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1.
目的:为了研究急性冠脉综合征(ACS)患者血浆N氨基末端脑钠肽前体(NT-proBNP)水平变化及对经皮冠状动脉介入术(PCI)治疗预后的临床意义。方法:荧光免疫分析156例ACS患者(包括84例AMI和72例UAP)和30例SAP患者以及42例正常对照组的血浆NT-proBNP水平并进行了比较分析。结果:在156例ACS患者中,84例AMI组(P〈0.01)和72例UAP组(P〈0.05)患者血浆NT-proBNP水平显著高于30例SAP组和42例正常对照组,30例SAP组较之42例正常对照组无明显差异(P〉0.05)。156例ACS患者随疾病的严重程度、UAP分级和冠脉病变支数,血浆NT-proBNP水平增加。156例ACS患者PCI治疗后,44例心血管事件组血浆NT-proBNP水平明显高于112例无心血管事件组(P〈0.01),并与LVEDD呈正相关,与LVEF呈负相关,故血浆NT-proBNP水平是随访、考核疗效的有效指标。结论:血浆NT-proBNP的测定是ACS患者诊断、疾病严重程度判断和PCI疗效考核的有效工具。  相似文献   

2.
目的观察血浆脂蛋白(a)[LP(a)]水平与冠心病的相关性。方法入选住院并行选择性冠状动脉造影检查的患者160例,其中急性冠状动脉综合征(ACS)患者60例,稳定型心绞痛(SAP)患者40例,正常对照组60例。测定各组血浆LP(a)浓度并进行比较分析。结果ACS组和SAP组LP(a)水平显著高于对照组,而ACS组LP(a)水平明显高于SAP组。脂蛋白水平与冠状动脉狭窄程度、狭窄范围呈正相关关系(r2=0.44,P〈0.01)。结论LP(a)与冠脉粥样病变的范围、程度及稳定性相关,对冠心病的诊断和预后判断具有一定意义。  相似文献   

3.
目的探讨慢性心衰患者血浆脑钠肽(BNP)变化的临床意义。方法采用荧光免疫分析法对328例慢性心衰患者及50例健康对照者进行血浆BNP水平的测定,同时以彩色多普勒超声心电动仪测定慢性心衰患者左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF),并与血浆BNP含量作相关性分析。结果慢性心衰组患者血浆BNP水平明显高于健康对照者(P〈0.01),且不同心功能患者之间的血浆BNP含量亦存在显著差异(P〈0.01):慢性心衰组患者血浆BNP水平与LVEF、LVESD、LVEDD呈现良好的相关性(r分别为-0.61、0.55和0.59,P均〈0.01)。结论BNP是反映慢性心衰患者心室功能的灵敏指标。  相似文献   

4.
目的探讨测定心力衰竭(HF)患者血浆脑钠肽(BNP)、血清尿酸(UA)水平在临床应用中的意义。方法测定102例HF患者,按NYHA心功能分级分为:Ⅱ、Ⅲ、Ⅳ级及30例对照组血浆BNP、血清uA、左心房内径(LAd),左室舒张末期内径(LVEDd)及左室射血分数(LVEF)。结果HF患者UA增高组血浆BNP、IAd、LVEDd均显著高于UA正常组;LVEF显著低于UA正常组(P〈0.05)。HF患者血浆BNP、血清UA均显著高于对照组(P〈0.05),随HF程度的加重而显著增加。NYHA心功能分级Ⅲ、Ⅳ级患者LAd、LVEDd均显著高于Ⅱ级组;LVEF显著低于Ⅱ级组(P〈0.05)。结论血浆BNP、血清UA对HF患者的诊断、治疗、病情和预后判断具有重要意义。  相似文献   

