Comparison of low-dose sequences of dual-source CT and echocardiography for preoperative evaluation of aortic valve disease

Background Accurate evaluation of coronary artery,aortic valve annulus diameter （AVAD）,and cardiac function in patients with aortic valve disease is of great significance for surgical strategy.In this study,we explored the preoperative evaluation of low-dose sequence （MinDose sequence） scan of dual-source CT （DSCT） for those patients.Methods Forty patients suspected for aortic valve disease （the experimental group） underwent MinDose sequence of DSCT to observe coronary artery,AVAD,and left ventricular ejection fraction （LVEF）.Another 33 subjects suspected for coronary artery disease （the control group） underwent conventional retrospective electrocardiographically-gated sequence of DSCT.Two-dimensional transthoracic echocardiography （2D-TTE） and four-dimensional transthoracic echocardiography （4D-TTE） were applied in the experimental group to measure AVAD and LVEF and compared with MinDose-DSCT.Results There was a strong correlation between LVEFs measured by 2D-TTE and MinDose-DSCT （r=0.87,P ＜0.01）,as well as between 4D-TTE and MinDose-DSCT （r=0.90,P ＜0.01）.AVAD measured by MinDose-DSCT was in good agreement with corresponding measurements by 2D-TTE （r=0.90,P ＜0.01）.The effective dose in the experimental group was 63.54％ lower than that in the control group.Conclusions MinDose sequence of DSCT with a low radiation dose serving as a one-stop preoperative evaluation makes effective assessment of the coronary artery,AVAD,and LVEF for patients with aortic valve disease.     

A comparative study of coronary angiography and optical coherence tomography findings in coronary artery disease patients with moderate stenosis

Objective To compare coronary angiography(CAG) and optical coherence tomography(OCT) findings in stenosis and culprit lesion morphology assessment in coronary artery disease patients with moderate stenosis(50%～70%).Methods 23 CAD patients with moderate stenosis(50%～70%) were enrolled in the study.These patients then underwent OCT analysis.CAG and OCT stenosis results were compared for conformity.OCT images of the culprit lesions were analyzed for more details about the morphological characteristics of the plaques in relation with the clinical diagnosis.Results Evaluation of stenosis of coronary lesions by Quantitative Coronary Angiography(QCA) corresponds approximately with OCT analysis estimation:CAG stenosis was 57.26% ±5.05,whereas the same OCT stenosis analysis reached a value of 61.17%±11.36,(P=0.032).From OCT image analysis,the vulnerable plaque was detected more in the culprit lesions of patients with a clinical diagnosis of unstable angina,than in stable angina pectoris patients(61.5%vs10%;P=0.012).     

Effect of chinese herbal medicine for calming Gan (肝) and suppressing hyperactive yang on arterial elasticity function and circadian rhythm of blood pressure in patients with essential hypertension

Objective:To observe the effect of Chinese herbal medicine for calming Gan(肝) and suppressing hyperactive yang(平肝潜阳,CGSHY) on arterial elasticity function and the circadian rhythm of blood pressure in patients with essential hypertension(EH).Methods:Adopting a parallel,randomized design,sixty-four patients with EH of stagesⅠandⅡwere randomly divided into two groups according to a random number table,with 32 in each group.The patients in the treatment group were treated with CGSHY and those in the control group were treated with Enalapril.All patients were given 24-h ambulatory blood pressure monitoring(ABPM) before and after a 12-week treatment.Trough/peak(T/P) ratios of systolic and diastolic blood pressure(SBP & DBP) of each group were calculated.The circadian rhythm of their blood pressure was observed at the same time. The changes in elasticity of the carotid artery in the patients,including stiffness parameter(β),pressure-strain elastic modulus(Ep),arterial compliance(AC),augmentation index(Al),and pulse wave velocity(PVWβ) were determined by the echo-tracking technique before and after a 12-week treatment.In the meantime,their levels of nitric oxide(NO) and endothelin-1(ET-1) were measured respectively.Results:After treatment,all parameters in the 24-h ABPM and the elasticity of the carotid artery(β,Ep,AC and PVWβ) were markedly improved,the level of NO was increased,and ET-1 was decreased in both groups as compared with values before treatment (P<0.05 or P<0.01).Further,the improvements in the ratio of T/P of SBP & DBP and in the level of NO and ET-1 in the treatment group were more significant than those in the control group(P<0.05).There were no significant differences in all parameters in the ABPM monitoring and the elasticity of the carotid artery,the recovery of blood pressure circadian rhythm,and the therapeutic effect of antihypertension in EH patients between the two groups (P>0.05).Conclusions:Chinese herbal medicine for CGSHY may lower the blood pressure smoothly and recover the circadian rhythm of blood pressure in EH patients.They may also improve the carotid elasticity of EH patients similar to that of Enalapril.The mechanism of action of Chinese herbs on EH might be related to the regulation of vascular endothelium function.     

