Increased levels of markers of vascular inflammation in patients with coronary heart disease

Elevated levels of soluble cell adhesion molecules (sCAMs), inflammatory cytokines and C-reactive protein (CRP) have been associated with atherosclerotic disease states. The aim of the present study was to evaluate whether circulating levels of vascular cell adhesion molecule-1 (sVCAM-1), intercellular adhesion molecule-1 (sICAM-1), E- and P-selectin were significantly elevated in patients with coronary heart disease (CHD) compared with healthy controls, and to study possible associations between these sCAMs, tumour necrosis factor alpha (TNFalpha). interleukin-6 (IL-6), CRP and major CHD risk factors. The study included 193 patients in various stages of CHD and 193 matched controls. To evaluate any possible influence of acute phase reaction, reinvestigation was performed after 6 months. After adjustment for major CHD risk factors, sVCAM-1, sICAM-1, P-selectin, IL-6 and CRP remained significantly elevated in the CHD patients (p for all <0.001). In multivariate analysis sVCAM-1 was predicted by age (p=0.015), sICAM-1 by smoking (p<0.001) and total cholesterol (p=0.026), E-selectin by body mass index (BMI) (p=0.004) and P-selectin by male gender (p=0.015). TNFalpha significantly predicted sICAM-1 and E-selectin levels, while IL-6 predicted CRP but none of the sCAMs measured. This might indicate that TNFalpha, but not IL-6, plays a major role in the regulation of sCAM levels in vivo.     

Serum markers of vascular inflammation in dyslipemia

Atherosclerosis is widely recognized as an inflammatory disease because systemic and local inflammatory events mediate all phases of plaque development and progression. Basic and clinical studies have focused on identifying potentially useful markers of inflammation. In this article, we review the inflammatory pathogenesis of atherosclerosis, and highlight recent results of several of the more promising markers of inflammation for cardiovascular risk assessment. Of these markers, the most reliable and accessible for clinical use is currently high-sensitivity C-reactive protein (CRP). At present, most clinical guidelines do not recommend routine measurement of these inflammatory markers. However, these serum markers of vascular inflammation may be useful as an adjunct to lipid screening, especially for patients whose lipid values may not be severely elevated, but who are at intermediate risk according to scoring systems that take into account multiple established risk factors. In addition, since the pleiotropic effects of statins include the inhibition of inflammatory response, serum inflammatory markers could also be useful for monitoring this action. Nevertheless, several issues have to be evaluated before the measurements of inflammatory markers can be used for cardiovascular risk prediction in either clinical practice or in clinical trials evaluating anti-atherosclerotic drugs.     

Platelet activation and inflammation markers in patients with coronary heart disease and depression

AIM: To study morphological features and functional activity of platelets, their relations with the level of inflammation markers in coronary heart disease (CHD) patients with depression. MATERIAL AND METHODS: The study group consisted of 33 CHD patients with stable effort angina (NY-HA FC I-III), 14 had depression, 19 were free of depression. Sixteen healthy volunteers comprised the control group. Platelet aggregation was registered by a mean size of aggregates and turbidometrically. Platelets shape, leukocytic-thrombocytic and erythrocytic-thrombocytic aggregates (LTA, ETA) in the whole blood were studied electron-microscopically. The levels of IL-2, IL-6, TNF-alpha, sVCAM, hsCRP were measured in the blood, serotonin--in platelets. RESULTS: Spontaneous aggregation enhanced in 52.6% CHD patients (p < 0.05). The blood contained reticular platelets, high number of prothrombocytes (p < 0.05), mean volume of thrombocytes was greater (p < 0.05). This reflected changes in megakaryocytopoiesis. Some of the patients had LTA and ETA. Out of inflammation markers, only IL-6 and sVCAM were elevated (p < 0.01), hsCRP concentration rose, but not above normal range. Serotonin in platelets was the same in the patients and controls. Depression aggravated the disorders and elevated other indices. Spontaneous aggregation was high in 71.4% of depressive CHD patients. The count of reticular platelets, prothrombocytes, mean volume platelets were also elevated. LTA and ETA were high in all the depressive patients. Elevated were also concentrations of IL-6, sVCAM, IL-2, hsCRP. Serotonin in platelets was low (p < 0.05). CONCLUSION: Depression stimulates functional activity of platelets, is a factor of risk of intravascular inflammation and contributes to development of thrombotic complications in CHD patients.     

