Effects of Mediterranean Diet or Low-Fat Diet on Blood Fatty Acids in Patients with Coronary Heart Disease. A Randomized Intervention Study

The Mediterranean diet (MD) prevents cardiovascular disease by different putative mechanisms, including modifications in the blood fatty acid (FA) profile. Polytherapy for secondary cardiovascular prevention might mask the effect of MD on the FA profile. This study was aimed to assess whether MD, in comparison with a low-fat diet (LFD), favorably modifies the blood FA profile in patients with coronary heart disease (CHD) on polytherapy. One hundred and twenty patients with a recent history of coronary stenting, randomized to MD or to LFD, completed 3 months of this open-label dietary intervention study. Diet Mediterranean-ness was evaluated using the Mediterranean Diet Adherence Screener (MeDAS) score. Both diets significantly reduced saturated FA (p < 0.01). Putative favorable changes in total n-3 FA (p = 0.03) and eicosapentaenoic acid plus docosahexaenoic acid (EPA + DHA; p = 0.04) were significantly larger with MD than with LFD. At 3 months, in the whole cohort, the MeDAS score correlated inversely with palmitic acid (R = −0.21, p = 0.02), and with palmitoleic acid (R = −0.32, p = 0.007), and positively with total n-3 FA (R = 0.19, p = 0.03), EPA (R = 0.28, p = 0.002), and EPA + DHA (R = 0.21, p = 0.02). In CHD patients on polytherapy, both MD and LFD shift FA blood composition towards a healthier profile, with a more favorable effect of MD on omega−3 levels.     

冠心病合并心力衰竭患者冠状动脉支架术后临床效果的研究分析

目的:分析冠状动脉粥样硬化性心脏病(简称,冠心病)合并心力衰竭患者冠状动脉支架术后的临床效果。方法:选择2017年1月~2018年3月在本院就诊的72例冠心病合并心力衰竭患者作为本次的研究对象,术前3d给予患者肠溶阿司匹+氯吡格雷术前准备,手术时患者取半卧位,选择搏动良好的桡动脉行介入治疗,介入术后行经皮冠状动脉支架植入术,术后给予氯吡格雷+阿司匹林治疗。采用超声心动图监测,比较治疗前后的心功能相关指标。行6min步行试验,评估患者的运动耐力。依据纽约心脏病协会(NYHA)分级标准对患者治疗前后的心功能进行分级。结果:治疗后,患者各项心功能指标较治疗前比较,差异有统计学意义,P<0.05。治疗前,患者的平均6min步行距离为(165.3±48.8)m,治疗后,患者的平均6min步行距离为(232.6±69.4)m,较治疗前比较,差异有统计学意义,P<0.05。依据纽约心脏病协会(NYHA)分级标准:Ⅰ级25例(34.7%),Ⅱ级26例(36.1%),Ⅲ级21例(29.2%),Ⅳ级0例(0.0%),较治疗前比较,差异有统计学意义,P<0.05。结论:使用冠状动脉支架术治疗冠心病合并心力衰竭患者,能明显改善患者的心功能,疗效确切。     

冠心病患者的血清apoB水平及与营养的关系

以１０１名男性冠心病（ＣＨＤ）患者和１００名健康对照为研究对象。分别进行了体格测量、生活史询问、膳食史调查并抽取血样作常规血脂和载脂蛋白Ｂ（ａｐｏＢ）测定。结果表明,冠心病组和对照组的平均ａｐｏＢ水平分别为（８７７±１２９）ｍｇ／Ｌ和（８００±９５）ｍｇ／Ｌ;研究还表明,体重指数和腰围／臀围比值（ＷＨＲ）均与ａｐｏＢ水平具有密切关系,此外,喜食肥肉也与ａｐｏＢ水平升高有关,而ＶＣ摄入量则与ａｐｏＢ水平降低有关。     

冠心病患者血清胆红素水平的价值

　［Objective］To detect the association of serum c oncentration of bilirubin with coronary heart disease. ［Methods］The serum concentration of bilirubin was determined with autobiochemical analyser.［Results］The serum concentration of bilirubin was 11.97±4.95μmol/L in cases and 14.12±4.30μmol/L contrast. ［ Conclusions］There was a close relationship of low serum concentration of bilirubin with increased risk of coronary heart disease.     

