冠心病患者细胞间粘附分子-1变化的研究

目的:观察心绞痛、急性心肌梗死时血清细胞问粘附分子-1(ICAM-1)水平的变化,以探讨其与冠心病的关系及意义。方法:选择健康体检者(正常对照组)30例、稳定性心绞痛(SAP)患者(SAP组)20例、不稳定性心绞痛(UAP)患者(UAP组)25例和急性心肌梗死(AMI)患者(AMI组)30例,采用酶联免疫吸附分析法(ELISA法)检测血清中ICAM-1浓度的变化。结果:(1)SAP组、UAP组、AMI组与正常对照组比较;血清中ICAM-1水平显著升高(P<0.01);(2)与SAP组比较,UAP组、AMI组血清ICAM-1水平显著升高(P均<0.01);(3)与UAP组比较,AMI组血清ICAM-1水平显著升高(P<0.05)。结论:血清中ICAM-1水平的高低与冠心病的严重程度有关,具有判断病情和预后的价值。     

亚硝酰氢对冠心病心力衰竭大鼠心肌线粒体功能的影响

目的 探讨亚硝酰氢对心肌梗死后心力衰竭大鼠心肌线粒体Na ,K -ATP酶和Ca₂ -ATP酶及线粒体呼吸链复合体I、IV活性的的影响。方法 结扎大鼠前降支制作心肌梗死后心力衰竭模型,35只Wistar大鼠随机分为假手术组、心力衰竭模型组、亚硝酰氢组。分别给予各组大鼠皮下注射0.9%生理盐水2ml或亚硝酰氢供体0.1mg/100g,4周后差速离心法提取线粒体,测量其Na ,K -ATP酶与Ca₂ -ATP酶活性;应用紫外分光光度法测定缺血再灌注后心肌线粒体呼吸链复合体I、IV的活性。结果 与模型组相比,亚硝酰氢组大鼠线粒体Na _,K -ATP酶和Ca₂ -ATP酶活性及线粒体呼吸链复合体I、IV活性明显增加。 结论 亚硝酰氢改善心力衰竭大鼠心功能的作用通过增加线粒体Na ,K -ATP酶和Ca₂ -ATP酶活性及线粒体呼吸链复合体I、IV活性而实现。     

丹七软胶囊对冠心病患者的心肌保护及血液流变学改善作用

目的:探讨丹七软胶囊对冠心病患者的心肌保护及血液流变学改善的作用。方法:选择2013年12月~2014年12月我院收治的冠心病患者84例,患者被随机均分为常规治疗组(42例)和联合治疗组(42例,在常规治疗组的基础上加用丹七软胶囊治疗)。对两组患者治疗前后血液流变学指标、心电图及炎症因子[C反应蛋白(CRP)和肿瘤坏死因子α(TNF-α)]水平进行检测比较。结果:与治疗前比较,治疗后两组上述血液流变学指标均显著降低(P均0.05),且与常规治疗组比较,联合治疗组全血高切黏度[(5.12±0.73)mPa/s比(4.47±0.86)mPa/s]、全血低切黏度[(7.36±1.32)mPa/s比(6.21±1.03)mPa/s]、血浆黏度[(1.47±0.31)mPa/s比(1.31±0.25)mPa/s]、红细胞聚集指数[(3.53±0.45)比(2.93±0.26)]和纤维蛋白原水平[(2.95±0.28)g/L比(2.08±0.24)g/L]降低更显著,P均0.05。联合治疗组的心电图总有效率显著高于常规治疗组(85.71%比57.14%,P0.05)。与治疗前比较,两组CRP和TNF-α水平均显著降低(P均0.05),且与常规治疗组比较,联合治疗组CRP[(6.52±1.61)mg/L比(5.18±1.25)mg/L]和TNF-α水平[(283.28±18.28)pg/ml比(245.08±12.24)pg/ml]降低更显著,P均0.05。结论:丹七软胶囊联合常规疗法治疗冠心病,可明显改善血液流变学和降低相关炎症因子水平,有心肌保护作用,值得推广。     

