内脂素与冠心病关系的探讨

Objective To study the relationship of serum visfatin level and coronary heart disease (CHD). Methods Eighty eight hospitalized patients were enrolled into the study and divided into CHD group(n = 62) and non-CHD control group(n = 26) according to the angiography results; the CHD group was further divided into single-, double-, multi-vessel affected groups. The serum level of visfatin was measured by ELISA,the lesion severity of coronary arteries was assessed by Gensini coronary scoring system, and the correlation between serum visfatin level and coronary lesion severity was evaluated statistically. Results The level of serum visfatin was significantly higher in CHD group than the control group([ 10. 77 ± 2. 63 ] μg/L vs. [ 7. 13 ± 2. 06 ]μg/L,P ＜ 0. 05). The visfatin level increased along with the the number of stenosis vessels(P ＜ 0. 05). The sermn visfatin levels of no stenosis, single-, double-, multi-vessel groups were(7. 13 ± 2. 06) μg/L,(9. 30±2. 19) μg/L,(10. 81 ± 2. 12) μg/L,(12. 79 ± 2. 20) μg/L respectively. A significant positive correlation was found between coronary lesion severity score and serum visfatin level(r = 0. 483, P ＜ 0. 01). Conclusion The visfatin may be directly related to the initiation and development of coronary diseases. The higher level of serum visfatin was, the more severe coronary artery disease would be.     

血清基质金属蛋白酶-9与2型糖尿病颈动脉粥样硬化的关系

目的 探讨血清基质金属蛋白酶-9(MMP-9)与2型糖尿病(T2DM)患者颈动脉粥样硬化的关系.方法 选择93例T2DM患者作为研究对象,测量患者颈动脉内中膜厚度(IMT)、斑块情况.根据IMT值将选取T2DM患者分为3组:单纯糖尿病组32例(糖尿病组),糖尿病颈动脉内中膜增厚组31例(中膜增厚组),糖尿病颈动脉粥样硬化斑块形成组30例(斑块组);另选健康查体者30名作为对照组.测定血清MMP-9浓度并进行相关分析.结果 糖尿病组血清MMP-9为(550.26±269.28)μg/L,显著高于对照组(359.70±215.62)μg/L,差异有统计学意义(t=2.23,P＜0.05);中膜增厚组MMP-9为(712.15±340.47)μg/L明显高于对照组(t=4.53,P＜0.01)和单纯糖尿病组(t=2.40,P＜0.05);斑块组MMP-9为(889.08±247.80)μg/L明显高于对照组(t=7.01,P＜0.01)、糖尿病组(t=4.89,P＜0.01)和中膜增厚组(t=2.53,P＜0.05).结论 血清MMP-9升高与颈动脉粥样硬化的病变程度密切相关.

Abstract：

Objective To investigated the relationship between serum matrix metalloproteinase-9(MMP-9) and carotid atherosclerosis(AS) in type 2 diabetes mellitus(T2DM).Methods A total of 93 patients with T2DM were recruited to our study.The intima-media thickness(IMT) and plaques of carotid artery were measured.These patients were divided into 3 groups according to their IMT values: diabetes mellitus(DM) group(n=32),carotid artery intima thicken group(n=31) and carotid artery intima plaque group(n=30).At the same time,30 healthy individuals were selected as control.Serum level of MMP-9 were determined and analyzed.Results The serum MMP-9 in DM group was significantly higher than that in healthy controls([550.26±269.28]μg/L vs.[359.70±215.62]μg/L,t=2.23,P＜0.05).The serum MMP-9 level of intima thicken group(712.15±340.47)μg/L was significantly higher than that in healthy controls(t=4.53,P＜0.01) and DM group(t=2.40,P＜0.05).The serum MMP-9 level of plaque group([889.08±247.80]μg/L) was even more significantly higher than DM group(t=4.89,P＜0.01),IMT group(t=2.53,P＜0.05) and healthy controls(t=7.01,P＜0.01).Conclusion The severity of carotid atherosclerosis in T2DM is closely associated with the serum MMP-9 level.     

青春期多囊卵巢综合征患者瘦素的监测及意义

目的 通过监测青春期多囊卵巢综合征患者(PCOS)瘦素的含量,探讨瘦素与PCOS的关系,寻求青春期PCOS的分型诊断方法及肥胖型患者的疗效监测指标.方法 收集30名正常青春期志愿者(正常对照组)、30例单纯型青春期肥胖者(单纯肥胖组)和41例青春期PCOS患者(27名肥胖者和14名非肥胖者)的空腹血清标本,测定瘦素,并进行统计学分析.结果 正常对照组、单纯肥胖组、青春期PCOS肥胖组与PCOS非肥胖组瘦素分别为(19.44±6.63)、(23.09±7.39)、(42.99±9.83)、(31.92±7.02)μg/L,青春期PCOS肥胖组血清中的瘦素高于对照组和单纯肥胖组,且差异均有统计学意义(t值分别为2.903、2.714,P均＜0.05);青春期PCOS肥胖组瘦素高于青春期PCOS非肥胖组,差异有统计学意义(t=2.472,P＜0.05).结论 测定瘦素可以帮助进一步明确青春期PCOS的分型,有效指导治疗,并可以作为青春期PCOS肥胖患者治疗效果的一个监测指标.

