阿托伐他汀钙对高血压病患者血脂异常的疗效及对高敏C反应蛋白的影响

目的 观察阿托伐他汀钙对高血压病患者血脂异常的疗效和安全性及对高敏C反应蛋白(hs-CRP)的影响.方法 观察128例高血压伴有血脂异常的患者,其中治疗组68例,在降压治疗和低脂饮食的基础上,给予阿托伐他汀钙20 mg/d,睡前服,治疗12周;对照组60例,予降压治疗和低脂饮食.测定2组治疗前后的血压、TG、TC、LDL-C、HDL-C、极低密度脂蛋白胆固醇(VLDL-C)、hs-CRP、Cr、ALT、肌酸激酶水平,并进行比较分析.结果 治疗组用药后与用药前比较,血压无明显改变,TG下降[(1.6±1.2)mmol/L比(2.0±0.9)mmoL/L,P＜0.05],HDL-C有升高的趋势,但差异无统计学意义,TC下降[(4±1)mmol/L比(6±1)mmol/L,P＜0.01),LDL-C下降[(3±1)mmol/L比(4±1)mmol/L,P＜0.01],hs-CRP明显下降[(2.3±1.5)mg/L比(5.3±2.9)mg/L,P＜0.01].仅2例患者出现血清肌酸激酶的轻度升高,1个月后复查均恢复正常.与对照组治疗后比较,治疗组的TC、LDL-C、TG、VLDL-C和hs-CRP明显降低,差异有统计学意义(P＜0.05或P＜0.01),SBP、DBP、Cr及ALT均差异无统计学意义.结论 阿托伐他汀钙可有效地改善高血压病患者血脂异常和炎症状态,而且是安全的.

Abstract：

Objective To investigate the effect and safety of atovastatin calcium on dyslipidemia and hypersensitive C-reactive protein in hypertension patients. Methods One hundred and twenty-eight hypertensive patients with dyslipidedmia were divided into two groups: control group and treatment group. All patients were in low-fat and low-cholesterol diet and received antihypertensive treatment as usual. Patients in treatment group took atovastatin (20 mg/day) for 12 weeks. Systolic blood pressure (SBP), diastolic blood pressure(DBP), serum total glycerin (TG), total cholesterol ( TC ), low-dense-lipoprotein cholesterol ( LDL-C ), high-dense-lipoprotein cholesterol (HDL-C), very low-dense-lipoprotein cholesterol (VLDL-C), hypersensitive C-reactive protein (hs-CRP), creatinin (Cr), glutamate pyruvate transaminase (ALT) and creatine kinase (CK) were measured before and after the treatment. Results In patients with atovastatin treatment, TG was reduced 16%[(1.6 ±1.2)mmoL/L vs (2.0 ±0.9) mmol/L, P ＜ 0.05], TC was reduced 24% [(4 ± 1 ) mmol/L vs (6 ± 1 ) mmoL/L, P ＜ 0.01], LDL-C was reduced 34% [(3 ± 1 ) mmol/L vs (4 ± 1 ) mmol/L, P ＜ 0.01] and hs-CRP was significantly reduced [(2.3 ± 1.5 )mg/L vs (5.3 ± 2.9)mg/L, P ＜ 0.01]. CK increased lightly in two patients with atovastatin treatment and were in normal range in one month although the patients received atovastatin ( 10 mg/day) treatment. Compared to control group, TC, LDL-C, VLDL-C and hs-CRP were significantly reduced in treatment group. There was no significant difference in HDL-C, SBP, DBP, Cr and ALT. Conclusion Atovastatin can decrease hypersensitive C-reactive protein in hypertension patients with dyslipidemia.     

