川芎嗪注射液对急性脑梗死患者血清sCD40L及hs—CRP水平的影响

目的：观察川芎嗪注射液对急性脑梗死患者血清可溶性CD40配体（sCD40L）及超敏C-反应蛋白（hs-CRP）水平的影响。方法：采用随机对照的方法,将78例急性脑梗死患者随机分成治疗组和对照组,每组39例。所有患者均采用西医常规方法进行治疗,治疗组患者在此基础上加用川芎嗪注射液治疗,疗程为14d。评价两组患者的临床疗效及神经功能缺损评分,观察治疗前后两组患者血清sCD40L和hs—CRP水平的变化。结果：治疗后,治疗组和对照组的总有效率分别为92．31％和74．36％,治疗组的疗效优于对照组（P〈0．05）。治疗后,两组患者的血清sCD40L及hs—CRP水平均显著降低（P〈0．01）,且治疗组患者的血清sCD40L及hs—CRP水平均低于对照组（P〈0．05）;治疗组患者的神经功能缺损评分显著降低（P〈0．01）,且治疗组患者的评分低于对照组（P〈0．05）。结论：川芎嗪注射液治疗急性脑梗死具有较好的疗效,其机制可能与干扰脑缺血后血小板CD40／CD40L信号通路、抑制血小板活化、减轻炎症损伤有关。     

Daily flaxseed consumption improves glycemic control in obese men and women with pre-diabetes: a randomized study

The study hypothesis was that fasting glucose, insulin, fructosamine, C-reactive protein, and interleukin-6 decrease and adiponectin increases with daily flaxseed consumption in overweight or obese individuals with pre-diabetes. In this randomized, cross-over study overweight or obese men and postmenopausal women (n = 25) with pre-diabetes consumed 0, 13, or 26 g ground flaxseed for 12 weeks. Glucose, insulin, homeostatic model assessment (HOMA-IR), and normalized percent of α-linolenic fatty acid (ALA) were significantly different by treatment (multiple analysis of variance, P = .036, P = .013, P = .008, P = .024 respectively). Paired t tests showed glucose decreased on the 13 g intervention compared to the 0 g period [13g = −2.10 ± 1.66 mg/L (mean ± SEM), 0 g = 9.22 ± 4.44 mg/L, P = .036]. Insulin decreased on the 13 g intervention but not the 26 g (P = .021) and 0 g (P = .013) periods (13 g = −2.12 ± 1.00 mU/L, 26 g = 0.67 ± 0.84 mU/L, 0g = 1.20 ± 1.16 mU/L). HOMA-IR decreased on the 13 g period but not on the 26 g (P = .012) and 0 g (P = .008) periods (13g = −0.71 ± 0.31, 26g = 0.27 ± 0.24, 0g = 0.51 ± 0.35). The α-linolenic fatty acid decrease for the 0 g period was different than the 13 g (P = .024) and 26 g (P = .000) periods (13 g = 0.20 ± 0.04, 26g = 0.35 ± 0.07, 0g = −0.01 ± 0.07). Fructosamine, high sensitivity C-reactive protein, adiponectin, and high-sensitivity interleukin-6 had no significant differences. Flaxseed intake decreased glucose and insulin and improved insulin sensitivity as part of a habitual diet in overweight or obese individuals with pre-diabetes.     

阿托伐他汀联合米力农治疗慢性心力衰竭的临床研究

目的探讨阿托伐他汀钙联合米力农注射液治疗慢性心力衰竭的临床疗效。方法选取2018年12月—2019年12月于河南省人民医院进行治疗的慢性心力衰竭患者93例,随机分为对照组(46例)和治疗组(47例)。对照组iv米力农注射液,首次采用50μg/kg负荷剂量静脉推注10 min,随后以0.25～0.50μg/(kg·min)静脉匀速泵入,连续使用72 h;治疗组患者则在对照组基础上口服阿托伐他汀钙片,10 mg/次,2次/d。两组均连续治疗1周。观察两组的临床疗效,比较两组治疗前后临床症状评分、6 min步行距离、心功能指标及血清去甲肾上腺素、细胞间黏附分子-1(ICAM-1)、超敏C反应蛋白(hs-CRP)、醛固酮(ALD)、脑自然肽氨基端前体蛋白(NT-proBNP)、心肌肌钙蛋白I(cTnI)水平。结果治疗后,对照组临床总有效率78.26%明显低于治疗组93.62%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者临床症状评分显著降低,但6 min步行距离显著升高(P0.05);且治疗后治疗组临床症状评分和6 min步行距离相较于对照组改善更为显著(P0.05)。治疗后,两组患者心功能指标左心室射血分数(LVEE)、左心室收缩末内径(LVESD)、左心室收缩末期容积(LVESV)均较治疗前明显改善(P0.05);且治疗后治疗组心功能相关指标相较于对照组改善更为显著(P0.05)。治疗后,两组患者血清去甲肾上腺素、ICAM-1、hs-CRP、ALD、NT-proBNP、cTnI水平均较治疗前明显降低(P0.05);且治疗后治疗组这些相关血清生化指标显著低于对照组(P0.05)。结论阿托伐他汀钙联合米力农注射液治疗慢性心力衰竭疗效确切,能显著改善患者临床症状及心功能指标,可改善患者相关血清生化指标,具有一定的临床推广应用价值。     

