Correlative Analysis Between Frequency-Domain Correlative Cardiogram And STI in 90 Patiennts

<正> Both systolic time interval （STI） and Frequency-domain Correlative Cardiogram （FCG）can reflect blood supply to the heart. From the FCG and STI recording of 90 patients who received cardiac function examination, we found that there was a significant correlation between FCG grades （FCGG） and STI grades （STIG）, FCGG and PEP, FCGG and LVET, FCGG and PEP/LVET, FCG Scores （FCGS） and STIG, FCGS and PEP, FCGS and LVET.FCGS and PEP/LVET, PEP/LVET and Gxx2. The discriminating function was above the level of α=0.01. And There was a significant correlation between ICT and FCGG, PEP/LVET and Gyy2. The discriminating was above the level α=0.05. But no significant correlation was found between ICT and FCGS、PEP/LVET and Rxy、PEP/LVET and Gxx1, PEP/LVET and Gxx1/Gxx2, PEP/LVET and Gyy1, PEP/LVET and Gyy1/Gyy2, PEP/ LVET and Pmax, PEP/LVET and Pmin.The results indicate that FCG is a new noninvasive method for cardiac function examiantion. And we can say that STI is a reliable method.     

Association between HLA class Ⅱ gene and susceptibility or resistance to chronic hepatitis B

AIM: To investigate the association between the polymorphism of HLA-DRB1, -DQA1 and -DQB1 alleles and viral hepatitis B. METHODS: HLA-DRB1, -DQA1 and -DQB1 alleles in 54 patients with chronic hepatitis B, 30 patients with acute hepatitis B and 106 normal control subjects were analyzed by using the polymerase chain reaction/sequence specific primer (PCR/SSP) technique. RESULTS: The allele frequency of HLA-DRB1*0301 in the chronic hepatitis B group was markedly higher than that in the normal control group (17.31% vs 5.67 %), there was a significant correlation between them (X^2= 12.3068,PC=0.0074, RR=4.15). The allele frequency of HLA-DQAI*0501 in the chronic hepatitis B group was significantly higher than that in the normal control group (25.96 % vs 13.68 %), there was a significant correlation between them (X^2=9.2002, PC=0.0157, RR=2.87). The allele frequency of HLA-DQBI*0301 in the chronic hepatitis B group was notably higher than that in the normal control group (35.58 % vs 18.87 %), there was a significant correlation between them (x^2=15.5938, PC=0.0075, RR=4.07). The allele frequency of HLA-DRB1*1101/1104 in the chronic hepatitis B group was obviously lower than that in the normal control group (0.96 % vs 13.33 %), there was a significant correlation between them (X^2=11.9206, PC=0.0145, RR=18.55). The allele frequency of HLA-DQAI*0301 in the chronic hepatitis B group was remarkably lower than that in the normal control group (14.42 % vs30 %), there was a significant correlation between them (X^2=8.7396, PC=0.0167, RR=0.35). CONCLUSION: HLA-DRBI*0301, HLA-DQAI*0501 and HLA-DQBI*0301 are closely related with susceptibility to chronic hepatitis B, and HLA-DRB1*1101/1104 and HLA-DQAI*0301 are closely related with resistance to chronic hepatitis B. These findings suggest that host HLA class Ⅱ gene is an important factor determining the outcome of HBV infection.     

Association between HLA class Ⅱ gene and susceptibility or resistance to chronic hepatitis B