Role of Wnt/β-catenin Signaling Pathway in the Mechanism of Calcification of Aortic Valve简

Aortic valve calcification is a common disease in the elderly, but its cellular and molecular mechanisms are not clear. In order to verify the hypothesis that Wnt/β-catenin signaling pathway is involved in the process of calcification of aortic valve, porcine aortic valve interstitial cells（VICs） were isolated, cultured and stimulated with oxidized low density lipoprotein（ox-LDL） for 48 h to induce the differentiation of VICs into osteoblast-like cells. The key proteins and genes of Wnt/β-catenin signaling pathway, such as glycogen synthase kinase 3β（GSK-3β） and β-catenin, were detected by using Western blotting and real-time polymerase chain reaction（PCR）. The results showed that the VICs managed to differentiate into osteoblast-like cells after the stimulation with ox-LDL and the levels of proteins and genes of GSK-3β and β-catenin were increased significantly in VICs after stimulation for 48 h（P0.05）. It is suggested that Wnt/β-catenin signaling pathway may play a key role in the differentiation of VICs into osteoblast-like cells and make great contribution to aortic valve calcification.     

MRI与DSA对颈动脉支架置入术适应证选择的比较

目的 比较3.0T磁共振(MRI)和数字减影血管造影(DSA)对颈动脉粥样硬化患者支架置入术适应证选择的效能差异.方法 收集2009年1月至2010年12月卫生部北京医院神经外科就诊的46例初发或复发脑缺血疾病的患者,超声检查发现颈动脉粥样硬化斑块后分别行颈动脉MRI及DSA检查.比较两种方法对血管狭窄程度、溃疡斑块的检出和对手术适应证确定的效能差异.结果 共92支颈动脉,除3支血管为支架置入后,症状性血管组25支血管,无症状血管组64支血管.MRI和DSA对颈动脉管腔狭窄的判断具有很好的一致性(Kappa值为0.882);对溃疡斑块检出的差异有统计学意义(P<0.01);对手术适应证的确定,症状组的差异无统计学意义(分别为14支和13支血管,P>0.05),无症状组的差异具有统计学意义(分别为22支和14支血管,P＜0.05).在接受手术的14例患者中2例的手术依据仅参照MRI.MRI发现37支血管有斑块内出血,71支有斑块内钙化,而DSA未能检出.结论 与DSA相比,MRI可以更好地检出符合手术适应证要求的血管.

Abstract：

Objective To compare the efficacy of cardiovascular MRI and DSA in stent-treatment selection for patients with carotid atherosclerosis.Methods Forty-six patients with carotid plaque detected by ultrasound were enrolled in this study.Carotid plaque MRI and DSA was performed.Images were evaluated for luminal stenosis(NASCET standard), fibrous cap rupture, intra-plaque hemorrhage and calcification.Kappa value and paired chi-square test were used for the statistical analysis.Results These 92 carotid arteries were divided into two groups, that were the symptomatic artery group with 25 vessels and asymptomatic artery group with 64 vessels, and the other 3 arteries were excluded due to stent placement.There was good concordance between the degree of stenosis measured by MRI and DSA (Kappa value 0.882).There was significant difference in detecting FC rupture by two modalities (P<0.01).As to the indication selection for stent treatment by two modalities, there was significant difference for asymptomatic group(22 vessels by MRI and 14 vessels by DSA, P<0.05), neither did the symptomatic group.There were two patients, among those 14 who underwent the stent treatment, that decided stent treatment only rely on the FC rupture detected by MRI.Furthermore, MRI detected 37 vessels with intra-plaque hemorrhage and 71 vessels with calcification in the plaque.Conclusion MRI was much more suitable for the selection of stent treatment for patients with carotid atherosclerosis as compared with DSA.     

