住院治疗男性冠心病患者血液流变性变化的特点

２８例男性住院治疗冠心病（ＣＨＤ）患者，接受１０～４０天流变药物的治疗，虽然患者比积明显低于对照组（Ｐ＜０．０５），而血浆粘度明显高于对照组（Ｐ＜０．０１），但患者表观全血粘度及红细胞聚集指数与对照组无显著区别。若采用固定比积（０．５０）的红细胞ＰＢＳ，悬液，患者血样的表观粘度则明显高于对照组（Ｐ＜０．０５或＜０．０１）；红细胞聚集指数也明显高于对照组（Ｐ＜０．０５）。结果表明，红细胞变形性明显减弱和聚集性显著升高是住院男性冠心病患者血液流变性异常的主要特点，并提示，改善红细胞流变性异常和降低血浆粘度对冠心病患者可能是一种有益的治疗措施。     

胰岛素及生长抑素在高血压病中的作用

本研究采用放射免疫分析方法检测原发性高血压患者血浆胰岛素和生长抑素含量。结果表明：（１）原发性高血压病人血浆胰岛素水平明显增高（Ｐ＜０．０１），而生长抑素含量却明显减少（Ｐ＜０．０１）；（２）原发性高血压伴左室肥厚者，其血浆胰岛素水平显著高于无左室肥厚高血压患者（ｐ＜０．０１），而生长抑素含量却明显低于无左室肥厚高血压患者（Ｐ＜０．０５）；（３）原发性高血压患者其心电图Ｓ一Ｔ段下移。Ｔ波畸变者，血浆胰岛素水平明显高于心电图正常的高血压患者（Ｐ＜０．０５），而生长抑素含量却明显低于心电图正常的高血压病人（Ｐ＜０．０５）。结果提示：在原发性高血压时，体内胰岛素合成与释放增加，参与了血压的调节。胰岛素分泌增加可能与生长抑素分泌减少有关。     

泽兰对家兔血液流变性及球结膜微循环的影响

观察泽兰水煎剂对家兔血液流变性及微循环的影响。实验结果表明，腹腔注射泽兰１ｇ／ｋｇ（体重），对全血比粘度、血浆比粘度、红细胞压积和全血还原粘度均有明显降低作用（Ｐ＜０．０１～０．０５），红细胞电泳时间缩短（Ｐ＜０．０１）。体外血栓形成实验表明，泽兰能够缩短血栓长度，减轻血栓干、湿重（Ｐ＜０．０１）。腹腔注射泽兰０．５ｇ／ｋｇ，可见功能毛细血管开放增加（Ｐ＜０．０１），也能改善高分子右旋糖酐所致急性微循环障碍     

献血员能否作为正常对照？

对２４名献血员进行血液流变学检查，发现同性别献血员的全血粘度、全血还原粘度和红细胞聚集指数均低于正常人；血沉和纤维蛋白原高于正常人（Ｐ＜０．０５）。同时发现，献血员血液流变性有性别差异，即男性的全血粘度、全血还原粘度高于女性，而血沉和Ｋ值则低于女性（Ｐ＜０．０５），与正常人相仿。综合分析认为选择献血员作为正常对照时应谨慎     

896例脑血栓患者血液流变性分析

检测８９６例脑血栓患者血液流变性九项指标，结果发现其均明显高于８０８例对照组（Ｐ＜０．０５或＜０．０１）。以红细胞流变性改变为基础，分为正常型、全高型、高粘型、高聚型及高压积型。血液流变性的异常是脑血栓发病的重要因素。粘度越高，脑血流量越低；压积越高，粘度越大；ＲＢＣ表面电荷越少，聚集性越强。提示：血液流变学检测的意义在于阐明发病机理、指导临床治疗、帮助患者康复。     

体外反搏对血液流变性和血小板聚集性的影响

观察４０例心脑血管疾病患者体外反搏前后血液流变性和血小板聚集性变化。结果表明，反搏后全血比及还原比粘度、血浆粘度有不同程度的下降（Ｐ＜０．０５～０．０１）。反搏治疗后，１～５ｍｉｎ血小板聚集率、最大聚集率和最大聚集速度较反搏前均明显降低（Ｐ＜０．０５～０．０１），而５ｍｉｎ解聚率则明显增加（Ｐ＜０．０５）。提示体外反搏治疗不仅影响血液动力学，而且明显降低血液粘度，对血小板聚集功能有明显抑制作用。     

