分析胰激肽原酶治疗高血压合并微量白蛋白尿患者的有效性

目的探讨胰激肽原酶治疗高血压合并微量白蛋白尿患者的有效性。方法选取高血压合并微量白蛋白尿患者90例作为研究对象,将其随机分为研究组和对照组,各45例。对照组采用常规降压治疗,研究组在常规治疗的基础上加用胰激肽原酶药剂,比较两组患者的疗效以及治疗前后的A/C值。结果研究组在A/C比值中明显低于对照组,所以疗效明显高于对照组,差异有统计学意义(P0.05)。结论胰激肽原酶能够有效治疗高血压合并微量白蛋白尿,值得推广应用。     

叶酸 、维生素 B6、维生素 B12 联合干预对H型高血压患者血压变异性与动脉弹性的长期影响

目的 探讨叶酸 、维生素B6、维生素B12联合干预治疗对H型高血压患者血浆同型半胱氨酸（homocysteine，Hcy）水平、血管内皮功能及随访期间血压变异性的影响。方法 120例轻、中度原发性高血压的患者采用随机数字法分为两组，即叶酸和维生素B6、B12联合干预组（60例）和对照组（60例）。治疗前（基线水平）及治疗后1个月测定患者血浆Hcy水平及血管内皮的功能的检测，并对所有入组患者随访1年，记录其血压水平。结果 叶酸、维生素B6、B12联合干预组治疗1个月后，Hcy水平较对照组［（19.44±2.91）μmol/L比（23.05±2.91）μmol/L，P<0.05］及治疗前［（19.44±2.91）μmol/L比（24.03±3.28）μmol/L，P<0.05］均有明显降低；踝肱脉搏波传导速度（baPWV）较治疗前变化不明显［（1560.9±253.8）cmPs比（1503.9±252.1）cmPs，P＞0.05］；1年随访结束后，干预组平均收缩压水平较对照组明显下降，差异有统计学意义［（124.4±19.8）mm Hg比（131.0±26.7）mm Hg，P<0.05］，而且干预组收缩压的变异性小于对照组，差异有统计学意义［（7.82±5.19）比（9.60±4.87），P<0.05］。舒张压的变化在组间比较差异无统计学意义（P>0.05）。结论 叶酸、维生素B6、B12 联合干预治疗可降低高血压患者血浆Hcy水平，而且可以改善患者不良的血管内皮功能损害，降低血压变异性。     

依那普利和氯沙坦对自发性高血压大鼠同型半胱氨酸及一氧化氮水平的影响

目的 :探讨血浆同型半胱氨酸 (Hcy)、叶酸、维生素 (Vit)B12 和一氧化氮 (NO)水平与高血压的关系 ,以及依那普利、氯沙坦在降压的同时对Hcy、叶酸、VitB12 和NO水平的影响。　　方法 :雄性自发性高血压大鼠 (SHR)分为 3组 (n =6 ) :依那普利组 1 5mg/(kg·d)灌胃 ,氯沙坦组 37 5mg/(kg·d)灌胃 ,SHR对照组及Wistar kyoto(WKY)对照组用等量蒸馏水灌胃。采用全自动荧光偏振免疫分析法测定血浆Hcy水平 ,离子捕捉分析法测定血浆叶酸水平 ,微粒子酶固有因子分析法测定血浆VitB12 水平 ;Griess法测定血浆NO代谢产物硝酸盐 (NO-3 )水平。　　结果 :①SHR对照组血浆Hcy、叶酸水平与WKY对照组相比无显著性差异 (P >0 0 5) ;②SHR对照组血浆VitB12水平较WKY对照组明显升高 ;③依那普利、氯沙坦治疗后对Hcy、叶酸及VitB12 水平均无明显影响 ;④SHR对照组血浆NO-3 水平明显下降 ;⑤依那普利治疗 2周后NO-3 含量回升至 4 1 2 6± 5 1 6 μmol/L ,与SHR对照组之间有显著性差异 (P <0 0 1 ) ;氯沙坦治疗 2周后NO-3 含量虽有上升 ( 35 0 3± 4 31 μmol/L) ,但与未治疗的SHR相比无显著性差异 (P>0 0 5)。　　结论 :本研究未发现Hcy水平与高血压有相关性 ;SHR较高的VitB12 水平可能与预防Hcy的危险性有关 ,但也不排     

