阿托伐他汀对急性冠脉综合征患者血脂及C反应蛋白的影响

目的:探索阿托伐他汀对急性冠脉综合征(ACS)患者高脂血症及C反应蛋白(CRP)的作用。方法:82例 ACS患者随机分为阿托伐他汀组和常规治疗组,分别在入院时、1周后及接受高脂餐负荷实验后检测CRP和血脂水平。结果:阿托伐他汀治疗组患者治疗后CRP及总胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)水平显著降低 (P<0．01),餐后血浆TG、CRP较对照组显著降低(P<0．001,<0．01)。结论:短期阿托伐他汀治疗可有效降低 ACS患者血清中CRP、TG、LDL-C水平。     

化瘀降浊治疗高脂血症30例疗效观察

目的探讨化瘀降浊治疗高脂血症的疗效.方法 60例观察病人随机分为化瘀降浊组(治疗组)30例和非诺贝特组(对照组)30例,两组疗程均为30 d,疗程结束后评定疗效.结果治疗组治疗前后比较症状积分、体重指数、TC、TG、HDL-C、LDL-C有统计学意义(P<0.01);对照组治疗前后TC、TG、HDL-C亦有统计学意义(P<0.01或P<0.05);治疗后两组比较:症状积分、体重指数、TC、LDL-C有统计学意义(P<0.01).结论 化瘀降浊治疗高脂血症具有明显改善症状、体重指数和降低多项血脂指标的作用.     

老年透析病人血脂水平及相关因素分析

目的　观察血透和腹透治疗对老年病人血脂的影响 ,并对相关因素进行探讨。方法　血液透析治疗的尿毒症病人 31例 ,CAPD治疗的尿毒症病人 2 3例 ,正常对照组 30例 ,分别检测开始透析时及透析后 1 2个月时的血脂、血浆白蛋白、血肌酐 (Scr)。结果　老年血透、腹透病人透析前 TG、TC、LDL- C、Apo B、Lp(a)已明显增高 ,HDL- C、Apo A1明显降低 (均 P<0 .0 5) ;老年腹透病人 1 2个月后与透析前比较 ,TC、TG、LDL- C均明显增高 ,HDL- C明显降低 (均 P<0 .0 5)。透析 1 2个月后腹透病人 Apo A1及 Apo B与透析前差异显著 (均 P<0 .0 1 )。两组病人透析前均有明显的低蛋白血症 ,透析后血浆白蛋白显著降低 ,腹透病人尤其显著 ;而且血浆白蛋白水平与血脂呈显著相关。结论　老年透析病人透析前即存在血脂异常 ,透析治疗并不能消除高脂血症 ,甚至加重高脂血症 ,尤其以腹透病人明显。营养不良、低蛋白血症可能是透析病人高脂血症的主要致病因素。     

有氧运动对老年高血压合并代谢综合征患者的影响

目的比较老年高血压合并代谢综合征患者有氧运动及有氧结合抗阻运动在改善血压及多种心血管危险因素方面的效果。方法160例老年高血压合并代谢综合征患者随机分为对照组(40例)、有氧运动组(60例)、有氧结合抗阻运动组(60例)。三组患者原有的饮食,服药习惯保持不变,后两组患者进行24周规则运动。干预前后观察体重指数、收缩压、舒张压、血糖、胰岛素抵抗指数、血清C-反应蛋白及血脂指标的变化。结果24周后,有氧运动组及有氧结合抗阻运动组体重指数、收缩压、舒张压、血糖、胰岛素抵抗指数、血清C-反应蛋白及血脂指标显著改善(P<0.05或0.01),且有氧结合抗阻运动组较有氧运动组收缩压、FPG及LDL的改善更显著(P<0.05)。结论长期有规律的运动可显著改善老年高血压合并MS患者的CVD危险因素,将有氧运动和抗阻运动相结合运用,能取得血压及多种CVD危险因素改善的效果。     