乌司他丁对老年冠心病患者造影剂肾病保护作用的临床研究

目的 探讨乌司他丁对老年冠心病患者造影剂肾病是否具有保护作用.方法 将2007年3月至2008年5月行冠状动脉介入治疗的年龄≥65岁的冠心病患者87例完全随机分为对照组和乌司他丁组.对照组44例常规水化.乌司他丁组43例,在对照组基础上分别于术前4 h予乌司他丁15000 U/kg加0.9%氯化钠注射液稀释至20ml静脉滴注1次,术后第1、2天分别再次静脉滴注乌司他丁1次(10000U/kg加0.9%氯化钠注射液稀释至20 ml).比较两组造影后48 h及5 d时血尿素氮、肌酐、内生肌酐清除率和尿β2微球蛋白(β2-MG)、尿N2乙酰β2氨基葡萄糖苷酶(NAG)、肾损伤因子(KIM-1)、自由水清除率(CH2O)以及造影剂肾病发生率.结果 两组在应用造影剂后48 h血BUN、Cr及尿β2-MG、NAG、KIM-1、CH2O[对照组分别为(12.8±3.4)mmol/L、(132.3±38.5)μmol/L、(314.2±98.1)μg/L、(25.8±7.2)U/L、(4.29±0.76)μg/L、(-7.3±15.8)ml/h;乌司他丁组分别为(8.4±3.7)mmol/L、(102.3±29.8)μmol/L、(253.4±88.7)μg/L、(18.3±5.6)I/L、(2.12±0.83)μg/L、(-15.9±20.1)ml/h]均较本组造影前[对照组分别为(7.5±2.4)mmol/L、(93.5±19.4)μmol/L、(178.9±50.9)μg/L、(14.8±2.2)U/L、(0.38±0.15)μg/L、(-22.1±22.6)ml/g;乌司他丁组分别为(6.6±2.7)mmol/L、(87.1±15.4)μmol/L、(187.1±67.3)lμg/L、(13.4±3.5)U/L、(-24.0±24.6)ml/h]升高,而内生肌酐清除率下降(P＜0.05),但乌司他丁组明显低于对照组(P＜0.05);对照组造影后5 d较48 h有所下降,但未达到造影前水平.而乌司他丁组造影5 d后达到造影前水平.对照组造影剂肾病8例(18.2%),乌司他丁组3例(6.9%),两组比较差异有统计学意义(P＜0.05).结论 乌司他丁对老年冠心病患者造影剂肾病具有一定的预防保护作用.

Abstract：

Objective To investigate the effect of ulinastatin on contrast-induced nephropathyin patients with coronary heart disease. Methods Eighty-seven patients of or above 65 with coronary heart disease from March 2007 to May 2008 were randomly divided into control group and ulinastatin(UTI)group: control group had 44 cases of normal hydration and UTI group had 43 cases. The parameters of renal functions were measured and compared 48hours and 5 days after contrast administration,including serum urea nitrogen and creatinine and creatinine clearance rate and urineβ2-microglobulin and urine N-acety l-β-glucosaminidase (NAG),Kidney damage factor (KIM-1),free water clearance (CH2O) and contrast medium nephroma. Results Forty-eight hours after application of contrast agent,serum BUN,Cr and urine β2-MG,NAG,KIM-1,CH2O in the two groups were significantly increased and CrCl declined (P ＜ 0.05),but these indexes in observation group were significantly lower than those in the control group (P ＜ 0.05). Contrast agent nephropathy occurred in 8 patients (18.2%) in control group,while 3 occurred in observation group patients (6.9%),(P ＜ 0.05). Conclusion Ulinastatin has preventive effect on contrast induced nephropathy in patients with coronary heart disease.     

阿托伐他汀钙对高血压病患者血脂异常的疗效及对高敏C反应蛋白的影响

Objective To investigate the effect and safety of atovastatin calcium on dyslipidemia and hypersensitive C-reactive protein in hypertension patients. Methods One hundred and twenty-eight hypertensive patients with dyslipidedmia were divided into two groups: control group and treatment group. All patients were in low-fat and low-cholesterol diet and received antihypertensive treatment as usual. Patients in treatment group took atovastatin (20 mg/day) for 12 weeks. Systolic blood pressure (SBP), diastolic blood pressure(DBP), serum total glycerin (TG), total cholesterol ( TC ), low-dense-lipoprotein cholesterol ( LDL-C ), high-dense-lipoprotein cholesterol (HDL-C), very low-dense-lipoprotein cholesterol (VLDL-C), hypersensitive C-reactive protein (hs-CRP), creatinin (Cr), glutamate pyruvate transaminase (ALT) and creatine kinase (CK) were measured before and after the treatment. Results In patients with atovastatin treatment, TG was reduced 16%[(1.6 ±1.2)mmoL/L vs (2.0 ±0.9) mmol/L, P ＜ 0.05], TC was reduced 24% [(4 ± 1 ) mmol/L vs (6 ± 1 ) mmoL/L, P ＜ 0.01], LDL-C was reduced 34% [(3 ± 1 ) mmol/L vs (4 ± 1 ) mmol/L, P ＜ 0.01] and hs-CRP was significantly reduced [(2.3 ± 1.5 )mg/L vs (5.3 ± 2.9)mg/L, P ＜ 0.01]. CK increased lightly in two patients with atovastatin treatment and were in normal range in one month although the patients received atovastatin ( 10 mg/day) treatment. Compared to control group, TC, LDL-C, VLDL-C and hs-CRP were significantly reduced in treatment group. There was no significant difference in HDL-C, SBP, DBP, Cr and ALT. Conclusion Atovastatin can decrease hypersensitive C-reactive protein in hypertension patients with dyslipidemia.     

