meier survival curve were used to investigate clinical value of miR-30d in ACS.Results At 0-3 h after pectoralgia, miR-30d were significant higher in STEMI 7.208(0.170-11 070.735)and NSTEMI 7.989(0.836-151.391)than the controls 1.561(0.044-17.520)（Z1＝-5.792,Z2 ＝-6.113,P＜0.001）, but there were no statistic differences between UAP 1.073 （0.051-11.095）patients and the controls（Z＝-0.325,P＝0.745）.In 20 AMI patients,miR-30d levels peaked at 4-6 h and then dropped following 7-9 h, both earlier than cTnI, and the variation tendency was positive correlated with cTnI（r＝0.402,P＜0.01）.At 0-3 h after pectoralgia, the AUC, sensitivity and specificity of miR-30d for differentiating AMI and UAP were 0.882（95％ CI:0.830-0.935）,0.795（95％CI:0.711-0.861）and 0.854（95％ CI:0.716-0.935）respectively.When combined miR-30d and cTnI, the diagnostic AUC and specificity were 0.937（95％ CI: 0.902-0.972）and 0.937（95％ CI:0.818-0.984）,both enhanced when compared with miR-30d or cTnI alone.Kaplan-Meier survival curves revealed that there were no significant correlations between the miR-30d levels and MACE in both 30 days and 12 months（χ$lt@span sup=1$gt@2$lt@/span$gt@＝0.506,P＝0.477 and χ$lt@span sup=1$gt@2$lt@/span$gt@＝0.002, P＝0.963 respectively）.Conclusion Plasma miR-30d may be used as a potential biomarker for early diagnosis, but not prognosis in ACS patients.

Corin-serine protease and clinical applications in cardiovascular disease / 中华检验医学杂志

Corin is a newly identified membrance protease which responsible for converting pro-B-type natriuretic peptide to biologically active B-type natriuretic peptide.B-type natriuretic peptide play an important role in regulating blood pressure and cardiac function.It is a biological marker of heart failure.So Corin plays a role in reducing blood volume, blood pressure, regulating body fluid balance, and improving cardiac function.Corin may be used as a biomarker for heart failure or other cardiovascular disease.Recent studies have found that Corin is associated with the occurrence and development of cardiovascular diseases, such as heart failure and acute coronary syndrome.The article mainly expound the biological characteristics of Corin, testing methods and its clinical application in cardiovascular disease status.

Analytical performance of high-sensitivity cardiac troponin I detection by VITROS ECIQ with enhanced chemiluminescence method / 中华检验医学杂志

Objective To evaluate the performances of high-sensitivity cardiac troponin I ( cTnI ) on VITRO ECIQ with enhanced chemiluminescence method .Methods This verification study validated the limited of detection,function sensitivity,imprecision,linearity of the high-sensitivity cardic troponin used VITROS ECIQ according to the document EP-17A, EP-6A,EP-15A published by Clinical and Laboratory Standards Institute (CLSI) and determined 99th percentiles.All 652 patients with chest pain on immediate admission in TEDA International Cardiovascular Hospital during January to November 2013 were enrolled in this study.Including 323 cases of acute ST segment elevation myocardial infarction and non ST segment elevation myocardial infarction patients as the case group , exclude 329 cases of other diagnosis ,303 cases of apparent normal people as control group .The receiver operating characteristic curve was used to evaluated the sensitivity and the specificity of cTnI . Non-normal distribution of quantitative data were used nonparametric test Mann-Whitney U, With P was 1.73 % -2.33 %, reproducibility CV was 4.93% -9.96%.The imprecision were lower than that declared by assay producer.The linearity was 0.015 5-78.4 ng/ml(R2 =0.999 9); the 99th percentile reference value was 0.017 ng/ml.The area under the curve ( AUC) of cTnI was 0.986,95%CI 0.973 -0.994,with the cut-off value as 0.017 ng/ml, the diagnostic sensitivity and specificity in CIN were 90.09%and 99.34%.Compared between STEMI and NSTEMI groups after admission , the levels of cTnI had no significantly difference , Z were -0.485, P >0.05;compared between STEMI and control groups after admission, the levels of cTnI had significantly difference , Z were -19.567,P<0.001;compared between NSTEMI and control groups after admission , the levels of cTnI had significantly difference , Z were-14.598,P<0.001.Conclusions High-sensitivity cardiac troponin I detection by VITROS ECIQ with enhanced chemiluminescence method has good performances of sensitivity , linearity, specificity, which meet the clinical needs.

