CL10B472KC85PNC | Samsung Electro-Mechanics CL 系列 4.7nF 100 V X7R电介质 SMD 多层陶瓷电容器 (MLCC) CL10B472KC85PNC, ±10%容差, 0603封装 | Samsung Electro-Mechanics
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电容值4.7 nF
封装/外壳0603
安装类型表面贴装
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容差 负-10%
容差 正+10%
温度系数±15%
最高工作温度+125°C
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最低工作温度-55°C
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医学专业英语3
Review of Word Elements(2) A．The following words contain word elements that stand for either part of the body or a substance that constitutes the body．Try to iise slashes to break the words，g
ive meaning to those word elements and then translate the whole term into Chinese． &angi／o／plasty a．gio&vessels 1．appendicitis &append／i／citis appendic／o&appendix 2．bilirubin &bil／i／rubin bil／i&bile 3．chondrosarcoma &chondr／o／sarc／oma ehrondr／o&cartilage；sarc／o&flesh 4．cholesteml &chol／esteral chol／e&bile，gaU 5．buccal &bucc／al bucc／o&buccus 6．cranial &crani／al crani／o&skull 7．colonoscope &colon／o／scope colon／o&colon 8．sigmoidoscope &sigmoid／o／scope 9．intemostal lO．dentin ? -――104? -―― sigmoid／o&sigmoid colon &inter／cost／al cost／o&rib &dent／in dent／o&teeth &血管成型术 & 阑尾炎 & 胆红素 & 软骨肉瘤 & 胆固醇 & 口腔的；颊的 &颅的，颅侧的 & 结肠镜 & 乙状结肠镜 & 肋间的 & 牙质 11．epigastric 12．enteritis &epi／gastr／ic gastr／o&stomach&enter／itis enter／0&small intestine 13．arthritis &arthr／itis arthr／i&joint 14．bronchogenic &bronch／o／gen／ic bronch／o&bronchus 15．p．~cuin &cec／um cec／o&cecuin 16．sublingual &sub／lingu／al lingu／o&tongue 17．gingivitis &gingiv／itis gingiv／o&gum 18．nasogastfic &nas／o／gastr／ic gas／o&nose；gastr／o&stomach 19．hypopharyngeal&hypo／pharyng／eal pharyng／o&pharynx 20．diverticulosis &diverticul／osis diverticul／o&things that tum aside 21．ileostomy &ile／o／stomy ile／o&ileurn 22．cholecystectomy&chol／e／cyst／ectomy 23．abdominal 24．pneumonia 25．thoracic chol／e&bile；cyst／o&sac &abdomin／al abdomin／o&abdomen &pneumon／la pneumon／o&lung &thorac／ic thorac／o&plemal cavity 26．duodenum &duoden／um deoderr／o&duodenum 27．1a 肿 gopI 娜&laryng／o／pharynx 28．vertebrate larygn／o&larynx；pharyng／o&pharynx &vertebr／ate vertebr／o&back bone 29．osteomyelitis &oste／o／myel／itis 0ste／o&bone；myel／o&bone malTow & 胃上部的，腹上部的 & 肠炎 & 关节炎? & 支气管原的& 盲肠 & 舌下的 & 牙龈炎 & 鼻饲的 & 下咽的 & 憩室病 & 回肠造口术 &胆囊切除术 & 腹部的 & 肺炎 & 胸腔的 & 十二指肠 & 咽喉 & 脊椎动物 & 骨髓炎 一 105― 30．pancreatic &pancreat／ic & 胰腺的 B? Each of the fonowing words contains a word element that has the mean~of abnormal condition．Break and define the word elements in the fonowing terms，and then define the term itself． 1． bronchitis 2．hepatomegaly 3． acidosis 4．hemangioma 5． malabsorption 6．dyspnea 7． alkalosis 8． myopathy 9． inelanoIna 10．pathogenesis 11．peritonitis 12． cyanosis 13．1ymphoma ―106 一 gingiv／itis inflammation of the gum gum／inflammation bmnch／itis inflammation of the bronchial tube bronchial tube／inflammation hepat／o／megaly liver／enlargement acid／osis acid／abnormal condition henCangi／omablood／vessel／tumor mal／absorp／tion bad／absorb／condition dys／pnea difficult／breathing alkal／osis alkaline／abnormal condition myo／pahty mUSC】e／disease melan／oma black／tumor path／o／genesis disease／forming，producing periton／itis abdominal cavity／inflammation cyan／osis blue／abnormal condition lymph／oma lymph gland／tumor enlargement of the liver abnormal condition caused by too much carbon dioxide in the blood tumor of the blood vessel bad or poor absorption of nutrients difficulty in breathing abnormal condition caused by too lit― tie carbon dioxide in 山 e blood disease of muscles a tumor made of black pigmented cells the development of a diseased condi― tion inflammation of the abdominal cavity a bluish discoloration of skin tumor of the lymph 咖 d C．Some of the sI】 【mxes are very useful in forming adjectives．Now write a word for each of the following definitions by using adjective endings such as-oid，-ar，-eal，-ic，-ar，-al and ary． For example：pertaining to muscle and bone pertai?nin?g to allergy pertm。nm?g to the lower part of the pharynx pertain?in?g to the lobe of the lung pertai?nin?g to the artery pertai?nin?g to the lungpertai?ni?ng to a diagnosis pertain?i?ng to the stomach and intestine resembling rheumatism pertaining to the cells of the liver pertaining to atrophy pertaining to heredity shaped like the letter S(part ofthe colon) pertaining to the skin persisting a long period of time musculoskeletal allergic hypopharyngeal lobular arterial pulmonary diagnostic gastrointestinal rheumatoid hepatocellular atrophic hereditary sigmoid epithelial Phronic ―107 一 卜互王钆孓丘一&叭 m¨ B M 他 Chapter 7 terminology meanUlg aneurysmotomy aneurysmorrhaphy aneurysmectomy aortitis aortogram aortopathy atherosclerosis atheroembohsm atherogenesis interatrial atriomegaly atriotomy bradycardia bradyrhythmia bradykinetie coronarycoronavirus coronoid tricuspid operation of incising the sap of an anem'ysm the operation of suturing an aneurysm extirpation of an aneurysm by removal of the sac inflanunation of the aorla radiographic record resulting from ao~ography any disease of the aorta sclerosis hardening，hence condition in which fatty deposi~within a blood vessel obstruct blood flow and reduce the elasticity ofthe vessel(动脉硬化症) embolism due to blockage of a blood vessel by all atheroembolus the formation of athemmatous lesions in the arterial intiIna between 山 e atria abnormal dilatation or enlargement of an atrium of the heart surgical incision of an atrium of the heart abnormally slow heart rate abnormal heart rhythm with rate less than 印 beats per minute in an adult characterized by or~rformed by slow movement pertaining to crown；emwnlike virus sh．