阿托伐他汀钙对高血压病患者血脂异常的疗效及对高敏C反应蛋白的影响

Objective To investigate the effect and safety of atovastatin calcium on dyslipidemia and hypersensitive C-reactive protein in hypertension patients. Methods One hundred and twenty-eight hypertensive patients with dyslipidedmia were divided into two groups: control group and treatment group. All patients were in low-fat and low-cholesterol diet and received antihypertensive treatment as usual. Patients in treatment group took atovastatin (20 mg/day) for 12 weeks. Systolic blood pressure (SBP), diastolic blood pressure(DBP), serum total glycerin (TG), total cholesterol ( TC ), low-dense-lipoprotein cholesterol ( LDL-C ), high-dense-lipoprotein cholesterol (HDL-C), very low-dense-lipoprotein cholesterol (VLDL-C), hypersensitive C-reactive protein (hs-CRP), creatinin (Cr), glutamate pyruvate transaminase (ALT) and creatine kinase (CK) were measured before and after the treatment. Results In patients with atovastatin treatment, TG was reduced 16%[(1.6 ±1.2)mmoL/L vs (2.0 ±0.9) mmol/L, P ＜ 0.05], TC was reduced 24% [(4 ± 1 ) mmol/L vs (6 ± 1 ) mmoL/L, P ＜ 0.01], LDL-C was reduced 34% [(3 ± 1 ) mmol/L vs (4 ± 1 ) mmol/L, P ＜ 0.01] and hs-CRP was significantly reduced [(2.3 ± 1.5 )mg/L vs (5.3 ± 2.9)mg/L, P ＜ 0.01]. CK increased lightly in two patients with atovastatin treatment and were in normal range in one month although the patients received atovastatin ( 10 mg/day) treatment. Compared to control group, TC, LDL-C, VLDL-C and hs-CRP were significantly reduced in treatment group. There was no significant difference in HDL-C, SBP, DBP, Cr and ALT. Conclusion Atovastatin can decrease hypersensitive C-reactive protein in hypertension patients with dyslipidemia.     

尿微量蛋白联合尿酶检测在酒依赖早期肾损害诊断中的意义

目的：了解尿微量蛋白联合尿酶检测在酒依赖早期肾损害诊断中的意义。方法：收集30例正常对照组和22例酒依赖者测定尿中微量白蛋白（mALB）、转铁蛋白㈣、视黄醇结合蛋白（RBP）和N-乙酰-β—D-氨基葡萄糖苷酶（NAG）,以及血、尿肌酐和血尿素、r-谷氨酰转移酶（GGT）水平。结果：正常对照组尿mALB／Cr（2．81±1．65）mg／mmol,TRF／Cr（0．17±0．14）mg／mmol,RBP／Cr（18．32±5．87）μg／mmol,NAG／Cr（1．42±0．65）U／mmol;酒依赖组尿mALB／Cr（15．33±9．54）mg／mmol,TRF／Cr（1．92±1．09）mg／mmol,RBP／Cr（355．12±265．32）μg／mmol,NAG／Cr（9．53±5．22）U／mmol,与正常对照组比较,差异显著（P〈0．01）。GGT与尿微量蛋白系列和NAG无相关关系。结论：尿微量蛋白联合尿酶检测能敏感地反映酒依赖者早期肾功能受损的情况,且早于传统生化指标和常规尿蛋白的测定。     

