脑梗死患者外周血CD34+细胞水平和预后价值

Objective To detect the alteration of circulating CD34 + cell level in patients with the In'st-ever nonlacunar stroke and to investigate the prognostic value of CD34 +cell level. Methods 1he level of the circulating CD34+ cells were examined using flow eytometry in 119 patients with nonlacunar infarction. 1he patients were divided into group A (higher than average) and group B (lower than average) according to the detected values, The National Institutes of Health Stroke Scale (NIHSS) scores on admission and the modified Rankin Scale (mRS) scores at 3 months after the onset in the two groups wre compared. Results The level of CD34 + cells in group A was significantly higher than that in group B (0. 048 ± 0. 001 versus 0. 032 ± 0. 002, P < 0. 05 ), however, there was no significantly difference in NIHSS sores between the two groups. One week after admission, the increased level of CD34 + cells in group A was significantly higher than that in group B (0. 001 ±0. 003 versus - 0. 005 ± 0. 000, P < 0. 05 ). Three months after the onset of symptoms, the average mRS score in group A was significantly superior to that in group B (2. 98 ± 1.14 versus 3.25 ± 1.39, P <0. 05). 1he level of circulating CD34 + cells at the initial onset of symptom was negatively correlated with the mRS score at 3 months after stroke (r = -0. 48, P <0. 05). Conclusions The higher level of circulating CD34+ cells had better prognosis in patients with cerebral infarction. The level of circulating CD34+ ceils may be used as a prognostic indicator in patients with cerebral infarction.     

脑梗死患者外周血CD34+细胞水平和预后价值

Objective To detect the alteration of circulating CD34 + cell level in patients with the In'st-ever nonlacunar stroke and to investigate the prognostic value of CD34 +cell level. Methods 1he level of the circulating CD34+ cells were examined using flow eytometry in 119 patients with nonlacunar infarction. 1he patients were divided into group A (higher than average) and group B (lower than average) according to the detected values, The National Institutes of Health Stroke Scale (NIHSS) scores on admission and the modified Rankin Scale (mRS) scores at 3 months after the onset in the two groups wre compared. Results The level of CD34 + cells in group A was significantly higher than that in group B (0. 048 ± 0. 001 versus 0. 032 ± 0. 002, P < 0. 05 ), however, there was no significantly difference in NIHSS sores between the two groups. One week after admission, the increased level of CD34 + cells in group A was significantly higher than that in group B (0. 001 ±0. 003 versus - 0. 005 ± 0. 000, P < 0. 05 ). Three months after the onset of symptoms, the average mRS score in group A was significantly superior to that in group B (2. 98 ± 1.14 versus 3.25 ± 1.39, P <0. 05). 1he level of circulating CD34 + cells at the initial onset of symptom was negatively correlated with the mRS score at 3 months after stroke (r = -0. 48, P <0. 05). Conclusions The higher level of circulating CD34+ cells had better prognosis in patients with cerebral infarction. The level of circulating CD34+ ceils may be used as a prognostic indicator in patients with cerebral infarction.     

脑梗死患者外周血CD34+细胞水平和预后价值

Objective To detect the alteration of circulating CD34 + cell level in patients with the In'st-ever nonlacunar stroke and to investigate the prognostic value of CD34 +cell level. Methods 1he level of the circulating CD34+ cells were examined using flow eytometry in 119 patients with nonlacunar infarction. 1he patients were divided into group A (higher than average) and group B (lower than average) according to the detected values, The National Institutes of Health Stroke Scale (NIHSS) scores on admission and the modified Rankin Scale (mRS) scores at 3 months after the onset in the two groups wre compared. Results The level of CD34 + cells in group A was significantly higher than that in group B (0. 048 ± 0. 001 versus 0. 032 ± 0. 002, P < 0. 05 ), however, there was no significantly difference in NIHSS sores between the two groups. One week after admission, the increased level of CD34 + cells in group A was significantly higher than that in group B (0. 001 ±0. 003 versus - 0. 005 ± 0. 000, P < 0. 05 ). Three months after the onset of symptoms, the average mRS score in group A was significantly superior to that in group B (2. 98 ± 1.14 versus 3.25 ± 1.39, P <0. 05). 1he level of circulating CD34 + cells at the initial onset of symptom was negatively correlated with the mRS score at 3 months after stroke (r = -0. 48, P <0. 05). Conclusions The higher level of circulating CD34+ cells had better prognosis in patients with cerebral infarction. The level of circulating CD34+ ceils may be used as a prognostic indicator in patients with cerebral infarction.     

