Rho激酶抑制剂治疗冠状动脉向心性狭窄变异性心绞痛的疗效

目的观察Rho激酶抑制剂对冠状动脉向心性狭窄的变异性心绞痛患者的疗效。方法将34例冠状动脉向心性狭窄的变异性心绞痛患者随机分为治疗组(n=17)和对照组(n=17),2组均给予硝酸酯类、钙离子拮抗剂、阿司匹林、他汀类药物等药物常规治疗,治疗组在此基础上给予Rho激酶抑制剂(盐酸法舒地尔)治疗(法舒地尔60 mg,静脉滴注,每天2次,14 d为1疗程)。2个疗程后比较2组疗效及治疗前后hs-CRP和IL-6水平。结果 2组治疗后hs-CRP、IL-6水平较治疗前明显下降(P<0.05或P<0.01),且治疗组治疗后hs-CRP、IL-6水平明显低于对照组(P均<0.05)。治疗组总有效率稍高于对照组,但差异无统计学意义(P>0.05)。结论 Rho激酶抑制剂对冠状动脉向心性狭窄的变异性心绞痛有较好疗效。其机制可能与抑制炎性因子及冠状动脉痉挛,稳定动脉粥样硬化斑块有关。     

Impact of intensive statin therapy on hs-CRP and sCD40L in AMI patients during perioperative period of emergency PCI

Background It's an effective treatment to achieve percutaneous coronary intervention(PCI) in acute myocardial infarction(AMI) patients for reperfusion of coronary artery.The PCI treatment can improve the blood supply of coronary artery,make some adverse effects at the same time.Studies have shown that statins have other effects in addition to lipid-lowering,such as anti-inflammatory effects.It can significantly reduce the incidence of coronary heart disease,cardiovascular disease mortality and even all-caus...     

氯沙坦对不稳定型心绞痛患者hs-CRP、sCD105的影响及意义

目的 探讨氯沙坦对不稳定型心绞痛(UA)患者超敏C-反应蛋白(hs-CRP)、可溶性CD105(sCD105)的影响及意义.方法 将68例UA患者随机分为对照组(n=30)及治疗组(n=38).对照组给予硝酸酯类、B受体阻滞刺、钙离子拮抗剂、阿司匹林、他汀类药物等常规治疗,治疗组在常规治疗基础上加用氯沙坦(100 mg,1次/d),均治疗3个月.观察治疗前后hs-CRP、sCD105、胆固醇等变化及心绞痛发作情况.结果 2组患者心绞痛症状均明显改善,治疗组总有效率高于对照组(86.8%vs 63.3%,P<0.05).2组治疗后hs-CRP、sCD105水平均较治疗前明显下降(P<0.05,P<0.01),且治疗后治疗组hs-CRP、sCD105水平明显低于对照组(P均<0.05).结论 氯沙坦在常规治疗基础上治疗UA效果显著,可明显降低hs-CRP、sCD105,其机制可能与抗炎、稳定血管内皮及斑块等有关.     

代谢综合征病人颈动脉粥样硬化与C-反应蛋白、瘦素及脂联素关系

目的 了解代谢综合征(MS)病人颈动脉粥样硬化与C-反应蛋白(CRP)、瘦素(Leptin)、脂联素(APN)及胰岛素抵抗的相互关系及其机制.方法 根据双侧颈动脉超声检查结果,将226例MS病人分为无颈动脉斑块组(MS-1组,94例)及颈动脉斑块形成组(MS-2组,132例),测定两组病人血清胰岛素、超敏CRP(hs-...     

不同剂量阿托伐他汀治疗急性冠状动脉综合征对可溶性CD105、高敏C反应蛋白及心率震荡的影响

目的 通过观察血清可溶性CD105.(sCD105)、高敏C反应蛋白(hs-CRP)及心率震荡参数的变化,探讨阿托伐他汀强化治疗急性冠状动脉综合征(ACS)的效果及意义.方法 将106例ACS患者按随机数字表法分为治疗1组(38例,常规治疗+阿托伐他汀20 mg)、治疗2组(38例,常规治疗+阿托伐他汀40mg)和对照组(30例,仅给予常规治疗),测定三组治疗前及治疗4周后的心率震荡参数及sCD105、hs-CRP水平,并进行比较.结果 治疗前三组震荡初始(TO)、震荡斜率(TS)、sCD105、hs-CRP比较差异无统计学意义(P＞0.05).治疗后三组TO、sCD105、hs-CRP均明显下降,TS明显升高(P＜0.05或＜0.01),而治疗2组改变最显著,治疗后治疗2组上述指标与治疗1组比较差异均有统计学意义[TO比较:(0.22±0.18)%比(0.66±0.23)%;TS比较:(6.22±0.83)ms/RR间期(RRI)比(3.90±0.73)ms/RRI;sCD105比较:(1.65±0.43)mg/L比(2.92±0.50)mg/L;hs-CRP比较:(1.68±0.55)mg/L比(2.08±0.61)mg/L](P＜0.01).相关分析表明,sCD105、hs-CRP水平与TO呈显著正相关(P＜0.01),而与TS呈显著负相关(P＜0.01).结论 ACS患者给予阿托伐他汀治疗,可稳定冠状动脉血管内皮及粥样斑块,改善自主神经功能,大剂量应用更能获益.

