冠心病冠脉病变严重程度与红细胞分布宽度及尿酸的相关性分析

目的 探讨冠心病冠脉病变严重程度与红细胞分布宽度及血尿酸的相关性。方法 选取中医药大学第一附属南院心血管病区2016年12月~2017年12月因胸痛疑诊冠心病或已明确冠心病患者134例,根据既往或入院后冠状动脉造影结果,左主干、左前降支、左回旋支、右冠状动脉或其主要分支血管直径狭窄≥50％者为冠心病组共96例,上述主要分支血管直径狭窄＜50％者共40例为对照组。根据冠状动脉病变支数分为单支病变组、双支病变组和三支病变组,采用Gensini法分别对冠脉病变进行评分。结果 冠脉病变严重程度与红细胞分布宽度与血尿酸水平呈正相关,尿酸（OR=1.006,P＜0.05）和红细胞分布宽度（OR=2.450,P＜0.05）的升高为冠心病的独立危险因素,且红细胞分布宽度与UA水平随着冠脉病变支数的增加逐渐递增,三支病变组红细胞分布宽度、血尿酸水平高于单支病变组（P=0.004、0.016＜0.05）,三支病变组红细胞分布宽度水平高于双支病变组（P＜0.05）;双支病变组红细胞分布宽度、血尿酸水平高于单支病变组,三支病变组血尿酸水平高于双支病变组,差异无统计学意义（P＞0.05）,考虑与样本量较小及患者用药控制因素有关。结论 冠心病冠脉病变严重程度与红细胞分布宽度及血尿酸呈正相关。     

冠状动脉病变程度与血浆B型利钠肽对冠心病的影响因素

目的 探讨冠心病患者冠状动脉病变程度与血浆B型利钠肽的关系。方法 选择我院2017年1月~8月住院的冠心病患者54例为A组,同时选择冠脉血管无狭窄的患者26例作为B组,收集所有研究对象的年龄、性别、血糖、血脂、血压、血浆脑钠肽（BNP）浓度、冠状动脉的病变部位及程度等临床资料,观察不同程度冠状动脉病变患者的血浆BNP水平。结果 血浆BNP水平A组较B组升高,统计学意义显著（P＜0.001）。Logistic回归分析显示,年龄、BNP水平、舒张压是冠状动脉狭窄的独立危险因素。在A1、A2及A3组中随着Gensini评分增加,血浆BNP水平逐渐升高,Gensini评分与血浆BNP水平呈明显的正相关（r=0.594,P＜0.05）。结论 血浆BNP参与了冠状动脉狭窄的病理生理过程,是冠状动脉病变的独立危险因素之一;血浆BNP的水平能一定程度上的反映冠脉病变程度。     

冠心病患者血脂相关指标与冠状动脉狭窄的相关性分析

目的 评估血脂相关指标对冠心病患者冠状动脉狭窄病情评估的临床价值。方法 回顾性纳入422名行冠状动脉造影检查的患者,记录相关实验室检查数据。根据冠脉狭窄程度分位冠状动脉狭窄程度<50%组和≥50%组,根据Gensini评分分为G1组(积分<4),G2组(积分4～20),G3组(积分21～32),G4组(积分>32)四组。血脂相关指标进行组间比较和与Gensini积分的相关性分析。结果 冠脉狭窄程度不同的两组患者血清总胆固醇(TC)、三酰甘油(TG)、三酰甘油葡萄糖指数(TyG指数)、低密度脂蛋白胆固醇(LDL-C)、残余胆固醇(RC)、非高密度脂蛋白胆固醇(non-HDL-C)、小而密低密度脂蛋白胆固醇(sd-LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平差异均具有统计学意义(P<0.05)。血清脂蛋白a[Lp(a)]水平差异无统计学意义。Gensini积分进行分组比较,发现血清TC、TG、non-HDL-C和sd-LDL-C水平,G4组显著高于G3组,G3组显著高于G2组,G2组显著高于G1组。G4组血清LDL-C水平显著高于G3组,TyG指数和RC水平,...     