Association of LOX-1 and CX3CR1 with coronary artery stenosis disease and its outcomes / 中华检验医学杂志

Objective To explore the association of lectin-like oxidized low-density lipoprotein (oxLDL) receptor-1 (LOX-1),CX3C chemokine receptor 1 (CX3CR1) with coronary artery stenosis disease and its outcomes.Methods A case-control study was conducted.A total of 176 cases of coronary artery stenosis which were confirmed coronary artery stenosis ≥ 50％ by coronary angiography(CAG) were served as case group from department of cardiology of TEDA International Cardiovascular Hospital of Tianjin from May 2011 to April 2013.A total of 129 patients without coronary artery lesion by CAG from this hospital in the same period were served as control group,which has no history of heart disease,liver and kidney dysfuction,brain disease,hematological disease,other disorders that could bring out atherosclerosis and thrombosis.General information and laboratory parameters,LOX-1,CX3CR1,uric acid (UA) and creatinine (CREA) were measured in 2 groups.These parameters of each group were compared,the levels of LOX-1 and CX3CR1 in one-vessel stenosis were compared than that in multi-vessels stenosis in case group,the correlations between LOX-1,CX3CR1 and Gensini score and other variables were analyzed.Comparison of the levels of LOX-1 and CX3CR1 between major adverse cardiovascular events (MACEs) group and nonmajor adverse cardiovascular event (MACE) group was made during follow up 1.5 years.MACEs in patients with different levels of LOX-1 and CX3CR1 were compared during 1.5-year follow up.All of the data were analyzed by SPSS 16.0 software.The independent-samples T test,Mann-Whitney U test,Chi-square test,Spearman correlation,Binary Logistic Regression and Kaplan-Meier probability were adopted for data analysis.Results Comparison between case group and control group,LOX-1:3.72 (1.44,8.15) μg/L vs 0.75(0.50,1.19) μg/L,z =11.072,P ＜0.001 ;CX3CR1:(2.82 ± 1.85) μg/L vs (2.32 ±0.79) μg/L,t =2.021,P ＜ 0.05 ; UA:(351.34 ± 94.82) μmol/L vs (326.74 ± 79.51) μmol/L,t =2.094,P ＜ 0.05 ;CREA:(70.86 ± 20.94) μmol/L vs (65.55 ± 12.96) μmol/L,t =2.077,P ＜ 0.05.CX3CR1 level was significantly higher in patients with multi-vessels stenosis (2.84 ± 1.78) μg/L than that in one-vessel stenosis(2.48 ± 1.64) μg/L,there was significance in difference (t =2.207,P ＜ 0.05).There were no statistically significant correlation between LOX-1,CX3CR1 and Gensini score (R was 0.032,0.079 respectively,P＞ 0.05).LOX-1 was negatively related to left ventricular ejection fraction(LVEF) (R =-0.272,P ＜ 0.01),but positively related to left ventricular end-diastolic diameter (LVDD)(R =0.190,P＜0.05),positively related to UA (R =0.121,P ＜ 0.05).Comparison between MACE group and nonMACE group,LOX-1:7.38(4.97,11.88)μg/L vs 3.52(1.45,7.75) μg/L,z =2.762,P ＜0.01;CX3CRl:(4.02 ±2.90) μg/L vs (2.67 ± 1.48) μg/L,t =3.086,P ＜0.01.LOX-1 and TG were independent risk effects of coronary artery stenosis disease.MACEs were increased in patients with high levels of LOX-1 after PCI during following up 1.5 years (comparison between high-LOX-1 group and lowLOX-1 group,the probability of non-MACE was 87.1％ (115/132) vs 97.7％ (43/44),Log-ranK test,x2 =6.957,P ＜ 0.01).Conclusions LOX-1 and CX3CR1 may be involved in the process of coronary artery stenosis,and a high level of LOX-1 may be associated with left ventricular systolic dysfunction in patients with coronary artery stenosis.Elevated LOX-1 level are closely related to afterwards MACE incidence after PCI in patients with coronary artery stenosis.

