胰岛素样生长因子1与冠心病病变程度的关系

目的为了研究冠心病发病的机制. 方法测定了16例正常人血清胰岛素样生长因子1(IGF1)水平和40例冠心病患者血清IGF1水平,且把冠心病患者血清IGF1水平与冠脉造影的血管病变支数进行了比较分析. 结果冠心病患者外周血IGF1水平显著低于正常人(分别为27.23±15.48 μg/L和48.02±33.43 μg/L,P＜0.01);且在冠脉造影血管病变支数增加时其血清IGF1水平下降变得更加明显. 结论 IGF1可能参与了冠心病的病理生理过程.     

青、老年人扩张型心肌病的临床研究

探讨老年人扩张型心肌病 ( DCM)的临床特征并与青年人 DCM进行比较 .通过临床观察对 80例老年人和 140例青年 DCM的临床资料进行对比分析 .结果发现 :( 1)老年组醛固酮值( 30 4 .8± 69.1)较青年组 ( 2 13.3± 54.5,pmol/ L)明显增高 ( P<0 .0 5) ,老年组 T3和 FT3值 ( 0 .78± 0 .2 1,2 .87± 0 .73)较青年组 ( 1.2 6± 0 .33nmol/ L ,3.55± 0 .64pmol/ L )明显降低 (均为 P<0 .0 1) ;( 2 )老年组室性心律失常发生率 ( 61.3% )较青年组 ( 92 .1% )低 ( P<0 .0 1) ;( 3)老年组低血钾、低血镁发生率高 (分别为 51.3%和 2 7.5% ) ,对洋地黄敏感性增加 ,易发生洋地黄中毒( 2 8.8% ) ;( 4 )老年组的病程 [( 11.0± 4 .7)年 ]和平均生存期 [( 6.9± 4 .2 )年 ]均较青年人 [( 5.2±2 .5)和 ( 3.4± 2 .7)年 ]长 (均为 P<0 .0 5) ;( 5)老年组的主要死因是充血性心力衰竭 ( 78.9% ) ,青年组则为恶性心律失常 ( 61.9% ) .结论为老年人 DCM的预后比青年人相对要好 ;老年人 DCM常伴低 T3综合征 ;心力衰竭、电解质失衡及交感神经兴奋是老年人 DCM室性心律失常的主要原因     

口腔颌面部恶性肿瘤患者血清免疫抑制酸性蛋白的研究

为探讨免疫抑制酸性蛋白 (IAP)检测在口腔颌面部恶性肿瘤中的临床应用价值 .采用单向免疫扩散法检测了 6 8例口腔颌面部恶性肿瘤患者及 30例正常对照的血清 IAP.结果表明 :正常人血清 IAP含量为 (346± 10 7) μg/ m L,口腔颌面部恶性肿瘤患者血清 IAP为 (6 73± 149) μg/ m L,两者相比有显著性差异 (P<0 .0 1) ;肿瘤患者的 IAP阳性率高达 85.3% (58/ 6 8) , - 期患者血清IAP水平明显高于 - 期患者 (P<0 .0 1) ,随着临床分期的增加 ,IAP水平也随之增高 ;口腔颌面部鳞癌与唾液腺癌之间 IAP水平无显著性差异 (P>0 .0 5) ;治疗后血清 IAP水平明显下降 (P<0 .0 1) ,复发者血清 IAP复又回升 ,而未复发者 IAP水平处于正常水平 .说明检测口腔颌面部恶性肿瘤患者血清 IAP有助于监视病情的发展、观察疗效及判断预后 ,动态研究可监测肿瘤的复发与转移 .     

急性淋巴细胞白血病患者外周血原始淋巴细胞DNA修复功能的初步研究

配对观察了11例急性淋巴细胞白血病患者用UV诱发~3H-T_dR掺入外周血原始淋巴细胞非程序DNA合成(Unscheduled DNA Synthesis, UDS)的水平,发现急性淋巴细胞白血病组的UDS水平明显地低于正常对照组:实际CPM值是115±13对257±13(P<0.01);UI_1是0.50±0.05对1.09±0.04(P<0.01);UI_2是1.53±0.02对2.11±0.02(P<0.01);提示急性淋巴细胞白血病患者存在着DNA修复功能缺陷。     

