联合他汀类与普罗布考抗动脉硬化斑块的研究进展

动脉粥样硬化(AS)是以富含脂肪的斑块聚积在大动脉壁为特征的疾病,其病变起始于动脉内膜中层的退变,先后有脂质和复合糖类聚积、纤维组织增生和钙化沉着。斑块内出血、斑块破裂及局部血栓形成是AS的继发病变。AS可累及全身动脉如:主动脉、冠状动脉、脑动脉、颈动脉、下肢动脉等。AS斑块形成是心脑血管事件的重要危险因素。     

动脉粥样硬化炎症及其影像学评价方法

炎症是动脉粥样硬化(AS)发生及进展的主要因素。AS炎症可表现在AS斑块、血管外膜及血管周围脂肪组织,炎症因素在AS斑块、血管外膜及血管周围脂肪组织之间相互作用,促进AS病变进展,进而引发心脑血管事件。采用多种影像学手段综合评价上述三方面的炎症反应,对于准确诊断AS病变、监测抗AS治疗的疗效及预测AS相关危险事件有重要意义。本文对AS斑块、血管外膜及血管周围脂肪组织的炎症及其影像学评价方法进行综述。     

黄芩苷对动脉粥样硬化作用机制的研究进展

动脉粥样硬化(AS)主要累及大动脉及中动脉,特别是冠状动脉、脑动脉和主动脉,其他常见的AS类型还有小动脉硬化和动脉中层硬化.其特点是受累动脉的病变从内膜开始,先后有多种病变合并存在,其基本病变是动脉内膜的脂质沉积、内膜灶性纤维灶、粥样斑块形成,导致管壁变硬、管腔狭窄,并引起斑块内出血、斑块破裂及局部血栓形成等一系列继发性病变,特别是发生在心和脑等器官,可引起缺血性改变.     

转化生长因子β与动脉粥样硬化斑块稳定性的关系

<正> 动脉粥样硬化(atherosclerosis,AS)是多种因素作用下的慢性炎症过程,随着AS的进展,可导致急性冠状动脉事件的发生。有研究表明,急性冠状动脉事件通常是由斑块破裂并发出血造成的,而不是由于纤维斑块逐渐进行性增大引起血管阻塞所致,导致急性血栓形成和心肌梗死等临床事件的"罪犯病变"血管造影通常并不显示明显病变。大量的研     

应用血管内超声显像技术评价高敏性C反应蛋白与不稳定型心绞痛的相关性

目的: 应用血管内超声（intravascular ultrasound,IVUS）技术探讨血清高敏性C反应蛋白（hsCRP）与冠心病不稳定型心绞痛（UAP）的关系。方法: 38例拟诊为冠心病患者行冠状动脉造影（coronary angiography,CAG）和IVUS检查,其中8例患者经CAG和IVUS检查未发现冠脉有明显病变为对照组;30例经IVUS检查发现冠脉有明显狭窄病变,为冠心病组,其中UAP 18例、稳定型心绞痛（SAP）12例。检测所有患者的hsCRP浓度。结果: 38例患者均有不同程度的内膜增厚;8例对照组无动脉粥样硬化(AS)斑块;30例冠心病患者IVUS示有不同类型的AS斑块。UAP组患者血清hsCRP水平显著高于SAP组及对照组;不稳定斑块组hsCRP水平高于稳定斑块组。结论: UAP患者血清hsCRP水平明显增高,提示hsCRP水平升高与AS斑块不稳定有关。     

颈动脉粥样硬化斑块稳定性超声检查研究进展

<正>动脉粥样硬化(AS)斑块分为稳定性和不稳定性斑块(即易损斑块),AS斑块的稳定性与心脑血管疾病有重要的关系,大部分心脑血管急性事件是由AS易损斑块破裂继发血栓所致~([1,2])。易损斑块的早期识别、早期干预,可减少心脑血管急性事件的发生,对临床有重要意义。本文就颈AS(CAS)斑块的     

