Roux-en-Y胃旁路手术对肥胖大鼠脑组织炎症和脂质蓄积的影响

目的:探讨Roux-en-Y胃旁路(RYGB)手术对高脂饮食诱导的肥胖大鼠脑组织炎症和脂质蓄积的影响.方法:将30只4周龄雄性Wistar大鼠随机分为正常饮食组(ND组)、高脂饮食组(HFD组)及高脂饮食且接受RYGB手术组(HFD+RYGB组),各10只.ND组大鼠给予正常饮食,HFD组和HFD+RYGB组给予高脂饮食.饲养16周后,HFD + RYGB组大鼠行RYGB术,ND组和HFD组行假手术.术后ND组继续正常饮食,HFD组和HFD+RYGB组继续高脂饮食,术后第4周处死大鼠,收集血样,ELISA法测定大鼠血清三酰甘油 (TG)、胆固醇 (TC)和游离脂肪酸(FFA)水平;并取大鼠脑组织,ELISA法检测大鼠脑组织匀浆二酰基甘油(DAG)和FFA及肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1、IL-6水平,免疫组织化学法检测大鼠下丘脑离子钙接头蛋白分子1(Iba-1)和胶质纤维酸性蛋白(GFAP)表达,电镜观察大鼠下丘脑神经元形态学变化.结果:HFD组大鼠血清TG、TC、FFA水平均高于ND组和HFD+RYGB组(P<0.05~P<0.01);HFD+RYGB组FFA水平明显高于ND组(P<0.01),2组TG、TC水平差异均无统计学意义(P>0.05).HFD组大鼠脑组织DAG、FFA水平均显著高于HFD+RYGB组和ND组(P<0.01);HFD+RYGB组脑组织DAG、FFA水平亦均显著高于ND组(P<0.01).ND组和HFD+RYGB组大鼠脑组织中TNF-α、IL-1和IL-6水平均显著低于HFD组(P<0.01);HFD+RYGB组TNF-α水平亦明显高于ND组(P<0.01),但2组IL-1和IL-6水平差异均无统计学意义(P>0.05).免疫组织化学检测显示,HFD组和HFD+RYGB组大鼠下丘脑Iba-1和GFAP阳性星形胶质细胞数量增多,胞体增大,突起增粗变长;与HFD组比较,HFD+RYGB组Iba-1和GFAP阳性表达减少.电镜下可见HFD组大鼠下丘脑神经元线粒体水肿、空泡形成及大量自噬体形成,HFD+RYGB组大鼠下丘脑神经元病变减轻.结论:RYGB可以下调高脂饮食的诱导肥胖大鼠下丘脑脑组织中TNF-α、IL-1、IL-6的表达,减轻下丘脑神经元病变,改善脑组织的炎症状态,降低脑组织中脂质含量.     

动态观察非酒精性脂肪肝大鼠肝脏ChREBP的表达

目的 观察非酒精性脂肪性肝病(NAFLD)模型大鼠肝脏糖类应答元件结合蛋白(ChREBP)mRNA的动态表达情况,探讨ChREBP在大鼠NAFLD发病中的作用.方法 随机将48只大鼠分为正常对照组(C组)和模型组(M组),分别给予普通饲料和高脂饮食喂养,于第4,8和12周末,测定大鼠血清肿瘤坏死因子α(TNF-α)、游离脂肪酸(FFA)、甘油三酯(TG)、总胆固醇(TC)以及肝组织匀浆TG,测定空腹血糖(FBG)、空腹胰岛素(FINS),并计算胰岛素敏感指数(ISI).应用半定量RT-PCR检测各个时点大鼠肝组织ChREBP mRNA的表达.结果 第4,8和12周末M组大鼠肝组织ChREBP mRNA表达量显著高于C组(P<0.01),且随造模时间延长表达量显著增加(P<0.05);M组大鼠血清FFA、TG、TC和TNF-α及肝组织匀浆TG较同期c组均显著升高(P<0.01),ISI显著降低(P<0.01);相关分析显示,在第8和12周末,M组大鼠肝组织ChREBP mRNA表达量与血清TNF-α水平呈正相关(r=0.754,P<0.05;r=0.845,P<0.01),在第12周末ChREBP mRNA表达量与肝脏炎症活动度计分呈正相关(r=0.711,P<0.05),在第8和12周末ChREBP mRNA表达量与ISI呈负相关(r=-0.773,P<0.05;r=-0.820,P<0.05).结论 高脂饮食诱导的NAFLD模型大鼠随造模时间的延长,肝脏ChREBP基因表达增加,ChREBP可能通过参与胰岛素抵抗的调控而在NAFLD的发生发展过程中发挥作用.     