血糖链抗原125和153在心力衰竭中的意义

目的探讨心力衰竭患者部分肿瘤标志物血浓度的变化情况及其临床意义。方法分别在25例正常人和65例心力衰竭患者（按NYHA心功能分级分为II至IV级）测定血糖链抗原125（CA125）、糖链抗原153（CA153）和脑型钠尿肽（BNP）浓度。结果心力衰竭患者血CA125浓度（74.92&#177;24.92）nmol/L,明显高于正常对照组（20.77&#177;13.64）nmol/L,P〈0.101;BNP浓度（99.48&#177;286.60）nmol/L亦明显高于正常对照组（64.45&#177;42.32）nmol/L,P〈0.101。且CA125浓度与脑钠肽水平存在正相关性（r=0.3316,P〈0.01）。而心力衰竭患者血清中CA153浓度与正常对照组相似,分别为（18.39&#177;12.23）nmol/L与（17.19&#177;14.93）nmol/L,P〉0.05）;CA153浓度与脑钠肽水平间无明显相关性（r=-0.1932,P〉0.05）。结论心力衰竭患者血清肿瘤标志物CA125含量明显升高,与病情严重程度有一定相关性,其变化程度对评价心功能的程度和转归可能有一定的参考价值,另说明其升高亦可见于非恶性肿瘤性疾病。     

2型糖尿病患者高胰岛素血症的研究

2 型糠尿病患者的高胰岛素血症为众多学者所关注。本文对148 例2 型糠尿病患者进行研究,结果显示高胰岛素血症者(A 组)42 例,占28-4 % ,空腹胰岛素为28-7 ±10-2mIu/L,胰岛素/ 血糖比为3-9 ±0-5 ,较对照组(B组) 明显增高,二者有显著性差异;且高胰岛素血症组高血压、冠心病、高血脂、肥胖的发生率明显增高。提示:2 型糖尿病高胰岛素血症患者存在胰岛素抵抗,其X综合症的发生率明显增高     

流行性出血热血清甘油三酯改变及临床意义

分析142例流行性出血热(EHF)患者血清甘油三酯(TG)值改变,发现EHF患者各期TG均值(mmol/L)均较对照组(0.98±0.48)增高,分别为:发热期1.68±0.46,低血压期1.723±0.44,少尿期2.31±1.1,多尿期2.06±0.81,恢复期1.36±0.8.且各型TG均值(mmol/L)又有明显差别;轻型1.49±0.43,中型2.79±1.14,危重型3.48±1.20,轻中型与重危型比较P<0.05.并系统观察32例,各期增高的例数分别为:发热期64％,低血压期78％,少尿期100％,多尿期100％,恢复期为45％.故提示TG值增高与疾病的严重程度成正相关,动态观察TG值可作为判断病情轻重,观察病期及估计预后的一种参考方法.作者同时探讨了EHF患者TG值改变的机制.     

实时BIA技术对蛋白A与免疫球蛋白G相互作用的研究

应用实时BIA技术 ,探讨了蛋白A与小鼠免疫球蛋白G (MIgG)之间的相互作用 ,求出相互作用的动力学速率常数ka=5 0 7× 1 0 4 (mol/L) - 1 s- 1 ,kd=9 65× 1 0 - 5(s- 1 ) ,结合常数KA=5 2 5× 1 0 8(mol/L) - 1 .同时使用蛋白A固定的传感片用于MIgG浓度的检测 ,在 0 64～ 1 2mg/L浓度区间内 ,MIgG的响应值与其浓度有非常好的线性关系 .     

肝肾疾病患者血清转铁蛋白和铜蓝蛋白含量的分析

对肝肾疾病进行转铰蛋白(Transferren简称TF)和铜蓝蛋白(Ceruloplasmin简称CP)测定,结果表明:各组肝炎病人的TF均显著低于正常组,且谷丙转氨酶异常和HBsAg阳性者TF含量明显低于正常者,TF可作为判断肝病预后的一个指标。肾炎病人的TF也比正常人低,CP含量各组不一,肝癌患者的CP(52.44±8.73mg％)显著高于正常人(46.75±7.92mg％),乙型肝炎病人和正常组间未见差异.肝豆状核变性患者CP非常显著低于正常人,故检测CP有助于鉴别肝硬化和肝癌,同时对临床诊断肝豆状桉变性提供一项可靠的客观指标.     

中药制剂通心络抗家兔动脉粥样硬化实验研究

目的　用高胆固醇饲料复制动脉粥样硬化模型,观察通心络生药对家兔动脉粥样硬化的预防作用,并探讨其对血脂和血管细胞粘附分子-1(VCAM-1)mRNA表达的影响.方法　选30只雄性健康家兔,随机分为三组:①对照组10只,喂以普通饲料;②高胆固醇组10只,喂以含1.5%胆固醇的饲料;③通心络组10只,喂以含1.5%胆固醇的饲料和通心络生药0.72g/(kg·d).12周后测定:①血脂;②主动脉内膜/中膜厚度比值及斑块面积;③RT-PCR法检测主动脉中VCAM-1mRNA表达的水平.结果　通心络组和高胆固醇组的血清总胆固醇水平均显著高于对照组(P<0.01),通心络组低于高胆固醇组(P<0.05);通心络组主动脉内膜/中膜厚度比值、斑块面积和主动脉VCAM-1mRNA表达量均低于高胆固醇组[(0.57±0.06)vs(1.06±0.09),P<0.01;(38.93±3.42)%vs(71.75±3.82)%,P<0.01;(0.59±0.15)vs(0.91±0.18),P<0.01].结论　通心络具有抗动脉粥样硬化作用,可降低血脂和主动脉组织VCAM-1mRNA的表达.     