老年冠心病患者接受全麻胃镜检查安全性分析

目的探讨老年冠心病患者接受患者全麻胃镜检查安全性。方法选取接受胃镜检查的老年冠心病患者145例,分为对照组(72例)及观察组(73例),对照组患者行常规胃镜检查,观察组患者在全麻下行胃镜检测,对患者生命体征、心电图改变、心肌酶水平进行监测并比较。结果对照组患者收缩压(SBP)及舒张压(DBP)、心率(HR)较术前有显著升高(P0.05),观察组患者术后SBP及DBP较术前有显著下降,且较对照组有显著性下降(P0.05)。对照组患者术后乳酸脱氢酶(LDH)、谷草转氨酶(AST)、磷酸肌酸激酶(CK)水平较术前显著升高(P0.05),观察组患者术后LDH、AST、CK水平较对照组显著下降(P0.05)。对照组患者室性早搏、传导阻滞、ST段改变分别有4例、2例、7例,观察组分别有3例、2例、4例,两组比较差异具有显著统计学意义(χ2=0.242,P0.05)。结论老年冠心病患者接受全麻胃镜检查可减轻冠脉缺血,减少心血管事件的发生。     

冠心病患者与健康人血清微量元素水平的比较

目的测定冠心病患者血清8种微量元素水平,探讨冠心病与微量元素的关系。方法选择80例冠心病患者及57例健康人,分别测定其血清微量元素水平;其中,血硒采用荧光分光光度法测定。其他微量元素采用电感耦合等离子体发射光谱法(ICP-AES)测定。结果与健康对照组比较,冠心病患者血清Zn、Fe、Co水平以及Zn/Cu比值明显升高,两组差异有显著性(P<0.05、P<0.01);而Mn、Cu、Se、Sr水平均明显下降,两组差异有显著性(P<0.05、P<0.01)。结论微量元素代谢的不平衡与冠心病发病有一定的关系。     

The Triglyceride-Lowering Effects of a Modest Dose of Docosahexaenoic Acid Alone Versus in Combination with Low Dose Eicosapentaenoic Acid in Patients with Coronary Artery Disease and Elevated Triglycerides

Background: Hypertriglyceridemia is a risk factor for coronary artery disease (CAD). The American Heart Association recommends 1000 mg of omega-3 fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), daily for cardioprotection and higher doses for triglyceride-lowering in patients with CAD.

Methods: This was a prospective, randomized, double-blind study comparing DHA to DHA + EPA in patients with CAD and triglycerides greater than 200 mg/dL. Subjects were randomized to either 1000 mg of DHA or 1252 mg of DHA + EPA for eight weeks. Baseline and eight-week laboratories were drawn to assess changes in the fasting lipid profile. The primary objective was to evaluate the change in triglycerides between the two groups at eight weeks.

Results: A total of 116 subjects were enrolled; 57 in the DHA group and 59 in the DHA + EPA group. Baseline characteristics were similar between groups. The mean age was 69.4 ± 9.1 years and 70.7% were male. Triglycerides decreased by an average of 21.8% in the DHA group (p < 0.001) and 18.3% in the DHA + EPA group (p < 0.001). The difference between groups was not significant. A greater proportion of subjects in the DHA group achieved triglyceride goal (less than 150 mg/dL) compared to the DHA + EPA group (24.6% versus 10.2%, p < 0.05).

Conclusions: Our results indicate that the American Heart Association recommended cardioprotective dose of omega-3 fatty acids can also significantly lower triglycerides in patients with CAD. There do not appear to be significant differences in triglyceride-lowering between DHA only and DHA + EPA combination products when dosing is based on DHA.     

