超声检测股动脉、腹主动脉及颈动脉粥样硬化与冠状动脉粥样硬化的相关性

目的:探讨股动脉、腹主动脉及颈动脉粥样硬化与冠状动脉粥样硬化的相关性。方法: 采用高频超声测量109例行冠状动脉造影术后1周的患者股动脉、腹主动脉及颈动脉的内-中膜厚度（IMT）、斑块积分及斑块数目。结果: 股动脉、腹主动脉及颈动脉粥样硬化与冠状动脉粥样硬化呈正相关（P<0.01、P<0.05）;股动脉斑块预测冠状动脉粥样硬化的灵敏度为89%,特异度为77%,准确度84%;腹主动脉斑块预测冠状动脉粥样硬化的灵敏度为73%,特异度为72%,准确度72%;颈动脉斑块预测冠状动脉粥样硬化的灵敏度为83%,特异度为79%,准确度82%。结论: 超声检查股动脉、腹主动脉及颈动脉IMT及斑块可间接预测不同程度的冠状动脉粥样硬化;股动脉的灵敏度与准确度较腹主动脉更好。     

MCP-1 gene A-2518G polymorphism and carotid artery atherosclerosis in patients with type 2 diabetes

AimsCardiovascular diseases are the major cause of mortality in patients with diabetes mellitus. Monocyte chemoattractant protein-1 (MCP-1) is a potent chemokine and plays an important role in cardiovascular diseases. The objective of this study was to evaluate the relation between the genotypes of the MCP-1 A-2518G polymorphism and the development of carotid atherosclerosis in patients with type 2 diabetes.MethodsThe subjects were 303 unrelated patients who were diagnosed with type 2 diabetes mellitus. To evaluate macroangiopathy, we measured carotid artery intima-media thickness (IMT) by ultrasonography. The MCP-1 A-2518G polymorphism was determined by TaqMan PCR method.ResultsIMT in patients with the MCP-1 −2518 AG or GG genotype was significantly greater than the AA-genotype (P = 0.007). Simple regression analysis showed that age, systolic blood pressure, LDL-cholesterol, the MCP-1 −2518 AG + GG polymorphism, and HbA1c level were correlated with IMT (P < 0.0001, <0.0001, 0.006, 0.007, 0.025, respectively). In multiple regression analysis, the MCP-1 −2518 AG + GG polymorphism was the third strongest independent determinant of IMT in patients with type 2 diabetes (P = 0.021), subsequent to age and systolic blood pressure.ConclusionAssessment of the MCP-1 A-2518G polymorphism would be useful in identifying the risk of developing carotid atherosclerosis in patients with type 2 diabetes.     

苯扎贝特对兔动脉粥样硬化单核细胞趋化因子的影响

目的探讨苯扎贝特对兔动脉粥样硬化（AS）时单核细胞趋化因子（MCP-1）的影响。方法 24只新西兰大白兔随机分为高脂组、苯扎贝特组和正常对照组,每组8只。对照组饲以常规颗粒饲料,高脂组饲以高胆固醇饲料（1%胆固醇＋5%猪油的颗粒饲料）,苯扎贝特组饲以高胆固醇饲料加苯扎贝特[5mg/（kg·d）],共饲养4个月。HE染色检测免胸主动脉AS程度,并用免疫组化检测AS斑块的MCP-1蛋白及RT-PCR检测MCP-1 mRNA的转录水平,同时检测血胆固醇和甘油三酯的浓度。结果与高脂组比较,苯扎贝特显著降低了甘油三酯的浓度[（0.71±0.11）vs（1.72±0.96）mmol/L,P〈0.05]。在苯扎贝特组动脉粥样硬化的程度明显减轻,动脉内膜面积减少[（2.92±0.54）vs（4.16±0.98）mm~2,P〈0.05]。苯扎贝特治疗组斑块内的MCP-1蛋白表达减少[（19.8±2.2）%vs（26.2±3.1）%,P〈0.01],RT-PCR结果显示,苯扎贝特组MCP-1 mRNA的水平亦明显减少[（0.61±0.06）vs（1.06±0.06）,P〈0.05]。结论使用苯扎贝特明显减轻了动脉粥样硬化程度,其中MCP-1基因及蛋白表达的下降具有重要的作用。     

