巴戟天醇提取物促大鼠缺血心肌治疗性血管生成的实验研究

目的探讨巴戟天糖链(MOO)对急性心肌梗死(AMI)大鼠缺血心肌治疗性血管生成的影响及其机制。方法♂Wistar大鼠,结扎冠状动脉左前降支,成功制成AMI模型40只,随机分为MOO小、中、大剂量组、麝香保心丸组及模型组,每组8只。另取10只建立假手术组。药物治疗组分别灌胃给予巴戟天醇提物水溶性部分(0.7、1.4、2.8mg.kg-1.d-1)及麝香保心丸悬浊液(30mg.kg-1.d-1),其余两组灌胃给予等量蒸馏水。连续灌胃6wk后处死大鼠,心肌取材,应用免疫组织化学法检测大鼠缺血心肌Ⅷ因子及血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)、碱性成纤维细胞生长因子(basic fibroblast growthfactor,bFGF)蛋白表达情况;计算微血管密度(microvessecdensity,MVD),用图像分析软件测定VEGF及bFGF表达灰度值,并进行半定量分析。结果与模型组相比,MOO中、大剂量组能增加缺血心肌MVD及VEGF、bFGF灰度值(P<0.05),但作用弱于麝香保心丸组(P<0.05);MOO3个剂量组之间MVD差异均有显著性(P<0.05);MOO3个剂量组之间VEGF灰度值差异均有显著性(P<0.05);MOO中、大剂量组bFGF灰度值与小剂量组相比差异有显著性(P<0.05)。结论MOO可促进AMI后大鼠缺血心肌的血管生成,其机制可能与上调缺血心肌VEGF、bFGF蛋白的表达有关。     

Granulocyte-colony stimulating factor augments neovascularization induced by bone marrow transplantation in rat hindlimb ischemia

Because granulocyte-colony stimulating factor (G-CSF) mobilizes bone marrow cells including endothelial progenitor cells, we examined whether G-CSF augments angiogenesis and collateral vessel formation induced by bone marrow-mononuclear cells transplantation (BMT). Unilateral hindlimb ischemia was surgically induced in Lewis rats. One week after surgery, administration of 100 mg/kg per day G-CSF significantly increased the laser Doppler blood perfusion index (LDBPI), number of angiographically detectable collateral vessels (angiographic score), and capillary density determined by alkaline phosphatase staining. In the BMT group (1 x 10(7) cells/rat) and the group with combined G-CSF treatment and BMT, LDBPI was significantly increased compared with that in the vehicle-treated group. In the BMT group, neovascularization was significantly increased as evidenced by the angiographic score and capillary density compared with the vehicle-treated group. Furthermore, the combination of G-CSF treatment and BMT augmented neovascularization compared with BMT alone, as evidenced by the angiographic score and capillary density. Moreover, G-CSF significantly increased vascular endothelial growth factor mRNA and fibroblast growth factor-2 mRNA in hindlimb muscle. In conclusion, G-CSF was found to augment neovascularization in rat hindlimb ischemia. Combined use of G-CSF treatment and BMT may be a useful strategy for therapeutic neovascularization in ischemic tissues.     

碱性成纤维生长因子与血管内皮生长因子联合对大鼠后肢动脉硬化闭塞血管再生作用机制的研究

目的探讨联合应用血管内皮生长因子(VEGF)与碱性成纤维细胞生长因子(bFGF)对大鼠后肢动脉硬化闭塞血管再生的作用机制。方法建立大鼠后肢动脉硬化闭塞模型60只,随机分为4组,生理盐水治疗组(NS组)15只,碱性成纤维细胞生长因子组(bFGF组)15只,血管内皮生长因子组(VEGF组)15只,血管内皮生长因子+碱性成纤维细胞生长因子(VEGF+bFGF组)15只。NS组、VEGF组分别隔日一次腹腔注射生理盐水1mL、100μg/LVEGF 1mL;bFGF组隔日一次后肢股内侧多点肌肉注射100μg/L bFGF 1mL;VEGF+bFGF组隔日一次腹腔注射100μg/L LVEGF 1mL+后肢股内侧多点肌肉注射100μg/L bFGF 1mL,共治疗21d。分别于7d、14d、21d观察大鼠后肢缺血情况如:间歇性跛行情况、皮肤颜色改变、皮温改变、足溃疡情况等。继续饲养至3个月后取后肢股内侧部位肌肉组织行免疫组化观察血管数。结果 VEGF+bFGF组微血管密度显著高于bFGF组、VEGF组及NS组,差异有显著性意义(P<0.05);其他各组间差异无显著性意义(P>0.05)。可见VEGF与bFGF联合应用可促进后肢动脉硬化闭塞大鼠的血管再生。结论 VEGF联合bFGF能促进大鼠后肢动脉硬化闭塞血管再生,为临床治疗下肢动脉硬化闭塞提供新的治疗依据。     