阿托伐他汀对2型糖尿病患者血脂和血清超敏C-反应蛋白、白介素-6、8水平的影响

目的探讨阿托伐他汀对2型糖尿病患者血脂和血清超敏C-反应蛋白(hs-CRP)、白介素(IL)-6、8水平的影响。方法 70例2型糖尿病患者随机分为观察组和对照组。两组均予以饮食控制、体育锻炼及口服降糖药物或注射胰岛素控制血糖。观察组加用阿托伐他汀20mg/次,1次/d,连用12周。结果治疗12周后,观察组TC、TG、LDL-C水平下降(P<0.05),HDL-C水平上升(P<0.05)。而对照组治疗期间血脂变化不明显(P>0.05);同时两组血清hs-CRP和IL-6、8水平均有明显下降(P<0.05或P<0.01),且观察组下降值比对照组更明显(P<0.05)。结论阿托伐他汀治疗2型糖尿病可调节血脂代谢紊乱,降低血清炎症因子水平,抑制慢性血管的炎症反应。     

2型糖尿病血浆纤维蛋白原、血小板参数及高敏CRP与微血管病变的关系

目的探讨2型糖尿病血浆纤维蛋白原、血小板参数及高敏CRP与微血管病变的关系。方法将243例糖尿病患者分为A组(有微血管病变组123例)、B组(无微血管病变组120例);120例健康人为正常对照组。分别检测血浆纤维蛋白原(Fib)、血小板计数(PLT)、血小板压积(PCT)、血小板平均体积(MPV)和血小板体积分布宽度(PDW)、高敏CRP(hs-CRP)的水平。结果与正常对照组比,A组PCT、MPV、PDW、Fib、Hs-CRP的检测差异有统计学意义(P<0.01),PLT检测有差异有统计学意义(P<0.05)。B组Fib、Hs-CRP的检测差异有统计学意义(P<0.01),PLT检测差异有统计学意义(P<0.05)。A组与B组相比PCT检测差异有统计学意义(P<0.01),MPV、PDW、Fib、Hs-CRP检测差异有统计学意义(P<0.05)。结论 PCT、MPV、PDW、Hs-CRP、Fib的检测对糖尿病微血管病变的早期诊断有重要的临床意义。     

Coagulation activation and ultrasound characteristics in patients with carotid artery disease

Introduction

Elevated levels of markers for thrombin activation are associated with plaque echogenicity and degree of stenosis in patients with carotid artery stenosis. The Activated Protein C-Protein C Inhibitor (APC-PCI) complex reflects activation of the Protein C system and is a measure of thrombin generation. The aim of the present study was to examine APC-PCI complex in patients undergoing thrombendartherectomy for carotid artery stenosis, and to relate the findings to clinical characteristics and plaque morphology as determined by ultrasound.

Materials and Methods

Blood was obtained from 125 patients (39 female, median age 71 years) with carotid artery stenosis admitted from September 2005 to May 2007. The APC-PCI complex was measured using a sandwich immunofluorometric method and compared to an age- and sex-matched healthy control-group. Clinical and demographic characteristics, routine laboratory markers and ultrasound characteristics were analysed using univariate and multivariate analysis.

Results

APC-PCI complex concentration was significantly increased in patients with carotid artery stenosis (median 0.21 µg/L; 10th to 90th percentile 0.15-0.36) compared to a healthy control-group (0.19 µg/L; 0.11-0.31; P = .009). There was no significant difference in APC-PCI-values between asymptomatic (n = 48) and symptomatic (n = 77) patients with carotid artery stenosis (0.22 vs. 0.20 µg/L; p = 0.626). Patients with minor stroke (n = 31) had a higher median APC-PCI-concentration (0.27 µg/L; 0.15-0.63) than patients with amaurosis fugax (0.19 µg/L; 0.15-0.36) or transient ischemic attack (0.21 µg/L; 0.12-0.36) (p = 0.016). No association was found between APC-PCI-values and the degrees of carotid artery stenosis or the time from the latest neurological symptoms to blood sampling. Patients with echolucent plaques had significantly lower APC-PCI concentrations (0.20 µg/L; 0.14-0.35 vs. 0.24 µg/L; 0.15-0.60; p = 0.043), according to the Gray-Weale classification.

Conclusions

Patients with carotid artery disease exhibit increased concentrations of APC-PCI compared to a healthy control-group, particularly those patients with echogenic plaques, who have significantly higher APC-PCI levels than patients with echolucent plaques.     

