ApoE基因多态性与冠心病患者抑郁情绪的关系

目的:了解ApoE基因多态性与冠心病患者抑郁情绪的关系。方法: 用聚合酶链反应扩增技术和限制性片段长度多态性技术(PCR-RFLP)对26例冠心病伴抑郁者、30例冠心病不伴抑郁者和30例健康对照组的载脂蛋白E基因(ApoE)进行分析,用汉密尔顿抑郁量表(HRSD)评定抑郁。结果: 冠心病伴抑郁组的ApoEε4等位基因频率显著高于对照组(P<0.05),而其它等位基因频率在各组中的差异无统计学显著性(P>0.05)。携带ε4等位基因者HRSD(因子分中的运动迟缓、绝望感分)、HAD(包括D因子分和A因子分)总分以及总胆固醇水平均高于非携带ε4等位基因的患者,但在认知损害、体重、睡眠障碍因子得分上的差异没有统计学显著性。结论: ApoE基因多态性与冠心病抑郁情绪有一定的关联,尤其是ApoEε4等位基因在冠心病患者抑郁情绪的发生中可能起重要作用。     

直接冠状动脉支架植入治疗冠状动脉病变25例

冠状动脉支架植入可以降低经皮冠状动脉成形术(ＰＴＣＡ)后再狭窄率及防止ＰＴＣＡ术中急性血管闭塞等并发症 ,这种观点已获得共识。近年来 ,临床上开始应用直接冠状动脉支架植入技术 ,即未预扩张的单独支架植入技术来治疗冠状动脉病变。本研究旨在探讨直接冠状动脉支架植入治疗冠心病的可行性、效果及适应症。1　材料与方法1·1　对象　冠心病患者 2 5例 ,男 2 3例 ,女 2例 ,年龄4 2～ 71岁 ,平均 (5 8± 11 4 )岁 ,其中心绞痛 2 2例 ,心肌梗死 3例。冠状动脉造影显示 2 4例为单支病变 ,1例为双支病变 ,其中前降支 16支 ,回旋支 3支 ,右冠…     

通心络胶囊对冠心病心绞痛甲襞微循环和血液流变学变化的影响

目的:探讨通心络胶囊治疗冠心病心绞痛的疗效机制。方法:选择符合WHO诊断标准的冠心病心绞痛患者112例,随机分为治疗组60例和对照组52例。两组均服用β受体阻滞剂、硝酸脂等西药常规治疗;治疗组在常规治疗基础上加用通心络胶囊,每次2粒,每日2次,连服2个月。观察两组患者治疗前后临床疗效、心电图疗效、甲襞微循环积分值和血液流变学变化。结果:治疗组用药后临床疗效总有效率达86.67%,心电图疗效总有效率达80.00%,与对照组(78.85%和69.23%)比较差异均有显著性(P均<0.01);治疗组甲襞微循环和血液流变学各项指标变化均优于对照组(P均<0.01)。结论:通心络胶囊治疗冠心病心绞痛疗效显著,可明显改善临床症状,逆转心电图缺血变化,显著改善甲襞微循环和血液流变学指标。     

钾通道开放剂烟酰胺治疗不稳定型心绞痛的临床研究

烟酰胺属吡啶类衍生物 ,是人工合成的钾通道开放剂。已有实践证明 ,钾通道开放剂能有效防治心肌缺血损伤 ,促进心脏功能恢复。目前尚未发现有关钾通道开放剂烟酰胺对不稳定型心绞痛患者血浆内皮素 ( ET)影响及心肌保护作用的研究报道。本研究主要是采用钾通道开放剂烟酰胺干预治疗 ,观察不稳定型心绞痛患者症状改善情况、心肌缺血变化以及血浆内皮素变化 ,进一步探讨钾通道开放剂在治疗心血管疾病中的作用机制。1　对象与方法1.1　对象 :1999年 1月— 2 0 0 3年 12月心内科住院患者 16 6例 ,符合 WHO对冠状动脉粥样硬化性心脏病 (冠心病 )…     