Serum phosphate in acute myocardial infarction

The aim of this study is to measure phosphate levels in AMI, compare and analyse its relation with left ventricular (LV) dysfunction and mortality. Serum phosphate was measured by kinetic assay method in 40 patients with acute myocardial infarction (AMI). Echocardiographic LV function was assessed in all and the patients were followed up for 30 days. Hypophosphatemia (< 2.5 mg/dl) was observed in 27% of AMI patients (11/40). These patients formed group 1 of our study. The rest 73% patients (29/40) with normal phosphate levels formed group 2. Mean Phosphate level in group 1 was 1.96 mg/dl (range 1.2-2.37) and mean ejection fraction (EF) was .35 (range .25-.50, p value < .001). Mean phosphate in group 2 was 3.693 (range 2.6-6.00) and mean EF was .53 (range .38-.65, p value < .001). In hospital mortality of the group 1 was 28% (3/11) while in group 2 was 6.8% (2/29). We conclude hypophosphatemia in AMI is associated with LV dysfunction which results in increased 30 day mortality.     

Effect of angiotensin-converting enzyme inhibitor on collagenolytic enzyme activity in patients with acute myocardial infarction

Matrix metalloproteinases and their tissue inhibitors are key enzymes degrading myocardial collagen in acute myocardial infarction (AMI). The aim of the present study was to determine whether angiotensin-converting enzyme inhibitors (ACEI) influence collagenase-1 (MMP-1) and their tissue inhibitor (TIMP-1) activity in AMI patients. Plasma levels of MMP-1, TIMP-1 and MMP-1/TIMP-1 complex were measured in 24 patients (aged 58.4 +/- 13.9 years) with AMI. Thirteen patients received perindopril 4 mg/day (group A) and 11 did not (group B). Plasma samples collected on admission and at 0, 3, 6, 9, 12, 18, 24, 36 and 48 hours and on days 3, 4, 5, 7, 15 and 30 thereafter were analyzed by relevant ELISA kits. Ejection fraction (EF) was assessed by ventriculography and end-diastolic diameter (EDD) echo-study on days 6 and 30. Values of collagenolytic enzymes of group A compared with those in group B were on average lower by 34%, 18.3% and 40%, respectively. The difference in values between groups at 0 h, 3 h and 9 h was significant (p < 0.048). ANOVA repeated measurement analysis showed significance within subjects for MMP-1 alone (p < 0.043) and for MMP-1 and ACEI (p < 0.046), while for TIMP-1 and MMP-1/TIMP-1 complex significance was only p < 0.0009. Regarding EDD changes, patients in group A showed minimal or no changes (51.23 +/- 1.8 mm to 51.6 +/- 2.13 mm), their EF was 38.8% and infarct size was medium to large. In contrast, group B showed a trend to increase EDD (41 +/- 0.78 mm to 42.33 +/- 0.59 mm), their EF was 50.5% and infarct size was small to medium. In conclusion, early initiation of ACEI treatment reduces collagenolytic activity. This effect may be considered an alternative mechanism for beneficial effects on postinfarction remodeling.     