5.
血浆纤维蛋白原与急性冠脉综合征的相关性研究   总被引:1,自引:1,他引:1  
李华 《医学信息》2006,19(5):867-868
目的 探讨血浆纤维蛋白原(FIB)水平与急性冠脉综合征(ACS)的相关性。方法 150例入选者,随机分为两组,病变组100例为ACS患者,对照组50例为正常体检人群,均测定血浆FIB。结果 QFIB在病变组显著高于对照组(P〈0.01);②急性心肌梗死(AMI)组中,FIB显著高于不稳定型心绞痛(UA)组(P〈0.01);③发生心脏事件患者(UA组出现AMI,心力衰竭,心源性休克,心源性死亡),FIB水平更高。结论 血浆FIB水平与ACS呈正相关,说明血浆FIB在冠脉粥样斑块的形成、稳定性及继发血栓方面有重要意义,是ACS的危险因素,且对评价病情轻重、估计预后有作用。  相似文献   

6.
急性冠脉综合征患者血浆脑钠素水平变化及临床意义   总被引:2,自引:1,他引:2  
目的探讨急性冠脉综合征(acute coronary syndrome,ACS)患者血浆脑钠素(brain natriuret-ic peptide,BNP)水平的变化规律及对诊断急性冠脉综合征的临床意义.方法采用酶联免疫吸附法测定ACS患者和对照组血浆BNP浓度,将55例ACS患者分为急性心肌梗死组(acute myocardial infarction,AMI组,n=25),不稳定型心绞痛组(unstable angina,UA组,n=30),分别测定症状发作6 h及24h的BNP,并和30例正常健康体检者(对照组)作比较.结果①症状发作6 h内,BNP含量AMI组(60.10±17.10)μg/L和UA组(34.80±14.80)μg/L,均显著高于对照组(10.60±1.70)μg/L(P《0.01).②症状发作24h,AMI组BNP(154.00±18.60)μg/L,UA组BNP(70.31±23.30)μr/L,显著高于正常对照组(10.54±1.80,P《0.01).结论血浆BNP水平升高与ACS有显著关系,并认为血浆BUN水平升高可作为ACS的早期诊断的有效指标.  相似文献   

7.
目的探讨急性心肌梗死患者经急诊介入治疗后心肌顿抑发生情况,为急性期心功能的维护提供依据。方法筛选62例首次急性前壁及前间壁心肌梗死患者,其中男性43例,女性19例,年龄47—72岁,平均年龄58.76岁。32例行急诊冠状动脉介入治疗(PCI组),30例为内科保守治疗患者(药物治疗组),于术后或入院后0(即刻)~2d及10~14d静息状态下分别行超声心动图检查,记录左心室内径(舒张末前后径)、心输出量及左心室射血分数,同时监测肌酸激酶、肌酸激酶同工酶、肌钙蛋白T,找出酶峰值。结果与药物治疗组比较,PCI组术后0(即刻)-2d左心室内径明显增加(P〈0.01),心输出量明显减少(P〈0.01),左心室射血分数明显降低(P〈0.01),心肌酶峰值提前出现,且低于药物治疗组酶峰值(P〈0.05);治疗前后比较,PCI组术后10。14d较前左心室内径明显减小(P〈0.01),心输出量增加(P〈0.05),左心室射血分数明显升高(P〈0.01),而药物治疗组入院后10-14d较治疗前左心室内径、心输出量及左心室射血分数无显著变化(P〉0.05)。结论急性心肌梗死患者行急诊PCI治疗可有效减少心肌坏死面积,但存在心肌顿抑,因此术后心功能的维护非常重要。  相似文献   

8.
目的 分析血清高敏C反应蛋白(hs-CRP)/白蛋白(Alb)与急性冠状动脉综合征患者经皮冠状动脉介入(PCI)术后对比剂肾病的相关性。方法 选取我院接受PCI的496例急性冠状动脉综合征患者作为研究对象,根据PCI术后是否发生对比剂肾病分为对比剂肾病组(n=56)和非对比剂肾病组(n=440)。采用ELISA法检测患者术前血清hs-CRP水平,使用血液分析仪测定术前血清Alb水平,并计算hs-CRP/Alb。Logistic回归分析急性冠状动脉综合征患者PCI术后发生对比剂肾病的影响因素;受试者工作特征(ROC)曲线分析血清hs-CRP/Alb对急性冠状动脉综合征PCI术后对比剂肾病的预测价值。结果 与非对比剂肾病组相比,对比剂肾病组患者术前血清hs-CRP水平、hs-CRP/Alb均明显升高(P<0.001),Alb水平显著下降(P<0.001)。与非对比剂肾病组相比,对比剂肾病组患者术前肌酐水平、对比剂剂量明显升高(P<0.05);对比剂肾病组患者术后肌酐水平显著高于术前(P<0.05),术后血尿酸显著低于术前(P<0.05)。Logistic回归分...  相似文献   