不同膳食脂肪酸对大鼠肝脏SREBP-1c基因表达和非酒精性脂肪肝发生的影响

目的 探讨不同膳食脂肪酸构成对非酒精性脂肪肝(nonalcoholic fatty liver disease,NAFLD)发生、发展的影响及其与固醇调节元件结合蛋白-1 c(SREBP-1c)的关系.方法 100只成年SD大鼠,按随机数字表法分为5组:对照组、NAFLD模型组、单不饱和脂肪酸组(monounsaturated fatty acid,MUFA)、n-6多不饱和脂肪酸组(n-6 polyunsaturated fatty acids,n-6 PUFA)和4∶1 n-6/n-3 PUFA组,每组20只.对照组用基础饲料喂养,其余各组饲料中加1％胆固醇和10％不同油脂(分别是10％猪油、10％橄榄油、10％玉米油、8％玉米油+2％鱼油).分别于第8、16周时,采用HE染色观察肝脏脂肪变性情况,测定血清和肝脏中脂质含量,采用实时定量PCR分析SREBP-1c、FAS mRNA表达,Western blot检测SREBP-1c、FAS的蛋白表达.结果 NAFLD模型组大鼠体质量显著高于对照组和其他膳食脂肪酸组(P＜0.05),模型组、MUFA组大鼠肝脏中TG含量显著高于对照组(P＜0.05),而n-6 PUFA组和4∶1n-6/n-3 PUFA组大鼠血清中TG及肝脏中TC、TG浓度显著低于模型组(P＜0.05);HE染色后,NAS量化评分显示模型组大鼠肝脏脂肪变性程度较对照组、MUFA组、n-6 PUFA组、4∶1 n-6/n-3 PUFA组严重;与对照组比较,NAFLD模型组大鼠肝脏SREBP-1c与FAS mRNA表达升高,MUFA组、n-6 PUFA组和4∶1 n-6/n-3 PUFA组SREBP-1c蛋白表达降低(P＜0.05).结论 降低膳食中饱和脂肪酸,增加不饱和脂肪酸(尤其是适当比例的n-6/n-3 PUFA)可下调高脂喂养大鼠肝内SREBP-1c的表达,延缓高脂膳食引起的NAFLD发生、发展.     

肝脂康胶囊对大鼠非酒精性脂肪性肝病SREBP-1表达的影响

目的观察肝脂康胶囊对大鼠非酒精性脂肪性肝病（NAFLD）及固醇调控元件结合蛋白-1（SREBP-1）的影响。方法采用高脂饮食复制大鼠NAFLD模型。SD大鼠40只雌雄各半,随机分为正常对照组、模型组、低、中、高剂量肝脂康胶囊干预组,每组各8只。干预组大鼠在进行高脂饮食同时每日给予不同剂量肝脂康胶囊灌胃。药物干预12周末结束实验。分别检测血清丙氨酸氨基转移酶（ALT）、门冬氨酸氨基转移酶（AST）、甘油三酯（TG）、总胆固醇（TC）、肝组织TG、TC以及免疫组化法检测肝脏SREBP-1表达。结果与正常对照组相比,模型组大鼠血清ALT、AST、TG、TC及肝组织TG、TC显著升高（P〈0.01）。与模型组相比,肝脂康干预组大鼠血清AST、ALT、TC、TG和肝组织中TG、TC降低（P〈0.05）。模型组SREBP-1的表达明显高于正常组,肝脂康干预组SREBP-1的表达较模型组明显减少。结论肝脂康胶囊对高脂饮食诱导的大鼠NAFLD有治疗作用,并降低肝脏SREBP-1表达。     