AIM: To investigate the association between the polymorphism of HLA-DRB1, -DQA1 and -DQB1 alleles and viral hepatitis B.METHODS: HLA-DRB1, -DQA1 and -DQB1 alleles in 54patients with chronic hepatitis B, 30 patients with acute hepatitis B and 106 normal control subjects were analyzed by using the polymerase chain reaction/sequence specific primer (PCR/SSP) technique.RESULTS: The allele frequency of HLA-DRB1*0301 in the chronic hepatitis B group was markedly higher than that in the normal control group (17.31% VS 5.67%), there was a significant correlation between them (χ2= 12.3068,Pc=0.0074, RR=4.15). The allele frequency of HLADQA1*0501 in the chronic hepatitis B group was significantly higher than that in the normal control group (25.96% VS 13.68%), there was a significant correlation between them (χ2=9.2002, PC＝0.0157, RR=2.87). The allele frequency of HLA-DQB1*0301 in the chronic hepatitis B group was notably higher than that in the normal control group (35.58%vs 18.87%), there was a significant correlation between them (χ2=15.5938, PC=0.0075, RR=4.07). The allele frequency of HLA-DRB1*1101/1104 in the chronic hepatitis B group was obviously lower than that in the normal control group (0.96% VS 13.33%), there was a significant correlation between them (χ2=11.9206, PC=0.0145, RR=18.55). The allele frequency of HLA-DQA1*0301 in the chronic hepatitis B group was remarkably lower than that in the normal control group (14.42% VS30%), there was a significant correlation between them (χ2=8.7396, Pc=0.0167, RR=0.35).CONCLUSION: HLA-DRB1*0301, HLA-DQA1*0501 and HLA-DQB1*0301 are closely related with susceptibility to chronic hepatitis B, and HLA-DRB1*1101/1104 and HLADQA1*0301 are closely related with resistance to chronic hepatitis B. These findings suggest that host HLA class Ⅱ gene is an important factor determining the outcome of HBV infection.     

The Changes of Coronary Artery Stenosis on FCG-A New Method of Diagnosing Ischemia Heart Disease

<正> Frequency domain correlative cardiogram （FCG） is a new developing technique in noninvasive measurement. It is not clear that FCG diagnoses cardiac ischemia. This study was made cn dogs with different degree of coronary artery stenosis, the relationship between the changes of cardiac ischemia and FCG is discussed in this paper.In open chest dogs, an external stenosis was produced by a micrometer constrictor cn the left circumflex coronary artery or the left anterior dis-cending coronary artery, which caused three different degrees of coronary artery stenosis: namely mild, moderate and severe stenosis. Coronary blood flow （CBF）, aortic pressure, left ventricular pressure, systolic time intervals, admittance plethysmography, two-dimensional echocardiography and FCG were synchronously recorded.The result showed that FCG did not change when CBF was slightly decreased; FCG had a significant change when CBF was decreased to 40% of resting value; there was a remarkable change in FCG when CBF was decreased to 80% of resting value. The amplitude of change in FCG was in concordance with that of decreased CBF. A positive correlation between the changes of FCG and CBF was found.So we think that FCG is a valuable diagnostic method for myocardial ischemia when CBF is obviously decreased. It can reflect the degree and extensiveness of myocardial ischemia.     

Plasma levels of omentin-1 and visfatin in senile patients with coronary heart disease and heart failure

Objective:To investigate the alteration of plasma levels of omentin-1 and visfatin in elderly patients with coronary heart disease(CHD)and heart failure.Methods:Plasma omentin-1 and visfatin levels were measured in 90 subjects(29 stable angina pectoris(SAP)cases,30 unstable angina pectoris(UAP)cases and 31 age-and sex-matched healthy controls(age≥60 years)by enzyme-linked immunosorbent assay methods.According to the New York Heart Association classification.59 CHDs were divided into three groups:functional I class,11 cases;functional II/III class,36 cases;and functional IV class,12 cases.Results:The plasma level of omentin-1in CHO patients was significantly lower than thai of the control group.Otnenlin-lin SAP group and UAP group were significantly lower compared to the control group(there was no statistical significance between UAP group and SAP group;P0.05).The plasma level of visfatin in CHD patients was significandy higher than that of the control group.Similarly,visfatin in SAP group and UAP group were all significantly higher compared to the control group,while there was no statistical significance between UAP group,and SAP group.The plasma omentin-1 level was negatively correlated with SBP(r=-0.264,P0.05),positively correlated with HDL-c level(r=0.271,P0.05);the plasma visfatin level was positively correlated with TC(r=0.292,P0.05),negatively correlated with HDL-c level(r=-0.266,P0.05).There was a negative correlation between plasma omentin-1 and visfatin levels(r=-0.280,P0.05).Moreover,multiple linear stepwise regression analysis showed that omentin-1 and visfatin levels might be affected by HDL-c level.Logistic regression analysis showed that visfatin could be an independent risk factor of CHD.Conclusions:Decreased levels of omentin-1 and increased levels of visfatin may be involved in the occurrence and development of CHD.Omentin-1 and visfatin,independently,may be protective and pro-inflammatory cytokines.Additionally,both omentin-1 and visfatin may be related to lipid metabolism.Visfatin may be an independent risk factor of CHD.     

