冠心病与血尿酸的关系

目的　确定血尿酸是否与冠心病独立相关以及是否与性别有关。方法　 35 5例行冠状动脉 (冠脉 )造影的患者分为两组 ,以性别、年龄、体重指数、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血尿酸、纤维蛋白原、吸烟量、高血压病病史、冠心病家族史等多重危险因素及冠脉评分进行多变量分析。结果　女性以血尿酸的四等分计算每组的冠脉评分 ,显示血尿酸越高 ,冠脉评分越高 ,而男性无此关系。多元logistic回归分析显示 :性别、纤维蛋白原、空腹血糖、吸烟等级与冠心病独立相关 (P值均 <0 0 5 ) ,年龄与冠心病有独立相关的趋势 (P =0 0 5 6 ) ,血尿酸与冠心病无独立相关 (P >0 0 5 )。逐步回归分析结果显示 :年龄、性别、纤维蛋白原、空腹血糖、总胆固醇与冠脉评分独立相关 (P值均 <0 0 5 ) ,血尿酸与冠脉评分无独立相关 (P >0 0 5 )。以女性病人专门进行多元逐步回归分析 ,血尿酸与冠心病及冠脉评分均无独立相关。结论　女性血尿酸越高 ,冠脉评分越高 ,但无论男女 ,血尿酸与冠心病及冠脉狭窄严重程度无独立相关。     

血尿酸与冠心病的相关性分析

目的分析研究冠心病和血尿酸的形成、扩散与患者治疗、恢复之间的关系。方法抽取近年来在我院给予血尿酸检测的冠心病病人180例（实验组）,并且再次抽取在这期间在我院进行常规体检的健康人群180例（对照组）当做对比分析观察。结果实验组病人的血尿酸含量：（421．23±43．52）μmol／L;对照组的血尿酸含量：（362．45±40．57）μmol／L,两组间差异具有统计学意义（P〈0．05）;然而心绞痛和陈旧性心肌梗死病人的血尿酸水平明显优于急性心肌梗死以及对照组病人,其差异具有统计学意义（P〈0．05）;急性心肌梗死病人的血尿酸水平（平均）和对照组差异不具有统计学意义（P〈0．05）。结论冠心病的形成、扩散是造成患者血尿酸的浓度升高的重要因素,对于冠心病病人应该采取定期对血尿酸进行检测,这样对及时预防这种疾病的发生具有非常大的帮助,对病人的生活质量起到至关重要的作用．具有临床推广价值应用。     

血尿酸水平与冠心病的关系

目的　探讨血尿酸与冠心病之间的关系。　方法　对 39例冠脉造影者测定血尿酸及其他生化指标 ,并根据造影结果分为冠心病和对照组进行病例对照研究。　结果　冠心病组血清尿酸显著高于正常冠状动脉组 (t =2 16 ,P<0 0 5 ) ,尿酸水平与冠心病的病变血管数目有关 (F =3 39,P<0 0 5 )。　结论　血尿酸水平升高是冠心病发病的一个相关因素。     

脂联素基因多态性与冠心病研究进展

脂联素(APN)是脂肪组织分泌的具有心血管保护活性的多肽,其基因呈现多态性,位于启动子区(rs266729)、外显子区(rs2241766)和内含子区(rs1501299)的三个多态性位点被广泛报道与冠心病(CHD)显著相关,其他位点如rs12495941、rs822395、rs182052、rs3774261和rs17366568也有报道与CHD显著相关。在关联机制上,APN基因多态性主要通过降低血浆APN水平、引起血脂紊乱、升高血压和促进肥胖等机制而增加CHD风险。文章就APN基因多态性与CHD的相关性及关联机制作一综述。     