肠道菌群代谢产物琥珀酸对非酒精性脂肪性肝病小鼠的影响

目的观察肠道菌群代谢产物琥珀酸对非酒精性脂肪性肝病(NAFLD)小鼠血脂、葡萄糖耐量及肝脏病理形态的影响。方法2021年9月—2022年3月于贵州医科大学实验室进行实验。将雄性C57小鼠40只按随机数字表法分为正常饮食组(ND组)、正常饮食+琥珀酸处理组(ND+Suc组)、高脂饮食组(HFD组)、高脂饮食组+琥珀酸处理组(HFD+Suc组),每组10只,ND组给予正常饮食,ND+Suc组在ND组基础上加用2.5%琥珀酸喂养,HFD组采用高脂饲料喂养建立NAFLD模型,HFD+Suc组另加用2.5%琥珀酸喂养,每周监测小鼠体质量,喂养15周后检测葡萄糖耐量,血清三酰甘油(TG)和总胆固醇(TC)水平,肝组织苏木素—伊红(HE)染色、油红O染色,观察肝脏脂质沉积及肝细胞病理形态变化。结果实验15周后,与ND组比较,HFD组体质量、OGTT试验各时间点(0、15、30、60、120min)血糖、血清TG和TC水平均升高(P<0.01);与HFD组比较,HFD+Suc组体质量、OGTT试验各时间点(0、15、30、60、120min)血糖、血清TG和TC水平均降低(P<0.01);ND组与ND+Suc组上述指标比较差异无统计学意义(P>0.05)。HE染色、油红O染色显示,ND组、ND+Suc组小鼠肝脏组织中肝细胞排列整齐,细胞核大而圆,小叶结构清晰可见,未观察到明显脂质沉积;HFD组小鼠可见肝细胞弥漫分布脂肪沉积,以大小泡混合性肝细胞脂肪变性为主,部分细胞核被挤压变形甚至消失,肝细胞排列紊乱;HFD+Suc组肝细胞脂肪变性及肝脏脂质沉积较HFD组明显减轻。结论肠道菌群代谢产物琥珀酸能降低NAFLD小鼠体质量及血清TG、TC水平,减轻葡萄糖调节受损及肝脏脂质沉积,对于NAFLD具有潜在治疗作用。     

褪黑素对非酒精性脂肪性肝病中NLRP3炎症小体和肝脏纤维化的影响及机制研究

目的 观察褪黑素(melatonin,MLT)对NLRP3炎症小体和肝脏纤维化的影响,阐明其对非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)防治作用及相关的分子机制.方法 利用高脂饮食(high-fat diet,HFD)喂养的方法构建NAFLD动物模型,分为正常饮食组(NFD组)、HFD组、褪黑素干预组(HFD+ MLT组);采用游离脂肪酸(free fatty acids,FFA)干预HepG2细胞的方法构建NAFLD细胞模型,分为未处理组(ctl组)、模型组(FFA组)、褪黑素干预组(FFA+ MLT组)、褪黑素干预同时过表达lncRNA MALAT1组(FFA+ MLT+ MALAT1组);分别检测NLRP3炎症小体、纤维化、lncRNA MALAT1等相关指标.结果 HFD+ MLT组小鼠血清中TG、TC和LDL的水平低于HFD组(P＜0.05);HFD组小鼠肝脏组织中NLRP3、ASC、活化caspase-1、TGF-β1和p-Smad2蛋白相对表达量高于NFD组(P＜0.05)和HFD+ MLT组(P＜0.05);与HFD组相比,HFD+ MLT组小鼠肝脏组织中lncRNA MALAT1、col-lage Ⅰ和collage Ⅲ mRNA水平明显降低(P＜0.05);与FFA组相比,FFA+ MLT组中NLRP3、ASC、活化caspase-1、TGF-β1、p-Smad2和lncRNA MALAT1表达明显降低(P＜0.05).与FFA+ MLT组相比,FFA+ MLT+ MALAT1组中NLRP3、ASC、活化caspase-1、TGF-β1和p-Smad2蛋白相对表达量减少现象得到逆转(P＜0.05).结论 褪黑素通过抑制NLRP3炎症小体介导的炎症反应和TGF-β1/Smad介导的纤维化,改善NAFLD,其与下调lncRNA MALAT1有关.     

决明山楂降脂方对大鼠脂代谢的影响及其分子机制的研究

目的研究决明山楂降脂方对高脂血症大鼠脂代谢的影响及其分子机制。方法采用高脂喂养Wistar大鼠建立高脂血症大鼠模型,将高脂血症大鼠随机分为模型组、中药组(决明山楂降脂方)、辛伐他汀组(阳性对照),另设正常对照组。药物干预治疗后测定各组大鼠血脂、脂代谢相关酶活性及相关蛋白表达、肝组织病理学检查及肝脏三酰甘油(TG)含量。结果与模型组比较,中药组大鼠血清总胆固醇(TC)、TG、低密度脂蛋白胆固醇(LDL-C)、游离脂肪酸(FFA)、载脂蛋白B(ApoB)明显降低(P0.05,P0.01),肝组织固醇调节元件结合蛋白1c(SREBP-1c)表达较模型组降低(P0.01);而高密度脂蛋白胆固醇(HDL-C)、载脂蛋白AⅠ(ApoAⅠ)升高,脂蛋白脂酶(LPL)活性显著升高(P0.05,P0.01),肝组织低密度脂蛋白受体(LDL-R)蛋白表达较模型组明显升高(P0.01),肝脏脂肪沉积减少,TG含量明显下降。结论决明山楂降脂方可有效治疗大鼠高脂血症,其机制可能与增加肝组织LDL-R蛋白表达,提高LPL活性以及降低肝组织SREBP-1c蛋白表达有关。     