细胞间黏附分子-1在动脉粥样硬化组织中的表达

目的 探讨细胞间黏附分子-1(ICAM-1)在动脉粥样硬化(AS)形成中的作用。方法采用高脂饲料加大剂量VitD3制备大鼠AS模型。用Western blot和RT-PCR方法分别检测动脉壁细胞间ICAM-1蛋白及mRNA含量。结果AS大鼠血管壁ICAM-1蛋白及mRNA表达较正常对照组大鼠显著增高。结论 ICAM-1在血管壁的表达与AS的发生发展密切相关。     

美托洛尔对大鼠冠状动脉微栓塞心肌中炎性细胞因子表达及心功能的影响

目的探讨美托洛尔对大鼠冠状动脉微栓塞心肌组织中炎性细胞因子表达及心功能的影响。方法雄性SD大鼠162只,经左心室注射42μm微栓塞球,建立大鼠冠状动脉微栓塞模型,将存活的100只大鼠随机分为微栓塞组(CME组,50只)、关托洛尔组(CME-M组,50只),另以左心室注射等量生理盐水为假手术组(S组,50只),各组按注射后3、6、12、24 h、4周共5个时间点,每个时间点各10只,观察炎性细胞因子在心肌组织中表达水平及对心功能的影响。结果与S组比较,CME组在微栓塞后3、6、12、24 h时间点TNF-α、白细胞介素1β(IL-1β)、白细胞介素10(IL-10)的mRNA和蛋白表达水平显著升高(P<0.05),LVEF显著下降(P<0.05),4周两组比较,无统计学差异。与CMF组比较,CME-M组3、6、12、24 h时间点TNF-α、IL-1β的mRNA和蛋白表达水平显著降低(P<0.05),IL-10的mRNA和蛋白表达水平显著升高(P<0.05),4周两组比较,无统计学差异。与CME组比较,CME-M组12、24 h和4周LVEF显著升高(P<0.05)。结论美托洛尔可以明显改善冠状动脉微栓塞后心功能损伤,其作用机制可能与心肌炎性细胞因子表达有关。     

氟伐他汀对心肌梗死后心力衰竭大鼠心肌单核细胞趋化蛋白-1表达的影响

目的:探讨羟甲基戊二酰辅酶A还原酶抑制剂氟伐他汀对急性心肌梗死(AMI)后心力衰竭(心衰)大鼠心肌单核细胞趋化蛋白-1(MCP-1)表达变化的影响。方法:雌性SD大鼠AMI术后6h随机分为:AMI对照组;氟伐他汀组;假手术组。直接灌胃给药8周后行高频多普勒超声、血流动力学、心脏重塑指标和左心室非梗死区心肌MCP-1mRNA表达的测定。结果:与假手术组比较,AMI组左心室舒张末期内径(LVEDD)、左心室舒张末期容积(LVEDV)、E峰、E峰减速度、E/A、左心室舒张末压(LVEDP)、左心室、右心室心肌肥厚指数、左心室非梗死区胶原容积分数(CVF)和MCP-1mRNA表达均显著增加(P<0.01),左心室短轴速短率(FS)和射血分数(EF)均显著降低(P<0.01)。与AMI组比较,氟伐他汀组的LVEDD、LVEDV、E峰、E峰减速度、E/A、LVEDP和左心室、右心室心肌肥厚指数、CVF和MCP-1mRNA表达均显著降低(P<0.01),FS和EF显著升高(P<0.01)。结论:氟伐他汀能有效抑制心室重塑,延缓心衰进展,其机制可能部分通过下调心肌梗死后心衰大鼠心肌MCP-1的表达,抑制炎症反应。     

Effects of levocarnitine on cardiac function,urinary albumin,hs-CRP,BNP, and troponin in patients with coronary heart disease and heart failure