普伐他汀、非诺贝特、鱼油对血脂及血浆内皮素、血栓烷B2水平的影响

目的　观察原发性高脂血症患者分别应用三种不同血脂调节剂后对血脂及血浆内皮素(endothelin,ET 1)、血栓烷B2 (thromboxaneB2 ,TXB2 )水平的影响。方法　 91例原发性高脂血症患者 ,其中 ,男 67例 ,女 2 4例 ,平均年龄 (5 3 1± 8 9)岁。随机分别服用普伐他汀(pravastatinP,n=3 0例 )、非诺贝特(fenofibrateF。n=3 3例 )、鱼油 (fishoilFO。n=2 8例 )血脂调节剂 12周后 ,比较其服药前后调脂剂的疗效及对ET 1,TXB2 ,6 酮 前列环素 (6 酮 PGF1a)水平的影响 ,并分析血脂与ET 1、TXB2 / 6 酮 PGF1a比值间的相互关系。高脂血症类型 :Ⅱa 型 19例 ,Ⅳ型 5 2例 ,Ⅱb 型 2 0例。结果　治疗 12周后 ,三组血清甘油三酯 (TG)、低密度脂蛋白 (LDL C)、载脂蛋白B10 0 (apoB10 0 )水平均明显降低 (P <0 0 5～0 0 0 1)。P组与F组血清胆固醇 (TC)水平降低显著性 (P <0 0 5～ 0 0 0 1)。血清高密度脂蛋白 (HDL C)水平三组均有升高 ,但仅F组有显著性 (P <0 0 5～ 0 0 0 1)。HDL C与TG水平三组均呈负相关 (P<0 0 5～0 0 0 1)。血浆ET 1水平三组均有显著降低 (P <0 0 0 1) ,TXB2 / 6 酮 PGF1a比值三组治疗前高于健康人 ,治疗后均降低 (P <0 0 1～ 0 0 0 1)。血浆ET 1水平及TXB2 / 6 酮 PGF1a比值下降 (除FO组TC)     

高脂血症患者粘附分子水平及调脂干预的研究

目的　观察高脂血症患者可溶性 P-选择素 ( s P- sel)和可溶性细胞间粘附分子 - 1( s ICAM- 1)的表达及阿托伐他汀的调脂干预的作用。方法　用酶联免疫吸附法 ( EL ISA)及放免法检测 32例高脂血症患者 (男 19例 ,女 13例 )服用阿托伐他汀 ( 10 mg/ d,疗程 4～ 6周 )前后血浆 s ICAM- 1和 s P- sel的水平并与性别、年龄相匹配的 30例正常血脂组对照。结果　高脂血症患者血浆 s ICAM- 1和 s P- sel的水平明显高于对照组 ( P<0 .0 1) ;阿托伐他汀治疗 4～ 6周后总胆固醇 ( TC)、甘油三酯 ( TG)、低密度脂蛋白胆固醇 ( L DL - C)、s ICAM- 1和 s P- sel的水平显著下降 ( P<0 .0 1) ;s ICAM- 1和 s P- sel与 TC、L DL- C、TG呈正相关 ( P<0 .0 5 ) ,HDL- C升高不明显。结论　 1)血浆 s ICAM- 1和s P- sel的表达增加推测是高脂血症致动脉粥样硬化的一个重要环节 ;2 )阿托伐他汀降低 s ICAM- 1和 s P- sel水平可能主要是通过调节血脂而产生。     