Abstract：

Objective To investigate the clinical effects and significance of different-dose atorvastatin on soluble CD105(sCD105),high sensitive-C reactive protein(hs-CRP)and the parameters of heart rate turbulence in patients with acute coronary syndrome(ACS). Methods One hundred and six ACS patients were divided into three groups by random digits table: control group(30 patients, routine treatment),treatment group Ⅰ(38 patients, routine treatment + atorvastatin 20 mg), and treatment group Ⅱ(38patients, routine treatment + atorvastatin 40 mg). All patients were treated for 4 weeks. The levels of serum sCD105,hs-CRP,and the parameters of heart rate turbulence before and after treatment. Results Before treatment, the levels of turbulence onset(TO), turbulence slope(TS),sCD105 and hs-CRP in three groups had no significant difference(P ＞ 0.05). After treatment, TO,sCD105 and hs-CRP decreased significantly,and TS increased significantly(P＜ 0.05 or ＜ 0.01). The change amplitude of treatment group Ⅱ was the most obvious, and the levels of above mentioned index showed significantly difference compared with that of treatment group Ⅰ[TO:(0.22 ±0.18)% vs.(0.66 ± 0.23)%;TS:(6.22 ±0.83)ms/RR interval(RRI)vs.(3.90 ±0.73)ms/RRI;sCD105:(1.65 ±0.43)mg/L vs.(2.92 ±0.50)mg/L;hs-CRP:(1.68 ±0.55)mg/L vs.(2.08±0.61)mg/L](P ＜0.01). Correlation analysis showed the levels of sCD105 and hs-CRP had significantly positive correlation with TO(P ＜ 0.01)and had negative correlation with TS(P ＜ 0.01).Conclusions The atorvastatin treatment in patients with ACS may stabilize coronary vascular endothelial cells and atherosclerotic plaque, and improve autonomic nerve function. Larger doses of atorvastatin may get more benefit.     

急诊PCI围术期强化他汀类药物治疗对急性心肌梗死患者hs-CRP、sCD40L的影响

目的通过观察血清高敏C反应蛋白(hs-CRP)、可溶性CD40L(sCD40L)等指标变化,探讨在急性心肌梗死(AMI)急诊经皮冠状动脉介入治疗(PCI)围术期他汀类药物强化治疗的效果及意义。方法将112例行急诊PCI治疗的AMI患者随机分为治疗1组40例(术前服阿托伐他汀80mg,术后服阿托伐他汀40mgqd)、治疗2组40例(术前服阿托伐他汀40mg,术后服阿托伐他汀20mgqd)和对照组32例(常规治疗),3组基线资料具有可比性。分别测定3组PCI术后血清hs-CRP、sCD40L及肌酸激酶同工酶(CK-MB)水平。结果与对照组比较,治疗1组和治疗2组PCI治疗后12h、24h、7d血清hs-CRP、sCD40L水平均明显下降(P均<0.01),治疗1组和治疗2组之间差异有统计学意义(P均<0.01)。2个治疗组术后12、24h的CK-MB升高>2倍正常值上限的患者发生率均较对照组明显降低(P均<0.05),2个治疗组比较差异亦有统计学意义(P均<0.05)。结论 AMI患者急诊PCI围术期强化他汀类药物治疗,可能通过抗炎、抗血小板、稳定冠脉血管内皮及粥样斑块等作用,使患者获益。     