Abstract：

Objective To discuss the relationship between leptin level and polycystic ovary syndrome (PCOS) in adolescent patients with polycystic ovary syndrome, and to explore the classification diagnosis method of adolescent PCOS and indicator for clinical monitoring of obese patients. Methods All enrolled adolescent individuals were assigned into four groups: 30 normal adolescent individuals in the control group, 30 simple adolescent obese individuals in the simple obesity group,27 obese adolescent PCOS patients in the obese PCOS group and 14 nonobese adolescent PCOS patients in the nonobese PCOS group. The fasting serum samples were prepared for leptin level measurement and analysis, Results The serum leptin level of in the control group, the simple obesity group, the obese PCOS group and the nonobese PCOS group were ( 19.44 ± 6. 63 ) μg/L vs.(23.09 ±7. 39) μg/L, (42. 99 ±9. 83) μg/L and (31, 92 ±7, 02) μg/L,respectively. Leptin in the obese PCOS group was significantly higher than that in the control group and the simple obese group (t = 2. 903 and 2. 714 respectively,Ps ＜ 0. 05 ). Conclusion Monitoring the serum level of leptin can not only aid the classification of adolescent PCOS patients and guide the treatment, but also can serve as a indicator for therapeutic monitoring of obese adolescent PCOS.     

2型糖尿病患者血清同型半胱氨酸浓度变化分析

Objective To study the relationship between serum level of homocysteic acid(Hcy)and type 2 diabetic mellitus(T2DM),and to explore the influencing factors serum for Hey level in T2DM patients.Methods Totally T2DM 122 patients(T2DM group),67 patients with chronic kidney diease(CKD group)and 50 healthy controls(CON group)were enrolled in the investigation.The variation of serum Hcy of all groups was observed,and the correlation of serum Hcy level with estimated glomerular filtration rate(eGFR),fasting serum glucose,HbA1C,Urea and creatinine was analyzed.Serum Hcy was measured by enzymatic cycling assay;HbA1C was measured by high-pressure liquid chromatography assay;and eGFR was calculated by using the Levey-modified Modification of Diet in Renal Disease formula.Results There was no significant difference in serum level of Hcy between T2DM group and CON group(P＞0.05).The serum concentration of Hey was significantly higher in CKD group than that of T2DM group and CON group(P＜0.01).There was only 8.20% exceeding the upper limit of 95% of CON group in T2DM group,while 64.18% exceeding the upper limit of 95% of CON group in CKD group.There was no significant difference of Hcy level between patients with eGFR≥90 mL·(min·1.73 m2)-1 in T2DM group and healthy controls(P＞0.05),but the Hey level was significantly higher in patients with eGFR＜90 mL·(min·1.73 m2)-1 than that of healthy controls(P＜0.05).In T2DM group and CKD group,serum Hey level was negatively correlative to eGFR(P＜0.01).positively correlative to Urea and creatinine(P＜0.01);but serum Hcy level did not correlate with fasting serum glucose,HbA1C,total cholesterol and triglyceride(P＞0.05).Conclusion Renal function is an independent risk factor for serum homocysteine level in type 2 diabetes rather than diabetes itself.     

2型糖尿病患者血清同型半胱氨酸浓度变化分析

Objective To study the relationship between serum level of homocysteic acid(Hcy)and type 2 diabetic mellitus(T2DM),and to explore the influencing factors serum for Hey level in T2DM patients.Methods Totally T2DM 122 patients(T2DM group),67 patients with chronic kidney diease(CKD group)and 50 healthy controls(CON group)were enrolled in the investigation.The variation of serum Hcy of all groups was observed,and the correlation of serum Hcy level with estimated glomerular filtration rate(eGFR),fasting serum glucose,HbA1C,Urea and creatinine was analyzed.Serum Hcy was measured by enzymatic cycling assay;HbA1C was measured by high-pressure liquid chromatography assay;and eGFR was calculated by using the Levey-modified Modification of Diet in Renal Disease formula.Results There was no significant difference in serum level of Hcy between T2DM group and CON group(P＞0.05).The serum concentration of Hey was significantly higher in CKD group than that of T2DM group and CON group(P＜0.01).There was only 8.20% exceeding the upper limit of 95% of CON group in T2DM group,while 64.18% exceeding the upper limit of 95% of CON group in CKD group.There was no significant difference of Hcy level between patients with eGFR≥90 mL·(min·1.73 m2)-1 in T2DM group and healthy controls(P＞0.05),but the Hey level was significantly higher in patients with eGFR＜90 mL·(min·1.73 m2)-1 than that of healthy controls(P＜0.05).In T2DM group and CKD group,serum Hey level was negatively correlative to eGFR(P＜0.01).positively correlative to Urea and creatinine(P＜0.01);but serum Hcy level did not correlate with fasting serum glucose,HbA1C,total cholesterol and triglyceride(P＞0.05).Conclusion Renal function is an independent risk factor for serum homocysteine level in type 2 diabetes rather than diabetes itself.     