生活方式干预对代谢综合征患者影响10年随访研究

目的通过10年随访研究,探讨生活方式干预对代谢综合征(MetS)患者的代谢异常状况及相应指标水平的影响。方法选择体检发现的广西南宁市部分高校MetS患者1039例为研究对象进行饮食联合运动干预,随访10年。根据随访结果,将符合干预要求的患者111例作为干预组,不符合干预要求的患者256例作为对照组。比较干预组及对照组中高血压患者、高血糖患者、血脂紊乱患者、超重或肥胖患者干预前后的血压、血糖、血脂水平以及体重指数(BMI)的变化情况。结果饮食联合运动干预10年后,干预组中高血糖MetS患者的空腹及餐后2h血糖下降,对照组中高血糖MetS患者的空腹及餐后2h血糖升高,前者的空腹及餐后2h血糖显著低于后者,差异有统计学意义(P 0. 05);干预组中血脂紊乱MetS患者的甘油三酯(TG)、总胆固醇(TC)水平显著降低,高密度脂蛋白胆固醇(HDL-C)水平显著升高;对照组中血脂紊乱MetS患者的TG、TC水平显著升高,HDL-C水平显著降低;干预组中血脂紊乱MetS患者的TG、TC水平显著低于对照组,HDL-C水平显著高于对照组,差异有统计学意义(P 0. 05);干预组中高血压MetS患者的收缩压(SBP)、舒张压(DBP)水平显著降低,其SBP、DBP水平显著低于对照组,差异有统计学意义(P 0. 05);干预组中超重或肥胖MetS患者的体质量指数(BMI)水平显著降低,其BMI水平显著低于对照组,差异有统计学意义(P 0. 05)。结论饮食联合运动干预可明显改善MetS患者的糖代谢、脂代谢、血压及BMI水平。     

国产辛伐他汀与舒降之调血脂作用的对比观察

目的 :对比观察国产辛代他汀与进口辛伐他汀 (舒降之 )对高脂血症患者的调血脂作用。　　方法 :将 16 0例高脂血症患者以抽签法随机分为辛伐他汀组 (n=10 0 )及舒降之组 (n=6 0 ) ,分别口服国产辛伐他汀及舒降之。观察用药 4周及 8周患者的血清总胆固醇 (TC) ,低密度脂蛋白胆固醇 (L DL- C) ,高密度脂蛋白胆固醇 (HDL- C) ,(TC- HDL- C) /HDL- C及甘油三酯 (TG)变化。　　结果 :服用国产辛伐他汀 4周及 8周可分别使患者血清 TC降低 2 2 .8%、2 8.1% ,L DL - C降低 2 7.9%、32 .2 % ,(TC-HDL- C) /HDL- C降低 36 .3%、45 .2 % ,HDL- C升高 13.4%、16 .1% ,合并高甘油三酯血症患者 TG降低 19.4%、2 9.4% ,但对单纯高胆固醇血症患者 TG水平无显著影响。服药 4周即有明显调血脂疗效。　　结论 :国产辛伐他汀调血脂作用疗效肯定 ,与其相应进口产品舒降之比较基本相同。     

两种剂量阿托伐他汀对冠心病患者踝臂指数和hs CRP影响的比较

目的:观察不同剂量阿托伐他汀治疗冠心病的疗效及其对踝臂指数（ABI）和高敏C反应蛋白（hs CRP）的影响。方法: 选择冠心病患者110例,随机分为40 mg组和10 mg组,每组各55例。10 mg组予以阿托伐他汀10 mg/次,1次/晚,40 mg组予以阿托伐他汀40 mg/次,1次/晚。观察比较两组的血脂及治疗前后的ABI和hs CRP的水平。结果: 治疗后,两组的总胆固醇（TC）,三酰甘油（TG）和低密度脂蛋白胆固醇（LDL C）的水平均较治疗前显著降低（P<005或P<001）,高密度脂蛋白胆固醇（HDL C）水平较治疗前显著升高（P<005）;与10 mg组比较,40 mg组LDL C 较10mg组降低更显著（P<005）。hs CRP水平较治疗前也显著降低（P<001）;与10 mg组比较,40 mg组hs CRP水平下降更为显著(P<005)。而ABI水平治疗后较治疗前显著升高（P<001）,与10 mg组比较,40 mg组ABI的改善更为显著(P<005)。结论: 阿托伐他汀对冠心病患者的ABI和hs CRP改善明显,而且40 mg组改善更显著。     

