种植体周围炎龈沟液中IL-2、IFN-γ、IL-4、IL-6的表达及临床意义

目的探讨探讨白细胞介素2、4、6(IL-2、IL-4、IL-6)、干扰素γ(IFN-γ)在种植体周围炎龈沟液(GCF)中的表达及意义。方法选择2011年6月~2014年6月50例种植体周围炎患者为研究对象。另选择健康种植体患者50例和健康人群50例为对照组。统计3组探诊深度(PD)、龈沟出血指数(SBI)、IL-2、IFN-γ、IL-4、IL-6水平。结果种植体周围炎组PD、SBI、GCF均高于健康种植体组和对照组,差异有统计学意义(P<0.01);但健康种植体组和对照组PD、SBI、GCF差异无统计学意义(P>0.05);种植体周围炎组IL-2、IFN-γ水平低于健康种植体组和对照组(P<0.01),健康种植体组IL-2、IFN-γ水平低于对照组(P<0.05),种植体周围炎组IL-4、IL-6水平高于健康种植体组和对照组(P<0.01),健康种植体组IL-4、IL-6水平高于对照组(P<0.05); ≥60岁组IL-2、IFN-γ水平低于<60岁组(P<0.01), ≥60岁组IL-4、IL-6水平高于<60岁组(P<0.01);种植体周围炎患者GCF中IL-2与IFN-γ呈正相关(r=4.267, P=0.016),与IL-4、IL-6分别呈负相关(r=4.352、4.615,P=0.005、0.002),IFN-γ与IL-4、IL-6分别呈负相关(r=4.322、4.603,P=0.009、0.005),IL-4,IL-6呈正相关(r=4.065, P=0.019)。结论种植体周围炎患者IL-4、IL-6高表达,IL-2、IFN-γ低表达,IL-2、IFN-γ、IL-4、IL-6的表达与种植体周围炎患者性别无关,与种植体周围炎患者的年龄有关。     

寻常型银屑病伴肥胖患者血清Ghrelin Obestatin水平及其诊断价值

目的 探究寻常型银屑病伴肥胖患者血清中胃生长素(Ghrelin)、肥胖抑制素(Obestatin)水平及其诊断价值。方法 选取三二○一医院收治的106例寻常型银屑病患者,根据是否伴有肥胖将其分为寻常型银屑病无肥胖组50例和寻常型银屑病伴肥胖组56例,另选取同期健康体检者43例作为对照组。采用酶联免疫吸附试验(ELISA)检测所有受试对象血清中Ghrelin、Obestatin水平;采用全自动生化分析仪检测所有受试者血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平;采用Pearson法分析寻常型银屑病伴肥胖患者血清中Ghrelin与Obestatin水平的相关性,及2者与血脂指标的相关性;同时使用受试者工作特征(ROC)曲线分析血清中Ghrelin、Obestatin水平单独及联合对寻常型银屑病伴肥胖的预测价值。结果 寻常型银屑病无肥胖组和伴肥胖组血清Ghrelin、TC、TG、LDL-C水平高于对照组(P<0.05),血清Obestatin、HDL-C水平低于对照组(P<0.05);寻常型银屑病伴肥胖组血清Ghrelin、TC、TG、LDL-C水平高于寻常型银屑病无肥胖组(P<0.05),血清Obestatin、HDL-C水平低于寻常型银屑病无肥胖组(P<0.05)。寻常型银屑病伴肥胖患者血清中Ghrelin与Obestatin水平呈负相关(r=-0.328,P<0.05);血清Ghrelin水平与TC、TG、LDL-C呈正相关(r=0.389、0.554、0.520,P<0.05),与HDL-C呈负相关(r=-0.672,P<0.05);血清Obestatin水平与TC、TG、LDL-C呈负相关(r=-0.516、-0.435、-0.468,P<0.05),与HDL-C呈正相关(r=0.634,P<0.05)。血清Ghrelin、Obestatin水平单独及2者联合检测预测寻常型银屑病伴肥胖的曲线下面积(AUC)分别为0.725、0.821、0.823,灵敏度分别为82.07%、92.86%、89.43%,特异度分别为90.00%、88.44%、92.00%。结论 寻常型银屑病伴肥胖患者血清Ghrelin呈高表达,Obestatin呈低表达,2者水平均与血脂密切相关,有望作为预测此病的生物学辅助指标。     