Apelin-13对急性心肌梗死家兔的治疗作用

目的探讨Apelin-13对急性心肌梗死(AMI)家兔的治疗作用。方法 30只雄性家兔,随机分为假手术组、AMI对照组和Apelin组,各10只。术后开始给药, Apelin组耳缘静脉注射Apelin-130.1 mg/(kg·d),连续7 d, AMI对照组及假手术组注射等量生理盐水。比较三组家兔血管内皮生长因子(VEGF)、梗死边缘区微血管计数、凋亡指数(AI)、心脏重量/体重,观察三组心肌损伤程度及胶原沉积情况。结果假手术组VEGF含量、梗死边缘区微血管计数、AI、心脏重量/体重分别为(44.94±2.76)ng/L、(7.820±1.059)个、(42.84±2.65)%、(1.90±0.12)‰,显著低于AMI对照组的(59.72±4.17)ng/L、(13.540±1.704)个、(73.97±5.03)%、(2.70±0.01)‰,差异均有统计学意义(P<0.05)。Apelin组VEGF含量、梗死边缘区微血管计数分别为(68.65±4.91)ng/L、(16.130±2.220)个,均高于AMI对照组, AI及心脏重量/体重分别为(65.73±4.42)%、(2.60±0.15)‰,均低于AMI对照组,差异均有统计学意义(P<0.05)。HE染色可见假手术组家兔心肌组织结构排列整齐, AMI对照组可见心肌组织中有广泛的炎性细胞浸润,心肌纤维断裂,排列紊乱,心肌细胞坏死。Apelin-13组可见炎性细胞浸润、心肌纤维断裂比AMI对照组减轻。结论 Apelin-13可促进AMI家兔梗死周围新生血管生成、侧支循环形成,缩小心肌梗死面积,且可有效抑制心肌细胞凋亡、减轻心肌细胞损伤、改善AMI家兔心肌重构。     

VEGF和bFGF联用对小鼠卵巢组织移植后的影响

【摘要】 目的 观察血管内皮生长因子(VEGF)和碱性成纤维细胞生长因子(bFGF)对同种异体卵巢移植后卵泡的存活和血管再生的作用。方法 将18日龄ICR雌性小鼠卵巢移植到成年ICR雌鼠的颈后皮下,将小鼠分为4组,分别皮下注射10μL生理盐水、bFGF、VEGF和bFGF+VEGF,每日1次,连续注射4d,于7d后处死取材,用HE染色观察卵泡的形态和数目,CD31抗体免疫组织化学染色观察血管密度。结果 移植前新鲜的小鼠卵巢组织内各级卵泡数目多,卵泡结构形态好。与移植前相比,各组移植后的卵巢组织内一些卵泡结构出现异常,各级卵泡数目及卵泡总数显著减少。VEGF+bFGF组始基卵泡数和移植物血管密度均优于bFGF和VEGF组,差异有统计学意义。结论 VEGF和(或)bFGF干预,能够促进卵巢组织移植后血管生成,减少卵泡丢失,从而改善卵巢组织移植后的质量。     

精氨酸对胰腺癌介入治疗患者血清VEGF和bFGF水平的影响

目的探讨精氨酸增强胃肠外营养对胰腺癌导管动脉化疗栓塞术（TACE）患者血清血管内皮生长因子（VEGF）和碱性纤维母细胞生长因子（bFGF）水平的影响及其临床意义。方法采用酶联免疫吸附法（ELISA）检测52例中晚期胰腺癌患者行TACE前后血清VEGF和bFGF水平的改变,并与健康对照组比较分析。结果胰腺癌组介入治疗前VEGF和bFGF水平增高,与对照组比较有显著性差异（P〈0.01）;行TACE后,患者血清VEGF和bFGF水平降低,治疗前后有显著性的差异（P〈0.05）;应用精氨酸治疗组较未用组血清VEGF和bFGF水平下降更显著（P〈0.05）。结论检测胰腺癌患者血清VEGF和bFGF水平,有助于了解患者的浸润转移状况,TACE辅以合理的免疫营养素能增强患者的抗浸润转移功能。     

经导管向血管远端注射三磷酸腺苷对急诊PCI术中无复流现象的疗效

目的观察急诊经皮冠状动脉介入治疗(Percutaneous coronary interventions,PCI)术中出现无复流现象后,经导管向远端血管床注射三磷酸腺苷(ATP)的临床效果。方法 2008年6月-2010年9月,接受急诊PCI手术出现无复流的46例患者,随机分为研究组(B组)24例和对照组(A组)22例。B组经导管注入ATP 200μg,A组注入维拉帕米200μg,必要时可以反复注射。观察注射药物后校正的TIMI血流帧幅数(CTFC)、术中血流动力学参数,记录术后左室射血分数(EF值)及住院期间主要不良心血管事件发生率。结果两种药物在多次给药后,均可以使90%的患者恢复TIMI 3级血流(A组:90.1%,B组:91.7%,P>0.05),A组、B组的CTFC值分别为26.5±14.6、258±10.3(P>0.05),但B组血压下降幅度明显小于A组[(8.7±5.6)mmHg vs(13.4±10.6)mmHg,P<0.05],需要IABP支持的患者数量有减少的趋势。两组的并发症及不良事件发生率差异无统计学意义。结论经导管向远端血管床注射三磷酸腺苷,可以即刻提高靶血管血流灌注和心肌组织灌注,是一种安全有效的治疗无复流的方式。     