胰激肽原酶治疗高血压合并微量白蛋白尿患者的疗效观察

目的 观察胰激肽原酶针剂与片剂治疗高血压合并微量白蛋白尿的疗效.方法 38例高血压合并微量白蛋白尿的患者随机分为2组.对照组常规降压治疗;治疗组在对照组治疗基础上加用胰激肽原酶针剂2w,续以片剂10 w,两组疗程均为12w,观察2组疗效及血肌酐(Scr)水平变化.结果 治疗组尿微量白蛋白(MAU)有下降,4 w时下降更显著(近似P值为0.002).治疗组中肾小球滤过率(GFR)正常亚组MAU无论4 w后还是12 w后均较研究前有显著下降(近似P值分别为0.008和0.015).治疗组和对照组研究前后Scr差异无统计学意义(近似P值为0.784).结论 胰激肽原酶对高血压患者的MAU控制有效,针剂相对于片剂疗效更显著,为巩固降MAU的疗效,有必要定期注射该药.胰激肽原酶对于GFR正常的患者,降MAU疗效更佳,佐证该药有助于高血压早期肾损的防治.     

胰激肽原酶对自发性高血压大鼠肾脏结构与功能的保护作用

目的:观察胰激肽原酶干预对自发性高血压大鼠(SHR)肾脏结构与功能的影响,探讨激肽释放酶-激肽系统在高血压及肾脏保护方面的作用。方法:12只36周龄SPF级雄性SHR随机分成2组,治疗组给予胰激肽原酶(800U/kg/d)灌胃治疗12周,观察大鼠血压、血肌酐(Scr)、尿素氮(BUN)及尿微量白蛋白(mALB)、尿β2微球蛋白(β2-MG)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)浓度及肾脏组织病理改变,并用逆转录-聚合酶链反应(RT-PCR)方法测定肾皮质组织型激肽释放酶 mRNA的表达。结果:较之SHR对照组胰激肽原酶治疗后血压明显下降(P<0.01);尿mALB、β2-MG、NAG定量明显降低(P<0.01);肾皮质组织型激肽释放酶 mRNA表达水平增加(P<0.05)。病理上SHR对照组大鼠肾小球小动脉管壁增厚,管腔狭窄,个别小球硬化;胰激肽原酶治疗组肾小动脉结构正常,未见肾动脉硬化。结论:胰激肽原酶能显著减少尿微量蛋白、逆转肾小动脉硬化改变,保护肾功能,其机制可能与降低血压,增加肾脏中组织激肽释放酶水平有关。     

胰激肽原酶对自发性高血压大鼠肾损害的保护作用

背景胰激肽原酶是一种糖蛋白,作用于激肽原,使之裂解生成激肽,激肽促进内皮细胞释放一氧化氮(NO)与前列腺素I2(PGl2),引起血管扩张、血管渗透性增加,从而发挥降压、保护肾脏、心脏等生理学作用。目的观察胰激肽原酶干预对自发性高血压大鼠(SHR)肾功能的影响,探讨激肽释放酶激肽系统在高血压及肾脏保护方面的可能机制。方法36周龄SPF级雄性SHR12只随机分成高血压对照组(B组)与高血压治疗组[C组,给予胰激肽原酶800U/(kg.d)灌胃治疗12周],每组各6只。另有年龄匹配的雄性WKY大鼠6只作为正常血压对照组(A组)。治疗前、后,观察3组大鼠血压、血肌酐(Scr)、尿素氮(BUN)、NO、6-酮-前列腺素F1a(6-K-PGF1a)及尿微量白蛋白(MAU)、尿β2微球蛋白(β2-MG)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)浓度及肾脏组织病理改变,并用逆转录聚合酶链反应(RT-PCR)方法测定肾皮质组织型激肽释放酶mRNA的表达。结果胰激肽原酶治疗后C组血压较B组明显下降(P<0.01);MAU、β2-MG、NAG定量明显降低(P<0.01),血清NO、6-K-PGF1a水平升高(P<0.05);肾皮质组织型激肽释放酶mRNA表达水平增加(P<0.05)。对照组大鼠肾小球小动脉管壁增厚,管腔狭窄,个别小球硬化;胰激肽原酶治疗后肾小动脉结构正常,未见小球硬化。结论胰激肽原酶能显著减少尿微量蛋白、逆转肾小动脉硬化改变,保护肾功能,其机制可能与血压下降,血清NO、6-K-PGF1a水平及肾脏组织激肽释放酶水平升高有关。     