全段甲状旁腺激素预测慢性肾脏病肾功能损伤和肾性贫血的价值

目的 探讨全段甲状旁腺激素(iPTH)在慢性肾脏病(CKD)患者肾功能损伤和肾性贫血中的预测价值。方法 选取2018年1月至2021年10月就诊于安徽医科大学附属巢湖医院肾脏内科的250例CKD患者作为研究对象,根据患者CKD病情分期分为CKD早期组(n=100)、CKD晚期组(n=150),同时选取50例体检结果无明显异常的健康体检人群作为健康对照组。分析不同CKD分期患者iPTH水平与肾功能损伤和肾性贫血之间的相关性。结果 Spearman相关分析显示CKD患者血红蛋白(Hb)和肾小球滤过率(eGFR)与血清iPTH水平呈负相关(r_Hb=-0.415,r_eGFR=-0.736,P<0.05),尿素(Ur)、肌酐(SCr)、胱抑素C (Cys)和磷(P)与iPTH水平呈正相关(r_Ur=0.662、r_SCr=0.812、r_Cys=0.756、r_P=0.423,P<0.05);多重线性回归分析表明iPTH是CKD患者eGFR (β=-3.324,P=0.003)和Hb浓度(β=-3.125,P＜0.001)的独立影响因素。通过受试者工作特征曲线分析显示,血清iPTH对CKD肾功能损伤和肾性贫血均具有辅助诊断价值(P<0.05),当iPTH取56.25 pg/mL和40.15 pg/mL时具有最大诊断效能。结论 血清iPTH水平是CKD患者肾功能和Hb的独立影响因素,并对CKD患者肾功能损伤和肾性贫血有一定的辅助诊断价值。     

精神分裂症患者梦威胁模拟水平与敌意归因偏向及精神症状的关系

目的 探讨精神分裂症患者梦威胁模拟水平与敌意归因偏向及精神症状的关系。方法 选取2017年6月至2019年5月在安徽医科大学附属心理医院精神科住院治疗的精神分裂症患者68例为患者组,另选取本院及周边社区的70例健康志愿者作为对照组。采用梦威胁事件问卷(DTQ)评估患者组和对照组的梦威胁模拟水平,采用中文版模棱两可、目的和敌意问卷(AIHQ-C)评估患者组和对照组的敌意归因偏向,采用阳性和阴性症状量表(PANSS)评估精神分裂症患者的精神症状。结果 患者组DTQ分、AIHQ-C的各项评分均高于对照组,差异有统计学意义(P＜0.05)。Spearman相关分析显示,精神分裂症患者DTQ得分与敌意偏向总分(r=0.529,P＜0.05)、责备偏向总分(r=0.398,P＜0.001)、攻击偏向总分(r=0.442,P＜0.05)及阳性症状分(r=0.395,P＜0.05)呈正相关。敌意偏向总分(r=0.507,P＜0.05)、责备偏向总分(r=0.426,P＜0.05)及攻击偏向总分(r=0.481,P＜0.05)与阳性症状分均呈正相关。精神分裂症患者DTQ总分(r=-0.272,P＜0.05)、敌意偏向总分(r=-0.299,P＜0.05)及责备偏向总分(r=-0.397,P＜0.05)与阴性症状分均呈负相关。回归分析显示,精神分裂症患者的敌意偏向与阳性症状均可以预测梦的威胁模拟水平。结论 精神分裂症患者梦的威胁模拟水平过度激活,敌意归因偏向明显,阳性症状及敌意归因偏向均对梦威胁模拟水平有一定影响。     

系统性硬化病血脂和同型半胱氨酸水平异常的临床研究

目的 探讨系统性硬化病(SSc)患者血脂和同型半胱氨酸(Hcy)的变化及其与病情活动度的关系。 方法 对65例SSc患者和65名年龄、性别配对的健康体检者(对照组)的甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、极低密度脂蛋白胆固醇(VLDL-C)、血清同型半胱氨酸(Hcy)、C反应蛋白(CRP)等的水平进行检测分析,并根据血脂情况把SSc患者分为高脂血症组和非高脂血症组,利用统计软件检验各组之间的差异,并进行相关分析。 结果 与对照组相比,SSc患者TG(P=0.000)、VLDL-C(P=0.000)升高,总胆固醇(P=0.025)、LDL-C(P=0.038)及HDL-C(P=0.000)下降。SSc患者高Hcy血症和高血脂率分别为69.23%和38.46%。血清Hcy水平与皮肤厚度总分值(r=0.759,P=0.006)和CRP(r=0.398,P=0.028)水平呈正相关,血清HDL-C水平与SSC疾病严重程度Valentini评分(r=-0.319,P=0.0413)和CRP(r=-0.270,P=0.045)呈负相关,而Hcy水平与TG、TC水平无明显相关性(P>0.05)。 结论 SSc 患者的血脂和Hcy的异常与疾病活动度有关,这有可能增加SSc患者发生心血管不良事件的风险。     

