补肾法对颈动脉粥样硬化患者颈动脉血流动力学的影响

目的:观察补肾中药对颈动脉粥样硬化患者颈动脉粥样硬化程度和血流动力学的影响。方法:将125例颈动脉粥样硬化患者随机分为治疗组64例,对照组61例,对照组口服舒降之和肠溶阿司匹林,治疗组口服补肾汤,治疗3个月后观察两组患者颈动脉粥样硬化程度和血流动力学变化。结果:两组治疗后颈动脉平均斑块数量、颈动脉管腔直径、平均斑块面积以及颈动脉收缩期血流速度(SPV)、舒张期末血流速度(EDV)明显降低(P<0.01),血流量较治疗前显著升高(P<0.01),治疗组治疗后颈动脉平均斑块数量、平均斑块面积以及SPV、EDV明显低于对照组,血流量显著高于对照组(P<0.01)。结论:补肾中药可调节颈总动脉血流动力学,提高颈动脉血流量,抑制颈动脉粥样硬化。     

Atherosclerosis in women with endometriosis

OBJECTIVE: This study aims to determine whether women with endometriosis have greater subclinical atherosclerosis than the general population. STUDY DESIGN: This case-control study included 66 women with endometriosis and 66 controls matched for age and body mass index. All subjects were >or=35 years old. Exclusion criteria were obesity, diabetes, hypertension, hyperlipidemia, renal or metabolic diseases. Before laparoscopy, all patients underwent a measurement of intima-media thickness (IMT) and distensibility coefficient (DC) on the common carotid artery. In addition, blood samples were taken to determine the levels of lipids, fibrinogen, C-reactive protein, homocysteine, fasting glycemia, antithrombin III, plasminogen, protein C, protein S, and activated protein C resistance. RESULTS: All the biochemical parameters evaluated had similar levels in the two study groups. IMT was similar in women with endometriosis and in controls both on left (p=0.330) and right (p=0.648) carotid artery. Similarly, no significant difference was observed in the DC between women with endometriosis and controls both on left (p=0.539) and right (p=0.178) carotid artery. No significant difference was observed in IMT and DC between women with mild and severe endometriosis. CONCLUSION: Women with endometriosis do not have more subclinical atherosclerosis than the general population.     

瑞舒伐他汀与辛伐他汀治疗高脂血症临床疗效比较

目的 比较瑞舒伐他汀与辛伐他汀治疗高脂血症的疗效及安全性.方法 选择2015年6月至2016年6月期间我院收治的128例高脂血症患者为研究对象,根据随机数表法随机分为观察组(n=64)与对照组(n=64),分别予瑞舒伐他汀(5 mg/d)与辛伐他汀(10 mg/d)治疗,疗程均为8周.比较两组患者治疗前后的血脂变化及不良反应发生情况.结果 治疗后,观察组与对照组患者的甘油三脂(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)分别为(1.88±0.21)mmol/L、(4.28±1.28)mmol/L、(2.48±0.97)mmol/L和(1.94±0.19)mmol/L、(4.44±1.35)mmol/L、(3.04±1.02)mmol/L,均较治疗前的(2.38±0.36)mmol/L、(6.25±2.34)mmol/L、(4.79±1.28)mmol/L和(2.25±0.23)mmol/L、(6.04±2.41)mmol/L、(4.86±1.36)mmol/L明显下降,高密度脂蛋白胆固醇(HDL-C)为(1.38±0.29)mmol/L和(1.34±0.41)mmol/L,均较治疗前的(1.25±0.34)mmol/L和(1.22±0.35)mmol/L明显上升,差异均有统计学意义(P<0.05);治疗后观察组患者仅LDL-C明显低于对照组(P<0.05),差异均无统计学意义(P>0.05);观察组患者的LDL-C达标率为82.81%,明显高于对照组的62.50%,差异均有统计学意义(P<0.05);两组患者均未发现药物相关严重不良反应.结论 瑞舒伐他汀与辛伐他汀均可有效调节高脂血症患者血脂水平,但是瑞舒伐他汀降LDL-C的效果更加明显,且具有较好的用药安全性.     