单个核细胞源性血管内皮生长因子在急性心肌梗死患者中的动态变化及意义

目的 动态观察急性心肌梗死后外周血单个核细胞分泌的血管内皮生长因子水平的变化,探讨VEGF水平与急性心肌梗死患者左室收缩功能的关系。方法 分别抽取28例急性心肌梗死患者发病后第1、5、10、15天及正常对照12例的外周静脉血,并对外周血单个核细胞进行分离、培养,用酶联免疫吸附法测定单个核细胞培养的上清液中VEGF的浓度。同时检测CK峰值及入院和出院时左室射血分数。结果 (1)AMI患者外周血单个核细胞分泌的VEGF在心梗后第5天即达高峰(343.2±82.5)pg/mL,显著高于对照组的(143.3±24.2)pg/mL(P<0.05);(2)外周血单个核细胞分泌的VEGF峰值与CK峰值无显著相关;(3)LVEF改善的患者,其单个核细胞分泌的VEGF水平(867.6±113.1)pg/mL显著高于LVEF未改善者(234.8±82.4)pg/mL(P<0.05)。结论 AMI患者外周血单个核细胞产生的VEGF与AMI患者左室收缩功能改善有关。     

强化血糖控制对糖尿病伴急性心肌梗死患者经皮冠状动脉介入治疗术后心肌组织灌注及心室功能的影响

目的 观察强化血糖控制对糖尿病伴急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后心肌组织灌注及心室功能的影响.方法 68例2型糖尿病伴AMI患者完全随机分为糖尿病常规治疗组(34例)和糖尿病强化治疗组(34例),并以69例糖耐量正常NGT的AMI患者为NGT对照组.常规治疗为诺和灵30R皮下注射,维持血糖在8.0～11.1 mmol/L;强化治疗为静脉滴注胰岛素和(或)胰岛素泵治疗,维持血糖在4.4～6.1 rmnol/L.所有患者均于发病后24 h内行PCI,治疗后行心肌呈色分级(MBG),评价心肌微循环灌注情况,并于术后1周及1个月行心脏超声心动图检查,分别测定左心室射血分数、心指数,评价心室功能.结果 3组患者PCI术后心肌梗死溶栓试验(TIMI)3级的比率差异无统计学意义(P>0.05),糖尿病常规治疗组和糖尿病强化治疗组患者MBG 2-3级比例均明显低于NGT对照组(64.7%,82.3%比94.2%.均P<0.01),PCI术后1周和1个月时糖尿病强化治疗组心指数明显高于糖尿病常规治疗组[(3.17+0.42)L/(min·m2)比(2.62±0.43)L/(min·m2),(3.85±0.51)L/(min·m2)比(3.14±0.57)L/(min·m2),P<0.05],而糖尿病强化治疗组心指数和NGT对照组间差异无统计学意义(P>0.05);3组患者术后1周与术后1个月比较心指数均改善且差异有统计学意义(均P<0.05);NGT对照组左心室射血分数高于糖尿病常规治疗组和糖尿病强化治疗组(P<0.01),PCI术后1个月NGT对照组和糖尿病强化治疗组左心室射血分数较术后1周时明显改善(P<0.05),糖尿病常规治疗组亦有一定改善,但差异无统计学意义.结论 强化血糖控制可明显改善糖尿病伴AMI患者急诊PCI术后的心肌组织灌注及心室功能.

