冠心病患者血清胆红素与血脂水平的关系

目的　探讨血清胆红素及血脂水平与冠心病的关系。方法　回顾性分析经冠状动脉造影确诊的冠心病患者6 7例及非冠心病患者 6 7例的血清胆红素及血脂水平。结果　冠心病患者血清总胆红素、直接胆红素、间接胆红素、高密度脂蛋白胆固醇水平均低于非冠心病患者 ,总胆固醇、三酰甘油、低密度脂蛋白胆固醇水平高于非冠心病患者。相关分析表明 ,血清胆红素尤其是间接胆红素与低密度脂蛋白胆固醇呈负相关 ,与高密度脂蛋白胆固醇呈正相关。结论　低水平胆红素及高水平低密度脂蛋白胆固醇对冠心病的发生产生不利影响     

血清胆红素、血脂与冠心病的关系研究

目的 探讨血脂、血清胆红素与冠心病的关系。方法 实验组为57例冠状动脉造影阳性、确诊冠心病患者，又将其分为单支病变、二支病变及三支病变组，对照组为同期人院67例非冠心病患者，分别检测血清胆红素及血脂水平，并进行比较。结果 冠心病组血清总胆红素、直接胆红素、间接胆红素、高密度脂蛋白胆固醇均低于非冠心病组，差异有统计学意义；冠心病组总胆固醇、低密度脂蛋白胆固醇、总胆固醇／总胆红素、总胆固醇／（高密度脂蛋白胆固醇＋总胆红素）、低密度脂蛋白胆固醇／（高密度脂蛋白胆固醇＋总胆红素）均高于非冠心病组，差异有统计学意义。结论 低胆红素血症及血脂异常均与冠心病相关，两者联合检测则统计学意义更为显著。     

血清胆红素水平与女性冠心病关系的探讨

目的：探讨血清胆红素水平与女性冠心病的关系。方法：109例女性患者按冠状动脉造影结果分为冠心病组（74例）和非冠心病组（35例）。同时测定血清胆红素及各项生化指标。冠状动脉狭窄程度用冠状动脉狭窄计分表示。结果：女性冠心病组血清总胆红素、直接胆红素和间接胆红素水平均显著低于非冠心病组（P〈0．01）。相关分析显示，女性冠心病组直接胆红素与总胆固醇（TC）和甘油三酯（TG）呈显著负相关（r1=-0．398，r2=-0．405，P均〈0．01）。三种胆红素水平与冠状动脉病变积分均不呈负相关。结论：低血清胆红素水平是冠状动脉粥样硬化的危险因素。     

冠状动脉病变程度与血清尿酸、胆红素及血脂水平的相关性

目的:探讨血清尿酸、胆红素及血脂水平与冠状动脉狭窄的关系及意义。方法:对225例疑为冠心病的患者行冠脉造影并测定空腹血清尿酸,胆红素及血脂水平,采用Gensini评分系统衡量冠脉造影结果。依据冠脉造影结果,分为正常对照组(105例)和冠心病组(120例),冠心病组又分为单支病变组(43例)、双支病变组(38例)和多支病变组(39例),分析血清尿酸、胆红素及血脂水平在各组间的差异性,及与冠脉病变程度的相关性。结果:单因素方差分析显示,血清尿酸、总胆红素、间接胆红素、总胆固醇、甘油三酯、低密度脂蛋白-胆固醇及低密度脂蛋白-胆固醇/总胆红素比值在各组间的分布差异有显著性(除甘油三酯F=1.058,P0.05外余F=10.913～56.238,P0.001);多元线性回归分析显示,血清尿酸、总胆红素、直接胆红素、甘油三酯及低密度脂蛋白-胆固醇/总胆红素比值与冠状动脉狭窄程度的评分独立相关(β=0.268,-0.526,0.250,-0.039,0.316,P0.05～0.01)。结论:血清总胆红素浓度降低,尿酸、总胆固醇、甘油三酯及低密度脂蛋白-胆固醇/总胆红素比值升高是冠心病的危险因素,血清尿酸、胆红素与血脂联合检测在冠心病的诊断中具有重要意义。     

