结合珠蛋白基因多态性与冠心病

结合珠蛋白(Hp)又称触珠蛋白,是一种酸性糖蛋白,属急性期反应蛋白之一。Hp通过与游离血红蛋白结合而具抗氧化活性,有抑制前列腺素合成、促进血管生成及调节机体免疫等功能。Hp由于所含轻链类型的不同而具有遗传多态性,本文综述了Hp遗传多态性与冠心病的发生、发展、治疗、转归及预后之间关系,以便为临床干预提供指导依据。     

结合珠蛋白基因多态性与冠心病

结合珠蛋白(Hp)又称触珠蛋白,是一种酸性糖蛋白,属急性期反应蛋白之一.Hp通过与游离血红蛋白结合而具抗氧化活性,有抑制前列腺素合成、促进血管生成及调节机体免疫等功能.Hp由于所含轻链类型的不同而具有遗传多态性,本文综述了Hp遗传多态性与冠心病的发生、发展、治疗、转归及预后之间关系,以便为临床干预提供指导依据.     

血浆结合珠蛋白浓度与早发冠心病的关系研究

目的检测早发冠心病（PCHD）患者血浆结合珠蛋白（Hp）水平,观察不同类型早发冠心病患者血浆珠蛋白水平。方法纳入2010年5月～2011年1月PCHD患者72例,同期纳入健康体检者74例作为对照组。将PCHD组依诊断进一步分为稳定性心绞痛组（SA,n=15）、不稳定性心绞痛组（UA,n=36）和急性心肌梗死组（AMI,n=21）;检测并比较各组Hp浓度的差异。结果 PCHD组Hp浓度高于对照组,差异有统计学意义[（1.785±0.525）ng/mLvs.（0.869±0.172）ng/mL,P〈0.05];SA组、UA组和AMI组Hp浓度分别为（1.699±0.723）ng/mL、（1.685±0.453）ng/mL和（1.946±0.584）ng/mL,组间比较无明显差异（P=0.281）。结论 PCHD患者血浆Hp浓度明显升高,且与类型无关。     

早发冠心病患者结合珠蛋白的基因多态性

目的检测早发冠心病患者结合珠蛋白(Hp)基因型的分布,探讨冠心病易感性及其与冠状动脉病变严重程度的关系。方法 92例早发冠心病患者及74例健康对照者,采用Gensini冠状动脉评分系统(Gensini积分)对冠心病组冠状动脉的狭窄程度进行分组:A组积分<50分,B组50分≤积分<90分,C组积分≥90分。应用PCR-SSP技术检测Hp基因。结果早发冠心病组与对照组间的Hp2-2基因型频率分别为43.48%、54.05%,差异不显著(P=0.376)。早发冠心病组A、B、C亚组的Hp2-2基因型频率分别为28%、50%、77.78%,C组Hp2-2基因频率明显高于A组(P<0.001)。且早发冠心病组Hp1-1、Hp1-2、Hp2-2基因型Gensini积分分别为22.50±13.844、47.05±25.504、65.52±40.580,Hp2-2基因型积分显著高于Hp1-1基因型(P<0.001)。结论 Hp2-2基因型可能不是早发冠心病的独立危险因素但可能与冠心病冠状动脉狭窄程度相关。     

冠心病合并糖尿病患者结合珠蛋白基因多态性研究

目的 检测冠心病合并糖尿病患者结合珠蛋白（Hp）基因型的分布,探讨其易感性及与冠状动脉病变严重程度的关系.方法 选择92例冠心病患者（其中45例合并糖尿病）及74名健康对照者,应用PCR-SSP技术检测Hp基因;采用Gensini冠状动脉评分系统（Gensini积分）对冠状动脉的狭窄程度进行评分.结果 冠心病组与对照组间的Hp2-2基因型频率分别为43.48％和54.05％,差异无统计学意义（P=0.376）.冠心病合并糖尿病组、单纯冠心病组的Hp2-2基因型频率分别为77.78％和42.55％,冠心病合并糖尿病组Hp2-2基因频率明显高于单纯冠心病组和对照组（P,＜0.01）.冠心病合并糖尿病组Hp1-1、Hp1-2、Hp2-2基因型Gensini积分分别为25.16±11.13、42.05±20.04和65.32±32.78,Hp2-2基因型积分显著高于Hp1-1基因型（P＜0.01）.结论 Hp2-2基因型可能是冠心病合并糖尿病的独立危险因素且与冠心病冠状动脉狭窄程度相关.     