2型糖尿病患者血清同型半胱氨酸浓度变化分析

Objective To study the relationship between serum level of homocysteic acid(Hcy)and type 2 diabetic mellitus(T2DM),and to explore the influencing factors serum for Hey level in T2DM patients.Methods Totally T2DM 122 patients(T2DM group),67 patients with chronic kidney diease(CKD group)and 50 healthy controls(CON group)were enrolled in the investigation.The variation of serum Hcy of all groups was observed,and the correlation of serum Hcy level with estimated glomerular filtration rate(eGFR),fasting serum glucose,HbA1C,Urea and creatinine was analyzed.Serum Hcy was measured by enzymatic cycling assay;HbA1C was measured by high-pressure liquid chromatography assay;and eGFR was calculated by using the Levey-modified Modification of Diet in Renal Disease formula.Results There was no significant difference in serum level of Hcy between T2DM group and CON group(P＞0.05).The serum concentration of Hey was significantly higher in CKD group than that of T2DM group and CON group(P＜0.01).There was only 8.20% exceeding the upper limit of 95% of CON group in T2DM group,while 64.18% exceeding the upper limit of 95% of CON group in CKD group.There was no significant difference of Hcy level between patients with eGFR≥90 mL·(min·1.73 m2)-1 in T2DM group and healthy controls(P＞0.05),but the Hey level was significantly higher in patients with eGFR＜90 mL·(min·1.73 m2)-1 than that of healthy controls(P＜0.05).In T2DM group and CKD group,serum Hey level was negatively correlative to eGFR(P＜0.01).positively correlative to Urea and creatinine(P＜0.01);but serum Hcy level did not correlate with fasting serum glucose,HbA1C,total cholesterol and triglyceride(P＞0.05).Conclusion Renal function is an independent risk factor for serum homocysteine level in type 2 diabetes rather than diabetes itself.     

2型糖尿病患者血清同型半胱氨酸浓度变化分析

Objective To study the relationship between serum level of homocysteic acid(Hcy)and type 2 diabetic mellitus(T2DM),and to explore the influencing factors serum for Hey level in T2DM patients.Methods Totally T2DM 122 patients(T2DM group),67 patients with chronic kidney diease(CKD group)and 50 healthy controls(CON group)were enrolled in the investigation.The variation of serum Hcy of all groups was observed,and the correlation of serum Hcy level with estimated glomerular filtration rate(eGFR),fasting serum glucose,HbA1C,Urea and creatinine was analyzed.Serum Hcy was measured by enzymatic cycling assay;HbA1C was measured by high-pressure liquid chromatography assay;and eGFR was calculated by using the Levey-modified Modification of Diet in Renal Disease formula.Results There was no significant difference in serum level of Hcy between T2DM group and CON group(P＞0.05).The serum concentration of Hey was significantly higher in CKD group than that of T2DM group and CON group(P＜0.01).There was only 8.20% exceeding the upper limit of 95% of CON group in T2DM group,while 64.18% exceeding the upper limit of 95% of CON group in CKD group.There was no significant difference of Hcy level between patients with eGFR≥90 mL·(min·1.73 m2)-1 in T2DM group and healthy controls(P＞0.05),but the Hey level was significantly higher in patients with eGFR＜90 mL·(min·1.73 m2)-1 than that of healthy controls(P＜0.05).In T2DM group and CKD group,serum Hey level was negatively correlative to eGFR(P＜0.01).positively correlative to Urea and creatinine(P＜0.01);but serum Hcy level did not correlate with fasting serum glucose,HbA1C,total cholesterol and triglyceride(P＞0.05).Conclusion Renal function is an independent risk factor for serum homocysteine level in type 2 diabetes rather than diabetes itself.     