缺血性脑卒中牛津郡社区卒中项目亚型与颈动脉病变特点的关系

目的 观测缺血性脑卒中颅外段颈动脉狭窄的发生率及粥样硬化斑块性质;了解患者牛津郡社区卒中项目(OCSP)分型与颅外段颈动脉病变之间的关系.方法 纳入并登记2008年1月至2009年12月郑州大学第一附属医院神经内科连续入院的缺血性脑卒中患者,行颈部双功能彩色多普勒超声检查,观测患者的颈动脉狭窄程度及粥样斑块性质.结果 符合标准的缺血性脑卒中患者854例,其中675例(79%)患者进行了颈动脉彩超检查,OCSP各亚型构成比如下:部分前循环梗死占32.7%,腔隙性脑梗死占26.1%,完全前循环梗死占23.0%,后循环梗死占18.2%.颅外段颈动脉狭窄215例(31.9%),其中颈动脉狭窄≥50%包括颈动脉闭塞在内共93例(13.8%).在386例(57.2%)患者中共检出515个粥样硬化斑块,其中不稳定斑块占51.0%,发生部位以颈动脉分叉处最常见,占61.5%(317/515).OCSP亚型间比较,重度颈动脉狭窄患者中,部分前循环梗死发生率最高(14.5%),中度颈动脉狭窄患者中,完全前循环梗死发生率最高(22.6%),且不稳定斑块的检出率最高(P＜0.05).结论 缺血性脑卒中患者颈动脉病变常见,OCSP分型可能与颈动脉病变有相关性. Abstract： Objective To observe the incidence of extracranial carotid artery stenosis and plaque nature,and to understand the relationship between Oxfordshire community stroke project (OCSP) classification and extracranial carotid artery in ischemic stroke. Methods From Jan. 2008 to Dec. 2009 in department of neurology of the first affiliated hospital of Zhengzhou university, the consecutive patients with ischemic stroke admitted to hospital were registered, and by neck color Doppler ultrasound the degree of carotid stenosis and the characteristics of atherosclerotic plaque were recorded.Results Eight hundred and fifty-four cases of ischemic stroke were registered in two years, of which 675 cases (79%) underwent carotid ultrasonography examination. The proportion of ischemic stroke subtype according to OCSP criteria was as following: 32.7% for partial anterior circulation infarcts, 23.0% for total anterior circulation infarcts, 18.2% for posterior circulation infarcts and 26.1% for lacunar infarcts. In 215 cases of extracranial carotid artery stenosis (31.9%), there were 93 cases (13.8%) with carotid artery stenosis ≥50% including occlusion. Five hundred and fifteen carotid plaques were found in 386 cases (57.2%), Composed of 263 unstable plaque (51.0%),carotid plaque were commonly seen most in the carotid bifurcation 61.5% (317/515). Among OCSP subtypes, the propotion of severe carotid artery stenosis was the highest for PACI patients and the propotion of moderate carotid artery stenosis and unstable plaque were the highest for TACI patients(P＜0.05). Conclusions Ischemic stroke patients with carotid artery disease is common, the carotid artery disease is different among OCSP subtypes, the type can be used to predict severe carotid artery stenosis.     

The value of pulse wave velocity in the diagnosis of coronary heart disease

Objective: Using receiver operating characteristics (ROC) curve to evaluate the value of pulse wave velocity (PWV) in the diagnosis of coronary heart disease (CHD). Methods: By using coronary angiography as golden diagnostic standard of CHD, 218 patients were divided into both CHD group (n=121) and non-CHD group (n = 97). All these patients received PWV test. The efficacy of PWV of each artery segments in the diagnosis of CHD was evaluated by ROC curve. The sensitivity and specificity were calculated with the golden diagnostic standard of CHD. Results:The PWV of right carotid to femoral artery (Rc-f), left carotid to femoral artery (Lc-f), right radial to carotid artery (Rc-r), left radial to carotid artery (Lc-r) in CHD group were significantly higher than that of non-CHD group (9. 31±1. 75 vs 7.60±1.59, P<0. 01; 9. 02±1.71 vs 7. 52±1.50, P<0. 01; 8. 69±1. 37 vs 8. 00±1. 27, P<0. 01; 8.52±1. 03 vs 8. 03±1. 2, P<0. 01 respectively). However, the PWV of both right and left femoral to ankle artery (Rf-a and Lf-a) had no significant differences between the two groups. We then compared the area under curve (AUC) of each ROC(AUCROC) of PWV of Rc-f, Lc-f Rc-r and Lc-r to evaluate their diagnostic efficacy for CHD. We found that AUCROC of Rc-f PWV was the biggest (AUCROC = 0. 818), at the peak point of its ROC curve, the PWV was 8. 32 m/s. PWV>8. 32 m/s of Rc-f could predict the presence of CHD with a sensitivity of 79% and specificity of 77%. Conclusion: The PWV of Rc-f, Lc-f, Rc-r, Lc-r are significantly higher in CHD group than that in non-CHD group, and PWV of Rc-f is the most accurate in the detection of CHD. The PWV>8. 32 m/s of RC-F is a valuable predictor of CHD.     