脑梗死患者外周血CD34+细胞水平和预后价值

Objective To detect the alteration of circulating CD34 + cell level in patients with the In'st-ever nonlacunar stroke and to investigate the prognostic value of CD34 +cell level. Methods 1he level of the circulating CD34+ cells were examined using flow eytometry in 119 patients with nonlacunar infarction. 1he patients were divided into group A (higher than average) and group B (lower than average) according to the detected values, The National Institutes of Health Stroke Scale (NIHSS) scores on admission and the modified Rankin Scale (mRS) scores at 3 months after the onset in the two groups wre compared. Results The level of CD34 + cells in group A was significantly higher than that in group B (0. 048 ± 0. 001 versus 0. 032 ± 0. 002, P < 0. 05 ), however, there was no significantly difference in NIHSS sores between the two groups. One week after admission, the increased level of CD34 + cells in group A was significantly higher than that in group B (0. 001 ±0. 003 versus - 0. 005 ± 0. 000, P < 0. 05 ). Three months after the onset of symptoms, the average mRS score in group A was significantly superior to that in group B (2. 98 ± 1.14 versus 3.25 ± 1.39, P <0. 05). 1he level of circulating CD34 + cells at the initial onset of symptom was negatively correlated with the mRS score at 3 months after stroke (r = -0. 48, P <0. 05). Conclusions The higher level of circulating CD34+ cells had better prognosis in patients with cerebral infarction. The level of circulating CD34+ ceils may be used as a prognostic indicator in patients with cerebral infarction.     

脑梗死患者外周血CD34+细胞水平和预后价值

Objective To detect the alteration of circulating CD34 + cell level in patients with the In'st-ever nonlacunar stroke and to investigate the prognostic value of CD34 +cell level. Methods 1he level of the circulating CD34+ cells were examined using flow eytometry in 119 patients with nonlacunar infarction. 1he patients were divided into group A (higher than average) and group B (lower than average) according to the detected values, The National Institutes of Health Stroke Scale (NIHSS) scores on admission and the modified Rankin Scale (mRS) scores at 3 months after the onset in the two groups wre compared. Results The level of CD34 + cells in group A was significantly higher than that in group B (0. 048 ± 0. 001 versus 0. 032 ± 0. 002, P < 0. 05 ), however, there was no significantly difference in NIHSS sores between the two groups. One week after admission, the increased level of CD34 + cells in group A was significantly higher than that in group B (0. 001 ±0. 003 versus - 0. 005 ± 0. 000, P < 0. 05 ). Three months after the onset of symptoms, the average mRS score in group A was significantly superior to that in group B (2. 98 ± 1.14 versus 3.25 ± 1.39, P <0. 05). 1he level of circulating CD34 + cells at the initial onset of symptom was negatively correlated with the mRS score at 3 months after stroke (r = -0. 48, P <0. 05). Conclusions The higher level of circulating CD34+ cells had better prognosis in patients with cerebral infarction. The level of circulating CD34+ ceils may be used as a prognostic indicator in patients with cerebral infarction.     