Establishment of homogeneous chemiluminescent immunoassy for detecting serum cardiac troponin I / 实用医学杂志

Objective To establish homogeneous immunoassay for detecting serum cardiac troponin I (cTnI) by using light induced chemiluminescent immunoassay (LiCA). Methods Polyclonal antibodies of cTnI were coated on the receptor particles, monoclonal antibodies of cTnI were biotinylated, and the donor particles were coated with streptavidin, all of which were composed of LiCA reagents. The optimal test conditions and analytical performance of the detection method were studied. Results The method was rapid, sensitive, and detection time was 17.5 min.The analytical sensitivity was 0.045 ng/mL and the functional sensitivity was 0.053 ng/mL.The recovery rate was 104.96%-108.21%;The within-run and the between-run coefficients of variation were 3.88%-5.53%and 7.60%-8.75%, respectively. The interference rates for the endogenous substances were less than 10%. The reference value of cTnI was less than 1.05 ng/mL;Results of cTnI LiCA correlated well with direct chemiluminescence detection (r2 =0.979). Conclusions This approach can be used for the quantitative detection of serum cTnI, and it is homogeneous and is free of clean separation. It provides a convenient, highly sensitive detection platform for clinical practice.

The clinical significance of neutrophil gelatinase-associated lipocalin in early kidney injury after elective percutaneous coronary intervention / 中华检验医学杂志

Objective To explore the clinical application value of neutrophil gelatinase-associated lipocalin(NGAL)which were tested by immunity transmission turbidity in early kidney injury after elective percutaneous coronary intervention.Methods A case-control study was conducted.All 201 stable angina pectoris and acute coronary syndrome patients undergone percutaneous coronary intervention in TEDA International Cardiovascular Hospital,during April to August 2013,were enrolled in this study.Before and 2 h,4 h,8 h,24 h,48 h after the operation,the plasma creatinine of the patient samples were tested by enzymic method.Before and 2 h,4 h,8 h,24 h after the operation,the plasma NGAL was tested by immunity transmission turbidity method.Before and 8 h,24 h after the operation,the urinary NGAL was tested by immunoturdimetric method.The data were compared between contrast induced nephrpathy (CIN) and non-CIN groups.For normal distribution of quantitative data,t test were used and for non-normal distribution of quantitative data,nonparametric rank and inspection were used.Results CIN occurred in 8 of 201 enrolled patients,the incidence was 3.98％.Receiver operating characteristic curve (ROC) analysis confirmed the diagnostic accuracy of the plasma NGAL in CIN,and the area under the curve(AUC) of 2 h plasma NGAL was 0.928,95％ CI 0.800-0.985,with the cut-off value NGAL as 109 ng/ml,the diagnostic sensitivity and specificity for CIN were 87.5％ and 100％ ;the AUC of 8 h plasma NGAL was 0.945,95％ CI 0.824-0.992,with the cut-off value NGAL as 96 ng/ml,the diagnostic sensitivity and specificity for CIN were 87.5％ and 87.5％ ;the AUC of 8 h urinary NGAL was 0.969,95％ CI 0.859-0.999,with the cutoff value NGAL as 91 ng/ml,the diagnostic sensitivity and specificity for CIN were 87.5％ and 100％.Conclusions The change of plasma and urinary NGAL is earlier to that of serum creatinine for the early diagnosis of CIN.It can be used as the predictor of early renal damage after elective coronary artery interventional.

The problems in detection and clinical application of high-sensitivity cardiac troponin / 中华检验医学杂志

Troponin is an important biomarker of acute coronary syndrome.Especially highsensitivity cardiac troponin in recent years played an important role for the early diagnosis and prognosis of myocardial infarction.Recommendations for the use of high-sensitivity cardiac troponin have been issued in some guidelines.But the clinical doctors and laboratory workers still have many problems in practice.Some problems in high-sensitivity cardiac troponin assay and the clinical application were introduced here.Suggestions were also put up from international organizations,including unified high-sensitivity cardiac troponin name,unit,establish healthy population,selection guidelines to identify the 99th percentile value.