冠脉钙化与冠脉血管病变严重程度的相关性分析

目的 探讨冠状动脉钙化与冠脉血管病变严重程度的相关性。方法 回顾性分析2017年1月~2018年7月我院收治的经256层螺旋CT检查并于30 d内行选择性冠脉造影（CAG）检查的疑似冠心病患者51例的相关资料。统计多层螺旋CT扫描的患者冠脉钙化总积分。应用Spearman秩相关分析进行冠脉钙化与冠脉病变的相关性。结果 51例患者钙化积分为0~2645.6分,平均钙化积分为（285.66±420.87）分,其中钙化积分为0分的患者有6例（11.80%）。Spearman秩相关分析显示,钙化积分与反映冠脉病变严重程度的变量冠脉狭窄病变≥50%的病变支数、冠脉狭窄病变≥50%的血管节段数、冠脉狭窄病变≥75%的血管节段数呈相关程度较弱的正相关（r=0.291~0.319,P＜0.05）;钙化积分与Gensini积分无相关性（r=0.264,P＞0.05）。钙化积分与年龄无相关性（r=0.253,P＞0.05）。结论 冠脉钙化总积分与冠脉病变的严重程度呈相关较弱的非线性正相关,冠脉钙化程度较难预测冠脉病变的狭窄程度。     

Haplotypes Encompassing the KIAA0391 and PSMA6 Gene Cluster Confer a Genetic Link for Myocardial Infarction and Coronary Artery Disease

The role of the KIAA0391 and PSMA6 genes in predisposing individuals to disease is still not fully understood. We evaluated by molecular beacon-based genotyping assays the roles of five single nucleotide polymorphisms (SNPs) in the chromosomal region 14q13.2 harbouring the KIAA0391 and PSMA6 gene cluster in coronary artery disease (CAD) in the Saudi population. Two of the studied SNPs rs8008319 (denoted as 1) and rs7157492 (2), reside in the KIAA0391 locus, two others rs1048990 (3) and rs12878391 (4) are components of the PSMA6 , while rs4981283 (5) resides downstream of both genes. In a study involving 1071 patients and 929 controls, none of the studied SNPs showed significant association with CAD. In contrast, two haplotypes consisting of 1A-2G-3C-4A-5A [O.R.(95% C.I.) = 1.49(0.95–2.35); p = 0.022] and 1A-2G-3G-4A-5A [2.24(0.84–5.98); p = 0.031] conferred risk for both CAD and myocardial infarction (MI) in a five-SNP locus model, while another comprising 1A-2G-3C-4A-5G [2.24(0.84–5.98); p = 0.079] showed a borderline association. One haplotype consisting of 1T-2G-3C-4G-5A [0.79(0.59–1.05); p = 0.015] exhibited protective properties and another, 1T-2G-3C-4A-5G [0.20(0.03–139); p = 0.073], showed a similar but weaker trend. Our study identified haplotypes in the chromosomal region encompassing the KIAA0391 and PSMA6 genes as a possible genetic link between CAD and MI. These results also suggest that haplotypes may be more informative than individual SNPs in identifying risk factors for disease.     

The Ratio of Second to Fourth Digit Length (2D:4D) and Coronary Artery Disease in a Han Chinese Population

Background: The association between index finger to ring finger length ratio (2D:4D) and cardiac disorders has been reported, however it has not been discussed in terms of coronary artery disease (CAD). We investigated whether 2D:4D could be used as a marker for predisposition to CAD as assessed by coronary angiography in Chinese men and women.Methods: This study included 1764 persons divided into 4 groups, 441 cases with CAD and 441 persons without CAD as control in each sex of the same age. Finger lengths were measured twice for both hands using electronic calipers. Student t test was used to detect the difference of 2D:4D among groups. The receiver operator characteristic curves (ROCs) were used to detect the diagnostic effect of 2D:4D for CAD.Results: There were no significant differences in age among the four groups. A significant difference of 2D:4D ratios between right and left hand were observed only in men in both control and CAD groups. On the right hand in the control group and on both hands in the CAD group, the 2D:4D ratios were higher in women than in men (all, P < 0.001). In men with CAD, mean 2D:4D was higher than mean 2D:4D in control men (right hand 0.962±0.042:0.927±0.038; left hand 0.950±0.044:0.934±0.048; both hands, P < 0.001), but this was not observed in women. No relationship was found between 2D:4D and age (all, P >0.05). The area under the curve of right hand 2D:4D in male was 0.72 (95% CI 0.683-0.753, p<0.001), while it was 0.602 (95% CI 0.565-0.639, p<0.001) in left hand.Conclusions: The present study showed an association between high 2D:4D ratio and CAD in both hands in men. There were no significant differences in mean 2D:4D between women with CAD and controls.     