脑梗死患者外周血CD34+细胞水平和预后价值

Objective To detect the alteration of circulating CD34 + cell level in patients with the In'st-ever nonlacunar stroke and to investigate the prognostic value of CD34 +cell level. Methods 1he level of the circulating CD34+ cells were examined using flow eytometry in 119 patients with nonlacunar infarction. 1he patients were divided into group A (higher than average) and group B (lower than average) according to the detected values, The National Institutes of Health Stroke Scale (NIHSS) scores on admission and the modified Rankin Scale (mRS) scores at 3 months after the onset in the two groups wre compared. Results The level of CD34 + cells in group A was significantly higher than that in group B (0. 048 ± 0. 001 versus 0. 032 ± 0. 002, P < 0. 05 ), however, there was no significantly difference in NIHSS sores between the two groups. One week after admission, the increased level of CD34 + cells in group A was significantly higher than that in group B (0. 001 ±0. 003 versus - 0. 005 ± 0. 000, P < 0. 05 ). Three months after the onset of symptoms, the average mRS score in group A was significantly superior to that in group B (2. 98 ± 1.14 versus 3.25 ± 1.39, P <0. 05). 1he level of circulating CD34 + cells at the initial onset of symptom was negatively correlated with the mRS score at 3 months after stroke (r = -0. 48, P <0. 05). Conclusions The higher level of circulating CD34+ cells had better prognosis in patients with cerebral infarction. The level of circulating CD34+ ceils may be used as a prognostic indicator in patients with cerebral infarction.     

脑梗死患者外周血CD34+细胞水平和预后价值

Objective To detect the alteration of circulating CD34 + cell level in patients with the In'st-ever nonlacunar stroke and to investigate the prognostic value of CD34 +cell level. Methods 1he level of the circulating CD34+ cells were examined using flow eytometry in 119 patients with nonlacunar infarction. 1he patients were divided into group A (higher than average) and group B (lower than average) according to the detected values, The National Institutes of Health Stroke Scale (NIHSS) scores on admission and the modified Rankin Scale (mRS) scores at 3 months after the onset in the two groups wre compared. Results The level of CD34 + cells in group A was significantly higher than that in group B (0. 048 ± 0. 001 versus 0. 032 ± 0. 002, P < 0. 05 ), however, there was no significantly difference in NIHSS sores between the two groups. One week after admission, the increased level of CD34 + cells in group A was significantly higher than that in group B (0. 001 ±0. 003 versus - 0. 005 ± 0. 000, P < 0. 05 ). Three months after the onset of symptoms, the average mRS score in group A was significantly superior to that in group B (2. 98 ± 1.14 versus 3.25 ± 1.39, P <0. 05). 1he level of circulating CD34 + cells at the initial onset of symptom was negatively correlated with the mRS score at 3 months after stroke (r = -0. 48, P <0. 05). Conclusions The higher level of circulating CD34+ cells had better prognosis in patients with cerebral infarction. The level of circulating CD34+ ceils may be used as a prognostic indicator in patients with cerebral infarction.     

脑梗死患者外周血CD34+细胞水平和预后价值

Objective To detect the alteration of circulating CD34 + cell level in patients with the In'st-ever nonlacunar stroke and to investigate the prognostic value of CD34 +cell level. Methods 1he level of the circulating CD34+ cells were examined using flow eytometry in 119 patients with nonlacunar infarction. 1he patients were divided into group A (higher than average) and group B (lower than average) according to the detected values, The National Institutes of Health Stroke Scale (NIHSS) scores on admission and the modified Rankin Scale (mRS) scores at 3 months after the onset in the two groups wre compared. Results The level of CD34 + cells in group A was significantly higher than that in group B (0. 048 ± 0. 001 versus 0. 032 ± 0. 002, P < 0. 05 ), however, there was no significantly difference in NIHSS sores between the two groups. One week after admission, the increased level of CD34 + cells in group A was significantly higher than that in group B (0. 001 ±0. 003 versus - 0. 005 ± 0. 000, P < 0. 05 ). Three months after the onset of symptoms, the average mRS score in group A was significantly superior to that in group B (2. 98 ± 1.14 versus 3.25 ± 1.39, P <0. 05). 1he level of circulating CD34 + cells at the initial onset of symptom was negatively correlated with the mRS score at 3 months after stroke (r = -0. 48, P <0. 05). Conclusions The higher level of circulating CD34+ cells had better prognosis in patients with cerebral infarction. The level of circulating CD34+ ceils may be used as a prognostic indicator in patients with cerebral infarction.     