心电图检查结果正常的冠心病患者冠脉病变特点分析

目的:观察研究心电图检查结果正常的冠心病患者冠脉病变特点。方法:选择41例心电图检查正常的冠心病患者作为A组,另选择同时期心电图检查结果显示存在异常的41例冠心病患者作为B组,对两组患者诊疗资料进行对比分析,总结冠脉病变特点。结果:A组出现稳定性心绞痛几率明显高于B组(P<0.05)。比较两组ST段抬高型心肌梗死发生率,A组明显低于B组(P<0.05)。A组患者多为单支病变,与B组相比差异明显(P<0.05)。结论:心电图检查结果未见异常的冠心病患者多为单支病变,狭窄程度较轻,更易出现稳定性心绞痛,而ST段抬高型心肌梗死发生率相对心电图检查结果显示存在异常的冠心病患者而言更低。     

心电图检查结果正常的冠心病患者冠脉病变特点分析

目的:观察研究心电图检查结果正常的冠心病患者冠脉病变特点。方法:选择41例心电图检查正常的冠心病患者作为A组,另选择同时期心电图检查结果显示存在异常的41例冠心病患者作为B组,对两组患者诊疗资料进行对比分析,总结冠脉病变特点。结果:A组出现稳定性心绞痛几率明显高于B组(P<0.05)。比较两组ST段抬高型心肌梗死发生率,A组明显低于B组(P<0.05)。A组患者多为单支病变,与B组相比差异明显(P<0.05)。结论:心电图检查结果未见异常的冠心病患者多为单支病变,狭窄程度较轻,更易出现稳定性心绞痛,而ST段抬高型心肌梗死发生率相对心电图检查结果显示存在异常的冠心病患者而言更低。     

老年冠心病心律失常动态心电图监测分析

目的:探讨老年冠状动脉粥样硬化性心脏病(简称,冠心病)心律失常患者行动态心电图监测的临床价值。方法:研究资料共86例,均为本院于2017年2月~2019年2月收治的老年冠心病心律失常患者,均行常规心电图与动态心电图监测,评价监测结果及应用价值。结果:动态心电图检出心律失常阳性率显著高于对照组(82.56%,60.47%,P<0.05);与常规心电图相比,动态心电图对室早二、三联律、室早成对、房早二、三联律、房早成对、短阵室上速等检出率更高,差异具有显著性意义(P<0.05)。结论:在老年冠心病心律失常诊治中行动态心电图监测可更加详细的提供患者心律失常的变化,如发作频率、持续时间等,为治疗提供可靠的依据。     

吸烟对冠心病的影响Ⅱ:血清淀粉样蛋白A的作用

[目的 ]探讨吸烟、血清淀粉蛋白A(SAA)与冠心病的关系。 [方法 ]采用ELISA法分别检测血浆中SAA、C 反应蛋白 (CRP)、白介素 6(IL 6)浓度。 [结果 ]血浆SAA、CRP浓度在对照组、心绞痛组和心梗组依次升高 ,SAA的浓度分别 2 .97,3 .90和 8.77mg/L ,CRP浓度分别为 3 .0 3 ,3 .10和 6.85mg/L ,两两比较差异有显著性 (P <0 .0 5 ) ;SAA与CRP的偏相关系数为 0 .793 ,呈正相关 (P <0 .0 5 ) ;SAA及CRP与IL 6间具较弱的正相关 ,r分别为 0 .15 7和 0 .3 14 ,均为P <0 0 5 ;吸烟与SAA在冠心病发生中具有交互作用。 [结论 ]高水平血浆SAA可能是冠心病的一个危险因素 ;吸烟与SAA在冠心病发生中具有交互作用 ,吸烟能增加高水平SAA患冠心病的危险性     

Dietary Patterns,Alcohol Consumption and Risk of Coronary Heart Disease in Adults: A Meta-Analysis

Previous studies reported the potential associations between dietary patterns and the risk of coronary heart disease (CHD) in adulthood, however a consistent perspective has not been established to date. Herein, we carried out this meta-analysis to evaluate the associations between dietary patterns and the risk of CHD. MEDLINE and EBSCO were searched for relevant articles published up to April 2015. A total of 35 articles (reporting 37 original studies) met the inclusion criteria and were included in the present meta-analysis. The decreased risk of CHD was shown for the highest compared with the lowest categories of healthy/prudent dietary patterns (odds ratio (OR) = 0.67; 95% confidence interval (CI): 0.60, 0.75; p < 0.00001) and alcohol consumption (OR = 0.68; 95% CI: 0.59, 0.78; p < 0.00001). There was evidence of an increased risk of CHD in the highest compared with the lowest categories of the unhealthy/Western-type dietary patterns (OR = 1.45; 95% CI: 1.05, 2.01; p = 0.02). The results of this meta-analysis indicate that different dietary patterns may be associated with the risk of CHD.     