血栓前体蛋白与老年脑梗死患者颈动脉粥样硬化的相关性研究

目的探讨血栓前体蛋白与老年脑梗死患者颈动脉粥样硬化之间的关系。方法采用酶联免疫吸附法测定44例老年动脉粥样硬化性脑梗死患者(脑梗死组)和30例老年健康对照者(对照组)血浆血栓前体蛋白水平,并对脑梗死患者进行颈动脉超声检查,检测颈动脉内膜中层厚度,并分析血栓前体蛋白水平与颈动脉内膜中层厚度的关系。结果与对照组比较,脑梗死组患者血栓前体蛋白[(9.27±2.29)mg/Lvs(2.20±0.30)mg/L,P=0.000]、纤维蛋白原[(3.79±1.06)g/L vs(3.30±0.69)g/L,P=0.012]和D-二聚体[(1154.05±1038.54)μg/L vs(696.33±443.18)μg/L,P=0.035]明显升高。脑梗死组颈动脉内膜中层厚度≥1.0mm患者血栓前体蛋白水平明显高于内膜中层厚度<1.0mm患者[(10.12±2.46)mg/L vs(7.79±0.30)mg/L,P<0.01];脑梗死组患者血栓前体蛋白与颈动脉内膜中层厚度呈正相关(r=0.518,P<0.05)。结论老年脑梗死患者的血浆血栓前体蛋白水平显著升高,且与颈动脉粥样硬化密切相关。     

The effect of oxygen on the development of atherosclerosis in WHHL rabbits

The effect of hyperoxic or hypoxic inhalation on blood lipid levels and on the development of atherosclerosis was studied in young male WHHL rabbits. They were exposed to ordinary room air containing different concentrations of oxygen: 6 animals were exposed to 40% oxygen (hyperoxia group) or 5-10% oxygen (hypoxia group) for 5 h a day, 5 days a week for 8 weeks. Four control rabbits inhaled ordinary room air. The following results were obtained. (1) The severity of aortic lesions significantly decreased in the hyperoxia group and increased in the hypoxia group, when these two groups were compared. However, both hypoxic and hyperoxic groups did not statistically differ from the control. (2) Plasma cholesterol levels were not changed either by hyperoxic or hypoxic inhalation. (3) Plasma triglyceride levels were elevated only in the hypoxia group, with significant differences from the values in both control and hyperoxia groups. (4) There was no significant correlation between mean plasma lipid level and severity of aortic lesions. From these results, we conclude that hyperoxic or hypoxic inhalation respectively regresses or aggravates the development of atherosclerotic lesions, not by an indirect action on blood lipid concentrations but by a direct action on the vascular wall.     

Effects of local MCP-1 protein therapy on the development of the collateral circulation and atherosclerosis in Watanabe hyperlipidemic rabbits

OBJECTIVE: The objective of our study was to quantify the arteriogenic potency of Monocyte Chemoattractant Protein-1 (MCP-1) under hyperlipidemic conditions. Additionally, we aimed to determine the effects of locally applied MCP-1 on systemic serum lipid levels as well as on atherosclerosis. METHODS: A total of sixty-four Watanabe rabbits was treated with either low dose MCP-1 (1 microg/kg/week), high dose MCP-1 (3.3 microg/kg/week) or PBS as a control substance. Substances were applied directly into the collateral circulation via an osmotic minipump with the catheter placed in the proximal stump of the ligated femoral artery. Either 1 week or 6 months after initiation of the treatment X-ray angiography was performed as well as measurements of collateral conductance using fluorescent microspheres. The extent of atherosclerosis was quantified in whole aortas using Sudan IV staining. RESULTS: One week after ligation of the femoral artery a significant increase in collateral conductance was observed in animals treated with high dose MCP-1 (control: 2.2+/-0.8 ml/min/100 mmHg vs. MCP-1 high dose: 8.9+/-2.0 ml/min/100 mmHg, P<0.05). Six months after femoral artery ligation no differences were found between the treated and the control group (PBS; 44.9+/-11.6 ml/min/100 mmHg, MCP-1; 47.8+/-11.5 ml/min/100 mmHg, P=NS). No influence was found on serum lipids or on the development of atherosclerosis in the present model. CONCLUSION: MCP-1 accelerates arteriogenesis upon femoral artery ligation under hyperlipidemic conditions. Six months after treatment these pro-arteriogenic effects of MCP-1 can no longer be observed. The present data do not show an effect of local MCP-1 treatment on serum lipids or on atherosclerosis. It should be noted however that a high standard deviation was observed for the data on atherosclerotic surface area, necessitating additional experiments in a different model of atherosclerosis.     

动脉粥样硬化危险因素视黄醇结合蛋白4与血脂的相关性

目的 探讨颈动脉粥样硬化患者血清视黄醇结合蛋白4(RBP4)与血脂的关系,为动脉粥样硬化的临床诊治提供依据.方法 选取2017年7月至2018年11月在昆明医科大学附属延安医院就诊的患者共236例,根据超声测量颈动脉中层内膜厚度(IMT),将入选病例中IMT＜1 mm的患者纳入非AS组(共39例),IMT≥1mm的患者...     