血浆纤维蛋白原含量升高与冠心病

用盐析－双缩脲法对９７例健康人和７９例冠心病患者进行了血浆纤维蛋白原含量的测定，结果表明：冠心病患者血浆纤维蛋白原含量显著高于健康人（Ｐ＜０．０１），提示纤维蛋白原含量升高是冠心病、中风、血栓形成的一种重要的危险因素．对血浆纤维蛋白原进行检测，将为冠心病的临床诊断及预防提供依据     

Pregnancy Associated Plasma Protein-A (PAPP-A) Levels in Acute Coronary Syndrome: A Case Control Study in a Tertiary Care Centre

In recent years, an important objective of cardiovascular research has been to find new markers that would improve the risk stratification and diagnosis of patients presenting with symptoms of acute coronary syndrome (ACS). Established biomarkers for diagnosis of ACS includes troponins and creatine kinase MB (CK-MB). Pregnancy associated plasma protein A (PAPP-A) is an emerging marker which has been described as a marker of plaque instability. PAPP-A is a large metalloproteinase involved in insulin-like growth factor signaling and has been shown to be involved in pathological processes like atherosclerosis. Many studies have been published regarding release of PAPP-A in circulation during ACS. The objective of this study was to evaluate the role of PAPP-A as an early marker of ACS by comparing levels of PAPP-A in patients with acute myocardial infarction (AMI) and unstable angina (UA) with asymptomatic controls. The association of PAPP-A with markers of myocardial necrosis and the association of PAPP-A levels to the presence of risk factors for coronary artery disease was also studied. We measured PAPP-A levels in patients with AMI (30), UA (23) and asymptomatic controls (45). PAPP-A was estimated using PAPP-A US (ultra sensitive) ELISA manufactured by DRG (Germany). PAPP-A levels were significantly elevated in patients with AMI and in patients with UA (mean levels 64.26 ± 1.05 and 36.23 ± 1.05 ng/ml respectively; p < 0.001). Mean PAPP-A levels in controls were 10.68 ± 1.04 ng/ml. In UA cases PAPP-A levels were elevated when the troponin I and CK-MB levels were within the normal range. No correlation was observed between PAPP-A with markers of myocardial necrosis. PAPP-A can serve as a useful biomarker in the diagnosis of ACS, especially UA, where cardiac troponin levels and CK-MB levels are not elevated and ECG changes are inconclusive.     

蒺藜皂甙治疗冠心病150例临床观察

采用蒺藜皂甙(商品名:心脑舒通)治疗冠心病150例,发现该药在改善冠心病主要症状如胸闷、胸痛、心悸和治疗总有效率(达88.67％)方面均较对照组明显为好(P<0.01),改善心电图的有效率为55.77％,较对照组为高(P<0.05).蒺藜皂甙是一个高效、无毒、安全,副作用小,使用方便,适合于临床长期、持续服用的良药.     

A commentary on ‘The economic implications of alternative publishing models’

Jay Stone is a final year Ph.D. student based at the Institute of Ophthalmology in London. She is attempting to identify novel therapeutic targets for the treatment of vascular proliferation in retinal disease. She believes that to be effective in the laboratory, scientists need to communicate their work to all audiences. She currently writes articles for the British Society of Cell Biology and BioNews.     

Oxidised LDL, HDL cholesterol, LDL cholesterol levels in patients of coronary artery disease

Coronary artery disease is a major cause of morbidity and has various risk factors. Lipid profile i.e. low HDL-cholesterol, high LDL cholesterol, high total cholesterol, high triglycerides playing important role in its causation. Recently interest has been shown in the oxidized fraction of LDL as one of the risk factors. In the present study 60 age and sex matched normal healthy individuals were taken as controls and 60 patients of CAD were taken. Cholesterol was measured by enzymatic method, HDL cholesterol by phosphotungstate precipitation method. Serum levels of LDL fraction of cholesterol was measured by a new and simpler method of precipitation. Result was expressed as mol/L of diene conjugates. It was observed that LDL cholesterol, VLDL cholesterol, total cholesterol, total cholesterol: HDL cholesterol, LDL cholesterol: HDL cholesterol were significantly raised and HDL cholesterol was significantly low in patients. (p<0.001). Though HDL cholesterol was significantly raised in females as compared to males in both the groups (p<0.001). Serum level of total cholesterol, oxidized LDL:HDL cholesterol were also raised significantly (p<0.05). The level of oxidized LDL showed an increasing trend in patients.     

