光电容积脉搏波特征参数与冠状动脉病变程度的相关性研究

目的探讨光电容积脉搏波(PPG)特征参数与冠状动脉病变程度的相关性。方法选取2018年8～11月解放军总医院行冠状动脉造影(CAG)检查的冠心病患者226例,按CAG结果分为单支病变组55例、双支病变组74例和多支病变组97例。采集患者一般临床资料,行PPG检测,提取硬化指数(SI)、主峰时间(CT)、标准化主峰时间(NCT)和主峰时间比(CTR)等,进行相关性分析。结果单支病变组、双支病变组和多支病变组SI比较,差异有统计学意义[(6.479±0.819)m/s vs (6.692±1.051)m/s vs (6.943±1.096)m/s,P=0.024];3组CT、NCT和CTR比较,差异均无统计学意义(P0.05)。SI与冠状动脉病变程度呈正相关(r=0.162,P=0.015)。结论 PPG特征参数SI与冠状动脉病变程度有一定的相关性,可能对预测冠状动脉病变程度有一定的价值。     

心血管危险因素对冠状动脉狭窄严重程度的影响

目的 :探讨冠状动脉病变不同严重程度与心血管各种危险因素强度关系。方法 :选择冠状动脉造影病变 3 10例 ,其中三支病变 (三支病变组 ) 116例 ,二支病变 (二支病变组 ) 80例 ,单支病变(单支病变组 ) 114例。冠状动脉造影正常 (正常组 ) 13 2例。造影前常规测定 :总胆固醇 (TC)、低密度脂蛋白胆固醇(LDL C)、高密度脂蛋白胆固醇 (HDL C)、甘油三酯 (TG)。询问是否患有糖尿病、高血压并记录患病年限。询问是否吸烟并记录年限。是否有冠心病家族史。结果 :Logistic回归分析显示 :三支病变组、二支病变组、单支病变组与正常组相比 :风险比值 (OR)较大均为TC。三支病变组与二支病变组和单支病变组相比 ,OR较大为糖尿病。结论 :血清总胆固醇水平升高 ,对冠心病发生起主要作用 ,而糖尿病则是单支病变或二支病变向三支病变发展的最主要危险因素。     

急性心肌梗塞循环内皮祖细胞与冠状动脉病变严重程度的分析

目的：研究急性心肌梗塞（AMI）患者外周血中内皮祖细胞（EPCs）的水平与冠状动脉病变程度之间的关系。方法：选取55例AMI患者,以定量冠状动脉造影评估冠状动脉的血管狭窄程度,同时选取30名冠状动脉造影阴性的患者为对照组。所有患者均在入院后即刻[AMI发病平均时间（2．5±1．5）h],第24h、48h、72h、7d、14d及一个月时采血,以CD133作为EPCs标记物,用流式细胞仪检测患者外周血中CD133标记细胞数量。结果：AMI组患者及对照组均有EPCs（CD133）的表达,AMI患者EPCs数目明显低于非冠心病患者（P〈0．05）。多支病变者较单支病变者有降低趋势,但无显著性差异（P〉0．05）。EPCs数目和Gensini评分呈明显负相关（n=55,r=-0．619,P〈0．05）。结论：急性心肌梗塞患者EPCs数目和冠状动脉病变程度有关。     

青年冠心病患者心血管病危险因素与冠状动脉病变程度的相关性分析

目的 探讨青年冠心病患者心血管疾病危险因素与冠状动脉（冠脉）造影病变程度相关性.方法 疑似青年冠心病患者（≤45岁）行冠脉造影住院病例91例,经冠脉造影确诊冠心病患者67例,排除冠心病患者24例.冠脉造影病变程度由病变支数和病变Gensini总积分表示.危险因素包括性别、高血压病、吸烟、饮酒、2型糖尿病、血脂异常、肥胖.采用单因素和多因素分析.结果 （1）单因素分析显示,在病变程度不同的各组间比较,随各组中存在单个危险因素病例百分率的增加,冠脉造影病变支数和病变Gensini总积分随之增加.（2）多因素Logistic回归分析（前进法）显示,高LDL-C为冠脉造影诊断冠心病最显著的独立相关危险因素,其他危险因素依次为男性、吸烟、高血压病、2型糖尿病、低HDL-C、肥胖和饮酒.结论 高LDL-C是冠脉造影诊断冠心病最显著的独立相关危险因素,但其他危险因素如男性、吸烟、饮酒、2型糖尿病、低HDL-C、高血压病和肥胖亦不可忽视,各危险因素在不同性别中危险程度有所不同.     