9.
目的:观察髓过氧化物酶(myeloperoxidase,MPO)在稳定性心绞痛(stable angina pectoris,SAP)患者血浆中的表达,分析其与冠状动脉病变严重程度及侧支循环形成的关系。方法:收集160例中南大学湘雅医院心内科行选择性冠状动脉造影术的SAP患者,以Gensini评分为标准对冠状动脉病变严重程度分级,其中评分≥50分为重症组(n=72),〈50分为轻症组(n=88);其中至少一支主要冠状动脉狭窄≥90%患者62例,按照Rentrop法对其冠状动脉侧支循环评分,将0级、1级设为侧支循环不良组(n=27),2级、3级设为侧支循环良好组(n=35)。在冠状动脉造影前取血,酶联免疫吸附法(enzyme linked immunosorbent assay,ELASA)测定上述病人MPO水平。结果:Gensini评分重症组血浆MPO水平[(7.76±1.08)ng/mL]显著高于评分轻症组[(4.39±0.99)ng/mL](P〈0.05)。相关性分析发现MPO水平与冠心病Gensini积分呈正相关(R^2=0.582,P〈0.01)。侧支循环形成不良组MPO浓度[(6.19±O.92)ng/mL]高于侧支循环良好组[(4.32±0.80)ng/mL](P〈0.05),相关性分析发现血浆MPO水平与冠脉侧支循环Rentrop分级呈负相关(R2=0.427,P〈0.01)。结论:稳定性心绞痛患者血浆MPO水平与冠状动脉Gensini积分呈正相关,与Rentrop分级呈负相关,其水平升高反映冠状动脉侧支循环的形成不良。  相似文献   

10.
目的 观察应激诱导的心肌缺血发生时髓过氧化物酶(MPO)水平的变化.方法 选取97例疑似冠状动脉疾病(CAD)患者行负荷心肌灌注显像(S-MPI),71例急性冠脉综合征(ACS)患者在入组前已接受经皮冠状动脉介入治疗,15位健康志愿者作为对照组.采用胶乳增强免疫比浊法对183例入组患者测定血浆MPO水平.对接受S-MPI的患者,在负荷试验前和负荷试验后测定MPO水平.结果 97例S-MPI患者中有48例被诊断为应激诱导的心肌缺血.应激诱导心肌缺血患者的MPO水平高于没有应激诱导心肌缺血患者(33 ±4ng/mL vs.24 ±4ng/mL,P=0.02),但未超过MPO参考值上限.ACS患者与S-MPI患者分别和正常人相比,MPO水平均显著升高(132±16ng/mL vs.29±3ng/mL,P<0.01),(132±16ng/mL vs.26±2ng/mL,P<0.01).结论 S-MPI后没有增加血浆MPO水平,因此,MPO对于应激诱导的心肌缺血并不敏感.  相似文献   