ObjectiveTo investigate the effects of levocarnitine on cardiac function, urinary albumin (ALB), high-sensitivity C-reactive protein (hs-CRP), brain natriuretic peptide (BNP), and troponin in patients with coronary heart disease (CHD) and heart failure (HF).MethodsIn total, 246 patients with CHD-caused HF were selected and randomly divided into Group A and Group B. A fully automatic biochemical analyzer was used to measure the levels of ALB, hs-CRP, BNP, and troponin in both groups of patients, and the expression levels of LVDD and LVEF were detected by cardiac color ultrasonography. Patients in Group B were intravenously injected with 3.0 g of levocarnitine, once per day. After 14 days, changes in levels of ALB, hs-CRP, BNP, troponin, LVDD, and LVEF in Group A patients were detected.ResultsThe effective cure rates of patients in both groups were 65.8% and 81.3%, respectively, and there was a statistically significant difference between the two groups (p < 0.05). After administration of levocarnitine, all indicators showed decreasing trends, but the LVEF level increased. Among them, patients treated with levocarnitine showed the most evident decrease in LVEF. Decrease in BNP was the largest (p < 0.05). Additionally, there was no statistical difference in incidence rate between the two groups (5.8% vs. 2.5%, p = 0.222).ConclusionLevocarnitine can effectively improve ALB, hs-CRP, BNP, troponin, and LVDD levels to improve cardiac function rating and thus improve cardiac function.     

冠心病猝死患者心肌组织纤维连接蛋白及内皮素的表达

目的探讨冠心病猝死患者心肌组织中纤维连接蛋白、内皮素的表达情况。方法选择150份冠状动脉组织切片标本,其中正常血管标本50份,动脉粥样硬化稳定斑块50份和不稳定斑块50份,用MaxVision免疫组化方法对比检测纤维连接蛋白(FN)和内皮素(ET)的表达。结果正常心肌组织FN、ET均呈阴性表达;稳定斑块组FN呈散在、单个细胞性胞质棕褐色着色,ET呈局灶性心肌细胞胞质阳性表达;不稳定斑块组FN呈大片状心肌细胞胞质棕褐色着色,ET呈血管平滑肌、血管内皮及心肌细胞胞质呈棕色阳性着色。3组患者心肌中ET、FN阳性反应物累积吸光度值比较均具有统计学意义(P0.05)。结论 FN和ET的阳性表达是心肌缺血和损伤的灵敏指标,对推断冠心病猝死具有一定的实际应用价值。     

红景天酪醇对老年大鼠心肌缺血缺氧型冠心病的影响

目的探讨红景天酪醇对老年大鼠心肌缺血缺氧型冠心病的作用。方法取30只老年大鼠随机分为正常对照组、模型组与给药组,每组10只,采用高脂饮食联合用药的方法,正常对照组喂养基础饲料,模型组与给药组喂养高脂饲料,连续5 w。腹腔注射4%异丙肾上腺素(Iso)5 ml/kg,在通过装有钠石灰缺氧再给氧的装置制造大鼠心肌缺血缺氧冠心病模型,红景天酪醇灌胃给药1 h后,记录心功能,检测血清乳酸脱氢酶(LDH)和肌酸磷酸激酶(CK)及心肌髓过氧化物酶(MPO)和丙二醛(MDA)含量。结果给药组心电图变化较模型组明显改善,LDH和CK水平明显下降,心肌MPO和MDA含量明显降低(均P<0.05)。结论红景天酪醇对老年大鼠心肌缺血缺氧损伤有保护作用。     

Effect of tyramine on myocardial catecholamine release in coronary heart disease

The influence of tyramine on myocardial catecholamine release and on coronary blood flow has not previously been determined in man. Therefore, the effect of tyramine was measured on coronary and systemic hemodynamics and on norepinephrine (NE) and epinephrine levels in blood from the aorta and coronary sinus in 9 patients with coronary artery disease. Tyramine produced a striking increase in coronary sinus NE, from a baseline of 344 ± 56 to a peak level of 1416 ± 310 pg/ml (p < 0.01) 2 minutes after tyramine. The increase in aortic NE was less striking, from 265 ± 32 to 421 ± 63 pg/ml (difference not significant). Therefore, the net release of NE from the heart was increased by tyramine from 12,007 ± 393 to 139,357 ± 46,156 pg/ ml/min (p < 0.03). There was no release of epinephrine across the coronary bed. There was a variable response of coronary blood flow and resistance after tyramine. Thus, the rich innervation of the heart by sympathetic nerve endings can result in marked NE release into the coronary sinus.     

