基质金属蛋白酶9表达与人冠状动脉粥样硬化性斑块中的肺炎衣原体相关

为研究动脉粥样硬化斑块中肺炎衣原体与基质金属蛋白酶9的关系。用免疫组织化学、聚合酶链反应、逆转录聚合酶链反应等方法研究了31个动脉粥样硬化斑块，检测肺炎衣原体抗原及其基因组DNA、基质金属蛋白酶9蛋白表达和转录。结果：免疫组织化学分析确认冠状动脉粥样硬化斑块中肺炎衣原体抗原的存在与基质金属蛋白酶9的生成有着明显的相关性（P=0．001）。而且，     

肺炎衣原体感染对老年患者冠状动脉粥样硬化及再狭窄的影响

目的　探讨肺炎衣原体感染和炎症对老年患者冠状动脉粥样硬化和支架内再狭窄的影响。方法　 5 5 5例接受冠状动脉造影检查的患者根据造影结果分为冠状动脉粥样硬化组和无冠状动脉粥样硬化组 ,检测血清肺炎衣原体抗体IgA及C反应蛋白 (CRP)。 89例放置冠状动脉内支架的患者分感染组和非感染组 ,随访半年 ,再次行冠状动脉造影检查 ,测量支架内管腔丢失率。结果　冠状动脉粥样硬化组肺炎衣原体抗体IgA的阳性率及滴度显著高于非冠状动脉粥样硬化组 ;血清CRP水平明显升高 ,且随着病变程度加重而增加。肺炎衣原体感染组和非感染组内膜增厚发生率差异无显著性意义。但内膜增厚者血清CRP水平明显高于无内膜增厚者。结论　肺炎衣原体感染与冠状动脉粥样硬化相关 ,但不能预示支架内再狭窄的发生 ;而炎症标志物与冠状动脉粥样硬化和再狭窄的发生均相关。     

家鸽实验性冠状动脉粥样硬化斑块的超微结构观察

本文报道用家鸽喂以胆固醇,并用电镜观察冠状动脉斑块的超微结构及泡沫细胞的来源。结果表明,来自中膜平滑肌细胞增生形成的肌性小斑块出现在巨噬细胞源性泡沫细胞性斑块之前。     

冠状动脉粥样硬化斑块的稳定性研究进展

本文概述了冠状动脉粥样硬化斑块的形成、发展和破裂的机理,以及增加斑块的稳定性、防治斑块破裂的措施。     

颈动脉粥样硬化与冠状动脉粥样硬化的关系

~~颈动脉粥样硬化与冠状动脉粥样硬化的关系@何勤$海军青岛疗养院军以上干部疗养科!山东青岛266071 @宋文宣$青岛市立医院干部保健科!审校者~~     

肺炎支原体感染与冠状动脉粥样硬化的关系

目的探讨肺炎支原体（MP）感染与冠状动脉粥样硬化（CAS）的关系。方法采用EusA法检测CAS患者（CAS组）和健康者（对照组）的血清MP抗体IgG、IgM,胶乳增强免疫比浊法检测CAS组的血清高敏C反应蛋白（Ha-CRP）,酶法检测血脂,ELISA法检测TNF-α、IL-1β、IL-6。结果CAS组MPIgG阳性率明显高于对照组（P〈0．01）;与MPIgG阴性患者比较,CRP组MPIgG阳性患者的TC、TG、LDL-C明显升高,HDL—C明显降低,TNF-α、IL-1β、IL-6明显升高（P〈0．01或〈0．05）。各检测指标与CAS患者MP感染均独立相关,以Hs—CRP、IL-6的相关性最大（P〈0．01或〈0．05）。结论MP感染与CAS有关,其可能通过感染及炎症反应参与CAS的发生、发展。     

亚临床冠状动脉粥样硬化的检测与干预

亚临床冠状动脉粥样硬化(subclinical coronary athemsclerosis,SCA)是一项基于无创检查的病理学诊断,多指采用电子束断层(EBT)等无创检查发现的冠状动脉粥样硬化斑块。国外研究显示,绝大多数冠状动脉事件发生在“无血流动力学意义”的病变。因此,在具备生理意义前识别SCA,有望进行早期干预,并改善临床后果。     