OX40基因rs2298212位点与汉族人群冠状动脉粥样硬化疾病的关联研究

目的 探讨OX40基因(TNFRSF4)rs2298212G/A位点与山东汉族人群冠状动脉粥样硬化疾病的相关性.方法 在山东大学齐鲁医院心内科和健康体检中心分别收集到冠状动脉粥样硬化疾病患者536例和正常对照544名,采用聚合酶链反应-限制性片段长度多态性方法 对OX40基因rs2298212G/A多态性位点进行基因分型,并对数据进行统计分析.结果 基因型与等位基因频率分布在病例组与对照组之间差异均无统计学意义(P＞0.05).在回归校正了年龄、性别、体重指数、收缩压、舒张压、血糖、总胆固醇及甘油三酯等因素的影响后,基因型频率分布差异仍无统计学意义(P＞0.05).在对冠状动脉受累支数进行的分层分析发现,受累1支与受累3支之间,基因型与等位基因频率分布差异均有统计学意义(P＜0.05).结论 OX40基因rs2298212G/A多态位点同山东汉族人群冠状动脉粥样硬化疾病之间无关联性存在,但该位点可能与冠状动脉粥样硬化的严重程度相关.     

乌鲁木齐地区维汉两民族中糖蛋白Ⅲa基因多态性与冠心病危险性的关系

目的 探讨乌鲁木齐地区维汉两民族冠心病患者糖蛋白(GP)Ⅲa基因多态性与冠心病的关系。方法 用酚氯仿抽提核酸法从凝血块中分离DNA,用多聚酶链式反应-限制性片段长度多态性(PCR-RFLP)方法对乌鲁木齐地区维汉两民族105例冠心病患者和56例对照组人群进行GPⅢa基因多态性(由P1~(A1)和P1~(A2)决定的P1~(A1/A2)、PI~(A1/A2)和PI~(A1/A2))MspI酶切研究。结果 (1)GPⅢa之PI~(A1)和PI~(A2)等位基因频率在冠心病组分别为1.00和0.00,与对照组(0.9910和0.0090)比较,无显著差别(P>0.05)。(2)PI~(A1/A2)与冠心病其它危险因子一起作Logistic回归分析,PI~(A1/A2)(危险比OR=0.0051,P>0.05)不作为冠心病的危险因子。结论 乌鲁木齐地区维汉两民族人群中CAD患者GPⅢa PI~(A2)等位基因频率为0,对照组PI~(A2)等位基因频率为0.0090;仅在一正常对照维族女性患者出现PI~(A1/A2);PI~(A2)等位基因频率在中国乌鲁木齐地区汉族人群中缺如,在维族中罕见;PI~(A2)等位基因频率与冠心病无相关性。     

染色体9p21-22区域两个新的SNPs位点在湖南汉族人群中的多态分布

目的 在人类染色体9p21—22区域克隆的两个候选抑瘤基因NGX6和UBAPl以及该区域另一个已知抑瘤基因CDKN2A中筛查未知的单核苷酸多态(single nucleotide polymorphisms，SNPs)。方法 用96名正常人外周血白细胞基因组DNA在3个基因的外显子及基因上下游调控区中逐段PCR扩增、大规模涵序。结果 在UBAP1基因第6外显子及CDKN2A基因第4外显子中各发现一个新的SNP位点，dbSNP登录号为rs3135929和rs3088440，其多态信息含量分别为0．102和0．213。两个SNPs之间不存在连锁不平衡，单倍型分析表明两个SNPs联用，其多态信息含量可达到0．302。结论多 个SNP联用，其多态信息含量明显提高，可克服SNPs信息量不足的弱点；两个SNPs均位于基因的3'非翻译区，对基因表达调控是否有影响值得进一步研究。     