pea like a el-own(冠状病毒) resembling a crown having three points ―108― 续表 bicuspid bk?uspidal do'rsalis dorsenasal dorsalgia echocardiography echocardiogram echogenic embolism end)olization emboliforrn cardiogenic pathogenic allergenic arrhythmia analgesia asphyxia having two cusps or points pertaining to two cusps or pointspeflaining to the back the upper ridge of the nose(鼻梁) pain in the luck use of high―frequency~otnld w~tveb to produce all image of structures within Lhe heart the record produced by echocardiography in ultrasonography，giving rise to reflections(eeh~s)of ultrasound waves occlusion of a vessel by a thrombus or other mass carried in the bloodstream the process or condition of becoming an embelus shaped like a wedge；resembling an en~30lus produced in the heart giving origin to disease or to morbid symptoms caused by the nature of allergy any irregu]arity in the heaIt beat absence ofsensibility to pajn a condition due to lack of oxygen in respired air involuntary performed independently of the will involuntomotory insufficiency schemia ischesis ischuria arteriole bronchiole centrinle pertaining to motion that is not voluntary t11e condition 0f being insmcient or inadequate to the performance of the allotted func― tion temporary blood deficiPncy due to an interruption of blood flow to a tissue or organ ―es／s condition，hence retention or suppression of a discharge suppression or retention of the urine a minute arterial branch，especially one just proximal to a capillary one of the finer subdivisions of the branched bronchial tree 岫 s 涮 l derIse s 呲呲 in the middle ofthe centrosome(中心粒) disorders marked by inflammation，degeneration，or ITIetabolic derangement of the c【)n― nective tissl】e stn】ctLIre of the body，especially the joints and related structure 续表 rheumato]ogy rheumatoid phlebitis phlebothrombosis pbleboplasty semilunar semiCOMB． semiconductorangiospasm vasospasm antispasmodic sphy~nomanometer sphygmoscopy sphygmometer systole systolic systolometer tachycardia tachyar~ythmia tachypnea hypertension hypotension rlolTnotenslOn endothelium epithelium thelitis thromb~is thrombopblebifis the branch ofme~cine dealing with rheumatic disorder，their caLlse8，pathology，diag― nosis，treatment，etc resembling rheumatism；associated with rheumatoid arthritis inflammafion of a vein presence of a clot in a vein，unassociated with inflammation ofthe wall ofthe vein plastic operationforthe repair of a vein lunar the moon，hence like a halfmoon partty unconscious a subetanee that Call only p,miy conduct electrical Cthrrerfl sudden contraction of the muscles in a blood vessel spasm of the blood vessels，resulting in decrease in their caliber reheving spasm．usually of smooth muscle，as in arteries，bronchi，intestine，bile duct， ureters or sphincters mano thin，8par~；meter instrument，hence an instrument for measuring the pressure of gases orliquids examination ofthe pulse an instnm~nt for measuring the force and frequency of the pulse contraction phase of the heart cycle pertaining to or produced by systole an instrument for measuring the sound of systole abnormally rapid heart rate disturbance of the heart rhythm in which the heart rate is abnormally increased，usually to greater than 100 heats per minute in all adult excessive rapidity of respirationelevated blood pressure abnormally low blood pressure normal tone，tension，or pressure t}Ielayer of epithehal cellsthat hnesthe cavitiesofthe heartand ofthe bloodandlymph vesscls，ere the coveting ofintemal and extemal surfaces ofthe body inflammation of a nipple state 0f，co 础 tion，hence formation of a blood clot or thrombas in a vessel innaⅡlr 枷 on of a vein associated with thrombns formation ～110 一 续表 terminology meaning thromtx~ytosis valvuloplasty valvulitis valvulotomy vasoactive vasopressor vasespasttc venipuncture VCnlSuture vcmsection increased numbers of platelets in the peripheral blood surgical repair or replacement of a valve inflammation of a valve or valvula，especially a valve of the heart incising a heart valve acting on the blood vessels all agent that stimulates contraction of the muscular tissue of the capillaries and arteries producing Or affected by vasospasm procedure in which a vein is punctured with a needle，usually to withdraw blood for diag― nostic pLlrposeS suturing of a vein incision of a vein i nterventricular between the ventricles ventriculography ventriculometry cardioversion InVer 与 lon radiography of a ventricle 0fthe heart after injection of a contrast mediuln measurement ofthe intraventricular pressure application of an electrical shock t。the chest to re~tore a normal rhythm to the heart beat；also referred to as deftbrillation a turning outward a turning inward1． 2． 3． 4． The word cardiogenic means originating in the An atriotomy is an incision into the A valveetomy is surgical removal of the The word interventricular means between the (atrium)． (heart)． (valve)．_ (ventricles)． B．Write a word(holm or adjective)for each 0f me following definitions? 1．pertaining to the heart 2．pertaining to the myocardium 3．pertaining to the ventricle 4．inflammation of the artery cardiac myocardial ventricular artentls 5．pertaining to the valve 6．study of the heart 7．X―ray study of the blood vessel 8．dilatation(一 ectasis)of the blood vessel 9．spasm of the artery 10．enlargement ofthe heart 11．above the ventricle 12．inflammation of the lining of the heart C． ，Match Colunm 1 wi 廿 l Column I． valvular cardiology angiography angiectasis arteriospasm cardiomegaly supraventrieular endocarditis Cohmm I (0 啪岣临 ng form，prefix and suffix) Cohmm II (En#mterm) 一 sclerosis ―teDslon―cuspid ―spasm ．1unar ? VerSlOn ven／o aott／o vas／0 cardi／o thromb／o dors／o senu― sphy~／o coron／o atri／o D．Give the stress to the foUowing medical ter'n~，for example，~histo?therapy? 1．,aneurysmotomy 4．CO?IonaIvirus 7．?embolism 10．ven,tricu?lography 13．Ibrady?cardia 一 1 12― 2．Iaor?titis 5．techo?cardiogram 8．?anglo,spasm 11．iendo?thelium 14．throm?bosis 3．?coronary 6．techo?genic 9．Iinterven?tricular 12．Iatheroscle?rosis 15．,cardio?genic 1J 1l 1j ¨ u 州¨ 纠 引插 幅 他引引引 M m 玛=' r}rL rL rL rL rL rL rL rL rL rL rL rL rL 16．iStchemia 19．tanal?gesia 22．,atrio?megaly 25．dot?salis 28．Isemi?lunar Section B 17．ialle?rgenic 20．sy?stolic 23．tathero?genesis 26．ar?teriole18． 21． 24． 27． 29．isphygmoma?nometer 30． B．Fill in each blank witll one proper word． ar?rhvthrnia Iinter?atrial bi?cuspid ~phle?bitis dachy?cardia Blood (1) (returning)from the t~xty tissues enters the right (2) (atriBin)， which is the upper chamber of the right side of the (3)(heart)．When the muscles of this chamber contract，they force the blood into the right (4) (ventricle)，which is the nlajor pump chamber of the right side of the heart．when the ventricle muscle__(5)__(contracts)． it forces blood out through the__(6)(pulmonary)artery and through the small blood vessels of the lungs． these small lung vessels， blood is sepamted from air by very thin membranes， In the and oxygen (7) (enters)the blood and carbon dioxide (8) (1eaves)the blood by simple diffusion．This cleaned and re 雠 shed (9) (blood)then passes into the (10) (1eft)ventricle which is powerful，and when it contracts，it pushes the blood，under considerable pressure，into the (11) (systemic)circulation by means of a large artery called the (12) (aorta)．