脑梗死患者外周血CD34+细胞水平和预后价值

Objective To detect the alteration of circulating CD34 + cell level in patients with the In'st-ever nonlacunar stroke and to investigate the prognostic value of CD34 +cell level. Methods 1he level of the circulating CD34+ cells were examined using flow eytometry in 119 patients with nonlacunar infarction. 1he patients were divided into group A (higher than average) and group B (lower than average) according to the detected values, The National Institutes of Health Stroke Scale (NIHSS) scores on admission and the modified Rankin Scale (mRS) scores at 3 months after the onset in the two groups wre compared. Results The level of CD34 + cells in group A was significantly higher than that in group B (0. 048 ± 0. 001 versus 0. 032 ± 0. 002, P < 0. 05 ), however, there was no significantly difference in NIHSS sores between the two groups. One week after admission, the increased level of CD34 + cells in group A was significantly higher than that in group B (0. 001 ±0. 003 versus - 0. 005 ± 0. 000, P < 0. 05 ). Three months after the onset of symptoms, the average mRS score in group A was significantly superior to that in group B (2. 98 ± 1.14 versus 3.25 ± 1.39, P <0. 05). 1he level of circulating CD34 + cells at the initial onset of symptom was negatively correlated with the mRS score at 3 months after stroke (r = -0. 48, P <0. 05). Conclusions The higher level of circulating CD34+ cells had better prognosis in patients with cerebral infarction. The level of circulating CD34+ ceils may be used as a prognostic indicator in patients with cerebral infarction.     

脑梗死患者外周血CD34+细胞水平与脑血管病危险因素的相关性

目的 观察急性脑梗死患者外周血CD34+细胞水平的变化,探讨其与脑血管病危险因素、神经功能缺损评分及颈动脉内膜-中层厚度(IMT)的相关性.方法 选择急性期脑梗死(发病72 h内)患者45例(梗死组)和具有脑血管危险因素的非脑梗死患者27例(高危组)为研究对象.记录两组患者脑血管病危险因素,包括酗酒史、吸烟史、冠心病、高血压、糖尿病、血清三酰甘油、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平;通过流式细胞仪测定两组患者外周血CD34+细胞水平,再将两组外周血CD34+细胞水平与脑血管病危险因素进行相关性分析;分别记录梗死组神经功能缺损评分及颈动脉IMT,将外周血CD34+细胞水平与神经功能缺损评分及颈动脉IMT进行相关性分析.结果 (1)脑血管病危险因素中冠心病、高血压、糖尿病和LDL-C水平均与外周血CD34+细胞水平呈显著负相关(r分别为-0.749,-0.717,-0.688,-0.764),差异均有统计学意义(P＜0.01);(2)通过多元线性回归分析得出外周血CD34+细胞水平可以作为急性脑梗死的独立影响因素(P＜0.05);(3)梗死组患者外周血CD34+细胞水平低于高危组,其与神经功能缺损评分呈负相关(r=-0.721,P＜0.01),与颈动脉IMT亦呈负相关(r=-0.695,P＜0.01).结论 外周血CD34+细胞水平可以作为急性脑梗死的独立影响因素;急性脑梗死患者外周血CD34+细胞水平与神经功能缺损评分及颈动脉IMT呈显著负相关;外周血CD34+细胞水平可以作为缺血性脑卒中患者早期血管内皮功能的细胞学标志物.