血浆同型半胱氨酸与冠状动脉病变支数的关系

目的 探讨冠心病新的危险因素同型关胶氨酸（Ｈｃｙ）与冠状动脉（冠脉）病变支数的关系。方法 采用高效液相色谱法对１１７例行选择性冠脉造影的口才进行了血浆Ｈｃｙ水平的测定。冠脉造影显示３支冠脉中至少单支血管病变狭窄≥５０％者为冠心病患者（１０１例）。３支血管中任一血管狭窄程度均为０％者归入下沉对照组（１６例）。冠心病患者分为单支病变组（２９例）、双支病变组（３５例）及３支病变组（３７例）。结果 冠心病     

辛伐他汀对冠状动脉造影病变的影响

目的：评价辛伐他汀治疗对冠状动脉造影病变的影响。方法：７３例冠心病患,无论血清总胆固醇水平升高与否,随机分为辛伐他汀组（３９例）和空白对照组（３４例）。平均治疗１年后重复冠状动脉造影,采用计算机定量测定系统评价冠状动脉病变狭窄程度的变化,同时随访患的临床情况。结果：辛伐他汀组患在接受降脂治疗后血清总胆固醇降低１５．４％,低密度脂蛋白－胆固醇下降２５．３％,高密度脂蛋白－胆固醇增加１１．５％。辛伐他汀组２０．７％的病变进展,对照组４１．９％的病变进展（Ｐ〈０．０５）。辛伐他汀治疗使冠状动脉病变进展的危险性下降５０．６％。辛伐他汀组２０．５％的病人病情恶化,对照组５５．９％的病人病情恶化（Ｐ〈０．０５）。辛伐他汀治疗使恶化病例减少６３．３％。心脏事件（急性心肌梗死、血管重建和死亡）辛伐他汀组１２例（３０．７％     

血清淀粉样蛋白A与老年冠心病患者冠状动脉病变严重程度的相关性分析

目的分析血清淀粉样蛋白A(SAA)与老年冠心病患者冠状动脉病变严重程度的相关性。方法选择2014年6月~2015年6月在我院接受住院治疗的168例胸痛患者,其中男性85例,女性83例,年龄60~82(68.21±5.61)岁。所有入选的胸痛患者均行冠状动脉造影术,根据冠状动脉造影的结果分为冠心病组121例和非冠心病(non-CHD)组47例。冠心病组根据其亚型又分为:稳定性心绞痛(SAP)组36例、不稳定性心绞痛(UAP)组48例、急性心肌梗死(AMI)组37例。所有患者根据是否行PCI术分为PCI组100例,non-PCI组68例。采用ELISA法检测SAA水平,Gensini评分评价冠状动脉病变的严重程度。结果冠心病组患者血清SAA水平明显高于nonCHD组患者[(139.20±87.42)mg/L vs(31.69±6.69)mg/L,P=0.005]。AMI组及UAP组的血清SAA水平明显高于SAP组和non-CAD组[(224.11±91.98)mg/L及(135.80±42.82)mg/L vs(56.46±18.98)mg/L和(31.69±6.69)mg/L],且AMI组明显高于UAP组。相关分析显示,血清SAA水平与LDL-C呈负相关(r=-0.081,P=0.040),总体血清SAA水平与Gensini评分呈正相关(r=0.489,P=0.000)。PCI组患者术后7d血清SAA水平较术前明显下降(P0.05)。结论老年冠心病患者血清SAA水平与冠状动脉病变严重程度呈正相关。     