The Clinical Value of the Different Components of Glycosylated Hemoglobin in Patients with Coronary Artery Disease / 天津医药

Objective To explore the clinical value of the different components of glycosylated hemoglobin in pa-tients with coronary artery disease (CAD). Methods A total of 217 patients were divided into 3 groups:CAD group (groupⅠ, n=60), CAD patients without acute coronary syndrome (ACS) and with diabetes mellitus group (groupⅡ, n=60) and ACS patients with diabetes mellitus group (groupⅢ, n=97). Fifty-eight healthy volunteers in the same time period were selected as control group. The values of fructose glycosylated hemoglobin (HbA1a), lactose glycosylated hemoglobin (HbA1b), glucose glycosylated hemoglobin (HbA1c), hemoglobin P3 component (HbP3), hemoglobin A0 component (HbA0), unstable glycosyl-ated hemoglobin (LA1c/CHb1) and alkali-resistant hemoglobin (HbF) were measured. These parameters were compared be-tween 4 groups. Logistic regression was used to analyze factors that influencing CAD and CAD with diabetes mellitus. The re-ceiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of these factors. Results There were significant differences in titers of HbA1b, HbA1c, HbP3 and HbA0 between groupⅠ, groupⅡ, groupⅢand control group (P＜0.01, or P＜0.05). There were no significant differences in levels of glycosylated hemoglobin parameters between groupⅡand groupⅢ(P>0.05). Logistic regression and ROC curve analysis showed that HbA1c and HbP3 were indepen-dent effects of CAD, and there were some diagnostic efficiency of CAD. The diagnostic efficiency of ROC curve was consis-tent in HbA1c and HbP3 between group Ⅱ and group Ⅲ. Conclusion Levels of HbA1b, HbA1c, HbP3 and HbA0 are closely related to CAD and CAD with diabetes mellitus. HbA1c and HbP3 are independent effects of CAD and, there are some diagnostic efficiency in CAD.

Galectin-3 is an emerging biomarker of heart failure / 中华检验医学杂志

Galectin-3 (gal-3),a member of the galectin family,is directly associated with cardiac fibrosis and cardiac remodeling.Recently it has been approved by the US Food and Drug Administration as a prognostic aid in patients with heart failure (HF).Gal-3 is associated with age,kidney function and B-type natriuretic peptide (BNP).Compared with the diagnostic utility of BNP,the long-term prognosis value of gal-3 is higher than the value of diagnosis.Higher concentration of Gal-3,a marker of cardiac fibrosis,is associated with increased risk for incident CHF and mortality.

Progress of circulating microRNA in cardiovascular disease management / 中华检验医学杂志

MicroRNA (miRNA),a type of 22-25nt non-coding RNA,plays an important role in proliferation and apoptosis of the cardiomyocyte,as well as the pathogenesis of some common cardiovascular diseases.Recently,researches on circulating miRNA in cardiovascular disease draw more attentions.This review will focus on the application value of miRNA in cardiovascular disease,the characteristics of miRNA and its detection technology will be described as well.

Preliminary assessment on the combined level of estimated glomerular filtration rate and qualitative determination of urine albumine on prognosis after percutaneous coronary intervention / 中华检验医学杂志