应用丙基硫氧嘧啶复制动脉粥样硬化模型中对大鼠心脏损伤的影响

目的通过高脂饲料结合免疫损伤方法复制大鼠动脉粥样硬化模型,并观察丙基硫氧嘧啶在动脉粥样硬化模型复制中对大鼠心脏损伤的影响。方法选择36只雄性Wistar大鼠,随机分为正常组、高脂饲料组和高脂饲料+丙基硫氧嘧啶组,后两组同时辅以免疫损伤和腹腔注射VD3,饲养90 d后,测定和观察血液生化指标、病理变化、免疫组化情况。结果 (1)高脂+丙基硫氧嘧啶组与高脂组和正常组相比较,心肌损伤指标肌酸激酶、肌酸激酶同工酶差异均有显著性(P<0.05);(2)HE染色发现高脂+丙基硫氧嘧啶组心肌细胞排列紊乱、水肿,血管内壁增厚,泡沫细胞和少量炎性细胞浸润;(3)免疫组化法方法测定心肌细胞中Bcl-2和Bax的表达,高脂+丙基硫氧嘧啶组表达显著升高(P<0.05),心肌细胞凋亡加速。结论丙基硫氧嘧啶在应用于大鼠动脉粥样硬化模型复制中,对大鼠心肌病理学及Bcl-2、Bax蛋白表达产生影响。     

Interventional therapy for chronic simple atherosclerotic occlusive disease of lower extremity

Objective： To explore the efficacy of interventional therapy for chronic atherosclerotic occlusive disease of the lower extremity. Methods： Fifty-six cases of simple atherosclerotic occlusive disease of lower extremity were divided into 3 types according to the location of occhision, including 17 cases of abdominal aorta-iliac artery, 18 cases of iliac-femoral artery, and 21 cases of inferior popliteal artery. Catheter and guide wire combined with blunt dissection and subtle banding were used to dredge the occluded vessels, and stents were implanted when interlayer appeared. Results： After the treatment, 46 cases of occlusion were dredged （82.1%）, 6 cases remained occluded with the same symptoms （10.7%）, and 4 cases had severer symptoms （7.1%）. Among the 46 successful cases, there were 16 cases of abdominal aorta-iliac artery （94.1%）, 16 cases of iliac-femoral artery （88.9%） and 14 cases of inferior popliteal artery, artery （66.6%）. There was no statistical difference between the abdominal aorta-iliac artery cases and iliac-femoral artery cases （P〉0.05）, but there was statistical difference between these two types and the inferior popliteal artery cases （P〈0.05）. In the successful cases, 9 cases of abdominal aorta-iliac artery （52.9%）, 10 cases of iliac-femoral artery （55.5%） and 10 cases of inferior popliteal artery （33.3%） had 5-10 cm of occlusion, with no statistical difference between the first two types （P〉0.05）, but with statistical difference between the first two types and the third type （P〈0.05）. Compared with the 14 dredged cases （71.4%）, the 7 cases （33.3%） of inferior popliteal artery cases had richer compensatory circulation （P〈0.05）. Conclusion： It＇s safe and effective to treat simple atherosclerotic occlusive disease of the lower extremity with interventional therapy. The location and length of occlusion and the abundance of compensatory circulation had effect on the therapy.     

兔动脉粥样硬化发病机制的实验研究

目的:通过兔动脉粥样硬化中血脂含量、一氧化氮(NO)及诱导性一氧化氮合成酶(iNOS)和纤溶酶原激活物抑制物-1(PAI-1)的表达,探讨免动脉硬化的发病机制。方法:将健康雄性新西兰兔16只随机分为两组(n=8):空白对照组(N组)、AS模型组(M组),常规高脂饮食构建动脉粥样硬化模型,喂养12周,全自动生化分析仪检测血清脂蛋白的表达水平,硝酸还原酶法检测家免血清NO水平;免疫组织化学法检测主动脉组织iNOS和PAI-1蛋白表达,半定量逆转录聚合酶链反应(RT-PCR)技术检测免主动脉组织iNOSmRNA和PAI-1 mRNA的表达。结果:与对照组相比,模型组血清NO含量明显升高(P<0.01)。主动脉组织iNOS和PAI-1组化染色及iNOS mRNA和PAI-1 mRNA的表达均明显增强(P<0.01)。结论:动脉硬化的发生机制和血脂的升高及iNOS和PAI-1的表达升高有着密切联系。     

脑梗死患者颈动脉彩色多普勒超声研究

目的 探讨颈动脉粥样硬化及其危险因素与不同类型的脑梗死间的关系。方法：根据头颅ＣＴ或ＭＲＩ结果将１８８例脑梗死患者分成四个亚组：皮层梗死组（ＣＩ）,皮层下梗死组（ＳＣＩ）,椎－基底动脉支配区梗死组（ＶＢＡＩ）及心源性脑栓塞组（ＣＥＩ）,用彩色多勒超声（彩超）对各型脑梗死患者颅外颈动脉粥样硬化严重程度进行评估,并对可能危险因素进行探讨。结果 ３０％的ＣＩ组患者,１０％ＣＥＩ患者,６．９％ＶＢＡＩ患者     