不同性别冠心病患者血管病变程度的比较分析

目的研究不同性别的需行PCI的冠心病患者的血管病变严重程度,旨在为不同性别的冠心病患者采取行之有效的二级预防措施提供循证医学证据。方法选择已成功施行PCI手术的262例冠心病患者,对患者的常见的危险因素严格测量评估,根据患者不同血管病变严重程度的危险因素进行分组比较。结果研究结果显示,在侵犯病变血管男性和女性几乎一致,而在病变严重程度二者更是趋于一致。不同性别冠心病患者血管病变严重程度LM、LAD、LCX和RCA男性分别为25（11．8％）、176（83．4％）、105（49．8％）和148（70．1％）。女性患者为6（11．8％）、43（84．3％）、22（43．1％）、36（70．6％）;构成比比较男女患者无差别,差异无显著意义,P〉0．05。结论研究结果提示,尽管女性患者比男性患者需行支架植入大约推迟5年,而且随着年龄增长,二者病变血管和血管病变严重程度并无区别,而女性患者随着年龄增长,患高血压的病人比男性患者多;高密度脂蛋白胆固醇（HDL-C）可能是女性患者的保护因素。     

C反应蛋白与白细胞介素-6对冠脉介入并发症的预测

目的 探讨经皮冠状动脉介入治疗（PCI）术前增强的炎症性反应对急性血管并发症及早期冠脉事件的预测价值。方法按照前瞻性临床试验方案,连续选择100例行PCI治疗的稳定性（SAP）和不稳定性心绞痛（UAP）患者,于术前留取外周血标本,分别测定C反应蛋白（CRP）和白介素-6（IL-6）水平;通过冠状动脉造影和临床指标判定PCI术中及围术期血管并发症及术后冠脉事件。结果100例患者中,13例于术中发生急性管腔闭塞,1例于术后2d发生亚急性血栓,均于闭塞处行PTCA和／或支架植入,恢复TIMⅢ级血流。余84例术中无并发症发生;术后30d临床随访,无缺血性事件及各种原因的死亡发生。血管并发症发生率在CRP下四分位数组与上四分位数组间差异具有统计学意义（P〈0．05）;IL-6水平在无并发症组和并发症组中位数分别为：4．25（0．00～75．00）pg／ml和7．5（0．00～48．00）pg／ml,P〈0．05;Logistic单因素回归分析表明,增高的CRP、IL-6水平、糖尿病和靶血管AHA／ACC分型是术中急性血管并发症的预测因素。结论 PCI术前增高的CRP、IL-6水平可能与术中急性血管事件的发生率相关。     

Increased expression of vascular cell adhesion molecule-1 (VCAM-1) in cultured endothelial cells exposed to serum from type 1 diabetic patients: no effects of high glucose concentrations