冠心病患者血浆结合珠蛋白的检测及临床意义

目的检测冠心病患者血浆结合珠蛋白(Hp)水平的变化、探讨其与冠状动脉病变严重程度的相关性和临床意义。方法经冠状动脉造影确诊的冠心病患者175例,非冠心病患者作为对照组121例。采用Gensini冠状动脉评分系统(Gensini积分)对冠状动脉的狭窄程度进行分组,根据积分将患者分为:积分50分组,积分≥5090组,积分≥90组三个亚组。检测患者血浆结合珠蛋白浓度,比较冠心病组与对照组,冠心病亚组间血浆结合珠蛋白的差异及冠脉严重程度与血浆结合珠蛋白的相关性。结果冠心病组与对照组血浆结合珠蛋白浓度分别为70.93±42.71、95.07±52.92mg/L,冠心病组的血浆结合珠蛋白浓度明显高于对照组(P0.05)。冠心病亚组间血浆结合珠蛋白浓度分别为88.57±51.96、105.73±59.555、97.96±44.04mg/L,均高于对照组,但组间比较无明显差异(P=0.269)。结论冠心病患者血浆中结合珠蛋白浓度明显升高,提示血浆结合珠蛋白与冠心病的发生可能有关,但本研究未发现冠状动脉病变的严重程度与血浆结合珠蛋白浓度有相关性。     

急性心肌梗死患者血浆结合珠蛋白的变化及其意义

目的探讨急性心肌梗死(AMI)患者血浆结合珠蛋白(Hp)的变化及其与冠状动脉狭窄的严重程度的相关性。方法 AMI并行冠状动脉造影术检查的患者98例,非冠心病的健康体检者90例作为对照组,检测血浆Hp浓度,对比AMI组与对照组血浆Hp浓度的差别;分析AMI患者血浆Hp浓度与冠状动脉病变支数及Gensini积分的相关性。结果 AMI组的血浆Hp浓度明显高于对照组,差异有统计学意义(P0.01)。双支病变、三支病变AMI患者的Hp浓度明显高于单支病变AMI患者的Hp浓度,差异有统计学意义(P0.05);Gensini积分30的AMI患者Hp浓度明显高于Gensini积分30的患者,差异有统计学意义(P0.05)。AMI患者Hp血浆浓度与Gensini积分有显著性正相关(P0.05)。结论 Hp水平的升高与AMI的发生有关,Hp水平与AMI患者冠状动脉狭窄的严重程度有关。     

结合珠蛋白基因多态性与冠状动脉狭窄程度的相关性研究

目的探讨结合珠蛋白基因多态性与冠状动脉狭窄严重程度的相关性。方法入选经冠状动脉造影确诊的冠心病患者103例,非冠心病患者83例作为对照组。采用免疫浊度分析仪定量测定血浆结合珠蛋白浓度,通过非变性聚丙烯酰胺凝胶电泳分型鉴定Hp基因型,分析Hp血浆浓度及Hp基因型与冠心病发生发展及冠状动脉狭窄严重程度的相关性。结果冠心病组血浆Hp浓度(93.98±53.10mg/L)明显高于对照组(68.88±43.83mg/dL),组间比较有显著性差异(P<0.05)。冠心病组与对照组间Hp基因型的分布频率无显著性差异(P>0.05)。但冠心病组间,Hp2-2基因型组的Gensini积分明显高于Hp1-1/Hp1-2基因型(p<0.05)。结论冠心病组血浆Hp浓度明显升高,Hp2-2基因型组的Gensini积分高于Hp1-1/Hp1-2基因型组,本研究结果提示HP血浆浓度与冠心病的发生发展有关,而Hp2-2基因型可能与冠心病患者冠状动脉狭窄的严重程度有关。     