冠心病合并2型糖尿病患者冠状动脉病变严重程度的研究

目的:探讨2型糖尿病与冠状动脉病变严重程度的关系。方法:对象为选择性冠状动脉造影确诊的冠心病患者266例,其中合并2型糖尿病者96例,无糖尿病者170例。计算冠脉病变支数和进行Gensini冠脉病变评分。结果:冠心病合并2型糖尿病患者的冠脉病变Gensini评分和三支病变者明显多于不合并2型糖尿病的冠心病患者(P<0.05);简单直线相关分析表明,甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、体重指数等与冠状动脉病变严重程度显著相关(P均<0.01)。结论:冠心病患者合并2型糖尿病将加重冠状动脉病变严重程度。     

冠状动脉分叉病变介入治疗策略

<正>冠状动脉分叉病变,是指冠状动脉狭窄毗邻和(或)累及重要分支血管的开口。血管分叉处由于血流涡流及切变力的增加,容易发生动脉粥样硬化。分叉病变占所有介入治疗的8%～20%。分叉病变分型的不同,决定了介入治疗策略选择和技术应用有所不同。     

新疆伊犁地区不同民族无偿献血者ABO血型分布回顾性分析

目的：对伊犁地区5个人口较多的长居民族的血型分布进行回顾性分析,为我地区合理地实施采供血工作提供依据。方法：对2000-2005年首次无偿献血者ABO血型及Rh血型的鉴定结果进行分析。结果：伊犁地区ABO血型分布特点为：汉族、回族O〉B〉A〉AB,维吾尔族、锡伯族B〉A〉O〉AB,哈萨克族O〉A〉B〉AB。结论：掌握本地区主体民族的血型分布特点,为进一步做好血液资源的调配将起到积极地作用。     

The association between ambulatory systolic blood pressure and cardiovascular events in a selected population with intensive control of cardiovascular risk factors

Recent guidelines recommend a target clinic systolic blood pressure (BP) of <140 mm Hg. These recommendations are based on the relationship of office BP measurements and cardiovascular (CV) events. We evaluated the association between 24-hour ambulatory BP measurements (24H ABPM) and CV events in a selected population with intensive control of CV risk factors. We retrospectively followed all patients who had undergone 24H ABPM during 2005 at the Institute of Periodic Medical Examinations, Chaim Sheba Medical Center, Tel-Hashomer, Israel, to monitor the development of CV events. These patients were followed closely and treated meticulously in order to control CV risk factors. The study population consisted of 317 patients (81% males; mean age, 59.2 ± 9.8 years) followed for a mean period of 6.4 ± 2.1 years (median, 6 years). During follow-up, 22 patients had their first CV event. Patients who experienced CV events were significantly older, more likely diabetic, and had a history of previous CV disease. Twenty-four-hour ABPM systolic BP ≥140 mm Hg was not associated with increased CV events, whereas 24H ABPM systolic BP ≥150 mm Hg was. Logistic regression analysis showed that 24H ABPM systolic BP ≥150 mm Hg, a former smoker, old age, and a history of CV disease were associated with CV events during follow-up. We found that, in a population aggressively managed for CV risk factors, 24H ABPM systolic BP ≥150 mm Hg is associated with increased CV events.     

Association of ABO blood group type with cardiovascular events in COVID-19

Journal of Thrombosis and Thrombolysis - Cardiovascular complications have been reported in patients with COVID-19. We sought to examine the association of ABO blood group type with cardiovascular...     

ABO血型与疟疾易感性:基于中国人群的Meta分析

目的 研究中国人群ABO血型与疟疾易感性之间的关系. 方法 通过查询重庆维普、Medline数据库收集国内外1980年1月1日至2013年3月1日之间公开发表的关于ABO血型与疟疾易感性的中英文文献资料,采用荟萃分析软件RevMan 5进行Meta分析. 结果 7篇文献被纳入到本次分析.Meta分析结果显示,A型血与非A型血人群相比,疟疾的发病风险合并相对危险度(RR)及(95％CI)为1.27(1.03～1.57);B型血与非B型血人群相比,为0.97(0.80～1.17);AB型血与非AB型血人群相比,为0.92(0.80～1.06);O型血与非O型血人群相比,为0.80(0.73 ～ 0.88).各亚组研究通过Egger回归法进行发表性偏倚分析,P值分别为0.32、0.87、0.30、0.72,均＞0.10. 结论 各亚组研究可认为无发表性偏倚,对于中国人群,A型血较之其他血型对疟疾多27％的感染可能,而O型血较之其他血型少20％的感染可能.     