卟 e pressure developed in the aorta by the contractile forces of the left ventricle is great enough to drive the blood to all the (13) (tissues)of the body in sufficient quantity to supply their needs．A one―way flow of blood in this system is maintained by―― (14) (valves)located in the heart and veins． (15) (Between)the right atrium and the fight ventricle is the――(1 6)――(tricuspid)valve，which prevents blood――(1 7)一 (from)flowing from the ventricle back into the atrium． the opening of the pulmonary valve is At a set of (18) (semilunar)valves，which prevent blood from flowing back into the right 一 (19) (ventricle)．Similarly，on the left side of the heart，the――(20)――(bicuspid) valves Drevent backward flow between the left ventricle and left――(21)――(atrium)，and an― o 山 er set of semilunar valves，the (22) (aortic)valves，prevent blood from flowing from the aorta back int0 the (23) (1eft)ventricle．Some veins also have semilunar valves，and the Dressur℃0f contracting muscles against the veins works with the action of these valves to―― (24) (increase)the venous (25)(return)to the heart． C．Spell the following words according to the co~nding definitions． 1．the largest artery．which receives blood from the left ventricle and branches to all parts of the body 2．a vessel that carries blood away from the heart，most of which CatTy oxygenated blood 3．an entrance chamber；one of the two upper receiving chainbers of the heart 4．the force exerted by blood against the wall of a vessel5．one of the millions of microscopic blood vessels through which materials ale exchanged between the blood and the tissues 6．the relaxation phase of the heart cycle 7．the thin membrane that lines the chambers of the heart and covers the valves 8．the thick middle layer ofthe heart wall composed of cardiac muscle 9．the fibrous sac that SUlTOUBds the heart 10．a structure that keeps fluid flowing in a forward direction 11．a vessel that carries blood back to the heart．Most of these vessels carry blood low in oxygen 12．a small cavity，one of the two lower pumping chambers of the heart 13．a small vein aorta arterv atrium blood pressure capillary diastole endocardium pericardium valve Veln ventricle ventlle D．Match Calunm One with Column Two． Column One Column Two s-A node ventricle aorta atria valves veilae CaVae coronary arteiaes bradycardia tachycardia interatrial ―114 一 ]]_^_；]]1 r=U ㈠眨．m．p№B L!．b 一随 E．Translate the fonowing into English．主动脉弓 aortic arch 舒张压 diastolic Dressure 收缩压 systolic DreSSUre 毫米汞柱 millimeter mercury(mmHg) 最里层的 innermost 二尖瓣 mitral valve／bicuspid valve 上腔静脉 superior vena cava 心肌 myocardium 细分；分支 subdivision 小动脉 arteriole Exercises(Passage Two) 胸主动脉 腹主动脉 脊柱 半月形的 升主动脉 体循环 下腔静脉 心内膜 心外膜 心包 B．Spell out the medical term for each of the fonowing definitions． For example：slow heart condition&&bradycardia 1．hardening of the arteries 2．discomfort around the heart，usually radiating to the left shoulder and anTi，caused by insufficient blood supply to the heart 3．10w blood pressure 4．inflammation of a vein complicated by the formation of a blood clot 5．narrowing of the aorta 6．inflammation of the blood vessels 7．all abnormally rapid heart rate 8．high blood pressure ? 9．circulatory failure resulting in inadequate supply of blood to the heart with symptoms of cold，clammy skin，etc． 10．any abnormality in the rate or rhythm of the heartbeat． 11．10cal deficiency of blood supply due to obstruction of thP circulation 1 2．any disease of the heart muscle thoracic aorta abdominal aortavertebral column semilunar ascending aorta systemic circuit inferior vena cava endocardium epicardium pericardium && atherosclerosis && angina pectoris &&hypotension &&thrombophlebitis && aortostenosis && valvulitis &&tachycardia &&hypertension && shock && arrhythmia && ischemia && cardiomyopathy C．Put the following words or phrases inm the following sentences and change the forms if necessary? Hypertension accelerates the process of(1) the arteries，which is a(2) (factor)contributing to strokes and heart attacks．Damage to the arterioles leads to brain hemorrhage or kidney failure． arterioles can be visualized in the The retina，thus pemaitting the physician to evaluate the severity of the disease and to estimate the prog― nosis by examining the(3) (eyes)．(4) heart muscle．and this may result in(5) heart disease)and ultimately in(6) (enlargement)of the heart(hypertensive (heart failure)．The brain，the heart，the kid― neys．and the eyes are especially vulnerable to the(7) cal(8)(features)of heart failure may vary considerably．The main symptom of(9)一 (1eft)heart failure is shortness of breath，which often OCCUI'~during mild exercise and which may resuh in periodic sudden attacks that frequently occur(10) the victim is lying(11) (at night)when (shortness)of breath becomes more difficult to relieve．The principal symptoms of(13)―― (right)heart failure include edema of the ankles，and tenderness in the upper part of the abdomen due to swellingofthe(14)(fiver)．In advanced stages swelling becomes mole severe， and(15)(fluid)may collect in the abdomen． D．Tick the term that is spelled correctly and write its mean~in Chinese? For example： ＼／ 1． ＼／coronary 2． ＼／arrhythmia 3．disastole 4． angina pectorus 5． ＼／， vasodilation 6． 、， cardiomegaly 、 7． artheriosclerosis 8．dispenea 9． symptem 10． artrium ―116 一 rheumatic rhumatic coronery arythemia ＼／diastole ＼／， angina pectofis vasodilitation cardiomegely x／ athemsclerosis √dyspnea ＼／ symptom ＼／ atrium 风湿的 冠状的 心律不齐 心脏舒张期 心绞痛 血管舒张 心脏肥大 动脉硬化 呼吸困难 症状 心房 E．Fill in one word to make the following sentences true． 1． 2． 3． 4． 5． Elevated blood pressure of u~nown cause is called――(：essential)hypertensionBlood pressure which is elevated as a result of another condition is called ondary)hypertension． ? Rheumatic heart disease is a type of heart disease caused by The muscular layer of the heart is called――(myocardium) The fight and left atria are separated by a muscular wall called the tum)． 6．The right and left ventricles are separated by a structure known as the tricular septum)． 【see(rheumatic fever) (interatrial sep7．The sequence of events occurring during each beat of the heart is called the (cardiac)cycle． 8． 9． (interven 一 (Blood pressure)refers to the force exerted by blood on the walls of the arteries． (Myocardial infarction)is a condition in which delivery of oxygen to a portion of the heart muscle is impaired，resuhing in death of the tissue in that area． 