阿托伐他汀治疗高血压患者颈动脉粥样硬化临床研究

目的 研究阿托伐他汀对高血压患者颈动脉粥样硬化的影响及动脉粥样硬化斑块的消退作用. 方法 入选颈动脉粥样硬化斑块形成患者122例,入院后随机分为阿托伐他汀组(62例,A组)和常规治疗组(60例,B组).在常规降压,抗血小板治疗的基础上,阿托伐他汀组加用阿托伐他汀10mg,每晚1次.共20周,观察治疗前后胆固醇(TC),甘油三酯(TG),低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)的变化,高频超声检测颈动脉,记录颈动脉内膜中层厚度(IMT). 结果 阿托伐他汀治疗后能明显消退颈动脉粥样硬化斑块IMT[(1.24±0.13)比治疗后(0.98±0.19)]mm,P均<0.05.降低TC,TG,LDL- C水平(P<0.05),升高LDL-C水平.结论 阿托伐他汀可改善高血压患者颈动脉粥样硬化程度及消退颈动脉粥样硬化斑块,有效降低血脂水平.     

阿托伐他汀对脑梗死患者血脂及颈动脉粥样硬化斑块的影响

目的:探讨应用阿托伐他汀治疗脑梗死对患者血脂与颈动脉粥样硬化斑块的影响。方法:将2010年10月-2011年10月笔者所在医院就诊的76例脑梗死患者随机均分为两组,对照组给予常规治疗,试验组在常规治疗基础上加服阿托伐他汀,分别于治疗前和治疗后6个月检测患者总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平、颈动脉粥样硬化斑块内膜中层厚度(IMT)和斑块面积。结果:治疗后两组患者TC、TG、LDL-C、HDL-C、IMT均有不同程度的下降,且两组治疗后差异具有统计学意义(P0.05)。结论:应用阿托伐他汀治疗脑梗死可以起到较好的降脂、缩小颈动脉粥样硬化斑块的作用,值得临床进一步推广应用。     

脑心通胶囊联合阿托伐他汀治疗37例脑梗死患者颈动脉硬化的临床疗效分析

目的分析脑心通胶囊联合阿托伐他汀治疗脑梗死的临床疗效。方法将福州市第二医院2010年1月-2011年12月收治的74例脑梗死颈动脉粥样硬化患者随机分为对照组和治疗组,对照组给予阿托伐他汀治疗,治疗组在对照组基础上加服脑心通胶囊。6个月之后观察两组患者的总胆固醇（TC）、血清甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、颈动脉内膜中层厚度（IMT）以及颈动脉粥样硬化斑块面积的大小。结果两组患者的TC、TG、LDL-C水平均较服药前有所降低,HDL-C较治疗前升高,IMT、颈动脉粥样硬化斑块面积明显缩小。但是治疗组的变化明显优于对照组,P〉0.05,差异有统计学意义。结论脑心通胶囊联合阿托伐他汀治疗脑梗死颈动脉粥样硬化比单纯应用阿托伐他汀治疗效果更好,值得临床应用和推广。     

瑞舒伐他汀联合银杏叶片对脑梗死患者颈动脉粥样硬化斑块及血脂异常的影响

目的观察瑞舒伐他汀联合银杏叶片对脑梗死患者颈动脉粥样硬化斑块及血脂异常的影响。方法选取脑梗死伴颈动脉粥样硬化斑块和血脂异常患者56例,采用随机数字表法将患者分为2组,每组28例。对照组患者睡前顿服瑞舒伐他汀10 mg;观察组患者睡前顿服瑞舒伐他汀10 mg,同时服用银杏叶片,每次2片,每日3次;2组患者均治疗6个月。采用颈动脉多普勒超声分别于治疗前后检测颈动脉内膜-中膜厚度(IMT)及颈动脉粥样硬化斑块,计算斑块面积和斑块总积分;采用全自动生物化学分析仪检测三酰甘油(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)水平。结果治疗前,2组患者颈动脉IMT、斑块面积、斑块总积分及TC、TG、LDL-C、HDL-C水平比较差异均无统计学意义(P>0.05)。与治疗前比较,治疗后2组患者颈动脉IMT、斑块面积、斑块总积分及TC、TG、LDL-C水平均降低(P<0.05),HDL-C水平升高(P<0.05);与对照组治疗后比较,观察组患者治疗后颈动脉IMT、斑块面积、斑块总积分及TC、TG、LDL-C水平降低,HDL-C水平升高(P<0.05)。结论瑞舒伐他汀联合银杏叶片能更好地逆转脑梗死患者颈动脉粥样硬化斑块的形成,缩小颈动脉IMT值、斑块总积分及斑块面积,降低血脂。     