Effects of alpha-tocopherol and astaxanthin on LDL oxidation and atherosclerosis in WHHL rabbits

The aim of this study was to evaluate the influence of -tocopherol and astaxanthin on low-density lipoprotein (LDL) oxidation lag time and atherosclerotic lesion formation in Watanabe heritable hyperlipidemic (WHHL) rabbits. Thirty-one, 3-month-old WHHL rabbits were divided into three experimental groups. One group (n=10) was fed standard rabbit feed alone and served as a control, a second group (n=11) was supplied with the same feed containing 500 mg alpha-tocopherol/kg and a third group (n=10) was given a feed containing 100 mg astaxanthin/kg. Plasma lipids, lipoproteins and LDL oxidation lag time were followed for 24 weeks. At the end of the treatment period, the animals were killed and the thoracic aorta was used for evaluation of the degree of atherosclerosis. Colour photographs of the intimal surface of the vessel were taken for determination of the atherosclerotic area. Cross-sections of the thoracic aorta were used for histological examination and for determination of intimal thickening. Specimens of the vessel were used for determination of the tissue cholesterol content. Plasma cholesterol remained at a high level during the time of the experiment and there were no differences between the experimental groups. After 24 weeks, the LDL oxidation lag time was 53.7+/-1.7 min, 109+/-4 min (P<0.001) and 56.4+/-3.4 min (P=0.47) in the control, alpha-tocopherol and astaxanthin groups, respectively. In the thoracic aorta, the atherosclerotic area was 80.7+/-5.1%, 67.1+/-6.7% (P=0.13) and 75.2+/-5.7% (P=0.49) in the control, alpha-tocopherol and astaxanthin groups, respectively. The intimal thickening was 45.6+/-3.2%, 44.0+/-4.1% (P=0.89) and 40.0+/-4.5% (P=0.33) in the control, alpha-tocopherol and astaxanthin groups, respectively. Finally, the cholesterol content was 107+/-9 mol/g, 95.7+/-11.5 mol/g (P=0.31) and 101+/-5 mol/g (P=0.33) in the control, alpha-tocopherol and astaxanthin groups, respectively. It can be concluded that alpha-tocopherol but not astaxanthin prolonged the LDL oxidation lag time. The two antioxidative substances did not prevent atherogenesis in WHHL rabbits in this setting.     

Interrelation between the extent of atherosclerosis in the thoracic aorta, carotid intima-media thickness and the extent of coronary artery disease

Intima-media thickness (IMT) of the common carotid artery and atherosclerosis of the thoracic aorta have been shown to correlate with coronary artery disease (CAD). This study compares the relation between wall changes in the thoracic aorta and the carotid arteries and the angiographic severity and extent of atherosclerotic lesions in the coronary arteries in patients with verified CAD. Atherosclerotic wall changes in the carotid arteries and the thoracic aorta were measured by B-mode ultrasonography and transesophageal echocardiography (TEE), respectively, in 37 subjects aged 65+/-10 years with angiographically verified CAD. The mean value of the common carotid IMT of the right and left sides was 0.87+/-0.21 mm. All subjects had carotid plaques. TEE detected grades II-IV atherosclerotic plaques in the thoracic aorta in 32 of the 37 (86%) patients. A significant correlation was seen between the extent of coronary artery stenosis and aortic plaques score (r=0.46, p=0.008). Mean carotid IMT was also significantly correlated with coronary artery stenosis extent score (r=0.44, p=0.007). Moreover, a significant correlation was seen between the aortic plaque score and the mean carotid IMT (r=0.39, p=0.02). In conclusion, we found a clear and significant relationship between wall changes in the thoracic aorta, common carotid IMT and the angiographic extent of coronary artery stenosis in patients with severe CAD. These findings indicate a potential of B-mode ultrasonography of the carotid arteries and transesophageal echocardiographic aortic examination in the diagnostic and prognostic evaluation of patients with suspected CAD.     

颈动脉粥样硬化兔模型的建立

动脉粥样硬化是一种全身性疾病,以动脉分叉、分支开口及血管弯曲的凸面为病变的好发部位.Fusari等采用血管造影的方法检查了1000例因腹主动脉或颈动脉粥样硬化需要手术患者的冠状动脉,其中720例患者（72%）因腹主动脉粥样硬化需要手术,238例患者（24%）因颈动脉粥样硬化需要手术,42例患者（42%）同时因以上两种原因需要手术.     