11.
目的 探讨中国天津地区汉族人群白细胞介素-10(interleukin-10,IL-10)-592C/A基因多态性的功能性以及其对经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后再狭窄的发病,PCI术后血清IL-10水平的影响.方法 对437例接受PCI并进行冠状动脉造影随访的患者,按冠状动脉造影结果分为再狭窄组(166例)和非再狭窄组(271例),应用聚合酶链反应-限制性片段长度多态性方法检测IL-10-592位点基因型和等位基因频率的分布;用酶联免疫吸附试验法测定2组PCI术前及PCI术后24 h血清IL-10浓度,并比较两组间和各基因型间IL-10水平.结果 (1)IL-10-592C/A基因型和等位基因频率在再狭窄组和非再狭窄组之间差异无统计学意义(P均>0.05);(2)PCI术后24 h血清IL-10水平再狭窄组显著低于非再狭窄组[(82.67±35.02)ng/Lvs.(95.08±32.26)ng/L,P<0.05];(3)IL-10-592位点A等位基因携带者(AA+AC基因型)术后24 h血清IL-10水平明显低于非携带者(CC型)[(86.13±34.77)ng/L vs.(102.50±27.52)ng/L,P<0.05];(4)再狭窄组A等位基因携带者术后24 h血清IL-10水平明显低于非携带者[(78.51±34.09)ng/L vs.(102.19±33.66)ng/L,P<0.05];(5)再狭窄危险的多因素Logistie回归分析显示:急性冠状动脉综合征、术前狭窄程度、靶病变长度与冠状动脉内支架再狭窄呈正相关(()R值分别为5.90、1.86、2.83),术后24 h血清IL-10水平、参照血管直径、支架直径与冠状动脉内支架再狭窄呈负相关(OR值分别为0.99、0.70、0.46).结论 (1)IL-10基因-592 C/A多态性与中国天津地区汉族人群再狭窄发病无关;(2)IL-10是PCI术后早期的炎症细胞因子,术后24 h血清IL-10水平为再狭窄的独立预测因素,携带A等位基因的个体可能通过降低其表型血清IL-10水平而增加了冠状动脉内支架术后再狭窄的发病.
Abstract:
Objective To investigate the relationship of interleukin-10 gene (IL-10)polymorphism and the serum IL-10 level with restenosis after percutaneous coronary intervention (PCI) in Tianjin Chinese Han population and study the effect of IL-10 gene polymorphism on serum IL-10 level. Methods Four hundred and thirty-seven patients who successfully underwent PCI with a follow-up angiography were divided into a restenosis group (n= 166) and non-restenosis group (n= 271). The IL-10 gene promoter polymorphism at position -592 was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Meanwhile their serum IL-10 level before and 24 h after PCI was determined by enzyme-linked immunosorbent assay (ELISA). Results (1) There was no significant difference in frequencies of -592 genotypes and alleles between the two groups (P>0. 05); (2) The 24 hpost-PCI IL-10 serum level of restenosis group was significantly lower than that of the non-restenosis group [(82. 67±35. 02) ng/L vs. (95.08±32.26) ng/L, P<0.05]; (3) The serum level of the A allele carriers (AA+AC) was significant lower than that of the CC carriers [(86.13±34.77) ng/L vs. (102. 50±27.52)ng/L,P<0.05]; (4) In the restenosis group, the 24 h post-PCI serum level of IL-10 in the A allele carriers was also significantly lower than that in those without the A allele [(78.51 ± 34.09) ng/L vs. (102.19 ±33.66) ng/L, P< 0. 05]; (5) Logistic regression analysis revealed positive correlations between acute coronary syndrome patients, pre-PCI degree of stenosis, length of target stenosis lesion and restenosis (OR=5.90, 1.86, 2.83 respectively); and there were negative correlations between 24 h post-PCI serum level of IL-10, the stent diameter, the diameter of reference vessel before stent implantation and restenosis (OR=0. 99, 0. 70, 0. 46 respectively). Conclusion (1) TheIL-10 gene -592 C/A polymorphism was not associated with restenosis in the Tianjin Chinese Han population; (2) IL-10 is an early post-PCI inflammatory cytokine, 24 h post-PCI serum IL-10 level was an independent predictive factor for restenosis,the IL-10 A allele carriers may have increased incidence of in-stent restenosis (ISR) by reducing the serum IL-10 levels.  相似文献   