辛伐他汀对高脂血症患者血浆C反应蛋白的短期疗效

目的 :了解辛伐他汀对血浆C反应蛋白 (CRP)的影响。方法 :90例高脂血症患者随机分为治疗组4 5例 (口服辛伐他汀 2 0mgqn× 1个月 )和对照组 4 5例 (饮食和生活方式调整 ,未服用调脂药物 ) ,治疗前后分别测定血浆总胆固醇 (TC)、三酰甘油 (TG)、高密度脂蛋白胆固醇 (HDL C)、低密度脂蛋白胆固醇 (LDL C)和高敏感CRP(hsCRP)。结果 :1个月后治疗组TC、LDL C分别降低了 2 0 .8%和 2 1.4 % ,HDL C升高了 6 .3% ,hsCRP降低了 7.6 % ,hsCRP的变化与HDL C的变化呈负相关。对照组上述指标均无明显变化。结论 :辛伐他汀不仅可以调节血脂代谢的失衡 ,而且可以降低血浆CRP水平 ,CRP的降低独立于LDL C的降低 ,但与HDL C的升高相关。     

In search of the false-negative exercise treadmill testing evidence-based use of exercise echocardiography

BACKGROUND: Controversy exists regarding the role of exercise treadmill testing (ETT) versus exercise stress echocardiography (ESE) as the appropriate initial noninvasive test to risk-stratify patients with chest pain. The majority of studies to date that evaluated these methodologies included patients with poor functional status and baseline electrocardiogram (ECG) abnormalities, potentially limiting the sensitivity of ETT. HYPOTHESIS: We examined the hypothesis that given stringent standards of exercise duration and ECG interpretability, the ETT would have a high diagnostic sensitivity for the presence of significant coronary artery disease (CAD). METHODS: Results of concurrent ETT and ESE in 3,098 patients were examined, and the subset of patients with a negative ETT and positive ESE (-ETT/ + ESE) were reviewed for the presence of CAD as a function of exercise duration (< or > or = 6 min) and baseline ECG normality. RESULTS: In those patients with a - ETT/ + ESE who exercised > or = 6 min, 54 had a normal baseline ECG, 22 underwent angiography and 6 had CAD (all of whom had either small, grafted or collateralized vessels). Patients with a - ETT/ + ESE who were incapable of exercising 6 min were more frequently older and female. Mortality was significantly greater in the < 6 min exercise duration group (31.4 versus 3.1%). CONCLUSIONS: These findings support the use of the ETT without imaging as the initial test in patients with chest pain who have a normal baseline ECG and are able to exercise 6 min. Using these criteria, false negative findings are generally seen in patients without critical large vessel epicardial disease. The ESE should be reserved as the initial test for patients with an abnormal baseline ECG or reduced functional capacity.     

Aerobic,resistance and combined training for adults with chronic kidney disease: A protocol for a systematic review and network meta-analysis

Background:Chronic kidney disease (CKD) as a disease that poses a great threat to human health, which has become a public health issue of great concern. Studies have found that exercise training has a positive effect on improving the condition of chronic kidney disease. We will conduct a network meta-analysis to assess the effects of aerobic training, resistance training and combined aerobic and resistance training in treating CKD patients.Methods:We will search PubMed, EMBASE, Medline, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of science to identify randomized control trails (RCTs) that assessed the effect of different exercise training for CKD patients. Cochrane Handbook will be used to evaluate the risk of bias of included articles. We will use Stata or R software to perform data analysis.Results and Conclusion:Our systematic review and network meta-analysis will be the first study that investigates the effect of different exercise training for CKD patients, and will provide evidence for management of chronic kidney disease.Ethics and dissemination:The data involved in this study are from published articles. For this reason, there is no need for ethical approval or patient consent.Trial registration:the registration number was: CRD42020157280     

Effects of muscle strengthening versus aerobic exercise program in fibromyalgia

The purpose of this study was to compare the effects of aerobic training with a muscle-strengthening program in patients with fibromyalgia. Thirty women with fibromyalgia were randomized to either an aerobic exercise (AE) program or a strengthening exercise (SE) program for 8 weeks. Outcome measures included the intensity of fibromyalgia-related symptoms, tender point count, fitness (6-min walk distance), hospital anxiety and depression (HAD) scale, and short-form health survey (SF-36). There were significant improvements in both groups regarding pain, sleep, fatigue, tender point count, and fitness after treatment. HAD-depression scores improved significantly in both groups while no significant change occurred in HAD-anxiety scores. Bodily pain subscale of SF-36 and physical component summary improved significantly in the AE group, whereas seven subscales of SF-36, physical component summary, and mental component summary improved significantly in the SE group. When the groups were compared after treatment, there were no significant differences in pain, sleep, fatigue, tender point count, fitness, HAD scores, and SF-36 scores. AE and SE are similarly effective at improving symptoms, tender point count, fitness, depression, and quality of life in fibromyalgia.     