A Clinicopathological Study on Aortic Valves in Children

In order to investigate the clinicopathological characteristics of aortic valve disease in children, all the native surgically excised aortic valves obtained between January 2003 and December 2005 were studied macroscopically and microscopically. The patients’ medical records were reviewed and the clinical information was extracted. According to preoperative echocardiography, intraopera- tive assessment, and postoperative pathology, combined with clinical symptoms and signs, aortic valve diseases were divided into three categories: aortic stenosis (AS), aortic insufficiency (AI), and aortic stenosis with insufficiency (AS-AI). The etiology was determined according to the macro- scopic, microscopic and clinical findings. The results showed that among 70 aortic valves, patient age ranged from 6 to 18 years, with a mean of 15.4 years, and there were 56 boys and 14 girls (male: fe- male=4:1). Forty-four children only had pure aortic valve disease, and the other 26 children had aor- tic valve disease associated with other heart valve diseases. There were 5 cases of AS (7.14%), 60 cases of AI (85.71%) and 5 cases of AS-AI (7.14%). The causes were congenital aortic valve mal- formation (32 cases, 45.71%), rheumatic disease (28 cases, 40%), infective endocarditis (7 cases, 10%), Marfan syndrome (2 cases, 2.86%), and undetermined (1 case, 1.43%). It was concluded that the common causes of aortic valve disease in order of frequency in children were congenital aortic valve malformation, rheumatic disease, infective endocarditis, and Marfan syndrome. AI was more common in children with aortic valve disease. Compared with adult patients, congenital bicuspid aor- tic valve in children was often AI. Histologically, the leaflets of congenital bicuspid aortic valve were mainly myxomatous, fibrosis and calcification less seen. AI was frequently found in rheumatic dis- ease, mostly associated with other heart valve diseases. Macroscopic and microscopic examinations together with clinical information, echocardiographic findings and operative details were important in evaluating the etiology of aortic valve disease.     

Congenital quadricuspid aortic valve: analysis of 11 surgical cases

Background  Congenital quadricuspid aortic valve is rarely seen during aortic valve replacement (AVR). The diagnosis and treatment of the disease were reported in 11 cases.

Methods  Eleven patients (nine men and two women, mean age 33.4 years) with quadricuspid aortic valve were retrospectively evaluated. Medical records, echocardiograms and surgical treatment were reviewed.

Results  In accordance with the Hurwitz and Roberts classification, the patients were classified as type A (n=2), type B (n=7), type F (n=1) and type G (n=1). Three patients were associated with other heart diseases, including infective endocarditis and mitral prolaps, left superior vena cava, aortic aneurysm. All had aortic regurgitation (AR) except two with aortic stenosis (AS), detected by color-flow Doppler echocardiography. The congenital quadricuspid aortic valve deformity in seven patients was diagnosed by echocardiography. All patients underwent successful aortic valve replacement.

Conclusion  Quadricuspid aortic valve is a rare cause of aortic insufficiency, while echocardiography plays an important role in diagnosing the disease. Aortic valve replacement is the major therapy for the disease.

     

高血压病患者颈动脉粥样硬化与血尿酸及载脂蛋白水平的相关性

目的 通过对高血压病患者颈动脉超声多普勒检查和血尿酸及载脂蛋白水平的测定,探讨血尿酸及载脂蛋白与颈动脉硬化程度的关系.方法 测定100例高血压病患者血尿酸及载脂蛋白水平,用超声多普勒检测颈动脉粥样硬化程度.结果 颈动脉粥样硬化程度与血尿酸及载脂蛋白水平有关.结论 血尿酸及载脂蛋白水平与颈动脉粥样硬化的程度具有相关性,血尿酸及载脂蛋白B水平升高、载脂蛋白A水平降低是动脉粥样硬化的危险因素. Abstract： Objective To evaluate the correlation among the level of serum uric acid, apolipoproteins and the degree of carotid artery atherosclerosis in patients with hypertension. Methods The serum uric acid, apolipoproteins in 100 patients with hypertension were detected, and the degree of carotid artery atherosclerosis was determined by ultrasonic Doppler examination. Results The serum uric acid,apolipoproteins had the positive correlation to the degree of carotid artery atherosclemsis. Conclusions The concentrations of serum uric acid, apolipoproteins have positive relationship to the degree of carotid artery atherosclerosis. Increase of level of serum uric acid and ApoB, reduce of level of ApoA are risk factors for carotid artery atherosclerosis.     

