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The most common complaint is shortness of breath, chiefly exertional dyspnea at first and then progressing to orthopnea, paroxysmal nocturnal dyspnea, and rest dyspnea.

最常见的主诉是气短,最初主要是劳力性呼吸困难,然后发展成端坐呼吸,阵发性夜间呼吸困难和静息状态下呼吸困难。

Orthopnea and paroxysmal nocturnal dyspnea are unusual in pulmonary disease, except in a very advanced phase when the increased efficiency of breathing in the upright position is manifest.

肺病患者的端坐呼吸和阵发性夜间呼吸困难不常见,除非是在很晚期,此时,直立位呼吸功率增加明显。

A 78-year-old woman presented with marked dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. Eight years earlier, she had receied a bioprosthetic mitral ale because of mixed mitral-ale disease.

患者,女性,78岁,因呼吸急促,端坐呼吸、阵发性夜间呼吸困难就诊。8年前,她由于复杂的二尖瓣疾病进行了二尖瓣的生物瓣植入术。

Measurements and Main Results: The model comprises 16 variables of which 10 (older age, male sex, prolonged immobilization, history of deep vein thrombosis, sudden-onset dyspnea, chest pain, syncope, hemoptysis, unilateral leg swelling, electrocardiographic signs of acute cor pulmonale) are positively associated, and 6 (prior cardiovascular or pulmonary disease, orthopnea, high fever, wheezes, or crackles on chest auscultation) are negatively associated with pulmonary embolism.

测量和主要结果:模型包含16种变量,其中10种(老年、男性、长期制动、深静脉血栓形成病史、突然发作的呼吸困难、胸痛、晕厥、咯血、一侧下肢肿胀、心电图急性肺心病波形)与肺栓塞正相关,另外6种(原有心血管或肺部疾病、端坐呼吸、高热、喘息、或胸部听诊的爆裂音)与肺栓塞负相关。

Rats with CHF were divided randomly into two groups, one group was injected dexamethasone(1mg /kg) intramuscularly at the first and forth day respectively,the other group was injected equi-volume saline likewise, and observing the changes of symptoms of rats with CHF; measuring rats hemodynamics index including blood pressure, heart rate and left ventricular end-diastolic pressure 4 days later. Part 2: To measure every group rats myocardialα1、β1、β2、β3-AR density by immunohistochemical method ,and to understand the AR density changes .Taking the first part rats'myocardium tissues for testing myocardialα1、β1、β2、β3-AR density and 5 normal rats for normo-contrast group and taking gray scale of slice as AR density. Part 3: The study enrolled 35 patients with DCHF. Patients were included if they had orthopnea and refractory edema due to acute DCHF that was severe and had taken more 1 week hospitalization and intravenous therapy in addition to diuretics.

观察心衰大鼠的症状,4天后对两组大鼠进行血流动力学检测,检测指标包括血压、心率和左室舒张末压;第二部分:取第一部分实验动物大鼠的心肌组织,并取5只正常大鼠的心肌组织作为正常对照,用免疫组化法检测大鼠心衰前后及糖皮质激素治疗前后大鼠心肌组织肾上腺素能受体α1、β1、β2、β3受体的变化,取镜下切片的灰度值反应受体的密度;第三部分:研究对象为临床难治性心衰病人35例,病人的选择标准包括由于急性失代偿的心力衰竭出现的端坐呼吸,难治性水肿,患者病情严重,住院超过1周,包括利尿剂之外药物的静脉治疗。

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