Abstract：

Objective To examine the effects of intensive glucose control on myocardial tissue perfusion and ventricular function in post-percutaneous coronary intervention(PCI)diabetes mellitus(DM)patients with acute myocardial infarction(AMI).Methods Sixty-eight DM patients with AMl were divided into two groups:DM routine treatment group(n=34)and DM intensive treatment group(n=34),and 69 AMI patients with normal glucose tolerance(NGT)as NGT control group.DM routine treatment group were treated with novolin 30R.to maintain blood glucose in 8.0～11.1mmol/L;DM intensive treatment group were treated with insulin.and(or)insulin pump,to maintain blood glucose in 4.4-6.1 mmol/L.All patients underwent emergency coronary angiography after PCI.We estimated the myocardial tissue perfusion according to the myocardial blush grade(MBG).The left ventricular ejection fraetio(LVEF)and cardiac index(CI)were measured in all patients at 1 week and l month after PCI to estimate ventricular function.Resuits There was no significant difference in TIMI Grade 3 after PCI among three groups(P>0.05),and the percentage of efficient reperfusion in DM group was significantly lower than NCT control groups(64.7%,82.3%vs 94.2%,P<0.01).The CI value was much higher in NGT intensive treatment group than DM routine treatment group(P<0.01),and there was no significant difference between DM intensive treatment group and NGT control group at 1 week and 1 month after PCI(P>0.05),but the CI value was significandy improved in all three groups at 1 month than at 1 week after PCI(P<0.05).The LVEF was much higher in NGT control group than DM groups(P<0.01),and significandy improved in NGT control group and DM intensive treatment group at 1 month than at 1 week after PCI(P<0.05),but there was no significant improved in DM routine treatment group(P>0.05).Condusion Intensive glucose control may significantly improve myocardial tissue perfusion and ventricular function after PCI in DM patients with AMI.     

磁共振评估急性心肌梗死患者心肌活性及与超敏C反应蛋白的相关性

目的用磁共振评估急性心肌梗死(AMI)患者心肌活性,并分析其与超敏C反应蛋白(hs-CRP)的相关性。方法选择AMI患者43例,健康对照组30名,利用磁共振灌注及延迟成像将AMI患者分为透壁增强组、非透壁增强组和混合组。AMI患者于经皮冠状动脉介入治疗(PCI)术前及术后6个月分别行心脏磁共振分析梗死心肌质量、左室射血分数及室壁运动异常评分的变化。AMI患者分别于病程第7日及PCI术后6个月抽取肘静脉血测血清hs-CRP水平。健康对照组抽1次血测血清hs-CRP水平。分析PCI术前及术后血清hs-CRP水平的变化及与磁共振检测结果的相关性。结果梗死心肌质量及室壁运动异常评分在PCI术后均减少,梗死心肌质量在非透壁增强组及混合组中减少差异有统计学意义(P<0.05),室壁运动异常评分在非透壁增强组降低(P<0.05);左室射血分数在3组患者PCI术后均增加,在非透壁增强组及混合组中增加差异有统计学意义(P<0.05)。PCI术前及术后6个月血清hs-CRP较健康对照组均降低,但术前与健康对照组比较差异有统计学意义(P<0.05)。PCI术后6个月血清中hs-CRP较术前明显降低(P<0.05)。PCI术前的左室射血分数与血清中hs-CRP独立相关(R2=0.318,P<0.05)。结论磁共振灌注技术可以有效预测心肌梗死患者的心肌活性,对临床治疗及评估预后具有较为重要的临床价值。检测血清hs-CRP对预测心肌活性,评估冠状动脉缺血严重程度及判断预后具有一定的临床意义。     

急性心肌梗死伴新发心房纤颤的临床分析

目的研究探讨急性心肌梗死（AMI）伴新发心房纤颤（AF）的临床特点。方法回顾性分析344例急性心肌梗死患者住院期间的资料,其中新发房颤患者53例（AF组）,未发生房颤者291例（NAF组）,AF组按新发AF持续时间分为AF1组23例（心肌梗死24h内发生AF者）,AF2组30例（心肌梗死24h后发生AF者）。比较AF组和NAF组之间的年龄、并发症、CK—MB峰值、心功能（Killp分级）、死亡率以及NAF组和AFl组、AF2组之间心肌梗死部位病变血管情况等因素的对比。结果AF组老年患者多于NAF组（P〈0．01）,AF伴有高血压病、糖尿病者高于NAF组（P〈0．01）,AF组CK—MB峰值、心力衰竭发生率、死亡率显著高于NAF组（P〈0．01）,AF组冠状动脉多支病变的发生率较NAF组高（P〈0．05）,AF1组下壁AMI发生率高于NAF组和AF2组（P〈0．05）,AF2组前壁AMI发生率高于AF1组（P〈0．05）。结论高龄、伴发高血压、糖尿病、梗死面积及多支血管病变是AMI并新发AF的危险因素,AF发生时间与AMI梗死部位相关,AMI并新发AF者严重并发症多,预后差,应给予早期积极干预。     