12.
 目的:应用可视化血液流变性检测仪(MC-FAN)并结合血小板功能指标的检测,观察急性冠脉综合征(ACS)介入术后患者血液流变性的变化特点,并探讨患者血液流变性可视化结果与血小板功能指标的相关性。方法:纳入74例ACS介入术后1~3年的患者,21例健康者为健康对照组,应用MC-FAN检测2组人群的血液通过模拟人体毛细血管的时间(MC-FAN TT)和比较不同时段的结果,同时检测血小板聚集性、血小板黏附性、血小板P-选择素、血小板衍生生长因子BB和血管假性血友病因子指标,观察ACS介入术后患者的MC-FAN 结果与血小板功能的相关性。结果:与健康对照组相比,ACS介入术后患者的血流MC-FAN TT延长(P<0.01),红细胞变形能力减弱,白细胞附壁及血小板的黏附、聚集相对增多;ACS介入术后患者的血小板最大聚集率、血小板黏附率、血小板P-选择素水平及血小板衍生生长因子BB水平均高于健康对照组(P<0.01);2组间血管假性血友病因子差异无统计学意义(P>0.05)。组内相关性分析显示:MC-FAN TT与血小板功能存在相关性,其中10 μL MC-FAN TT和30 μL MC-FAN TT与P-选择素呈正相关(r=0.601,P<0.01;r=0.334,P<0.01);60 μL MC-FAN TT与血小板最大聚集率呈正相关(r=0.527,P<0.01);100 μL MC-FAN TT与血小板黏附率呈正相关(r=0.815,P<005)。结论:ACS介入术后患者的可视化血液流变性及血小板功能异常,MC-FAN TT与血小板功能存在相关性,MC-FAN检测仪可客观地评价介入术后患者血液流动的状态。  相似文献   

13.
Plasma levels of substance P (SP) and neurokinin A (NKA) tachykinin and of gamma interferon (IFN-gamma) and tumor necrosis factor alpha (TNF-alpha) cytokines were assayed in plasma obtained from peripheral blood of 19 patients presenting with stable chronic coronary stenosis and 12 patients with acute coronary syndrome (ACS). Plasma samples were obtained before, during, and after percutaneous coronary intervention (PCI) consisting of implantation of a metallic stent. Fourteen healthy subjects without any evident risk factors for coronary artery disease (CAD) were also included for comparison at basal time. We found that plasma levels of both IFN-gamma and TNF-alpha were significantly higher in patients with chronic or acute CAD than those in control subjects at the time of presentation. NKA and IFN-gamma levels were also significantly increased in ACS patients compared with those in patients with stable disease. The analysis performed during and after PCI revealed that IFN-gamma levels increased 15 min after stent implantation in both chronic and ACS patients and that TNF-alpha levels increased in chronic patients only compared to basal values. In addition, a significant decrease of both NKA and SPA levels 48 h after the end of the revascularization procedure was observed in ACS patients. These data suggest that modulation of tachykinin and/or cytokine release with proinflammatory activity in chronic or acute cardiac ischemia and during following coronary stenting might play an important role in heart tissue damage and in long-term inflammatory complications of PCI.  相似文献   

14.
目的 测定急性冠脉综合征(ACS)患者血清中同型半胱氨酸(Hcy)的水平,探讨血清Hcy水平对ACS患者的临床意义.方法 入选2010年5月至2012年12月本院住院65例ACS患者,其中不稳定型心绞痛(UA)33例、急性心肌梗死(AMI)32例,同时入选稳定性心绞痛(SA)35例,并以32例健康体检者作为阴性对照组,测定各组血清Hcy水平,进行统计学分析.结果 血清Hcy水平,UA组(18.15±4.72)μmol/L、AMI组(21.62±5.56) μmol/L、SA组(16.03±3.16)μmol/L、对照组(9.86±2.53) μmol/L,UA及AMI组明显高于SA组及对照组(P<0.05);且AMI组显著高于UA组,各组间差异有统计学意义(P<0.05).结论 血清Hcy水平升高为ACS的危险因素,可作为反映ACS病情的指标.  相似文献   