同型半胱氨酸水平与冠心病的关系

目的观察同型半胱氨酸(Hey)水平与冠心病(CHD)的关系,并探讨蛋氨酸合成酶还原酶(MTRR)A66G基因多态性、叶酸、维生素B12(VitB12)与Hcy水平及CHD的关系。方法 选择190例经冠状动脉造影证实的CHD患者(CHD组)和100例冠状动脉造影正常者为对照组。应用荧光偏振免疫分析法测定Hey水平,离子捕获分析法测定叶酸水平,微粒酶免疫分析法测定VitB12水平。聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法分析MTRRA66G基因多态性。结果 CHD组血Hcy水平显著高于对照组(15.8±8.8)μmol/L与(12.9±6.3)μmol/L,P=0.002。叶酸、VitB12水平与血Hcy水平呈负相关。叶酸、VitB12与CFD无关。MTRR A66G基因多态性GG纯合子、AG杂合子和AA野生型3种基因型组间血Hcy水平差异无显著性意义。(P=0.908)。MTRR A66G各基因型在CHD组和对照组的分布差异无显著性意义(P=0.198)。结论CHD患者血Hcy水平升高,叶酸、VitB12水平与血Hcy水平呈负相关。MTRR A66G基因多态性与血Hcy水平及与CHD均无关。     

Inverse association between the existence of coronary artery disease and progression of abdominal aortic aneurysm

ObjectivesA strong degree of co-existence between coronary artery disease (CAD) and abdominal aortic aneurysm (AAA) is widely acknowledged, however, it remains to be elucidated whether the existence of CAD is associated with an accelerated expansion rate of AAA. Also, the relationship between preoperative CAD and postoperative major adverse cardiovascular events (MACE) has not been examined in Japanese patients. The aim of this study was to investigate the deleterious effects of CAD on the progression of AAA and the onset of postoperative MACE after elective AAA repair.Methods and resultsA retrospective cohort study of 665 consecutive Japanese patients who underwent elective surgical repair for infrarenal AAA at 2 high-volume Tokyo hospitals from 2003 through 2010 was performed. Preoperative CAD was shown to be a significant determinant of postoperative MACE (HR 2.29; 95%CI, 1.12–4.66; p = 0.02). In the analysis of 510 patients for whom there were at least 2 follow-up CT scans of the size of their AAA before repair, the existence of CAD was shown to be inversely associated with the accelerated expansion rate of AAA.ConclusionThis study on the patients undergone elective repair for infrarenal AAA identified an inverse association between the existence of CAD and progression of AAA as well as the significant impact of preoperative CAD on the occurrence of postoperative MACE after elective AAA repair.     

血栓调节蛋白水平与冠心病关系的研究

目的：探讨血栓调节蛋白水平(Thrombomdulin,TM)与冠心病(coronary heart disease,CHD)的相关性。方法：81例CHD者(CHD组)均在我院确诊；57例健康体检者为对照组；均采用酶联免疫吸附法(ELISA)方法,检测外周血浆TM水平；比较两组TM水平差异；多元线性回归分析冠心病危险因素对TM的影响；Pearson相关分析TM水平与动脉硬化指数的关系；受试者工作特征曲线(ROC曲线)分析TM对CHD诊断价值。结果：CHD组TM水平明显高于对照组(P<0.05)。TM水平与动脉硬化指数存在正相关(P<0.056)；ROC曲线下面积为0.596,面积的95%CI：0.498～0.694,TM判断CHD无显著意义(P=0.056)。结论：CHD患者TM水平明显升高；但TM判断CHD无显著意义。     

Lack of association between water hardness and coronary heart disease mortality in Japan

BACKGROUND: Elevated levels of water hardness are related to lower mortality from coronary heart disease (CHD) in different populations. This ecologic study assessed whether water hardness is related to lower mortality from CHD in Osaka Prefecture, with 44 municipalities, Japan. METHODS: The mortality rate from CHD per municipality was calculated based on the number of coronary deaths and midyear population in 1995. Values for water hardness in each of the municipalities were estimated based on the yearly amount of water supply per source and the yearly average of water hardness for each source in 1997. Multiple logistic regression analysis was used to control socioeconomic status and health care status in each municipality. RESULTS: In males, after adjustment for age, an inverse dose-response relationship between water hardness and mortality from CHD was significant (P for linear trend=0.004). However, this relationship virtually disappeared after further adjusting for socioeconomic status and health care status. In females, there was no material association between water hardness and coronary mortality. CONCLUSIONS: This study provides no evidence that water hardness is preventive against mortality from CHD in Japan.     

