超敏C-反应蛋白与脑梗死关系的研究

目的 研究血清中超敏C-反应蛋白(hs-CRP)与脑梗死发生的关系.方法 采用免疫比浊法测定血清中hs-CRP浓度.结果 与健康对照组比较,脑梗死组血清中hs-CRP浓度差异有统计学意义(P＜0.01).首发和复发脑梗死组急性期患者血清中hs-CRP浓度比较无显著性差异(P＞0.05).重度神经功能缺损患者和中度以及轻度神经功能缺损患者血清hs-CRP 浓度比较有显著性差异(P＜0.05);脑梗死患者血清hs-CRP 浓度与神经功能缺损程度呈正相关( r = 0.48, P＜0.05).结论 hs-CRP可能是导致脑梗死的独立危险因素之一,血清hs-CRP检测对于脑梗死的临床诊断和病情评估具有重要意义.     

急性缺血性脑卒中与炎症反应

炎症反应是急性缺血性脑卒中发病的一个重要危险因素 ,引起炎症的主要原因是肺衣原体、幽门螺杆菌或其它细菌、病毒感染。炎症反应的一个重要生化指标是C -反应蛋白水平升高 ,根据炎症的不同病因使用相应的抗生素、阿斯匹林和 /或进行规律性耐力锻炼 ,可降低C -反应蛋白水平、终止或减轻炎症反应损害 ,从而降低急性脑卒中的发病危险。     

血清超敏C-反应蛋白与老年急性缺血性脑卒中的关系

目的　探讨和研究血清高敏 C-反应蛋白(high-sensitivity C-reactive protein hsCRP)与老年急性缺血性脑卒中(AIS)的关系及其可能机制。方法　对 72 例老年 AIS患者和 56 例健康查体者,检测血浆hsCRP水平,以多项临床及生化指标为危险因素进行统计学分析。结果　老年 AIS组的hsCRP水平(4.68±3.16)mg/L明显高于对照组(1.65±1.89) mg/L,差异具有显著性意义。单因素Logistic回归分析,发现hsCRP是AIS发生的一个独立危险因素,高 hsCRP(≥1.5 mg/L)发生 AIS的OR值为6.9。且随hsCRP水平的增高,AIS临床病情严重程度增加。年龄、BMI、总胆固醇、HDL-C以及临床病情严重程度与hsCRP显著相关,但校正年龄和BMI后,只有临床病情严重程度与hsCRP仍保持显著相关。结论　老年AIS患者的体内炎症反应水平是升高的,hsCRP是老年 AIS患者临床病情严重程度的一个敏感指标。     

C反应蛋白与脑卒中关系的研究进展

C-反应蛋白(CRP)是机体非特异性炎症反应的敏感标志物之一。它存在于动脉粥样硬化斑块内,导致斑块不稳定,促进血栓形成。其血清水平可以筛选卒中高危患者及判断预后。他汀类降脂药能降低血浆CRP水平。     

炎症标志物与心房颤动相关卒中关系的研究进展

急性缺血性脑卒中具有发病率高、致残率高、复发率高的特点，给家庭和社会带来了沉重的负担。与非心房颤动相关卒中相比，心房颤动相关卒中的症状更重，致残率、病死率更高，容易复发。目前关于心房颤动引起卒中的机制的假设包括内皮损伤、高凝、炎症、心房重塑、左心耳形态等，其中炎症标志物在心房颤动发生及发展为缺血性卒中的过程中起着重要作用。因此，关于炎症因子与心房颤动相关卒中的研究对于心房颤动患者的卒中预防及心房颤动相关卒中的临床用药指导有着重要意义。本文主要综述炎症因子与心房颤动相关卒中的联系。     

C-反应蛋白与脑梗死关系的探讨

目的 探讨脑梗死患者发病早期血液中C-反应蛋白(CRP)含量高低及与病情严重程度的关系.方法 采用免疫比浊法测定50例脑梗死患者CRP的含量,与正常对照组比较.结果 (1)脑梗死患者中CRP阳性率为56%,较对照组显著升高,差异有统计学意义(P<0.01).(2)大面积脑梗死较一般脑梗死CRP阳性数明显升高,差异有统计学意义(P＜0.05).结论 CRP水平升高与脑梗死病情严重程度呈正相关.     