10．Enlargement of the left ventricular wall，usury occurring as a result of chronic hypertension， is called――(1eft ventricular hypertrophy)． F．Read the following statements and then deride whether they are true or false? 1．[T]Atherosclerosis is an extremely common form of arteriosclerosis in which deposits of yellowish plaques containing cholesterol，lipoid material，and lipophages ale formed within the intima and inner media of large and medium―sized arteries． 2． [T]Heart failure is inability of the heart to pump blood at all adequate rate to 删 tissue metabol― ic requirements or the ability to do SO only at all elevated filling pressure．It can be defined clinically as a syndrome of ventricular dysfunction accompanied by reduced exercise capacity and 0ther characteristic hemodynamic，renal，neural，and hormonal responses． 3．[F]Secondary hypertension is hypertension due to or associated with a variety of primary dis― eases． such as essential hypertension， renal disorders， disorders of the central nervous sys― tem，endocrine diseases，and Vascular diseases． (Secondary hypertension is hypertension due to or associated with a variety of primary dis― eases．such as renal disorders，disorders of the central nervous system，endocrine diseases， and vascular diseases．) 一 1 17 一 4．1 Fj Rheumatic heart disease is directly caused by streptococci．or is the most important manifes― tation of and sequel to rheumatic fever，consisting chiefly of valvular deformities． (Rheumatic heart disease is the most important manifestation of and sequel to rheumati(fever，which can follow a few weeks after a streptococcal inf~tion that sets up an immunereaction ultimately damaging the heart valves．) 5．[T]Shock may be a condition of profound hemodynamic disturbance characterized by failure of the circulatory system to maintain adequate perfusion of vital organs ． The clinical manifesta― tions of hypovolemic or cardiogenic shock include hypotension，hyperventilation，cold， claimny，cyanotic skin，a weak and rapid pulse，oliguria，and mental confusion，combativeness，or anxiety． Exercises(Passage Three) A．According to the passage，decide whether the following statements are true or false? 1．[F](right)venrtricular failure is characterized by signs of systemic venous congestion and periph― eral edema． while left ventrieular failure is dominated by symptoms of pulmonary congestion and edema． 2．[T]111e patient with orthopnea always has difficult breathing except that he is in all upright position． Two-pillow orthopnea call be defined as orthopnea that is relieved by elevating the head and chest from the recumbent position by the use of two pillows． 3．[F]Paroxysmal nocturnal dyspnea is an episode of respiratory distress that awakens patients from sleep and is related to posture(especially reclining at night)． 4． 『T]Hemoptysis is expectoration of blood or of blood―stained sputum，which is observed with particular frequency in patients wi 山 advanced bicuspid stenosis． 5． 『V]Right ventricular failure is encountered most often as a complication of left ventficular fail― ure．And in the presence ofbiventrieularfailure，signs ofright ventrieular failure may domi? nate，but the presence of dyspnea and rales should suggest additional left ventricular failure． 6． 『F]Ascites is an effusl?on and accumulation of serous fluid in the abdominal cavity． begins as It a late si 印 of right heart failure， usually associated with systemic venous hypertension， pe― ripheral edema，and hydrothorax． 7．[F]Dyspnea is a 帅 ical manifestation of the left heart failure，is usually accompanied by an increased rate of breathing．The dyspnea relates to the increase in blood vohtme and intersti。 tial fluid content of the lungs and ventilation increases．ne patient is then aware of more se― vere shortness of breath． 8．[T]Hepat 叫 leg 由 is enlargement of the liver and is typically observed in fight heart failum， bu? splenomegaly is uncommon except in prolonged passive congestion of the liver? 9． 『F1During acute left ventricular failure， pulmonary venous and capillary pressure can m。 teas。 abmptlv to so high a level as to exceed plasma oncotic pressure，with consequent rap?d accu― mulation of edema fluid in the interstitial spaces． 10． 『v]cvanosis is a bluish discoloration，applied especially to such discoloration of skin and mu 一 一 118 一COUS membranes due to excessive concentration of reduced hemoglobin in the blood． Cyanosis is usually absent in left heart failure if not caused by a complication or by pul― monary edema． B．(1)Perform a meaning-analysis of the following list of words if possible by using the knowledge of word elements you have just learned． (2)Translate the case note into Chinese． 患者，女性，45 岁，白种人，因胸痛三月，发作日趋频繁，于七月二十九日收 治人院。发作时伴恶心、出汗；舌下含化硝酸甘油片，症状缓解。曾作运动试验和铊 扫描检查，均显示某些异常。 家族史提示，其母和外祖母均有心肌梗死史。系统回顾和查体，无特殊。入院时 作心电图检查，结果是：正常窦性心律，但 T 波倒置。七月三十日作心导管检查，结 果显示冠状动脉左前降支严重狭窄，但左室功能正常。七月三十一日作经皮经腔冠状 动脉成形术(FFCA)，狭窄有所缓解。 患者于八月四日出院。出院时的医嘱为：硝苯地平 IO 毫克，每日四次；潘生丁 75 毫克，每日三次；阿司匹林 5 克，口服，每日一次；硝酸甘油片，O．3 毫克，必要 时舌下含化，每五分钟一次，可用三次。出院后饮食应为低胆圃醇，活动量应适度。 安排四周后作随访检查，由史密斯医生为该患者作运动试验复查。 译文： 心血管系统是由心脏和血管组成。心脏位于两肺之问，其尖指向左侧。心肌是构成 心脏的一层厚厚肌肉；内面由一层薄薄心内膜覆盖，外面由一层薄薄心外膜覆盖 u 心脏 还被包裹在一个称为心包的纤维囊中。 一 119― 位于心脏上面部分的是接受回心血液的心房；下面部分是具有泵血作用的心室。两 心室之间是室间隔；两心房之间是房间隔。 血管分为三大类，即动脉、静脉、毛细血管。动脉将血液带出心脏；其血管壁最 厚，因为动脉要承受心室泵血所产生的压力。血管壁分为三层，与心脏的三层相似，即 (1)最内面的内膜，其构成光滑的表面，有利于血液流过；(2)第二层，其所占比例较 大，由不随意肌组成，并伴以弹力结缔组织；(3)外膜，由具有支撑作用的结缔组织构 成。主动脉是最大的动脉，管腔直径约为 1 英寸，血管壁最厚。小动脉是动脉的最小分 支，管壁较薄。其血管壁内，几乎没有结缔组织；但所含肌肉相对较多。动脉的这些较 小分支将血液带到最细的毛细血管。 毛细血管的壁只有一个上皮细胞那样厚。毛细血管具有通透性，由盘状的平滑细胞 组成，由动脉的内膜延续而成。毛细血管的壁很薄，便于氧和营养物质透过这薄薄的一 层壁进入细胞周围的组织液中。同时，二氧化碳和水等废物则从细胞中出来，进入壁薄 的毛细血管。毛细血管网是整个循环系统的最重要活动中心。 静脉壁比动脉壁薄。静脉将含有废物的血液从组织携带到心脏。静脉几乎不含弹力 组织，其结缔组织也比动脉少。与动脉内的血压相比，静脉内的血压极低。亦称微静脉 的最小静脉由毛细血管汇集而成，其壁只比毛细血管稍厚一点。随着静脉不断增粗，管 壁也不断增厚。然而，静脉壁比相应动脉壁薄得多。虽然与动脉管壁一样，较大静脉的 管壁也由三层组成，但静脉管壁的中层相对较薄。所以，静脉容易塌陷。肿瘤或其他包 块稍加压迫，回心血就会受阻。大多数静脉具有单向瓣膜，使血液朝着一个方向流动。 在四肢的静脉中，这样的瓣膜最多。 心脏将血液泵人两个循环体系。心脏的右边将血泵入肺，通过肺循环使血发生氧 合。肺的血管包括肺动脉及其分支、肺毛细血管、肺静脉。肺动脉携带右心室出来的、含氧量低的血液；而肺静脉将含氧量高的血液从肺携带到左心房。肺循环将血液中的二 氧化碳排除，并向血液提供新鲜的氧。心脏的左边泵出血液通过体循环，将血液分配到 机体的其它部位。体循环向机体的所有组织提供营养物质和氧，并从组织中带走废物以 便处理。 从组织(肺组织除外)而来的血液经腔静脉，即上腔静脉与下腔静脉，回到心脏。血 液通过腔静脉流回右心房。当心房收缩时，右心房的血液则通过三尖瓣进人右心室。当 心室收缩时，右心室的血液则通过肺动脉瓣进入肺动脉。同时，三尖瓣关闭以阻止血液 回流到心房。进入肺动脉的血液被携带到肺；在那里，血液经过氧合作用使二氧化碳 (细胞代谢的一种废物)与从外界进入的氧进行交换。 被氧合的血液通过肺静脉回到心脏的左心房。心房收缩将血液从左心房挤压通过二 尖瓣，进入左心室。当心室收缩时，左心室的血液被挤压通过主动脉瓣，进入主动脉 (机体内的最大动脉)，然后分配到机体的各个组织中。主动脉是一条连续的管道，分成 以下几部分：(1)升主动脉一靠近心脏，位于心包内；(2)主动脉弓一从右弯曲到左，并 向后延伸；(3)胸主动脉一位于心脏之后，脊柱之前，胸膜后的间隙里；(4)腹主动脉一 主动脉的最长部分，跨过腹腔。 