阿托伐他汀对冠心病合并充血性心力衰竭患者血管内皮功能的影响

目的 研究阿托伐他汀对冠心病(CHD)合并充血性心力衰竭(CHF)患者血浆中一氧化氮(NO)、降钙素基因相关肽(CGRP)和内皮素(ET)的影响.方法 将68例CHD并CHF患者随机分为两组,常规治疗组(地高辛、氢氯噻嗪、硝酸异山梨酯)34例,联用组常规用药加阿托伐他汀34例,另选34例健康体健者为正常对照组.采用Greiss法测定NO水平,放射性免疫法测定治疗前后血中CGRP和ET的水平.结果 CHD并CHF患者中NO和CGRP水平明显低于正常组(P＜0.01),ET显著高于正常组(P＜0.01),治疗后均显著改善(P＜0.01),且以联用组改善更为显著,与常规组治疗后比较差异有统计学意义(P＜0.05).结论 常规用药加阿托伐他汀能显著改善CHD合并CHF患者的NO、CGRP和ET的代谢失衡. Abstract： Objective To study the effect on levels of plasma calcitonin gene-related peptide (CGRP) and endothelin(ET) of atorvastatin in patients with coronary artery heart disease(CHD) complicated with congestive heart failure(CHF). Methods Patients with CHD complicated with CHF were divided into two groups usual medicine group(usual medicine) and atorvastatin group. The plasma CGRP and ET levels were observed before and after treatment. Results The levels of CGRP in patients with CHF were lower than that in normal group before treatment (P＜0.05),and the level of ET was higher (P＜0.05),the improvement of CGRP and ET in atorvastatin group was better than that in the usual medicine group(P＜0.05). Conclusions Atorvastatin had the action of improving the imbalance of CGRP and ET in Patients with CHD complicated with CHF.     

D-二聚体与纤维蛋白原在冠心病中的临床意义

目的 研究D-二聚体(D-Dimer,DD)与纤维蛋白原(Fg)的含量在冠心病患者中的差异.方法 将入选的130例经冠状动脉造影(CAG)的患者分为确诊的冠心病组94例与正常对照组36例,其中冠心病组又分为急性心肌梗死(AMI)组25例、不稳定型心绞痛(UAP)组36例和稳定型心绞痛(SAP)组33例;再将冠心病组按CAG结果分为轻度病变组24例、中度病变组27例和重度病变组43例.用免疫透射比浊法分别测定DD、Fg含量进行比较.结果 AMI、UAP两组DD、Fg含量及阳性检出率明显高于SAP和对照组(P＜0.05),AMI组的DD、Fg含量明显高于UAP组(P＜0.05),重度病变组DD、Fg含量高于轻、中度病变组(P＜0.05).结论 联合检测DD与Fg在冠心病的诊断中具有重要的临床意义. Abstract： Objective To examine the diversity of D -dimer(DD) and fibrinogen (Fg)in the patients with coronary heart disease(CHD). Methods The 130 subjects were divided into CHD group(94 cases) which were confirmed by coronary artery angiography(CAG) and control group (36 cases). CHD group was divided into acute myocardial infarction (AMI) group (25 cases), unstable angina pectoris (UAP) group (36 cases) and stable angina pectoris (SAP) group ( 33 cases). In addition, CHD group was divided into slight (24 cases), moderate (27 cases)and severe (43 cases)lesion groups according to the outcome of CAG. The levels of DD and Fg were measured respectively and compared among all groups. Results The levels of DD, Fg in AMI and UAP groups were significantly elevated as compared with that of SAP and control groups ( P＜0.05), and DD, Fg in AMI group were higher than that of UAP group. The levels of DD and Fg in severe lesion group were higher than that of moderate and slight groups ( P＜0.05 ). Conclusions To measure the levels of DD and Fg simultaneously has important clinical significance in CHD.     

血清脂蛋白(a)、胆红素水平与冠状动脉病变程度关系研究

目的 检测冠心病(CHD)患者的血清脂蛋白(a)和胆红素水平,并探讨其与CHD的关系.方法 对196例疑诊冠心病而接受冠状动脉造影的患者检测血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白(a)[Lp(a)]、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL).根据冠状动脉狭窄情况分为非冠心病组(冠状动脉狭窄小于50%,52例)、单支病变组(仅有一支冠状动脉分支狭窄大于或等于50%,53例)和多支病变组(有一支以上冠状动脉分支狭窄大于或等于50%,91例).分析影响冠状动脉病变的相关因素及冠状动脉病变程度与血脂、胆红素的关系.结果 各组间LDL-C、Lp(a)水平依次呈递增趋势,差异有统计学意义(P＜0.05)各组间间接胆红素水平呈依次递减趋势,多支病变组与非冠心病组、单支病变组差异有统计学意义(P＜0.05).单因素logistic回归结果表明血清脂蛋白(a)、间接胆红素均为影响冠状动脉病变的因素(回归系数分别2.125、-1.557,P＜0.01).进一步多因素logistic回归分析表明脂蛋白(a)对冠状动脉病变的影响要弱于低密度脂蛋白胆固醇、甘油三酯(0R值分别为1.238、5.031、3.996,95%CI分别为1.069-6.322、2.457-12.356、2.785-14.764).结论 血清Lp(a)水平升高、IBIL水平降低是CHD发病及病变程度的危险因素. Abstract： Objective To investigate the association of Lipoprotein (a) and bilirubin with coronary heart disease(CHD). Methods One hundred and ninty -six patients undergone coronary angiography and completed clinical examination of TC, TG, HDL - C, LDL - C, Lp ( a), TBIL, DBIL, IBIL were divided into the without coronary diseases group ( coronary artery stenosis ＜50% ,52 cases) ,the single vessel disease group(with only one vessel stenosis ≥50% ,53 cases) and the multi -vessel disease group (with more than one vessel stenosis ≥50% ,91 cases)according to the coronary angiographic results. The correlative factors of coronary lesion and the relationship between Lipid,bilirubin and the severity of coronary lesion were analyzed. Results Higher levels of LDL - C and Lp(a) were found in the single vessel disease group and in the multi -vessel disease group compared with the without coronary disease group, significant difference was found in the LDL- C and Lp(a) level among the 3 groups(P＜0.05). The levels of IBIL were lower in the single vessel disease group and in the multi -vessel disease group compared with the without coronary disease group,significant difference was found in indirect bilirubin level in the multi -vessel disease group compared with in the without coronary disease group and in the single vessel disease group(P＜0.05). Single factor logistic regression showed that Lp (a) and indirect bilirubin are both correlation factors with coronary lession (r =2. 125 and - 1. 557, P ＜0.01 respectively). Advanced multi - factor logistic regression showed weaker correlation of Lp (a) with coronary lesion compared with LDL - C and TG (OR = 1. 238,5.031 and 3.996,95% CI1.069 - 6.322,2.457 - 12.356,2.785 - 14.764 respectively). Conclusions High level of Lp(a) and Low level of IBIL in human significantly influence the severity of coronary heart disease(CHD).     

