2型糖尿病大血管病变与C肽水平相关性研究

目的探讨2型糖尿病（T2DM）性大血管病变与C肽之间的关系。方法对252例T2DM患者进行临床资料的回顾性分析,根据有无血管病变分为大血管病变组及对照组,分析两组患者病史及空腹血糖（FBG）、餐后2h血糖（PBG）、糖化血红蛋白（HbA1C）、空腹C肽（FCP）、餐后2h C肽（PC）、甘油三脂（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、尿酸（UA）等临床指标。结果两组间比较,大血管病变组患者的年龄较大、病程较长、FCP较低,差异有显著统计学意义（P〈0.01）;FBG、PBG、HbA1C及LDL-C均高于对照组,HDL-C低于对照组,差异有统计学意义（P〈0.05）,然而PC差异无统计学意义（P＆gt;0.05）。Logistic回归分析结果显示年龄、吸烟、FBG为2型糖尿病大血管病变危险因素,（P〈0.05）,而HDL-C及FC为保护因素（P〈0.05）。结论 2型糖尿病的大血管病变是常见并发症,C肽可能对2型糖尿病的大血管病变具有保护作用。     

Soluble guanylate cyclase

Soluble guanylate cyclase (sGC) is a heterodimeric haemoprotein, which represents the intracellular receptor for the ubiquitous biological messenger nitric oxide (NO). Activation of the enzyme facilitates conversion of GTP to the intracellular second messenger cGMP, and it is this molecule which mediates the majority of biological actions attributed to NO. sGC is expressed in virtually all mammalian cells and is important in mediating numerous physiological processes, including vascular and non-vascular smooth muscle relaxation, peripheral and central neurotransmission, platelet reactivity and phototransduction. Due to its ubiquitous nature, the pathogenesis of various disease states has been linked to aberrations in sGC signalling. This is especially true of the cardiovascular system, where inappropriate activation of sGC may underlie conditions such as stroke, atherosclerosis, impotence and septic shock; however, altered sGC activation has also been associated with the pathogenesis of asthma and certain neurodegenerative disorders. Therefore, agents that can modulate sGC function selectively will have considerable therapeutic potential, particularly in the treatment of cardiovascular disease.     

稳心颗粒治疗冠状动脉粥样硬化性心脏病心绞痛37例

目的观察稳心颗粒治疗冠状动脉粥样硬化性心脏病(简称冠心病)心绞痛的疗效及安全性。方法选取2010年12月至2011年12月冠心病心绞痛患者74例,随机分为两组,对照组37例采用常规治疗,观察组37例在常规治疗基础上采用稳心颗粒治疗,对比两组的临床疗效及心电图改变情况。结果观察组的总有效率为75.68%,明显高于对照组的54.05%(P<0.05)。治疗后两组ST段平均下移和T波平均下移明显减少(P<0.05),观察组明显少于对照组(P<0.05)。两组均未见严重不良反应。结论稳心颗粒治疗冠心病心绞痛疗效明显,可改善患者心电图状态,值得临床推广。     

动脉粥样硬化内膜损伤模型研究现状

动脉粥样硬化(AS)动物模型的研制对研究AS发病机制、病理变化及其防治起着至关重要的作用。现已运用不同动物成功地建立了多种方法诱导的AS模型。文章对近年AS动物模型的研究进行比较,期望为今后的研究提供一定的线索。     

Coronary artery lesion distribution in patients with chronic kidney disease undergoing percutaneous coronary intervention

PurposeTo determine the location of coronary atherosclerosis distribution observed in patients with chronic kidney disease (CKD).MethodsA cross-sectional study was conducted using the database of cardiovascular medicine data from Saitama Sekishinkai Hospital to clarify the association between renal function and angiographic characteristics of coronary atherosclerosis. In total, 3268 patients who underwent percutaneous coronary intervention were included. Propensity score matching revised the total to 1772. The association of renal function with the location and/or distribution of coronary atherosclerosis lesions was then examined.ResultsOverall, coronary lesion was observed in the left anterior descending coronary artery (LAD) in 56% patients, whereas 28% and 22% were in the right coronary artery (RCA) and left circumflex coronary artery (LCX), respectively. LAD was most affected and observed in 57% patients with stage 1 CKD. RCA was second-most affected, at 26% CKD stage 1, but it increased to 31%, 38%, and 59% in CKD 3, 4, and 5, respectively. In CKD 5 patients, the RCA was the most affected artery (59%), with 41% LAD lesions. Logistic regression analysis after propensity score matching showed that the odds ratios for an RCA lesion was 3.658 in CKD 5 (p = .025) compared with CKD 1 after adjusting for traditional risk factors.ConclusionThe prevalence of RCA lesions, but not LAD or LCX lesions, increased with increasing CKD stage. The pathophysiology of coronary atherosclerosis may differ by lesion location. Deterioration of renal function may affect progression of atherosclerosis more in the RCA than in the LAD or LCX.     