Gallbladder function and dynamics of bile flow in asymptomatic gallstone disease

AIM： To investigate the effects of gallbladder stones on motor functions of the gallbladder and the dynamics of bile flow in asymptomatic gallstone disease. METHODS： Quantitative hepatobiliary scintigraphy was performed to detect the parameters of gallbladder motor function [gallbladder ejection fraction （GBEF）, gallbladder visualization time （GBVT）, gallbladder time to peak activity （GBTmax）, gallbladder half emptying time （GBT1/2）, and transit time of bile to duodenum （TTBD）] in 24 patients with asymptomatic cholelithiasis who were diagnosed incidentally during routine abdominal ultrasonographic examination and 20 healthy subjects with normal gallbladder. RESULTS： Even though there was no significant difference in the clinical and laboratory parameters between the patient and control groups, all parameters of gallbladder function except TTBD were found to differ significantly between the two groups. GBEF in the patient group was decreased （P = 0.000） and GBVT, GBT GBT1/2 in the patient group were longer （P = 0.000, P = 0.015, P = 0.001, respectively）.there were not any clinical and laboratory findings, gallbladder filling and emptying could be impaired in patients with gallstone disease.     

Red blood cell level is increased in obese but not in non-obese patients with coronary heart disease

Objective To examine the changes of red blood cell levels in the obese and non-obese patients with coronary heart disease （CHD） and its clinical significance. Methods 230 cases of coronary heart disease were selected and divided into the obese group and the non- obese group. Obesity and non-obesity were defined based on the body mass index （BMI if 28.0kg/m2）, or waist-hip ratio （men〉 0.9, women〉 0.85）. In addition, 130 healthy subjects were recruited as controls. The pathological status of coronary lesions was quantita- tively analyzed according to the Coronary Vascular Image Segmentation Evaluation Criteria （American Heart Association 1984） and the Gensini scoring system. Results of the changes of both the hemoglobin levels and the red blood cell count in the obese group, the non- obese group with CHD and the control group were compared. Besides, Multivariant Logistic Regression Analysis was applied to assess the correlation between the red blood cells and the coronary artery disease. Results The red blood cell count and the level of hemoglobin in the obese group with CHD was higher than that in the non-obese group with CHD [（4.35 ± 0,55） and （4.13 ± 0.56） 10^9/L; （136.71± 15.87） and （129.96 ±16.23） g/L, P 〈 0.05 in both]; the proportion of acute coronary syndrome in the obese group with CHD was higher in the obese group with CI-/D than that in the non-obese group with CHD （P〈0.05）; Multivariant logistic regression analysis also showed that the red blood cell count was positively correlated with obesity with CHD.Conclusion The red blood cell count and the level of hemoglobin in the obese group were higher than those in the non-obese group; the increase of red blood cell count and hemoglobin level is one of the independent risk factors for the obese patients with CHD.     

Endoscopic and histopathological evaluation of acute gastric injury in high-dose acetaminophen and nonsteroidal anti-inflammatory drug ingestion with suicidal intent