血清同型半胱氨酸水平与颈动脉粥样硬化关系的分析

目的探讨血清同型半胱氨酸(HCY)水平与颈动脉粥样硬化的相关性,以及与高血压、糖尿病、高脂血症等动脉粥样硬化性血管病(ASVD)危险因素的关系.方法选取住院患者97例,用酶联免疫吸附法(ELISA)测定血清HCY水平,用彩色多普勒超声仪行颈动脉壁内膜-中膜厚度(IMT)、动脉斑块积分检查.结果血清HCY水平与颈动脉IMT、动脉斑块积分呈正相关,与高血压、糖尿病、高脂血症无关.结论血清同型半胱氨酸水平与颈动脉粥样硬化密切相关,与高血压、糖尿病、高脂血症等动脉粥样硬化性血管病危险因素无直接关系,血清HCY水平是动脉粥样硬化的一个独立危险因素.     

颈动脉粥样硬化与冠状动脉SYNTAX积分的相关性研究

目的:研究颈动脉粥样斑块病变情况与冠状动脉SYNTAX积分的关系,探讨颈动脉粥样硬化(As)的病变程度,对冠心病患者的冠状动脉病变程度及其预后的预测作用。方法:选取武汉大学中南医院心内科,2012年1月至2013年9月,住院行冠状动脉造影患者296例,根据结果进行SYNTAX评分,并分为轻度组(1<积分<21)51例,中度组(21<积分<31)71例,重度组(积分>31)136例,以及对照组(0分)38例,采用颈动脉超声检查患者的颈动脉As病变情况,并采用AS评分及Crouse评分对颈动脉As病变情况进行量化。结果:随着冠状动脉病变情况的加重,颈动脉粥样斑块的发生率明显增高,且病变程度也逐渐加重;针对冠状动脉病变情况的SYNTAX评分和针对颈动脉病变情况的AS评分之间的相关系数r=0.865(P<0.01),其对冠心病预测作用的曲线下面积AUC=0.9(P<0.01),与Crouse评分之间的相关系数r=0.852(P<0.01),曲线下面积AUC=0.89(P<0.01)。结论:颈动脉As与冠状动脉病变严重情况相关,颈动脉超声是筛查冠心病的有力手段。     

颈动脉粥样硬化与冠状动脉粥样硬化的关系

目的　探讨颈动脉粥样硬化与冠状动脉粥样硬化的关系。方法　对 94例老年患者进行了冠状动脉造影和颈动脉超声检查。颈动脉粥样硬化斑块积分采用Sutton法。结果　单支组及多支组内膜中膜厚度、斑块积分显著高于正常组 ,多支组显著高于单支组 (P<0 .0 5 )。斑块指数与年龄、吸烟、低密度脂蛋白胆固醇与高密度脂蛋白胆固醇的比值、收缩压以及高血压病程的程度呈正相关。结论　颈动脉粥样硬化与冠状动脉粥样硬化的病变是平行的     

汕头地区人群颈动脉粥样硬化与高血压的关系

目的探讨汕头地区人群颈动脉粥样硬化程度与高血压之间的关系。方法用彩色多普勒对高血压患者290例与健康者110名行颈动脉检测。结果高血压组颈动脉内膜-中层厚度随高血压程度加重而增厚(P<0．01),颈动脉血管内径随高血压病情加重而扩大(P<0．01);高血压组收缩期峰值血流速度、舒张末期血流速度降低,阻力指数、搏动指数明显增高(P<0．05或P<0．01)。结论颈动脉超声早期检测高血压患者动脉粥样硬化有助于预防并发症和指导治疗。     

颈动脉粥样硬化斑块稳定性与C反应蛋白的关系

目的探讨颈动脉粥样硬化斑块稳定性与C反应蛋白(CRP)的关系。方法用高分辨超声技术检测97例患者颈动脉斑块,并将其分组。A组:颈动脉无斑块发生;B组:颈动脉有稳定斑块;C组:颈动脉有不稳定斑块。检测各组患者血清CRP水平。结果CRP在A组为(3.53±1.23)mg/L,在B组为(4.29±2.50)mg/L,在C组为(7.35±9.81)mg/L。B组与A组比较无显著性差异,C组与A组、C组与B组比较有显著性差异。结论不稳定斑块患者血清CRP增高,血清CRP与斑块稳定性相关。     