胰激肽原酶对自发性高血压大鼠肾损害的保护作用

背景 胰激肽原酶是一种糖蛋白,作用于激肽原,使之裂解生成激肽,激肽促进内皮细胞释放一氧化氮(NO)与前列腺素I2(PGl2),引起血管扩张、血管渗透性增加,从而发挥降压、保护肾脏、心脏等生理学作用.目的 观察胰激肽原酶干预对自发性高血压大鼠(SHR)肾功能的影响,探讨激肽释放酶激肽系统在高血压及肾脏保护方面的可能机制.方法 36周龄SPF级雄性SHR 12只随机分成高血压对照组(B组)与高血压治疗组[C组,给予胰激肽原酶800 U/(kg·d)灌胃治疗12周],每组各6只.另有年龄匹配的雄性WKY大鼠6只作为正常血压对照组(A组).治疗前、后,观察3组大鼠血压、血肌酐(Scr)、尿素氮(BUN)、NO、6-酮-前列腺素F1a(6-K-PGF1a)及尿微量白蛋白(MAU)、尿β2微球蛋白(β2-MG)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)浓度及肾脏组织病理改变,并用逆转录聚合酶链反应(RT-PCR)方法测定肾皮质组织型激肽释放酶mRNA的表达.结果 胰激肽原酶治疗后C组血压较B组明显下降(P＜0.01);MAU、β2-MG、NAG定量明显降低(P＜0.01),血清NO、6-K-PGF1a水平升高(P＜0.05);肾皮质组织型激肽释放酶mRNA表达水平增加(P＜0.05).对照组大鼠肾小球小动脉管壁增厚,管腔狭窄,个别小球硬化;胰激肽原酶治疗后肾小动脉结构正常,未见小球硬化.结论 胰激肽原酶能显著减少尿微量蛋白、逆转肾小动脉硬化改变,保护肾功能,其机制可能与血压下降,血清NO、6-K-PGF1a水平及肾脏组织激肽释放酶水平升高有关.     

冠心病人同型半胱氨酸水平的主要影响因素

目的　分析影响冠心病人血浆同型半胱氨酸水平的主要非遗传因素。方法　 16 4例住院冠心病患者 ,测定血浆同型半胱氨酸水平并分析其与血浆及全血叶酸、血浆维生素B12 、血清雌二醇浓度以及冠心病传统危险因素之间的关系。结果　血浆同型半胱氨酸水平与叶酸、维生素B12 水平呈负相关 ,男性血浆同型半胱氨酸浓度高于女性 [(2 0 74± 13 42 )× 10 -6mol/L比 (15 5 6± 8 16 )× 10 -6mol/L ,P <0 0 5 ],吸烟者高于不吸烟者 [(2 2 2 9± 15 18)× 10 -6mol/L比 (17 2 1± 9 5 4)× 10 -6mol/L ,P <0 0 5 ]。结论　叶酸、维生素B12 、性别和吸烟是影响冠心病患者血浆同型半胱氨酸水平的主要非遗传因素     

对原发性高血压伴缺血性脑卒中患者血浆同型半胱氨酸水平的临床观察

目的 :探讨叶酸、维生素B6、腺苷辅酶维生素B12 对原发性高血压伴缺血性脑卒中患者血浆同型半胱氨酸 (Hcy)水平的影响。方法 :血浆Hcy水平增高的缺血性脑卒中住院患者 70例分为干预组 (n =3 5 )和对照组 (n =3 5 )。干预组口服叶酸10mg/d ,维生素B610mg/d ,腺苷辅酶维生素B12 5 0 0 μg/d 4周。对照组未服用上述药物。入院时及 4周后采用高压液相色谱法 (HPLC)测定血浆Hcy含量。结果 :干预组在实施叶酸、维生素B6、腺苷辅酶维生素B12 干预 4周后 ,血浆Hcy水平下降 ,与对照组相比有显著性差异 (P <0 0 5 )。两组患者 4周前后血浆Hcy水平的变化差值具有极显著性差异 (P <0 0 0 1)。结论 :口服叶酸、维生素B6、腺苷辅酶维生素B12 可使原发性高血压伴缺血性脑卒中患者血浆Hcy水平下降     