全血铬与冠心病及血脂关系的研究

全血铬与冠心病及血脂关系的研究崔金山，张玉敏，王薛君，张宝珍（沈阳医学院预防医学系，沈阳１１００３１）刘道荣，冯丰（沈阳医学院附属二院，沈阳１１０００１）关键词：血铬，冠心病，血脂ＳｔｕｄｉｅｓｏｎｔｈｅＲｅｌａｔｉｏｎｓｈｉｐＢｅｔｗｅｅｎＢｌｏｏ...     

慢性肾脏病伴冠心病冠状动脉介入后行血液透析护理

目的 分析慢性肾脏病合并冠心病患者接受冠状动脉介入术治疗后进行血液透析的护理方法与效果.方法 2019年3月-2020年3月选取本院收治的72例慢性肾脏病合并冠心病患者,全部患者都接受冠状动脉介入术治疗后进行血液透析处理,按照双盲法分为两组,对照组予以常规护理,观察组实施系统护理,并对两组患者生活质量评分、临床症状评分...     

Meta-analysis of Egg Consumption and Risk of Coronary Heart Disease and Stroke

The possible relationship between dietary cholesterol and cardiac outcomes has been scrutinized for decades. However, recent reviews of the literature have suggested that dietary cholesterol is not a nutrient of concern. Thus, we conducted a meta-analysis of egg intake (a significant contributor to dietary cholesterol) and risk of coronary heart disease (CHD) and stroke. A comprehensive literature search was conducted through August 2015 to identify prospective cohort studies that reported risk estimates for egg consumption in association with CHD or stroke. Random-effects meta-analysis was used to generate summary relative risk estimates (SRREs) for high vs low intake and stratified intake dose–response analyses. Heterogeneity was examined in subgroups where sensitivity and meta regression analyses were conducted based on increasing egg intake. A 12% decreased risk (SRRE = 0.88, 95% confidence interval [CI], 0.81–0.97) of stroke was observed in the meta-analysis of 7 studies of egg intake (high vs low; generally 1/d vs <2/wk), with little heterogeneity (p-H = 0.37, I² = 7.50). A nonstatistically significant SRRE of 0.97 (95% CI, 0.88–1.07, p-H = 0.67, I² = 0.00) was observed in the meta-analysis of 7 studies of egg consumption and CHD. No clear dose–response trends were apparent in the stratified intake meta-analyses or the meta regression analyses. Based on the results of this meta-analysis, consumption of up to one egg daily may contribute to a decreased risk of total stroke, and daily egg intake does not appear to be associated with risk of CHD.

Key Teaching Points:

? The role of egg consumption in the risk of stroke and coronary heart disease has come under scrutiny over many years.

? A comprehensive meta-analysis of prospective cohort studies that reported risk estimates for egg consumption in association with CHD or stroke was performed on the peer-reviewed epidemiologic literature through August 2015.

? Overall, summary associations indicate that intake of up to 1 egg daily may be associated with reduced risk of total stroke.

? Overall, summary associations show no clear association between egg intake and increased or decreased risk of CHD.

? Eggs are a relatively low-cost and nutrient-dense whole food that provides a valuable source of protein, essential fatty acids, antioxidants, choline, vitamins, and minerals.     