吡格列酮对非酒精性脂肪性肝病大鼠血小板源生长因子-B和基质金属蛋白酶抑制因子-2表达的影响

目的:观察吡格列酮对非酒精性脂肪性肝病(NAFLD)大鼠肝组织血小板源生长因子B(PDGF-B)和基质金属蛋白酶抑制因子-2(TIMP-2)表达的影响,并研究吡格列酮防治NAFLD发病和进展的疗效及作用机制。方法:选用雄性SD大鼠60只,随机分为正常对照组、模型对照组和吡格列酮组,每组20只。正常对照组大鼠给予普通饲料,其余组均给予高脂饲料;吡格列酮组大鼠在高脂饮食8周后吡格列酮10ml.kg-1.d-1灌胃。于第20周结束时将3组动物处死,取材备检。结果:①肝组织病理变化:模型对照组动物肝细胞均出现中、重度大泡性脂肪变、有明显的炎细胞浸润聚集,吡格列酮组肝细胞也出现较明显的脂肪变和炎症表现,但较模型对照组病变轻。②TIMP-2染色指数3组分别为1.22±0.31,4.52±0.61,1.89±0.45,PDGF-B表达面积3组分别为(0.82±0.13)、(3.79±0.32)、(0.91±0.27)μm2,模型对照组明显高于其他两组(P<0.05),吡格列酮干预后TIMP-2染色指数和PDGF-B表达面积明显降低(P<0.05)。结论:在高脂饮食诱导的NAFLD模型中PDGF-B和TIMP-2表达增强,吡格列酮可以明显改善模型动物肝脏脂肪变性、炎症活动、纤维化变性程度,同时能降低PDGF-B和TIMP-2表达水平,有抗炎、抗纤维化作用。     

益气化痰祛瘀方对冠心病模型大鼠PAI-1、t-PA表达的影响

目的 观察益气化痰祛瘀方对冠心病大鼠心肌及主动脉组织PAI-1、t-PA表达的影响及作用机制.方法 采用高脂饲料、脑垂体后叶素腹腔注射建立大鼠冠心病模型,分为正常组、模型组、复方丹参滴丸对照组、益气化痰祛瘀方高、低剂量组,采用免疫组化法检测大鼠心肌和主动脉组织PAI-1、t-PA的表达.结果 模型组大鼠心肌和主动脉组织PAI-1表达增强,t-PA表达减弱(P＜0.01);给药后各用药组PAI-1的表达减弱,t-PA的表达增强(P＜0.01);高、低剂量组均优于对照组(P＜0.05或P＜0.01),高、低剂量组间无明显差异(P＞0.05).结论 益气化痰祛瘀方可通过调节心肌和主动脉组织PAI-1、t-PA的表达,以达到治疗冠心病的目的.     