Objective To evaluate the values of the combined eGFR and qualitative determination of urine albumine on in both during and 3 years after hospitalization prognosis of after PCI.Methods One thousand and five PCI patients were divided into 4 groups by level of eGFR and qualitative determination of urine albumine.A group:eGFR ＜ 60 ml/min,urine albumine negative ( n =34 ) ; B group:eGFR ＜ 60 ml/min,urine albumine positive ( n =34) ; C group:eGFR ≥60 ml/min,urine albumine negative ( n =797 ) ; D group:eGFR ≥60 ml/min,urine albumine positive (n =140).The levels of serum creatinine and urine albumine of PCI patient were measured,and then compare body mass index,smoking,hypertension,hyperlipaemia,diabetes mellitus,previous MI,perioporative PCI and etc.All patients were followed up from 30 d to 3 years.The prognostic facters of PCI patients were analyzed by COX proportional hazards models.Kaplan-Meier survival analysis was used to compare survival curves between the four groups stratified by level of eGFR.The log rank statistic was used to test for differences between groups.Results By multivariate COX regression adjustment for body mass index,smoking,hypertension,hyperlipaemia,diabetes mellitus,previous MI,perioperative PCI,the relative risk (RR) of albuminuria for cardiac events was 2.006 ( 95％ CI:1.020 - 3.947,P ＜ 0.05 ),perioperative PCI 3.375 ( 95％ CI:2.106 - 5.410,P ＜0.05 ).The cardiac events rate of B group with PCI after 1,2 and 3 year was 20.59％,2.94％,2.94％respectively,have statistical significant(x2 =8.774,P ＜ 0.05 ).The cardiac events rate of the first year in A,B,C,D groups was 5.89％,20.59％,4.01％,2.86％ respectively.The different cardiac events rate among four groups had statistical significant(x2 =22.050,P ＜0.01 ).B group cardiac events rate of the first year was significant higher than C,D group,which had statistical significant (x2 =20.020,14.520,P ＜0.01 ).The survival rate of 3 year follow-up after PCI was 91.2％,73.5％,91.6％,93.6％ respectively in four group,the different survival rate among four groups have statistical significant(x2 =16.750,P ＜0.01 ).Conclusion For the identification and treatment of high incidence of cardiac events in patients undergoing PCI,eGFR and qualitative determination of urine albumine are simple and effect tools.

Postoperative prognosis of estimated glomerular filtration rate in coronary artery bypass graft surgery / 中华检验医学杂志

Objective To evaluate the postoperative prognosis of the modification of diet in renal disease formula (MDRD) in coronary artery bypass graft surgery (CABG) in hospital or 4 years after hospitalization. Methods Two hundred and seventy-two CABG patients were divided into 3 groups according to the levels of estimated glomerular filtration rate (eGFR) including 35 cases in eGFR < 60 ml/min group, 119 cases in 60 ≤ eGFR < 90 mL/min group and 118 cases in eGFR ≥90 ml/min group. The prognostic factors of CABG patients were analyzed by COX proportional hazards models. Kaplan-Meier survival analysis was used to compare survival curves among the three groups stratified by eGFR levels. The Log-rank statistic was used for comparing between groups. Results By multivariate COX regression adjustment for body mass index, smoking, hypertension, hyperlipaemia, diabetes mellitus, previous MI, perioperative PCI and etc. , the relative risk (RR) of the increasing age for cardiac events was 1.077(95% CI 1.002-1.158,P =0.044). RR of left ventricular ejection fraction (LVEF) was 0.005(95% CI 0.000-0.456,P =0.022). RR of eGFR was 0.968(95% CI 0.948-0.988,P =0.002). The survival rate in the first, second, third and fourth year were same in every group. The survival rate of group with eGFR < 60 ml/min, 60 ≤ eGFR < 90 ml/min and eGFR≥ 90 mL/min was 76.4%, 93.1%, and 96.6%. The survival rates among three groups were statistically significant. In the survival curve of 4 year follow-up after CABG, the survival rate of group with eGFR < 60 mL/min was lower than that of 60 ≤ eGFR < 90 ml/min group and eGFR ≥ 90 ml/min group. Conclusions The preoperative eGFR is an independent risk factor in evaluating cardiac events in hospital and after hospitalization. It has a higher prognosis value in patients undergoing CABG.

Effect of Shenfu Injection on postoperation of mitral and aortic valve combined replacement / 中华中医药杂志

Objective: To investigate the effect of Shenfu injection on postoperation of mitral and aortic valve combined replacement surgery.Methods:46 cases, elective patients with mitral and aortic valve combined replacement in September 2008 to December 2009,were randomly assigned into two groups, the observation group 24 patients with the control group 22 patients. The Shenfu Injection, 50ml with 5% glucose injection 250ml,was used on postoperative day and 1-5day after that in the observation group. Other treatments were in the same with the control group patients. Monitoring pre and postoperative left ventricular end systolic diameter (LVSD),left ventricular end diastolic diameter (LVDD),left ventricular ejection fraction (LVEF),biochemicalmarkers of myocardial injury, dopamine dosage and the time of ventilator-assisted breathing. Results: The levels of reducing of left ventricular end systolic diameter and increasing of left ventricular ejection fraction in the observation group were higher than those in the control group(P