冠状动脉粥样硬化斑块愈合的研究进展

动脉粥样硬化斑块破裂后的愈合过程对临床结果意义重大,良好的斑块愈合可以阻止血栓的进一步发展,避免急性心血管事件的发生,但反复的斑块愈合也被认为可加重斑块负荷,引起血管慢性狭窄。随着腔内影像技术的发展,对斑块愈合的研究愈加深入,许多针对斑块愈合的治疗方法也在实施或研究中。     

冠状动脉粥样硬化斑块稳定性鉴别的研究进展

不稳定性冠状动脉粥样硬化斑块是急性冠脉综合征(ACS)发生发展的主要原因。目前,迅速发展的影像学技术及各种炎症标志物的检测可较好的反映斑块的不稳定性,故其对于ACS及时正确诊断及治疗有重要意义。     

The Study of Chlamydia Pneumoniae DNA in the Peripheral Blood Mononuclear Cell of Coronary Heart Disease

Cardiovascular disease is the leading cause of death in developed countries. The cause is multifactori- al. A substantial proportion of patients with coronary artery disease do not have traditional risk factors. Therefore, scientific attention has recently focused on investigating hypothetical additional risk factors and on achieving a deeper understanding of the development of atherosclerosis . Infectious diseases may play a role in these cases , or they may intensity the effect of other risk…     

肺炎衣原体感染对冠心病发病影响的临床观察

目的 研究肺炎衣原体(Cpn)感染与冠心病(CHD)的关系.方法 应用酶联免疫吸附试验(ELISA)测定冠心病组(120例)和对照组(111例)血清Cpn特异性抗体IgM、IgG及IgA,同时应用免疫浊度法测定冠心病组(97例)和对照组(95例)血清C-反应蛋白(CRP)含量.结果 冠心病组血清Cpn抗体IgG和/或IgA阳性率及IgG和IgA滴度明显高于对照组(均P<0.05);急性心肌梗死(AMI)、不稳定型心绞痛(UAP)及慢性冠心病(CCHD)患者血清Cpn抗体IgG及IgA滴度均分别高于对照组(均P<0.05);冠心病组Cpn抗体IgM阳性率及滴度与对照组无明显差异;IgG和/或IgA及CRP均为阳性组的冠心病发生率明显增高;多元回归分析显示Cpn慢性感染与冠心病发病呈正相关(P=0.045),Cpn慢性感染与冠心病其他危险因素间无相关性.结论Cpn慢性感染可作为冠心病的独立危险因素,炎症反应的发生可能是Cpn慢性感染导致动脉粥样硬化的关键环节.     

冠状动脉病变程度与肺炎衣原体感染及炎症反应的关系

目的 :探讨冠心病冠状动脉 (冠脉 )病变程度与肺炎衣原体 (Cpn)抗体IgA (Cpn IgA)、C 反应蛋白 (CRP)及人白细胞介素 6的关系。　　方法 :用酶联免疫吸附试验 (ELISA)测定 10 4例经冠脉造影诊断为“冠心病 (包括不稳定性心绞痛 )”患者 (冠心病组 )和 2 0例正常对照者 (对照组 )的血清Cpn IgA、CRP及人白细胞介素 6水平 ,比较它们与不同的冠脉病变程度之间的关系。　　结果 :冠心病组Cpn感染率明显高于对照组。多支冠脉病变者血清Cpn IgA水平明显高于单支病变者。入选病例的血清Cpn IgA、CRP及人白细胞介素 6水平 3者之间两两成正相关关系。　　结论 :血清Cpn IgA水平与冠脉粥样硬化的程度有一定关系 ,在Cpn感染致冠脉粥样硬化的过程中 ,有炎症反应的参与。     