血清淀粉样蛋白A与冠心病及冠心病危险因素的关系

目的 :探讨血清淀粉样蛋白A (SAA)与冠心病 (CHD)及CHD相关危险因素的关系。方法 :用微粒增强免疫比浊法测定SAA的血浆浓度。结果 :急性冠状动脉综合征 (ACS)亚组和稳定型心绞痛 (SAP)亚组SAA血浆浓度均高于对照组 (P <0 .0 1) ;ACS亚组SAA血浆浓度高于SAP亚组 (P <0 .0 1) ;比较CHD危险因素导致CHD发生的危害性 ,SAA >CHD家族史 >TC >吸烟指数 >高血压史。结论 :CHD患者SAA血浆浓度升高可促进动脉粥样斑块的不稳定性 ,导致ACS的发生     

Inverse association between serum concentrations of neopterin and antioxidants in patients with and without angiographic coronary artery disease

Neopterin is released from human monocyte-derived macrophages upon stimulation with interferon-gamma and is a sensitive indicator for cellular immune activation. Furthermore, reactive oxygen species (ROS) are produced in case of immune activation and inflammation. In a cross-sectional approach, plasma concentrations of neopterin and of antioxidant compounds and vitamins were compared in 1463 patients investigated by coronary angiography, which were recruited within the LUdwigshafen RIsk and Cardiovascular Health (LURIC) study. Serum neopterin concentrations were higher in patients with coronary artery disease (CAD; mean+/-S.D.: 8.7+/-7.3 nmol/L) compared to controls (7.4+/-5.0 nmol/L; Welch's t-test: p<0.001). Mean concentrations of ascorbic acid (p<0.0001), gamma-tocopherol (p<0.05), lycopene (p<0.001), lutein+zeaxanthin (p<0.05), alpha-carotene (p<0.05) and beta-carotene (p<0.05) were lower in CAD than in controls. Neopterin concentrations correlated with CAD-score (r(s)=0.156; p<0.0001) and inversely with antioxidants lycopene (r(s)=-0.277; p<0.0001) and lutein+zeaxanthin (r(s)=-0.175; p<0.0001) levels and with vitamins ascorbic acid (r(s)=-0.207; p<0.0001) and alpha-tocopherol (r(s)=-0.105; p<0.0001). The study demonstrates that higher neopterin production is associated with lower concentrations of antioxidant compounds in patients at risk for atherosclerosis. Results suggest that lower concentrations of antioxidant compounds may relate to higher grade of chronic immune activation in patients.     

阻塞性睡眠呼吸暂停综合征与冠心病相关性的研究进展

阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)是一种发病率高、具有潜在危险性的疾病.近年研究显示OSAS与冠心病(coronary heart disease,CHD)关系密切,是CHD的独立危险因素,充分认识OSAS引起和促进CHD的发病机制,可以为OSAS相关CHD的防治提供重要的理论依据和新思路.     

超声测量心外膜脂肪组织厚度与冠心病的相关性研究

目的 评价心外膜脂肪组织厚度(EAT)与冠心病(CHD)的相关性及其诊断预测价值.方法 共298例符合入选标准的对象行冠状动脉造影,符合CHD诊断标准的200例为CHD组,余98例为对照组,通过经胸彩色多普勒超声心动图测量EAT,用SPSS 17.0软件进行数据分析,比较两组EAT差异.结果 CHD组EAT大于对照组[(5.44±1.50)mm比(4.52±1.31)mm,P＜0.01];EAT与CHD呈正相关(OR=1.598);EAT诊断CHD的受试者工作特征曲线下面积:男性为0.67,诊断敏感度59％,特异度82％,诊断切点值为5.06 mm;女性为0.71,诊断敏感度58％,特异度72％,诊断切点值为4.88 mm.结论 EAT是CHD的一个独立危险因素,经胸彩色多普勒超声心动图测量EAT可以作为CHD预测评估的一个有效指标.     

No serological evidence of association between chlamydia pneumonia infection and acute coronary heart disease.

Today's medical literature shows more and more evidence that Chlamydia pneumoniae plays a role in coronary atherosclerotic disease. This cross-sectional study examines the serostatus for C. pneumoniae of patients with an acute cardiovascular event. A total of 58 patients with acute myocardial infarction or with proven unstable angina (occlusion > or = 70% of at least 1 vessel at coronary angiography) ('patients') were compared with 58 age- and sex-matched patients without a cardiovascular event ('controls'). Serological testing for C. pneumoniae was performed by a microimmunofluorescence test during the first week of the event and 4-6 weeks later. Although more patients from the cardiovascular event group showed a positive history of a respiratory tract infection during 6 weeks preceding hospitalization (18/58 patients, 8/58 controls, p = 0.03), there was no significant difference between the two groups for an acute, chronic or past infection by C. pneumoniae (19/58 patients, 24/58 controls, p = 0.93). In conclusion, contrary to previous published papers, this study could not confirm an association of C. pneumoniae infection with an acute coronary event. Serological testing alone may not be the best way to demonstrate this association. An acute infection by C. pneumoniae, which should have been detected by serological testing, is probably not the origin of the rupture of an atheromatous plaque.     