氯沙坦对慢性肾脏疾病患者血浆中炎症性细胞因子及TGF-β1的影响

目的研究血管紧张素Ⅱ受体拮抗剂-氯沙坦对慢性肾脏疾病患者血浆细胞因子浓度及尿转化生长因子β1排泄的影响,探讨其保护肾脏的可能机制。方法选取符合入选标准的慢性肾脏疾病患者32例,观察6个月,ELISA法检测血浆TNF-α、IL-6及尿TGF-β1的水平;免疫散射比浊法检测血浆hs CRP;放射免疫法检测尿白蛋白的浓度;全自动生化分析仪测定治疗前后血尿素氮、肌酐、HDL-C、LDL-C。结果与氯沙坦治疗前基础值相比,患者血浆hs CRP水平[(1 403±198)ng/m L vs.(998.1±138)ng/m L]明显增高(P<0.05),尿白蛋白/尿肌酐[(73.4±16.5)mg/mmol.Cr vs.(96.5±12.1)mg/mmol.Cr)]和TGF-β1/尿肌酐[(43.56±17.49)mg/mmol.Cr vs.(78.81±40.32)mg/mmol.Cr]水平明显降低,差异有统计学意义(P<0.05);TNF-α[(1.39±0.03)pg/m L vs.(1.46±0.04)pg/m L]、IL-6[(1.79±0.07)pg/m L vs.(1.81±0.09)pg/m L]水平变化差异无统计学意义(P>0.05)。与治疗前基础值比较,LDL-C[(117.0±1.4)mg/d L vs.(126.0±2.7)mg/d L]显著降低,但BUN[(28.3±0.6)mg/d L vs.(21.1±0.8)mg/d L]明显升高,差异有统计学意义(P<0.05);血肌酐[(139.4±36.3)μmol/L vs.(124.5±52.5)μmol/L]、HDL-C[(58.6±0.9)mg/d L vs.(56.2±3.0)mg/d L]与治疗前比较,差异无统计学意义(P>0.05)。结论氯沙坦对慢性肾脏疾病患者的肾脏有保护作用,其部分机制可能与上调细胞因子hs CRP和下调TGF-β1作用有关。     

海洛因依赖者尿微量蛋白联合尿酶检测分析

目的：探讨尿微量蛋白联合尿酶检测在海洛因依赖者中的临床意义。方法：对50例正常对照组和50例海洛因依赖组测定尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）、视黄醇结合蛋白（RBP）、微量白蛋白（mALB）和尿转铁蛋白（TRF）,同时检测尿肌酐。结果：正常对照组尿NAG／Cr为（0．72±0．33）U／mmoL,RBP／Cr为（9.46±4．81）μg／mmoL,mALB为（5．22±3．17）mg／L,TRF／Cr为（0．07±0．04）mg／mmoL;海洛因依赖组尿NAG／Cr、RBP／Cr、mALB及TRF／Cr值分别为（10．18±10．01）U／mmoL、（156．75±198．68）μg／mmoL、（30．65±26．38）mg／L、（1．92±3．02）mg／mmoL,与正常对照组比较,差异性显著（P〈0．01）。两项指标联合检测,其阳性率分别为：NAG＋mALB82％,NAG＋TRF76％,NAG＋RBP88％。结论：联合检测尿NAG与RBP是诊断海洛因依赖早期肾损害的最灵敏与可靠的实验室指标。     

尿微量蛋白测定在高血压肾损害中的作用

目的探讨检测尿微量白蛋白（mALB）、β2微球蛋白（β2-MG）、尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）、视黄醇结合蛋白（RBP）在高血压早期肾损害中的意义。方法选取67例原发性高血压病患者为观察组,选取62例本院体检健康职工为对照组。比较两组尿mALB、β2-MG、NAG、RBP的水平。结果观察组与对照组比较,尿mALB、β2-MG、NAG、RBP水平均明显升高。结论联合检测尿mALB、β2-MG、NAG、RBP对早期高血压肾损害有重要的临床意义。     

尿检中多项指标联合检测对妊娠期高血压的诊断价值分析

目的 探讨尿免疫球蛋白G(IgG)、转铁蛋白(TRF)、微量蛋白(mALB)、β2-微球蛋白(β2-MG)联合检测对妊娠期高血压的诊断价值。方法 320例妊娠期高血压患者,根据疾病严重程度将患者分为A组(150例,重度子痫前期)和B组(170例,妊娠期高血压);另选取160例体检健康的妊娠妇女作为对照组。三组均行尿检。比较三组尿IgG、TRF、mALB及β2-MG水平及尿检异常率。结果 A组尿IgG、TRF、mALB及β2-MG水平分别为(108.26±28.89)mg/L、(75.52±25.57)mg/L、(226.63±78.85)mg/L、(1108.36±225.56)μg/L, B组分别为(36.65±12.27)mg/L、(30.18±14.45)mg/L、(64.45±41.19)mg/L、(746.63±172.23)μg/L,对照组分别为(14.41±5.59)mg/L、(3.25±1.87)mg/L、(12.24±4.86)mg/L、(241.18±88.39)μg/L。A组尿IgG、TRF、mALB及β2-MG水平均高于B组与对照组,B组均高于对照组,差异具有统...     