CD40/CD40L参与动脉粥样硬化的机制

CD40/CD40L在T淋巴细胞和B淋巴细胞的活化及其介导的体液免疫过程中起重要作用,CD40/CD40L相互作用是淋巴细胞之间传递炎症和免疫信号的重要途径。近年来发现,CD40/CD40L广泛存在于动脉粥样硬化(AS)斑块的各种细胞中,其相互作用显著影响AS相关细胞的功能,并且与斑块的发生发展密切相关,本文主要讨论CD40/CD40L在AS病变及相关细胞中的表达、参与AS过程的机制、信号转导途径以及基因表达的调节。1CD40/CD40L在AS病变及相关细胞中的表达正常动脉未发现CD40L,仅在内皮细胞有少量CD40表达。在人类AS发生过程中,CD40/CD40L在T…     

分析动脉粥样硬化斑块的MRI影像显示的信号特征及病理研究

目的分析和研究动脉粥样硬化(AS)斑块在MRI影像显示的信号特征,并分析斑块内部的病理学特点,为诊断和治疗动脉粥样硬化作价值参考。方法抽取自2013年7月~2014年7月期间我院收治的26例AS患者(30块斑块)作为本次研究标本,对所有标本行MRI影像检测,再行病理检查,对比观察两组检查结果。结果以病理为参照标准,在对斑块的动脉狭窄程度、斑块占比和斑块病变的危险系数上MRI的敏感性、特异性和准确性较高,P0.05,差异没有统计学意义。结论 MRI和病理检查诊断AS的一致性较好,敏感性、特异性和准确性高,是诊断AS的具有前途性的影像学手段,值得临床推广。     

PLGF和sTie-2与冠状动脉临界病变患者靶血管定量造影特征的相关性研究

目的分析胎盘生长因子(PLGF)和可溶酪氨酸激酶受体-2(sTie-2)与冠状动脉(冠脉)临界病变患者靶血管定量造影特征的相关性。方法回顾性分析2016年1月～2018年1月于陕西省第四人民医院心血管内科经冠脉造影证实具有冠脉临界病变的183例患者的临床资料。根据不同的冠脉斑块形态进行分组,其中冠脉粥样硬化(AS)组57例、不稳定型心绞痛(UAP)组71例、稳定型心绞痛(SAP)组55例。分析冠脉造影检查结果,检测血浆PLGF和sTie-2水平;比较三组患者血浆PLGF和sTie-2水平、靶血管定量造影特征、病变范围、形态及易损病变;采用Pearson相关性分析PLGF和sTie-2与靶血管定量造影特征的相关性。结果 UAP组血浆PLGF水平显著高于SAP组和AS组(P0.05),SAP组与AS组比较,差异无统计学意义(P0.05);UAP组血浆sTie-2水平显著高于AS组(P0.05),UAP组与SAP组、SAP组与AS组比较,差异无统计学意义(P0.05);SAP组靶血管的最小管腔直径、直径狭窄率、最小管腔面积、面积狭窄率与UAP组、AS组比较,差异有统计学意义(P0.05),UAP组与AS组比较,差异无统计学意义(P0.05);UAP组斑块面积显著大于AS组(P0.05),UAP组与SAP组、SAP组与AS组比较,差异无统计学意义(P0.05);三组患者靶血管的局部病变、偏心病变、光滑病变和易损病变构成比比较,差异有统计学意义(P0.05);PLGF和sTie-2与靶血管定量造影特征的Pearson相关性分析显示,PLGF与最小管腔面积呈正相关(P0.05),sTie-2与最小管腔面积、最小管腔直径均呈正相关(P0.05)。结论冠脉临界病变患者血浆PLGF和sTie-2水平升高,参与斑块内血管新生,与靶血管定量造影特征密切相关,有望成为预测斑块易损性的指标。     