主动脉内球囊反搏对冠心病患者手术治疗效果的影响

目的:分析主动脉内球囊反搏(IABP)对冠状动脉粥样硬化性心脏病(简称,冠心病)患者手术治疗效果的影响。方法:回顾性分析于2016年4月~2020年4月在本院接受介入治疗的60例冠心病患者的临床资料,根据患者的IABP置入时机分别归纳为术前预防组(30例)、术中术后紧急置入组(30例),对比分析两组患者的IABP置入时间、机械通气时间、住CCU时间、住院费用、住院病死率。结果:术前预防组患者的IABP置入时间、机械通气时间、住CCU时间均短于术中术后紧急置入组,且住院费用与住院病死率均低于对照组,组间差异统计学意义成立(P<0.05)。结论:冠心病患者接受介入治疗前预防置入IABP,可提高治疗安全性,减少患者的住CCU时间以及治疗费用。     

影响经皮冠状动脉介入治疗冠心病后复发的危险因素分析

目的：探究影响经皮冠状动脉介入治疗冠心病后复发的危险因素。方法：选取2011年5月-2014年2月来本院行经皮冠状动脉介入治疗的冠心病患者125例,有5例失访,最终纳入120例。收集并整理其病历资料和术后出院后定期电话随访或定期复查的资料,包括患者的基本资料、生活方式、抑郁评价和生存资料。结果：有高血压病史、运动量〈30 min/d、有糖尿病史、抑郁程度较重的患者1年复发率高（P〈0.05）;有高血压病史、运动〈30 min/d、有糖尿病史、重度抑郁是影响PCI治疗冠心病后复发的危险因素,其中有高血压病史的危险程度最大（OR=3.575,95%CI=1.446~8.842）,其他三个危险因素的危险程度由高到低为运动〈30 min/d（OR=3.347,95%CI=1.424~7.866）、重度抑郁（OR=2.824,95%CI=1.578~5.054）、有糖尿病史（OR=2.356,95%CI=1.246~4.455）。结论：有高血压病史、运动〈30min/d、有糖尿病史、重度抑郁是影响PCI治疗冠心病后复发的危险因素。     

冠心病合并慢性心力衰竭患者血清HCY、CF-6、UMA水平及意义

目的观察冠心病合并慢性心力衰竭患者血清同型半胱氨酸(HCY)、线粒体偶联因子-6(CF-6)、尿微量蛋白(UMA)水平及临床意义。方法选择2012年3月-2015年3月我院就诊的冠心病合并心力衰竭200例为观察组,选取同期体检的健康体检者100例为对照组。检测2组血清HCY、CF-6、UMA水平。观察组给予常规治疗并观察临床疗效,并根据治疗效果分为有效组和无效组,比较有效组与无效组血清HCY、CF-6与UMA水平变化。结果观察组总有效率为90.0%。观察组血清HCY、CF-6和UMA水平均高于对照组(P0.05),有效组血清HCY、CF-6与UMA水平均低于无效组(P0.05)。结论血清HCY、CF-6与UMA水平对冠心病合并慢性心力衰竭具有诊断价值,有助于评估预后。     

冠心病患者冠状动脉支架植入术前血清LOX-1表达与术后冠脉再狭窄发生的关系研究

目的 探讨冠心病（CHD）患者冠状动脉支架植入（PCI）术前血清LOX-1表达与术后冠脉再狭窄发生的关系。方法 选取行PCI治疗的98例CHD患者,检测术前血清LOX-1水平,统计术后冠脉再狭窄发生情况,分析术前血清LOX-1表达与PCI术后冠脉再狭窄的相关性。结果 98例CHD患者PCI术后冠脉再狭窄发生率为9.18%;冠脉再狭窄患者的术前血清LOX-1水平显著高于冠脉无再狭窄患者（P <0.05）; ROC曲线显示术前血清LOX-1水平预测CHD患者PCI术后冠脉再狭窄发生的AUC值为0.738,具有一定预测性能。结论 CHD患者PCI术后冠脉再狭窄的发生与其术前血清LOX-1表达密切相关。     

老年冠心病患者血清NO及NOS含量的变化

目的了解一氧化氮(NO)和一氧化氮合酶(NOS)与老年冠心病的关系及其临床意义。方法选取154例老年冠心病患者,106例健康人为对照组,分别测定其血清NO和NOS含量,然后对结果进行比较分析。结果老年冠心病组、健康对照组的血清NO含量分别为(62.51±15.36)mol/L和(89.31±17.26)mol/L,NOS含量分别为(8.26±5.98)和(13.45±6.24),老年冠心病组均低于对照组(P<0.05或P<0.01)。结论老年冠心病患者的NO和NOS较健康人明显减少,这可能是冠心病的一个危险因素。