AIM： To evaluate endoscopic and histopathologic aspects of acute gastric injury due to ingestion of high-dose acetaminophen and nonsteroidal antiinflammatory drugs （NSAIDs） with respect to some risk factors and patient characteristics. METHODS： The study group consists of 50 patients admitted to emergency department with high dose analgesic ingestion （group Ⅰ ） with suicidal intent. Thirty patients with or without mild complaints of dyspepsia （group Ⅱ） were selected as the control group. The study group was stratified according to the use of type and number of analgesics. Endoscopic findings were evaluated according to the Lanza score （LS）, expressing the severity of the gastroduodenal damage and biopsies according to a scoring system based on histopathologic findings of acute erosive gastritis. RESULTS： Gastroduodenal damage was significantly more severe in group Ⅰ compared to group Ⅱ （P 〈 0.01）. The LS was similar in both groups Ⅰ a and Ⅰb. However LS was significantly higher in patients who had ingested multiple NSAIDs （group Ⅰ c） compared to other patients （P 〈 0.01）. The LS was correlated to age （P 〈 0.01） and total amount of drug ingested （P 〈 0.05） in group Ⅰ ; but it was not correlated with Helicobacter pylori （H pylori） infection or duration of exposure （P 〉 0.05）. The biopsy score （BS） was higher in group Ⅰ than group Ⅱ （P 〈 0.01）, and higher in group Ⅰb than group Ⅰa （P 〈 0.05）. CONCLUSION： The histopathologic damage was more severe among NSAID ingesting patients compared to those ingesting only acetaminophen and there is no significant difference in the endoscopic findings between the groups. There is no significant difference in the LS between the groups. This lack of significance is remarkable in terms of the gastric effects of highdose acetaminophen.     

Effects of simulated carbon dioxide and helium peumoperitoneum on proliferation and apoptosis of gastric cancer cells

AIM：To investigate the effects of carbon dioxide （CO2） and helium insufflation administered at different pressures on the growth and apoptosis of cultured human gastric cancer cells. METHODS：The gastric cancer cells MKN-45 were exposed to a CO2 and helium environment maintained at different pressures （0, 5, 10 and 15 mmHg）. The cells were exposed to simulated pneumoperitoneum environment for 4 h, and pH of the culture media was measured after it was moved to normal conditions for 0, 2, 4, 6 and 8 h. Proliferation viability of MKN-45 was examined by 3-4,5Dimethylthiazol-2-yl,5-diphenyltetrazolium bromide or triazolyl blue （MTT） assay after it was moved to normal conditions. Apoptotic ratio was measured by Annexin V-FITC/PI double labelled staining. RESULTS：The pH of media was acid and recovered to normal after 4 h in the CO2 group while it was basic in the helium group. There was no difference between CO2 groups （under 10 mmHg ） and control group （P 〉 0.05） in the proliferative viability of the cells. The cultured cells exposed to 15 mmHg CO2 environment grew more slowly than control group from 4 to 7 d （P 〈 0.01 ） while there was no difference from 1 to 3 d （P 〉 0.05）. The proliferative viability in helium group was not obviously different from the control group （P 〉 0.05）. The apoptotic ratio of the cultured cells was markedly higher than that of the control group （P 〈 0.01） at 10 and 15 mmHg CO2 insufflation pressure. In helium group, the apoptotic ratio was not obviously different from the control group （P 〉 0.05）. CONCLUSION：There is no obvious effect in the proliferation and apoptosis of MKN-45 cells under 10 mmHg CO2 insufflation pressure and helium in any pressure. Fifteen mmHg CO2 insufflation pressure can inhibit the proliferation of the cells and improve apoptosis.     

Sphincter of Oddi hypomotility and its relationship with duodenal-biliary reflux, plasma motilin and serum gastrin

AIM： To detect whether patients with a T tube after cholecystectomy and choledochotomy have duodenal-biliary reflux by measuring the radioactivity of Tc99m-labeled diethylene triamine penta-acetic acid （DTPA） in the bile and whether the patients with duodenal-biliary reflux have sphincter of Oddi hypomotility, by measuring the level of plasma and serum gastrin of the patients. Finally to if there is close relationship among sphincter of Oddi hypomotility, duodenal-biliary reflux and gastrointestinal peptides.
METHODS： Forty-five patients with a T tube after cholecystectomy and choledochotomy were divided into reflux group and control group. The level of plasma and serum gastrin of the patients and of 12 healthy volunteers were measured by radioimmunoassay. Thirty-four were selected randomly to undergo choledochoscope manometry. Sphincter of Oddi basal pressure （SOBP）, amplitude （SOCA）, frequency of contractions （SOF）, duration of contractions （SOD）, duodenal pressure （DP） and common bile duct pressure （CBDP） were scored and analyzed.
RESULTS. Sixteen （35.6%） patients were detected to have duodenal-biliary reflux. SOBP, SOCA and CBDP in the reflux group were much lower than the control group （t = 5.254, 3.438 and 3.527, P 〈 0.001）. SOD of the reflux group was shorter than the control group （t = 2.049, P 〈 0.05）. The level of serum gastrin and plasma motilin of the reflux group was much lower than the control group （t = -2.230 and -2.235, P 〈 0.05）. There was positive correlation between the level of plasma motilin and SOBP and between the level of serum gastrin and SOBP and CBDP.
CONCLUSION： About 35.9% of the patients with a T tube after cholecystectomy and choledochotomy have duodenal-biliary reflux. Most of them have sphincter of Oddi hypomotility and the decreased level of plasma motilin and serum gastrin. The disorder of gastroin-testinal hormone secretion may result in sphincter of Oddi dysfunction. There is a close relationship between sphincter     