阿托伐他汀对高血压患者肾损害的影响

目的探讨阿托伐他汀对高血压患者肾损害的影响。方法选取血压控制达标的高血压并伴微量白蛋白尿患者80例,随机分为治疗组和对照组,每组40例。治疗组予以阿托伐他汀20mg/d,对照组加用安慰剂治疗。2组治疗前及治疗后12周采用速率散射比浊法检测尿微量白蛋白(mAlb)、β2-微球蛋白(β2-MG),采用全定量酶免疫法测定尿视黄醇结合蛋白(RBP),采用速率法检测N-乙酰-β2-D氨基葡萄糖苷酶(NAG),采用Jaffe速率法测定尿肌酐(Cr)。结果治疗组治疗后RBP/Cr、mAlb/Cr、β2-MG/Cr及NAG/Cr水平均降低(P<0.01);且治疗后治疗组上述指标均低于对照组,差异均有统计学意义(P<0.01)。且不良反应轻微。结论阿托伐他汀能减轻高血压患者肾损害症状,并能有效改善其肾功能。     

检测尿微量蛋白和尿酶对早期肾损伤的诊断意义

目的：探讨尿标本中视黄醇结合蛋白（RBP）、Br微球蛋白（BrMG）、微量白蛋白（mALB）及r-谷氨酰转肽酶（r-GT）检测在糖尿病肾病（DN）早期诊断中的作用。方法：用免疫比浊法检测尿RBP、BrMG及m—ALB,酶偶联法测定尿rGT、尿肌酐（Cr）。结果：正常对照组中尿RBP／Cr、β2-MG／Cr、r-GT／Cr及m—ALB／Cr的含量分别为（2．32±0．85）mg/mmol、（71．1±27．9）ug/mmol、（5．67±2．47）U／mmol、（1．85±0．31）mg/mmol。在糖尿病无肾病组中其微量白蛋白的含量与正常对照组相近（P〉0．05）,而RBP／Cr、β2-MG／Cr、r—GT／Cr的含量与正常对照组相比差异有显著性（P〈0．05）。在糖尿病初期肾病组和临床肾病组尿RBP／Cr、β2-MG／Cr、r-GT,Cr及m—ALB／Cr的含量均明显高于正常对照组（P〈0．01）。结论：联合检测尿RBP、β2-MG、r—GT及m—ALB是诊断DN早期损伤快捷、可靠的实验室指标。     

阿托伐他汀对高血压患者肾损害的影响

目的 探讨阿托伐他汀对高血压患者肾损害的影响.方法 选取血压控制达标的高血压并伴微量白蛋白尿患者80例,随机分为治疗组和对照组,每组40例.治疗组予以阿托伐他汀20mg/d,对照组加用安慰剂治疗.2组治疗前及治疗后12周采用速率散射比浊法检测尿微量白蛋白(mAlb)、β2-微球蛋白(β2-MG),采用全定量酶免疫法测定尿视黄醇结合蛋白(RBP),采用速率法检测N-乙酰-β2-D氨基葡萄糖苷酶(NAG),采用Jaffe速率法测定尿肌酐(Cr).结果 治疗组治疗后RBP/Cr、mAlb/Cr、β2-MG/Cr及NAG/Cr水平均降低(P＜0.01);且治疗后治疗组上述指标均低于对照组,差异均有统计学意义(P＜0.01).且不良反应轻微.结论 阿托伐他汀能减轻高血压患者肾损害症状,并能有效改善其肾功能.     

脑心通对急性冠脉综合征患者血脂及超敏C反应蛋白的影响

Objective To investigate the effects of atorvastatin combined with Naoxintong capsules on serum lipid level and hish sensitivity C-reactive protein(hs-CRP)in patients with acute coronary syndrome(ACS).Methods 82 ACS patients were randomly divided into observation group(10 mg/d of atorvastatin and 4 capsules 3 times of Naoxintong daily,n=41) and control group(20 mg/d of simvastatin daily,n=41).The levels of serum lipid and hs-CRP were detected before and after treatment.Results 8 weeks after treatment,the levels of serum hpid[TC (4.21±0.87)mmol/L,TG(1.99±0.48)mmol/L,LDL-C(2.71±0.83) mmol/L] and serum hs-CRP(5.63±1.38)mg/L in observation group were significantly lower than those in control group[TC(4.89±0.91)mmol/L,TG (2.58±0.52)mmol/L,LDL-C(3.28±0.89)mmol/L],and serum level HDL-C(1.89±0.47)mmol/L was higher than that in control group(1.63±0.45)mmol/L(t=2.55-4.36,P<0.01～0.05).Conclusion Adjuvant therapy of Naoxintong could promote the levels of serum lipid and hs-CRP in patients with ACS.and offer a better therapeutic effect in these patients.     