15.
Since B-type natriuretic peptide (BNP) concentration has been shown by recent studies to be elevated in patients presenting acute coronary syndrome (ACS) even in the absence of overt heart failure, other mechanisms for elevating plasma BNP (p-BNP) concentrations may be suggested to exist. We have studied the correlation between p-BNP level and the extent of myocardial ischemia (EMI) in non-ST elevation (NSTE) ACS and evaluated the BNP level as an objective marker of EMI. In 204 patients with NSTE ACS, we estimated the EMI by the echocardiographic wall motion score index (WMSI) and the coronary angiographic Gensini score. As the positive control group, 44 patients with stable angina were enrolled into the study. We compared their initial p-BNP levels with WMSI and the Gensini score. Additionally, peak troponin-T level was compared with p-BNP level in NSTE myocardial infarction (MI) patients. Using the multiple regression analysis, adjustments for age, left ventricle (LV) wall stress, LV mass amount and ejection fraction (EF) were made. Patients with LVEF < 45% or age > 75 years or underlying diseases that could elevate BNP levels were excluded from the study. P-BNP level was increased in NSTE ACS patients compared with stable angina patients (133.9 +/- 87.4 vs. 12.2 +/- 9.2 pg/ml, p < 0.05). P-BNP levels were found to correlate with WMSI and the Gensini score in unstable angina (r=0.519, p < 0.01; r=0.680, p < 0.01) and NSTEMI (r=0.716, p < 0.01; r=0.684, p < 0.01) patients, respectively. Additionally, p-BNP levels correlated with the peak troponin-T level in patients with NSTEMI (r=0.700, p < 0.01). P-BNP level might be a useful marker in the assessment of EMI.  相似文献   

16.
目的探讨血清骨保护素(OPG)水平、sRANKL水平与急性冠脉综合征(ACS)的关系。方法选取急性冠脉综合征患者50例,不稳定性心绞痛患者45例,32例冠脉造影正常无冠心病者为对照组。采用全自动生化仪测定LDL-C、hs-CRP等指标水平。采用ELISA法检测血清OPG、sRANKL水平,每例患者均行冠脉造影,并对冠脉进行Gensini评分。结果 ACS组患者血清OPG水平显著高于对照组及不稳定性心绞痛组(P〈0.01),而血清sRANKL水平显著低于其他两组(P〈0.01)。ACS组血清OPG水平与hs-CRP水平、Gensini评分成正相关(P〈0.05),而sRANKL水平与hs-CRP水平、Gensini评分成负相关(P〈0.01)。结论血清OPG水平升高、sRNAKL水平降低与ACS的冠状动脉病变严重程度密切相关,检测血清中两者的水平对ACS的辅助诊断、疗效观察及预后判断具有重要价值。  相似文献   

17.
探讨血清缺血修饰白蛋白(ischemia-modified albumin,IMA)测定在急性冠状动脉综合征(acute coronary syndrome,ACS)的临床应用价值及与血浆脑钠肽(BNP)、肌钙蛋白Ι(cTnΙ)等标志物的相关性.检测56例ACS患者、38例非冠心病患者及72名健康对照者(对照组)的血清...  相似文献   

18.
目的: 研究不稳定型心绞痛(UA)患者在经皮冠状动脉介入(PCI)治疗前应用大剂量血脂康对炎症的抑制作用。 方法: 对196例临床确诊为高危UA(心绞痛Braunwald 分级为Ⅲ和ⅡB级,CRP>3 mg/L)的患者按随机原则分别入选A组和B组,在相似常规治疗的基础上分别口服1.2 g/d和2.4 g/d血脂康治疗72 h。随后对所有病人进行冠状动脉造影和PCI治疗。测定在入院时、药物治疗3 d后(PCI术前)和PCI术后48 h的血浆CRP的水平,并随访半年内的冠脉事件和左室射血分数。 结果: 入院时2组血浆CRP水平无明显差别(P>0.05);治疗3 d后,两组血浆CRP水平明显低于入院时[A组:(5.44±1.57)mg/L vs (4.04±1.54) mg/L;B组: (5.42±1.36) mg/L vs (3.60±1.14) mg/L,P<0.05];PCI术后48 h,两组血浆CRP水平显著高于术前[A组升至 (9.22±5.03) mg/L;B组升至(4.97±1.75) mg/L,P<0.05]。PCI术前及术后48 h,B组的血浆CRP水平明显低于同期A组(P<0.05)。术后半年主要冠脉事件B组明显少于A组[21/104 (20.2%) vs 9/92 (9.8%),P<0.05],左室射血分数B组明显高于A组(55.41%±10.93% vs 59.30%±9.99%,P<0.05)。 结论: PCI术前大剂量血脂康治疗对PCI术引起的炎症具有抑制作用,抑制炎症可能是PCI术后冠脉事件减少和左室射血分数增加的重要因素。  相似文献   

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