心脏的跳动分为两期：舒张期与收缩期。这样的舒张一收缩的心动周期(舒张一充 盈；然后，收缩一泵血)每分钟发生 70～80 次，每次持续大约 0．9 秒。这就是说，心室泵 血进入动脉是有规律的，每分钟大约 70．80 次。心室收缩使压力波增大；这种压力波 开始于心脏，沿动脉传导。这种波叫做脉搏。脉搏在接近体表的动脉处可以扪到，特别 是在将血管压在骨上时更易扪及。在手腕处，桡动脉从前臂的拇指侧的骨上经过，这儿 最容易扪到脉搏。常用来扪脉搏的血管还有颈动脉和足背动脉。 血压是血液施加在动脉壁上的一种力。血压在心动周期中有所变化，在心脏喷血 (收缩期)时增大，在心脏舒张(舒张期)时减小。既然血管内的压力随着心脏和动脉情况 的变化、以及其它因素的不同而有所改变，所以血压测量和仔细分析能为健康评价和健 康护理提供有价值的指导。血液从动脉流向毛细血管和最后流进静脉的过程中，血压呈 下降趋势。一般情况下，血压的测定指的是动脉压的测定。所使用的仪器叫血压计。所 测的血压分为：(1)收缩压，即心脏收缩时所产生的压力，平均在 120 左右，用毫米汞 柱表示；(2)舒张压，即心脏舒张时所产生的压力，平均在 80 左右，用毫米汞柱表不。 所以，血压为 120／80 mmHg，指的是收缩压为 120 mmHg，舒张压为 80 mmHg。血压是容 易获得的一种诊断依据。 心血管系统的某些常见疾病 (Passage Two) [动脉粥样硬化]动脉粥样硬化是由脂肪沉积在动脉内膜上引起。所形成的粥样斑 块因纤维组织、细胞和其它沉积物的堆积而逐渐加厚，导致动脉管腔变窄，使流向组织 的血液减少。这种情况叫做局部缺血。 冠状动脉粥样硬化是冠心病的主要原因。其中一个症状是心绞痛，表现为心脏区域 的压榨性疼痛；这种疼痛可放射至左臂或左屑，常因用力而诱发。患者常有焦虑、出汗 和呼吸困难。 动脉粥样硬化会诱发血栓形成，其为血管内形成的血块、即血栓。血栓突然阻寒冠 状动脉导致组织坏死，梗死形成，这就叫做心肌梗死，其为心脏猝死的主要原因。 常有心律失常、即心律紊乱；通常表现为纤维性颤动，即极快而无效的心脏跳动。 [栓塞]栓塞是指血栓或血流携带的其它小块阻塞了血管。通常，这些小小的块状 物是从血管壁上脱落的血凝块，但也有空气、脂肪、细菌、或其它固体性物质。静脉血 栓常可循环通过心脏，停留在肺动脉内，导致危及生命的肺栓塞。从颈动脉来的栓子常 阻塞脑血管，导致中风。[心力衰竭]心脏不能有效排空，不能将需要的血液量泵出心脏；也就是说，从静 脉回流到心脏的血液多于离开心脏的血液。其结果，静脉压增高，水肿出现；常表现在 肺部(肺水肿)，导致左心衰。右心衰所致的血液淤积，会造成液体在腹部器官(肝和脾) 和下肢皮下组织的堆积。其临床表现还有发绀、呼吸困难和晕厥。 [高血压]动脉血压升高称为高血压。可分为两类：原发性高血压和继发性高血压。 原发性高血压的血压升高原因不清。继发性高血压的血压升高往往与某种疾病有关，如 肾小球肾炎、肾盂肾炎、或肾上腺疾病。 ， 。… 高血压的诊断标准是：收缩压高于 140 mmHg，舒张压高于 90 mmHg。左心墅负荷 过重导致左室增大(左室肥大)。心脏不得不加倍工作，以克服动脉阻力的增大。血管弹 一陛下降，也加重了心脏泵血负担。 [风湿性心脏病]风湿性心脏病是由风湿热引起的一种心脏病。风湿热常见于儿童， 多在链球菌感染后几周出现。其过程属于免疫反应，最终导致心脏瓣膜损害。心脏瓣膜 (特别是二尖瓣)出现发炎和瘢痕(伴赘生物生长)，不能正常开放与关闭。二尖瓣狭窄、 心房纤颤、充血性心力衰竭可能发生。心脏瓣膜损害的重要体征是瓣膜杂音出现。收缩 期杂音出现在收缩期，通常由二尖瓣或三尖瓣闭锁不全或主动脉瓣或肺动脉瓣狭窄引 起。舒张期杂音出现在舒张期，通常由主动脉瓣或肺动脉瓣闭锁不全或通过房室瓣膜时 的血流变化引起。舒张期杂音通常分为早期和中期。 [心内膜炎]心内膜炎是由细菌引起的心脏内膜的一种渗出性和增生性炎变，也称 为细菌性心内膜炎。心内膜炎也可能是另一种感染、手术、或损伤的并发症。心脏瓣膜 损害可能产生赘生物病变，赘生物可能脱落成为栓子；栓子可能进入小血管，导致血管 阻塞。 [心包炎]心包炎是围绕在心脏外的一层膜(心包)的炎症。在大多数情况下，心包 炎是继发于体内其它部位的疾病(如肺部感染)。病因可以是细菌和病毒，也可找不到病 因。心包腔可能有积液。如果积液量大，则对肺静脉产生压力，阻碍血液从肺部[『】J 到心 脏。心包积液对心脏的挤压可能导致心包填塞。 [出血]出血是血液从血管大量流失，是描述“血液从血管内进发出来”的一个术 语。出血分为外出血和内出血，可来自任何大小的血管，可波及身体的任何部位。毛细 血管的渗血通常可因正常的血凝过程而停止。较大血管的出血应由在场的任何人通过适 当的急救而止血。在大多数情况下，用干净的绷带直接压在出血处可以有效止血。血液 从动脉破 13 流失可来得很快，令人可怕，常常为致死性；但抢救及时、恰当，可以拯救 生命。因为出血是事故发生时第一个需要注意和处理的问题，所以每一个人都应知道某 些动脉可以通过按压而达到止血。 【休克]“休克”这术语有多种含义；但在谈及血液循环时，是指突然循环衰竭而导 致的高度危险症候群。休克可因多种因素促发：严重出血、突发精神刺激、烧伤、过长 手术、某些药物、导致血氧缺乏的任何因素、以及寒冷和疲惫等。 发生休克时，促使休克发生的一种或多种因素通过一系列复杂过程导致小血管扩 张，结果是血液从大血管进入组织小血管。于是，血液淤留、停滞在这些小血管而不参 与血液循环。休克病人可很快死亡，除非抢救使血液循环立即恢复。常见抢救措施是从 静脉输入血浆或全血，增加血容量，帮助恢复正常血液循环。如果全血或血浆都不能立 即得到，可以使用右旋糖酐。右旋糖酐能够扩大血浆容量，虽然不能完全代替血液。 休克的临床表现是：皮肤冷湿、面色苍白、憔悴、体温低下、血压陡降、呼吸浅 促。休克病人的急救措施有：置病人于水平位，用被子或热水袋保暖，将头偏向一侧以 免吸入呕吐物(休克的重要死因)。 [静脉曲张]静脉曲张是表浅静脉的肿胀、迂曲和功能减退的一种病理改变。常见于食管、直肠、男性的精索、女性子官的阔韧带。最常见的异常扩张的静脉是下肢的隐 静脉，多发生于长时问站立的人，如售货员。此外，妊娠可伴盆腔静脉受压，成为静脉 曲张的诱因。直肠的静脉曲张常被称为痔。静脉曲张的医学术语是 varices，单数形式是 varix。 [静脉炎]静脉的发炎叫静脉炎。表现为明显疼痛，常伴有明显肿胀，可波及整个 静脉壁。血凝块形成，导致称为血栓性静脉炎的危险疾病。血凝块可能变得松散，脱落 一 122― 而成为栓子悬浮在血液中。如果栓子进入肺(这种情况常常发生)，肺梗塞导致的突然死 亡可能发生。预防感染，在损伤或手术后应早期活动以保持循环畅通，使用抗凝药物， 可大大减少这种并发症的发生率。 心力衰竭的临床表现(Pas~e 3]irt~) 心力衰竭的体征和症状取决于哪一个心室发生了功能衰竭、以及衰竭的严重程度和 持续时间。左心衰的临床表现主要是肺淤血和肺水肿的体征和症状；而右心衰的临床表 现主要是体循环中的静脉淤血和周围水肿。无论左心衰、右心衰还是全心衰，患者都常 有无力、易倦和不能耐受过度劳累。 左心衰 左心衰患者的主要症状是呼吸困难，其轻重与体位、活动强度有关。左心衰的体征 最明显表现在心脏、肺或呼吸系统功能的控制机制上。 [呼吸困难]呼吸困难是典型左心衰的最初表现。通常伴有呼吸频率加快。虽然呼 吸困难的生理机制中还有许多细节尚不清楚，但是肺淤血所导致的呼吸系统症状的某些 起因是值得注意的。因为支气管的毛细血管主要通过肺静脉得到引流，所以肺淤血多同 时发生在肺泡和支气管的血管网。发生在肺毛细血管周围的问质性水肿似乎是刺激了毛 细血管旁的卜感受器，引出反射介导的快而浅呼吸。同时，支气管的淤血也会刺激粘 液的分泌，导致扩张状态的支气管破裂，于是出现咳嗽和咯血。支气管粘膜水肿使小气 道的阻力增加，导致喘息和呼吸困难，这就叫做心源性哮喘。肺的顺应性降低加上气道 内有液体积聚，此时的肺不得不加倍工作，致使呼吸肌里的血流减少，同时也使氧在通 过肺泡一毛细血管界面时的阻力增加，最终导致呼吸肌的疲惫，导致呼吸困难。 由此看来，左心衰所导致的呼吸困难显然是与血容量的增加和肺间质中的液体增多 有关。换气增加，呼吸困难的感觉变得更加严重，特别是当每分钟换气量接近最大值 时。 [端坐呼吸]平躺时出现的呼吸困难(坐立时缓解)称为端坐呼吸。端坐呼吸的病理 生理基础是，平躺时从下肢和内脏血管丛回流到肺的静脉血增多，加之一天中积蓄而来 的外周水肿液体的重吸收。端坐呼吸是左心衰的比较可靠体征；而与慢性肺部疾患或骨 骼肌肉系统疾病有关的呼吸困难因平躺而加重的情况一般比左心衰所引起的要少见一 些。为了避免这种类型的呼吸困难，患者通常会在头和胸部之下垫上两个或更多枕头。 在严重的心衰患者中，端坐呼吸可以十分严重，以致患者不得不坐在椅子上睡觉。端坐 咳嗽与端坐呼吸具有同样的 l 临床意义，也可能是因为肺静脉淤血和肺水肿造成。左心衰 患者也可能有仰卧时心前区不适，与心肌缺血导致的这类不适很难鉴别。 [夜尿]在心衰早期，患者可因白天的直立活动使肾脏血液循环受到限制，致使夜 晚仰卧时的肾脏血液灌注增多，导致小便增多。这就是夜尿发生的原因，也是心衰早期 的常见表现。 [阵发性夜间呼吸困难]严重呼吸困难可将患者从睡眠中惊醒。患者不得不立刻坐 起来，并将窗户打开，方可得到缓解。除了平卧使肺淤血和肺水肿加剧而外，睡眠时呼 吸中枢对来自肺的感觉刺激的反应性减弱以及静脉回流增多，致使肺静脉淤血和肺水肿一 123― 进一步加重，最后激发出将患者从睡眠中惊醒的阵发性夜间呼吸困难。 [急性肺水肿]在急性左心衰发作时，肺静脉和肺毛细血管内的压力会突然增大， 以至超过血浆容量增大所产生的压力，使水肿液在肺的间隙中迅速积聚，导致肺泡换气 过度，造成呼吸性碱中毒。然而，当游离的液体进入肺泡和细支气管时，由于呼吸活动 过度不能耐受，又可出现呼吸性酸中毒。同时，低氧血症常有发生，这是因为肺泡通气 与肺泡血流之间出现了不平衡。 肺水肿表现可以无痰性咳嗽开始，同时伴喘息或明显呼吸困难。查体时，除了发现 呼吸频率加快和基础心脏疾病表现出的体征外，在疾病早期很少有这方面的体征。之 后，随着游离液体在远端气道的积聚，在双肺底可闻及湿哕音；而且随着病情加剧，湿 哕音会伴随着较大的干哕音向上传导。在严重的急性肺水肿时，患者通常有面色苍白、 出汗、发绀、喘息，有时还会出现粉红色或血色泡沫痰。 [咯血]在严重的慢性左心衰患者中，有时会出现含有心力衰竭细胞(吞噬有含铁血 黄素的肺泡巨噬细胞)的铁锈色痰，特别是在严重二尖瓣狭窄患者中发生的频率更高。 明显的血色痰提示有肺梗塞的可能性，但在慢性左心衰患者(包括二尖瓣狭窄不能纠正 的患者)中，由于充血支气管的毛细血管破裂，会有大量血液咯出。 右心衰与全心衰 [临床表现]单纯性右心衰在成人中不常见，通常由继发于肺内疾病的肺心病所致； 或偶尔因先天性的左向右分流(如房间隔缺损)所造成的长时间血容量负荷过重而引起。 右心衰常是左心衰的并发症。在右心室的血液充盈压升高的情况下，颈静脉出现怒张， 充盈是自下而上的。肝脏肿大和轻度扪诊时产生的触痛均是因为被动充血所致；在挤压 肝脏时，会使颈静脉进一步怒张(肝颈静脉回流征阳性)。在出现全心衰时，可能会以右 心衰症状和体征为主；但有呼吸困难和哕音存在时，应考虑有进一步左心衰存在。在心 输出量下降时，会有交感神经活动增加所导致的 l 临床表现，以及器官的灌流量下降所导 致的 l 临床表现。应记住的是，任何足以导致代谢性酸中毒的因素所引起的心输出量显著 下降都会使患者有通气过度的表现，这是为了维持酸碱平衡。这样的情况必须与左心衰 所致的呼吸加快相鉴别。严重右心衰或全心衰可能合并有厌食、体重下降、以及营养不 良(“心性恶病质”)。 [发绀】发绀是因皮肤乳头层下静脉丛的未氧合血红蛋白在每 100 毫升血液达到 5 克或 5 克以上所致。可发生在右心衰时，因处于充盈状态的微小静脉由于血液流动缓 慢，所含血液的氧已被大量消耗。如果没有心脏内血液分流所导致的内源性肺部疾病存 在，则动脉血的氧分压在一般情况下还是比较正常的。在左心衰时，通常没有发绀，除 非有并发症(如肺炎)或肺水肿产生。 [心与肺的异常]虽然伴左心衰的呼吸困难可因右心衰出现而部分得到缓解，但是， 某些呼吸困难通常仍呈持续状态，并伴有呼吸频率加快和肺底哕音出现。三尖瓣关闭不 全常常伴有严重右室扩张和右心衰，导致体循环静脉淤血。三尖瓣关闭不全形成的杂音 与二尖瓣关闭不全形成的杂音的区别是杂音出现的部位(前者在胸骨的左下缘)，杂音在 吸气时有增强的趋势，以及相关的体征(如肝搏动、颈静脉搏动中的收缩波)。多普勒超 声心动图检查大大有助于该病诊断。胸膜腔积液(常为单侧)在右心衰或全心衰中比在单 ―― 1?4―― 纯左心衰中更常见。 [体循环的静脉淤血]体循环静脉压的升高是右心衰的必然表现。其机制是：(1)衰 竭的心室不能将泵回心脏的静脉血有效泵出，这势必人人增高心脏充盈压；于是，导致 (2)体循环中的大静脉血容量增大；以及(3)因交感神经活动增加而导致静脉舒缩张力增加。体循环静脉压升高导致肝脏肿大(偶有脾脏肿大)和外周水肿，这是右心衰失代偿所 表现出的 f 临床特征。通常情况下，与之相关的胃肠道充血和水肿较不明显。 颈静脉压是右心房压的有效指征，观察颈静脉的扩张程度，则可心中有数。在胸腔 内的压力未见升高时，直立状态下的颈静脉一般呈扁平状；而在右心衰时。可见颈静脉 充盈和扩张。 [肝脏肿大]右心衰时，肝脏通常肿大并有压痛。如起病突然，右上腹疼痛可【大 1 肝 脏肿大将肝被膜拉紧而导致。脾脏肿大不常见，除非肝脏长时间被动充血。脾区疼痛或 压痛可能提示并发体循环栓塞和脾梗塞。 肝脏早期充血可能导致肝脏酶浓度(如血清碱性磷酸酶)轻度升高，以及血清胆红素 升高。这种原因导致的高胆红素血症通常包括结合与非结合胆红素两种。明显黄疸不常 见，除非肝淤血合并伴长时间肺淤血或肺梗塞。 [外周水肿]下坠性水肿在一天活动后出现，在清晨消退，这是右心衰的典型表现。 这是体循环静脉压升高的直接后果。在这之前通常有体重增加。持续性水肿常常伴有某 些并发症，如轻度蜂窝织炎；如果水肿合并静脉流动缓慢，则很有可能出现深静脉部位 的血栓形成和肺栓塞。 [胸膜腔积液]单纯性右心衰发生时，胸膜腔积液发生率并不高。这提示，在胸膜 腔积液与肺心病合并存在时，应考虑有无其它原因，如肺梗塞。然而，全心衰时，该情 况是常见的。当肺循环和体循环中的静脉压升高时，等渗的液体从胸膜腔流出的路径受 到影响，导致胸膜腔积液，导致胸膜表面的通过毛细血管的液体交换，同时阻碍淋巴液 ：gl 流。胸膜腔积液反射性引起呼吸困难，机制可能是比较崮定的胸腔容量出现了通气肺 组织移位，Dii_L 来自于肺和胸壁的刺激。 [腹水]腹腔内游离液体的存在是右心衰的晚期表现，通常伴有体循环的静脉高压、 外周水肿，以及胸膜腔积液。常见于三尖瓣疾病或慢陛缩窄陛心包炎。门静脉高压和肝 静脉高压以及接受腹膜血液的体循环中的静脉高压，都是腹水形成的原因；但是，钠和 水在-肾脏的潴留是必须预先具备的条件。腹水可导致厌食；严重右心衰病人，常感腹部 不适和腹痛。 [心包积液]慢性心力衰竭病人常有心包腔内液体量增加，可用超声心动图检查。 