脑心通对急性冠脉综合征患者血脂及超敏C反应蛋白的影响

Objective To investigate the effects of atorvastatin combined with Naoxintong capsules on serum lipid level and hish sensitivity C-reactive protein(hs-CRP)in patients with acute coronary syndrome(ACS).Methods 82 ACS patients were randomly divided into observation group(10 mg/d of atorvastatin and 4 capsules 3 times of Naoxintong daily,n=41) and control group(20 mg/d of simvastatin daily,n=41).The levels of serum lipid and hs-CRP were detected before and after treatment.Results 8 weeks after treatment,the levels of serum hpid[TC (4.21±0.87)mmol/L,TG(1.99±0.48)mmol/L,LDL-C(2.71±0.83) mmol/L] and serum hs-CRP(5.63±1.38)mg/L in observation group were significantly lower than those in control group[TC(4.89±0.91)mmol/L,TG (2.58±0.52)mmol/L,LDL-C(3.28±0.89)mmol/L],and serum level HDL-C(1.89±0.47)mmol/L was higher than that in control group(1.63±0.45)mmol/L(t=2.55-4.36,P<0.01～0.05).Conclusion Adjuvant therapy of Naoxintong could promote the levels of serum lipid and hs-CRP in patients with ACS.and offer a better therapeutic effect in these patients.     

瑞舒伐他汀短期干预对急性冠状动脉综合征患者高敏C反应蛋白及血管性血友病因子和内皮依赖性血管功能的影响

目的 研究瑞舒伐他汀短期干预对急性冠状动脉综合征(ACS)患者血清高敏C反应蛋白(hsCRP)和血管性血友病因子(vWF)水平以及内皮依赖性血管舒张功能的影响.方法 将62例ACS患者完全随机分为他汀组和常规组,各31例,常规组施以常规和安慰剂治疗,他汀组在常规治疗基础上加服瑞舒伐他汀20 mg/d,疗程8周,并于治疗前后分别测定血清hs-CRP、vWF和内皮依赖性血管舒张功能的变化.结果 治疗8周后,常规组的hs-CRP、TC、TG、HDL-C、LDL-C、vWF水平分别为(12.41±5.36)mg/L、(6.31±0.80)mmol/L、(2.65±0.57)mmol/L、(1.33±0.28)mmol/L、(4.20±0.98)mmol/L、(150.68±27.85)%.他汀组上述指标分别为(6.15±2.07)mg/L、(5.87±0.63)mmol/L、(2.38±0.48)mmol/L、(1.48±0.27)mmol/L、(2.91±0.92)mmol/L、(127.46±18.25)%.他汀组治疗后hs-CRP、TG、HDL-C、LDL-C、vWF与治疗前比较,差异有统计学意义(P＜0.01).他汀组治疗后TC、HDL-C与常规组治疗后比较,差异有统计学意义(P＜0.05);他汀组治疗后hs-CRP、LDL-C、vWF与常规组治疗后比较,差异有统计学意义(P＜0.01).结论 应用瑞舒伐他汀对ACS进行干预,在有效调脂的同时可显著降低hs-CRP和vWF水平,改善血管内皮功能,有利于动脉粥样硬化斑块的稳定.

Abstract：

Objective To study the effects of short-term rosuvastatin therapy on high sensitive C-reactive protein (hs-CRP), von Willebrand factor(vWF) and endothelium dependent vasodilatation function in patients with acute coronary syndrome(ACS). Methods Totally 62 patients with ACS were randomly divided into the statin group (n =31 ) and control group (n =31 ). The patients in statin group were treated with Rosuvastain 20 mg/day besides conventional therapy; the patients in control group were treated only with conventional therapy and placebo.The course of therapy was 8 weeks. Plasma levels of hs-CRP and vWF, endothelium dependent vasodilatation function were measured before and after treatment. Results The plasma levels of hs-CRP and vWF in statin group were decreased significantly (P ＜0.01 ), also endothelium dependent vasodilatation function were improved than the patients in control group after 8 weeks. Conclusion It is suggested that short-term therapy with rosuvastatin in patients with ACS could reduces the levels of hs-CRP and vWF and improve the function of endothelium dependent vasodilatation, thus it promotes the stabilization of atheroselerotic plaque.     