血库存血不同时间内流变性的变化

通过血液流变性实验，初步探讨了血库存血（４℃）在不同时间内（２４ｈ、３天、７天、１４天）其血液流变学指标红细胞电泳时间（ＥｐＴ）、全血（比）粘度（ηｂ）、血浆（比）粘度（ηｐ）的变化，结果分别为存放１天（２４ｈ），ＥｐＴ值有非常显著延长，存放３天加值有非常显著性增高，Ｐ＜０．０１，储存时间越长其值越高；存放３天内ηｂ值无明显变化，Ｐ＞０．０５；７天与１４天有显著性和非常显著性变化，Ｐ＜０．０５和Ｐ＜０．０１；存放时间越长，其ηｐ值顺次变小。     

复方咳喘停治疗蛔虫变应原致喘豚鼠后血液流变性的动态变化

目的：观察蛔虫变应原致喘豚鼠后及平喘中药治疗后血液流变性的动态变化。方法：把豚鼠分为阴性对照、阳性激发和复方咳喘停中药治疗组。用蛔虫变应原诱发哮喘后,观察各组血液流变性的动态变化。结果：阳性激发组的血浆粘度、红细胞聚集指数及高切还原粘度增高,显著高于阴性组（Ｐ＜０．０１）;中药组上述指标显著低于阳性激发组（Ｐ＜０．０１）,与阴性组相比无显著性差异（Ｐ＞０．０５）。各组红细胞压积均无明显变化。结论：蛔虫变应原致喘豚鼠后,血液出现高粘滞状态;咳喘停能有效改善局部微循环、恢复流态。     

灵芝加降压药治疗难治性高血压时血糖、血脂、微循环和血液流变性的变化及意义

用各种血压测定法及活体微循环观察法发现，４０例难治性高血压病人（治疗组２７例，对照组１３例）口服灵芝３个月后在大动脉血压、小动脉血压和毛细血管血压下降的同时，病人血粘度（高切、低切时的全血粘度及血浆比粘度）、红细胞压积和红细胞沉降率明显下降（Ｐ＜０．０５），甲襞微血管数增多、口径扩大、流速加快（Ｐ＜０．０５），血糖明显下降（Ｐ＜０．０５），但胆固醇、甘油三酯及高密度脂蛋白下降不明显（Ｐ＞０．０５）。上述变化间相关性不显著（Ｐ＞０．０５），说明上述改变是通过相互独立的途径取得。因而认为，灵芝对治疗高血压伴高粘血症和／或高血糖的病人尤为合适，且对预防或减轻高血压并发症有益。     

脑脉宝对大鼠脑缺血再灌注后血液流变性及血小板形态的影响

采用四血管阻断法制成大鼠脑缺血３０ｍｉｎ再灌注３０ｍｉｎ模型后，大鼠全血粘度（２３ｓ－１、５．７５ｓ－１）、全血还原粘度（高切、中切）、红细胞聚集指数、内粘度、红细胞刚性系数、Ｃａｓｏｎ屈服应力等均较假手术组明显升高（Ｐ＜０．０１ ０．０５），其余指标也高于假手术组，但无统计学意义（Ｐ＞０．０５）。其血小板亦被激活，发生粘附、聚集反应。预先给予脑脉宝（由生黄芪、丹参、当归、川芎、地龙、水蛭、三七、牛磺酸等组成，具有“益气活血，豁痰，通络，补肾”功效）可显著改善其脑缺血再灌注后血液流变性异常，除１１５ｓ－１切变率下全血粘度、Ｃａｓｓｏｎ粘度、内粘度外，其余各指标均明显低于缺血再灌组（Ｐ＜０．０１０．０５），并可改善血小板形态和功能。提示该药可明显改善缺血再灌注后血液浓、粘、凝、聚等异常改变，促进血液循环正常运行，减轻脑损害。其机理可能与其使聚集的红细胞解聚及保持红细胞膜、增强红细胞变性等药理作用有关     

Plasma glucose and insulin responses to oral glucose loading in nonobese Nigerian subjects with essential hypertension.

In assessing the relationship between insulin levels and blood pressure, we analyzed glucose and insulin data after standard 75 g oral glucose tolerance tests in 16 nonobese male Nigerian subjects with essential hypertension and compared their results with those obtained from 16 age- and sex-matched healthy normotensive subjects. The fasting plasma glucose and insulin as well as 2-hour postload insulin values were similar in both groups. The hypertensive subjects had significantly greater 2-hour glucose levels, larger incremental areas under the glucose/time curves, and smaller ratios of incremental insulin to incremental glucose areas (P < .05). These parameters suggest some impairment of glucose tolerance in the hypertensive subjects related to an inadequate insulin response to the oral glucose load. Model analysis of the glucose and insulin data confirmed these observations in that the estimated rate of glucose uptake into peripheral tissues (M value) was lower in the hypertensive subjects (P = .02). There was no correlation at any time point between insulin values and blood pressure in either group of subjects. These results suggest that essential hypertension in Nigerian diabetic subjects is associated with a reduced insulin response to glucose loading, which is at variance with reports in whites, and deserve further investigation.     