超敏C-反应蛋白与白细胞介素-6在2型糖尿病合并冠心病患者中的表达和关系

目的 探讨超敏C-反应蛋白(hs-CRP)、白细胞介素(IL)-6在2型糖尿病合并冠心病患者中的水平及其关系.方法 将2型糖尿病患者80例分为合并冠心病组(40例)和单纯糖尿病组(40例),另选40例为正常对照组.比较各组间血清hs-CRP、IL-6、血脂的水平.结果 2型糖尿病组hs-CRP、IL-6水平明显高于对照组(P<0.01);2型糖尿病合并冠心病组hs-CRP、IL-6水平明显高于单纯糖尿病组(P<0.01).结论 血清中的hs-CRP及IL-6 水平与2型糖尿病合并冠心病密切相关,二者可能发挥协同作用. Abstract： Objective To investigate the correlationship between high sensitive C-reactive protein(hs-CRP)and interleukin-6(IL-6)in patients with diabetes mellitus complicated with coronary artery disease. Methods Eighty patients with T2DM were divided into two groups:40 cases complicated with coronary artery disease,40 cases without coronary artery disease, and 40 healthy people as control group. The levels of serum hs-CRP, blood lipid and IL-6 were compared between patients of three groups.Results Levels of hs-CRP and IL-6 were significantly higher in patients with T2DM than those in control group(P<0.01);and were significantly higher in patients with coronary artery disease than those without coronary artery disease(P<0.01).Conclusions Levels of hs-CRP and IL-6 were significantly higher in patients with T2DM complicated with coronary artery disease, and the close correlationship between hs-CRP and IL-6 may contribute to the pathogenesis of this process.     

血清脂蛋白(a)水平与冠状动脉病变的关系

目的 探讨血清脂蛋白水平与冠心病患者冠状动脉病变的关系.方法 冠状动脉造影患者323例,分为冠心病组和正常对照组,其中根据冠状动脉病变狭窄程度分为轻度、中度、重度狭窄组,根据冠状动脉病变范围分为单支病变组、双支病变组和多支病变组.分别测定其血清脂蛋白、总胆固醇、低密度脂蛋白、甘油三酯水平.结果 冠心病组血清脂蛋白、总胆固醇、低密度脂蛋白、甘油三酯水平明显高于正常对照组.其中血清脂蛋白、总胆固醇和低密度脂蛋白水平与冠状动脉病变呈正相关;双支及多支病变组明显高于对照组和单支病变组(P<0.01),中度狭窄和重度狭窄组明显高于对照组和轻度病变组(P<0.01).结论 血清脂蛋白、总胆固醇和低密度脂蛋白能够反映冠状动脉的病变情况,其水平随冠状动脉病变范围及病变程度的加重而升高,可作为预测冠状动脉病变的一个因素. Abstract： Objective To investigate the possible relationship between the serum LP(a) and coronary artery changes in patients with coronary heart disease (CHD). Methods Coronary angiography (CAG) was performed in 323 patients. The patients were divided into CHD group and control group. The serum levels of lipids were measured. According to the coronary number of stenosis, CHD group was further divided into 1-vessel group, 2-vessel group and 3-vessel group according to the degree of coronary lesion, CHD group was further divided into light stenosis group, moderate stenosis group and severe stenosis group. Results The levels of total cholesterol (TC),LP(a),LDL-C and triglyceride (TG) in CHD patients were significant higher than those in the control group. The serum levels of TC,LP(a) and LDL-C were significantly related to CHD (P<0.01).The serum levels of TC,LP(a) and LDL-C were higher in the 2-vessel group and 3-vessel group than that in the control group and 1-vessel group (P<0.01).The serum levels of TC,LP(a) and LDL-C were higher in the moderate stenosis group, severe stenosis group than that in the control group and light stenosis group(P<0.01). Conclusions The increasing of TC, LP(a) and LDL-C are associated with the stenosis degrees and lesion degrees of coronary artery in patients with CHD which indicated that TC,LP(a) and LDL-C have clinical significance for evaluating the change of degree of coronary artery lesion.     