普罗布考联合阿托伐他汀对急性脑梗死患者颈动脉粥样硬化斑块的影响

目的观察普罗布考联合阿托伐他汀对急性脑梗死患者血脂及颈动脉粥样硬化斑块的影响。方法将60例急性脑梗死患者,分为阿托伐他汀单独治疗(对照组)和阿托伐他汀联合普罗布考治疗(观察组),对照组使用阿托伐他汀20mg,每天1次;治疗组在此基础上使用普罗布考0.25g,每天2次,共治疗6个月。分别于治疗前及治疗后6个月测定患者血脂和颈动脉内膜中膜厚度(IMT)。结果两组患者在治疗后6个月较治疗前总胆固醇(TC)、三酰甘油(TG)及低密度脂蛋白胆固醇(LDL-C)明显降低(P<0.01),高密度脂蛋白胆固醇(HDL-C)增高(P<0.05),颈动脉IMT明显降低(P<0.01)。治疗后6个月观察组较对照组TC、LDL-C、TG及颈动脉IMT明显降低(P<0.05),HDL-C增高但差异无统计学意义(P>0.05)。结论普罗布考联合阿托伐他汀治疗急性脑梗死具有协同降脂和降低颈动脉IMT作用,能有效稳定颈动脉粥样硬化斑块。     

脑心通胶囊联合强力定眩胶囊及阿托伐他汀钙片对颈动脉粥样硬化斑块影响的临床观察

目的探讨脑心通胶囊联合强力定眩胶囊及阿托伐他汀钙片对颈动脉粥样硬化斑块的影响。方法回顾性分析2013年10月~2015年11月我院接诊的60例颈动脉粥样硬化患者的临床资料,通过随机数表法分为治疗组(30例)和对照组(30例),对照组给予阿托伐他汀钙片治疗,治疗组在对照组的基础上加用脑心通胶囊及强力定眩胶囊。比较两组患者治疗前后颈动脉硬化斑块数量、IMT、斑块的面积、血脂(TC、TG、LDL-C)、hs-CRP水平的变化情况,并比较治疗过程中所出现的不良反应。结果治疗组颈动脉斑块数量、面积、IMT水平均比对照组低[(1.24±0.31)vs(1.57±0.37),(16.17±2.05)mm~2vs(33.41±5.84)mm~2,(1.48±0.35)mm vs(1.74±0.54)mm](P0.05);TC、TG、LDL-C、hs-CRP水平也低于对照组[(3.81±0.67)mmol/L vs(4.32±0.80)mmol/L,(1.28±0.22)mmol/L vs(1.54±0.38)mmol/L,(2.07±0.50)mmol/L vs(2.41±0.48)mmol/L,(2.53±0.36)mg/L vs(4.23±0.94)mg/L](P0.05)。结论脑心通胶囊联合强力定眩胶囊及阿托伐他汀钙片在颈动脉粥样硬化斑块患者中疗效显著,值得应用推广。     