但是，心包积液很少引起进一步血液动力学改变，很少引起心包填塞。 一 J25― Chapter 8 Blood and Immunity Section A Medical Terminology albumin albuminoid albuminuria vaccinataon vaeonate vaccinator azotemaa azohma azotometer t~oohil t~ophili． basophJlismcoagulation coagulopathy co~om,n eosinophil eosmopema ―in substance，hence a protein substance found in every animal resembhngalbllmin urine containing albumin the process of making vaccine become effective to make vaccine become effective one who vaccinates；all instrument for use in vaccination all excess of u 呦 or other nitrogenous compounds in the blood all excess of urea or other nitrogen compounds in the urine an instrument for measuring the proportion of nitrogen compounds in a solution ? ph／／attraction，hence，a type of blood cell that alⅡ：日 cts alkaline dyes 。／a condition，hence all increase in the number of basophils abnormal increase of ba 刚】hil cells the process of clotting any disorder ofblood coagulation a term used colloquially in clinical hematology to denote a series of lab tests measuring the various parameters of hemostasis type of blood cell that attracts red dyespen~deficiency，hence a decrease in the number of eosinophils in the blood ―126― 续表 eosinophilia ferritin 亿 rriheme the formation and accumulation of an abnormally large number of eosinophils in the blood the iron-apoferritin codex，which is one of the chief forms in which iron is stored in the body hemastin；the hydroxide of heme ferrri―albuminie containing iron and albumin transfusion infusion profusion hemoglobin myoglobin hemnglobinuria granulocyte agranulocyte granulocytosis idiopathic idiopathyidiomorphie megaka~yocm karyoplasm karyogenesis leukocyte leukocytosis leukocytopoiesis hemolysis hemolytic trans―through；across，hence intravenous administration of blood the therapeutic introduction of a fluid other than blood．as saline solution，into a vein pounngin great amounts an iron-containing protein produced by e~ytes 山 e oxygen-transporting pigment of muscle，a conjugated protein(肌红蛋白) uria containing hemoglobin any granular blood cell a blood cell without granules ―cytos／s condition of ceUs，increase in number，hence，an abnormally 1arge number of granulocytes in the blood pertaining to a disease whose eall~e is unknown，hence very distinctive a disea．~whose cause is unknown pertaining to a distinctive shape or form 唧 la 学，hence the giant ceU of bone I／la／TOW，a large cell with a greatly lobulated nucleus pl 删 of nucleus generation of nucleus white blood cell increase in n 幽， hence all increase in the number of white blood cells po／es／s formation，hence，the production of leukoeytes breakdown ofthe blood pertaining to hemolysis ―127― 续表 terminology mean~ paralysis megakaryocyte megakaryoblast megaloblast molmcyte inonocytopema monoeytoslS natremia natriuresis natriureticnephropathy nephrosclerosis nephroscopy neutrophil neutrocyte neutropeilia nutrient nutrition nutriology pancytopema pmxtemic panesthesia eosinophil pofⅡ一&,dong the side of，hence losing control of vohmtary muscles of the body kary／o nucleus， heace the giant cell of tM】 Ill'J／TOW， large cell with 11~eatly lobtdat― 【Je a ed nucleus the earliest cytol 晒 cany identifiable precar~r in the throrobocytic series，which matureb to form the promegakaryocyte a large，nucleated，immature progenitor of an abnormal red blood cell selics a mononuclear phagocytic leukocyte abnormal decrease in the proportion of monocytes in the blood increase in the proportion of monocytes in the blood hypematremia the excretion of sodium in the uriBe peaaining to，characterized by，OF promoting natriuresis disease of the kidneys sclerosis or hardening of the kidney visualization of the kidney by means of the nephroscope type of blood cell that attracts both acidic and alkaline dyes a neutrophilic leukocyte decrease in the number of neutrophilic leukocytes in the blood particles or elements of nourishing the s 岫 0f the processes involved in taking in nutriments and assimilating and utilizing them me science of nutrition；the study offoods and their use in diet and therapy deficiency of all cellular elements ofthe blood a wide-spread epidemic of a disease the sum ofthe sensations experienced type of blood cell that attracts red dyes 一 128― 续表 basophil neutrophil leukopeniapancytopenia granulocytopenia retieuloeyte reticulocytosis reticulocytopenia hemorrhage meilonh~a type of Hood cell that attracts alkaline dyes type of blood cell that attracts both acidic and alkaline(1Ves leukocyte deficiency deficiency of all cellular elements of the blood a decrease in the number of granulocytes a young red blood cell showing a basophilie retieulum under vital staining all increase in the number of reticulocytes in the peripheral blood a decrease in the number of reticulocytes of the blood bleeding；usually refers to excessive or tmcontrolling bleeding 竹 1en／o menstrual flow，hence excessive menstrual flow leukorrha 百 a excessive whitish discharge from the vagina and uterine cavity seropositive serologically positive；showing positive results on serological examination seropositivity serologically positive seronegahve sideropenia sideropenie sideroblast thrombocytopoiesis thrombocytolysis thrombocytopenia inllnHill?zation semlogieally negative iron deficiency pertaining to or characterized by deficiency of iron a nuclealed red blood cell containing granules of iron in its cyt~asm the production of blood platelets 一蜘厶 breakdown，hence destruction of blood platelets decrease in the number of blood platelets process of inducing immunity to a particular infectious disease sensiti 枷 0n administration of antigen to induce a primary lln／nune respo 眦 hospitalizafi。n the process of being hospitalized ―129― 续表 termim~ogy meaning inilammation of small veins any of the small vessels that collect blood from the capillary plexuses and join to form veinspertaining to，composed of，or affex：ting venules Exercises A．Match Column 1 with Colmnn II． Colurea I Column II (Combining form，prefix and sIlI 堡! !垦型塑唑! 一一 eosin／o [11]red；msy baso． [12]alkaline eoagul／o [3]clotting ．globin [14]pmtein feⅡ／i [9]containing iron in its plus-three oxidation state ―lysis [6]breakdown，destruction mega 一 [8]large，oversize ―penia [10]deficiency ．rrh~a／．rrhage [13]excessive flow pan 一 [19]all，entire idi／o [17]unknown；individual；distinctive nephr／o [18]kidney thrombocyt／0 一 [1]platelet ―fusion [2]pouring ―ate [7]to i／lake something become into venul／／0 [20]small vein kary／o [15]nucleus neutr／0 [16]neutral kul∥0 [4]white ―phil [5l love―；attr―action ―130― B．