sICAM-1 correlates with myocardial ICAM-1 expression in dilated cardiomyopathy

BACKGROUND: Dilated cardiomyopathy (DCM) is etiopathogenically linked to intramyocardial inflammation, which is reflected by ICAM-1 abundance. We investigated whether soluble ICAM-1 (sICAM-1) levels in the sera of DCM patients are associated with intramyocardial ICAM-1 expression. METHODS: Immunohistochemically detected ICAM-1 expression was quantified semiquantitatively in endomyocardial biopsies from DCM patients (n=45; n=17 females; age: 48+/-15 years) and from n=12 donor hearts (controls) by a human observer (baseline vs. enhanced expression) and quantitatively by a digital image analysis (DIA) system. The DIA-measured qualities were area fraction (AF), surface-volume ratio (SVR) and integral optical density (ID). The sICAM-1 levels of the DCM patients and n=12 healthy volunteers (controls) were measured by ELISA (means of duplicate measurements). Intramyocardial ICAM-1 expression and sICAM-1 levels were compared in these DCM patients. RESULTS: Of the DCM patients, n=24 (53%) demonstrated statistically higher sICAM-1 levels compared to controls (>198 ng/ml). By semiquantitative and quantitative DIA evaluation, endothelial ICAM-1 abundance was present in n=25 (56%) of the DCM biopsies. sICAM-1 correlated significantly (P<0.001) both with the semiquantitatively assessed and the DIA-measured ICAM-1-AF, the ICAM-1-SVR and the ICAM-1-ID. The positive predictive value of sICAM-1 measurements for intramyocardial ICAM-1 abundance was 96%, and the negative predictive value was 71%, with a receiver operating characteristic area under the curve of 0.93. Furthermore, sICAM-1 levels correlated with intramyocardial T-lymphocytic (CD2+/CD3+) infiltrates (P<0.03). CONCLUSIONS: Measurement of non-invasively obtained sICAM-1 reliably reflects intramyocardial ICAM-1 expression and may therefore serve as a non-invasive marker of inflammatory activity in DCM.     

曲美他嗪对冠心病慢性心力衰竭患者心肌细胞凋亡及炎症因子的影响

目的 观察标准治疗基础上加用曲美他嗪对冠心病慢性收缩性心力衰竭的心肌细胞凋亡及炎症的影响。方法 将60例符合要求患者按随机数字表分为常规组和曲美他嗪组,各30例。常规组予以常规治疗,曲美他嗪组加用曲美他嗪片20mg/次,3次/d,观察3个月,比较治疗前后心肌细胞凋亡指标sFas及炎症指标NF-KB的影响。结果 治疗3个月后,曲美他嗪组较常规组LVEF升高13.7%(P＜0.05),曲美他嗪组较常规组左室舒张末期内径下降6.6%(P＜0.01)。两组均能减少心肌细胞凋亡,但曲美他嗪组患者心肌细胞凋亡指标sFas明显低于常规组（644.3±219.5 vs 781．7±223.9,P＜0.01）,炎症指标NF-KB在曲美他嗪组也明星低于常规组（53.8±6.1 vs 61.5±7.7,P＜0.05)。结论 曲美他嗪可能减少冠心病慢性心力衰竭的心肌细胞凋亡和炎症反应,这可能和其改善心功能有关。     

利心I号对CHF大鼠血流动力学、心肌细胞ICAM-1基因蛋白表达的影响

目的探讨利心I号对充血性心力衰竭（CHF）大鼠血流动力学、病死率及心肌细胞间黏附分子1（ICAM-1）表达的影响。方法利用阿霉素的心肌毒性复制CHF的动物模型。将84只Wistar雄性大鼠随机分为6组:对照组、单纯模型组、依那普利组、心宝丸组、利心I号低剂量组、利心I号高剂量组。各组均每日灌胃1次,连续灌胃4周,观察各组大鼠的一般状况及病死率,检测血流动力学变化,用免疫组化法测定ICAM-1基因蛋白的表达。结果利心I号能够改善CHF大鼠血流动力学参数,降低病死率,降低心肌细胞中ICAM-1的表达。结论利心I号通过降低CHF大鼠ICAM-1的表达,改善心功能。     

利心Ⅰ号对CHF大鼠血流动力学、心肌细胞ICAM-1基因蛋白表达的影响

目的探讨利心Ⅰ号对充血性心力衰竭（CHF）大鼠血流动力学、病死率及心肌细胞间黏附分子1（ICAM-1）表达的影响。方法利用阿霉素的心肌毒性复制CHF的动物模型。将84只Wistar雄性大鼠随机分为6组：对照组、单纯模型组、依那普利组、心宝丸组、利心Ⅰ号低剂量组、利心Ⅰ号高剂量组。各组均每日灌胃1次，连续灌胃4周，观察各组大鼠的一般状况及病死率，检测血流动力学变化，用免疫组化法测定ICAM-1基因蛋白的表达。结果利心Ⅰ号能够改善CHF大鼠血流动力学参数，降低病死率，降低心肌细胞中ICAM-1的表达。结论利心Ⅰ号通过降低CHF大鼠ICAM-1的表达，改善心功能。     