妊娠期高血压疾病患者瘦素、胰岛素测定及其与新生儿生长发育的关系

目的探讨妊娠期高血压疾病与瘦素、胰岛素的相关性及临床价值.方法1.采用放射免疫法检测62例妊娠期高血压疾病患者及30例正常组患者的母血、脐血瘦素和胰岛素水平,分析在不同程度妊娠期高血压疾病中的差异,及瘦素、胰岛素水平之间的相关性.2.分析脐血瘦素、胰岛素与妊娠期高血压疾病患者的新生儿体重、Ponder指数(PI=体重×100/身长3)的关系.结果妊娠期高血压疾病患者血清瘦素水平明显高于正常妊娠组,瘦素、胰岛素水平呈明显正相关.其中妊娠期高血压组、轻度子痫前期组、重度子痫前期组的新生儿体重、Ponder指数均与脐血瘦素正相关,与母血瘦素无关;而该相关性在子痫组则未发现.结论母血瘦素、胰岛素共同参与妊娠高血压疾病的发病且随病情的加重有逐渐升高的趋势.脐血中瘦素含量可能对新生儿生长发育有重要调节作用,可作为一项预测新生儿体重的指标.     

Hormonal and nutritional enhancement of Na-K-ATPase activity may aid the prevention and treatment of essential hypertension

Subnormal activity of the Na⁺-K⁺-ATPase appears to be a common feature of essential hypertension, and may in fact play a pathogenic role in this disorder. If so, methods which relieve inhibition or enhance the activity of the sodium pump should have therapeutic or preventive value. Diuretics enhance the activity of the sodium pump in hypertensives, apparently by suppressing secretion of an inhibitory natriuretic factor, and it is likely that low-sodium diets have a similar effect. Activity of the Na⁺-K⁺-ATPase is also stimulated by thyroid hormone and insulin, and there are indications that thyroid therapy, as well as various measures which increase tissue insulin sensitivity, may have therapeutic value in essential hypertension. Nutritional measures which may enhance sodium pump activity include potassium supplementation, insurance of adequate magnesium intake, and consumption of rich sources of gammalinolenic acid.     

Modulatory effects of vitamin E,acetyl-l-carnitine and α-lipoic acid on new potential biomarkers for Alzheimer's disease in rat model

Alzheimer's disease (AD) is the most common chronic neurodegenerative disorder associated with aging. This study aimed to explore new markers for AD as total homocysteine (tHcy), insulin, insulin like growth factor-1 (IGF-1), interlukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α); to determine the modulatory effects of vitamin E (VE), acetyl-l-carnitine (ALC) and α-lipoic acid (LA) on the investigated parameters and to evaluate the possible therapeutic role of these nutraceutical in AD-induced in rats. Our results revealed that brain acetylcholine esterase (AChE) activity and tHcy levels were significantly increased in AD model. Folic acid, vitamin B₁₂ levels and Na⁺/K⁺ ATPase activity were markedly reduced. Plasma insulin and IGF-1 levels were noticeably decreased but plasma TNF-α and IL-1β concentrations were significantly increased, confirming that abnormal inflammatory response is associated with AD. Treatment by VE, ALC and LA restored the above mentioned parameters to about normal levels comparable to those of donepezil, indicating that tHcy, insulin, IGF-1, IL-1β and TNF-α may be considered as new biomarkers for AD. The study points to the potential restoring effects of VE, ALC and LA in AD model. Our study provides evidence for the importance of dietary supplementation in delaying the progression of age-related neurodegenerative diseases.     