纤维蛋白(原)基序拮抗肽对动脉粥样硬化斑块基质金属蛋白酶和CD68表达的影响

目的检测纤维蛋白(原)基序拮抗肽(γ117-133)对动脉粥样硬化(AS)斑块基质金属蛋白酶(MMP)和CD68表达的影响。方法球囊导管损伤及模型饮食建立颈总动脉AS老龄兔模型,再通过Fogarty球囊导管把Fg(Fb)基序拮抗剂γ117-133肽或PBS导入损伤的血管周围,应用病理和激光共聚焦显微镜观察各组MMP和CD68的表达。结果模型组CD68、MMP-2和MMP-8表达水平比对照组增高(均P<0.01);干预组比模型组有显著降低(P<0.01,P<0.05);干预组与对照组相比无差异(均P>0.05)。结论 Fg(Fb)基序拮抗剂γ117-133肽对斑块有抗炎作用,具有改善AS病变程度和稳定AS斑块的作用,为Fg(Fb)相关基序拮抗剂作为研发治疗AS新药的有益靶标提供实验依据。     

猪源大肠杆菌同一质粒中检测到qnrA和aac（6′）-Ib—CF耐药基因

The prevalence of plasmid-mediated quinolone resistance （PMQR） determinants was determined in 198 E. coli isolates, which separated from pigs during 1998-2007 from China. Four isolates were found to be positive for qnrA gene. One isolate from Liaoning Province in 2004 was positive for qnrA1 ＋aac（6＇）-Ib-cr and the other three isolates, which derived on the same pig farm in 2005 in Jiangsu Province, were positive for qnrA3＋aac（6＇）-Ib-cr. The qnrA and aac（6＇）-Ib-cr genes were located on the same plasmid. The cotransfer of the two genes led to the minimum inhibitory concentration （MIC） to ciprofloxacin increasing 32- to 128- fold. The qnrA1 and qnrA3 in combination with aac（6＇）-Ib-cr in E. coli strains from pigs in China were reported.     

Protective Effect of Telmisartan on Endothelial Cells Exposed to High Glucose Levels in vitro

Objectives To investigate the effect of telmisartan on human umbilical vein endothelial cells （HUVEC） exposed to high glucose in vitro and the related mechanism. Methods HUVECs were incubated with telmisartan and glucose （5 mmol/L, 30 mmot/L） at 0 h, 12 h, 24 h, 36 h, 48 h, respectively. The level of malondialdehyde （MDA） and superoxide dismutase （SOD） in the supernatant of cultured endothelial cells was measured by thiobarbituric acid test and xanthine oxidase test. The expression of PPAR-γ was determined at 24 hour with Western blot technique. Results When the endothelial cells were cultured in high glucose environment, the MDA level was significantly increased, but the SOD activity and the protein expression of PPAR-γ were markedly decreased. However, the high glucose-induced effects were inhibited by telmisartan intervention. Conclusion Telmisartan can decrease oxidative stress and increase PPAR-γ expression of endothelial cells in high glucose environment. （S Chin J Cardio12009 ; 10 （4） ： 222 -226）     

心律失常合并急性心肌梗死的心电图诊断

众所周知,急性心肌梗死（AMI）病理性Q波是初始向量改变的结果,故凡改变初始向量的心律失常均可产生掩盖或酷似心肌梗死的心电图改变。另外,有些心律失常虽未影响初始向量改变,也可产生酷似心肌梗死的心电图改变。当出现酷似AMI时,易误诊,给患者造成精神上及经济上的负担;而掩盖时易漏诊,贻误抢救时机,造成严重的后果,     

Coronary Heart Disease Complicating With Impaired Glucose Tolerance and Constipation： A Case Report Cured by Integrated Chinese-Western Medicine

Complications are more frequent in elderly patients with coronary heart disease （CHD）, such as impaired glucose tolerance and constipations. It is always difficult to cure these complications in clinical practice. In this case we had successfully cured an eighty-three years old man with CHD complicating impaired glucose tolerance and constipation by integrated Chinese-Western medicine.     

Monitoring Dynamic Change of Land Cover Based on SVM and Satellite Images in Hanoi,Vietnam

An integral method, combining support vector machine （SVM） with remote-sensing analysis techniques, was explored to monitor Hnoi＇s dynamic change of land cover. The landsat thematic mapper （TM） image in 1993, the enhanced thematic mapper plus （ETM＋） image in 2000, and the image with the charge-coupled device camera （CCD） on the China-Brazil earth resources satellite （CBERS） in 2008 were used. Six land-cover types, including built-up areas, woodland, cropland, sand, water body and unused land, were identified. The detected results showed visually the rapid urban expansion as well as land-cover change of Hanoi from 1993 to 2008. There were 12 637.54 hm2 cropland decreased between 1993 and 2000, and 8 227.6 hm2 cropland decreased between 2000 and 2008. Compared with cropland, woodland firstly decreased and then increased, and the other types did not change significantly. The results indicate that CBERS dataset has the application potential in world resources researches.     