超敏C-反应蛋白与脑梗死的关系

研究表明炎症在动脉粥样硬化的发生和发展中起着非常重要的作用。脑梗死的发生与持续存在的炎症刺激有关，而超敏C-反应蛋白是反映炎症程度的敏感指标之一。本研究对2005年10月-2006年3月在本院住院的85例脑梗死患者的超敏CRP（hs-CRP）进行检测，以了解hs-CRP与脑梗死的关系。     

帕金森病与炎症反应关系研究进展

帕金森病 (Parkinsondisease ,PD)的病因和引起多巴胺 (DA)能神经元变性的准确机制至今仍未充分阐明 ,近几年来 ,随着人们对PD研究的不断深入 ,发现炎症反应 (主要是指小胶质细胞的异常激活 )可能参与了PD的DA能神经元进行性变性进程 ,我们就有关PD炎性反应特点及其参与PD病理过程的最新研究进展介绍如下。一、PD患者脑内存在炎症反应证据近年来诸多学者报道 ,PD患者脑脊液和黑质纹状体系统中炎性细胞因子均较健康对照组增高。这些细胞因子包括致炎性细胞因子 :肿瘤坏死因子 α(TNF α)、白细胞介素 1β(IL 1β)、白细胞介素 1(…     

C-反应蛋白与急性脑缺血损伤的关系

最近研究发现．多种炎性介质介导或参与了脑缺血及再灌注损伤的病理生理过程．是缺血后导致细胞死亡的主要因素之一。C-反应蛋白（C-reactive protein，CRP）是炎症的一种敏感性指标。[第一段]     

超敏C-反应蛋白与急性动脉粥样硬化性脑梗死关系的研究

目的研究血清超敏C-反应蛋白(hs-CRP)与急性动脉粥样硬化性脑梗死之间的关系。方法回顾性分析297例动脉粥样硬化性脑梗死(ATCI)患者血清hs-CRP水平及其与年龄、性别、危险因素、梗死灶体积、病情轻重程度的关系。另选40例健康对照者,测定其血清hs-CRP水平,并与ATCI组患者比较。结果动脉粥样硬化性脑梗死组患者血清hs-CRP水平明显高于对照组,两组间差别有显著性意义(P＜0．01);血清hs-CRP水平与梗死灶体积、病情轻重程度呈正相关(P＜0．05),尤以梗死灶体积更为明显,且三者之间呈明显正相关:血清hs- CRP水平与年龄、性别及有无高血压病等常见危险因素无关(P＞0．05)。结论血清hs-CRP水平可作为评价动脉粥样硬化性脑梗死病变程度的一个重要指标。     

Platelet adhesion in atrial fibrillation

BACKGROUND: Increased platelet activation has been reported in nonvalvular atrial fibrillation (AF) but it remains unclear whether or not this is due to the underlying cardiovascular diseases, clinical subtype of AF and the influence of anti-thrombotic therapy. METHODS: Platelet adhesion in AF patients was assessed using a 'platelet adhesion assay', and compared to both 'healthy controls' and 'disease controls' (patients with hypertension, coronary artery disease, diabetes or stroke but in sinus rhythm). RESULTS: AF patients on no anti-thrombotic treatment (N=20) had increased platelet adhesion compared to 'healthy controls' (N=57) (p=0.044). Initiating treatment with both aspirin and warfarin resulted in significant reduction in platelet adhesion in AF patients (p=0.014 and 0.019 respectively). AF patients on optimal anti-thrombotic therapy (N=98) had no significant difference in platelet adhesion compared to 'healthy controls' and 'disease controls' (p=0.312). Platelet adhesion failed to distinguish between 'high-risk' (i.e. CHADS score > or = 2) and 'low-risk' (i.e. CHADS score < 2) AF patients (p=0.352). Amongst the clinical parameters that contribute to increased stroke risk in AF, platelet adhesion was only correlated with age (r=0.215, p=0.034), and not with other stroke risk factors. There was no significant difference in platelet adhesion between paroxysmal and permanent AF (p=0.618). CONCLUSION: There is a significant, albeit weak, excess of platelet adhesion in AF patients on no anti-thrombotic therapy compared to 'healthy controls'. In optimally treated AF patients, platelet adhesion is not different to both 'healthy' and 'disease controls'. It is possible that abnormal platelet adhesion does not significantly contribute to the increased risk of stroke and thromboembolism that persists despite anti-thrombotic treatment in AF or in identifying 'high-risk' AF patients.     

C反应蛋白与动脉粥样硬化性疾病的关系研究及进展

心脑血管疾病已经越来越成为现代社会危害人类健康的主要疾病，大多数心脑血管疾病都与动脉粥样硬化存在直接关系。近几年来，炎症在动脉粥样硬化及其并发症中起关键性作用的观点受到学者们相当的关注。炎症细胞侵润确见于动脉粥样硬化的各个阶段，从脂纹到晚期，到斑块破裂和血栓形成。     