载脂蛋白A5基因-1131T>C多态性与冠心病易感性的关联研究

目的探讨载脂蛋白A5(apoA5)-1131T>C单核苷酸多态性与冠心病(CAD)发病风险之间的关系。方法经冠状动脉造影确诊的江苏地区冠心病患者235例,同一地区正常对照262名,采用PCRRFLP分析对apoA5基因的-1131T>C多态进行检测,比较不同基因型与个体血脂水平和冠心病患病风险的关系。结果-1131T>C单核苷酸多态位点等位基因T、C频率在CAD组和正常对照组中分别为59.57%、40.43%和65.65%、34.35%。CAD组中C等位基因的频率高于对照组(P<0.05)。与-1131TT基因型者比较,CC基因型者的冠心病患病风险显著增加(OR=1.872,95%CI=1.039-3.376,P=0.037),用Logistic回归模型对个体的年龄、性别、体重指数和抽烟、高血压等因素后,其患病风险仍明显增加(OR=2.285,95%CI=1.222-4.274)。对照组中不同基因型个体血浆甘油三酯水平差异有统计学意义(P=0.007),携带C等位基因的个体TG水平显著高于TT基因型个体。结论apoA5基因-1131T>C多态性C等位基因是中国人群中冠心病发病的危险因素之一,且与血浆TG水平的变化密切相关。     

Interleukin 8 and Susceptibility to Coronary Artery Disease: a Population Genetics Perspective.

INTRODUCTION: Interleukin 8 is a strong chemoattractant factor for neutrophils and T lymphocytes. We investigated the potential influence of two common polymorphisms of the interleukin-8 gene, -251A/T, and 781C/T on susceptibility to coronary artery disease. MATERIALS AND METHODS: The hypothesis was tested by screening for the prevalence of the above polymorphisms in 241 angiographically diagnosed coronary artery disease patients compared to 157 selected controls with negative coronary angiography. RESULTS AND DISCUSSION: We found no significant differences between cases and controls concerning the allelic and genotypic frequencies of both the studied polymorphisms. Nevertheless, a statistically significant lower frequency of the AA containing genotypes was observed in cases presenting with acute coronary syndromes compared to asymptomatic subjects or patients with stable coronary artery disease (OR = 0.44, 95%CI: 0.2-0.98, p = 0.04). The strongest statistical significance was observed in the AA(251)TT(781) combined genotype (OR = 0.34, 95%CI: 0.14-0.85, p = 0.02). CONCLUSION: Our results suggest that the genetic diversity of the interleukin-8 gene influences the clinical manifestation of CAD.     

Association of Chromosome 9p21 Genetic Variants with Risk of Coronary Heart Disease in the East Asian Population: A Meta‐Analysis

Our aim was to evaluate the effect of SNPs in the 9p21 locus on genetic susceptibility of coronary heart disease in the East Asian population. We searched PubMed, EMBASE and CNKI for publications relating to the association between SNPs within the 9p21 locus and coronary heart disease in the East Asian population. This meta‐analysis was assessed by STATA 9.2. Twenty‐one studies from 15 eligible papers composing 25,945 cases and 31,777 control subjects were included in the meta‐analysis. The odds ratio (OR) and 95% confidence interval (CI) for the risk allele was 1.30 (1.25–1.35) with moderate heterogeneity. No publication bias was observed in this study. Sensitivity analysis further strengthened the validity of this association. In conclusion, SNPs within the 9p21 locus were strongly associated with the risk of coronary heart disease in the East Asian population with a similar risk OR to the Caucasian population.     

1p13.3 rs599839单核苷酸多态性与早发冠状动脉粥样硬化性心脏病的关联研究

目的 探讨中国汉族人群染色体1p13.3 rs599839基因多态性与早发冠状动脉粥样硬化性心脏病(简称早发冠心病)的相关性.方法 用聚合酶链反应-限制性片段长度多态性技术分析303例经冠状动脉冠脉造影确诊的早发冠心病患者rs599839基因多态性,以同期冠脉造影阴性、排除冠心病诊断的312名受试者为财照组,比较两组间rs599839基因多态性频率分布差异.结果 早发冠心病组与对照组中均检出AA、AG基因型,GG基因型末检出.G等佗基因频率在早发冠心病组和对照组中分别为5.0%、9.1%,差异有统计学意义(P=0.004),使用Logistic回归分析排除吸烟、高血压、糖尿病等因素的影响后,两组G等位基因频率差异仍有统计学意义(P＜0.05).两组中G等位幕因携带者(AG型)低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)水平均低于AA纯合子.结论 中国汉族人群染色体1p13.3 rs599839基因多态性可能与早发冠心病发病相关;rs599839基因多态性可能与血清LDL-C浓度差异相关;rs599839基因多态性与冠脉狭窄程度无关.     