2型糖尿病患者血清同型半胱氨酸浓度变化分析

Objective To study the relationship between serum level of homocysteic acid(Hcy)and type 2 diabetic mellitus(T2DM),and to explore the influencing factors serum for Hey level in T2DM patients.Methods Totally T2DM 122 patients(T2DM group),67 patients with chronic kidney diease(CKD group)and 50 healthy controls(CON group)were enrolled in the investigation.The variation of serum Hcy of all groups was observed,and the correlation of serum Hcy level with estimated glomerular filtration rate(eGFR),fasting serum glucose,HbA1C,Urea and creatinine was analyzed.Serum Hcy was measured by enzymatic cycling assay;HbA1C was measured by high-pressure liquid chromatography assay;and eGFR was calculated by using the Levey-modified Modification of Diet in Renal Disease formula.Results There was no significant difference in serum level of Hcy between T2DM group and CON group(P＞0.05).The serum concentration of Hey was significantly higher in CKD group than that of T2DM group and CON group(P＜0.01).There was only 8.20% exceeding the upper limit of 95% of CON group in T2DM group,while 64.18% exceeding the upper limit of 95% of CON group in CKD group.There was no significant difference of Hcy level between patients with eGFR≥90 mL·(min·1.73 m2)-1 in T2DM group and healthy controls(P＞0.05),but the Hey level was significantly higher in patients with eGFR＜90 mL·(min·1.73 m2)-1 than that of healthy controls(P＜0.05).In T2DM group and CKD group,serum Hey level was negatively correlative to eGFR(P＜0.01).positively correlative to Urea and creatinine(P＜0.01);but serum Hcy level did not correlate with fasting serum glucose,HbA1C,total cholesterol and triglyceride(P＞0.05).Conclusion Renal function is an independent risk factor for serum homocysteine level in type 2 diabetes rather than diabetes itself.     

2型糖尿病患者血清同型半胱氨酸浓度变化分析

Objective To study the relationship between serum level of homocysteic acid(Hcy)and type 2 diabetic mellitus(T2DM),and to explore the influencing factors serum for Hey level in T2DM patients.Methods Totally T2DM 122 patients(T2DM group),67 patients with chronic kidney diease(CKD group)and 50 healthy controls(CON group)were enrolled in the investigation.The variation of serum Hcy of all groups was observed,and the correlation of serum Hcy level with estimated glomerular filtration rate(eGFR),fasting serum glucose,HbA1C,Urea and creatinine was analyzed.Serum Hcy was measured by enzymatic cycling assay;HbA1C was measured by high-pressure liquid chromatography assay;and eGFR was calculated by using the Levey-modified Modification of Diet in Renal Disease formula.Results There was no significant difference in serum level of Hcy between T2DM group and CON group(P＞0.05).The serum concentration of Hey was significantly higher in CKD group than that of T2DM group and CON group(P＜0.01).There was only 8.20% exceeding the upper limit of 95% of CON group in T2DM group,while 64.18% exceeding the upper limit of 95% of CON group in CKD group.There was no significant difference of Hcy level between patients with eGFR≥90 mL·(min·1.73 m2)-1 in T2DM group and healthy controls(P＞0.05),but the Hey level was significantly higher in patients with eGFR＜90 mL·(min·1.73 m2)-1 than that of healthy controls(P＜0.05).In T2DM group and CKD group,serum Hey level was negatively correlative to eGFR(P＜0.01).positively correlative to Urea and creatinine(P＜0.01);but serum Hcy level did not correlate with fasting serum glucose,HbA1C,total cholesterol and triglyceride(P＞0.05).Conclusion Renal function is an independent risk factor for serum homocysteine level in type 2 diabetes rather than diabetes itself.     

2型糖尿病患者血清同型半胱氨酸浓度变化分析

Objective To study the relationship between serum level of homocysteic acid(Hcy)and type 2 diabetic mellitus(T2DM),and to explore the influencing factors serum for Hey level in T2DM patients.Methods Totally T2DM 122 patients(T2DM group),67 patients with chronic kidney diease(CKD group)and 50 healthy controls(CON group)were enrolled in the investigation.The variation of serum Hcy of all groups was observed,and the correlation of serum Hcy level with estimated glomerular filtration rate(eGFR),fasting serum glucose,HbA1C,Urea and creatinine was analyzed.Serum Hcy was measured by enzymatic cycling assay;HbA1C was measured by high-pressure liquid chromatography assay;and eGFR was calculated by using the Levey-modified Modification of Diet in Renal Disease formula.Results There was no significant difference in serum level of Hcy between T2DM group and CON group(P＞0.05).The serum concentration of Hey was significantly higher in CKD group than that of T2DM group and CON group(P＜0.01).There was only 8.20% exceeding the upper limit of 95% of CON group in T2DM group,while 64.18% exceeding the upper limit of 95% of CON group in CKD group.There was no significant difference of Hcy level between patients with eGFR≥90 mL·(min·1.73 m2)-1 in T2DM group and healthy controls(P＞0.05),but the Hey level was significantly higher in patients with eGFR＜90 mL·(min·1.73 m2)-1 than that of healthy controls(P＜0.05).In T2DM group and CKD group,serum Hey level was negatively correlative to eGFR(P＜0.01).positively correlative to Urea and creatinine(P＜0.01);but serum Hcy level did not correlate with fasting serum glucose,HbA1C,total cholesterol and triglyceride(P＞0.05).Conclusion Renal function is an independent risk factor for serum homocysteine level in type 2 diabetes rather than diabetes itself.     