合并房颤的急性缺血性卒中患者CHADS2评分与预后的关系

目的 探讨CHADS2评分与合并非瓣膜性房颤的急性缺血性卒中患者近期预后的关系.方法 前瞻性纳入发病7d内合并非瓣膜性房颤的卒中患者,行发病前CHADS2评分,分3组(0～1、2、3～6分),随访住院期间并发症和3个月时预后情况[改良Rankin量表评分(mRS)≤2为预后良好,mRS≥5为预后极差],单因素分析筛选影响3个月预后的危险因素后,再采用Logistic逐步回归分析CHADS2评分与3个月预后的关系.结果 共纳入203例患者,其中CHADS2 0～1、2、3～6组各72、53、78例,CHADS2评分高者入院时NIHSS评分较高,均数分别为9.8、12.6、13.0(F =3.404,P =0.035);肺部感染发生率较高,分别为12.5％、34.0％、39.7％( X2=14.643,P=0.001);预后良好率较低;预后极差率较高;多因素Logistic回归分析显示CHADS2评分是预后良好和预后极差的独立预测因子,以CHADS23～6组为参考,CHADS20～1预测良好预后的OR值为5.018(95％ CI为2.055 ～ 12.560);以CHADS2 0～1组为参考,CHADS23～6预测极差预后的OR值为6.197(95％ CI为1.670～22.996).结论 发病前CHADS2评分与合并非瓣膜性房颤的缺血性卒中患者预后相关,评分低者(0～1)预后良好可能性大,评分高者(3～6)预后极差可能性大.     

额叶功能评定量表在房颤患者中的应用及相关因素分析

目的 使用额叶功能评定量表(Frontal assessment battery,FAB)评估房颤患者执行功能,并进行相关因素分析,以探索FAB识别房颤相关认知障碍的有效性。方法 选取本院30例房颤患者为房颤组,选择同期29例健康人群为健康对照组,使用FAB评估其执行功能并进行比较,同时分析FAB与年龄、性别、学历、病程、房颤类型、CHA2DS2-VASc评分、HAS-BLED评分及简易智能精神状态检查量表(Mini-mental state examination,MMSE)评分的关系。结果 与健康对照组比较,房颤组FAB总得分明显降低,在概念化能力、动作程序性和对干扰的敏感度方面表现更差; Spearman相关分析显示FAB分数与房颤患者的学历、MMSE分数呈正相关,而与CHA2DS2-VASc评分、HAS-BLED评分呈负相关。结论 FAB有助于识别房颤患者执行功能受损。     

Fibrinolytic function and atrial fibrillation

Atrial fibrillation (AF) is the commonest sustained cardiac arrhythmia, which is associated with a substantial risk of stroke and thromboembolism. A prothrombotic or hypercoagulable state has been observed in these patients, although previous studies have mainly focused on various clotting factors, endothelial damage or dysfunction markers and platelet activation. However, fibrinolytic function has been less frequently studied, despite the fibrinolytic system playing an important role in preventing intravascular thrombosis. Indeed, increasing evidence suggests that an imbalance between the fibrinolytic function is of great importance in cardiovascular disease. This review will begin by providing a brief approach to fibrinolytic function and examine previous studies about fibrinolytic activity and atrial fibrillation.     

Depressive symptoms predict recurrence of atrial fibrillation after cardioversion

OBJECTIVE: The aim of this study was to evaluate whether depressive symptoms and the type-D personality are predictive of early recurrence of atrial fibrillation (or atrial flutter; AF) after successful electrical cardioversion (CV). BACKGROUND: Depressive symptoms are associated with an adverse prognosis in patients with coronary artery disease, congestive heart failure, and ventricular arrhythmias. Anger and hostility have been shown to be predictive of development of AF. However, little is known about the effects of depression on AF. METHODS: Fifty-four patients with persistent AF completed the Hospital Anxiety and Depression Scale (HADS) and the Type D Scale (DS-14) prior to elective electrical CV. Patients with a successful CV were followed for 2 months. RESULTS: During the follow-up period, 27 patients (50%) had recurrence of the arrhythmia. Depressive mood (HADS depression scale >7) was the only significant nonsomatic predictor of recurrence, which was observed in 85% of depressed versus 39% of nondepressed patients [odds ratio=8.6; 95% confidence interval (CI)=1.7-44.0, P=.004]. HADS anxiety scores and the presence of the type-D personality pattern were not associated with recurrence of AF. On multivariate Cox regression analysis, including variables with a prevalence >10% of the total study population and a univariate discriminative effect yielding a P value of <.2, a HADS depression score >7 was found to be the only independently predictive variable of arrhythmia recurrence (hazard ratio=2.7; 95% CI=1.05-7.2; P=.046). CONCLUSIONS: Our results indicate that depressive mood is a major risk factor for recurrence of AF after electrical CV. Heightened adrenergic tone and a proinflammatory state are possible mechanisms responsible for the observed association. Identification of depression may be of value prior to the decision to perform electrical CV.     