脂蛋白(a)基因多态性与冠心病相关性的Meta分析

目的 评估脂蛋白(a)基因(LPA)多态性与冠心病风险之间的相关性.方法 检索PubMed、Embase、Web of Science、Cochran、中国知网和万方数据库中LPA基因rs10455872和/或rs3798220多态性与冠心病的关联研究,检索时限均为建库至2021年6月10日.由两名研究者独立筛选文献、...     

冠心病与非冠心病患者在心肺功能相关指标中的差异

目的:观察心肺运动试验中的氧摄取动力学、无氧阈及心肺储备功能指标对冠心病的诊断价值。方法:对68例胸痛患者行心肺运动试验,彩色心超测定左室射血分数(LVEF),及冠心病造影,根据冠状动脉造影结果分成非冠心病组,冠心病组,进行组间二氧化碳呼吸当量、氧摄取动力学及无氧阈、LVEF等的比较。结果:与非冠心病组相比,冠心病组中的VO2peak[(20.67±6.01)vs.(26.63±4.51)mL.kg-1.min-1,P0.001]、VCO2[(1.34±0.52)vs.(1.72±0.49)L/min,P0.01]、AT[(1.21±0.36)vs.(1.48±0.32)L/min,P0.01]、O2pulsepeak[(10.39±3.04)vs.(12.33±2.53)mL/beat,P0.01]、VT[(1.37±0.43)vs.(1.56±0.32)L,P0.05]、VE/VCO2@AT[(31.18±4.79)vs.(28.88±4.04),P0.05]都有显著性差异。结论:冠心病与非冠心病患者在VO2peak、AT、O2pulsepeak等心肺运动的相关指标存在一定的差异。     

冠心病与高尿酸血症关系的探讨

目的:研究冠心病与高尿酸血症之间的关系。方法:选择156例经冠状动脉造影证实冠心病患者和非冠心病患者的临床资料,冠心病组又分为单支病变组55例,双支病变组21例,3支病变组20例,分别测定血尿酸(SUA)水平,同时记录性别、年龄、血尿酸、血糖、血脂、血压、肌酐及冠状动脉造影结果,分析2组之间血尿酸水平,分析冠心病与高血尿酸血症的关系。结果:冠心病组血尿酸水平显著高于非冠心病组(P<0.05)。单支病变组、双支病变组及多支病变组血尿酸水平呈递增趋势,各组之间的差异有统计学意义。结论:冠心病与血尿酸水平密切相关。     

高尿酸血症与冠心病的关系

目的 探讨血清尿酸水平升高与冠心病发生、发展的关系.方法 选取疑诊冠心病患者455例,根据冠状动脉造影情况分为冠心病组268例（又分为单支病变组102例和多支病变组166例）和非冠心病组187例.在未行冠状动脉造影前,所有病例分别进行血清尿酸（UA）、血肌酐（Cr）、尿素氮（BUN）、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）水平测定.结果 冠心病组与非冠心病组比较血清UA、Cr、BUN差异有统计学意义（P均＜0.05）,冠心病单支病变、多支病变血清UA、Cr、TG、LDL-C水平比较有统计学差异（P均＜0.05）.结论 高尿酸血症与冠心病的发生、发展有关,冠脉病变程度增加,血清尿酸水平增高.     

内脂素与冠心病

内脂素是一种新的脂肪因子,主要来源于内脏脂肪,具有类胰岛素样作用。近年来的许多研究发现,内脂素与缺氧、易损斑块、内皮功能紊乱、炎症、血管增生等冠心病,尤其动脉粥样硬化的发生和发展过程相关。此外,内脂素还能通过延长氧化应激状态下线粒体渗透转运孔（mPTP）的开放时间,发挥一定的心血管保护作用。