血清胆红素水平与SAP和AMI患病风险的关系

目的:研究血清胆红素水平与稳定型心绞痛(SAP)和急性心肌梗死(AMI)患病风险的关系.方法:我院的冠心病患者266例被选为冠心病组,依据疾病类型,冠心病组被分为AMI组(114例)和SAP组(152例),另选择同期健康体检者837例为健康对照组.比较各组间一般临床资料.根据血清总胆红素(TBIL)、直接胆红素(DBI...     

吸烟对血清总胆红素浓度的影响及其在致冠心病中的作用

目的：探讨吸烟对血清总胆红素浓度的影响及其在致冠心病（ Ｃ Ｈ Ｄ）中的作用。方法：对符合条件的１４８例患者作选择性冠状动脉造影检查,同时调查其吸烟史,分成吸烟组（５４例）、戒烟组（２８例）及非吸烟组（６６例）。采清晨空腹静脉血测定血清总胆红素浓度并进行比较。结果：吸烟组血清总胆红素浓度显著低于戒烟组（ Ｐ ＜ ０．０５）及非吸烟组（ Ｐ ＜ ０．０１）,而戒烟组与非吸烟组间血清总胆红素浓度无显著性差异。血清总胆红素浓度与 Ｃ Ｈ Ｄ 发病率间有明显负相关（ Ｐ ＜ ０．０１）。血清胆红素水平越低者,患 Ｃ Ｈ Ｄ 的相对危险度越高。结论：吸烟显著降低血清总胆红素浓度并可能以此作为其增加 Ｃ Ｈ Ｄ 危险性的途径之一。     

同型半胱氨酸及视黄醇结合蛋白检测在冠心病诊断中的应用

目的探讨冠心病(CHD)患者血清中同型半胱氨酸(Hcy)及视黄醇结合蛋白(RBP)的浓度,探讨其联合检测对CHD的诊疗的作用。方法在河南省中医院心病科住院怀疑为CHD并行冠状动脉造影的患者共358例,其中293例经冠脉造影确诊为CHD,65例为非CHD设为对照组。根据CHD的临床特点分为急性心肌梗死组75例、不稳定型心绞痛组123例、稳定型心绞痛组95例;检测各组患者的血清Hcy及RBP浓度,分析其在CHD不同阶段中的意义。结果急性心肌梗死组、不稳定型心绞痛组、稳定型心绞痛组与对照组的血清甘油三酯(TG)及总胆固醇(TC)水平无统计学差异(P>0.05),急性心肌梗死组血清Hcy、RBP水平高于对照组;不稳定型心绞痛组血清Hcy、RBP水平高于对照组;稳定型心绞痛组血清Hcy、RBP水平与对照组基本一个水平(P>0.05)。结论血清Hcy及RBP的水平与CHD的严重程度呈正相关。     

冠心病患者血清胆红素与低密度脂蛋白胆固醇水平的关系研究

目的探讨冠心病患者血清胆红素与低密度脂蛋白胆固醇(LDL-C)水平的关系。方法选择2013年9月—2014年9月西安交通大学医学院第一附属医院收治的冠心病患者55例作为观察组,另选择同期在西安交通大学医学院第一附属医院进行体检的健康者60例作为对照组。检测两组受检者血清总胆红素、直接胆红素、间接胆红素及LDL-C水平,并分析冠心病患者血清胆红素与LDL-C水平的关系。结果观察组患者血清总胆红素、直接胆红素及间接胆红素水平低于对照组,LDL-C水平高于对照组(P0.05)。观察组患者血清总胆红素、直接胆红素、间接胆红素水平与LDL-C水平均呈负相关(r值分别为-0.72、-0.31、-0.41,P0.05)。结论冠心病患者血清胆红素与LDL-C水平均出现异常改变,且血清LDL-C水平随胆红素水平上升而下降。     