冠心病合并2型糖尿病患者冠状动脉造影临床分析

目的 探讨冠心病合并2型糖尿病患者冠状动脉造影的特点.方法 选择120例冠心病患者进行冠状动脉造影,其中合并糖尿病60例,无糖尿病60例,根据临床特点及造影结果进行对比.结果 冠心病合并糖尿病患者冠状动脉血管病变明显重于单纯冠心病组.多表现为多支血管病变及弥漫性病变(P＜0.05).结论 冠心病合并糖尿病患者冠状动脉造影主要表现为广泛和严重的冠状动脉血管病变. Abstract： Objective To study the coronary artery disease characteristics by coronary angiography in coronary heart diseases patients with type 2 diabetes mellitus. Methods 120 cases of coronary heart disease were treated with coronary angiography, including 60 cases with type 2 diabetes,60 cases of non -diabetic, clinical characteristics and imaging results were compared. Results Coronary artery disease in patients with coronary artery disease with diabetes mellitus was more serious than the other group ( P ＜ 0.05). Conclusions Coronary angiography in patients with coronary heart disease with diabetes mellitus for coronary artery disease mainly manifested more extensive and severe.     

探讨血清视黄醇结合蛋白4与冠心病的相关性

目的 观察冠心病患者血清视黄醇结合蛋白4(RBP4)水平,并探讨RBP4与冠心病的关系.方法 64例冠心病患者分为急性心肌梗死(AMI)组10例,不稳定型心绞痛(UAP)组42例,稳定型心绞痛(SAP)组12例,另选择21例冠状动脉造影结果正常者为对照组.采用酶联免疫吸附法(ELISA)测定血清RBP4水平.结果 血清RBP4在AMI和UAP组中高于SAP组和对照组,差异有统计学意义(P＜0.05),在SAP组与对照组之间差异无统计学意义(P＞0.05);血清RBP4在单支、双支、三支病变组中均高于对照组(P＜0.05),但在单支、双支与三支病变组之间差异均无统计学意义(P＞0.05).结论 RBP4可作为预测斑块稳定性的标志物,为冠心病危险分层及采取积极干预措施提供依据,但不能反映冠状动脉狭窄程度及范围. Abstract： Objective To investigate the serum retinol - binding protein 4 ( RBP 4 ) of coronary heart disease (CHD)patients and evaluate whether plasma macrophage migration inhibitory factor were associated with CHD. Methods Sixty -four patients with CHD were divided into the acute myocardial infarction (AMI) group ( n = 10), the unstable angina pectoris (UAP) group ( n = 42) and the stable angina pectoris(SAP) ( n = 12),21 normal subjests without CHD diagnosed by CAG served as the control group. The serum level of RBP4 measured by enzyme linked immune sorbent assay (ELISA). Results The serum level of RBP4 were higher in AMI and UAP group thai in SAP group and control group ( P ＜ 0. 05 ). The mean level of RBP4 in SAP group was not differently significantly, compared with that in control ( P ＞ 0. 05 ) ;The mean level of in single, double and three vessel lesion group were higher than that in control group (P ＜0. 05 ),but the serum levels of RBP4 among single, double and three were not significant different ( P ＞ 0. 05).Conclusions RBP4 may act as one of vulnerable plaques,we can take active to stabilize vulnerable plaques and decrease the occurrence of cardiac events,but may not reflect the severity of artery stenosis.     