Association between lipoprotein-associated phospholipase A2 gene polymorphism and coronary artery disease in the Chinese Han population

The role of the lipoprotein-associated phospholipase A(2) gene (PLA2G7) in atherosclerosis remains controversial. We investigated the frequency of single-nucleotide polymorphisms (SNPs) of PLA2G7 (rs16874954 and rs1051931) and their association with coronary artery disease (CAD) in a cohort of CAD patients (n= 806) and age-matched healthy controls (n= 482) in the Chinese Han population. The VF and FF genotype of rs16874954 was significantly more frequent in the CAD patients (13.5%) than in the controls (9.3%, P= 0.024). The association remained after adjustment for age, gender, body mass index, smoking status, history of diabetes, positive family history of CAD, high-density lipoprotein cholesterol, and triglyceride (OR = 1.922; 95% CI [1.146-3.224]; P= 0.013). There was no significant difference in the frequency of any genotype of rs1051931 between the two groups. However, the frequency of the allele V379 was significantly greater in CAD patients with a history of myocardial infarction (MI) than in those without a history of MI (18.7% and 14.8%, P= 0.038). We conclude that there is significant association between the rs16874954 mutation and CAD in the Chinese Han population. The expression of rs1051931 variant in CAD patients may entail increased risk of MI.     

Four SNPS on Chromosome 9p21 Confer Risk to Premature, Familial CAD and MI in an American Caucasian Population (GeneQuest)

Genome-wide association studies have separately identified four single nucleotide polymorphisms (SNPs) on chromosome 9p21 that confer susceptibility to coronary artery disease (CAD) and myocardial infarction (MI). This study presents the first analysis of these SNPs (rs10757274, rs2383206, rs2383207, and rs10757278) in a premature, familial CAD/MI population (GeneQuest). We performed a case-control analysis of the GeneQuest Caucasian population with 310 cases with premature CAD and MI (average age at onset of 40.3 ± 5.1) and 560 non-CAD controls to determine if these SNPs are associated with risk of CAD using both the population-based and family-based association study designs. The four SNPs are significantly associated with premature and familial MI and CAD in the GeneQuest Caucasian population (allelic P = 6.61 × 10⁻⁷ to 1.87 × 10⁻⁸). Sib-TDT analysis showed that three of the four SNPs could confer significant susceptibility to premature CAD and MI. These results indicate that the four SNPs on chromosome 9p21 are also associated with premature, familial CAD.     

Dermatoclyphic Patterns in Angiographically Proven Coronary Artery Disease

Dermatoglyphics is the scientific study of epidermal ridges and their configurations on the palmar region of hand and fingers and plantar region of foot and toes. Against the genetic background of dermatoglyphic patterns and coronary artery disease, the study was undertaken to determine the correlation between them. The present study includes 150 cases of angiographically proven coronary artery disease (CAD) and 150 cases of healthy normal individuals. The palmar prints of both hands were taken on white paper by Ink method as described by Cummins and Midlo. It is noted that there is significant decrease in loops with corresponding increase in whorls in males, (M+F) combined series and left hand of CAD patients. The true palmar pattern is significantly decreased in thenar area in females; third interdigital area in (M+F) combined series and right hand; and fourth interdigital area in left hand of CAD patients. There is significant increase in ‘4’ palmar triradii in males, (M+F) combined series and right hand; and ‘5’ palmar triradii in females with significant decrease in ‘6’ palmar triradii in both sexes and both hands of CAD patients. The mean value of atd angle is significantly increased in males, (M+F) combined series and left hand of CAD patients as compared to the controls. There is no significant correlation in ab ridge count and CAD.     

Multidetector Computed Tomography for the Evaluation of Coronary Artery Disease; The Diagnostic Accuracy in Calcified Coronary Arteries,Comparing with IVUS Imaging

Purpose

Contrast enhanced multidetector computed tomography (MDCT) has been used as an alternative to coronary angiography for the assessment of coronary artery disease in the patient of the intermediate risk group. However, coronary calcium is a known limiting factor for MDCT evaluation. We investigated the diagnostic accuracy of 64-channel MDCT with each coronary artery calcium score (CACS) by compared with intravascular ultrasound (IVUS) imaging.