Association between difference in blood pressure reduction and risk of cardiovascular events in a type 2 diabetes population: A meta-regression analysis

AimRecent US recommendations indicate a target blood pressure (BP) of 130/80 mmHg for patients with type 2 diabetes (T2D). Our aim was to characterize the association between risk of cardiovascular events and differences in BP decreases in randomized trials of a T2D population.MethodsA systematic search was made for randomized clinical trials assessing the effects of antihypertensive treatments in T2D patients on mortality, and fatal and non-fatal cardiovascular events, using a meta-regression technique to explore the influence of BP decreases on treatment effects.ResultsA total of 88,503 patients from 44 randomized trials were included. There was no significant association between BP decreases and risk of all-cause or cardiovascular mortality, cardiovascular events or myocardial infarction. However, stroke risk was influenced by BP decreases: compared with no reduction, a 10-mmHg reduction in systolic BP was associated with a relative odds ratio (OR) decrease of 33% (OR: 0.67, 95% CI: 0.54–0.82), and a 5-mmHg diastolic BP reduction was associated with a relative OR decrease of 38% (OR: 0.62, 95% CI: 0.50–0.76). Restricting the analysis to double-blind studies did not change the results for diastolic BP.ConclusionA reduction in BP lowers the risk of stroke, but does not appear to affect the risk of other cardiovascular events in a T2D population.     

老年原发性高血压患者血压晨峰与心血管危险因素相关性研究

目的:探讨老年原发性高血压患者血压晨峰与心血管事件风险的相关性。方法:采用动态血压监测仪分析230例老年高血压患者的血压,分为晨峰组与非晨峰组,测定心电图和超声心动图。结果:与非晨峰组相比较,晨峰组凌晨收缩压、脉压较高,QT离散度增大,差异均有统计学意义(P<0.01);晨峰组的左室肥厚发生率为56.8%,非晨峰组为42.5%,差异有统计学意义。结论:血压晨峰使心血管事件的风险增加。     

不同性别冠心病危险因素与冠脉病变程度的相关性

目的:分析冠心病危险因素与冠状动脉病变程度的相关性及其性别差异。方法:入选2005年～2009年入院行冠状动脉造影术的患者1 786（男1 214,女572）例,记录性别、年龄、血压、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、尿酸（UA）、血糖、吸烟等指标,并计算Gensini积分。首先,根据Gensini积分将所有患者分成4个组,对各个组之间的各项危险因素分别进行比较分析。然后用Logistic回归分析法比较冠心病与各项危险因素之间的相关程度,最后通过性别分组再次行Logistic回归比较不同性别冠心病与各项危险因素之间的相关程度。结果:单因素分析发现随着Gensini积分的增高年龄、TC、LDL-C也增加,而HDL-C下降,但TG、UA在各组中无统计学差异,且各个小组中随着男性、吸烟者、高血压病、糖尿病比例的增加冠脉病变积分增高;多危险因素与冠状动脉造影诊断冠心病Logistic分析:糖尿病为冠心病最显著的独立危险因素,其他依次为吸烟、低HDL-C、高LDL-C、增龄、性别,而高血压病与高TC均无统计学意义。性别分组后,男性患者中吸烟为冠心病最显著的独立危险因素,其他依次为低HDL-C、高LDL-C、糖尿病、增龄;女性患者中糖尿病为最显著的独立危险因素,其次是低HDL-C、增龄,吸烟对女性冠心病的发生无显著性差异。结论:年龄的增加、TC的增加、LDL-C的增加、HDL-C的降低、高血压、糖尿病、吸烟等危险因素都会加重冠脉病变程度,其中糖尿病是冠心病最显著的危险因素,尤其在女性更为明显。     

Relationship between the ABO blood group and COVID-19 susceptibility,severity and mortality in two cohorts of patients