二维斑点追踪成像技术测得的左心房应变值与CABG术后新发房颤相关

目的应用二维斑点追踪成像(STI)技术分析左心房应变值与冠状动脉旁路移植术(CABG)术后新发房颤的相关性。方法应用STI技术测量行CABG的42例冠心病患者左房收缩功能,按患者是否新发房颤分为房颤组(n=13)和非房颤组(n=29),对2组相关因素做单因素和多因素分析。结果与非房颤组比较,术后房颤组LAD较大,E较高,A较低,E/A较高,左心室收缩期左心房长轴方向所测整体应变(Ss)及心房收缩期左心房长轴方向整体应变(Sa)和左心房各节段应变率(SRs)均较低,差异有统计学意义(均P0.05)。结论术前应用STI技术测得的左心房应变值与CABG术后房颤相关。     

新疆巴州地区人群脂蛋白（a）与冠心病相关性研究

目的 探讨新疆巴州地区汉族人群脂蛋白（a）[Lp（a）]与冠心病（CHD）及冠状动脉狭窄程度之间的相关性。方法采用病例对照研究,选择2007年1月至2011年6月在巴州人民医院住院并行冠状动脉造影检查确诊的汉族CHD患者443例;对照组452例,为同期入院行冠状动脉造影检查结果阴性或其他检查排除冠心病者。检测所有纳入对象静脉血清Lp（a）值及其他生物化学指标,探讨高Lp（a）血症及其他因素与CHD的关系,以及Lp（a）血症与冠脉病变程度的关系。结果 CHD组高Lp（a）血症的患病率为23.02%,高于对照组（15.04%）,两组有统计学差异（P〈0.01）;血Lp（a）水平与对照组有比较,差异具有统计学意义（P〈0.01）。多因素Logistic回归分析显示,在校正了年龄、吸烟、高血压、糖尿病、血脂异常等危险因素作用后发现,高Lp（a）血症是CHD的独立危险因素（OR=1.675,95%CI：1.184～3.115;P=0.009）。CHD组中随着病变支数的增加,高Lp（a）血症的患病率也增加,差异具有统计学意义（P=0.026）;血Lp（a）水平也随之增加,差异具有统计学意义（P=0.019）。结论本研究人群高Lp（a）血症是CHD发生的独立危险因素,高Lp（a）血症的患病率及血Lp（a）水平与冠脉狭窄程度呈正相关性,可作为CHD发病及严重程度的预测因子。     

原发f生高血压合并早发冠心病患者心率震荡分析

目的探讨原发性高血压合并早发冠心病患者心率震荡（HRT）的特点及其与单纯高血压病、单纯冠心病患者HRT的差异。方法将124例住院患者根据冠脉造影结果、实验室检查、心脏超声检查、血压等分为正常对照组、高血压组、冠心病组和高血压合并冠心病组（合并组）,4组均行24h动态心电图检查,分析单次室性期前收缩后HRT的初始值（TurbulenceOnset,TO）和斜率（TurbulenceSlope,Ts）。结果对各组患者一般情况的比较分析表明,合并组与高血压组相比,早发冠心病家族史、空腹血糖水平、甘油三酯水平存在显著差异。高血压组、冠心病组、合并组的TO、TS值与正常对照组比较均有显著统计学差异（P〈0．01～0．05）;高血压组的TO、TS值与冠心病组和合并组比较亦有显著统计学差异（P〈0．01）。结论高血压、冠心病及高血压合并冠心病患者HRT指标明显异常,其中高血压合并冠心病患者HRT指标受损最严重。     