高血压病患者不同左室构型与胰岛素抵抗的相关性

目的探讨高血压患者胰岛素抵抗对左室构型的影响。方法对高血压组164例进行常规心脏超声、空腹葡萄糖（FBG）、空腹胰岛素（FIN）、血脂检查。采用胰岛素敏感指数（HOMA-IR）作为评价胰岛素抵抗指标,按Gnanu分类法将高血压组划分为正常构型、向心性重构组、向心性肥厚组和离心性肥厚组。采用组间比较、相关性分析等统计学方法进行评价。结果高血压患者按左室重量指数（LVMI）分组,两组间空腹胰岛素及胰岛素抵抗差异无统计学意义（P〉0.05）;但按相对室壁厚度（RWT）分组,空腹胰岛素及胰岛素抵抗差异具有统计学意义（P〈0.05）。并且向心性重构组和向心性肥厚组明显高于正常构型组（P〈0.05）,而离心性肥厚组与正常构型组比较差异无统计学意义（P〉0.05）。逐步回归分析显示LVMI与体重指数、收缩压和舒张压呈正相关（P〈0.05～P〈0.01）,RWT与HOMA-IR呈负相关（P〈0.05）。结论胰岛素抵抗可能是高血压患者合并左室肥厚的重要影响因素之一,改善胰岛素抵抗有利于高血压患者左室肥厚的防治。     

980例原发性高血压患者血清胰岛素与年龄、性别间的关系探讨

目的 :探讨原发性高血压 (EH)患者血清胰岛素 (Ins)改变 ,及其与年龄、性别间的关系。方法 :放射免疫法分析了 980例EH患者和 12 0例正常对照组的血清Ins水平 ,并进行分组对照分析。结果 :EH组血清Ins水平显著高于对照组 (t=4 2 80 ,P <0 0 1) ,总体男女两性组间无显著差异 (P >0 0 5 ) ,同时各年龄段 (从2 0岁起 ,每 10年分成 1个年龄段 ,至 70岁以上段 )男女两性组间也无显著性差异 (P >0 0 5 )。在女性组中 ,绝经前后组间血清Ins也无显著差异 (P >0 0 5 )。Ⅰ、Ⅱ、Ⅲ期组间方差检验无显著差异 (P >0 0 5 )。结论 :EH患者平均空腹Ins水平显著高于对照组 ,且与平均动脉压 (MAP)呈正相关 ,但在男女两性组间却无显著差异 ,血清Ins可能是独立于性别、年龄之外的一个高血压危险因子。     

原发性高血压患者红细胞胰岛素受体与胰岛素测定的临床意义

本文对67例原发性高血压患者,采用Gambhir改良法测定红细胞胰岛素受体含量,用放射免疫分析法测定空腹血清胰岛素浓度的变化。我们发现,原发性高血压患者红细胞胰岛素受体数目较对照组显著减少(p<0.01);而空腹血清胰岛素浓度明显升高(p<0.01)。结果表明,原发性高血压存在的胰岛素抵抗,其发病的主要环节是红细胞胰岛素受体数目的减少;胰岛素浓度升高是胰岛素抵抗的代偿反应,常与胰岛素抵抗共存。     

Stability and cell uptake of calcium carbonate templated insulin microparticles

Therapeutic proteins are an integral part of today’s pharmaceutical practice, but they still present challenges from the drug delivery point of view. In this work, a new approach is studied based on hard templating for fabrication of microparticles composed of pure insulin, which may enable effective delivery, for instance pulmonary delivery. The approach is both simple and versatile: the protein particles are prepared by selective precipitation into porous CaCO₃ microtemplates, followed by full decomposition of the template at the isoelectric point of the protein (pH 5.2). Control over the main material parameters (mechanical properties, porosity, morphology and stability at physiological conditions) are critical for the envisioned application in drug delivery. It is demonstrated that these critical parameters can be significantly tuned by a slight final pH variation around the isoelectric point (pH range 4–6) and by the denaturation degree of insulin. Electrostatic interactions and inter-protein crosslinking in the protein particles as well as their internal structure are considered, to explain the variation in the particle properties. The particle property parameters are explored using atomic force microscopy, optical microscopy and circular dichroism spectra. Finally, phagocytic clearance of the protein particles in vitro was studied to explore possible enhancements in particle fabrication to improve the efficiency of insulin delivery by inhalation.     

测定血清INS、C-P对原发性高血压患者的临床意义

为探讨测定血清胰岛素（INS）,C－肽（C－P）对原发性高血压（EH）患者的应用价值,对32例EH患者的空腹和餐后2小时血糖（BG）、INS、C－P等指标进行测定,计算胰岛素敏感指数（ISI）,并与40名对照组进行比较,结果发现,EH组与对照组空腹血糖无明显差异,而空腹INS及餐后2小时BG、INS、C－P均明显高于对照组（P＜0．01）;胰岛素抵抗、高胰岛素血症比例均明显高于对照组（P＜0．01）。提示EH除血管和血液动力学异常外,尚存在多种物质代谢异常,同时血清INS、C－P的RIA测定在糖尿病以外疾病中的应用前景也很广扩。．