血清RBP4、visfatin、RIPK1水平在冠心病伴颈动脉粥样硬化患者中的表达及临床意义

目的 探究血清视黄醇结合蛋白4(RBP4)、内脏脂肪素(visfatin)、受体相互作用蛋白激酶1(RIPK1)水平在冠心病伴颈动脉粥样硬化(CAS)患者中的表达及临床意义。方法 选取2020年2月至2021年2月于该院就诊的163例冠心病患者作为研究对象,按是否伴CAS分为冠心病组79例和冠心病伴CAS组84例。同期选取72例于该院进行体检的体检健康者作为健康组,检测上述研究对象血清RBP4、visfatin、RIPK1水平并分析其与冠心病伴CAS组的相关性。结果 与健康组、冠心病组相比,冠心病伴CAS组血清RBP4、visfatin、RIPK1水平较高,差异有统计学意义(P<0.05)。与中度、轻度冠心病伴CAS患者相比,重度冠心病伴CAS患者血清RBP4、visfatin、RIPK1水平较高,差异有统计学意义(P<0.05);Pearson相关性分析显示,RBP4、Gensini评分呈正相关(r=0.429,P=0.001);RBP4、Gensini评分呈正相关(r=0.486,P=0.001);visfatin、Gensini评分呈正相关(r=0.630,P=0.0...     

阻塞性睡眠呼吸暂停低通气综合征与亚临床动脉粥样硬化

阻塞性睡眠呼吸暂停低通气综合征是心血管疾病的独立危险因素,严重影响患者的生命质量和生存时间,也是可以改变的心血管疾病危险因素之一。动脉粥样硬化是造成心血管疾病的病理基础,而大量研究发现阻塞性睡眠呼吸暂停低通气综合征与亚临床动脉粥样硬化相关,综述阻塞性睡眠呼吸暂停低通气综合征与亚临床动脉粥样硬化的研究进展,并梳理其中发病机制,为阻塞性睡眠呼吸暂停低通气综合征患者动脉粥样硬化的预防和早期干预提供依据。     

树突状细胞分布与糖尿病大鼠主动脉内膜增生的关系

目的 探讨糖尿病大鼠树突状细胞在外周血、动脉壁以及脾脏分布情况及与主动脉内膜增生的关系.方法 链脲菌素腹腔注射及经高脂饮食喂养8周形成糖尿病大鼠内膜增生模型,分别取外周血、动脉壁以及脾脏组织.并制备组织单细胞悬液.应用流式细胞仪检测树突状细胞及T淋巴细胞比例情况.结果 糖尿病大鼠及高脂饮食喂养合并糖尿病大鼠内膜较正常对照大鼠内膜增生明显(P＜0.05),其外周血树突状细胞分布明显减少且主动脉内树突状细胞比例明显升高(P＜0.05).T淋巴细胞比例检测同样发现,糖尿病大鼠及高脂饮食喂养合并糖尿病大鼠较正常大鼠,外周血及主动脉内T淋巴细胞比例升高(P＜0.05).结论 糖尿病大鼠及高脂饮食喂养的糖尿病大鼠主动脉内膜增生与树突状细胞及T淋巴细胞比例变化呈一定相关关系,树突状细胞等免疫细胞在糖尿病大鼠主动脉内膜增生形成中可能起重要作用.     

阿托伐他汀钙对冠心病颈动脉粥样硬化患者颈动脉粥样硬化斑块的影响

目的探讨冠心病颈动脉粥样硬化患者给予阿托伐他汀钙治疗对颈动脉粥样硬化斑块的影响。方法收集冠心病颈动脉粥样硬化患者45例,均给予阿托伐他汀钙口服治疗。观察血脂水平变化和颈动脉粥样硬化斑块变化。结果治疗后2、4、12周时患者TC、TG、LDL-C等指标水平明显下降,HDL-C明显上升;治疗后颈动脉内膜中层厚度(IMT)、斑块总面积和斑块总得分均低于治疗前,差异均具有统计学意义(P<0.05)。结论在冠心病颈动脉粥样硬化的临床治疗中进行调脂治疗可改善粥样硬化斑块,对患者的预后具有积极的临床意义。     

High-density lipoprotein-based drug discovery for treatment of atherosclerosis

Introduction: Although there has been great progress achieved by the use of intensive statin therapy, the burden of atherosclerotic cardiovascular disease (CVD) remains high. This has initiated the search for novel high-density lipoprotein (HDL)-based therapeutics. Recent years have witnessed a shift from traditional raising HDL-C levels to enhancing HDL functionality, in which the process of reverse cholesterol transport (RCT) has acquired much attention.

Areas covered: In this review, the authors describe the key factors involved in RCT process for potential drug targets to reduce the CVD risk. Furthermore, the review provides a summary of the effective screening methods that have been developed to target RCT and their applications. This review also introduces some new strategies currently being clinically developed, which have the potential to improve HDL function in the RCT process.

Expert opinion: It is rational that the functionality of HDL is more important than the plasma HDL-C level in the evaluation of pharmacological treatment in atherosclerosis. HDL-based strategies designed to promote macrophage RCT are a major area of current drug discovery and development for atherosclerotic diseases. A better understanding of the functionality of HDL and its relationship with atherosclerosis will expand our knowledge of the role of HDL in lipid metabolism, holding promise for a future successful HDL-based therapy.