Activation of the arterial endothelium may play an important role in the development of an atherosclerosis-prone vascular wall in diabetes. The induction of the adhesion molecules VCAM-1 and E-selectin on activated endothelial cells is crucial in monocyte recruitment during the atherogenic process. In the present study, we investigated whether sera from type 1 diabetic patients and non-diabetic persons are capable of inducing expression of VCAM-1 and E-selectin in human endothelial cells cultured in vitro . First, it was found that the addition of serum from non-diabetics to the cultures resulted in expression of adhesion molecules above basal level and also increased the cellular response to the cytokine tumor necrosis factor-alpha (TNF- &#102 ), a strong inducer of both adhesion molecules. Moreover, it was found that, on average, sera from 17 diabetic males induced a higher expression of VCAM-1 in the endothelial cells after 6 h of incubation than samples from 20 non-diabetic age-matched males (p<0.05). No difference between the diabetic and non-diabetic group was seen in the expression of E-selectin. Likewise, no differences were observed between the effects of the sera to induce TNF- &#102 responsivity. A series of experiments showed that alterations in the glucose concentrations of the growth medium (5.5 - 13.5 mmol/L) did not change the cellular content of either VCAM-1 or E-selectin before and after TNF- &#102 treatment. In conclusion, it has been shown that sera from diabetic patients contain component(s), capable of inducing VCAM-1 expression in endothelial cells independent of hyperglycemia. Augmented induction of endothelial VCAM-1 expression by circulating factor(s) may play a role in the development of atherosclerosis in diabetes.     

Levels of three inflammation markers,C-reactive protein,serum amyloid A protein and procalcitonin,in the serum and cerebrospinal fluid of patients with meningitis

The levels of C-reactive protein (CRP) and serum amyloid A protein (SAA) in blood are increased in patients with inflammatory diseases as acute phase proteins. Most of the presently used indicators of inflammation, such as body temperature, white cell count, erythrocyte sedimentation rate or CRP, are non-specific parameters. In contrast, procalcitonin (PCT) has been reported to be selectively induced by severe bacterial infection during the systemic inflammatory response syndrome (SIRS), and also in sepsis or multiorgan dysfunction syndrome. PCT expression is only slightly induced, if at all, by viral infections, autoimmune disorders, neoplastic diseases and trauma of surgical intervention. We measured the concentrations of CRP, SAA and PCT in the sera and cerebrospinal fluid (CSF) of 30 patients with bacterial, viral, or mycotic meningitis, and 12 patients with a noninflammatory central nervous system disease as controls. An extremely high CRP level in CSF of above 100 &#119 g/L was seen in all seven bacterial meningitis patients and in only 10% of the viral meningitis patients. A high SAA level in CSF of greater than 10 &#119 g/L was observed in all of the bacterial meningitis and mycotic meningitis patients, and in 95% of the viral meningitis patients. Among those with bacterial meningitis, the serum PCT level was more elevated in those with more serious bacterial meningitis. The PCT level in the CSF did not significantly differ among the patients with the three types of meningitis. However, the serum PCT level was very high above 0.1 &#119 g/L in all seven bacterial meningitis patients, especially in the clinically serious cases.     

运动训练对慢性心力衰竭患者内皮炎性相关因子的影响

目的探讨运动训练对老年慢性心力衰竭患者血管内皮功能炎性标志物的影响,具体包括粒细胞吞噬细胞克隆刺激因子(GMCSF)、吞噬细胞吸附蛋白(MCP1)、可溶性细胞内吸附分子1(sICAM1)及可溶性血管吸附分子1(sVCAM1)等在治疗前、后的变化情况。方法共选取48例心功能稳定的慢性心力衰竭患者,将其随机分为2组训练组(n=24)及休息组(n=24),2组患者均给予内科常规治疗,训练组患者在此基础上同时进行运动训练;并分别在治疗前及治疗12周后对2组患者进行GMCSF、MCP1、sICAM1、sVCAM1及6min步行试验等检查。结果运动训练可以显著降低训练组患者外周炎性标志物的浓度(均P<0.05),增加6min步行距离(P<0.05);休息组患者治疗12周后与入院时比较,上述各指标间差异均无统计学意义(P>0.05)。结论运动训练可以显著减轻慢性心力衰竭患者的炎性反应,并改善其运动功能。     