急诊PCI围术期强化他汀类药物治疗对急性心肌梗死患者hs-CRP、sCD40L的影响

目的通过观察血清高敏C反应蛋白（hs-CRP）、可溶性CD40L（sCD40L）等指标变化,探讨在急性心肌梗死（AMI）急诊经皮冠状动脉介入治疗（PCI）围术期他汀类药物强化治疗的效果及意义。方法将112例行急诊PCI治疗的AMI患者随机分为治疗1组40例（术前服阿托伐他汀80mg,术后服阿托伐他汀40mgqd）、治疗2组40例（术前服阿托伐他汀40mg,术后服阿托伐他汀20mgqd）和对照组32例（常规治疗）,3组基线资料具有可比性。分别测定3组PCI术后血清hs-CRP、sCD40L及肌酸激酶同工酶（CK-MB）水平。结果与对照组比较,治疗1组和治疗2组PCI治疗后12h、24h、7d血清hs-CRP、sCD40L水平均明显下降（P均〈0.01）,治疗1组和治疗2组之间差异有统计学意义（P均〈0.01）。2个治疗组术后12、24h的CK-MB升高〉2倍正常值上限的患者发生率均较对照组明显降低（P均〈0.05）,2个治疗组比较差异亦有统计学意义（P均〈0.05）。结论 AMI患者急诊PCI围术期强化他汀类药物治疗,可能通过抗炎、抗血小板、稳定冠脉血管内皮及粥样斑块等作用,使患者获益     

Correlation of carotid artery atherosclerosis with C-reactive protein and adiponectin in patient with metabolic syndrome

Background Metabolic Syndrome(MS) is a group of conditions included hypertension,hyperlipidemia,central obesity,impaired glucose tolerance and insulin resistance,which may contribute to risk factors for atherosclerosis syndrome.Insulin resistance is the core mechanism? while the underlying mechanism is not clear.This article aims to study the correlation of carotid atherosclerosis with C-reactive protein and adiponectin in metabolic syndrome(MS) patients.Methods According to bilateral carotid artery atherosclerosis echocardiography,226 patients with metabolic syndrome were randomized to three groups,of which were non-carotid atherosclerosis plaque group(MS-1 group,n = 94),carotid artery atherosclerosis plaque group(MS-2 group,n = 132),and normal control group(n = 36).Determination of serum insulin,high sensitivity C-reactive protein,adiponectin and bilateral carotid artery atherosclerosis ultrasonography and other indicators,semi-quantitative estimates of the extent and severity of plaque.Results ①In two MS groups,carotid artery atherosclerosis,intima-media thickness(IMT),insulin resistance index(HOMA-IR) and high sensitive C-reactive protein(hs-CRP) were significantly higher than the control group(P 0.01),while adiponectin was lower than the control group(P 0.01);When MS-2 group was compared to MS-1 group,there were significant differences(P 0.01).②IMT was positively correlated with HOMA-IR and hs-CRP(P 0.01) while negatively correlated with adiponectin(P 0.01).Conclusions C-reactive protein and adiponectin in MS patients were correlated with carotid atherosclerosis and insulin resistance,which may be used as the assessment of MS patients.     

强化他汀治疗对不稳定型心绞痛患者血清超敏C反应蛋白及可溶性CD40配体L的影响

目的观察强化他汀治疗不稳定型心绞痛的效果及可能机制。方法将130例不稳定型心绞痛患者随机分为治疗1组(瑞舒伐他汀钙片10 mg,1次/d,50例)、治疗2组(瑞舒伐他汀钙片20 mg,1次/d,50例)和对照组(常规治疗,30例),测定治疗前及治疗后1周、4周、8周时血清超敏C反应蛋白(hs-CRP)、可溶性CD40配体L(sCD40L)、血脂、肝功能等指标,主要心血管事件(MACE)的发生率以及瑞舒伐他汀的药物不良反应情况。结果与对照组相比较,治疗1组和治疗2组治疗后1周、4周、8周血清hs-CRP、sCD40L、LDL-C水平均降低(P<0.05),治疗1组和治疗2组之间治疗后8周hs-CRP、sCD40L差异有统计学意义(P<0.01)。结论不稳定型心绞痛患者强化他汀治疗,可能通过抗炎、改善内皮、稳定斑块等作用而最终获益。     

N末端B型钠尿肽原检测观察曲美他嗪治疗慢性心力衰竭的效果

目的 观察曲美他嗪治疗慢性心力衰竭(CHF)的效果及N末端B型钠尿肽(NT-proBNP)在指导CHF治疗中的作用.方法 将CHF患者60例随机分为2组,对照组(n=20)予以AcEI、利尿剂、β受体阻滞剂、洋地黄等常规治疗;治疗组(n=40)在常规治疗基础上加用曲美他嗪20mg tid.均治疗3个月.观察治疗前后NT-proBNP、心脏超声指标左室体积指数(LVMI)、左室射血分数(LVEF)及临床变化.结果 治疗后2组NT-proBNP、LVMI下降及LVEF均改善(P(0.05或p<0.01),但治疗组均明显优于对照组(P均<0.01);治疗组总有效率明显高于对照组(95%vs 65%,P<0.01);NT-proBNP与LVMI呈正相关(r=0.802,P<0.01),而与LVEF呈负相关(r=-0.762,p<0.01).结论 曲美他嗪治疗CHF效果显著,NT-proBNP可作为指导CHF治疗的量化指标.