基线外周血循环单核细胞水平对冠心病患者经皮冠状动脉介入治疗后长期死亡风险的影响

目的 探讨基线外周血循环单核细胞(MO)水平对冠心病(CHD)患者经皮冠状动脉介入治疗(PCI)术后长期死亡风险的影响。方法 对PCI术的6 045例CHD患者进行回顾性分析。根据基线外周血循环单核细胞水平将患者分为3组并对其进行随访:Ⅰ组:MO＜0.40×10⁹ L－1(n＝1 943);Ⅱ组:0.40×10⁹ L－1≤MO≤0.56×10⁹ L－1(n＝2 072);Ⅲ组:MO＞0.56×10⁹ L－1(n＝2 030)。随访终点包括:全因死亡(ACM)、心脏死亡(CM)、主要不良心血管事件(MACE)和主要不良心脑血管事件(MACCE)。平均随访时间为(35.9±22.6)个月。结果 309例患者发生ACM,其中Ⅰ组73例(3.8%),Ⅱ组98例(4.7%),Ⅲ组138例(6.8%);251例患者发生CM,其中Ⅰ组58例(3.0%),Ⅱ组80例(3.9%),Ⅲ组113例(5.6%);785例患者发生MACE,其中Ⅰ组226例(11.6%),Ⅱ组248例(12.0%),Ⅲ组311例(15.3%);862例患者发生MACCE,其中Ⅰ组250例(12.9%),Ⅱ组269例(13.0%),Ⅲ组343例(16.9%)。3组发生ACM、CM、MACE、MACCE的差异有统计学意义(P≤0.001)。ACM和CM在3组的Kaplan-Meier曲线分析显示,随着基线外周血循环单核细胞水平上升,患者的预后越差(P＜0.05)。COX回归分析显示,基线外周血循环单核细胞水平上升与ACM(Ⅲ组比I组,HR=1.418,95%CI:1.056～1.905,P＝0.020)、CM(Ⅲ组比I组,HR=1.425,95%CI:1.023～1.983,P＝0.036)的发生独立相关。结论 高水平的基线外周血循环单核细胞是CHD患者PCI术后长期死亡风险的一个独立预测指标。     

前列腺环素合酶基因GLu461ALa多态性与维吾尔族人群心肌梗死的相关性

目的 探讨前列腺环素合酶基因(CYP8A1)GLu461ALa多态性与维吾尔族人群心肌梗死(myocardial infarction,MI)的相关性.方法 采用聚合酶链反应-限制性片段长度多态性方法,对210例维吾尔族MI患者和206名维吾尔族健康受试者CYP8A1基因4号外显子GLu461ALa位点进行分析,同时进行血清6-酮前列腺素F1α水平测定.结果 CYP8A1基因4号外显子GLu461ALa在MI组和健康对照组中基因璎频率分别为:CC型0.024(5/210)和0.010(2/206),AC型0.124(26/210)和0.073(15/206),AA型0.852(179/210)和0.917(189/206),两组CC、AC和从3种基因型频率分布差异无统计学意义(χ2=0.782,P>0.05),但CC+AC(突变纯合子+突变杂合子)在MI组[0.148(31/210)]明显高于对照组[0.083(17/206)],差异具有统计学意义(χ2=4.321,P=0.031),且在两组人群中C等位基因频率[0.086(36/420),0.046(19/412)]差异具有统计学意义(χ2=5.284,P=0.021).MI组血清6-酬前列腺素F1α水平[(17.40±4.56)pg/ml]低于对照组[(20.34±5.02)pg/ml],差异具有统计学意义(t=6.255,P<0.01);MI组和对照组CC+AC基因型携带者血清6-酮前列腺素Fα水平[(14.30±3.31)pg/ml,(18.31±4.62)pg/ml]均较AA基因型者[(19.34±5.51)pg/ml,(25.10±5.00)pg/ml]降低,差异具有统计学意义(t'=6.934,P<0.05;t=5.393,P<0.01).logistic回归分析显示,调整传统危险因素的干扰后,CYP8A1 C等位基因仍为MI的独立危险因素(OR=1.77;95%CI:1.06～2.05).结论CYP8A1基因4号外显子GLu461ALa多态性和维吾尔族人群MI的发生具有相关性,可能和基因变异导致的血清前列腺环素水平降低有关.     