百令胶囊与胰激肽原酶联合治疗早期糖尿病肾病的临床观察

目的观察百令胶囊与胰激肽原酶联合治疗早期糖尿病肾病(EDN)的疗效以及治疗前后尿微量白蛋白的变化。方法将50例早期EDN患者随机分为两组,对照组在常规治疗基础上予胰激肽原酶240U,3次/d,口服;联合治疗组在对照组基础上加用百令胶囊1.0g,3次/d,口服,12周和6个月后观察联合治疗组与对照组治疗前后24h尿微量白蛋白排泄率(UAER)的变化。结果治疗后12周,两组患者治疗前后24h UAER均有较明显下降(P0.05);治疗后6个月,对照组患者治疗前后24h UAER有一定的下降(P0.05),联合组患者治疗前后24h UAER有明显的下降(P0.01);治疗后12周和6个月组间比较,联合组24h UAER与对照组比较差异有统计学意义(P0.05)。结论百令胶囊与胰激肽原酶联合应用能明显降低EDN患者的尿微量白蛋白排泄,可以有效延缓DN的讲展。     

Additive effect of homocysteine- and cholesterol-lowering therapy on endothelium-dependent vasodilation in patients with cardiovascular disease

Aim : Endothelial dysfunction is a marker for development and progression of atherosclerosis. Statin therapy improves endothelial function in cardiovascular patients by reducing LDL‐cholesterol and by pleiotropic effects. B‐group vitamin supplementation restores endothelial function mainly by reducing homocysteine‐induced oxidative stress. Thus, we evaluated the effect of rosuvastatin, B‐group vitamins and their combination on endothelial function in high‐risk cardiovascular patients. Methods : Thirty‐six patients with cardiovascular disease were randomly, double‐blinded assigned to either rosuvastatin 10 mg (group R, n = 18) or vitamin supplementation consisting of folic acid 1 mg, vitamin B12 0.4 mg, and B6 10 mg (group V, n = 18) for 6 weeks. After 6 weeks all patients received rosuvastatin and vitamin supplementation in combination for additional 6 weeks. Endothelial function was assessed by flow‐mediated vasodilation (FMD) at baseline and after 6‐ and 12‐week treatment. Results : At baseline, FMD, plasma lipids, vitamins, and homocysteine were comparable between both groups. After 6 weeks, FMD improved in both groups (from 4.4 ± 1.6 to 6.9 ± 1.4% group R, P= 0.0004 and from 4.9 ± 1.8 to 6.4 ± 1.8% group V, P= 0.0002). This improvement in FMD was mainly associated with a decrease of plasma lipids in group R and a decrease of homocysteine in group V. After 12 weeks, the combined therapy with rosuvastatin and vitamins further improved FMD to the normal range in 26/33 patients compared to 5/36 at baseline (P < 0.0001). Conclusions : In conclusion, both treatments, rosuvastatin and B‐group vitamin supplementation, improved endothelial function in high‐risk cardiovascular patients. The combination of both therapies had an additive effect on endothelial function suggesting different mechanisms of action.     

帕金森病患者认知障碍与血浆同型半胱氨酸水平的相关性研究

目的研究帕金森病(PD)患者认知障碍与血浆同型半胱氨酸(Hcy)水平的关系。方法选择PD患者90例.其中认知功能正常43例(认知正常组).伴认知功能障碍47例(认知障碍组)及健康体检者40例(对照组),比较3组血浆Hcy、叶酸、维生素B_(12)水平。结果认知正常组和认知障碍组患者血浆Hcy水平明显高于对照组[(1 5.70±4.38)μmol/L vs(1 6.20±5.53)μmol/L vs(1 3.51±3.59)μmol/L,P<0.05]。结论 Hcy水平可能与PD认知障碍无关。     

A pilot study with simvastatin and folic acid/vitamin B12 in preparation for the Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine (SEARCH)