急性胰腺炎大鼠肝脏NF-κB对ICAM-1表达的调控及其意义

目的:观察急性胰腺炎大鼠肝脏NF-κB对ICAM-1表达的调控及其在急性胰腺炎肝损伤中的作用.方法:Wistar大鼠72只随机分为急性胰腺炎组(AP组)、急性胰腺PDTC处理组(APP组)以及对照组(SO组).分别在术后3 h、6 h、12 h及24 h检测肝组织NF-κB活性、ICAM-1表达,肝组织髓过氧化物酶(MPO)活性以及血浆丙氨酸氨基转移酶(ALT)水平.结果:AP及APP组NF-κB活性在术后3-6 h显著高于SO组;ICAM-1表达在术后3-24 h显著高于SO组;MPO及ALT在术后6-24 h也显著高于SO组.然而,在运用了NF-κB抑制剂的APP组,NF-κB活性、ICAM-1表达、MPO以及血浆ALT均显著低于AP组.结论:急性胰腺炎发生时,肝脏中活化的NF-κB促进了ICAM-1的表达,并由此参与了肝损伤的发生.     

血清可溶性细胞间粘附分子-1和E-选择素水平与冠心病的关系

目的比较冠心病(CHD)患者血清可溶性细胞间粘附分子-1(sICAM-1)和血清可溶性E-选择素水平,探讨其临床意义.方法 145例冠心病患者,其中73例为急性冠脉综合征组(ACS组),72例为稳定型冠心病组(SCHD组),并选144名健康查体者作对照组.用酶联免疫吸附法(ELISA)检测血清sICAM-1、可溶性E-选择素水平,并比较上述指标水平在三组之间的差异.结果血清sICAM-1浓度ACS组(320.3±81.8)μg/L和SCHD组(266.5±63.5)μg/L明显高于对照组(176.3±78.3)μg/L,P<0.01,ACS组和SCHD组间也有显著性差异(P<0.05).血清可溶性E-选择素浓度ACS组(48.5±12.1)μg/L和SCHD组 (36.1±11.9)μg/L明显高于对照组(28.8±10.3)μg/L,P<0.01,ACS组和SCHD组间也有显著性差异(P<0.05).结论血清sICAM-1、可溶性E-选择素在冠心病患者中明显高于对照组,其中ACS患者明显高于SCHD患者.     

Statin therapy for coronary heart disease and its effect on stroke

Coronary heart disease (CHD) and stroke share common risk factors and are the leading causes of death and disability in the United States. Although the impact of elevated cholesterol on stroke risk has been disputed, numerous trials using 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitors (ie, statins) in patients with CHD have demonstrated a significant reduction in stroke incidence as a secondary endpoint. It is likely that statins are pleiotropic in stroke prevention, providing benefits through both cholesterol reduction and cholesterol-independent mechanisms. In this article, we review the relationship between cholesterol and stroke, randomized trials of statins in patients with CHD and high risk for CHD that have assessed stroke risk, and the putative mechanisms of stroke prevention by statins.     

细胞间黏附分子-1基因469K/E多态性与老年冠心病

目的　探讨细胞间黏附分子 1(intercellularadhesionmolecule -1,ICAM- 1)基因4 6 9K/E多态性与老年冠心病患者的关系。方法　利用巢式聚合酶链反应技术,检测12 2例老年冠心病患者(冠心病组)和117例非冠心病住院患者(对照组)的4 6 9K/E突变基因型。结果　基因型频率符合Hardy Weinberg平衡;冠心病组KK +KE基因型频率明显高于EE型,与对照组有显著性差异(P =0 .0 11) ;二元logistic回归显示,K等位基因、吸烟增加了冠心病发病的危险,K等位基因与吸烟对冠心病的发生具有协同作用。结论　ICAM 1基因4 6 9K/E多态性与老年冠心病的发病有关,K等位基因有可能是冠心病发病的遗传危险因素之一