阿托伐他汀治疗伴颈动脉粥样硬化的高血脂患者临床观察

目的:观察阿托伐他汀治疗伴有颈动脉粥样硬化斑块的高血脂患者的临床疗效.方法:对88例伴颈动脉粥样硬化斑块高血脂患者予晚上临睡前服阿托伐他汀,剂量20 mg,共24周,观察治疗前后颈动脉内膜中层厚度(IMT)、胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固(LDL-C)、动脉硬化指数(TC-HDL-C)/HDL-C、脂蛋白a[Lp(a)]高密度脂蛋白胆固醇(HDL-C)和血液流变学指标的变化.结果:阿托伐他汀能明显消退颈动脉粥样硬化斑块(IMT),治疗后为(0.68±0.18)mm,与治疗前(1.26±0.02)mm比较,P<0.05,降低TC、LDL-C、TG、(Tc-HDL-C)/HDL-C、LP(a)水平(P<0.05),升高HDL-C水平,可改善血液流变学指标.结论:阿托伐他汀可消退颈动脉粥样硬化斑块,有效降低血脂水平,且不良反应轻微.     

脑心通胶囊联合阿托伐他汀治疗脑梗死颈动脉粥样硬化患者的疗效

目的：探讨临床治疗脑梗死颈动脉粥样硬化的有效方案。方法根据治疗方案将135例脑梗死颈动脉粥样硬化患者分为对照组（63例）与观察组（72例）,对照组患者接受阿托伐他汀、阿司匹林治疗,观察组在此基础上联合使用脑心通胶囊,治疗6个月后评价疗效。结果经治疗,观察组TC、TG、LDL-C显著低于对照组（P 〈0.05）,HDL-C显著高于对照组（P 〈0.05）;NIHSS、IMT、hs-CRP显著低于对照组（P 〈0.05）。结论脑心通胶囊联合阿托伐他汀治疗脑梗死颈动脉粥样硬化的疗效确切,值得临床应用。     

缓释烟酸与阿托伐他汀联合治疗颈动脉粥样硬化的疗效观察

目的 研究烟酸缓释片联合阿托伐他汀对颈动脉粥样硬化的治疗效果. 方法 76例颈动脉粥样硬化患者随机分为两组:(1)对照组(38例),给予阿托伐他汀10mg/d;(2)治疗组(38例),给予阿托伐他汀10mg/d和烟酸缓释片1000mg/d.比较治疗前后两组血清总胆固醇(TC)、血清甘油三酯(TG)、血清低密度脂蛋白(LDL-C)和高密度脂蛋白(HDL-C)水平的改变;颈总动脉内膜-中层厚度(IMT)、颈动脉斑块厚度(Tmax)、颈动脉斑块面积(Smax)变化.结果 (1)经过6个月治疗,两组TC、TG、LDL-C均有明显下降(P ＜0.05),但治疗组较对照组下降更显著(P＜0.001).治疗组血清高密度脂蛋白(HDL-C)升高20.7%,对照组无明显变化.(2)治疗后,治疗组的 IMT、Tmax、Smax较治疗前明显下降,而对照组较治疗前无明显变化( P＞0.05). 结论 烟酸缓释片联合阿托伐他汀治疗颈动脉粥样疗效较单独使用阿托伐他汀好,且具有良好的安全性和耐受性.     

阿托伐他汀治疗短暂性脑缺血发作患者颈动脉粥样硬化斑块的分析

目的:观察阿托伐他汀对短暂性脑缺血发作(TIA)患者颈动脉粥样硬化斑块的治疗作用.方法:60例入院患者被随机分成两组.Ⅰ组(常规治疗组)、Ⅱ组(20 mg阿托伐他汀组),各30例.治疗12周后详细记录两组患者的血脂水平.并进行颈动脉超声检查,评估颈动脉粥样硬化斑块内膜-中层厚度(IMT).结果:12周后Ⅱ组颈动脉斑块IMT与Ⅰ组相比差异有显著性(P＜0.05);Ⅱ组总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)与Ⅰ组相比差异无显著性.结论:阿托伐他汀除具有良好的降脂作用外,还具有稳定斑块,甚至减轻动脉粥样硬化作用.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.