早发冠心病并发高血压病患者血浆结合珠蛋白水平与冠状动脉病变程度的相关性

目的:分析早发冠心病并发高血压病患者血浆结合珠蛋白（haptoglobin,Hp）水平的变化及其与冠状动脉病变严重程度的相关性。方法: 经冠脉造影确诊的早发冠心病患者90例,非冠心病的健康体检者90例作为对照组,据血压水平分类将90例早发冠心病患者分为3个亚组:正常血压及正常高值亚组（亚组1）、Ⅰ级和Ⅱ级高血压亚组（亚组2）、Ⅲ级高血压亚组（亚组3）。检测血浆Hp浓度,比较冠心病组与对照组血浆Hp浓度的差异;分析早发冠心病不同临床亚组间血浆Hp浓度、Gensini积分的差异及分析二者的相关性。结果: 早发冠心病组的血浆Hp浓度明显高于对照组,比较有统计学差异（P<001）。早发冠心病组3个亚组的Hp血浆浓度分别为（16±05） μg/L、（17±04） μg/L和（20±06） μg/L,3组之间差异有统计学意义（P<005）。两两比较,亚组3的Hp血浆浓度高于亚组1和亚组2,差别有统计学意义（均P<005）。3个亚组Gensini积分分别为（32±19）、（33±18）和（48±28）,3亚组之间差异有统计学意义（P<005）。两两比较,亚组3的Gensini积分高于亚组1和亚组2,差别有统计学意义（均P<005）,而亚组1与亚组2的Hp浓度和Gensini积分均无显著差异。结论: Hp水平的升高与早发冠心病的发生及冠脉狭窄的严重程度有关。     

Implementation of Newborn Screening for Hemoglobin H Disease in Mainland China

Hemoglobin H disease is the most severe non-fatal form of α-thalassemia syndrome characterized by pronounced microcytic hypochromic hemolytic anemia. It is predominantly seen in Southeast Asia, the Middle East and the Mediterranean. Studies suggest that hemoglobin H disease is not as benign a disorder as previously thought. Newborn screening for hemoglobin H disease is especially appealing because the screening test is based on the detection of hemoglobin Bart’s (γ4) that is only possible within the newborn period. In this study, we reported on a 4-year period of newborn screening program at a mainland Chinese hospital, which detected 35 babies with hemoglobin H disease in a total of 26 152 newborns. The overall prevalence for hemoglobin H disease among all newborns in southern China is ~1 in 1,000. These children need appropriate follow-up and potential comprehensive care during their growth and development.     

新生儿轮状病毒和小圆病毒无症状感染的探讨

从283份健康新生儿粪便标本中,用PAGE和EM法检测,发现轮状病毒和小圆病毒等,检出率分别为2.12％和4.94％。其中轮状病毒按基因分析可分为S和L两种图型,并存在互相取代的流行优势。上述所有感染者均未见临床腹泻症状,证实在福州地区存在新生儿轮状病毒和小圆病毒的无症状感染。 同时,我们还观察到应用PAGE法检测新生儿粪便标本时,约30.04％标本在凝胶上方可出现一条金黄色DNA带,经用EM和限制性内切酶图谱分析,证实所见的1条DNA带不是腺病毒的特异性DNA带,所以应用PAGE法直接检测新生儿粪便中的腺病毒,判断应取慎重的态度。     

内弹力膜损伤对新生内膜的影响

目的通过球囊扩张并拉伤兔腹主动脉建立血管损伤模型,分析血管损伤与新生内膜之间的关系,进一步探讨内弹力膜损伤对经皮冠状动脉介入术后再狭窄产生的影响。方法对32只雄性新西兰大耳白兔进行股动脉穿刺,经导丝送人球囊,球囊扩张并拉伤腹主动脉建立血管损伤模型。术后28天处死模型兔,分离损伤血管,进行固定、包埋及染色处理。使用计算机图像分析软件测量新生内膜厚度,分析确定血管损伤积分。结果血管损伤积分与新生内膜厚度呈正相关。血管损伤积分与新生内膜厚度之间的拟合曲线为呈"S"形的三次曲线。结论内弹力膜损伤加速新生内膜增生。     

The Study on the Correlation Between Plasma Adiponectin Level and Coronary Heart Disease