血胱抑素C及尿酶对糖尿病肾病早期诊断的意义

目的探讨血胱抑素C(CysC)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、尿微量白蛋白(mALB)对糖尿病肾病早期诊断的临床意义。方法选择我院60例糖尿病患者,其中尿蛋白阴性的患者31例为观察1组,阳性29例为观察2组;同时选择体检中心同期同年龄段正常体检者40例为对照组,测定糖尿病组和正常对照组血胱抑素C(CysC)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、尿微量白蛋白(mALB),同时测定尿肌酐(Cr)。结果分别以CysC、NAG/Cr、mALB/Cr表示。结果观察1组与观察2组CysC、NAG/Cr、mALB/Cr指标明显高于对照组,检测结果比较差异明显,具有统计学意义P<0.05;观察2组CysC、NAG/Cr、mALB/Cr指标明显高于观察1组,2组结果比较差异明显,具有统计学意义P<0.05。结论 CysC、NAG/Cr、mALB/Cr能较准确反应早期糖尿病患者肾损害程度的临床检测指标,三者联合检测是早期诊断糖尿病肾病的敏感指标。     

糖尿病患者早期肾损伤的检测结果分析

目的 探讨尿常规检查蛋白阴性的糖尿病患者早期肾损伤的几率和临床意义.方法 尿微量白蛋白采用微柱层洗法;转铁蛋白(TRF)、免疫球蛋白G(IgG)、a1-微球蛋白(a1-MG)测定采用免疫比浊法;N-乙酰-β-D-氨基葡萄糖苷酶(NAG)测定采用比色法.对206例尿常规检查蛋白阴性的糖尿病患者进行了早期肾损伤指标检测.结果 对照组52例,mAlb:(15.8±6.5)mg/L;TRF:(0.97±0.83)mg/L;IgG(3.7±2.2)mg/L;a1-MG(4.60±0.91)mg/L NAG(13.3±7.1)U/L.糖尿病组206例,mAlb:(98.1±45.2)mg/L;TRF:(3.97±3.10)mg/L;IgG:(12.26±9.87)mg/L;a1-MG:(13.2±10.23)mg/L;NAG:(55.2±32.5)U/L,两组间比较有统计学意义P＜0.01.结论 检测尿中的早期损伤项目,可提前发现肾损伤,阳性率占常规检查蛋白阴性患者的50%,检测尿微量蛋白等对临床具有重要意义.     

阿托伐他汀对老年高脂血症患者颈动脉斑块的影响

目的 探讨阿托伐他汀对老年高脂血症患者颈动脉斑块的影响.方法 155例伴有颈动脉斑块的老年高脂血症患者应用阿托伐他汀20 mg/d治疗.治疗前、治疗后6个月检测血脂水平,经彩色多普勒超声检测颈动脉内膜中层厚度(IMT)、斑块最大厚度(Tmax)及最大面积(Smax).结果 治疗后患者TC、TG、LDL-C较治疗前明显下降[(4.07±0.52)mmol/L比(5.83±0.76)mmol/L,(1.65±0.24)mmol/L比(2.18±0.37)mmol/L,(2.98±0.31)mmol/L比(3.75±0.49)mmol/L,均P＜0.05)],HDL-C较治疗前明显升高[(1.27±0.19)mmol/L(0.94±0.15)mmol/L,P＜0.05];颈动脉IMT、Tmax、Smax较治疗前明显下降[(1.15±0.13)mm比(1.41±0.19)mm,(2.01±0.19)mm比(2.29±0.24)mm,(13.61±2.87)mm2比(16.75±3.06)mm2,均P＜0.05].结论 阿托伐他汀具有延缓动脉粥样硬化进程及稳定斑块的作用.