血清同型半胱氨酸、胱抑素C、白细胞介素-6水平与老年冠心病合并抑郁情绪的关系

目的探讨血清同型半胱氨酸、胱抑素C、白细胞介素-6水平与老年冠心病合并抑郁情绪的关系。方法收集老年冠心病患者103例,进行ZUNG抑郁自评量表(SDS)评分,根据评分结果分为冠心病伴有抑郁组与不伴抑郁组,记录年龄、性别、体质量指数等一般资料,并测定血清同型半胱氨酸、胱抑素C、白细胞介素-6,血脂水平等相关资料。结果 103例冠心病患者中男性46例(44.66%),女性57例(55.34%),伴有抑郁情绪59例(57.28%),其中男性有21例(35.6%),女性38例(64.5%),男女冠心病患者伴抑郁情绪差异有统计学意义,冠心病伴有抑郁组同型半胱氨酸、胱抑素C、白细胞介素-6明显高于对照组,差异均有统计学意义。结论同型半胱氨酸、胱抑素C、白细胞介素-6水平升高对老年冠心病抑郁情绪的发生、进展具有重要意义。     

Markers of platelet activation in coronary heart disease patients

Abstract. We have applied flow cytometry to the detection of activated platelets in patients with coronary heart disease. Paraformaldehyde-fixed platelets were incubated with one of the following monoclonal antibodies (MAbs): Bx-1 (anti-GP Ib), AP-2 (anti-GP IIb-IIIa complex), VH10 (anti-GMP-140, a glycoprotein of the α-granule membrane), or PAC-1 (directed against an activation-dependent determinant on GP IIb-IIIa complexes). Bound antibody was quantitated after the addition of FITC-conjugated anti-immunoglobulin. This report highlights studies on 16 unstable angina patients undergoing transluminal angioplasty. Blood samples were taken at different periods before and after the angioplasty. Levels of activated platelets were variable, remaining in the 2–4% range of control donors for some, but increasing to 10–30% postangioplasty for others (despite all patients receiving heparin and aspirin). Maximum numbers of activated platelets were detected at 24 or 48 h. Nonetheless, the amount of antibody bound to individual platelets rarely reached the levels seen when control platelets were stimulated with thrombin in vitro. Results with VH10 and PAC-1 often, but not always, correlated suggesting different pathways of platelet activation.     

血清黏附分子和细胞因子与2型糖尿病患者血管病变的关系

目的 探讨2型糖尿病（T2DM）患者血清黏附分子与细胞因子水平以及与血管病变的关系.方法 选择96例T2DM患者按照血管病变情况分为无血管病变组（28例）、微血管病变组（33例）、大血管病变组（35例）,选择同期健康体检者30名作为对照组,ELISA法检测血清细胞间黏附分子1（ICAM-1）和血管细胞黏附分子1（VCAM-1）,细胞因子包括白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）和假性血友病因子（vWF）浓度,同时检测治疗半个月后T2DM患者黏附分子和细胞因子的表达.结果 与对照组比较,T2DM患者不同血管病变组ICAM-1、VCAM-1、IL-6和TNF-α水平都明显增高,差异有统计学意义（P均＜0.05）,且随着患者血管病变的严重,其表达也有升高趋势,差异有统计学意义（P均＜0.05）;治疗半个月后,患者血清ICAM-1、VCAM-1、IL-6和TNF-α水平显著性降低,差异具有统计学意义（t值分别为16.281、8.712、7.697、8.445,P均＜0.05）,各指标分别从治疗前（505.34±56.42） μg/L,（570.85±59.54）μg/L,（94.51±18.04） ng/L,（70.57±18.34） ng/L降到治疗后（390.53±45.23） μg/L,（482.93±69.85） μg/L,（77.31±15.49） ng/L,（50.45±12.66） ng/L;T2DM患者血清ICAM-1、VCAM-1、IL-6及TNF-α水平与vWF的表达都呈明显的正相关（r值分别为0.482、0.453、0.576、0.534,P均＜0.05）.结论 黏附分子和细胞因子共同参与了T2DM恶化以及血管病变的发生发展.     