BackgroundSeveral articles reported the existence of an association between ABO blood groups and COVID-19 susceptibility. Group A and group O individuals showed a higher and lower risk, respectively, of becoming infected. No association was observed between ABO groups and mortality. To verify this association, we performed a retrospective study of two cohorts of patients with different demographic and clinical characteristics.Material and methodsA total of 854 regular blood donors were recruited for convalescent plasma donation after recovering from a mild COVID-19 infection, and a group of 965 patients more severely affected who were transfused during hospitalisation were also included. We also investigated the potential role of the different risk factors on patient outcome and death. To eliminate the confounding effect of risk factors on mortality, a propensity score analysis was performed.ResultsBlood group A and blood group O COVID-19 blood donors showed a higher and lower risk, respectively, for acquiring COVID-19. In contrast, this association was not found in the group of patients transfused during hospitalisation, probably due to the great differences in demographic and clinical characteristics between the two groups. Regarding severity, age was one of the most significant risk factors. ABO blood groups were also seen to represent important risk factors for COVID-19 severity and mortality. Mortality risk in group A individuals was significantly higher than in group O individuals (OR: 1.75, 95% CI: 1.22–2.51).DiscussionThe association between the ABO blood groups and the susceptibility to acquire COVID-19 infection was confirmed in the group of blood donors. ABO blood groups were also associated to COVID-19 severity and mortality in the group of patients transfused during hospitalisation. Therefore, blood groups A and O are two important factors to be considered when evaluating the prognosis of patients with COVID-19.     

冠状动脉CT血管成像定量参数与老年冠心病患者病情严重程度的相关性

目的探讨冠状动脉CT血管成像定量参数与老年冠心病患者病情严重程度的相关性。方法回顾性分析在我院治疗的老年冠心病患者150例为观察组,同时收集健康志愿者150例为对照组,行冠状动脉CT血管成像检查,获取斑块及血管体积、斑块负荷、血管狭窄、血管重建等定量参数,分析定量参数与冠心病患者病情严重程度的相关性。结果与对照组比较,观察组斑块数[(2.43±0.53)个vs(0.82±0.32)个,P=0.000]、非钙化斑块体积[(321.84±124.92)mm^3 vs(125.83±43.28)mm^3,P=0.000]、钙化斑块体积[(43.28±12.84)mm^3 vs(12.74±4.39)mm^3,P=0.000]、总斑块体积[(365.12±109.85)mm^3 vs(138.57±40.92)mm^3,P=0.000]和重建指数(1.89±0.43 vs 1.12±0.24,P=0.000)等均显著增高。Pearson线性相关分析显示,斑块数、非钙化斑块体积、钙化斑块体积、总斑块体积、非钙化斑块负荷、钙化斑块负荷、总斑块负荷、血管狭窄程度与LVEF呈负相关(P<0.01),与平均室壁应力、左心室质量指数、左心室收缩末期容积、左心室舒张末期容积呈正相关(P<0.05,P<0.01)。结论冠状动脉CT血管成像定量参数与老年冠心病患者病情严重程度相关,可用于评估患者预后。     

Association between red blood cell distribution width and the risk of future cardiovascular events

In patients with acute myocardial infarction (AMI), high red blood cell distribution width (RDW) seems to predict further cardiovascular events, although the mechanism and its possible relation with anaemia and inflammation remains uncertain. We determined in 119 AMI patients before hospital discharge RDW, along with haemoglobin, haematimetric indices and inflammatory parameters (fibrinogen, C-reactive protein, plasma viscosity, neutrophil count). In the follow-up period (21 ± 11 months), 30 patients (25%) developed a recurrent cardiovascular event. In the lineal regression analysis, MCH and neutrophil count were independent determinants for RDW (beta coefficient = -0.544 p < 0.001; beta coefficient: 0.279 p = 0.001, respectively). The logistic regression analysis showed that RDW >14% increases the risk of future events by 6 times; OR 6.19 IC 95% (2.1-18.5); even after adjusting for anaemia, mean corpuscular haemoglobin (MCH) <27 pg/L, fibrinogen >400 mg/dL and neutrophil count >5.7 (103/μL). Our results confirm that RDW, an available and inexpensive measurement reported in routine blood cell counts, seems to be an independent predictor for recurrent cardiovascular events in AMI patients. As we found no association of RDW with either anaemia or inflammatory parameters, the mechanism responsible for increased RDW deserves further research.