CYP4F2基因单体型与心肌梗死的相关性研究

目的 研究CYP4F2基因单体型与心肌梗死的关系.方法 250例心肌梗死患者和250例对照分别分为整体组、男性组、女性组.选择CYP4F2基因的5个SNPs(rs3093105、rs3093135、rs1558139、rs2108622、rs3093200),应用TaqMan SNP基因分型方法进行基因分型,并应用病例对照单体型分析方法进行相关性研究.结果 对于男性,心肌梗死患者rs2108622的G等位基因频率远远高于对照(P=0.005);心肌梗死患者和对照相比较,单体型的总体分布在男性组显著不问(P=0.002);男性组心肌梗死患者的T-C-G单体型频率显著高于对照(P=0.002),男性组心肌梗死患者的T-C-A单体型频率显著低于对照(P=0.003).结论 CYP4F2基因rs2108622的G等位基因可能与男性心肌梗死相关,T-C-G单体型可能是男性心肌梗死的遗传标记.     

Maresin 1通过调控miR-340增强巨噬细胞吞噬功能

目的：研究促消退介质Maresin 1（MaR1）在脓毒症模型中促进巨噬细胞吞噬功能的机制。方法：通过检测F4/80表达情况评估小鼠原代巨噬细胞纯度。体内外脓毒症模型验证脂多糖（LPS）和/或MaR1对miR-340表达的影响。骨髓巨噬细胞转染miR-340模拟物（mimic）或抑制剂（inhibitor）后,qRT-PCR检测miR-340的表达量,评估转染效率。荧光显微镜及流式细胞仪检测小鼠原代巨噬细胞转染miR-340 mimic后巨噬细胞吞噬荧光微球能力的变化。最后收集临床样本检测脓毒症患者血浆中miR-340的表达与健康志愿者的区别。结果：经荧光显微镜和流式细胞仪鉴定小鼠原代巨噬细胞纯度达90%以上。体内外脓毒症模型均显示miR-340的表达明显升高（P＜0.05）。脓毒症患者与健康志愿者相比血液中miR-340的表达也显著增强（P＜0.05）。荧光显微镜及流式细胞仪检测小鼠原代巨噬细胞转染miR-340 mimic后,巨噬细胞吞噬荧光微球的能力降低（P＜0.05）。在体内外脓毒症模型中,MaR1均明显降低miR-340的表达水平（P＜0.05）。结论：MaR1通过抑制miR-340的表达,增强巨噬细胞吞噬功能,在脓毒症病理生理过程中发挥抗炎促消退作用。     

Association between matrix metalloproteinase-9 polymorphism (-1562C ＞ T/R279Q) and acute coronary syndrome in Uygur nationality of Xinjiang Autonomous Region of China

Objective To investigate the association between matrix metalloproteinase-9 (MMP-9) gene polymorphism (-1562C ＞ T/R279Q) and acute coronary syndrome (ACS) in Uygur nationality of Xinjiang Autonomous Region of China. Methods A total of 352 patients with ACS including 213 patients with unstable angina pectoris and 139 patients with acute myocardial infarction evidenced by using coronary arteriography and 421 control subjects were recruited in this study. The MMP-9-1562C ＞ T and R279Q genotypes were detemined by using PCR-RFLP method. The relationship between the polymorphism in the MMP-9 gene and the severity of coronary arterial stenosis was analyzed. All polymorphisms were determined for confimation with Hardy-Weinberg expectations in both groups separately. Differences in distributions of genotypes and alleles between two groups were analyzed with x2 test. The association between the MMP-9 polymorphisms and the risk of ACS was estimated by odds ratio(Ors) and their 95% confidence intervals (CIs), and the comprehensive evaluation of the factors associated with ACS was determined by using multifactor logistic regression. P ＜ 0. 05 was considered to be statistically significant. Results The genotype frequencies for CT + TT genotypes and T allele were 25.9 and14.5 percent in ACS subjects and 15.7 and 8.4 percent in control subjects, respectively. The genotype frequencies were different significantly between the two groups (x2 = 12.26,P ＜ 0.01;x2 = 14.15,P ＜ 0.01, respectively). No relationship between R279Q polymorphism and ACS was found in this study ( P ＞ 0.05). The multifactor logistic regression analysis showed that the T allele carrier (CT + TT) significantly increased the risk of ACS compared with the CC genotype ( OR = 1.791,95 % CI: 1. 088 - 2.951, P = 0.022) after adjustment for tradition risk factors. The frequencies for CT + TT and CC genotypes of the -1562C ＞ T polymorphism were not statistically different among ACS patients with one, two and three or more significantly diseased vessels ( x2 = 1.15, P = 0.56). Conclusions The findings suggest that the polymorphism in MMP-9 gene promoter (-1562C ＞ T) is associated with the susceptibility to the ACS. The T allele might be an independent risk factor for the ACS. But the -1562C ＞ T polymorphism may not be useful as a predictor of the severity of coronary arterial stenosis. The R279Q polymorphism of MMP-9 gene was not significantly associated with ACS in this studied population.     

