老年人冠心病与高血压,血脂,血糖,血尿酸关系分析

目的探讨冠心病的发病与高血压,血脂,血糖,血尿酸的关系。方法抽取2003年住院及门诊老年人(>60岁)病例共78例,以心电图,活动平板试验,心动超声,同位素扫描,冠脉造影的检查结果分为冠心病组(50例)和非冠心病组(28例),即对照组。合并其他心血管病的病例不在本项研究的入选中。有服用降脂药物的患者,停服降脂药物两周后再检测血液的生化指标。两组均采用OLYMPUSAU400测定血液的生化指标。结果冠心病组病人同时合并有高血压的发生率显著高于对照组(P<005),两组的低密度脂蛋白和血糖有显著差别(P<001和P<005)。胆固醇,甘油三脂,高密度脂蛋白,载脂蛋白A,载脂蛋白B和血尿酸指标的差别无统计学意义(P>005)。结论高血压作为冠心病的危险因素是老年人防治冠心病的重点内容,降低LDL或提升HDL/LDL比值以及防治胰岛素抵抗对防治老年人的冠心病有积极的意义。     

氟伐他汀治疗对不稳定心绞痛患者 CRP、PAI-1、Fib的影响

目的 观察不稳定心绞痛患者口服氟伐他汀后血脂和CRP、PAI-1、Fib的变化，探讨氟伐他汀应用的临床意义。方法不稳定心绞痛患者46例，常规治疗20例，常规治疗的基础上加口服氟伐他汀26例。治疗前和治疗后1周抽血查血脂、CRP、PAI-1、Fib，结果进行统计学分析。结果 治疗组治疗后较治疗前血脂情况改善，同时，治疗组治疗后CRP、PAI-1、Fib较治疗前得到改善，有统计学意义。结论 早期应用氟伐他汀即影响CRP、PAI-1、Fib，建议不稳定型心绞痛患者应尽量早期口服氟伐他汀治疗。     

血清Hcy、ADMA、UA水平与ACEI类药物治疗高血压合并脑卒中的疗效关联分析

目的:探讨血清Hcy、ADMA、UA水平与ACEI类药物治疗高血压合并脑卒中的疗效的关联性.方法:收集2014年1月~2016年6月来我院就诊的高血压合并脑卒中患者164例,随机分为试验组和对照组,每组82例.两组患者根据高血压脑卒中的基本治疗原则统一给予常规对症治疗,试验组额外给予ACEI类药物赖诺普利治疗.同期收集来我院体检健康的志愿者82例,为健康组.观察两组患者治疗有效率,治疗前后后血清Hcy、ADMA和UA水平变化,并与健康组进行比较,进一步分析各组有效与无效患者血清水平差异.结果:试验组治疗有效率明显高于对照组,两组患者治疗前及对照组患者治疗后血清HCY、ADMA和UA水平均明显高于健康组,试验组患者治疗后上述血清水平明显低于对照组,两组中有效患者血清水平均低于无效患者,上述差异分别经t检验或卡方检验比较,差异均具有统计学意义.并针对上述血清水平与患者治疗效果进行logistics回归相关性分析,差异亦具有统计学意义,且各项分子最大似然估计值和OR值均<0.结论:血清Hcy、ADMA、UA水平与ACEI类药物治疗高血压合并脑卒中的疗效存在明显的相关性.     

通脉活血汤治疗冠心病不稳定型心绞痛30例

冠心病是临床常见多发的心血管疾病,采用通脉活血汤治疗不稳定型心绞痛30例,取得了较好的疗效,值得临床推广使用。     

Assessing the potential of angiotensin II type 1 receptor and donor specific anti-endothelial cell antibodies to predict long-term kidney graft outcome