血清非对称性二甲基精氨酸与冠心病严重程度的相关性

目的 探讨血清非对称性二甲基精氨酸（ADMA）水平与冠心病严重程度的相关性。方法 冠脉造影确诊的冠心病患者45例,依据冠心病临床类型分为急性心肌梗死组（n=22例）和心绞痛组（包括稳定型心绞痛和不稳定型心绞痛,n=23）。患者在入院后采集病史,测定心肌酶、三酰甘油（TG）、总胆固醇(TC)、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、高敏C反应蛋白（hs-CRP）和血清ADMA。同时用Syntax积分来评估冠脉狭窄程度,比较组间ADMA水平,分析ADMA水平与TG、TC、LDL-C、HDL-C、hs-CRP以及Syntax积分的相关性。结果 急性心肌梗死组血清ADMA水平(60±24) μg/L显著高于心绞痛组(31±21) μg/L,P<0.05。患者血清ADMA水平与LDL-C、hs-CRP呈正相关。患者血清ADMA水平与冠脉狭窄程度的Syntax积分呈正相关。结论 血清ADMA水平与冠心病严重程度有相关性。     

冠心病与吸烟及血清胆红素浓度的关系

近年来的研究发现 ,血清总胆红素浓度与冠心病发病的危险性呈显著负相关 ,认为低血清胆红素水平可能是冠心病的新的危险因子〔1 ,2〕,而吸烟对降低血清总胆红素浓度并参与致冠心病机制〔3〕。为探讨吸烟对血清胆红素浓度的影响及其与冠心病发病的关系 ,我们对诊断明确的冠心病与非冠心病患者的吸烟史、血清胆红素水平进行对比分析。1　对象与方法1.1　 对象　资料选自我院 1999～ 2 0 0 1年接受选择性冠状动脉造影检查的病人 ,排除肝胆系统疾病者 ,共 15 2例。按造影结果分为冠心病组 (CHD组 )、非冠心病对照组。冠心病组 78例 ,男 6 1例 …     

No long-lasting or intermittent mast cell activation in acute coronary syndromes

BACKGROUND: Unstable coronary syndromes, such as acute myocardial infarction and unstable angina pectoris are mostly due to rupture of an atherosclerotic plaque. Recently mast cells were found to participate actively in the inflammatory process of atherosclerosis by excreting proteolytic and pro-inflammatory substances with the ability to cause plaque instability and rupture. Mast cell activity can be determined by measuring serum levels of tryptase, as has been demonstrated in patients with anaphylaxis and mastcytosis. HYPOTHESIS: Acute coronary events (acute myocardial infarction and unstable angina pectoris) are associated with increased mast cell activity, reflected by elevated serum tryptase levels. METHODS: Serum levels of tryptase were determined in the following three groups of patients: 13 patients with acute myocardial infarction, 10 patients with unstable angina pectoris, and 14 patients without ischaemic cardiovascular disease who were used as controls. Patients with known IgE mediated allergic diseases and/or anti-histaminical drugs were excluded. RESULTS: The groups were comparable for sex, blood pressure, smoking and cholesterol levels. The controls tended to be younger (P=0.05). Levels of tryptase did not differ between patients with acute myocardial infarction (7.9+/-4.6 microg/l), unstable angina pectoris (6.0+/-2.1 microg/l) or controls (6.9+/-4.1 microg/l), nor could a relation with levels of C-reactive protein be demonstrated. CONCLUSION: Serum levels of tryptase are not elevated in patients with acute coronary syndromes. This implies that increased mast cell activity, if any, in unstable coronary syndromes is not reflected systemically. Other, more specific methods will be needed to determine the activity of the mast cell in vivo.     