肾功能不全与伴非瓣膜性房颤的急性脑梗死患者不良预后的关系

目的 探讨肾功能不全与伴非瓣膜性房颤的急性脑梗死患者不良预后的关系.方法 纳入2013年1月~2015年1月于首都医科大学宣武医院神经内科住院的伴非瓣膜性心房颤动的急性脑梗死患者266例,使用肾脏病饮食改良(MDRD)简化公式计算肾小球滤过率估计值(eGFR),按照eGFR将患者分为肾功能不全组(36例)和无肾功能不全组(230例),出院后1年通过电话或门诊随访,观察不良卒中结局,包括全因死亡、卒中复发、联合终点事件(卒中或死亡)、卒中性残疾.结果 (1)肾功能不全组患者中,年龄≥65岁者的比例高于无肾功能不全组,差异有统计学意义[94.4%(34/36)比70.0%(161/230),P=0.002];(2)肾功不全组和无肾功能不全组比较,出院后1年不良预后结局事件发生率的差异有统计学意义(50.5%比29.6%,P=0.021);(3)多因素Logistic分析显示,肾功能不全为伴非瓣膜性房颤的急性脑梗死患者1年内发生不良卒中结局事件的独立危险因素,随着eGFR下降,患者不良结局事件的发生率增高(OR=1.485,P<0.05).结论 对于伴非瓣膜性房颤的急性脑梗死患者,肾功能随着年龄的增加而下降,肾功能不全是伴非瓣膜性房颤的急性脑梗死患者长期不良预后结局的独立预测因子.     

Changes in atrial fibrillation admissions following daylight saving time transitions

BackgroundDaylight saving time (DST) imposes a twice-yearly hour shift. The transitions to and from DST are associated with decreases in sleep quality and environmental hazards. Detrimental health effects include increased incidence of acute myocardial infarction (MI) following the springtime transition and increased ischemic stroke following both DST transitions. Conditions effecting sleep are known to provoke atrial fibrillation (AF), however the effect of DST transitions on AF are unknown.MethodsAdmitted patients aged 18–100 with primary ICD9 code of AF between 2009 and 2016 were included. The number of admissions was compiled and means were compared for the Monday to Thursday period and the entire seven day interval following each DST transition and the entire year for the entire cohort and separated by gender. Significance was determined with Wilcoxon nonparametric tests.ResultsAdmission data for 6089 patients were included, with mean age of 68 years and 53% female. A significant increase was found in mean AF admissions over the Monday to Thursday period (3.09 vs 2.47 admissions/day [adm/d], P = 0.017) and entire week (2.48 vs 2.09 adm/d, P = 0.025) following the DST spring transition compared to the yearly mean. When separated by gender, women exhibited an increase in AF admissions following the DST spring transition (1.78 vs 1.28 adm/d for Monday to Thursday period, P = 0.036 and 1.38 vs 1.11 adm/d for entire week, P = 0.050) while a non-significant increase was seen in men. No significant differences were found following the autumn transition for the entire cohort or when separated by gender.ConclusionAn increase in AF hospital admissions was found following the DST springtime transition. When separated by gender, this finding persisted only among women. This finding adds to evidence of negative health effects associated with DST transitions and factors that contribute to AF episodes.     

A prospective evaluation of the directionality of the depression–inflammation relationship

Cross-sectional studies have found that individuals with depressive disorders or symptoms have elevated levels of inflammatory markers predictive of coronary artery disease, including interleukin-6 (IL-6) and C-reactive protein (CRP). Due to the paucity of prospective studies, however, the directionality of the depression–inflammation relationship is unclear. We evaluated the longitudinal associations between depressive symptoms and both IL-6 and CRP among 263 healthy, older men and women enrolled in the Pittsburgh Healthy Heart Project, a 6-year prospective cohort study. During the baseline and follow-up visits, participants completed the Beck Depression Inventory-II (BDI-II) to assess depressive symptoms and underwent blood draws to quantify serum IL-6 and CRP. Path analyses revealed that baseline BDI-II (β = 0.18, p = 0.01, ΔR² = 0.02) was a predictor of 6-year change in IL-6, even after adjustment for demographic, biomedical, and behavioral factors as well as other negative emotions. Of all the factors examined, only body-mass index was a stronger predictor of IL-6 change than depressive symptoms. In contrast to these results, baseline IL-6 did not predict 6-year change in BDI-II. Evidence of a weak bidirectional relationship between BDI-II and CRP was also observed; however, neither of these longitudinal associations was significant. The present findings indicate that depressive symptoms may precede and augment some inflammatory processes relevant to coronary artery disease among healthy, older adults. Therefore, our results imply that depression may lead to inflammation and that inflammation may be one of the mechanisms through which depression contributes to cardiovascular risk.