Objectives To investigate the relationship between plasma adiponectin level and coronary heart disease （CHD）, and some established cardiovascular risk factors and to probe its probable pathogenesis which adiponectin results in CHD. Methods The levels of plasma adiponectin, fasting plasma insulin （FINS）, C-reactive protein （CRP） and P-selectin were measured by ELISA, plasma ET-1 was measured by radioimmunoassay （RIA） in 75 male patients with CHD and 30 healthy male people. Body mass index （BMI）, waist / hip ratio （WHR） and insulin resistance index （Homa-IR） were calculated respectively. Results （1）The plasma adiponectin levels in CHD group were lower compared with control group[（5.18±2.57）mg / L vs（8.94±2.59）mg / L, P〈 0.001 ], there was no significant difference of plasma adiponectin levels in CHD sub-groups （P 〉 0.05）.（2） Based on multinominal stepwise logistic regression analysis, adiponectin was one of significant and independent risk factors for CHD. （3） Multivariate liner stepwise regression analysis showed that adiponectin had significant correlation with BMI and TG, BMI and TG were independent factors influencing on plasma adiponectin levels. （4） Pearson correlation analysis indicated plasma adiponectin levels were inversely related to FINS levels , Homa-IR, CRP, P-selectin and ET-1. Conclusions （ 1 ）Plasma adiponectin levels are lower in CHD patients compared the control　subjects, there are no significant difference of plasma adiponectin levels in patients with SAP, UAP and AMI. （2） Plasma adiponectin levels are relative with CHD. Hypoadiponectinemia is an independent risk factor for CHD. （3）Established cardiovascular risk factors such as BMI and TG have an obvious influence on adiponectin. （4）The probable pathogenesis by which adiponectin involves in CHD is suggested that adiponectin relates to insulin resistance, inflammatory reaction and dysfunction of vessel endothelium.     

血浆抵抗素水平与肥胖间关系的横断面研究

目的:探讨血浆抵抗素水平与肥胖间的关系。方法:2005年对北京市石景山区1258例研究对象(其中男性439例,女性819例)进行流行病学调查,系统收集吸烟、饮酒、体力活动、血压、血脂、血糖、体重、腰围等心血管病危险因素资料,并采用酶联免疫吸附法测定研究人群血浆抵抗素水平。结果:同时按照腰围(男性85cm、85～90cm、≥90cm,女性80cm、80～85cm、≥85cm)和体重指数(BMI24kg/m2、24～28kg/m2、≥28kg/m2)分别比较各自的血浆抵抗素水平。结果显示,无论男性还是女性,随着BMI和(或)腰围增加,血浆抵抗素水平显著升高;男性BMI24kg/m2、腰围85cm者血浆抵抗素水平最低,而BMI≥28kg/m2、腰围≥90cm者血浆抵抗素水平最高,两者血浆抵抗素水平的中位数分别为1.66ng/ml和3.41ng/ml(P0.001);女性BMI24kg/m2、腰围80cm者血浆抵抗素水平最低,而BMI≥28kg/m2、腰围≥85cm者血浆抵抗素水平最高,两者血浆抵抗素的中位数分别为2.06ng/ml和3.81ng/ml(P0.001)。多元线性回归分析的结果显示,即使在控制了年龄、吸烟、饮酒、饮茶、体力活动、血压、血脂、高敏C反应蛋白的情况下,无论男性还是女性,血浆抵抗素水平与腰围和体重指数之间均存在显著的关联。结论:本研究显示血浆抵抗素水平和肥胖之间存在密切关联,然而由于本研究为横断面关联研究,其研究结果仍有待进一步的研究进行证实。     

酶联免疫法定量检测幽门螺杆菌抗体的研究

对73例十二指肠溃疡和胃炎进行血清抗HP抗体定量测定,结果以尿素酶试验和胃粘膜涂片同时阳性作为HP阳性标准,判断血清抗体法检测HP阳性符合率,以同样方法判断血清抗体法阴性符合率.在尿素酶和胃粘膜涂片阳性39例中,抗HP-IgG抗体阳性35例,阳性符合率为89%;尿素酶和胃粘膜涂片阴性34例中,30例阴性,阴性符合率为88%,5例在临界值范围.经卡方检验差别无显著性(P>0.05).抗HP-IgG定量方法的测定比定性方法更准确.定量方法可得出具体数据,可以判断患者感染细菌时间长短以及反映机体对HP免疫力强弱.HP血清学检查可用于观察抗HP疗效及HP普查.本操作每次应设阴阳性对照,用标准品作为定量标准,标本定量应在24h内完成,以免HP-IgG效价降低,若放置低温冰箱,应避免反复冻融.     