Abstract：

Objective To observe the change of peripheral blood CD34+ cell level in patients with acute cerebral infarction, and explore its relationships with cerebrovascular risk factors,neurological function and carotid artery intima-media thickness (IMT). Methods The 45 patients with acute cerebral infarction (onset within 72 h) (infarction group) and 27 patients with cerebr ovascular risk factors but without cerebral infarction (high-risk group) were chosen for the study. The cerebrovascular disease risk factors including history of alcohol abuse, smoking, coronary heart disease, hypertension, diabetes, abnormal levels of serum triglycerides, total cholesterol,low-density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C) were recorded in all subjects. The peripheral blood CD34+ cell levels were measured by flow cytometry.The correlations of peripheral blood CD34+ cell level with cerebrovascular disease risk factors were analyzed. The neurological function and carotid artery IMT were recorded in infarction group, and the correlations of peripheral blood CD34+ cell level with neurological function and carotid artery IMT were analyzed. Results (1) The peripheral blood CD34+ cell level was significantly negatively correlated with coronary heart disease, hypertension, diabetes and LDL-C level (r =- 0. 749,-0. 717, - 0. 688, - 0. 764, all P＜0. 01) ; (2) Multiple linear regression analysis showed that peripheral blood CD34+ cell level was an independent relative factor of acute cerebral infarction (P＜0.05); (3) The peripheral blood CD34+ cell level was lower in infarction group than in high-risk group, and was significantly negatively correlated with neurological deficit score (r=-0. 721, P＜0.01) and carotid artery IMT (r= -0. 695, P＜0. 01). Conclusions Peripheral blood CD34+ cell level could be an independent relative factor of acute cerebral infarction; The peripheral blood CD34+ cell level is significantly negatively correlated with neurological function and carotid artery IMT in patients with acute cerebral infarction; And it can be used as cytological marker which reflect early vascular endothelial function in patients with ischemic stroke.     

老年人慢性左心力衰竭严重程度与循环内皮细胞微颗粒CD31~+水平变化的关系

目的探讨外周血循环内皮细胞微颗粒CD31~+水平变化与老年人慢性左心力衰竭严重程度的相关性。方法根据纽约心功能分级(NYHA)和左心室射血分数(LVEF)将老年慢性左心力衰竭患者分成Ⅰ级、Ⅱ级、Ⅲ级和Ⅳ级组,并纳入同期健康老年人30名作为对照组。采用流式细胞仪检测健康对照者和老年慢性左心力衰竭患者CD31~+的表达。结果随着NYHA的升高和LVEF的下降,CD31~+的水平明显上升(P<0.01)[对照组(348±42)个/μl;Ⅰ级组(478±40)个/μl;Ⅱ级组(659±42)个/μl;Ⅲ级组(846±43)个/μl;Ⅳ级组(1596±46)个/μl,均为P<0.01]。结论 CD31~+表达显著上调可能参与了老年人慢性左心力衰竭发生发展。     

磷酸肌酸钠改善老年慢性心力衰竭患者左心功能的观察

目的 观察磷酸肌酸钠对老年慢性心功能不全患者的左心功能的治疗效果.方法 我科收治的172例老年慢性心功能不全患者,抽签随机分为治疗组和对照组各86例,对照组给予常规抗心力衰竭治疗,治疗组在常规治疗基础上加用磷酸肌酸钠,治疗4周.评价两组患者心功能改善情况及对浆氨基末端-脑钠肽前体(NT-proBNP)的影响.结果治疗组左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)改善程度优于对照组,差异有统计学意义(均P＜0.05);血浆NT-proBNP下降水平高于对照组,分别为治疗前(956.4±644.2)pmol/L和(973.6±639.8)pmol/L,治疗后(414.5±163.8)pmol/L和(719.3±477.5)pmol/L,差异有统计学意义(均P＜0.05).结论 磷酸肌酸钠能改善老年慢性心功能不全患者的心功能,降低血浆NT-proBNP水平.