增强型体外反搏对冠心病患者血清血管内皮生长因子的影响——附31例检测分析

目的：探讨增强型体外反搏对冠心病患者血清血管内皮生长因子（ＶＥＧＦ）的影响。方法：采用酶联免疫吸附测定法检测３１例冠心病患者和３４名正常人血清中ＶＥＧＦ水平,并观察冠心病患者在增强型体外反搏治疗过程中及反搏后血清ＶＥＧＦ的动态变化。结果：治疗前,冠心病患者血清ＶＥＧＦ含量（２７２±１４２）ｎｇ／Ｌ明显高于正常人（１２２±３０）ｎｇ／Ｌ,Ｐ＜０．００１。在体外反搏治疗第一疗程末患者血中ＶＥＧＦ水平明显降低,但在随后的两个疗程中ＶＥＧＦ又有一定程度的增高,但仍低于反搏前水平。结论：本研究从ＶＥＧＦ的角度发现体外反搏可改善冠心病患者的心肌缺血,并对ＶＥＧＦ的产生有一定的影响     

Relationship of adiponectin with markers of systemic inflammation, atherogenic dyslipidemia, and heart failure in patients with coronary heart disease

BACKGROUND: Adiponectin, an adipocyte-derived hormone, appears to be a modulator of lipid metabolism and systemic inflammation and is present in particularly low concentrations in patients with coronary heart disease (CHD). However, the clinical importance of adiponectin in individuals at markedly high risk for future cardiovascular morbidity and mortality has not been fully elucidated. We examined the associations between serum adiponectin and several biomarkers related to cardiovascular disease and heart failure in a large high-risk population comprising patients with prevalent CHD. METHODS: We measured fasting adiponectin, interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and markers of lipoprotein metabolism in 1174 patients with CHD. RESULTS: After adjustment for age and sex, adiponectin was associated with HDL-cholesterol (HDL-C; r = 0.25; P <0.0001), NT-proBNP (r = 0.17; P <0.0001), and plasma triglyceride (r = -0.21; P <0.0001) concentrations. There was, however, no statistically significant association between adiponectin and markers of systemic inflammation. In partial correlation analyses further adjusted for body mass index, alcohol intake, smoking status, presence of diabetes and/or hypertension, lipid-lowering drug therapy, and fasting plasma glucose, adiponectin remained significantly associated with HDL-C (r = 0.21; P <0.0001), NT-proBNP (r = 0.15; P <0.0001), and plasma triglycerides (r = -0.16; P <0.0001). CONCLUSIONS: Serum adiponectin is associated with the presence of atherogenic dyslipidemia and with NT-proBNP concentration but not with markers of systemic inflammation in patients with manifest CHD. Thus, atherogenic dyslipidemia may link adiponectin with the progression of atherosclerosis. Moreover, serum adiponectin may be related to BNP in patients with CHD.     

冠心病患者血浆高迁移率族蛋白B1与白细胞介素18水平变化研究

目的研究冠心病fCHDl患者血清白细胞介素-18（IL-18）、高迁移率族蛋白BI（HMGBl）水平变化的临床意义，为CHD的诊疗提供参考。方法CHD组102例为本院确诊患者。对照组52例为健康体检者．采集早晨空腹静脉血5ml于ED．TA-Na2抗凝管中，3000r／min离心15min后采用ELISA法测定HMGBl、IL-18水平。结果CHD组HMGBl、IL-18水平高于对照组（P〈O．01），CHD组中HMGBl、IL-18水平在不同病变程度各组间差异有统计学意义（P〈0．05）。其水平与冠状动脉病变程度呈正相关。结论HMGBl、II，_18水平变化佐证冠心病的发生和发展中炎症反应在起着重要作用．血浆HMGBl、IL-18水平检测可作为冠心病病程变化的参考指标。     