老年冠心病患者冠状动脉病变程度与血浆B型钠尿肽的关系

目的探讨老年冠状动脉粥样硬化性心脏病（冠心病）患者冠状动脉病变程度与血浆B型钠尿肽（BNP）的关系。方法2010年3月至2011年8月在我院行冠状动脉造影术的老年患者498例。根据造影结果将研究对象分为两组：冠心病组：经冠状动脉造影证实有单支或多支病变,狭窄程度≥50％共406例;对照组：同期住院冠状动脉造影狭窄程度〈50％患者共92例。记录所有研究对象的一般临床指标、左心室射血分数（LVEF）及血BNP等检查结果并进行比较。按冠状动脉病变程度不同,将研究对象分为：单支病变组177例,双支病变组129例,多支病变组100例。又按年龄不同将冠心病患者分为3个亚组：A组254例,年龄60～69岁;B组112例,年龄70—79岁;C组40例,年龄≥80岁。分别比较不同年龄与BNP以及与冠状动脉病变的关系。结果冠心病组患者BNP（387．5±132．3）ng,／L较对照组（58．6±22．1）ng／L明显升高（t=23．83,P〈0．01）;随着冠状动脉病变支数的增加,BNP明显升高,单支病变组为（202．2±116．6）ng／L,双支病变组为（487．5±152．3）ng/L,多支病变组为（768．7±264．3）ng／L,差异有统计学意义（F=87．42,P〈0．01）。随着年龄的增大,BNP亦逐渐升高,A组为（182．6±93．1）ng／L,B组为（352．2±121．2）ng／L,C组为（491．2±158．7）ng/L,差异有统计学意义（17=57．33,P〈0．01）。各组LVEF比较差异无统计学意义（F=0．21,P〉0．05）。结论血浆BNP水平与老年冠心病患者冠状动脉病变程度密切相关,是反映临床心肌缺血重要的预测指标。     

血尿酸在不同类型冠心病发生中的作用机制

目的 探讨血尿酸在不同类型冠心病发生中的作用机制.方法 88例住院患者分为对照组、稳定型心绞痛(SA)组和急性冠状动脉综合征(ACS)组,分别测定其血尿酸、血小板α-颗粒膜蛋白(GMP-140)、血管性假性血友病因子(vWF)、纤溶酶原激活物抑制物-1(PAI-1)、血栓素B_2(TXB_2)、C-反应蛋白(CRP).结果 (1)①UA、CRP:ACS组[(392.10±68.57)μmol/L、(42.2±39.4)mg/L]和SA组[(370.50±58.80)μmoL/L、(18.9±17.1)mg/L]均高于对照组[(286.00±65.31)μmol/L、(2.5±0.7)mg/L,P均＜0.05];UA在ACS组、SA组差异无统计学意义(P＞0.05),ACS组CRP高于SA组(P＜0.05);②vWF、TXB_2:ACS组[(1.65±0.48)%、(19.73±18.66)ng/L]和SA组[(1.35±0.49)%、(11.18±10.71)ng/L]均高于对照组[(1.07±0.26)%、(6.46±5.41)ng/L,P均＜0.05],ACS组高于SA组(P均＜0.05);③GMP-140、PAI-1:ACS组[(13.04±0.99)μg/,L、(65.65±14.76)μg/L]和SA组[(12.55±0.74)μg/L、(62.69±12.24)μg/L]均高于对照组[(12.32±0.29)μg/L、(50.78±13.88)μg/L,P均＜0.05],ACS组与SA组间差异无统计学意义(P均＞0.05).④ACS组血尿酸升高者与血尿酸正常者CRP[(71.3±18.9)、(20.70±17.9)mg/L]、vWF[(1.08±0.52)%、(0.84±0.54)%]、GMP-140[(13.57±1.11)、(13.23±1.07)μg/L]、TXB_2[(57.26±47.84)、(26.70±23.83)ng/L]、PAI-1[(72.12±9.23)、(61.30±12.07)μg/L]差异均有统计学意义(t值分别为7.394、0.008、0.227、7.605、0.421,P均＜0.05),SA组血尿酸升高者与血尿酸正常者CRP[(31.1±18.9)、(10.9±10.1)mg/L]、TXB_2[(21.54±3.90)、(5.02±4.93)ng/L]差异均有统计学意义(t值分别为0.494、8.669,P均＜0.05).(2)Logistic逐步回归分析:与急性冠状动脉综合征相关的因素有UA、CRP、PAI-1、PT、TG(OR值分别为1.046、7.615、1.301、0.300和2.243,P均＜0.05).结论 血尿酸升高是影响冠心病发生、发展的重要危险因素.血尿酸升高可能通过损害血管内皮功能、激活血小板、影响凝血和纤溶功能、引发炎症反应参与不同类型冠心病的发生与发展.     