中西医结合治疗痰热郁肺型肺胀的临床观察

目的观察分析中西医结合治疗痰热郁肺型肺胀的临床效果。方法选取2013年5月—2016年4月期间到我院就诊的97例痰热郁肺型肺胀患者,电脑随机分为2组。对照组40例,给予西医治疗;治疗组57例,给予中西医结合治疗。对比临床疗效。结果治疗组显效29例,有效24例,无效4例,总有效率为92.98%(53/57),对照组显效13例,有效18例,无效9例,总有效率为77.50%(31/40),组间数据经统计学分析,差异显著,有统计学意义(P0.05)。结论痰热郁肺型肺胀,联合中西医治疗,疗效显著,有推广价值。     

血清淀粉样蛋白A1基因多态性对汉族人群颈动脉内中膜厚度的影响

Objective To explore the association between genetic polymorphism of serum amyloid protein A1 (SAA1) with carotid intima media thickness in a healthy Han Chinese population of Xinjiang. Methods A total of 449 healthy Han Chinese participating the cardiovascular risk survey between June 2007 and September 2009 were included, the genotypes of the SAA1 were detected by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). The mean IMT of the right and left common carotid arteries were measured by B-mode ultrasonography. Results (1) There was strong linkage disequilibrium between rs12218 and rs2229338 (D'=0. 89). (2) The carotid common IMT (CC-IMT) and the carotid bulb IMT (CB-IMT) were similar between the AA genotype (wild genotype) and the GGFAG genotype (mutational genotype) in rs2229338 of SAA1 gene. (3) CC-IMT[(0.081 ±0.071)cm vs (0.068 ±0. 019 ) cm, P = 0. 01] was significantly thicker in CC + CT genotype ( mutational genotype) group than in TT genotype (wild genotype) of rs12218 group and the difference remains significant after adjustment for age,gender,blood pressure, waist circumference, creatinine and high density lipoprotein cholesferoL CB-IMT [(0.085±0. 038)cm vs. (0.081 ± 0. 052) cm,P =0. 36] was similar between CC +CT genotype and TT genotype of rs12218 groups. Conclusion Our results suggested that the genetic polymorphism of SAA1 might be linked with IMT and rs12218 mutation could serve as a promoting factor for IMT in Han Chinese people.     

新疆汉、维吾尔、哈萨克族慢性心力衰竭流行病学调查及其患病率研究

目的 了解新疆成年人慢性心力衰竭(心衰)的患病率和分布特征.方法 应用四阶段整群随机抽样法,在全疆23个市、7个地区、5个自治州抽取乌鲁木齐市、克拉玛依市、阜康市、吐鲁番地区、和田地区、伊犁哈萨克自治州等6个地区年龄在35岁以上样本,男女均衡.统计不同民族组、不同年龄组、不同性别组人群的心衰患病率,并对心衰患者合并心血管基础疾病进行分析.结果 共抽样35岁以上城市及农村游牧居民8459例,心衰患病率为1.26%;其中汉族为0.89%,维吾尔族为1.11%,哈萨克族为2.14%.男性为1.61%,女性为0.93%,男性患病率高于女性(u=2.79,P<0.05).35～44岁、45～54岁、55～64岁、65～74岁、75岁以上各年龄组的心衰患病率分别为0.29%、0.60%、1.32%、2.55%、4.10%,随着年龄增高,心衰发生的风险显著上升.107例心衰患者中合并高血压病者占63.55%,冠心病者占42.99%,糖尿病者占18.69%,心瓣膜病者占5.61%,心房颤动者占4.67%.结论 新疆心衰患病率较高,随年龄增加呈增多趋势,且存在民族差异.高血压病、冠心病、糖尿病为新疆各民族心衰患者共同合并心血管基础疾病.通过对新疆不同人群心衰的流行病学监测和调查,寻找适合新疆人文地域特点的心衰早期诊断方法和干预模式具有重大现实意义.     

新疆维吾尔族人群CYP2C19＊1、＊2两位点基因多态性分布

目的 研究新疆地区维吾尔族人群CYP2C19基因多态性分布情况.方法 随机选择新疆医科大学第一附属医院心脏中心住院体检者共132例,采用聚合酶链-限制性片段长度多态性方法对CYP2C19*1及*2基因位点进行分型,了解其基因型的分布频率,并与文献报道的汉族人群及欧洲人群进行比较.结果 CYP2C19两位点基因多态性符合Hardey-Weinberg平衡;CYP2C19*1:AA、AG、GG基因型频率在维吾尔人群分别为0.54%、5.4%、94.05%;CYP2C19*2:CC、CT、TT基因型频率分别为61.4%、34.8%、3.8%,与汉族人群及欧洲人群相比较,均有明显差异(P<0.001).结论 新疆地区维吾尔族人群中CYP2C19*1、*2两位点基因型频率分布与汉族及欧洲人群均有明显差异.