老年冠心病患者不同临床类型血脂水平的观察

目的　探讨老年冠心病患者不同临床类型血脂水平的差异。方法　将确诊为冠心病的 70岁以上老年患者6 4 7例 ,分为急性心肌梗死 (AMI)组、稳定性心绞痛 (SAP)组、不稳定性心绞痛 (UAP)组 ,另选无冠心病的老年患者 70例作为对照组 ,比较各组间的血脂水平。结果　AMI组和UAP组血清胆固醇水平与对照组及SAP组比较 ,差异有显著性意义 ;血清甘油三酯水平随着冠心病病情程度加重 ,呈逐渐升高的趋势 ;SAP组、UAP组和AMI组低密度脂蛋白胆固醇 (LDL C)水平高于对照组 ,高密度脂蛋白胆固醇 (HDL C)水平低于对照组 ,差异有显著性意义 ;SAP组、UAP组和AMI组LDL C HDL C比值均高于对照组 ,AMI组LDL C HDL C比值高于UAP组和SAP组 ,差异有显著性意义。结论　在 70岁以上老年冠心病患者中 ,LDL C HDL C比值与AMI的发生关系密切     

Prostaglandin I2 half-life regulated by high density lipoprotein is decreased in acute myocardial infarction and unstable angina pectoris

To investigate the prostaglandin I2 (PGI2) half-life regulated by high density lipoprotein (HDL) in patients with coronary artery disease (CAD), we determined the stability of PGI2 and serum apolipoprotein A-I (Apo A-I) and apolipoprotein A-II (Apo A-II) levels in four age-matched groups of patients: controls (n = 17), angina pectoris (n = 18), unstable angina pectoris (n = 17), myocardial infarction (n = 19) (acute phase, 3.6 +/- 1.7 hours from onset; subacute phase, 75 +/- 15 hours from onset in the same patients). Serum PGI2 half-life and total serum Apo A-I levels were lower in the CAD group than in the control group. PGI2 was least stable in patients with unstable angina and the acute phase of myocardial infarction. In these patients, the molar ratio of Apo A-I to Apo A-II and HDL-associated Apo A-I levels were decreased, and free Apo A-I levels were increased. After in vitro incubation of HDL with increasing amounts of Apo A-II, Apo A-I in HDL was displaced by Apo A-II, with the parallel decrease in stability of PGI2. Free Apo A-I cannot stabilize PGI2. HDL-associated Apo A-I, whose amount is affected by Apo A-II, stabilized PGI2 and correlated well with stability of PGI2 in patients with CAD and control patients. Decreased PGI2 half-life may play an important role in the pathogenesis of atherosclerosis and thrombus formation in the coronary arteries, especially thrombus formation during an acute coronary event.     

Decreased plasma CXCL16/SR-PSOX concentration is associated with coronary artery disease

OBJECTIVES: To investigate for the first time whether the plasma CXCL16 concentration is altered in coronary artery disease (CAD) patients. BACKGROUND: Accumulating evidence suggests that the novel chemokine/scavenger receptor CXCL16/SR-PSOX is involved in the development of atherosclerosis and CAD. METHODS: Using ELISA we assessed the plasma CXCL16 concentration in 40 stable angina pectoris (SAP) patients, 17 unstable angina pectoris/non-ST-elevation myocardial infarction (UAP/non-STEMI) patients, 387 survivors of a first myocardial infarction (MI) and healthy control subjects (44 controls for SAP and UAP/non-STEMI patient groups and 387 controls for post-MI patients). RESULTS: SAP patients exhibited significantly lower median CXCL16 levels (2111 pg/ml) than the corresponding control subjects (2678 pg/ml) (P=0.0012). UAP/non-STEMI patients also appeared to have lower CXCL16 levels (2192 pg/ml) compared with controls (NS). Patients investigated 3 months after MI tended (P=0.07) to have lower CXCL16 levels (2529 pg/ml) than the corresponding controls (2638 pg/ml). There were no significant correlations between CXCL16 levels and different measures of CAD severity determined by quantitative coronary angiography in post-MI patients. Neither patients nor controls exhibited significant correlations between CXCL16 levels and plasma lipoprotein fractions, inflammatory cytokines, C-reactive protein or numbers of inflammatory cells in peripheral blood. CONCLUSIONS: The finding that lower plasma CXCL16 concentration is associated with CAD might indicate a potential atheroprotective function of CXCL16.     