妊娠期糖尿病患者血清脂联素和内脂素水平与并发子痫前期的相关性

目的 观察妊娠期糖尿病患者血清脂联素、内脂素表达情况,探讨其与妊娠期糖尿病患者发生子痫前期的关系.方法 已分娩的369例妊娠期糖尿病患者为妊娠期糖尿病组,已分娩的363例健康孕妇为对照组,检测2组血清脂联素、内脂素水平.妊娠期糖尿病组根据是否并发子痫前期分为子痫前期组34例和无子痫前期组335例,比较2组血清脂联素、内...     

冠心病心绞痛患者血浆白细胞介素-6和超敏C-反应蛋白变化及其临床意义

目的 探讨白细胞介素-6(IL-6)及超敏C-反应蛋白(hsCRp)在冠心病心绞痛发病机制中的作用.方法 选择冠状动脉造影确诊的心绞痛患者150例,分为不稳定型心绞痛(UAP)组78例,稳定型心绞痛(SAP)组72例,50例冠状动脉造影正常者作为对照组.采用酶联免疫吸附(ELISA)法检测血浆IL-6、免疫浊度法检测hsCRp水平.结果 UAP组血浆IL-6、hsCRP含量为(36.98±9.35)pg/L、(2.25±0.73)μg/L,显著高于SAP组的(23.19±7.35)pg/L和(1.88±0.68)μg/L(P均＜0.01),2组IL-6、hsCRP均明显高于对照组(16.93±6.15)pg/L、(1.28±0.40)μg/L(P均＜0.01).相关分析表明IL-6与hsCRP正相关,相关系数r=0.875(P＜0.05).结论 炎症反应可能参与冠心病的发病过程,血浆IL-6与hsCRP对预测冠心病心绞痛的存在和发展有重要的临床意义.     

血清糖化白蛋白和同型半胱氨酸与冠状动脉病变的相关性

目的 探讨冠状动脉病变程度与血清糖化白蛋白（glycated albumin,GA）、同型半胱氨酸（homocysteine,Hcy）的关系及临床意义。方法 行冠状动脉造影检查患者151例,依据检查结果分为冠心病组121例和非冠心病组30例,冠心病组根据病变血管支数、Gensini积分、SYNTAX积分分为不同亚组,分析冠心病组和非冠心病组、冠心病不同亚组GA、Hcy水平差异。结果 冠心病组血清GA、Hcy、高密度脂蛋白胆固醇、陈旧性心肌梗死构成比分别为（15.38±3.68）%、（15.55±7.23）μmol/L、（0.93±0.22）mmol/L、18.2%,非冠心病组分别为（13.88±2.0）%、（12.73±4.42）μmol/L、（1.06±0.21）mmol/L、3.3%,2组比较差异有统计学意义（P〈0.05）;不同病变血管支数冠心病患者GA、Hcy水平比较差异无统计学意义（P〉0.05）;冠心病组Gensini积分、SYNTAX积分与血清GA、Hcy水平呈正相关（r值为0.4969~0.6731,P〈0.05）。结论 GA与Hcy联合检测对冠状动脉病变程度有预测价值。     

血清载脂蛋白A1、载脂蛋白B及其比值与冠脉病变程度相关性分析

目的研究血清载脂蛋白B（ApoB）、载脂蛋白A-1（ApoA1）及载脂蛋白A1/载脂蛋白B（ApoA1/ApoB）值与冠脉粥样硬化病变及其严重程度的关系。方法 510例行冠脉造影检查的住院患者根据冠脉造影结果分为单支病变组（132例）、多支病变组（266例）和对照组（112例）,比较血清ApoB、ApoA1水平及ApoA1/ApoB值在各组中的变化,分析其血清水平与冠脉狭窄严重程度的相关性。结果①冠心病单支病变组血清ApoB（0.98±0.35g/L vs0.76±0.48g/L,P〈0.05）和多支病变组血清ApoB（1.85±0.31g/L vs 0.67±0.48g/L,P〈0.05）均显著高于对照组,血清ApoB水平与冠脉病变支数（r=0.27,P〈0.05）及狭窄程度（r=0.32,P〈0.01）呈显著正相关性。②CHD组血清ApoA1和ApoA1/ApoB值显著低于对照组,与冠脉病变支数及狭窄程度呈负相关性。结论血清ApoB水平反映了动脉粥样硬化的程度,与冠脉病变严重程度呈正相关,血清ApoA1水平和ApoA1/ApoB值与冠脉病变严重程度呈负相关。     