脂联素及其受体信号通路在肢体缺血预适应对心肌保护中的作用

目的 探讨心肌脂联素(ADP)及其受体(ADPR1)的磷脂酰肌醇-3激酶(PI3k)/磷酸化的蛋白激酶B(p-Akt)通路是否介导了肢体缺血预适应对心肌的保护作用. 方法 30只健康雄性SD大鼠,随机分为假手术组、心肌缺血-再灌注损伤组(MIRI组)、肢体缺血预适应(LIPC)组、PI3k特异性抑制剂(LY294002)预处理组和LIPC+ LY294002预处理组.分别采用RT-PCR法和Western blot法检测心肌组织中ADP和ADPR1的mRNA及PI3k和p-Akt蛋白的表达水平. 结果 与假手术组相比,MIRI组ADP (0.53±0.07比0.74±0.08)和ADPR1 (0.52±0.02比0.72±0.04)的mRNA值明显减少(P＜0.05);与MIRI组相比,LIPC组上调ADP(0.72±0.21)和ADPR1(0.80±0.02)的mRNA值(P＜0.05),LY294002则下调ADP (0.49±0.07)和ADPR1(0.52±0.02)的mRNA值(P＜0.05); LY294002+ LIPC组ADP和ADPR1的mRNA值,与MIRI组比较差异无统计学意义(P＞0.05).与假手术组相比,MIRI组PI3k(3.85±0.23)和p-Akt( 3.77±0.32)蛋白水平表达降低(P＜0.05),LIPC组PI3k(2.65±0.32)和p-Akt(2.26±0.27)蛋白水平较MIRI组表达增加(P＜0.05),LY294002组的PI3k和p-Akt蛋白几乎不表达(P＜0.05); LIPC+LY294002组大鼠心肌组织PI3k和p-Akt蛋白表达与LY90024预处理组相比差异无统计学意义(P＞0.05).心肌ADP水平与ADPR1 mRNA、PI3K和P-Akt蛋白水平呈正相关(r=0.886、0.756、0.745,P＜0.05). 结论 肢体缺血预适应通过激活ADP/PI3k/Akt信号通路发挥对心肌再灌注损伤的保护性作用.     

冠状动脉斑块形态与外周血肿瘤坏死因子、内皮素和白细胞介素-6的关系

目的通过观察冠心病患者冠状动脉粥样硬化斑块形态与血清肿瘤坏死因子(tumornecrosis factor-alpha,TNF-α)、内皮素(endothelin,ET)和白细胞介素6(Interleukin-6,IL-6)的关系,探讨斑块发生破裂的原因,进而为临床上防治不稳定斑块的破裂提供理论依据。方法测定经冠状动脉造影(Coronary angiography,CAG)确诊的230例“冠心病、心绞痛”患者以及230例CAG正常者的血清TNF-α,ET和IL-6水平,并比较其与不同冠状动脉斑块形态之间的关系。结果冠心病患者血清TNF-α,ET和IL-6水平明显高于正常对照组,2型斑块组血清上述指标水平显著高于1型3、型斑块组,且3型斑块组明显高于1型斑块组。结论冠状动脉粥样硬化的过程中有炎症反应参与,炎症因子TNF-α,ET和IL-6水平与冠状动脉病变斑块形态均是导致冠状动脉斑块破裂的重要因素。     

高血压左室肥厚的研究进展

左室肥厚（LVH）是高血压最常见的亚临床靶器官损害之一,是高血压患者心血管不良预后的重要标志,及早发现并逆转LVH有重要的临床意义。该文介绍高血压LVH的流行病学、机制,以及与心血管疾病关系的相关研究。     

选择性冠状动脉造影556例分析

目的　评价选择性冠状动脉造影 (SCA)在临床上的应用及冠心病的临床特点。方法　对 5 5 6例SCA结果进行分析 ,对比冠状动脉狭窄与冠状动脉正常的部分临床特征 ,总结冠状动脉狭窄的病变情况 ,部分数据进行统计学处理。结果　冠心病患者年龄较大 ,男性为多 ,病变依次累及左前降支、右冠状动脉、左回旋支及左主干 ,多为单支病变 ,左主干病变最少 ,冠脉造影不良反应少见。结论　SCA是一种安全有效的检查方法 ,冠心病以老年男性为多 ,多累及一支血管。     

HMGB1对缺氧复氧环境下心肌细胞凋亡的影响及机制研究

目的 探讨高迁移率蛋白1(HMGB1)对缺氧复氧环境下心肌细胞凋亡的影响及机制。 方法 心肌细胞H9C2分为正常组、H/R组、siRNA-NC组、HMGB1 siRNA组。其中正常组细胞为正常培养的H9C2细胞,H/R组、siRNA-NC组、HMGB1 siRNA组细胞分别进行缺氧复氧处理,HMGB1 siRNA组、siRNA-NC组细胞在缺氧处理前48 h分别转染HMGB1小干扰RNA(HMGB1 siRNA)和小干扰RNA阴性对照(siRNA control)。RT-PCR和Western blot检测细胞中HMGB1表达水平,流式细胞术检测细胞凋亡,试剂盒检测细胞中丙二醛(MDA)、超氧化物歧化酶(SOD)水平及培养液上清中乳酸脱氢酶(LDH)水平,Western blot检测信号转导与转录因子3(STAT3)、磷酸化的STAT3(p-STAT3)、活化的含半胱氨酸的天冬氨酸蛋白水解酶3(Cleaved Caspase-3)蛋白表达水平。 结果 与正常组相比,H/R组细胞中HMGB1 mRNA、HMGB1蛋白、细胞凋亡率、LDH和MDA、 Cleaved Caspase-3水平显著升高(P<0.05),而SOD、p-STAT3水平明显降低,差异均有统计学意义(P<0.05)。siRNA-NC组细胞中HMGB1 mRNA和蛋白水平、细胞凋亡率、LDH、MDA及SOD水平、STAT3、p-STAT3、Cleaved Caspase-3水平与H/R组相比差异无统计学意义(P>0.05)。与H/R组相比,HMGB1 siRNA组细胞中HMGB1 mRNA、HMGB1蛋白、细胞凋亡率、LDH和MDA、 Cleaved Caspase-3水平明显降低,而SOD、p-STAT3水平明显升高,差异均有统计学意义(P<0.05)。 结论 HMGB1表达下调可能通过降低缺氧复氧对心肌细胞的氧化损伤而抑制心肌细胞凋亡。     