Abstract：

Objective To observe the clinical effects of phosphocreatine treatment on left ventricular function and on amino-terminal pro-brain natriuretic peptide (NT-proBNP) level in elderly patients with chronic heart failure. Methods In our department, the 172 elderly patients with chronic heart failure were randomly divided into treatment group and control group (n= 86, each).The control group received routine anti-heart failure treatment. The treatment group received conventional therapy plus creatine phosphate sodium for 4 weeks. The cardiac function was evaluated and the NT-proBNP level was measured in all subjects. Results Four weeks after treatment, the improvements of left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic dimension (LVEDD) were better in treatment group than in control group (all P＜0.05). The plasma NT-proBNP level decreased significantly in treatment group as compared with control group [before treatment: (956.4 ± 644.2) pmol/L and (973.6 ±639.8) pmol/L; after treatment: (414. 5 ± 163.8 ) pmol/L and ( 719.3 ± 477. 5 ) pmol/L, all P＜0. 05]. Conclusions Phosphocreatine could improve left ventricular function and decrease plasma NT-proBNP level in elderly patients with chronic heart failure.     

CD34与CD117在人肝癌组织中的表达及其临床意义

目的 研究肝细胞肝癌组织中CD34与CD117的表达情况,探讨其与临床病理的关系及其对肝细胞肝癌(HCC)患者预后的评价.方法 应用免疫组织化学PV-9000二步法检测55例HCC组织标本中CD34和CD117的表达,并与临床病理学指标和术后无瘤生存期进行比较分析,对照组为肝硬化组织10例,正常肝组织6例.采用SPSS16.0统计分析软件对CD34和CD117表达结果及与临床病理参数的关系进行Fisher精确检验,Pearson χ2检验,Kaplan-Meier生存分析,Log-Rank检验,Cox回归模型分析等检验.结果 CD34在HCC组、肝硬化组和正常肝组织组表达阳性率分别为65.4%、20.0%和16.7%,HCC组织中的阳性率大于肝硬化组织(P=0.012)及正常肝组织组(P=0.031),差异有统计学意义.但正常肝组织组与肝硬化组比较,差异无统计学意义.CD34表达在HCC组中与脉管瘤栓、中瘤分化程度有密切相关性,χ2值分别为4.000和11.008,P值分别为0.046和0.001.CD117在HCC组、肝硬化组和正常肝组织组表达阳性率分别为47.3%、10%和0,HCC组阳性率大于肝硬化组(P=0.037)及正常肝组织(P=0.033),差异无统计学意义.但正常肝组织与肝硬化组比较,差异无统计学意义.CD117表达在HCC组中与肿瘤分化程度、肿瘤分期有相关性,χ2值分别为5.115和15.459,P值分别为0.024和0.000.HCC组CD34阳性组及CD34阴性组的中位无瘤生存时间分别为17个月和19个月,CD34阳性组较CD34阴性组无瘤生存时间缩短,χ2=4.105,P=0.043,差异有统计学意义.CD117阳性组及CD117阴性组的中位无瘤生存时间分别为12个月和19个月,CD117阳性组的无瘤生存时间较CD117阴性组也明显缩短,χ2=28.023,P=0.000,差异有统计学意义.COX多因素分析显示CD117表达、血清甲胎蛋白水平及肿瘤大小是HCC患者术后2年无瘤生存时间的独立预后因素.结论 CD34与CD117可能在HCC发生、发展过程中具有重要作用,有望成为判断预后的指标.     

抗心肌纤维化治疗家兔慢性心力衰竭的实验研究

目的 探讨姜黄素的抗心肌纤维化作用对家兔慢性心力衰竭(心衰)的影响.方法 30只新西兰大耳白兔随机分为对照组、心衰组、姜黄素组,每组10只.心衰组和姜黄素组采用主动脉瓣反流及主动脉缩窄法制作心衰模型,对照组做假手术但不造成主动脉瓣反流和主动脉缩窄.姜黄素组口服姜黄素(100 nag·kg-1·d-1),对照组和心衰组口服安慰剂.主动脉瓣反流术及其假手术前,主动脉缩窄术及其假手术后8周,所有动物做2次心脏超声检查.第2次超声检查后,取出心脏行基质金属蛋白酶(MMP)-2和MMP-9的免疫组织化学染色和Masson染色,观察MMP表达的改变和心肌纤维化情况.结果 前后2次超声结果 比较,心衰组左室射血分数和左室内径缩短分数显著下降,左室内径、左室后壁和室间隔厚度显著增大;姜黄素组上述指标也有显著改变,但程度较心衰组轻;对照组上述指标无显著改变.Masson染色显示,心衰组胶原含量高于姜黄素组和对照组(P<0.05);免疫组织化学染色显示,心衰组MMP-2和MMP-9的表达低于姜黄素组和对照组(P<0.05).结论 姜黄素通过提高MMP的表达可减轻心衰时的心肌纤维化,该作用可能是其改善心衰时心肌重构和心脏收缩功能的重要机制之一.抗纤维化治疗有可能成为心衰治疗的新方法 .     