经皮冠状动脉介入术后护理进展

文章从经皮冠状动脉治疗(PCI)的相关知识、术后的一般护理、病情观察、拔除鞘管的护理、抗凝治疗护理、并发症的预防、心理护理及康复指导方面对经皮冠状动脉介入术后的护理进展进行了综述。     

The association of ABO blood groups with extent of coronary atherosclerosis in Croatian patients suffering from chronic coronary artery disease

Aim:

The aim of study was to: 1) examine the relationship between ABO blood groups and extent of coronary atherosclerosis in patients with chronic coronary artery disease (CAD), 2) compare ABO blood groups distribution in CAD patients and general population, 3) examine possible differences in traditional risk factors frequency in CAD patients with different ABO blood groups.

Materials and methods:

In the 646 chronic CAD patients (72.4% males) coronary angiograms were scored by quantitative assessment using multiple angiographic scoring system, Traditional risk factors were self reported or measured by standard methods. ABO blood distribution of patients was compared with group of 651 healthy blood donors (74.6% males).

Results:

Among all ABO blood group patients there was no significant difference between the extent of coronary atherosclerosis with regard to all the three scoring systems: number of affected coronary arteries (P = 0.857), Gensini score (P = 0.818), and number of segments narrowed > 50% (P = 0.781). There was no significant difference in ABO blood group distribution between CAD patients and healthy blood donors. Among CAD patients, men with blood group AB were significantly younger than their pairs with non-AB blood groups (P = 0.008). Among CAD patients with AB blood group, males < 50 yrs were significantly overrepresented when compared with the non-AB groups (P = 0.003).

Conclusions:

No association between ABO blood groups and the extent of coronary atherosclerosis in Croatian CAD patients is observed. Observation that AB blood group might possibly identify Croatian males at risk to develop the premature CAD has to be tested in larger cohort of patients.     

力平脂调血脂作用的临床观察：附68例临床分析

观察了力平脂对高脂血症者的治疗作用和安全性．确诊高脂血症者６８例，力平脂，０．１，Ｔｉｄ，服一个月为一疗程后，血清总胆固醇（ＴＣ）平均降低２０．９８％，甘油三酯平均降低５１．８８％，ＨＤＬ－Ｃ平均升高１０．２６％，ＬＤＬ－Ｃ平均降低１２．５７％，ＡｐｏＡ１平均升高２．２４％，ＡｐｏＢ平均降低２１．１０％，从调血脂的个体疗效分析，力平脂降低ＴＣ的总有效率８４．６１％，降低ＴＧ的总有效率９５．２４％，升高ＨＤＬ－Ｃ的总有效率６１．７７％，降低ＬＤＬ－Ｃ的总有效率为５５．８８％，升高ＡｐｏＡ１的总有效率３８．２４％，降低ＡｐｏＢ的总有效率７７．９４％．提示：力平脂治疗高脂血症者，对降低ＴＣ，ＴＧ，ＬＤＬ－Ｃ，ＡｐｏＢ和升高ＨＤＬ－Ｃ，ＡｐｏＡ１均有明显效果，其中降低ＴＧ的疗效尤为突出，副作用轻微．临床实践表明：力平脂是一个疗效高、安全、服用方便的调血脂新药     

Comparison of Mass Versus Activity of Creatine Kinase MB and Its Utility in the Early Diagnosis of Re-infarction

Currently employed markers for the detection of acute coronary syndrome are Troponin T, CK (Creatine Kinase) and CKMB activity. CKMB activity measured by immunoinhibition method can give falsely elevated results due to the presence of atypical CK and CKBB and at times lead to the mis-diagnosis of acute coronary syndrome. Hence, CKMB mass (CKMB) measured by electrochemiluminence sandwich principle was employed. In this cross-sectional study 183 samples of 61 patients were analyzed within 6 h of diagnosis of acute coronary syndrome and followed up to 72 h. The correlation coefficient between CKMB activity and CKMBM at 4–6 h was 0.744, while at 12–24 h it was 0.909 and at 48–72 h it was 0.337. Thus there was good association between the two methods at 12–24 h but, statistically for method comparison studies and for replacing one method by another, the two methods need to be in agreement with one another. In this study the two methods are not in agreement with one another and thus analytically not replaceable. Another finding was obtained that CKMBM reached cut off levels prior to CKMB enzyme activity and hence, CKMBM is clinically better than CKMB activity to detect reinfarction.