补阳还五汤对老龄大鼠脑缺血再灌注海马齿状回细胞增殖分化的影响

BACKGROUND： The mobilization of endogenous stem cells is an effective way to promote repair following ischemic brain damage. Buyang Huanwu decoction （BHD） can effectively improve cerebral blood flow and protect against cerebral ischemia/reperfusion damage. OBJECTIVE： To study the effects of BHD on cell proliferation and differentiation in the hippocampal dentate gyrus of rats following cerebral infarction, to investigate the protective effects of BHD against cerebral infarction, and to analyze the dose-effect relationship. DESIGN, TIME AND SETTING： This randomized, controlled, animal study was performed at the Laboratory of Department of Physiology, Henan College of Traditional Chinese Medicine, China from June 2007 to February 2008. MATERIALS： A total of 36 male, Sprague Dawley rats, aged 20-21 months, were equally and randomly assigned to the following groups： sham operation, model control, and nimodipine, as well as high-dose, moderate-dose, and low-dose BHD. BHD was composed of milkvetch root, Chinese angelica, red peony root, earthworm, peach seed, safflower, and Szechwan Iovage rhizome, which were provided by the Outpatient Department, Henan College of Traditional Chinese Medicine, China. METHODS： The Chinese medicinal ingredients described above were decocted. The external carotid artery was ligated in rats from the sham operation group. Rat models of focal cerebral infarction were established by middle cerebral artery occlusion in the model control and nimodipine groups, as well as the high-dose, moderate-dose, and low-dose BHD groups. The drugs were administered by gavage 5 days, as well as 2 hours, prior to model induction. Rats in the nimodipine group were daily administered a 6 mg/kg nimodipine suspension by gavage. Rats in the high-dose, moderate-dose, and low-dose BHD groups were administered daily 26, 13, and 6.5 g/kg BHD, respectively. Rats in the sham operation and model control groups were treated with an equal volume of saline. MAIN OUTCOME MEASURES： The effects of BHD on neurological dysfunction score, brain water content, cell proliferation and differentiation in the hippocampal dentate gyrus, and pathological changes in the ischemic brain hemisphere were measured in cerebral infarction rats. RESULTS： Compared with the sham operation group, the neurological dysfunction score, brain water content, number of BrdU-positive cells, BrdU/NeuN-positive cells, and BrdU/GFAP-positive cells in the hippocampal dentate gyrus significantly increased in the model control group （P 〈 0.01 ）. Compared with the model control group, neurological dysfunction score and brain water content were significantly decreased （P 〈 0.01 or 0.05）, as were the number of BrdU-positive and BrdU/NeuN-positive cells （P 〈 0.01 or 0.05）. The number of BrdU/GFAP-positive cells was significantly reduced （P 〈 0.05） in the nimodipine group, high-dose, moderate-dose, and low-dose BHD groups. Compared with the nimodipine group, the neurological dysfunction score was significantly reduced in the moderate-dose BHD group （P 〈 0.05）. However, the number of BrdU-positive cells was significantly increased in the rat hippocampal dentate gyrus in the high-dose and moderate-dose BHD groups （P 〈 0.01 or 0.05）. The following was determined by microscopy： slightly disarranged neural cells, mild vascular dilatation, inflammatory cell infiltration, and light tissue edema were observed in the nimodipine group; inflammatory celt infiltration was reduced in the low-dose BHD group; cerebral edema and inflammatory cell infiltration were significantly reduced in the high-dose and in the moderate-dose BHD group. Electron microscopy revealed lipofuscin, slightly swollen mitochondria, and normal rough endoplasmic reticulum in the high-dose and moderate-dose BHD groups. Improvement was best in the moderate-dose BHD group. CONCLUSION： Cerebral ischemia activated proliferation of neural stem cells in the rat hippocampal dentate gyrus. The actions of BHD against cerebral ischemia/reperfusion damage correlated with proliferation and differentiation of neural stem cells in the hippocampal dentate gyrus. A moderate-dose of BHD resulted in the most effective outcome.