BACKGROUND AND AIM: This study was conducted in preparation for the Study Evaluating Additional Reduction in Cholesterol and Homocysteine (SEARCH). SEARCH is a 12,000 patient 2X2 factorial study in post-myocardial infarction patients that will compare simvastatin 20 mg with simvastatin 80 mg to evaluate whether greater LDL-C reductions with simvastatin provide greater coronary event reductions. SEARCH will also test the hypothesis that lowering plasma homocysteine with folic acid and vitamin B12 will reduce coronary events. This pilot study was performed to determine whether any clinically meaningful interaction between simvastatin and folic acid/vitamin B12 exists. METHODS AND RESULTS: Following a 2-week diet/placebo run-in period, 141 patients with primary hypercholesterolaemia were randomised to one of three treatments for 6 weeks: 80 mg/day simvastatin and 2 mg folic acid/0.8 mg vitamin B12 daily (combination group); or 80 mg/day simvastatin and placebo vitamins (simvastatin alone group); or 2 mg folic acid/0.8 mg vitamin B12 daily and placebo simvastatin (vitamins alone group). The combination group and simvastatin alone group experienced similar serum lipid changes with reductions in LDL-cholesterol of 55.2% and 51.5% respectively. The combination group and vitamins alone group experienced similar homocysteine lowering with reductions in homocysteine of 25.3% and 23.1% respectively. All therapies were well tolerated. CONCLUSIONS: There was no detectable antagonistic effect when simvastatin and folic acid/vitamin B12 were administered concomitantly.     

同型半胱氨酸对KKAy小鼠心肌病变的影响

目的　观察高同型半胱氨酸 (Hcy)血症对糖尿病小鼠心肌的影响 ,以及补充叶酸对心肌病变的作用。方法　2 4只KKAy小鼠随机分成 3组 ,分别喂养高热量饮食 (KA组 )、高蛋氨酸饮食 (KB组 )以及高蛋氨酸加叶酸、维生素B1 2 饮食 (KC组 )。测定各组血浆Hcy、叶酸、维生素B1 2 水平 ,并观察心肌病理改变。结果　饲养 16周后 ,KB组血浆Hcy明显增高 [(2 9.33± 16 .85对 5 .33± 2 .0 3) μmol L ,P <0 .0 0 1],且心肌间质纤维化、钙化、小动脉管壁增厚、透明变性等病变加重 ,经叶酸、维生素B1 2 治疗的KC组血浆Hcy降至正常 (4 .0 4± 1.81) μmol L ,且心肌病变减轻。结论Hcy可以加重糖尿病小鼠的心肌病变 ,叶酸、维生素B1 2 可以有效减缓这一病变进程。     

73例老年慢性心脑血管病患者血清同型半胱氨酸含量的测定

目的　探讨老年慢性心脑血管病患者血清同型半胱氨酸 (Homocysteine ,Hcy)水平与冠心病及缺血性脑血管病的关系。方法　 6 0岁以上的老年慢性心脑血管病患者 73例 ,其中冠心病 38例 ,缺血性脑血管病 35例。 33名健康老年人作为对照组。对所有研究对象进行临床病史询问及全面体检 ,空腹取血检测血糖、甘油三酯、胆固醇、Hcy、叶酸和维生素B12 。结果　冠心病患者的Hcy平均含量为 (17.6 6± 5 .88) μmol/L ,缺血性脑血管病患者为 (16 .89±9.2 1) μmol/L ,均较对照组的 (14.36± 5 .87) μmol/L高 ,血清Hcy与叶酸水平呈负相关。 结论　老年慢性冠心病、缺血性脑血管病患者的血清同型半胱氨酸含量较正常老年人高。     

Helicobacter pylori eradication lowers serum homocysteine level in patients without gastric atrophy