强直性脊柱炎患者14-3-3η DKK-1及TGF-β1水平与BASDAI BASFI的相关性分析

目的 分析强直性脊柱炎（AS）患者血清14-3-3η、dickkopf相关蛋白1（DKK-1）及转化生长因子β1（TGF-β1）水平与Bath强直性脊柱炎病情活动指数（BASDAI）、Bath强直性脊柱炎功能指数（BASFI）的相关性。方法 选取2012年2月至2016年1月河南驻马店市中心医院收治的60例AS患者为研究对象,设为AS组,另按1∶1比例选取同期在本院接受体检的健康体检者60例设为对照组。比较两组研究对象入院时血清14-3-3η、DKK-1及TGF-β1水平,采用Pearson相关性分析血清14-3-3η、DKK-1及TGF-β1水平与BASDAI、BASFI的相关性。结果 AS组血清14-3-3η、TGF-β1高于对照组,DKK-1低于对照组,差异有统计学意义（P均<0.05）;AS组平均BASDAI评分（40.12±2.63）分,BASFI评分（42.67±5.22）分;经Pearson相关性分析显示,AS患者血清14-3-3η、TGF-β1与BASDAI评分（r=0.556、0.533,P均<0.05）、BASFI评分呈正相关（r=0.459、0.433,P均<0.05）;DKK-1则与BASDAI评分（r=-0.285,P<0.05）、BASFI评分（r=-0.464,P<0.001）呈负相关。结论 AS患者血清14-3-3η、TGF-β1、DKK-1与BASDAI评分、BASFI评分存在相关性,值得临床重视。     

半导体激光与高频电刀治疗牙龈瘤的临床效果

目的 比较半导体激光与高频电刀治疗牙龈瘤的临床效果。方法 收集2017年2月至2019年2月合肥市口腔医院牙周科就诊牙龈瘤患者64例,采用随机数字法分为高频电刀组(对照组)与半导体激光组(观察组),每组32例。分别收集术前、术后第7、14天的龈沟液(GCF),比较 GCF 量及 GCF 中转化生长因子-β1(TGF-β1) 和白细胞介素-1β(IL-1β)水平的变化,比较两组患者术前、术后第12、24、48小时视觉模拟评分(VAS)值大小及患者术后3个月的复发情况。结果 两组患者术后第7、14天GCF含量进行比较,差异有统计学意义(P<0.05),术后GCF随时间推移逐渐升高,随后又逐渐下降,术前及术后不同时间GCF含量进行比较,差异有统计学意义(P<0.05)。不同手术方式和时间对GCF有交互作用(P<0.05)。两组患者术前及术后不同时间点TGF-β1、IL-1β水平进行比较,差异均有统计学意义(P<0.05),不同术式和时间对TGF-β1和IL-1β有交互作用(P<0.05)。两组患者术后VAS评分比较,差异有统计学意义(P<0.05),且随时间推移有下降趋势,术前及术后不同时间VAS评分差异有统计学意义(P<0.05),不同术式和时间有交互作用(P<0.05)。结论 半导体激光可减轻牙龈瘤术后炎症反应和疼痛。     

分泌性中耳炎患者血清及耳积液IL-8 IL-10 IL-1β水平及意义

目的 探究分泌性中耳炎（SOM）患者血清与耳积液中白介素8（IL-8）、IL-10、IL-1β水平变化及其临床意义。方法 以南阳市中心医院2017年12月至2018年12月收治的97例SOM患者（观察组）和同期97例健康体检者（对照组）为研究对象,观察组依据病程、临床症状以及检查结果分为急性组（n=30）、亚急性组（n=33）以及慢性组（n=34）等亚组。比较观察组患者血清与耳积液、对照组血清炎症因子水平,观察组各亚组患者血清中、耳积液中炎症因子水平,分析血清及耳积液炎症因子水平与病程的相关性。结果 观察组患者血清中IL-8、IL-10、IL-1β水平高于对照组,差异有统计学意义（P<0.05）,观察组患者耳积液中IL-8、IL-10、IL-1β水平高于观察组血清中水平（P<0.05）;急性组SOM患者血清与耳积液中IL-8、IL-10、IL-1β水平低于亚急性组和慢性组,亚急性组上述指标水平低于慢性组,差异有统计学意义（P<0.05）;SOM患者血清与耳积液中IL-8、IL-10、IL-1β等炎症因子水平与患者病程之间均呈正相关性（r_血清=0.856,0.763,0.925;r_耳积液=0.776,0.849,0.927;P均<0.05）。结论 SOM患者血清中IL-8、IL-10、IL-1β水平异常上升,而这种异常上升状态在患者耳积液中更显著,炎症因子水平与患者病程关系密切。     