Endothelial cell antigens have been reported as potential targets for antibodies in the context of organ transplantation, leading to increased risk for graft failure. Serum samples from 142 consecutive living donor kidney recipients were tested for the presence of antibodies to angiotensin II – type 1 receptor (AT1R), donor endothelial cells, and donor HLA. Graft survival was monitored for five years post-transplant, and secondary outcomes, including biopsy-proven rejection, proteinuria, biopsy-proven vasculopathy, and renal function based on serum creatinine were also assessed for the first two to three years. AT1R antibody levels were positive (>17 U/mL) in 11.3%, 18.8% and 8.1% of patients pre-transplant, post-transplant and at time of indication biopsy, respectively. XM-ONE assay was positive in 17.6% of patients pre-transplant (7 IgG+; 15 IgM+; 3 IgG+/IgM+). Overall, 4 patients experienced antibody-mediated rejection (AMR), 31 borderline cellular rejection (BCR), 19 cellular rejection (CR) and 3 mixed AMR and CR within the first 24 months. While pre-existing and de novo donor-specific HLA antibodies were associated with graft failure and many secondary outcomes, no statistical association was found for either anti-endothelial or anti-AT1R antibodies, indicating that these tests may not be the best predictors of graft outcome in living donor renal transplantation.     

Lower serum UA levels in Parkinson's disease patients in the Chinese population

Parkinson's disease (PD) is the second most common neurodegenerative disease in the world, and oxidative stress plays an important role in its pathogenesis. Uric acid (UA) is a product of purine metabolism and is a natural antioxidant that can relieve the oxidative stress that occurs in PD. Recent studies have indicated that the serum UA level are associated with a risk of PD and PD progression of motor symptoms and have proposed UA as a possible biomarker of the underlying pathophysiology of PD. In our study, we investigated the association between serum UA level and PD in a Chinese population. We found that the serum UA levels in PD patients were lower than the levels in control patients and were correlated with PD progression and duration in the Chinese population. These associations were observed in both genders, but hyperuricemia is more strongly associated with lower rates of PD among men compared to women and older people compared to younger people. Our results indicate that UA could be an important biomarker of PD and that the serum UA level could be a useful biomarker of PD diagnosis and disease progression.     

Reclassification of Treatment Strategy With Instantaneous Wave-Free Ratio and Fractional Flow Reserve: A Substudy From the iFR-SWEDEHEART Trial

Objectives

The authors sought to compare reclassification of treatment strategy following instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR).

Combined Transradial and Transpedal Approach for Femoral Artery Interventions

Objectives

The purpose of this prospective study was to evaluate the acute success and complication rates of combined transradial and transpedal access for femoral artery intervention.

Efficacy and safety of alirocumab in insulin-treated patients with type 1 or type 2 diabetes and high cardiovascular risk: Rationale and design of the ODYSSEY DM–INSULIN trial

AimsThe coadministration of alirocumab, a PCSK9 inhibitor for treatment of hypercholesterolaemia, and insulin in diabetes mellitus (DM) requires further study. Described here is the rationale behind a phase-IIIb study designed to characterize the efficacy and safety of alirocumab in insulin-treated patients with type 1 (T1) or type 2 (T2) DM with hypercholesterolaemia and high cardiovascular (CV) risk.MethodsODYSSEY DM–INSULIN (NCT02585778) is a randomized, double-blind, placebo-controlled, multicentre study that planned to enrol around 400 T2 and up to 100 T1 insulin-treated DM patients. Participants had low-density lipoprotein cholesterol (LDL-C) levels at screening ≥ 70 mg/dL (1.81 mmol/L) with stable maximum tolerated statin therapy or were statin-intolerant, and taking (or not) other lipid-lowering therapy; they also had established CV disease or at least one additional CV risk factor. Eligible patients were randomized 2:1 to 24 weeks of alirocumab 75 mg every 2 weeks (Q2W) or a placebo. Alirocumab-treated patients with LDL-C ≥ 70 mg/dL at week 8 underwent a blinded dose increase to 150 mg Q2W at week 12. Primary endpoints were the difference between treatment arms in percentage change of calculated LDL-C from baseline to week 24, and alirocumab safety.ResultsThis is an ongoing clinical trial, with 76 T1 and 441 T2 DM patients enrolled; results are expected in mid-2017.ConclusionThe ODYSSEY DM–INSULIN study will provide information on the efficacy and safety of alirocumab in insulin-treated individuals with T1 or T2 DM who are at high CV risk and have hypercholesterolaemia not adequately controlled by the maximum tolerated statin therapy.