瑞舒伐他汀隔日与每日治疗对血脂异常患者血脂及炎症标志物的影响

目的研究瑞舒伐他汀隔日给药10mg与每日给药10mg对血脂异常患者的血脂和炎症标志物的治疗差异。方法将37例患者随机分为2组,分别接受瑞舒伐他汀隔日给药10mg(N=19)和每日给药10mg(N=18)治疗6周后,比较用药前后血清中的低密度脂蛋白胆固醇(LDL-C),和血浆中C-反应蛋白(CRP)、白细胞介素-6(IL-6)的浓度变化。结果服药6周后,隔日治疗组和每日治疗组患者血清LDL-C、CRP、IL-6浓度与治疗前相比均有明显下降,高密度脂蛋白胆固醇和甘油三酯均有明显改善,但治疗效果两组间相比无统计学差异(P>0.05)。结论 10mg瑞舒伐他汀隔日治疗和每日治疗能同样有效改善中国患者的血脂和炎性标记物水平。     

KLF2的抗动脉粥样硬化的研究进展

KLF2是近年新被发现的转录因子。因其在肺高表达,故又被称为LKLF2。其主要机能是稳定胸腺T细胞,调控T细胞的归巢和成熟,并参与生物体细胞分化和血管形成过程,在生物体的天然免疫及组织器官形成方面发挥重要的保护作用。近年研究报道了,KLF2具有抗炎症、保护内皮、抗凝血防止血栓形成及抗氧化机能,参与抗动脉粥样硬化防御调控。随着研究的不断深入,其将可能成为心血管疾病防治的重要防御标志因子。     

小檗碱的抗动脉粥样硬化作用及其机制

小檗碱是治疗胃肠道疾病的一种传统中药.随着研究的不断深入,新近研究结果显示小檗碱具有防治冠心病的作用.故小檗碱抗动脉粥样硬化的作用成为心血管病研究领域所注视的问题之一.本文从调脂,抗内皮损伤,抗炎症反应以及抗血栓等角度对小檗碱抗动脉粥样硬化的作用及机制加以综述.     

Short-andLong-Term Effects of Xuezhikang(血脂康),An Extract of Cholestin,on Serum Proprotein Convertase Subtilisin/Kexin Type 9 Levels

Objective:To investigate the short- and long-term effects of Xuezhikang(血脂康,XZK),an extract of Cholestin,on proprotein convertase subtilisin/kexin type 9(PCSK9) level.Methods:Thirty rats were randomly divided into three groups and were given saline,XZK 1,200 mg/kg or lovastatin 10 mg/kg respectively by daily gavage for 3 days(n=10 for each).Sixteen patients without previous iipid-lowering drug treatment for dyslipidemia received XZK 1,200 mg daily for 8 weeks.Fasting blood samples and liver tissue were collected at day 3 for rats,while the blood samples were obtained at baseline and week 8 from patients.The serum PCSK9 and lipid profile were measured.The expression of hepatic low density lipoprotein(LDL) receptor and sterol regulatory element binding protein 2(SREBP-2) were measured by real time-PCR.Results:PCSK9 levels in rats were significantly increased in the XZK and lovastatin groups(P=0.002,P=0.003 vs.control) at day 3,while no significant differences were found in the levels of lipid parameters.PCSK9 levels in patients increased by34%(P=0.006 vs.baseline) accompanied by total cholesterol and LDL-cholesterol decreased by 22%and 28%(P=0.001,P=0.002 vs.baseline).The hepatic mRNA levels of LDL-receptor and SREBP-2 were significantly increased in the XZK and lovastatin groups.Conclusion:XZK has significant impact on PCSK9 in a short- and long-term manner in both rats and humans.Moreover,the data indicated that as lovastatin,XZK increased PCSK9 levels through SREBP-2 pathway.     

N末端脑钠肽前体对冠心病的预测价值

目的 探讨N末端脑钠肽前体(NT-proBNP)对冠心病(CHD)的预测价值.方法连续选择因胸痛疑诊冠心病或已明确冠心病为进一步介入治疗的患者658例,其中经冠脉造影确诊为冠心病者484例为冠心病组,冠脉造影除外冠心病174例为对照组.记录两组的临床资料,分析冠心病危险因素及NT-proBNP、左室射血分数(LVEF)等,探讨NT-proBNP对冠心病的预测价值,采用改良Gensini法评价冠脉病变的严重程度并分析其与冠心病危险因素及NT-proBNP的关系.结果两组的基线资料中,年龄、男性、吸烟史、糖尿病、高血压、血脂异常、家族史、LVEF、NT-proBNP差异均有统计学意义(P均＜0.01).单因素logistic回归分析,年龄、男性、吸烟史、糖尿病、高血压、血脂异常、家族史、NT-proBNP均为冠心病的危险因素(P均＜0.05).经ROC曲线分析,NT-proBNP界值为641.15.多因素logistic回归分析,除年龄、男性、糖尿病与冠心病独立相关外(P均＜0.01),NT-proBNP也是冠心病的独立预测因素(OR＝1.66,95%CI:1.06～2.61,P＜0.05),且年龄、血脂异常、NT-proBNP与冠脉病变严重程度相关(P均＜0.05).进一步的NT-proBNP与改良Gensini评分的相关性分析,NT-proBNP与改良Gensini评分呈正相关(r＝0.14,P＜0.01).多因素logistic回归分析,NT-proBNP不是改良Gensini评分的独立预测因素(P＞0.05).结论传统冠心病危险因素中年龄、男性、糖尿病与冠心病独立相关.NT-proBNP也是冠心病的独立预测因素,其水平的升高对冠心病及冠脉病变严重程度可能有一定临床预测价值.