急性痛风性关节炎患者外周血脂联素与CD4+T细胞亚群的分析及相关性研究

目的 比较急性痛风性关节炎患者与健康对照组外周血脂联素及CD4⁺T细胞亚群的差异,并探究痛风患者脂联素与血尿酸、疾病活动度、CT4⁺T细胞亚群及部分细胞因子的相关性。方法 收集急性痛风组(n=90)及健康对照组(n=72)的临床资料(包括一般资料、中性粒细胞、红细胞沉降率、C反应蛋白、血尿酸、CT4⁺T细胞亚群及部分细胞因子);检测两组外周血脂联素水平,比较两组间外周血脂联素及CD4⁺T细胞亚群的差异;分析脂联素与各临床资料的相关性。结果 与健康对照组比较,急性痛风组外周血脂联素水平明显降低(P＜0.001),且Th2、Th17、Th17/Treg均升高(P＜0.05),Treg、Th1/Th2均降低(P＜0.05)。急性痛风组外周血脂联素与中性粒细胞、红细胞沉降率及C反应蛋白均呈负相关(r=-0.244,P＜0.05;r=-0.311,P＜0.05;r=-0.506,P＜0.001),而与血尿酸无相关性。急性痛风组外周血脂联素与Th1和Th1/Th2均呈正相关(r=0.252,P＜0.05;r=0.218,P＜0.05)。急性痛风组外周血脂联素与白细胞介素-2(interleukin-2,IL-2)、白细胞介素-4(interleukin-4,IL-4)和白细胞介素-10(interleukin-10,IL-10)均呈正相关(r=0.323,P＜0.05;r=0.377,P＜0.05;r=0.359,P＜0.05);而与白细胞介素-6(interleukin-6,IL-6)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)呈负相关(r=-0.265,P＜0.05;r=-0.299,P＜0.05)。多元线性回归分析显示,急性痛风组外周血脂联素与红细胞沉降率、C反应蛋白、IL-6及TNF-α均呈负相关(BESR=-12.541,P=0.003;BCRP=-8.256,P=0.024;BIL-6=-15.907,P=0.037;BTNF-α=-79.770,P=0.040),而与Th1呈正相关(BTh1=2.959,P=0.006)。结论 急性痛风性关节炎患者外周血脂联素水平降低,Th2和Th17升高,而Treg降低,脂联素降低与急性痛风性关节炎患者免疫紊乱及免疫炎症相关。     

D-D PCIS评分与肺炎支原体肺炎患儿生化指标的相关性及其在病情评估中的价值

目的 分析D-二聚体(D-D)和小儿危重病例评分法(PCIS)与炎症反应、肝功能指标的相关性,探讨二者联合检测对肺炎支原体肺炎(MPP)患儿病情评估的价值。方法 回顾性分析2019年3月至2021年9月南京医科大学附属儿童医院收治的200例MPP患儿临床资料,根据《儿童肺炎支原体肺炎诊治专家共识》分为普通组(149例)、重症组(51例)。对比两组一般资料、生化指标、PCIS评分差异;Pearson相关性分析MPP患儿D-D水平、PCIS评分与生化指标的相关性;绘制受试者工作特征(ROC)曲线分析D-D水平、PCIS评分及二者联合检测对MPP患儿病情严重程度的评估价值。结果 重症组D-D、PCT、hs-CRP、AST、ALT、LDH水平高于普通组,PCIS评分低于普通组,差异均具有统计学意义(P＜0.05)。Pearson相关性显示,MPP患儿PCT、hs-CRP、AST、ALT水平与D-D呈正相关(r=0.331、0.345、0.238、0.143,P＜0.05),与PCIS评分呈负相关(r=-0.614、-0.405、-0.377、-0.350,P＜0.05);LDH水平与D-D水平呈负相关(r=-0.209,P＜0.05),与PCIS评分呈正相关(r=0.132,P＜0.05)。ROC曲线结果显示,D-D联合PCIS评估MPP患儿病情严重程度的曲线下面积(AUC)为0.933,优于D-D水平、PCIS评分单独评估,差异具有统计学意义(P＜0.05)。结论 D-D、PCIS评分与MMP患儿生化指标相关,二者联合检测对此类患儿病情严重程度有一定预测价值。     

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.     

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     

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.     

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.