辛伐他汀加用Omega-3脂肪酸对混合性血脂异常患者高敏C反应蛋白、血脂及纤溶的影响

目的:评价辛伐他汀加用Omega-3脂肪酸对冠心病及冠心病等危症合并混合性血脂异常患者高敏C反应蛋白(HsCRP)、血脂及纤溶的影响.方法:采用随机、双盲、安慰剂平行对照方法,40例冠心病及冠心病等危症合并混合性血脂异常患者经6～12周辛伐他汀10mg或20mg治疗后,分为试验组(n=20)和对照组(n=20),分别加用Omega-3脂肪酸3g*d-1或安慰剂,治疗2个月,观察治疗前后对HsCRP、血脂及纤溶的影响.结果:试验组治疗后HsCRP、三酰甘油(TG)、总胆固醇(TC)、TC/高密度脂蛋白胆固醇(HDL-C)较基线分别降低(2.16±2.77)(38.5%),(94.0±65.4)(31.1%),(13.3±22.3)mmol*L-1(6.3%)和(0.78±1.60)mg*dL-1(P分别<0.01,<0.001,<0.05,<0.05),对照组HsCRP及TG降低更为显著(P分别为0.021及0.011).试验组TG降低的数值及百分数分别与HsCRP降低的数值及百分数呈显著正相关(r分别为0.51和0.45,P分别为0.021和0.047).结论:辛伐他汀加用Omega-3脂肪酸增加二者的调脂优势和非调脂优势.     

Homocysteine and markers of inflammation in acute coronary syndrome

BACKGROUND:

An elevated level of homocysteine (Hcy) has been shown to be a cardiovascular risk factor in the majority of research studies. Recently, it was found to be associated with new risk factors such as inflammatory markers.

OBJECTIVES:

To investigate the distribution of plasma total Hcy (tHcy) and the levels of inflammatory markers in patients with acute coronary syndrome (ACS), and to evaluate the association between these parameters and the severity of the disease.

METHODS:

A total of 122 patients with ACS and 80 control subjects were recruited from the cardiac intensive care unit of the Military Hospital of Tunis, Tunisia. Lipid profile and the levels of tHcy, high-sensitivity C-reactive protein (HsCRP), interleukin (IL)-6, IL-8, IL-1β and tumour necrosis factor-alpha (TNFα) were determined for all participants. The distribution of these parameters were compared between groups and according to the number of diseased vessels in patients with ACS.

RESULTS:

ACS patients had significantly elevated levels of tHcy (P<0.01), HsCRP (P<0.001), IL-6 (P<0.001), TNFα (P<0.001), folates (P<0.05) and vitamin B₁₂ (P<0.001), but lower high-density lipoprotein cholesterol (P<0.05) levels. The analysis of the association between these parameters and the number of diseased vessels showed significant differences in tHcy, HsCRP, IL-6 and TNFα, with positive correlations. Significantly negative correlations were found between the number of diseased vessels and folate (r=−0.34; P<0.01), and vitamin B₁₂ (r=−0.22; P<0.01).

CONCLUSION:

Elevated levels of tHcy, IL-6, TNFα and HsCRP appear to be associated with a greater number of diseased arteries and, consequently, the severity of coronary artery disease.     

ApoE phenotype is associated with inflammatory markers in middle-aged subjects

Objectives:  Apolipoprotein (apo) E phenotype has been associated with inflammation markers. The determinants of these associations and the relationship between novel inflammation marker, resistin, and apoE phenotype are studied here. Methods and Results:  Middle-aged subjects of the population- based cohort (n = 526) of the OPERA– study were studied. Intima-media thickness (IMT) was measured with carotid ultrasound. The results suggest that, apoE phenotype was a significant independent predictive factor for resistin (p < 0.01) and hsCRP (p < 0.01) levels. The association of ApoE phenotype with hsCRP was seen among the subjects with the normal renal function (p = 0.005). ApoE4 was associated (p < 0.01) with the lowest hsCRP in the lowest IMT quartile while it's relation with the highest resistin levels was evident in the highest IMT quartile. Conclusions:  ApoE phenotype is an independent determinant of plasma resistin and hsCRP levels. The extent of atherosclerosis and renal function seem to modify the effects of apoE phenotype on inflammatory parameters. Received 6 April 2008; returned for revision 6 August 2008; received from final revision 27 October 2008; accepted by M. Katori 28 October 2008     

Relationship between markers of metabolic control and inflammation on severity of periodontal disease in patients with diabetes mellitus