慢性心力衰竭的左心室舒张功能检测

目的探讨舒张性心力衰竭(心衰)与收缩性心衰的超声特点。方法选择舒张性心衰患者40例为舒张性心衰组,并选择基本情况与之匹配的收缩性心衰患者40例为收缩性心衰组。应用多普勒技术进行舒张功能的检测,进而评价2组在心房、心室容积,二尖瓣口血流舒张早期流速(E)与二尖瓣口血流舒张晚期流速(A)及其比值(E/A)和E峰减速时间,二尖瓣环舒张早期峰值速度(e)和二尖瓣环舒张晚期峰值速度(a)及其比值(e/a),左心房反流入肺静脉血流速度,P波终末电势等方面的差异。结果舒张性心衰组与收缩性心衰组比较,E/A、e/a倒置。舒张性心衰组E峰减速时间延长,左心房反流入肺静脉血流速度增宽。舒张性心衰组左心房增大,左心室舒张末径正常。P波终末电势负值增大。结论肺静脉血流频谱和二尖瓣环组织多普勒可作为二尖瓣血流频谱重要补充。     

老年原发性非小细胞肺癌患者外周血T细胞膜型和可溶性CD28的表达

目的 检测老年原发性非小细胞肺癌(NSCLC)患者外周血T细胞膜型CD28(mCD28)及血清中可溶性CD28(sCD28)的表达,探讨该分子增龄性改变与老年人肺癌发生发展之间的联系.方法 应用四色免疫荧光标记流式细胞术和酶联免疫吸附法对63例老年人NSCLC(老年肺癌组)外周血的mCD28和sCD28进行检测,将其结果 与老年肺良性病变组(老年非癌组35例)、老年健康组30例、青年健康组30例、青年肺良性病变组(青年非癌组20例)及青年肺癌组(20例)进行对比分析,并研究其与老年人肺癌临床病理特征之间的关系. 结果 老年肺癌组外周血mCD28的表达量[(19.27±6.93)%]显著低于其余各组(F=184.25,P<0.01).其血清sCD28含量[(72.00±6.85)μg/L]则显著高于其余各组(F=365.40,P<0.01);老年健康组外周血mCD28的表达量((46.09±7.34)%]明显低于青年健康组和青年非癌组,其血清sCD28的含量[(35.84±5.02)μg/L]则明显高于青年健康组和青年非癌组;老年非癌组[(42.84±5.82)%、(39.38±6.02)μg/L]与老年健康组比较,两者表达差异均无统计学意义;Logistic回归分析显示,增龄、mCD28表达下调、sCD28含量增加均与肺癌的发生有统计学关联(OR值分别为2.432、0.876,1.113);老年肺癌组Ⅲ～Ⅳ期mCD28和sCD28的表达[(16.51±5.64)%、(75.03±5.98)μg/L]与Ⅰ～Ⅱ期表达[(24.41±8.24)%、(66.73±7.52)μg/L]比较,差异均有统计学意义(t值分别为4.497、4.794,均为P<0.01),而不同病理类型之间比较,差异均无统计学意义(F值分别0.609、0.302,均为P0.05). 结论 呈增龄性下调的mCD28和增龄性上调的sCD28,在老年人原发性肺癌的形成和进展过程中可能起重要作用.     