AIM: To determine whether Helicobacter pylori ( H pylori)infection caused hyperhomocysteinemia by altering serum vitamin B12, serum folate and erythrocyte folate levels and whether eradication of this organism decreased serum homocysteine level.METHODS: The study involved 73 dyspeptic H pylori-positive patients, none of them had gastric mucosal atrophy based on rapid urease test and histology. Out of 73 patients, 41 (56.2%) showed a successful eradication of Hpylori4 wk after the end of treatment. In these 41 patients, fasting serum vitamin B12, folate and homocysteine levels, and erythrocyte folate levels before and 4 wk after Hpylorieradication therapy were compared.RESULTS: The group with a successful eradication of Hpylori had significantly higher serum vitamin B12 and erythrocyte folate levels in the post-treatment period compared to those in pre-treatment period (210&#177;97 pg/mL vs237&#177;94pg/mL, P&lt;0.O01 and 442&#177;212 ng/mL vs 539&#177;304 ng/mL,P = 0.024, respectively), but showed no significant change in serum folate levels (5.6&#177;2.6 ng/mL vs 6.0&#177;2.4 ng/mL,P= 0.341). Also, the serum homocysteine levels in this group were significantly lower after therapy (13.1&#177;5.2 μmol/L vs 11.9&#177;6.2 μmol/L, P = 0.002). Regression analysis showed that serum homocysteine level was positively correlated with age (P = 0.01) and negatively with serum folate level before therapy (P = 0.003).CONCLUSION: Eradication of H pylori decreases serum homocysteine even in patients who do not exhibit gastric mucosal atrophy. It appears that the level of homocysteine in serum is related to a complex interaction among serum vitamin B12, serum folate and erythrocyte folate levels.     

Methylenetetrahydrofolate reductase (MTHFR) polymorphism (C677T) in relation to homocysteine concentration in overweight and obese Thais

We analyzed the association between MTHFR (C677T) gene polymorphism with serum concentrations of homocysteine, folate, and vitamin B12 in 37 male and 112 female overweight/ obese Thai volunteers (BMI > or = 25.00 kg/m2), and compared them with 23 male and 90 female control subjects (BMI = 18.5-24.99 kg/m2). Statistically significant higher levels of serum homocysteine were found in the overweight/obese subjects than the control subjects (p < 0.05). Serum folic acid levels in the overweight/obese subjects were significantly lower than the control subjects (p < 0.05). When the data were grouped according to homocysteine concentration and MTHFR gene polymorphism, there were significantly higher homocysteine concentrations in the overweight/obese subjects than the control subjects in wild type gene polymorphism (CC) in the hyperhomocysteine group (homocysteine >10.0 mmol/l) (p < 0.05), but in genotype polymorphism (CC, CT, TT) there were lower folic acid and vitamin B12 concentrations in the overweight/obese subjects than in the control subjects. In the hyperhomocysteine groups, there was no significant difference in the frequencies of MTHFR (C677T) gene polymorphism between the overweight/obese subjects and the control subjects. Folic acid and gene polymorphism were found to be significantly related to the overweight/ obese and control groups in logistic regression analysis (p < 0.05). The results support the supposition that folic acid is more important than vitamin B12.     

Effects of Chai-Qin-Cheng-Qi Decoction on cefotaxime in rats with acute necrotizing pancreatitis

AIM： To investigate the effect of Chai-Qin-Cheng-Qi Decoction （CQCQD） on cefotaxime （CTX） concentration in pancreas of rats with acute necrotizing pancreatitis （ANP）. METHODS： Sixty healthy male Sprague-Dawley rats were divided randomly into an ANP group （ANP model ＋ CTX, n = 20）, treatment group （ANP model ＋ CTX ＋ CQCQD, n = 20） and control group （normal rats ＋ CTX, n = 20）. ANP models were induced by retrograde intraductal injection of 3.5% sodium taurocholate （1 mL/kg）, and the control group was injected intraductally with normal saline. All rats were injected introperitoneally with 0.42 g/kg CTX （at 12-h intervals for a continuous 72 h） at 6 h after intraductal injection. Meanwhile, the treatment group received CQCQD （20 mL/kg） intragastrically at 8-h intervals, and the ANP and control group were treated intragastrically with normal saline. At 15 min after the last CTX injection, blood and pancreas samples were collected for the determination of CTX concentration using validated high-performance liquid chromatography. Pathological changes and wet-to-dry-weight （W/D） ratio of pancreatic tissue were examined. RESULTS： Serum CTX concentrations in three groups were not significantly different. Pancreatic CTX concentration and penetration ratio were lower in ANP group vs control group （4.4 ± 0.6 μg/mL vs 18.6±1.7μg/mL, P = 0.000; 5% vs 19%, P = 0.000）, but significantly higher in treatment group vs ANP group （6.4 ± 1.7 μg/mL vs 4.4 ± 0.6 μg/mL, P = 0.020; 7% vs 5%, P = 0.048）. The histological scores and W/D ratio were significantly decreased in treatment group vs ANP and control group. CONCLUSION： CQCQD might have a promotive effect on CTX concentration in pancreatic tissues of rats with ANP.     