Materials and Methods

A total of 54 symptomatic patients with intermediate-risk (10 females, mean age 59.9±6.9 years, Framingham point scores 9-20) with 162 sites who had a culprit lesion on 64-channel MDCT before performing coronary angiography with IVUS were enrolled. Patients were divided into 4 subgroups depending on CACS: 0, 1-99, 100-399, and >400. Lesion length, external elastic membrane (EEM) cross sectional area (CSA), minimal luminal area, and plaque area were measured and compared between IVUS and MDCT.

Results

The correlation coefficients for the measurements of the EEM CSA, lumen CSA, and plaque area were r=0.514, r=0.837, and r=0.578, respectively. Furthermore, there were close correlation of plaque area between four subgroups of CACS (r=0.671, r=0.623, r=0.562, r=0.571, respectively).

Conclusion

Despite the increase in CACS, the geometric analysis of coronary arteries using with 64-channel MDCT was comparable with IVUS in symptomatic patient of the intermediate risk group.     

汉族人群caspase10基因中存在一个新的微卫星位点

目的检测汉族人群caspase10基因（CASP10）编码区外显子及剪接区域的多态性位点，研究CASP10基因与多基因复杂疾病的关联性。方法采用聚合酶链反应（polymerase chain reaction，PCR）、变性高效液相色谱技术（denaturing high-performance liquid chromatographv，DHPLC）、直接测序及克隆测序技术检测CASP10基因第9外显子及其部分侧翼序列。结果CASP10基因第9外显子在本人群70例血样本中未检测列存在于其他人群中已知的单核苷酸多态（single nucleotide polymorphism，SNP），但初步发现在第8内含子中靠近第9外显子处存在连续重复的单核苷酸T，且T的数目在不同的个体中存在差异。测序分析显示该处为一单核苷酸重复序列，提示该位点为一单核苷酸重复微卫星位点。经比较现存的基因组数据库，先前未有类似报道。进一步采用高保真酶扩增及测序都证实同样结果。用DHPLC法检测了70例浙江汉族人群血样本，结果均呈杂合状态，暂命名为IVS8-13（T）n。结论我们的结果提示汉族人群中该位点为一杂合度较高的单核苷酸重复的微卫星位点。这一结果与NCBI的dbSNP数据库中公布的该位点为一缺失型的SNP不同，提示这一位点的遗传差异可能与种族相关。汉族人群CASP10基因中存在的这个微卫星的意义还有待于深入研究。     

急性心肌梗死冠脉病变严重程度与骨桥蛋白的相关性分析

目的 探讨急性心肌梗死（AMI）冠脉严重程度与骨桥蛋白（OPN）的相关性。方法 回顾性分析2016年9月~2017年12月我院收治的急性心肌梗死患者127例,根据OPN水平分为高OPN组65例和低OPN组62例,比较两组患者基础资料及多元线性分析OPN与冠脉严重程度的影响因素。结果 两组年龄、TG、TC、HDL-C、LDL-C及Gensini积分比较,差异有统计学意义（P＜0.05）;两组性别、既往史、左室射血分数、药物治疗比较,差异无统计学意义（P＞0.05）。多元线性回归结果表明,OPN、年龄、LDL-C和HDL-C为Genisi积分的独立影响因素。结论 OPN与AMI患者冠脉病变严重程度独立相关,可评估急性心肌梗死冠脉病变严重程度。     

冠心病危险因素聚集与冠状动脉狭窄的关系研究

目的探讨冠心病危险因素聚集对冠状动脉狭窄的影响。方法以选择性冠状动脉造影为金标准,对2993例临床诊断冠心病患者的冠心病危险因素(高龄、男性、糖尿病、高脂血症、高血压以及吸烟)进行调查。结果随着伴发危险因素数目的增加,冠脉造影阳性率随着伴发危险因素数目的增加而明显上升,冠脉多支病变比例显著增加,重度和闭塞病变所占比例呈上升趋势。结论冠状动脉病变水平与伴随冠心病危险因素数量有关,危险因素越多,冠心病发生机率越高,累及支数越广,狭窄程度越重。