肺炎衣原体感染与冠心病的相关性研究

目的通过测定血清肺炎衣原体(TWAR)IgG、IgM抗体滴度水平,探讨肺炎衣原体感染与冠心病的相关性.方法应用间接微量免疫荧光法,测定115例冠心病病人(冠心病组)和60例健康人(正常对照组)血清肺炎衣原体IgC、IgM抗体滴度.结果冠心病组病人血清肺炎衣原体IgG平均几何滴度(GMT)(157.77±4.42)与正常对照组(119.93±4.29)相比有非常显著性差异(P<0.001).冠心病组肺炎衣原体既往感染阳性率明显高于正常对照组(70.4%vs36.7%,P<0.001),2组急性感染阳性率无明显差异(P>0.05).随着肺炎衣原体IgG抗体水平(IgG≥116)的增高,发生冠心病风险相对增高(OR4.36,95%CI 2.32～8.16).不稳定性心绞痛病人、急性心肌梗塞病人血清肺炎衣原体IgG平均几何滴度及感染阳性率均无明显差别,但两者与正常对照组相比均有非常显著性差异(P<0.001).结论研究结果表明,冠心病组病人肺炎衣原体感染率及血清肺炎衣原体IgG平均几何滴度均较高,有抗体者(IgG≥116)发生冠心病的风险相对增加,肺炎衣原体感染可能是构成冠心病发生发展的一个危险因子.     

肺炎衣原体感染、抗生素治疗和冠心病

最近血清流行病学研究、病原体检测、离体实验、动物模型以及抗生素的干预试验为肺炎衣原体在动脉粥样硬化的发生和发展中的作用提供了依据。肺炎衣原体在动脉粥样硬化及其他随后事件中是否有直接的因果作用 ?抗生素在冠心病的二级预防中是否有保护作用 ?这些问题尚无定论。目前在冠心病中正进行的大规模抗生素干预试验有望澄清此重要问题     

Clinical Results of Endarterectomy of the Right and Left Anterior Descending Coronary Arteries

Abstract In this study, we examined the clinical outcome of coronary endarterectomy. From 1990 to 1998, 4839 patients underwent surgical revascularization. Coronary artery bypass graft surgery (CABG) was performed alone on 4516 patients, was combined with right coronary artery endarterectomy (RCA-E) in 242 patients, and was combined with left anterior descending coronary artery endarterectomy (LAD-E) in 81 patients. An analysis of preoperative variables revealed a higher proportion of males (90.79'0 vs 80.2%, p < 0.001), of patients with low ejection fraction (< 35%; 4.69'0 vs 1.796, p < 0.001), and of three-vessel disease (47.9% vs 3696, p < 0.001) in the RCA-E versus the CABG patients. There was a higher proportion of unstable angina (51.9% vs 40.3%, p = 0.04) in the LAD-E patients. The 30-day mortality rate for CABG was 2% versus 2.5% for RCA-E and 3.7% for LAD-E (p = NS). Perioperative myocardial infarction (MI) rate for CABG was 3.49/0 versus 7.00/0 for RCA-E (p < 0.001) and 4.996 for LAD-E patients (p = NS). Postoperative low cardiac output syndrome was recorded in 11.596 of CABG, 18.6% of RCA-E (p = 0.01), and 11.1% of LAD-E (p = NS) patients. Predictors of postoperative bad outcome (death, MI, low cardiac output, cere-brovascular accident) were preoperative intra-aortic balloon pump, repeat operation, ejection fraction of < 350/, renal insufficiency, female gender, RCA-E, and age over 70. Protective factors included the use of internal mammary artery, multiple arterial grafts, and warm cardioplegia. Actuarial analysis at 6, 12, and 24 months showed late mortality rates of 0.8%, 1.3%, and 2.19'0 for CABG; 1.2%, 3.7%, and 3.7% for RCA-E; and 2.9%, 2.996, and 2.9% for LAD-E, respectively. Late MI occurrence was 0.4%. 0.49/0, and 0.7% for CABG; 1.5%, 1.5%. and 2.7% for RCA-E; and 0% for LAD-E, respectively. Multivariate analysis found renal insufficiency, ejection fraction of < 3556, repeat operation, female gender, New York Heart Association functional class IV, and diabetes to be predictors for late adverse events (recurrence of angina, MI, and cardiac death), and RCA-E was found to be a predictor of late MI. We conclude that the use of coronary endarterectomy to achieve complete revascularization in patients with diffuse distal coronary artery disease is a reasonable option, associated with a minimal addition in complication rates.     

Giant Left Anterior Descending Artery Aneurysm in a Patient with Behcet's Disease

Coronary artery aneurysm is a rare coronary abnormality nearly half of which originates from atherosclerotic lesions. The major causes of non-atherosclerotic coronary aneurysms include coronary ectasia, Kawasaki disease, Takayasu aortitis, thoracic trauma and complicated angioplasty; however, it has been rarely reported associated with Behcet's disease.