冠心病与血清高敏C反应蛋白、尿酸及血脂水平的检测与结果分析

目的 探讨冠心病患者血清高敏C反应蛋白(hs-CRP)、尿酸(UA)及血脂水平变化及临床意义.方法 抽取冠心病与健康对照组清晨空腹静脉血,应用全自动生化分析仪对血清hs-CRP、UA、血脂进行检测.结果 冠心病组高密度脂蛋白胆固醇(HDL-C)、载脂蛋白AI(apoAI)含量低于健康对照组;hs-CRP、UA、甘油三酯(TG)、胆固醇、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(apoB)浓度高于健康对照组.结论 血清hs-CRP、UA及血脂水平的联合检测对冠心病的诊断具有重要意义. Abstract： Objective Discussion coronary disease blood serum high sensitivity C-reactive protein (hs-CRP),the blood lipids and the uric level change and clinical significance. Methods Extraction coronary disease group with the healthy control group early morning the empty stomach venous blood, applied the whole blood to move the biochemistry analyzer to the blood serum hs-CRP, the uric acid, the blood lipids carries on the examination. Results The coronary disease group blood serum the high density lipoprotein cholesterol and carry the lipoprotein AI content were lower than that in the healthy control group. The hs-CRP, the uric acid, the triglyceride, the low density lipoprotein cholesterol, carry lipoprotein B were higher than that in the control group. Conclusions Combined determination of the patient blood serum hs-CRP, uric acid, blood lipids level is important for the diagnosis of coronary artery disease.     

血清胆红素和血脂对冠心病发生的作用

目的 探讨血清胆红素和血脂在冠心病发生中的作用.方法 75例冠心病患者被分为高脂血症组(46例)和非高脂血症组(29例),35例正常健康成人作为对照组,分别测定血清总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)以及总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)和高密度脂蛋白(HDL)水平等指标作对比分析.结果 高脂血症组TBIL、DBIL、IBIL均低于非高脂血症组和正常对照组,差异有统计学意义(P＜0.05);非高脂血症组血清胆红素水平低于正常对照组,差异有统计学意义(P＜0.05).高脂血症组同非高脂血症组、正常对照组比较,TC、TG和LDL增高,HDL降低,差异有统计学意义(P＜0.05);非高脂血症组同正常对照组比较,TC、TG和LDL增高,HDL降低,但差异无统计学意义(P＞0.05).结论 低胆红素水平在高脂血症和非高脂血症的冠心病发生中起着重要的作用,是冠心病的独立危险因素. Abstract： Objective To investigate the effection of serum bilirubin and serum lipid on coronary heart disease (CHD). Methods Seventy -five patients with CHD group were divided into hyperlipidemia group(46 cases) and non- hyperlipidemia group (29 cases),35 healthy controls (healthy control group)were enrolled in the study. Serum total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL)serum triglycride ( TG), total cholestrol ( TC ), low density lipoprotein (LDL), high density lipoprotein (HDLand serum lipid were examined for all subiects,and then the results were compared and analyzed. Results The contents of serum TBIL, direct bilirubin (DBIL), indirect bilirubin (IBIL)were lower in hyperlipidemia group than those of non - hyperlipidemia and healthy control group, the difference was significant (P ＜0. 05 ). The contents of serum bilirubin were lower in non - hyperlipidemia group than those of healthy control group, the difference was significant( P ＜ 0.05 ). TC,TG and LDL were higher and HDL was lower in hyperlipidemia group than those of healthy control group and non - hyperlipidemia group, the difference was significant( P ＜0.05). TC,TG and LDL were higher and HDL was lower in non -hyperlipidemia group than those of healthy control group,There was no difference in the two groups( P ＞0.05). Conclusions The lower serum bilirubin level is an independent risk factor of coronary heart disease in hyperlipidemia and non- hyperlipidemia groups.     

4排螺旋CT对冠状动脉粥样硬化性心脏病的临床价值

目的 探讨4排螺旋CT冠状造影在诊断冠状动脉粥样硬化性心脏病(简称冠心病)中的价值.方法 收集临床上初步拟诊为冠心病的35例患者的93支血管并进行螺旋CT冠状造影和常规冠状动脉造影检查,对比分析螺旋CT冠状造影的准确性.结果 螺旋CT冠状造影发现47支冠状动脉狭窄,常规冠状动脉造影检查发现51支冠状动脉狭窄.螺旋CT冠状造影发现的44支血管狭窄与冠状动脉造影结果一致,敏感性为86.3%,特异性为100%.螺旋CT冠状造影和常规冠状动脉造影检查结果大体一致.结论 4排螺旋CT冠状造影可作为诊断冠心病的一种无创筛选检查方法,提高了冠状动脉造影诊断冠心病的符合率. Abstract： Objective To explore the diagnosticclinical value of 4 -detector row spiral CT with coronary artery disease. Methods Spiral CT coronary angiography (CTCA) and conventionalcoronary angiography(CAG) were used in 93 arteries of 35 coronary artery disease patients. To analysis the precise level of CTCA through contrasting. Results CTCA showed the angiostegnosis with 47coronary arteries,CAG showed theangiostegnosis with 51coronary arteries. The angiostegnosis results of 44 coronary arteries were same with CTCA and CAG. The total sensitivity of CTCA was 86.3% , and specificity was 100%.The results of CTCA and CCA were coincidentalin general. Conclusions 4 - detector row spiral CT can be used as a noninvasive screening method for the patients with suspected coronary artery disease, and the coincidence ratewasincreased ofcoronary angiography with coronary artery disease.