Association between serum paraoxonase activity and oxidative stress in acute coronary syndromes

OBJECTIVE: The oxidation of low-density lipoprotein (LDL) is believed to have a central role in atherogenesis. Under oxidative stress not only LDL, but all other serum lipids are exposed to oxidation. High-density lipoprotein (HDL)-associated paraoxonase (PON1) was shown to inhibit LDL and HDL oxidation. We investigated the relationship between PON1 and oxidative stress in acute myocardial infarction and unstable angina in a comparative fashion. METHODS AND RESULTS: Activities of PON1, concentrations of malondialdehyde (MDA), lipids and lipoproteins were measured in patients (38 subjects with acute myocardial infarction and 33 subjects with unstable angina pectoris) and in age- and sex-matched controls (32 subjects). Serum PONI activity was significantly lower in patients than in controls (p < 0.001). Patients had significantly increased serum MDA concentrations (p < 0.001) and there were strong negative correlations (p < 0.001) between serum PON1 and MDA levels in the acute myocardial infarction group (r = -0.673), in the unstable angina pectoris group (r = -0.868) and in healthy controls (r = -0.778). Serum HDL-cholesterol (HDL-C) concentrations were lower in patients than controls (p < 0.05). No correlation was observed between PON1 and HDL-C levels in patients or controls. Apo A I concentrations were significantly lower in the patient groups (p < 0.01), but were insignificant between patients with AMI and UAP. Apo A-I and PON1 levels did not show any correlation. Apo B concentrations were lowest in the healthy controls, higher in the UAPgroup and highest in the AMI group (p < 0.001). In the acute myocardial infarction group LDL/apo B ratio was lower than in healthy controls and in the UAP group, suggesting smaller LDL particle size. CONCLUSIONS: Results of this study indicate that lower serum PON1 activity is associated with oxidative stress and the activity of PON1 is not related to HDL-cholesterol.     

感染、炎症与冠心病关系的临床研究

目的　探讨肺炎衣原体 (CP)感染及可溶性细胞间粘附分子 - 1(s ICAM- 1)与冠心病 (CHD)的关系。方法　采用酶标法 (EIA)测定冠心病组 (6 0例 )和对照组 (6 0例 )血清 CP特异性抗体 Ig G,同时应用 EL ISA法测血清 TNF,s ICAM- 1的浓度。结果　急性心肌梗死组 (2 0例 ) CP Ig G阳性 17例 (85 % ) ,不稳定型心绞痛组 (2 0例 )阳性 16例(80 % ) ,稳定型心绞痛组 (2 0例 )阳性 14例 (70 % ) ,对照组阳性 30例 (5 0 % )。急性心肌梗死组、不稳定型心绞痛组与正常对照组相比 ,差异有显著性 (P<0 .0 5 ) ;冠心病组、急性心肌梗死组、不稳定型心绞痛组与正常对照组相比 ,血清 TNF、s ICAM- 1显著增高 (P<0 .0 1)。结论　患者 CP感染、脂质代谢紊乱、粘附分子表达增加、TNF- α作用可能参与了冠心病发生、发展的过程     

低分子肝素治疗不稳定型心绞痛临床疗效观察

目的　观察低分子肝素 (吉派啉 )治疗不稳定性心绞痛 (UAP)的临床疗效。方法　 66例UAP患者随机分为常规治疗组 (对照组 )及常规治疗加吉派啉 (治疗组 ) ,疗程为 7天 ,观察用药前后临床症状、心电图、凝血指标及血总胆固醇、甘油三酯、纤维蛋白原的变化。结果　治疗组一周后总有效率为 91.7% ,对照组为 60 .0 % (P <0 .0 1) ;治疗组无一例发生急性心肌梗塞 ,对照组 2例发生 (6.66% ) ;治疗组未发现严重不良反应。血总胆固醇、甘油三酯及纤维蛋白原显著降低 (P <0 .0 1)。疗效明显优于对照组。结论　UAP急性期在常规治疗基础上加用低分子肝素 ,能有效地控制心绞痛发作 ,减少心肌梗塞发生率 ,且安全便利     