经皮冠状动脉介入治疗出血并发症的治疗进展

冠状动脉疾病（CAD）是心内科的常见病,近年来对于该疾病的治疗有了迅速的发展,经皮冠状动脉介入治疗（PCI）作为一种有效治疗CAD的手段日益应用广泛,使得缺血事件大大降低,但出血并发症却不断增加。现对PCI患者出血、贫血和输血等情况作一综述。     

吸烟致冠状动脉粥样硬化性心脏病机制研究进展

吸烟是促进心血管疾病发生、发展的重要危险因素。在全球,烟草相关疾病每年约引起500万人死亡,其中超过1／3死于心血管疾病。冠状动脉粥样硬化性心脏病（简称冠心病）是与吸烟关系最为密切的心血管疾病之一,吸烟者冠心病发生率可增加2～3倍[2]。研究吸烟与冠心病的关系及致病机制有助于禁烟、戒烟及对心血管疾病的防治。     

Carvedilol Inhibits Na^＋ Current in Rat Ventricular Myocytes

Objectives The effects of carvedilol on sodium current （INa） were investigated in isolated adult rat ventricular myocytes. Methods Single ventricular myocytes were enzymatically dissociated. INa was recorded by whole-cell patch- clamp recording technique. Results an IC50of （6. 35 - 0.40） mol . L^- 1. Carvedilol reversibly inhibited INa in a concentration-dependent manner, with 2. This inhibition was voltage- and frequency-dependent. 3. Carvedilol decreased the peak of the I-V relationship curve at -35 mV from （17.31± 1.68） pA/pF to （6. 58 ± 1.35） pA/pF, but did not change active potential, peak potential and the reverse potential significantly. 4. The steady-state inactivation curve of INa was shifted to more negative potentials. Conclusions Carvedilol inhibits INa in adult rat ventricular myocytes by mechanisms involving preferential interaction with the inactivated state of sodium channel.     

一氧化氮在原发性高血压的发生与发展中扮演的角色

1前言原发性高血压（essential hypertension,EH）是常见的心血管疾病,又是冠心病、脑卒中、心肌梗死、肾损害等疾病的诱因,已成为威胁人类健康的主要疾病。大量临床及动物研究证实,罹患EH的患者体内一氧化氮（N0）系统受损,NO生物合成障碍,造成基础状态下内皮依赖的血管扩张减弱,     

Contribution of L-type Ca2＋ channel to the regulation of coronary arterial smooth muscle contraction is different in rats and mice

Background L-type calcium channel participates in the regulation of a variety of physical and pathological process. In vasculature, it mainly mediated agonist-induced vascular smooth muscle contraction. However, it is not clear whether there are differences in L-type calcium channel mediated vessel responses to certain vasoconstrictors among different species. Methods The coronary arteries were dissected from the heart of rats and mice respectively. The coronary arterial ring contraction was measured by Multi Myograph System. Results Endothelin-1, U46619 and 5-HT could produce concentration-dependent vasoconstriction of coronary arterial rings from rats and mice. Compared with rats, the vessel rings of mice were more sensitive to ET-1 and U46619, and less sensitive to 5-HT. The L-type Ca2~ channel blocker nifedipine could significantly inhibit the coronary artery contractions induced by ET-1, U46619 and 5-HT. The inhibitory effect of i ixM nifedipine on ET-1 and 5-HT-induced coronary artery contractions were stronger in mice than in rats, but its effect on U46619 induced-vessel contractions was much weaker in mice than in rats. Conclusions L-type Ca2＋ channel plays an important role in the coronary arterial contraction, but the responses to vasoconstrictor and L-type Ca2＋ channel blocker are different between rats and mice, thus suggesting that the coronary arteries of rats and mice have different biological characteristics.