Increased plasma malondialdehyde and protein carbonyl levels and lymphocyte DNA damage in patients with angiographically defined coronary artery disease

We investigated the oxidative modifications of lipids, proteins and DNA, three potential molecular targets of oxidative stress, in 30 patients with angiographically defined coronary artery disease (CAD) and 30 healthy control subjects. In addition, we examined relationships between these oxidative modifications and the severity of vascular lesions in patients with CAD. Malondialdehyde (MDA) and protein carbonyl (PC) levels, as well as ferric reducing antioxidant power (FRAP), were measured in the plasma. DNA damage was evaluated as single strand breaks (SSBs), formamidopyrimidine glycosylase (Fpg) and endonuclease III (E-III)-sensitive sites by the comet assay in DNA isolated from lymphocytes. MDA and PC levels increased, but FRAP values decreased, in patients as compared to controls. However, these values did not vary with the number of affected coronary vessels and were not correlated with Duke score, a parameter of the severity of vascular lesions in patients with CAD. We also found that lymphocyte DNA damage (SSBs, Fpg and E-III sites) were increased in patients. Although there were no significant differences in SSBs values in patients grouped according to affected vessel number, Fpg and E-III sites increased. We also detected significant correlations between Duke scores and SSBs and Fpg sites. Serum cholesterol, triglyceride and LDL-cholesterol levels were found to increase, but HDL-cholesterol levels decreased in CAD patients, but these lipids were not correlated with Duke scores. The results of this study reinforce the presence of increased combined oxidative modifications in lipid, protein and DNA in patients with CAD. However, lymphocyte DNA damage seems to be a more reliable assay than MDA and PC determinations to detect the severity of vascular lesions in patients.     

胰岛素抵抗对冠心病患者血管内皮功能的影响

目的探讨胰岛素抵抗对冠心病患者血管内皮功能的影响，了解伴有或不伴有胰岛素抵抗患者内皮功能的差异，并指导治疗。方法将90例住院的冠心病患者经测定空腹血糖和血浆胰岛素水平后分成3组，第1组（30例）：非胰岛素抵抗的冠心病患者；第2组（30例）：伴胰岛素抵抗的冠心病患者未经治疗者；第3组（30例）：治疗组，予二甲双胍0．5g，3次／d，口服4周。分别观察3组在治疗前后内皮功能指标（ET、NO、TXB2、6-keto-PGF1α）和血浆肾素、血管紧张素的变化。结果3组统计显示：伴有胰岛素抵抗的冠心病患者其内皮功能指标明显差于不伴有胰岛素抵抗的患者，并且经治疗后，随着胰岛素抵抗的改善，其内皮功能指标也有一定的改善。结论胰岛素抵抗与冠心病患者的血管内皮功能密切相关，改善了胰岛素的抵抗就可能会改善冠心病患者的血管内皮功能，从而改善预后。     

冠心病心绞痛患者血浆白细胞介素-6和超敏C-反应蛋白变化及其临床意义

目的 探讨白细胞介素-6(IL-6)及超敏C-反应蛋白(hsCRp)在冠心病心绞痛发病机制中的作用.方法 选择冠状动脉造影确诊的心绞痛患者150例,分为不稳定型心绞痛(UAP)组78例,稳定型心绞痛(SAP)组72例,50例冠状动脉造影正常者作为对照组.采用酶联免疫吸附(ELISA)法检测血浆IL-6、免疫浊度法检测hsCRp水平.结果 UAP组血浆IL-6、hsCRP含量为(36.98±9.35)pg/L、(2.25±0.73)μg/L,显著高于SAP组的(23.19±7.35)pg/L和(1.88±0.68)μg/L(P均＜0.01),2组IL-6、hsCRP均明显高于对照组(16.93±6.15)pg/L、(1.28±0.40)μg/L(P均＜0.01).相关分析表明IL-6与hsCRP正相关,相关系数r=0.875(P＜0.05).结论 炎症反应可能参与冠心病的发病过程,血浆IL-6与hsCRP对预测冠心病心绞痛的存在和发展有重要的临床意义.     