吡柔比星联合顺铂膀胱灌注化疗对早期膀胱癌VEGF和HER-2表达的影响

目的 探讨吡柔比星联合顺铂膀胱灌注化疗对早期膀胱癌血管内皮生长因子(VEGF)、人类表皮生长因子受体-2 (HER-2)表达的影响.方法 收治的早期膀胱癌患者80例,参照抽签法分为对照组和试验组,每组40例.2组患者均于术后进行化疗,对照组给予顺铂常规化疗,研究组基于对照组联合吡柔比星行膀胱灌注化疗,比较2组患者治疗后VEGF水平、HER-2表达情况,生活质量变化,临床疗效,复发率及生存率,毒副反应.结果 治疗后,试验组VEGF低于对照组,比较差异有统计学意义(P＜0.05);试验组HER-2低表达率、过表达率优于对照组,差异有统计学意义(P＜0.05);试验组生活质量优于对照组(P＜0.05);试验组客观缓解率为87.50％高于对照组的62.50％,差异有统计学意义(P＜0.05);试验组复发率、生存率优于对照组(P＜0.05);2组毒副反应比较差异无统计学意义(P＞0.05).结论 吡柔比星联合顺铂膀胱灌注化疗能够显著改善早期膀胱癌患者VEGF水平,调节HER-2表达,提高患者的生活质量.     

2型糖尿病合并急性心肌梗死临床分析

目的 探讨2型糖尿病（T2DM）合并急性心肌梗死（AMI）患者的冠脉病变及临床特点.方法 对339例经冠脉造影确诊为冠状动脉粥样硬化病变的AMI患者分为T2DM合并AMI组（78例）和AMI组（261例）,进行冠脉病变程度和临床表现比较.结果 T2DM合并AMI组冠脉三支病变、重度狭窄、弥漫性病变多于AMI组（P＜0.01）,严重心律失常、心力衰竭、心源性休克、住院死亡率也高于AMI组（P＜0.01或＜0.05）.结论 T2DM合并AMI患者冠脉病变和临床表现较无T2DM的AMI患者重,病死率高.     

替格瑞洛联合阿托伐他汀和阿司匹林对急性ST段抬高型心肌梗死PCI术后心肌血流灌注的影响

目的 探讨替格瑞洛联合阿托伐他汀和阿司匹林对急性ST段抬高型心肌梗死（STEMI）经皮冠状动脉介入术（PCI）术后心肌血流灌注的影响,为其临床诊治提供参考。方法 选择2015年5月-2019年3月郑州市第一人民医院收治的100例行PCI手术的STEMI的患者作为研究对象,按照治疗方法将患者分为对照组和观察组,各50例。对照组口服阿托伐他汀钙片,20 mg/次,1次/d;阿司匹林肠溶片,100 mg/次,1次/d。观察组患者在对照组治疗基础上口服替格瑞洛片,180 mg/次为初始剂量,之后90 mg/次,2次/d。共治疗2个月,随访半年。比较两组患者PCI术后即刻冠状动脉血流及心肌血流灌注指标,分析两组患者住院期间及随访6个月的心功能指标及主要不良心血管事件（MACE）。比较两组患者治疗前后血清心肌肌钙蛋白I（cTnI）、血管性血友病因子（vWF）、肌酸激酶同工酶（CK-MB）及血管内皮生长因子（VEGF）水平变化。结果 治疗后,观察组患者PCI术后ST段回落率、TIMI血流分级3级以及TMPG3级患者均明显高于对照组,而cTFC值比对照组降低（P<0.05）。两组患者治疗后LVEF、E/A明显升高,LVEDD明显降低（P<0.05）;且观察组患者治疗后上述指标改善更为显著（P<0.05）。治疗后,两组患者的血清CK-MB水平明显降低,血清VEGF、vWF及cTnI水平均明显升高（P<0.05）。治疗后,观察组患者CK-MB水平显著低于对照组,VEGF、vWF和cTnI水平显著高于对照组（P<0.05）。观察组住院期间及术后随访MACE发生率低于对照组（P<0.05）。结论 替格瑞洛联合阿托伐他汀和阿司匹林可以更好改善PCI术后STEMI患者的凝血纤溶系统和心肌血流灌注,保护心功能,减少预后MACE事件的发生率,具有一定的临床应用价值。     