右美托咪定预处理对肝癌切除手术患者的肝缺血再灌注损伤的价值

目的探讨右美托咪定(Dex)预处理对于肝癌切除手术患者的肝缺血再灌注损伤的影响。方法前瞻性选取辽宁省朝阳市第二医院拟实施半肝切除手术治疗的95例原发性肝细胞癌患者作为研究对象,采用随机数字表法分为预处理组48例和常规组47例,预处理组手术前给予Dex 0.7μg/kg,10 min内输注完毕,后以0.4μg/(kg·h)维持至手术结束,常规组给予等量的0.9%氯化钠溶液。比较2组患者的手术时间、术中出血量、输血率、肝血流阻断时间及手术并发症。比较2组患者手术前、手术后24 h的血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)、总胆红素(STB)、结合胆红素(CB)、丙二醛(MDA)、超氧化物歧化酶(SOD)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、高迁移率族蛋白B1(HMGB1)、白细胞介素-6(IL-6)水平。结果 2组患者的手术时间、术中出血量、输血率、肝血流阻断时间比较,差异均无统计学意义(P> 0.05)。术前,预处理组和常规组患者的血清ALT、AST、GGT、STB、CB检测值比较,差异均无统计学意义(P> 0.05);术后24 h,预处理组患者的ALT、AST、GGT、STB、CB分别为(330.2±104.0) U/L、(367.1±110.8) U/L、(31.75±7.25) U/L、(65.20±11.35)μmol/L、(37.67±6.29)μmol/L,均低于常规组[(418.6±120.7) U/L、(440.8±127.6) U/L、(38.00±9.52) U/L、(74.18±13.37)μmol/L、(42.52±8.06)μmol/L],差异均有统计学意义(P <0.05)。术前,预处理组和常规组患者的血清MDA、SOD、TNF-α、CRP、HMGB1、IL-6检测值比较,差异均无统计学意义(P> 0.05);术后24 h,预处理组患者的血清MDA、TNF-α、CRP、HMGB1、IL-6分别为(4.36±1.33)μmol/L、(5.20±1.64)μg/L、(34.75±6.83) mg/L、(258.4±41.7)μg/L、(31.28±9.50)μg/L,均低于常规组[(5.11±1.57)μmol/L、(7.00±2.17)μg/L、(43.80±8.53) mg/L、(295.0±46.4)μg/L、(48.64±11.57)μg/L],预处理组的血清SOD[(126.9±25.0) U/L]高于常规组[(113.1±19.6) U/L],差异均有统计学意义(P <0.05)。预处理组患者的手术并发症发生率(12.50%)与常规组(21.28%)比较,差异无统计学意义(P> 0.05)。结论原发性肝细胞癌患者实施半肝切除手术时,术前Dex预处理能显著减轻肝缺血再灌注损伤,保护肝脏功能。     

血浆正五聚蛋白3水平及总胆固醇与高密度脂蛋白胆固醇比值与冠状动脉狭窄程度的关系

目的 研究血浆正五聚蛋白3(PTX-3)和总胆固醇(TC)/高密度脂蛋白胆固醇(HDL-C)与冠心病患者冠状动脉狭窄程度的关系.方法 采集并分析2008年7月至2009年12月在中南大学湘雅二医院心内科住院的择期行冠状动脉造影的冠心病患者87例,据冠状动脉造影结果,将患者分为2组:次全闭塞组和非次全闭塞组,所有患者入院第2天清晨空腹取静脉血测定PTX-3和血脂水平,并进行统计分析.结果 次全闭塞组冠心病患者的PTX-3浓度显著低于非次全闭塞组[(4.6±1.6)μg/L比(5.9±2.0)μg/L,t=-3.380,P＜0.05)];TC/HDL-C比值显著高于非次全闭塞组(4.9±1.1比4.1±1.2,t=3.107,P＜0.05).校正性别、老年、糖尿病、高血压等混杂因素后PTX-3＜5μg/L(OR=4.471,95%CI1.516～13.189,P＜0.01)及TC/HDL-C比值≥4(OR=5.087,95%CI:1.676～15.440,P＜0.01)冠心病患者冠状动脉易发生次全闭塞.结论 在冠心病患者中,血浆低水平PTX-3和高水平T℃/HDL-C比值可能与冠状动脉狭窄程度相关.