急性冠状动脉综合征患者血总胆红素、尿酸水平分析

目的:探讨急性冠状动脉综合征(ACS)患者血清总胆红素、尿酸(UA)水平的变化.方法:将238例ACS患者分为ST段抬高急性心肌梗死(STEMI)组,非ST段抬高急性心肌梗死(NSTEMI)组,不稳定型心绞痛(UAP)组,检测血清总胆红素、UA、血糖、血脂等生化指标,部分ACS患者行冠状动脉造影检查.109例冠状动脉造影检查未见冠状动脉明显狭窄者作为对照组.结果:ACS各组患者血清总胆红素、UA、血糖显著高于对照组,差异有统计学意义(P<0.01或P<0.05).STEMI组总胆红素、血糖显著高于NSTEMI组和UAP组患者,差异有统计学意义(P<0.01).1周后复查,ACS各组患者血清总胆红素明显回降,与对照组比较差异无统计学意义(P>0.05).结论:ACS患者血糖、UA升高,提示机体氧化应激加重;同时血清总胆红素升高,显示机体代偿性抗氧化程度加强.随病情逐渐稳定,胆红素回降.UA和胆红素可间接反映ACS机体氧化、抗氧化情况.胆红素对评估病情进程亦有一定帮助.     

Circulating miR-214 is associated with the severity of coronary artery disease

Objective To study whether miR-214 is regulated in coronary artery disease (CAD) patients and whether placental growth factor (PLGF) is a possible target for miR-214 in atherosclerosis. Methods Circulating miR-214 was measured by quantitative PCR using RNA isolated from 40 patients with CAD, including 12 with stable angina pectoris, 16 with unstable angina pectoris and 12 with acute myocardial infarction, and 15 controls without CAD. Plasma level of PLGF was measured by ELISA. Results The miR-214 level was significantly lower in CAD patients compared with that in controls (P < 0.01). Compared to controls, patients with unstable angina pectoris (UAP, 38.6±9.1 pg/mL) and acute myocardial infarction (AMI, 46.3±13.4 pg/mL) had significantly higher level of plasma PLGF, but not those with stable angina pectoris (SAP; P = 0.012, UAP vs. Control; P = 0.005, AMI vs. Control). In patients with AMI, the plasma level of miR-214 was positively correlated to that of PLGF. Conclusions The results suggest that miR-214 is a beneficial microRNA for CAD patients. Loss of its protection may lead to increased PLGF levels and worsening atherosclerosis. Circulating miR-214 is a promising biomarker for alerting severe CAD.     

Lipid markers, coronary score and coronary artery disease of stable angina pectoris type

In 120 middle aged male patients with stable angina pectoris and coronarographically documented CAD all examined serum lipid markers differed significantly in comparison with 30 male subjects with vertebro-cardial syndrome and negative coronaro-angiogram (p less than 0.001). The low mean overall coronary score values (4.017 +/- 2.376) reflect the low extent of the coronary atherosclerosis. The coronary score values were significantly positively correlated to the serum levels of cholesterol, triglyceride, LDL-cholesterol, VLDL-cholesterol and negatively correlated to the serum concentration of HDL-cholesterol and HDL-cholesterol/total cholesterol ratios in all examined subjects (CAD and n-CAD groups) (p less than 0.001). In contrast, no significant correlation between coronary score and the examined lipid markers was exhibited in the CAD group of patients when comparing subjects with low and middle coronary score values. According to our results the ratio HDL-cholesterol/total cholesterol represents the best single indicator of the presence and also discriminator of the severity of the coronary athero-sclerosis in the patients with stable angina pectoris.