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臨床病例報告.pdf

1、_Svv$L_SQEl# _qNO_gq2 gOmw _c/NK ez_ N mwY_bN mw 200235 N-W A case study of malignant pericardial mesothelioma with gas pericardiography XU Dongjin,DU Xiuhai,GE Xiaowei,XU Zhenzhi,FANG Lide.Shanghai Yodak Cardiac-Thoracic Hospital(Shanghai,200235,China) Internat J Cardiovasc Med,2009,10(1):83841. e1

2、.1. N,e u7 64kr0 N;4l#wO4N mnk 4g 0 4P gRMm;R_l#wNOR y9 N mnk0 q!ONq0 vlW0 TU0 T0 mvR t,N:SSS 2/6e6.g Kussmaul_0 ys q!Xu N SN N-U 7cm RN 9cm 0 0QIn0q!Xu08 VmA_ (+) yRo (-) N mnk01.3. Rjg ?O80NR0WGkc80 _Sm89 y: v 0 1.310 0 2+ XW rG j y: m 083% N-0 10% v0 7% gNQfW bxgFgr (-)0 T B2 PCR (-)0 i-lgr (-)0

3、0W R eO (-)0 l 56mm/h0 Ph8 fW (-)0 u2Rkc80 N- g r v! 0 (-)0QhYWbjn, (-)0b O(-)0oVP (- )0kv$|Rkc8 QMutvlkc80 CTy:Pl#k _SzMm0 _SzR:_mAr2zMm N SYv00 _SQEl# _q CTy:YN Pt_SPXS _Shbg P _Ss zMm0_Wy:z_ QhSg_e/P;n I b? P ; n0_ _i y: Tb?Ykc8 EF69% _SN-zMm0_Sut:e _Svv$01.4. lvB Qeb_8NNq e/c _SzR:uYn_mA Qq_ mA

4、Q 720ml m wk e _STQglQe_:vg25mg+Q 10mg0 _SQEl# _qS_SzMmj_au_Svv$_IQeYy L_SYRRdS S_* 1tg*Q_v|02. vv$8v|uW(0yv0 W(Qhkv$vv|usN-_ON _Svv$ff/U0 _Svv$Sv|uNNOUta YexW( 40krNN u7YNYs0_Svv$SNSv| N_SNu1_SvovVk O gYvf/vv$/S_S0_Svv$QvNOMvvv$f:e Sg 20%v1_Svv$W(uRMx: 0 gl_W Qg 196019892t 23O _ S v v$ v zq!NO:ekcx

5、 0pN GN fSVv_SzMm W(cdPh80 QhQvNVhkv$IyI8uu_wv_SzMm anR0_Svv$:e0 g,OtaPOY zq6Qsur S_SbQm bvFlvBq!eH bYg Ybg*x:0 Qeb_N8jg u2rzRQ _Rpz oqT|qerv!0 oIPDTu Ph8SQhQv|qkv$WGSNNcd0 W(_S/veg .uOX1TJ ._ Nv|svupv0 _Sm0xjgN-8N fv|s_b0bPv|skc80vT vv0 p S _ PZ _ Sm0xjg gYbS 500ml_SmPZ_0xjg j#fv|s_b00 _SzR:m;jNR0T

6、u_S NYYexSR0vDT_0g,O_SQEl# _q CTcy:_Shbg P S_utx:r2_Sv0v$ eE_SQEl# _q CTa ryR% eg_Svv$uv:efg a0V_SQEl# _q_XQidR SNnxW0oy:_qvY cdzMmv_q SniZoy:_SXS |#S_STQgkXJ kv$vOM:eg a0 _Svv$f/Nz.uVN f0 _vNz.3_kv$ evBSSvBSaN eOa 0 _Svv$Y 30%50%vuOv|uIy 8OMf/0 Ses1 gOmw ,RN .Sv|_Svv$NO .N-W _t_ ,1987, 5(1): 3042 g

7、l .Sv|_Svv$W Qg 30tesX1S: 23OTRg . :l ,1992,5(3):113-1143 Thomason R,Schlegel W,Lucca M,Cummings S,Lee S.Primary mali- gnant mesothelioma of the pericardium. Case report and literature review.Tex Heart Inst J,1994,21(2):170-174. (e6z? 2008.11.20OV 2009.1.5cS 2009.1.14)T1mP UIy0N0NN zTf z N8W(Qsur_ 2

8、P g 2tkN0 g,Ou(bKSRdvv$sr_bR * 1tq!_v| Sv|sueSuPg vRMNW(*N-0t|?uNvRaKXn,TQhVkNsAmbulatory Blood Pressure Monitoring and All-Cause Mortality in Elderly People With Diabetes Mellitus In a multiethnic cohort of older people with diabetes (n=1178), we assessed whether ambulatory blood pressure (BP) moni

9、toring improves prediction of all-cause mortality and cardiovascular mortality when added to baseline covariates, in-cluding office BP and heart rate (HR). Secondary analyses assessed whether albuminuria may mediate the association of pulse pressure with mortality. The ambulatory arterial stiffness

10、index was calculated as “1-slope“ from the within-person regression of diastolic-on-systolic ambulatory BP readings. Mean follow-up was 6.60.4 years. There were 287 deaths; death certificates were available for 215 deaths (75%), and 110 of them were deemed of car-diovascular cause.Cox models were bu

11、ilt incrementally. First, models using clinical and laboratory variables selected albuminuria and office HRs as inde-pendent predictors of all-cause and cardiovascular mortality. When ambulatory monitoring data were added, sleep: wake HR ratio and ambulatory arterial stiffness index added significan

12、tly to the prediction of all-cause mortality, but only sleep:wake HR ratio added to the prediction of cardiovascular mortality. Office HR and albuminuria retained significance as pre-dictors of both types of mortality. Secondary analyses without adjustment for albuminuria confirmed the predictive va

13、lue of office HR and sleep/wake HR, whereas 24-hour pulse pressure and sleep systolic BP were also independently predictive of all-cause and cardiovascular mortality, respectively. In conclusion, office HR and albuminuria were strong predictors of mortality.Ambulatory monitoring improved the prediction of risk through its assessment of sleep HR dipping and of ambu-latory arterial stiffness index, a measure of the dynamic relationship between systolic and diastolic BPs. Albuminuria may mediate the association between BP and mortality. Hypertension. 2009,53:120-127

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