Abstract：

Objective To study the effects of atorvastatin on atherosclerotic plaques in the elderly patients with hyperlipoidemia. Methods Atorvastatin 20 mg/d was administered in 55 cases of atherosclerotic plaques in elderly patients with hyperlipoidemia. The levels of blood fat and carotid intima-media thickness (IMT) , maximal plaque thickness (Tmax) and maximum size (Smax) were observed by Color Doppler ultrasound before and after 6 months treatment. Results The levels of TC, TG, LDL-C in patients after treatment were significant lower than those before treatment [(4.07±0.52) mmol/L vs (5. 83 ±0. 76)mmol/L, (1. 65 ±0.24)mmol/L vs (2. 18 ± 0.37)mmol/L, (2.98 ±0. 31)mmol/L vs (3.75 ±0.49)mmol/L,P＜0. 05] , HDL-C was significant higher than that before treatment [(1.27 ±0.19) mmol/L vs(0.94 ±0.15) mmol/L,P＜0.05]. The carotid IMT, Tmax, Smax were significantly lower than those before treatment [(1. 15 ±0.13) mm vs (1.41±0.19) mm, (2.01 ± 0.19)mm vs (2.29 ±0.24)mm,(13.61 ±2.87)mm2 vs (16.75 ±3.06)mm2,P＜0.05]. Conclusion Atorvastatin can delay the process of atherosclerosis and stabilize plaques.     

氨溴特罗口服液佐治小儿肺炎支原体肺炎疗效分析

目的 观察氨溴特罗口服液协助治疗小儿肺炎支原体肺炎的临床疗效,探讨肺炎支原体肺炎发病机制.方法 将96例肺炎支原体肺炎住院患儿完全随机分为治疗组48例、对照组48例,2组患儿均采用阿奇霉素治疗,治疗组在此基础上联合氨溴特罗口服液,连续治疗7 d.观察2组临床总有效率和不良反应率并记录病情好转时间.结果 治疗组总有效率93.8%(45/48)明显好于对照组的85.4%(41/45)(x2=11.68,P＜0.05),住院期间治疗组患儿肺部哮鸣音消失时间、止咳时间、肺部啰音消失时间及住院时间均比对照组明显缩短[分别为(2.3±1.1)d比(4.2±1.6)d,(3.4±1.1)d比(6.0±2.3)d,(3.3±1.2)d比(4.9±2.1)d,(5.8±1.0)d比(7.8±2.4)d].2组不良反应率较小,差异无统计学意义(P＞0.05).结论 氨溴特罗口服液联合阿奇霉素治疗小儿支原体肺炎疗效确切,安全,有助于缩短疗程.

Abstract：

Objective To study the effect of ambroxol hydrochloride and clenbuterol hydrochloride oral solution in treating mycoplasma pneumonia pneumonia, and to explore the possible immunopathogenesis. Methods Ninety-six hospitalized children with mycoplasma pneumonia were randomly divided in two groups. The treatment group (n=48) received ambroxol hydrochloride and clenbuterol hydrochloride oral solution in addition to conventional therapy and the control group (n=48) received routine therapy. Results The curative effect of the treatment group was superior to that of the control group[93.8% vs 85.4%, P＜0.05]. The disappearance time of the lungs wheeze, cough time, pulmonary rales disappeared time and length of stay of children in the treatment group were significantly shorter than that in the control group [(2.3 ±1. 1)d vs(4.2 ± 1. 6)d, (3.4 ± 1. 1)d vs(6. 0 ±2. 3)d, (3.3±1.2)d vs(4.9 ±2.1)d, (5.8±1.0)d vs(7.8±2.4)d]. Conclusion Oral administration of ambroxol hydrochloride and clenbuterol hydrochloride oral solution combined azithromycin is effective, secure and convenient for treatment of patients with mycoplasma pneumonia.     

高血压患者尿微量蛋白与尿酶的检测及临床价值

目的：探讨早期诊断高血压病患肾脏损伤的方法。方法：采用速率散射比浊检测尿微量白蛋白（mALB)、转铁蛋白（TRF），β2微球蛋白（β2－MG），终点法测尿N－乙酰－β－D－氨基葡萄糖苷酶（N-acetyl-β-D-glucosaminidase,NAG)和尿肌酐。结果：尿蛋白定性阴性的高血压病患尿TRF／Cr、mALB/Cr、β2－MG／Cr及MAG／Cr较正常对照组增高（P＜0．01）。单项及双项检测TRF、mALB、β2－MG或NAG位于三项和四项指标同时检测的阳性率，四项指标联合检测在高血压病中阳性率可达85．1％。结论：联合检测尿TRF、mALB、β2－MG及NAG是诊断高血压病患肾脏早期损伤灵敏、可靠的实验室指标。