Abstract：

Objective To evaluate the impact of plasma pentraxin-3 (PTX-3) together with total cholesterol( TC)/high-density lipoprotein cholesterol (HDL-C) on severity of coronary artery stenosis. Methods Eighty seven cases from Department of Cardiology of the Second Xiangya Hospital of Central South University from July 2008 to December 2009, accepted elective coronary angiography, were enrolled into the study and divided into two groups according to the results of coronary angiography: subtotal occlusion group and nonsubtotal occlusion group. All patients were hospitalized and fasting venous blood were extracted on the next morning for PTX-3 and lipids level measurement. The data were statistically analyzed. Results The PTX-3levels in patients with subtotal occlusion group were significantly lower than those in nonsubtotal occlusion group [ (4. 6 ± 1.6) μg/L vs. (5.9 ± 2. 0) μg/L, t = -3. 380, P ＜ 0. 05) ]; TC/HDL-C levels in patients with subtotal occlusion group were significantly increased when compared with those in nonsubtotal occlusion group (4. 9 ±1.1 vs. 4. 1 ± 1.2, t = 3. 107 ,P ＜ 0. 05). After adjusting for sex, age, diabetes, hypertension, and so confounding factors, the patients with PTX-3 ＜ 5 μg/L(OR = 4. 471,95 % CI 1.516 - 13. 189, P ＜ 0. 01) and TC / HDL-C ratio ≥4 (OR = 5.087,95% CI 1.676 - 15.440, P ＜0.01) were prone to become subtotal coronary occlusion. Conclusion Low plasma PTX-3 level and increased ratio of TC and HDL-C may be related with the severity of coronary artery stenosis in patients with coronary heart disease.     

新疆地区维吾尔族和汉族人群血浆同型半胱氨酸水平与冠心病的关系

背景冠心病的主要独立危险因素包括性别、吸烟、高血压、高脂血症、糖尿病和老年等,但仅约50%的冠心病患者存在这些传统的危险因素,确立冠心病其他危险因素的必要性显得越来越突出。目的研究新疆地区维吾尔族、汉族血浆同型半胱氨酸(homocysteine,Hcy)水平与冠心病的关系,探讨同型半胱氨酸在不同民族冠心病发病中的地位。设计以诊断为依据的病例对照研究。地点、对象和方法收集2001-10/2002-01新疆医科大学第一附属医院心内科住院并行冠状动脉造影术的110例患者,按冠状动脉造影结果分为冠状动脉狭窄组(n=74)与冠状动脉正常组(n=36),并用高效液相色谱法测定血浆同型半胱氨酸水平。结果冠状动脉狭窄组血浆Hcy水平(μmol/L)明显高于冠状动脉正常组(17.40±10.95和11.78±4.56;t=3.79,P<0.05),冠状动脉狭窄组中高Hcy血症占41%,高于冠状动脉正常组(14%),差异有显著性意义(χ2=6.75,P<0.01)。冠状动脉狭窄组汉族血浆Hcy水平(μmol/L)显著高于冠状动脉正常组汉族(18.40±11.86和12.36±5.17;q=3.65,P<0.05),冠状动脉狭窄组和冠状动脉正常组维吾尔族之间差异无显著性意义(q=1.34,P>0.05)。结论新疆地区冠心病患者血浆同型半胱氨酸水平明显升高,高同型半胱氨酸血症所占比例较大,而同型半胱氨酸对新疆地区冠心病患     

血清妊娠血浆相关蛋白A与冠心病斑块稳定性的关系

目的研究血清妊娠血浆相关蛋白A(PAPP-A)水平与冠心病斑块稳定程度的相关性。方法用酶联免疫吸附法(ELISA)检测了230例拟诊冠心病患者的PAPP-A水平,其中急性心肌梗死50例,不稳定型心绞痛110例,稳定型心绞痛40例,另30例为非冠心病,并对冠心病患者进行冠状动脉造影病变形态学分析,比较不同类型的冠心病及不同形态斑块的PAPP-A水平。结果血清PAPP-A在急性心肌梗死组为(26.13±4.65)mIU/L,不稳定型心绞痛组为(20.37±5.78)mIU/L,明显高于稳定型心绞痛组(12.82±3.94)mIU/L和非冠心病组(10.70±2.86)mIU/L(均P<0.01,不稳定型心绞痛组和急性心肌梗死组比较,P<0.05)。血清PAPP-A在Ⅱ型斑块组中的水平为(24.52±4.82)mIU/L,明显高于其他型斑块组(16.82±5.37)mIU/L及非冠心病组(10.70±2.86)mIU/L(均P<0.01)。结论血清PAPP-A水平与冠心病斑块稳定性相关。