原发性高血压病患者血清细胞因子水平变化的检测及临床意义分析

目的探讨原发性高血压病患者细胞因子IL-6、TNF-α及IL-10的变化及临床意义。方法采用酶联免疫吸附法(ELISA法)检测127例原发性高血压病患者及50例正常人血清细胞因子水平并进行比较。结果与正常对照组相比,原发性高血压病患者血清IL-6和TNF-α水平明显升高(P＜0．01),IL-10明显降低(P＜0．01)；治疗后患者血清IL-6和TNF-α水平明显下降(P＜0．01),血清IL-10明显升高(P＜0．01)。结论原发性高血压患者血清细胞因子水平出现明显变化,并在疾病的发生发展过程中起重要作用。     

Glutathione Synthetic Activity in the Lungs in Newborn Guinea Pigs

Depletion of glutathione, a key antioxidant, accelerates lung injury. Glutathione concentrations are reduced significantly in premature infants with respiratory distress syndrome, leaving them at greater risk of bronchopulmonary dysplasia. A study was designed to verify if the increased glutathione synthetic activity observed in oxygen-dependent and ventilated newborn infants was caused by their postsurgical state. Our objective was to evaluate the role of a general surgical procedure as a factor affecting lung glutathione. One-day-old guinea pig pups, a well characterized animal model for the study of neonatal lung disease, were divided between those undergoing a standardized surgical procedure and those that did not. The pups were fed by their mother. After 4 days the lungs were sampled to determine total glutathione content, activities of γ-glutamyltranspeptidase, glutathione peroxidase, and reductase as well as the glutathione synthetic activity. The surgical procedure was associated with a specific stimulatory effect limited to glutathione synthetic activity (p < 0.02) leading to an increased (p < 0.02) pulmonary glutathione content. Glutathione concentration was significantly correlated (r ²= 0.67) with the synthetic activity. We concluded that in this animal model an invasive procedure such as a general surgical procedure affects lung glutathione metabolism in a fashion similar to that of hyperoxia. In the lungs, the synthetic activity is a stronger determinant of glutathione concentrations than the activities of the other enzymes involved in maintaining glutathione levels. Accepted for publication: 21 May 1998     

A Study on Changes of the Plasma Endothelin Level in Patients with Dilated Cardiomyopathy

Objectives To evaluate the changes of the plasma endothelin level in patients with dilated cardiomyopathy, and to investigate the relationship between the plasma endothelin level and the severity of heart failure, heart size, left ventricular function and with or not with pulmonary arterial hypertension; the changes of the plasma endothelin level before and after treatment. Methods The plasma endothelin level of 30 patients with DCM, 30 healthy control subjects, and their LVEF, PAP, heart size, plasma endothelin level before and after treatment were determined. Results The plasma endothelin level in DCM group was significantly higher than that in control group ( 135.93 ± 70. 65pg/mL) vs(43.65 ± 12.07pg/mL), P < 0.05 ; there was a correlation between ET level and heart size ( r = O. 4580, P = 0. 0109 ) ; there was a significant negative correlation between LVEF of DCM and ET level( r = -0. 6922 ,P =0. 0021 ) ;and it was a significant positive correlation between ET level and pulmonary arterial hyperten     

血清胱抑素C与急性脑梗死患者颈动脉粥样硬化斑块的相关研究

目的:探讨血清胱抑素C (Cys-C)水平与急性脑梗死患者颈动脉粥样硬化斑块的关系.方法:选择我院神经内科收治的急性脑梗死患者120例,根据颈动脉彩色多普勒超声的检测结果将患者分为有斑块组(76例)和无斑块组(44例),比较两组患者血浆Cys-C、空腹血糖(FBG)、三酰甘油(TG)、胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、血尿素氮(BUN)、血肌酐(CREA)、血纤维蛋白原(FIB)等指标的水平有无差异,并进行相关及回归分析.结果:①有斑块组和无斑块组血浆Cys-C[(1.21±0.24) mg/L比(0.82±0.18)mg/L],胆固醇[(5.83±1.46)mmol/L比(4.22±0.98)mmol/L]、低密度脂蛋白[(2.92±1.08)mmol/L比(1.83±0.45) mmol/L]、纤维蛋白原[(3.89±2.03) g/L比(2.78±1.82) g/L]比较差异有统计学意义(P＜0.05).②多因素Logistic回归分析显示年龄、血清胱抑素C、胆固醇、低密度脂蛋白、纤维蛋白原为颈动脉粥样硬化斑块形成的危险因素,相关性分析显示Cys-C与年龄存在正相关(P =0.007),与胆固醇、低密度脂蛋白、纤维蛋白原无相关性(P＞0.05).结论:除了年龄、胆固醇、低密度脂蛋白、纤维蛋白原外,Cys-C也是颈动脉粥样硬化斑块形成的重要因素,同时也是急性脑梗死的危险因素.