Break down and define the word elements within each of the following terms，and then Exanlple hypertensi。n hyper／tensi。n excessive／bl。od eleVate(1 blood pressure pressure 续表 Example hypertension hyper／tension excessive／blood elevated blood 旦!!竺竺 radioactivity／image recording 14． radiography radio／graphy 15． ultrasonography ultra／sono／graphy beyond／sound／image recording use of photo~aphit。 plates to produce all image recording the absorption of X―raysby structures in the body diagnostic technique in which reflected ul― trasound waves are recorded to generate an image of structures within the body C．Give the stlae~to the following medical terms，for example，histotherapy? 1．?albumin 4．co~agu?lopathy 7．Iferrri―albu?minie 10．?granuloeyte 13．Ileukocy?tosis 16．,semposit?ivity 19．Isidero?penie 22．?ferritin 25．,pancyto?penia 28．,thromboleyto?penia 2．1azo?temia 5．teosAno?penia 8．Ihemo?globin 11．Iidio?pathie 14．ileukoleytopoi?esis 17．re,tieulocy?tosis 20．?hemorrhage 23．mono~cyto?penia 26．1thrombo,cytopoi?esis 29．jpanes?thesia 3．Ibaso?philia 6．IeosI ino?philia 9．,hemo,globi?nuria 12．Imeg?akaryocyte 15．Ihemo?lytie 18．Isidem?penia 21．pa?ralysis 24．Inephrosele?rosis 27．Ithm@y?tolysis 30．,leukor?rhagia Section B Exercises(Passage One) B．Put me fouO、viIlg words or phrases inm the following sentences and change the form if necessary? 一 132―?rhe main function of the red blood ceils is to transport(1)――(oxygen)from the lungs to the(2) (tissues)．Oxidation of val-ious food substances to supply most of the energy requirements of the body results in(3)――…一一(carbon dioxide)，and red blood cells carry it to the lungs for(4)――(rel 昀 Se)aJld to pick up more oxygen．The substance in the red blood cells that is largely responsible for the ability to CaITy oxygen and carbon dioxide is(5) (hemoglobin)，which gives the cells their red color．It is a protein complex comprising many linked amino acids．and occupies almost the entire volume of a red blood cell．Essential to its structure and function is(6) (iron)． hnmunity refers primarily to the(7)――――一(resistance)of an individual to reinfection with(8)(bacteria)，viruses，fungi，or parasites．Under normal(9) (circumstances)the immune system responds to foreign organisms by the production of(1 O)一 ―― ――(antibodies)and the stimulation of bpeciaJized(-e11s ， which destmy the organisms 0r neutralizP their toxic products．When the immune system involved in this functi(Jn becomes too active， howev― er，the result may be undesirable features， su【? as hypersensitivity or(1 1)――――(allergic) h reactions．0n the other hand，when the immune respollse is not working properly，as in AIDS， the individual may become more(1 2)一――一(susceptible)to repeated infection．Another major function 0f the immune system i¨ femoval of【tamaged or dyirig cells．?Fhis function may be lle misdi― Ijected． however， FCsuhing in an immune response against the body?s own cells or tissues， producing a condition knOWII as an(13) (autoimmune)disease．The function of the immune sys― tem m。 st recently discovered ib the system?s ability t 。 rP 【 -()gnize and eliminate the abnonnal(mutant) cells t11at frequently arise within the Lx)(ty．An immune system that is functioning properly can usual 一 1y(14)――(recognize)~,ld dispcse。i 呲?h nⅢtant，or callcer，cells by means。f a proce。 。 called(15) (inullune)surveillance． C．Complete the following table about the different types of white blood cells? D．Complete the following table about the common blood tests． E．Give the medical terms according to the following descriptions? 1．hemoglobin 2．hemostasis 3．phagocytosi。 4．plasma ―134 一 the iron―containing pi~nent in red blood cell that transports oxygen the stoppage of bleedingthe engulfing offoreign material by white blood cells the liquid portion of the blood 5．antibody 6．antigen 7．immunity 8．B cell 9．eosinophil 10．basophil 11．affinity 12．granulocyte 13．agranulocyte 14．megakaryocyte 15．macrophage a protein produced in response to，and interacting specifically with，an antigen a substance that induces 山 e formation of antibodies the state of being protested against a specific disease a lymphocyte that matures in lymphoid tissue and is active in producing antibodies leukocyte with dense，reddish granules having an affinity for red acid dye leukocyte whose granules have an affinity for basic dye inherent likeness 01&relationship ? white blood cell with dense，dark―staining granules white blood cell without dense，dark―staining granules in its cytoplasm forerunner of platelets(formed in the bone FflalTow) large phagocytes formed from monocytes and found in tissues；they de― stroy worn．out red blood cells and engulf foreign material B．Fill in each of the blanks、 ：?，itlI one proper word． Anemia is the loss of the oxygen―carrying capacity of the blood re― sulting from a de6ciency in quantity or quality。f red blood cells or the(1)hemoglobin (1) in the blood．The symptoms include pale skin，weakness，fatigue，and dizziness? Serere anemia 眦 y cause(2)(2)difficulIy in breathing and heart abnormalities． Anemia is generally classified as(3) by blood loss， abno 肿 aJ destrIJction of red blood cells，i．e． ，(4) and abnorrrlal bone(5)__function．The most common type of anemia is iron(6) anemia，which most often resuIts(7)――chronic blood loss and also from lack of iron in the(8) ，impaired absorption of iron from the 0f intestine，0r increased need for(9)(3)caused (4)hemolysis (5)nlalTOW (6)deficiency (7)from (8)diet ，as in pregnancy．(9)iron This de6ciencv resuIts in red blood cells that ale both smaller and paler than they are (10)――．Abnormal destruction of red cells leads t0 a shorter than nonnal red cell survival． (10)normally C? the following words or phrases inm the following sentence~and change the form if Put necessary? The symptoms of allergy vary with allergen， with the pail ofthe txxly affected． symp― and The toms，or(1)――(allergic)reactions，max，r include sneezing，watery eyes，and nasal(2)―― (congestion)，as in hay fever and allergic rhinitis；a rash，stomach upset，and itchy swellings on the skin，as in some food or drugs that interfere with breathing，as in(3) (astluna)；mid in rare cases，anaphylactic shock，which may lead to asphyxiation and(4)――一(death)．Anaphy― lactic(5)――(shock)occasionally follows injections of penicillin or other(6)一一(drugs) and may sometimes follow the sting of a bee or wasp． Acquired Immune Deficiency Syndrome，AIDS(7) (for short)，is the newest(8) (epidemic)to threaten human beings．