高敏C反应蛋白和肺炎衣原体感染与颈动脉粥样硬化及缺血性脑卒中的相关性研究

目的探讨高敏C反应蛋白水平、肺炎衣原体抗体与颈动脉粥样硬化及缺血性脑卒中TOAST亚型的关系。方法缺血性脑卒中组135例,对照组135例,测定2组的高敏C反应蛋白水平、肺炎衣原体IgG抗体、颈动脉内膜中层厚度及颈动脉粥样硬化程度。结果(1)高敏C反应蛋白水平升高与颈动脉内膜中层厚度及颈动脉粥样硬化程度相关,OR值分别为3.44和6.82;高敏C反应蛋白水平升高与大动脉粥样硬化性脑卒中危险性升高相关,OR值为10.11。(2)肺炎衣原体抗体的阳性率与颈动脉内膜中层厚度及颈动脉粥样硬化程度相关,OR值分别为1.76和4.89。结论高敏C反应蛋白水平和慢性肺炎衣原体感染与颈动脉粥样硬化密切相关,同时高敏C反应蛋白水平升高,可增加发生大动脉粥样硬化性脑卒中的风险。     

原发性高血压患者颈动脉粥样硬化与冠状动脉病变关系的探讨

目的研究原发性高血压(EH)患者颈动脉粥样硬化与冠状动脉病变的关系。方法选择114例EH患者,根据冠状动脉造影结果分成4组:正常组、单支病变组、双支病变组和3支病变组,各组分别进行颈动脉超声检查,测量颈动脉舒张末期内颈(DD)、收缩末期内径(DS)、DD与DS之差与DD的变化率DD-DS/DD(%)及粥样斑块。结果随着冠状动脉病变严重程度的增加,颈动脉DS、DD、DD-DS/DD(%)值下降,斑块发生率和斑块的严重程度增加。结论颈动脉超声检查能较好地预测EH患者冠状动脉病变的严重程度。     

颈动脉多普勒超声与心绞痛患者冠状动脉病变的关系

目的采用彩色多普勒超声仪分析心绞痛患者颈动脉病变,探讨其在冠状动脉病变中的临床诊断价值。方法选择因心绞痛行冠状动脉造影的住院患者328例,根据冠状动脉造影结果分为4组:对照组(80例)、单支病变组(102例)、2支病变组(62例)和多支病变组(84例)。用彩色多普勒超声仪测量颈总动脉内膜中层厚度(intimamediathickness,IMT)及颈动脉分叉处IMT,记录颈动脉斑块的位置、数量。结果与对照组比较,2支病变组分叉处IMT和斑块积分明显增高,多支病变组颈总动脉IMT、分叉处IMT和斑块积分明显增高,差异有统计学意义(P0.05,P0.01)。与对照组比较,多支病变组颈总动脉IMT增厚比例明显增高,差异有统计学意义(P0.05);与单支病变组比较,多支病变组颈总动脉IMT增厚比例明显增高,差异有统计学意义(P0.05)。糖尿病是冠状动脉病变的主要危险因素(OR=2.8,95% CI:1.18～6.63)。结论颈动脉粥样硬化与冠状动脉病变有相关性,采用彩色多普勒超声分析颈动脉病变情况,对冠心病患者具有较好的筛查及预测价值。     

血清同型半胱氨酸水平与颈动脉粥样硬化关系的研究

目的：探讨血清同型半胱氨酸（HCY）水平与颈动脉粥样硬化和高脂血症的相关性。方法：选取住院的中老年患者64例，用酶联免疫吸附法（ELISA）测定血清HCY水平。用彩色多普勒超声仪行颈动脉壁内膜一中膜厚度（IMT）、动脉斑块积分检查。结果：血清HCY水平与颈动脉IMT、动脉斑块积分呈正相关（r=0.498,0.747，P〈0．001），血清HCY水平与高脂血症无关。结论：血清HCY水平是动脉粥样硬化的一个独立危险因素。     

缺血性脑血管病彩色多普勒、经颅多普勒联合检测结果分析

目的 研究缺血性脑血管病发病与颈部动脉粥样硬化狭窄程度和斑块性质的关系.方法 采用彩色多普勒和经颅多普勒技术对缺血性脑血管病患者100例及健康者40例（对照组）进行检测,观察颈动脉解剖形态、内膜情况,有无斑块形成及斑块大小、形态、回声特征,颅内外动脉管腔是否狭窄和狭窄程度.结果 缺血性脑血管病组颈动脉不均质、不规则斑块的检出率及其颅内外动脉狭窄的比例均明显高于对照组,且颅内动脉狭窄的比例高于颅外动脉.结论 颈动脉粥样硬化斑块的性质及颅内外动脉狭窄与缺血性脑血管病的发生密切相关.