固醇调节元件结合蛋白-1c在大鼠非酒精性脂肪性肝炎中的表达及意义

目的 观察高脂饮食诱导大鼠非酒精性脂肪性肝炎(NASH)过程中肝组织固醇调节元件结合蛋白-1c(SREBP-1c)的表达变化,探讨SREBP-1c与NASH的关系.方法 建立大鼠高脂饮食诱导NASH模型,用免疫组织化学染色与Western blot方法检测NASH形成过程中肝组织SREBP-1c表达变化,并测定受其调控的脂肪酸合成酶(FAS)活性及相关血清学指标变化.结果 与对照组相比,NASH组大鼠血清FFA水平、肝组织SREBP-1c蛋白表达、FAS酶活性在第4周开始增加(P＜0.05),12周时升高最为显著(P＜0.01);而血清ALT和AST含量在8周时升高,12周时升高更加显著(P＜0.01).结论 高脂饮食可诱导SREBP-1c表达增强,过度表达的SREBP-1c可引起受其调控的FAS活性升高,导致脂肪酸代谢失衡,与NASH的发生关系密切.     

消痰化瘀中药对非酒精性脂肪肝大鼠肝X受体α和固醇调节元件结合蛋白1c表达的影响

目的观察消痰化瘀中药对非酒精性脂肪肝(NAFLD)大鼠脂代谢和肝脏肝X受体α(LXRα)、固醇调节元件结合蛋白1c(SREBP-1c)表达的影响,探讨其治疗NAFLD的作用机制。方法将SD雄性大鼠60只随机分为正常组,模型组,阳性药对照组以及消痰化瘀中药高、中、低剂量组,采用喂饲高脂饲料的方法复制NAFLD大鼠模型,造模成功后,用药治疗4周,取材检测各组大鼠血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、游离脂肪酸(FFA)和肝组织中TC,TG的含量或活性改变,并运用RT-PCR法观察肝组织LXRα和SREBP-1c mRNA的表达,运用HE染色法观察肝组织形态学的变化。结果消瘀化痰中药能明显降低模型大鼠血清和肝脏组织中TC,TG,FFA的含量,降低血清LDL含量以及肝组织LXRα和SREBP-1c的表达水平,改善肝组织的病变程度。结论消痰化瘀中药对NAFLD的治疗作用可能是通过对LXRα/SREBP-1c这一通路的调控来改善脂代谢紊乱而实现的。     

运动对高脂喂食小鼠肠黏膜屏障功能和肝脏脂质蓄积及炎症的影响

目的 观察运动对高脂喂食小鼠的肠黏膜屏障功能和肝脏脂质蓄积及炎症的影响,探讨肠黏膜屏障功能和肝脏脂质蓄积及炎症的潜在联系.方法 C57BL/6小鼠按随机数字表法分为3组:普通饲料组(ND)、高脂饲料组(HFD)、高脂运动组(HFD+ EX).采用小鼠跑步机对HFD+EX组小鼠进行运动干预.8周后检测各组小鼠血浆和肝脏的一般生化及炎症指标,进行肝组织HE染色、油红0染色,观察肠组织结构变化.结果 与ND组相比,HFD组小鼠血浆甘油三酯(TG)、总胆固醇(T-CHO)、低密度脂蛋白胆固醇(LDL-C)、内毒素(LPS)、空腹胰岛素(FINS),肝组织TG、T-CHO,空腹血糖(FBG)的含量和TLR4、TNF-α、IL-6的表达水平均显著增加(P＜0.05);与HFD组相比,HFD+EX组小鼠血浆TG、LPS,FBG,肝组织TG、T-CHO的含量和TLR4、TNF-α和IL-6的表达水平均显著降低(P＜0.05).病理切片显示,HFD组较ND组小鼠脂肪空泡增多,脂滴增大;HFD+EX组较HFD组小鼠脂肪空泡减少,脂滴减小.透射电镜结果显示,与ND组相比,HFD组小鼠肠上皮黏膜微绒毛稀疏且紧密连接结构宽度增大,HFD+ EX组小鼠较HFD组肠上皮黏膜微绒毛增多且紧密连接结构宽度减小.结论 运动可能通过保护肠黏膜屏障功能改善高脂喂食小鼠肝脏脂质蓄积和炎症状态.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.