冠心病与非冠心病患者运动试验血压变化的研究

目的：研究运动实验中冠心病（CHD）与非冠心病（NCHD）血压（BP）变化特点，方法：将130例患分成正常，CHD，高血压，高血压伴CHD4组，观察各组在实验过程中收缩压（SBP），SBP变异指数，舒张压（DBP），DBP变异指数的变化特点。结果：运动SBP多升高，SBP，SBP变异指数在CHD与NCHD之间无差异。运动中DBP多下降，正常组的DBP较CHD组的下降更明显（P＜0．01）。结论：运动实验中CHD的DBP较运动前下降程度比正常人少。     

冠心病患者血浆纤维蛋白原、血清脂蛋白(a)、血小板测定及其意义

目的：探讨血浆纤维蛋白原（Fg），血小板计数（PCT）和平均血小板体积（MPV）．血清脂蛋白（LP）a与冠心病的相关关系。方法：选择64例冠心病患者（冠心病组）．对照组36例，检测血浆Fg、PLT、MPV和血清LP（a）水平，并进行比较．分析它们与冠心病的相关关系。结果：冠心病组Fg、LP（a）、MPV明显高于正常对照组（P〈0．05）．PLT两组问无显著差异。经多元逐步回归分析证明，Fg、LP（a）、MPV与冠心病的发生存在有意义的回归关系（P〈0．01）。结论：冠心病是多因素疾病，联合应用Fg、LP（a）、血小板指标评价冠心病的发生风险有重要参考价值。     

2型糖尿病患者的脂代谢紊乱及其与冠心病的关系

目的：探讨2型糖尿病患脂代谢紊乱与并发冠心病（CHD）的关系。方法：56例2型糖尿病（DM）患（其中32例并发冠心病），测定其血脂、载脂蛋白浓度及血糖、胰岛素水平，与30例例健康人比较。结果：与对照组比较，2型DM并发CHD患高密度脂蛋白胆固醇（HDL－C）水平降低（P＜0．005），低密度脂蛋白胆固醇（LDL－C）及载脂蛋白B（ApoB)水平升高（P＜0．05）。单纯2型DM组仅有HDL－C水平的降低（P＜0．005）及LDL－C水平的升高（P＜0．05），无ApoB的变化，单纯DM及DM＋CHD组血糖及胰岛素水平无显差别，但均较对照组升高非常显（P＜0．005）；DM＋CHD组的ApoB水平较单纯DM组的显升高（P＜0．05）。结论：本组结果提示HDL－C水平的降低，LDL－C及ApoB水平的升高是2型DM并发冠心病的重要危险因素。     

冠心病患者血清sdLDL-C、Lp（a）水平变化与冠脉病变的相关性

目的：探讨冠心病（CHD）患者血清小而密低密度脂蛋白胆固醇（sdLDL-C）、脂蛋白（a）（Lp（a））水平变化与CHD临床类型及冠脉病变的相关性。方法：选取因胸痛入院的患者180例,根据冠脉造影结果分为对照组48例,CHD组132例,其中包括稳定型心绞痛（SAP）组41例,不稳定型心绞痛（UAP）组51例,急性心梗（AMI）组40例;根据冠脉造影病变支数又分为对照组48例、单支组44例及多支组88例。分别测定患者血清sdLDL-C、Lp（a）及其它血脂指标。结果：CHD组血清sdLDL-C、Lp（a）水平高于对照组（P<0.05）,CHD各亚组间血清sdLDL-C水平UAP组>SAP组、UAP组>AMI组,血清Lp（a）水平AMI组>UAP组（P<0.05）,两者水平均表现为多支组>单支组＞对照组（P<0.0 5）;Logistic回归分析表明,血清sdLDL-C、Lp（a）是CHD的独立危险因素。结论：血清sdLDL-C、Lp（a）水平变化与CHD的临床类型及冠脉病变程度呈正相关,可作为CHD的独立危险因素。     