冠心病患者动脉血IL-18水平检测的临床意义

目的 研究IL-18水平与冠状动脉病变程度的关系及其临床意义。方法 选择2005年2～12月在湖北襄樊市中心医院心内科住院的患者共91例,其中急性冠脉综合征（ACS）患者60例、稳定型心绞痛（SAP）患者31例和对照组55例。所有入选患者均进行选择性冠状动脉造影检查,冠心病组根据冠脉造影结果分为A组（50％≤冠脉狭窄〈70％）、B组（70％≤冠脉狭窄〈90％）及C组（90％≤冠脉狭窄）。采用ELISA方法检测动脉血IL-18水平。结果 冠心病患者（ACS组和SAP组）与对照组相比IL-18明显增高（P〈0．01）;IL-18在C组中明显升高（P〈0．01）。结论 IL-18水平与冠脉病变及其严重程度明显相关,可以作为评估冠心病严重程度及预后的重要指标之一。     

冠心病患者CRP、SAA、PCT、IL-6水平与冠状动脉粥样硬化的相关性研究

目的观察冠心病患者冠状动脉粥样硬化发生情况,分析血清C反应蛋白(CRP)、血清淀粉样蛋白A(SAA)、降钙素原(PCT)、白细胞介素-6(IL-6)水平与冠状动脉粥样硬化的相关性。方法选择该院2017年3月至2019年3月收治的60例冠心病患者作为研究组,参照Gensini积分评分标准评估冠心病患者冠状动脉粥样硬化程度,根据Gensini积分将研究组患者分为轻度硬化组、中度硬化组及重度硬化组。另选择同期于该院接受健康体检的30例健康者作为健康对照组。检测全部研究对象血清CRP、SAA、PCT、IL-6水平,分析冠心病患者血清生化指标水平与冠状动脉粥样硬化的相关性。结果60例冠心病患者均存在不同程度的冠状动脉粥样硬化,轻度硬化、中度硬化、重度硬化患者分别为21、19、20例。重度硬化组血清CRP、SAA、PCT、IL-6水平高于中度硬化组、轻度硬化组、健康对照组(P<0.05),中度硬化组以上指标水平高于轻度硬化组、健康对照组(P<0.05),轻度硬化组以上指标水平高于健康对照组(P<0.05)。Pearson相关分析显示,冠心病患者Gensini积分与血清CRP、SAA、PCT、IL-6水平呈正相关(r=0.905、0.857、0.828、0.827,P<0.05)。结论冠心病患者血清CRP、SAA、PCT、IL-6水平随着冠状动脉粥样硬化程度的加重而升高,以上指标可能参与了冠心病患者冠状动脉粥样硬化的发生、发展,可考虑将其用于冠心病患者早期冠状动脉粥样硬化的评估,指导疾病的早期防控与治疗。     

血管缝合器与人工压迫止血对冠心病介入术后病人的影响

目的探讨冠状动脉介入治疗后血管缝合器与人工压迫止血对病人止血时间、制动时间、舒适度及并发症的影响。方法冠状动脉介入治疗的518例病人,随机分为经皮血管缝合器组(观察组)及人工压迫止血组(对照组),观察2组病人止血时间、制动时间、舒适度及并发症的发生率。结果血管缝合器组平均止血时间为(4.0±2.5)min,卧床制动时间为(4.0±1.0)h。人工压迫止血组平均止血时间为(16.0±5.5)min,卧床制动时间为(24.0±4.0)h。观察组止血时间及卧床制动时间均明显少于对照组(P<0.05)。4 h后观察组舒适度明显高于对照组(P<0.05)。血管缝合器组如迷走神经反射发生率明显少于人工压迫止血组(P<0.05)。结论血管缝合器用于冠心病介入术后病人安全有效。