心脑通络液对腹主动脉粥样硬化家兔TXB2、hs-CRP的影响

[目的] 通过心脑通络液对腹主动脉粥样硬化兔血浆血栓素B₂（TXB₂）及血清高敏C反应蛋白（hs-CRP）的影响,探讨心脑通络液对动脉粥样硬化的治疗作用。[方法] 选取雄性新西兰兔40只,随机分成5组,即空白组、模型组、血脂康组、心脑通络液高剂量组（简称高剂组）、心脑通络液低剂量组（简称低剂组）,每组8只。造模成功后,连续治疗3个月,观察兔血清TXB₂及hs-CRP的水平变化。[结果] 与空白组对比,模型组TXB₂及hs-CRP值显着升高（P<0.05）.血脂康组及高、低剂量组的TXB₂及hs-CRP值均减低,且高剂组TXB₂及hs-CRP值与血脂康组相比差异无统计学（P>0.05）.[结论] 心脑通络液对动脉粥样硬化家兔有治疗作用。     

康复训练对心衰患者血清hs-CRP及心功能的影响

目的 探讨康复训练对心衰患者血清hs-CRP及心功能的影响.方法 将92例心衰患者分为观察组和对照组,各46例,两组患者均给予利尿、血管紧张素转化酶抑制剂等常规抗心衰治疗,观察组在此基础上给予康复训练,观察两组患者治疗效果.结果 观察组治疗后HR及6 min步行距离均优于对照组（P＜0.05）;观察组治疗后血清hs-CRP水平为低于对照组（P＜0.05）,左室射血分数高于对照组（42.8±4.2vs.33.6±3.5）,P＜0.05,差异具统计学意义.结论 康复训练可改善CHF患者心功能,降低其炎性反应,值得临床借鉴采用.     

冠心病患者血清超敏C反应蛋白、肌钙蛋白、血脂水平变化及临床意义

目的:研究冠心病患者血清超敏C反应蛋白(hs-CRP)、肌钙蛋白I(cTnI)、血脂水平变化及临床意义.方法:对102例冠心病患者[稳定型心绞痛( SAP)组48例、不稳定型心绞痛(UAP)组33例、急性心肌梗死(AMI)组21例]血清hsCRP,cTnI,甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)和高密度脂蛋白(HDL-C)等生化指标水平进行检测,并与正常对照组的40例健康受试者进行比较分析.结果:SAP组血清hs-CRP水平显著高于正常对照组,差异具有统计学意义(P＜0.05);UAP组、AMI组血清hs-CRP,cTnI,TC,TG及LDL-C水平均显著高于正常对照组,HDL-C水平均显著低于正常对照组,差异均具有统计学意义(P ＜0.05);SAP组、UAP组血清hs-CRP,cTnI,TC,TG及LDL-C水平均显著低于AMI组,HDL-C水平均显著高于AMI组,差异均具有统计学意义(P ＜0.05);SAP组血清hs-CRP,cTnI水平显著低于UAP组,差异亦均具有统计学意义(P＜0.05);hs-CRP与TC,TG,LDL-C均呈显著正相关(P＜0.05),与HDL-C均呈显著负相关(P＜0.05),hs-CRP与cTnI之间呈显著正相关(P＜0.05).结论:检测冠心病患者血清hs-CRP,cTnI及血脂水平对患者疾病预测及治疗具有重要的临床意义.     

Relationship between advanced glycation end products and gestational diabetes mellitus

Objective: To investigate the levels of and dynamic changes of advanced glycation end products (AGEs) in maternal plasma during pregnancy and explore the association between these levels and gestational diabetes mellitus (GDM).

Methods: This study recruited 90 GDM women and 90 healthy pregnant controls. The women received prenatal care and were hospitalized for delivery in Peking University First Hospital in China between October 2015 and April 2016. The patients were recruited and provided blood samples during gestational weeks 24–29. The levels of AGEs, TNF-α, hs-CRP, plasma glucose, and FINS and lipid profiles were measured, and HOMA-IR was calculated. New blood samples were collected and AGE was measured again in the two groups at 33–41 weeks of gestation to identify its dynamic changes.

Results: The levels of AGEs were significantly higher in the GDM group than in the NGT group at both 24–29 weeks (473.65?±?105.32 versus 324.36?±?57.86?ng/L; p?p?hs-CRP were significantly higher in the GDM group than in the NGT group (282.58?±?45.85 versus 177.54?±?35.14?pg/mL; 1.11?±?0.25 versus 0.6?±?0.19 µg/mL; p?p?=?.003), TNF-α (p?=?.005), and hs-CRP (p?p?=?.001). In the NGT group, there was no significant change in the concentration of AGEs between the two gestational periods (p?=?.388).

Conclusions: Plasma levels of AGEs are associated with GDM. During pregnancy, the changes observed in the levels of AGEs were different between GDM and normal pregnancies.