金属硫蛋白和瑞舒伐他汀对小鼠动脉粥样硬化和SM22α表达的影响

目的 探讨金属硫蛋白（MT）和HMG-CoA还原酶抑制剂瑞舒伐他汀对ApoE基因缺陷小鼠动脉粥样硬化以及血管平滑肌22α蛋白（SM22α）表达的影响.方法 30只6周龄雄性ApoE基因缺陷小鼠随机分为高脂模型组、瑞舒伐他汀组、金属硫蛋白组,高脂饮食喂养13周;10只背景品系雄性C57BL/6J小鼠作为正常对照组,正常饮食喂养13周.13周后,摘眼球取血测定血浆总胆固醇（TCH）、甘油三酯（TG）、低密度脂蛋白（LDL-C）的水平,处死小鼠后取主动脉,剪取主动脉弓部位5 mm长主动脉用10％甲醛固定,石蜡包埋,切片,HE染色及SM22α免疫组织化学染色;其余标本-80℃保存,取100 mg主动脉组织两份,分别提取总蛋白和RNA,并做WesternBlot和RT-PCR检测,观察主动脉血管壁形态学变化,定性和定量分析主动脉组织SM22α表达强度变化.结果 与高脂模型组比较,瑞舒伐他汀组血清中TCH、TG、LDL-C水平显著降低（P＜0.05）;金属硫蛋白组与高脂高脂模型组比较,TCH、TG、LDL-C水平无统计学差异（P＞0.05）;和正常对照组相比,高脂模型组主动脉粥样硬化病变程度明显加重,免疫组织化学、Western Blot和RT-PCR方法分析主动脉SM22α蛋白和mRNA的表达均明显减少;金属硫蛋白和瑞舒伐他汀组主动脉粥样硬化病变程度减轻,SM22α蛋白和mRNA的表达均增加.结论 金属硫蛋白对血脂无明显影响,瑞舒伐他汀降低血脂作用明显;ApoE基因缺陷小鼠主动脉组织动脉粥样硬化明显且SM22α表达减少,金属硫蛋白和瑞舒伐他汀可减轻主动脉粥样硬化病变程度并可增加主动脉SM22α的表达.     

沙棘黄酮对粥样硬化大鼠NADPH氧化酶亚基Nox4及ox-LDL的影响

目的：探讨沙棘黄酮（TFH）对粥样硬化大鼠NADPH氧化酶亚基Nox4及ox-LDL的影响及机制。方法将50只SD大鼠随机分为：正常对照组（CON组）、粥样硬化组（AS组）、沙棘黄酮低、中、高剂量组,除CON组其余4组喂高脂饲料,TFH低、中、高剂量组以不同剂量TFH灌胃,60 d后,取血清测定SOD、MDA及ROS水平, ELISA技术测主动脉ox-LDL和Nox4蛋白表达水平。结果 AS组比CON组SOD下降,MDA及ROS含量升高;沙棘黄酮干预能改善以上指标;沙棘黄酮降低了AS大鼠Nox4及 oxLDL蛋白表达水平。结论沙棘黄酮可降低AS大鼠Nox4及ox-LDL蛋白表达从而减少ROS生成防治粥样硬化。     

不同病因心房颤动患者卒中危险的评估

目的 本研究旨在比较不同病因的房颤患者左心耳血栓前状态、血栓形成以及临床缺血性脑卒中发生率的异同.方法 持续性房颤患者140例,按是否存在动脉粥样硬化相关疾病,分为伴有动脉粥样硬化相关疾病组(AS组)和非动脉粥样硬化相关疾病组(NAS组),应用经胸超声和经食管超声(TEE)技术,比较两组患者心脏结构和功能改变,检测患者左心耳血流速度,观察是否存在重度自发声学显影(SEC)、血栓以及临床是否存在缺血性脑卒中.结果 与NAS组比较,AS组患者左心耳重度SEC(71.6％ vs 47.0％)、左心耳血栓(35.1％ vs16.7％)和缺血性脑卒中(19.8％ vs 9.9％)的发生率显著增加(P＜0.05);两组间左室收缩功能、左房内径和面积、左心耳面积和血流速度均差异无统计学意义(P＞0.05).结论 伴有动脉粥样硬化相关疾病的房颤患者左心耳血栓前状态、血栓形成以及临床缺血性脑卒中的发生率显著高于非动脉粥样硬化相关疾病的房颤患者,提示对此类患者的处理需要独特的策略,为房颤患者抗凝治疗的个体化研究提供了依据.