AIDS is caused by infection with a virus officially known as HIV．Considerable evidence(9) (demonstrates)that it iS indeed the(1 0) (causative)agent for AIDS．HIV attacks(1 1) (selected)cells in the human immune system and produces defects in function．These defects may not be apparent for years，but the)?will severely (12) (suppress)the immune system?s,ability to resist harmful organisms． D．Match the types of anemia witll the following descriptions． 一 136― E．Translate the following into English． F．Translate tlIe following case studies? 患者，38 岁，白人女性，因泌尿道感染、发热(10l。F)，到急症室就诊。过去，曾 诊断患有淋巴瘤；化疗后稳定。入院时，血红蛋白 7．9；白细胞计数 3，700，多核 62％，带核 1 1％；血小板计数 72，000。尿培养革兰氏阴性杆菌阳性。 患者一开始就采用抗生素联合疗法。在血培养显示有对氨苄青霉素敏感的沙门氏菌 生长时，则持续使用了该抗生素进行治疗，2 克，静脉内给药，每 6 小时一次。治疗期 间，血小板计数降至大约 40，000，可能由化疗合并感染引起。再上 Septra 治疗，以防 氨苄青霉素引起的血小板破坏。 患者出院，嘱其一周后复查。 A．Acco 咖 to Passage Three，select the best aillswer from the four choices given? 1．In acute leukemia the affected pluripotent hematopoietic stern cells giVe rise to progenY that failt0 differentiate 珊 1d instead continue to proliferate in a(n) a．contmlled c．ordinary b．uncontrolled d．normal 2．T―he 10ss。f n。rrnal mam)W fl 岫 cti 伽舀 ves rise to the comlnon clinical complications。 f leukemia： C．blood 10SS 坠 bleeding 3．In d．intemal hemorrhage eases acute leukemia develops for unknown reasons，but sometimes a possible cause can be identified． a．some c．nearly all the b．most d．the n 牝 4．If leukemia develops before age 10 in a patient with an identical twin，one affected twins will subsequently develop an identical form of leukemia． a．out of C．from b．in d．to 5．Heavy occupational exposure which sometimes evolves into leukemia． five un― benzene frequently results in malTow hypoplasia， a．with 生 to b．among d．into 6．Acute leukemia can be classified in a variety of ways including morphology，eytochemistry， cell― surface md(ers，cytoplasmic markers， a．cytogenetms b．degree of differentiation 垒 duration d．pathogen ，and oneogene expression． 7．The most important distinction is between AML and ALL，since these two diseases in their clinical behavior，prognosis，and response to therapy． a．are similar 垒 differ considerably b．very different d．眦 the same 8．The clinical manifestations of acute leukemia result from decreased normal n 璃 nuw function and invasion of normal organs by a．radiation b．toxin C．chemicals d．1eukemic blasts 9．The diagnosis of acute leukemia is generally established by mallow aspiration and biopsy， usuallyfrom the ． 塾 posterior iliac crest c．stemum b．anterior iliac crest d．1umber vertebra 10． 1eukemia and aplastic anemia eaR both manifest with peripheral paneytopenia， the finding but of hypoplastie marrow without blasts usually distinguishes a．1eukemia 坠 aplastie anemia b．1eukemia and aplastie anemia d．them B．Read the case note below first and then do the exercises according to the instruction． 1．List words you dO not know and perform a meaning-analysis if possible by using the knowledge of word dements you have learned? 一 138― 2．?l'ranslate the case note into(．'hilleSe． 患者，女，52 岁，白人，有多发性肺部栓子史，目前正用华法林钠抗凝血药治疗。 此次就诊主诉为用力后呼吸困难加重。查体时，除右肺底有细小捻发音和心脏有软性收 缩期杂音而外，其余无特殊。实验室检查结果：血红蛋白下降(8 克／100 毫升)，提示抗 凝治疗所致的胃肠道出血或腹膜后出血。肺扫描符合多发性肺栓塞诊断。 下肢检查未发现血栓形成。腹部 CT 扫描未发现血肿和其它异常。输血后，临床情 况大为好转。患者出院，继续以前的治疗，并按时去呼吸专科复诊。 译文： 血液是由血细胞(有形成分)和血浆组成。血细胞悬浮在清亮草黄色血浆中。血细胞 包括红细胞、白细胞和血小板，三者约占血液总体积 45％；其余 55％为血浆。血浆有 90％．水，余下 10％为营养素、电解质(被溶解盐)、气体、白蛋白(一种蛋白质)、凝血 因子、抗体、废物、酶、激素。血浆 pH 值稳定在 7．4 左右。 血液吸收肺部来的氧和消化道来的营养物质，并输送到组织。同时，组织的细胞代 谢产生的二氧化碳和其它废物，送到排泄器官。血液还将内分泌腺产生的激素输送到它 们的靶器官。 [红细胞]红细胞的主要功能是将氧从肺携带到组织，将二氧化碳从组织携带到肺。 氧与血红蛋白结合。血红蛋白由含铁血红素和珠蛋白组成。血红蛋白对氧有很大亲合 力，使红细胞通过血液携带大量的氧。血红蛋白使红细胞成为红色。红细胞体积小，呈 盘状，无核。这种形态最大程度增加对氧和二氧化碳吸收面积。每立方毫米血液中有大 约 500 万红细胞，这使得红细胞成为血细胞中数量最多的一种血细胞。所携带血红蛋白 平均为每 100 毫升 15 克。红细胞生于骨髓，生成过程受肾脏分泌的红细胞生成素刺激 影响。在循环血液中，红细胞寿命大约 120 天。 [白细胞]白细胞主要功能是保护机体，使之不受细菌和其它潜在危害异物的影响。 染色后的白细胞，可显示明显的核。白细胞总数约为每立方毫米 ，但感染 一 1 39― 时司升高。白细胞分为以 F 五种不同类型：三种粒细胞(嗜酸性、嗜碱性和嗜中性)；两 种无粒白细胞(单核细胞和淋巴细胞)。 粒细胞特征为细胞质内有明显颗粒存在，核分多叶。因具奇形怪状核，故有时称为 多形核白细胞(PMN)。三种粒细胞命名源于它们在实验室检验时所摄取的染料颜色。嗜 酸性粒细胞摄取的是称为伊红的红色酸性染料，主要功能是对异性蛋白解毒，特别是对 那些导致过敏反应的异性蛋白。嗜碱性粒细胞摄取碱性染料。其主要功能是在损伤部位 释放组胺(导致炎性反应的化学物质)和肝素(一种抗凝化学物质)。嗜中性粒细胞既摄取 酸性染料又摄取碱性染料。是有吞噬作用的细胞，吞噬和破坏细菌及其它异性颗粒。与粒细胞不同，无粒白细胞的细胞质没有颗粒，其核也不是多叶，而仅有一大核。 无粒白细胞分为单核细胞和淋巴细胞。 与嗜中性白细胞样，单核细胞也具有吞噬作用。事实上，许多单核细胞游到组织， 变成体积较大的具有吞噬作用的巨噬细胞。淋巴细胞在淋巴结成熟，在血液系统和淋巴 系统循环。淋巴细胞在免疫反应中起重要作用。 白细胞保护人体，使之不受外来物质影响。某些白细胞可吞噬异物；某些在免疫系 统中发挥一定功能。在诊断中，不但应了解白细胞总数，而且应知道分类计数，这一点 十分重要。白细胞中，数量最多的是嗜中性白细胞，也叫多形核白细胞，因它具有多形 细胞核。 [血小板]血小板，也称为凝血细胞，实际上是细胞碎片，而不是完整细胞。血小 板在骨髓形成，由巨大多核的巨核细胞演变而来。巨核细胞小片从胞体脱落，形成血小 板。血小板在止血方面起重要作用。血小板主要功能是，在血管损伤部位促使血凝块形 成，防止血液丢失。当血管受损时，血小板在损伤处聚合，形成阻塞。血小板和受损组 织释放的物质与血浆凝血因子相互作用，形成使伤口闭合的血凝块。当损伤出现时，血 液凝血因子被激活。13 种不同凝血因子相互作用才会有血凝现象出现，这就防止了不 必要血凝出现。最后一种反应是纤维蛋白原转化为纤维蛋白，将血细胞和血浆拉在一 起，形成血凝块。 [血浆]血浆是血液液体部分，由水、溶解蛋白质、糖、盐类、激素、及其它物质 组成。四种主要血浆蛋白是：白蛋白、球蛋白、纤维蛋白原、凝血酶原。 白蛋白维持血液正常容量。白蛋白不容易通过毛细血管，被留在血液中，将分子更 小物质粘附在其表面。将组织的水吸收回血流。球蛋白含抗体。抗体是机体免疫系统的 组成部分，破坏抗原这样的异物。免疫球蛋白是特殊类型的 7 球蛋白，是血浆中三种球 蛋白(a 球蛋白、p 球蛋白、7 球蛋白)的一种，能够充当抗体。 [免疫系统】免疫系统为机体提供特异性对抗异物的防卫反应。该系统包括淋巴器 官(淋巴结、脾脏、胸腺)及其产物(淋巴细胞和抗体)和巨噬细胞(血液、肝脏、脑、淋巴结、 脾脏、以及其它器官中的吞噬细胞)。 细胞进入机体时，吞噬细胞(如嗜中性白细胞)游走到感染部位，吞噬细菌。吞噬细 胞释放一些蛋白，而这些蛋白能吸引其它免疫细胞，导致局部发热和炎症。局部组织和 血流而来的巨噬细胞，在感染消退时，便将死亡细胞和碎片清除。 当细菌或病毒大量进入机体，击溃局部感染部位的吞噬细胞时，第二道防线则是淋 巴细胞。循环在淋巴系统和血液的淋巴细胞分两种：T 细胞和 B 细胞。T 细胞，即 T 淋 一 140― 巴细胞，成熟于胸腺，能直接进攻外来细胞，形成细胞介导免疫。而 B 细胞，即 B 淋 巴细胞，成熟于淋巴组织。B 细胞遇到外来抗原时，迅速增殖，产生抗体以对抗抗原， 使其丧失活性。抗体停留在血液，常可对付导致抗体形成的特异有机体，提供长时免 疫。依靠抗体进行的免疫叫体液免疫。 如抗原遇到 T 细胞，T 细胞会迅速增殖。被活化的 T 细胞可吞噬和消化抗原，如癌 细胞、病毒、霉菌、细菌。T 细胞也可与外来组织发生反应，如移植皮肤、移植器官。 某些 T 细胞(TR 细胞)具有细胞毒性，其被叫做细胞杀手，直接作用于载有抗原的 细胞(肿瘤细胞、外来移植组织)。还有一些 T 细胞能产生叫做淋巴因子(如干扰素、白细 胞介素)的化学物质，对细胞或细菌具有毒性。干扰素能抑制病毒对正常细胞的影响， 刺激巨噬细胞吞噬细菌。白细胞介素能活化 T 细胞，对某些肿瘤细胞具有细胞毒性。 还有一类特殊 T 细胞，称为细胞助手或 T4 细胞，能刺激抗体生成。还有一些 T 细 胞能调节抗体生成，起细胞抑制物作用，抑制 B 淋巴细胞活性。血液疾病(Passage Two) [贫血]贫血是血液中血红蛋白减少的一种疾病。原因是红细胞太少、太小、或血 红蛋白太少。诊断贫血的主要实验室检查有平均红细胞体积(MCV)和平均红细胞的血红 蛋白浓度(MCHC)。网织红细胞计数也很重要。贫血的一般临床表现是易倦、气促、心 悸、面色苍白、烦躁不安。 贫血最常见类型是缺铁导致的缺铁性贫血。铁是血红蛋白生成的必要物质。贫血的 其它类型有再生障碍性贫血、溶血性贫血、恶性贫血、镰状细胞贫血、地中海贫血。 再生障碍性贫血由骨髓破坏所致。骨髓破坏导致全血细胞减少。原因可能是药物、 毒素、病毒、放射、骨髓瘤；但是，大多数病例的原因不清楚(特发性)。骨髓中的干细 胞不能制造白细胞、红细胞和血小板时，全血细胞减少症发生。 溶血性贫血是溶血导致的严重破坏所引起的红细胞减少。其中一个例子是先天性球 形红细胞症，也叫遗传性球形红细胞症。红细胞的球形改变使红细胞脆性增大，容易遭 到破坏(溶血)，导致贫血。过度溶血导致黄疸，因为循环血液的胆红质增加。有时，溶 血性贫血由自身免疫抗体引起，这种抗体导致红细胞破坏。 恶性贫血是一种与营养有关的贫血。缺乏一种叫做内因子的物质。内因子由胃产 生，有助于维生素 B12 在肠道吸收。维生素 B12 是红细胞正常发育和成熟所必要的物质。 恶性贫血病人的胃液中缺乏内因子，结果是红细胞不能成熟，使血液循环中存在过量的 体积大、未成熟、功能差的红细胞，即巨幼红细胞。 镰状细胞贫血是一种遗传性疾病，特征为红细胞形态异常和溶血。红细胞呈镰状是 因为红细胞的血红蛋白不正常，即为血红蛋白 S。这种形态异常而易脆的红细胞聚合在 一起。将血管阻塞，导致血栓形成和组织坏死。镰状细胞贫血的临床表现是关节疼痛、 腹痛突发、四肢溃疡。这种