Plasma homocysteine status in patients with ankylosing spondylitis

Homocysteine (Hcy), a sulfur-containing amino acid, is eliminated through B vitamins-dependent pathways. Hyperhomocysteinemia has been found to be an independent risk factor for atherosclerotic cardiovascular, cerebrovascular, and peripheral vascular diseases. Recently, psoriasis, lupus, and rheumatoid arthritis were reported to be associated with hyperhomocysteinemia. This study was aimed to evaluate the changes of plasma Hcy level before and after sulfasalazine and MTX therapy in patients with ankylosing spondylitis (AS). One hundred and two patients with AS and ten normal controls were enrolled in the cross-sectional case-control study. Fasting plasma Hcy levels were determined by ELISA kits (IMX, Abbott). Hcy levels were compared to their Bath AS disease activity index (BASDAI) and the usage of sulfasalazine and/or MTX. Active disease was defined by BASDAI as more than 3 in a 10-cm scale with ESR >20 mm/h. For those patients with plasma Hcy ≥15 μmol/l, a perspective trial of daily supplement of vitamin B-12 0.5 mg, B-6 50 mg, and folic acid 5 mg for 2 weeks were also tested for the efficacy. Plasma Hcy level increased significantly in AS patients under sulfasalazine (10.4±3.8 μmol/l, p<0.05), MTX (11.9±4.7, p<0.05) and sulfasalazine/MTX combination treatment (11.2±2.6, p<0.05) compared with normal controls (8.6±1.2 μmol/l) and AS patients without DMARD(9.4± 2.6μmol/l). No correlation between disease activity and plasma Hcy level was found. Daily supplement of vitamin B-12 0.5 mg, B-6 50 mg, and folic acid 5 mg can lower Hcy level in 2 weeks (32.3±24.0 vs 15.6±11.1 μmol/l, p=0.007). Plasma homocysteine level did significantly increase in AS patients under sulfasalazine or MTX treatment. B-vitamins should be considered as a routine supplementation for patients who underwent sulfasalazine and/or MTX treatment. Further longitudinal studies are required to confirm the conclusions.     

Effect of antihypertensive treatment with candesartan or amlodipine on glutathione and its redox status, homocysteine and vitamin concentrations in patients with essential hypertension

OBJECTIVE: To compare the effect of candesartan or amlodipine on concentrations of cellular markers of oxidative stress, plasma homocysteine and vitamins in hypertensive patients. METHODS: Forty-nine middle-aged patients with untreated stage I-II essential hypertension were recruited in a randomized double-blind double-dummy study to receive a daily dose either of 8 mg candesartan (n = 25) or 5 mg amlodipine (n = 24) for 16 weeks. Blood pressure, reduced glutathione (GSH) and oxidized glutathione (GSSG), glutathione redox ratio (GSSG : GSH) in red blood cells, plasma homocysteine, vitamin B12 and folic acid status were measured at baseline, at week 2 and at week 16. The same parameters were measured in 32 healthy age- and sex-matched controls. An increase in homocysteine of at least 2 micromol/l was considered significant. RESULTS: Hypertensive patients had significantly greater oxidative stress and homocysteine concentrations than controls. In addition to a significant decrease in blood pressure, in both treatment groups GSSG decreased (P < 0.03), GSSG : GSH had a tendency to decrease (P = 0.054), but homocysteine did not change. An increase in homocysteine concentration of at least 2 micromol/l was found in 12 patients (five in the candesartan group, seven in the amlodipine group), with a significant decrease in folic acid concentration and no changes in cellular oxidative stress. In patients with no increase in homocysteine concentration, both GSSG (P < 0.02) and GSSG : GSH (P = 0.051) decreased. GSH and vitamin B12 did not change in any of the groups studied. CONCLUSION: Untreated hypertension is associated with disturbed glutathione redox status and increased plasma homocysteine concentrations. Both candesartan and amlodipine had favourable effects on cellular oxidative stress, but the oxidative stress status did not decrease in patients with adverse changes in homocysteine.