AIM: The aim of this study was to investigate the relationship between markers of metabolic control and inflammation and periodontal disease parameters in patients with diabetes. MATERIAL & METHODS: One hundred and eighty one adult patients with diabetes attending treatment at two diabetes centres were invited to participate in the study. Periodontal examination included full-mouth assessment for probing depths and bleeding on probing (BOP). Blood analyses were carried out for glycated haemoglobin, (HbA1c), high-sensitivity C reactive protein, (hsCRP) and lipid profile comprising total cholesterol, low-density lipoprotein cholesterol (LDL chol), high-density lipoprotein cholesterol (HDL chol) and triglycerides. RESULTS: Upon multivariate analysis, periodontal disease severity in terms of increased percentage of BOP and mean percentage of sites with probing depths > or = 5 mm were found to be associated with inadequate glycaemic control as measured by HbA1c (p<0.01). HsCRP was also found to be a significant predictor for mean percentage of sites with probing depths > or = 5 mm (p<0.05). After controlling for age, gender, smoking habits and number of teeth, positive correlations were found between HbA1c and percentage sites with probing depths > or = 5 mm, percentage sites BOP, total cholesterol, LDL chol and triglycerides (p<0.05). Using the adjusted differences, subjects with acceptable glycaemic control (HbA1c < 8%) showed a lower percentage of sites with BOP and probing depths > or = 5 mm (p<0.05) when compared with those having inadequate glycaemic control. There was also a trend towards lower blood cholesterol in the well-controlled group. CONCLUSION: The level of glycaemic control as measured by HbA1c emerged as the most consistent risk factor associated with the extent and severity of periodontal disease in this study cohort.     

雷米普利对原发性高血压病患者微量蛋白尿及其血浆VWF和血清HsCRP的影响

目的:探讨雷米普利治疗原发性高血压病患者对患者的血压,微量蛋白尿的疗效以及对血浆血管性假性血友病因子(VWF)和血清高敏C-反应蛋白(HsCRP)水平的影响。方法:选取未经药物治疗的原发性高血压1级患者50例为治疗组,同时选取健康志愿者20例为正常对照组。采用雷米普利2.5～5.0 mg,1次/d,治疗前及治疗后测血压,血浆VWF和血清HsCRP水平以及24 h尿蛋白量。结果:经雷米普利治疗后血压、尿蛋白量及血清VWF和HsCRP水平显著下降(P<0.01)。结论:雷米普利不仅可降低原发性高血压患者血压,还能显著降低尿微量白蛋及血浆VWF和血清HsCRP的水平。     

肝炎后肝硬化患者检测血清hsCRP与体液免疫的意义

[目的]探讨肝炎后肝硬化患者血中免疫球蛋白（IgG、IgM、IgA）和补体（C3、C4）及血清高敏CRP（hsCRP）的变化。[方法]对2007年1月1日至12月31日到我院住院的76例肝炎后肝硬化患者用免疫比浊法测定血清IgG、IgM、IgA、C3、C4、hsCRP．同时以50名到我院健康体检者为对照组进行对比分析。[结果]76例肝炎后肝硬化组与对照组比较：IgM、IgG、hsCRP均高于对照组（P〈0．01）,C3和C4低于对照组（P〈0．01、P〈0．05）。IgA高于对照组（P〉0．05）。[结论]血清免疫球蛋白、补体及hsCRP与肝炎后肝硬化有明显的相关性,其检测结果不仅对肝硬化的分期,而且对判断病情、衡量治疗效果和预后的估计都有重要价值。     

Hb和血清白/球比值、hsCRP在多发性骨髓瘤的临床意义

目的探讨血红蛋白（Hb）和血清白/球比值（A/G）及超敏C反应蛋白（hsCRP）在多发性骨髓瘤（multiple myeloma,MM）的变化及临床意义。方法对31例多发性骨髓瘤患者（均为初诊病例）,入院治疗前留取血标本,100名年龄、性别相仿的健康人作对照。应用各相关仪器检测全血Hb值和血清白/球比值及hsCRP水平;并与MM组骨髓瘤细胞所占比例进行相关分析。结果MM患者Hb和血清白/球比值明显低于健康对照者（P〈0.05）;hsCRP明显高于健康对照（P〈0.05）;且与骨髓瘤细胞比例存在相关性（-1〈r〈1）。结论联合检测Hb和血清白／球比值、hsCRP有助于MM的临床诊断,且Hb对监测骨髓浸润程度,观察患者病情进展和治疗效果有明显的临床意义和社会效应。     

维持性血液透析并脑出血患者血浆超敏C反应蛋白、D-二聚体与同型半胱氨酸的变化

目的探讨维持性血液透析并脑出血患者HsCRP、D-D及HCY的变化与意义。方法选取医院血液净化中心维持性血液透析并发脑出血患者30例(维持性血液透析脑出血组),维持性血液透析未并发脑血管病为维持性血液透析组(34例),医院体检中心健康体检者(正常对照组)31例,分别测定各组患者血清HsCRP、D-D、HCY及尿素动力学指数(Kt/V)进行统计分析。结果 (1)维持性血液透析脑出血组和单纯维持性血液透析组患者Hs-CRP、D-D及HCY水平较正常对照组显著升高(P<0.05);(2)维持性血液透析脑出血组Hs-CRP、D-D及HCY水平较单纯MHD组显著升高(P<0.05);(3)MHD脑出血组患者Kt/V与血清HsCRP、D-D及HCY呈负相关(r=-0.633,r=-0.645,r=-0.655,均P<0.005),单纯MHD组Kt/V与HsCRP、D-D及HCY间无相关性(均P>0.05)。结论 MHD患者血浆Hs-CRP、D-D及Hcy水平增高对对预测MHD患者脑出血发生及早期诊断具有重要的临床意义。