中国苗族人群血管紧张素原和血管紧张素转化酶基因多态性与冠心病的关系

目的 研究血管紧张素原(ACT)基因M235T分子变异和血管紧张素转化酶(ACE)基因I/D多态性与冠状动脉粥样硬化的关系.方法 采用聚合酶链反应一限制性片段长度多态性(PCR-RFLP)技术检测冠心病(CHD)组151例和正常对照组127例AGT基因多态性,采用聚合酶链反应技术检测CHD组151例和正常对照组127例ACE基因I/D多态性.结果 CHD组AGT-TT基因型频率为76.26%,显著高于对照组44.10%(P<0.01).ACE-DD基因型频率为35.10%,显著高于对照组14.96%(P<0.01).结论 在中国苗族人群中,AGT基因TT基因型和AGE基因DD基因型是CHD发病既相互独立又具有协同作用的危险因子.     

冠心病患者胸腺苷合成酶多态性的探讨

目的研究胸腺苷合成酶(TS)5’-非翻译区(UTR)28bp串联重复序列多态性、3-’UTR1494bp位6bp插入或缺失多态性与血浆同型半胱氨酸(Hcy)水平及冠心病之间的关系。方法用多聚酶链式反应(PCR)方法检测122例冠心病患者(冠状动脉造影显示至少有一支血管狭窄≥50%)与56例对照组(冠状动脉造影未发现任何可辨认斑块或狭窄)的TS 5-’UTR 28bp串联重复序列多态性;用聚合酶链反应-限制性片段多态性(PCR-RFLP)分析3-’UTR1494bp位6bp插入或缺失多态性;用荧光衍生后高压液相色谱分离法检测血浆总Hcy水平。结果(1)冠心病组的血浆Hcy水平(12.99±4.76)μmol/L高于对照组(10.95±4.75)μmol/L(P=0.009)。(2)TS5-’UTR 28bp串联重复序列有三种基因型(3R/3R,3R/2R,2R/2R),这三种基因型频率在冠心病组和对照组之间的分布有差异(P=0.029);TS28各基因型个体的Hcy水平在冠心病组高于对照组(P=0.03)。3R/3R、3R/2R基因型个体的Hcy水平均高于2R/2R型个体(分别为P<0.001和P=0.011),但3R/3R基因型个体与3R/2R基因型个体的Hcy水平间的差异没有统计学意义(P=0.979)。(3)TS3-’UTR6bp插入或缺失多态性有三种基因型(+6bp/+6bp,+6bp/-6bp,-6bp/-6bp),这三种基因型频率在冠心病组和对照组之间的分布差异无显著性(P>0.05)。TS6各基因型个体的Hcy水平在冠心病组高于对照组(P=0.006)。冠心病组TS6 bp各基因型个体间Hcy水平的的差异均没有统计学意义(P均>0.05)。结论(1)高Hcy血症与冠心病有关系。(2)TS基因5-’UTR28bp串联重复序列多态性可能是冠心病发病中的一个遗传因素。3 R与冠心病组个体的Hcy水平有关系。     

冠心病预后与冠状动脉侧支循环的关系

目的：研究冠心病（CHD）预后与冠状动脉侧支循环的关系。方法：依据冠状动脉造影结果98例患者被分为CHD无侧支循环组（62例）、CHD有侧支循环组（20例）、正常对照组（16例）,分析各组患者的临床资料。结果：CHD组（无论有无侧支循环）与正常对照组相比,除糖尿病发病率较高外（P〈0.01）,其他CHD易患因素差异均无显著性（P〉0.05）;有侧支循环与无侧支循环CHD患者相比,主要CHD易患因素、不稳定型心绞痛的发生率差异均无显著性（P〉0.05）;但无侧支循环患者左室射血分数〈50%患者比率（29.0%比10.0%）,心肌梗死（61.3%比30.0%）、室壁瘤（22.6%比0）的发生率较有侧支循环患者显著增加（P〈0.01）。结论：侧支循环存在与否与冠心病患者预后有关。