左室Tei指数对老年人充血性心力衰竭的诊断价值

目的探讨多普勒超声测定左室Tei指数,评价其对老年人充血性心力衰竭的诊断价值。方法选择138例心力衰竭(心衰)或疑似心衰的老年患者,30例中年健康体检者,以超声检测其左心室Tei指数、左室射血分数(LVEF)、心室舒张早期与舒张晚期二尖瓣血流峰值流速的比值(E/A)等指标。比较老年心衰患者、老年非心衰者和中年体检者Tei指数的差异,评价上述指标对老年人心衰的诊断价值。结果老年心衰患者Tei指数较非心衰老年患者(0.77±0.14与0.45±0.10,P<0.01)和中年体检者(0.77±0.14与0.40±0.11,P<0.01)均明显延长,Tei指数对老年人心衰的综合诊断价值优于LVEF和E/A比值,其灵敏度、特异度和准确度分别为86.6%、85.4%和84.6%。结论Tei指数可作为判断老年患者心功能的指标。     

老年心力衰竭患者核因子-κB活化与细胞凋亡抑制因子的相关性研究

目的 探讨充血性心力衰竭（CHF）患者外周血单个核细胞（PBMCs）中核因子-κB（NF-κB）表达与细胞凋亡抑制因子（CD95）分泌的相关性。方法 采用凝胶电泳迁移率变动分析法（EMSA）测定60例心力衰竭患者和20例健康对照组PBMCs NF-κB的表达，用双抗体夹心ABC—ELISA法测定CD95，多普勒超声心动图测定患者的心功能。结果 心力衰竭患者PBMCs NF-κB活性和血清CD95含量显著高于健康对照组（P〈0．01），且NF-κB和血清CD95含量呈正相关（P〈0．05）。结论 CHF患者NF-κB表达增高，CD95分泌增多。在CHF，可能通过NF-κB表达的上调促进CD95的分泌。     

老年慢性心力衰竭住院患者药物治疗情况分析

目的 了解老年心衰患者药物干预的实际情况,为临床规范化治疗提供资料和依据.方法 入选天津医科大学第二医院1973年7月至2007年7月、天津市第一中心医院1983年1月至2002年12月年龄60～98岁的心力衰竭住院患者,回顾性调查年龄、性别、病因、心功能、药用等,根据年代分为1973～1979、1980～1989、1990～1999、2000～2007年共4组,建立数据库并应用SPSS13.0软件分析.结果 入选4704例次,占同期成人心力衰竭患者(6602例次)的71.3%,男2430例次(51.7%),女2274例次(48.3%),平均年龄(71.3±7.1)岁,80～98岁的患者占12.8%(4704/6602).1973～1979、1980～1989年组前3位病因分别为肺心病、冠心病和风湿性心脏病(风心病),1990～1999、2000～2007年组的前3位病因则分别为冠心病、肺心病和风心病.心力衰竭治疗药物在4组的应用差异有统计学意义(均P<0.05),血管紧张素转换酶抑制(ACEI)+β受体阻滞剂2种药物合用、ACEI+β受体阻滞剂+醛固酮拮抗剂3药物合用也呈逐年代增加.各种药物及联合应用最多的病因分别为冠心病、风心病、肺心病及扩张型心肌病.随心功能级别的增加,利尿剂、洋地黄制剂、醛固酮拮抗剂、ACEI+β受体阻滞剂+醛固酮拮抗剂3药合用、利尿剂+洋地黄制剂+ACEI+β受体阻滞剂4药合用的应用比例增加;β受体阻滞剂以心功能美国纽约心脏病协会(NYHA)心功能分级Ⅱ级和Ⅲ级的患者应用多;ACEI在NYHA心功能分级Ⅲ级的患者应用多;血管紧张素Ⅱ受体拮抗剂(ARB)以NYHAⅢ级和Ⅳ级患者居多.结论 天津市部分医院老年心力衰竭住院患者的治疗药物以利尿剂、硝酸酯制剂和洋地黄制剂等为主;ACEI、β受体阻滞剂、ARB、醛固酮拮抗剂等药物的应用逐年代增加迅速.