Cardiopulmonary Exercise Testing in Children and Adolescents with Asthma Who Report Symptoms of Exercise-Induced Bronchoconstriction

Patients with asthma often report symptoms of exercise-induced bronchoconstriction. We performed cardiopulmonary exercise testing to establish the cause of exercise limitation in patients with asthma, under treatment, who reported symptoms of exercise-induced bronchoconstriction. Ten of the 42 patients meeting criteria for inclusion in our study (24%) developed exercise-induced bronchoconstriction. Exercise limitation without exercise-induced bronchoconstriction was found in both obese and non-obese patients, suggesting that poor fitness is a problem independent of body habitus. Including cardiopulmonary exercise testing in the management of children with suspected exercise-induced bronchoconstriction would provide a better understanding of the etiology of their symptoms and facilitate more appropriate treatment.     

Cardiopulmonary Exercise Testing in Children and Adolescents with Asthma Who Report Symptoms of Exercise-Induced Bronchoconstriction

Patients with asthma often report symptoms of exercise-induced bronchoconstriction. We performed cardiopulmonary exercise testing to establish the cause of exercise limitation in patients with asthma, under treatment, who reported symptoms of exercise-induced bronchoconstriction. Ten of the 42 patients meeting criteria for inclusion in our study (24%) developed exercise-induced bronchoconstriction. Exercise limitation without exercise-induced bronchoconstriction was found in both obese and non-obese patients, suggesting that poor fitness is a problem independent of body habitus. Including cardiopulmonary exercise testing in the management of children with suspected exercise-induced bronchoconstriction would provide a better understanding of the etiology of their symptoms and facilitate more appropriate treatment.     

Superiority of supine bicycle over isometric handgrip exercise in the assessment of ischemic heart disease: An evaluation of left ventricular ejection fraction response using radionuclide angiography

Left ventricular ejection fraction (LVEF) response to supine bicycle and isometric handgrip exercise was evaluated in 15 patients with documented coronary artery disease (CAD) and stress-induced ischemia using radionuclide angiography. For purposes of analysis, the patients were divided into two groups: group I (n=7) with single-vessel disease and group II (n = 8) with multiple-vessel disease including 3 with left main artery disease. The studies were repeated 18 days later at similar external workloads to assess reproducibility of both tests. LVEF response to bicycle exercise was different for the two groups. The change in LVEF from rest to peak exercise was +0.04±0.02 for group I and -0.07±0.04 for group II (p <.001). LVEP response to isometric handgrip exercise was not different between the two groups. The change from rest to end of handgrip exercise was -0.02+0.02 for group I and -0.05 ±0.02 for group II. The reproducibility of LVEF response to bicycle exercise at similar workloads on day 1 and day 19 was good (r=0.85) while it was poor for isometric handgrip testing (r=0.67). Our data demonstrate that radionuclide angio-graphic measurement of LVEF response to supine bicycle exercise testing is superior to LVEF response to isometric handgrip testing in the evaluation of patients with CAD.     

Exercise-induced stridor due to abnormal movement of the arytenoid area: videoendoscopic diagnosis and characterization of the "at risk" group

We evaluated 4 patients who developed severe, symptomatic stridor during maximal cardiopulmonary exercise testing, all referred due to exercise-related dyspnea. All underwent resting, unsedated transnasal fiberoptic laryngoscopy and had normal findings. Four patients performed repeat maximal exercise testing with fiberoptic laryngoscopy, and they form the basis of this report. They had normal vocal cord motion during exercise, but developed abnormal anterior motion of the arytenoid and aryepiglottic folds only at peak exercise, leading to partial airway obstruction and severe stridor. This report details the workup and characterizes patients at risk for this unusual phenomenon.