症状性子宫肌瘤子宫内膜中VEGF、bFGF表达的实验研究

目的 研究子宫肌瘤子宫内膜中血骨内皮生长因子(VEGF)、成纤维生长因子(bFGF)的表达,揭示症状性子宫肌瘤子宫内膜内环境的改变.方法 将子宫肌瘤65例患者根据有无月经过多的症状分为2组(A组:症状性子宫肌瘤组;B组:无症状性子宫肌瘤组),各组再根据子宫内膜病理类型进行组内分型.C组:正常子宫内膜作为对照组共12例.用免疫组化技术检测VEGF、bFGF在3组子宫内膜中表达水平.结果 VEGF及bFGF在3组子宫内膜中均有表达,VEGF、bFGF在A组子宫内膜增生期、分泌期中的表达水平高于B组及C组同型子宫内膜,差异有显著性(P＜0.05);在A组单纯性增生过长和复杂性增生过长子宫内膜中的表达水平显著低于A组及B组、C组增生期, 差异有显著性(P＜0.01).在B组与C组同型子宫内膜中的表达水平,差异无显著性 (P＞0.05).A组增生过长、增生期和分泌期子宫内膜中VEGF表达水平与bFGF表达水平呈显著正相关(r=0.829,P＜0.05;r=0.798,P＜0.01;r=0.626,P＜0.05).结论 子宫内膜内环境异常是子宫肌瘤患者产生月经过多的原因.VEGF、bFGF作为促血管生成因子发挥着重要作用.     

Cyclo-oxygenase-2 enhances basic fibroblast growth factor-induced angiogenesis through induction of vascular endothelial growth factor in rat sponge implants

Angiogenesis is reportedly enhanced by prostaglandins (PGs). In the present study, we investigated whether or not cyclo-oxygenase (COX)-2 mediated angiogenesis in chronic and proliferate granuloma. In rat sponge implants, angiogenesis was gradually developed over a 14-day experimental period as granuloma formed. This angiogenesis was enhanced by topical injections of human recombinant basic fibroblast growth factor (bFGF). In sponge granuloma, mRNA of COX-1 was constitutively expressed, whereas that of COX-2 was increased with neovascularization in parallel with that of vascular endothelial growth factor (VEGF). Topical injections of bFGF increased the expression of COX-2 mRNA. bFGF-stimulated angiogenesis was inhibited by indomethacin or selective COX-2 inhibitors, NS-398, nimesulide, and JTE-522. The levels of PGE(2) and 6-keto-PGF(1alpha) in the sponge granuloma were increased with bFGF 13 fold and 9 fold, respectively, and these levels were markedly reduced by NS-398. The expression of VEGF mRNA in the granuloma was also enhanced by bFGF, and was reduced by NS-398. Topical injections of PGE(2) and beraprost sodium, a PGI(2) analogue, increased the expression of VEGF mRNA, with angiogenesis enhancement. The enhanced angiogenesis by bFGF was significantly inhibited by topical injections of VEGF anti-sense oligonucleotide. These results suggested that COX-2 may enhance bFGF-induced neovascularization in sponge granuloma by PG-mediated expression of VEGF, and that a COX-2 inhibitor would facilitate the management of conditions involving angiogenesis.     

西妥昔单抗联合三维适形放疗在中晚期食管癌患者中的疗效

目的:探讨西妥昔单抗联合三维适形放疗在中晚期食管癌患者中的疗效及对血清肿瘤标志物水平、新生血管指标水平、生存情况的影响。方法:回顾性分析选取南阳市第一人民医院2020年1月至2021年8月收治的106例中晚期食管癌患者作为研究对象,分析患者的病历资料后,根据治疗方案的不同将患者分对照组和观察组各53例。对照组接受三维适...