简介:目的:探讨血清可溶性ST2(sST2)及和肽素水平在慢性心力衰竭(CHF)患者的变化及其诊断价值。方法:收集2015年6月1日至2015年12月1日在我院心内科住院的CHF患者80例作为CHF组,同时收集心脏神经官能症或心律失常患者30例作为心功能正常组。根据NYHA心功能分级,CHF组进一步分为II级组(22例)、III级组(32例)和IV级组(26例)。检测并比较各组血清sST2及和肽素水平,并分析其相关性。结果:与心功能正常组比较,CHF组血清sST2[(0.27±0.09)ng/ml比(1.18±0.81)ng/ml]及和肽素[(1239.64±229.98)pg/ml比(1987.16±426.84)pg/ml]水平均显著升高,P均〈0.01。与II级组比较,III级和IV级组的血清sST2[(0.46±0.17)ng/ml比(0.77±0.18)ng/ml比(2.31±0.29)ng/ml]及和肽素[(1625.61±522.13)pg/ml比(2103.15±340.74)pg/ml比(2194.31±332.97)pg/ml]水平均显著升高,且IV级组的显著高于III级组,P〈0.05或〈0.01。Pearson积矩相关分析显示CHF患者血清sST2与和肽素水平呈显著正相关(r=0.66,P=0.005)。结论:血清sST2及和肽素水平与心力衰竭的严重程度密切相关,可作为心力衰竭的标志物,值得推广。
简介:目的探讨急性冠状动脉综合征(ACS)患者经皮冠状动脉介入(PCI)术后血浆脑钠肽(BNP)和超敏C反应蛋白(hs-CRP)水平与临床预后的关系。方法纳入2012年10月至2014年1月合肥市第三人民医院心内科收治的ACS且行PCI治疗的患者120例。入院后根据血浆BNP和hs-CRP水平分组。分别于PCI术后3-5d、术后1个月、3个月行超声心动图检查,测量左室射血分数(LVEF)、左室舒张末期内径(LVEDD),左室舒张末期容积(LVEDV),左室收缩末期容积(LVESV)等指标。对患者住院期间、PCI术后30d、术后3个月病死率及主要心脏不良事件(MACE)发生率和心功能进行随访。结果ACS患者病死率和MACE事件发生率随血浆BNP、hs-CRP水平的升高呈明显递增趋势(P〈0.05),血浆BNP水平与LVEF呈负相关(r=-0.782,P〈0.001),与血清hs-CRP呈正相关(r=0.736,P〈0.001)。结论hsCRP、BNP对ACS行PCI治疗患者的预后有一定的指导意义。
简介:目的探讨瑞舒伐他汀治疗慢性心力衰竭的疗效及对内皮素及炎性因子的影响。方法慢性心力衰竭患者98例采用随机数字表法分为观察组和对照组两组,各49例,对照组患者采用常规对症治疗,观察组患者在常规对症治疗的基础上加用瑞舒伐他汀治疗,比较两组患者治疗前后心功能、血浆内皮素等炎性因子水平及血管内皮细胞功能变化情况。结果所有患者治疗前,各指标水平差异无统计学意义(P〉0.05),治疗后,两组患者左心室射血分数(LVEF)明显升高,且观察组明显高于对照组(P〈0.05),两组患者左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室舒张末容积(LVEDV)、左心室收缩末容积(LVESV)等指标水平较治疗前明显降低(P〈0.05),且观察组明显低于同期对照组(P〈0.05)。治疗后两组患者的血浆内皮素、白介素6(IL-6)、白介素23(IL-23)及肿瘤坏死因子-α(TNF-α)等炎性因子水平明显降低(P〈0.05),且观察组患者各指标水平明显高于同期对照组,具有统计学意义(P〈0.05)。观察组患者治疗后静脉血一氧化氮(NO)水平明显低于对照组(P〈0.05),而静脉血内皮素-1(ET-1)、血浆α-颗粒膜蛋白(GMP-140)、血管性假血友病因子(VWF)水平则明显高于对照组,差异具有统计学意义(P〈0.05)。结论瑞舒伐他汀可有效降低慢性心力衰竭患者血浆内皮素和炎性因子水平,有效扩充患者心室容积,明显改善心室射血功能和血管内皮细胞功能。
简介:T1mappingusingcardiovascularmagneticresonance(CMR)introducesnoveltechniquesformyocardialtissuecharacterizationtodetectandquantifydiseaseprocessesoccurringatthemicroscopiclevel.EventhoughT1mappinghaslimitedspatialresolution,cellularandmolecularchangesoccurringwithineachvoxelcanaffecttheaggregateT1signalrenderingthemquantifiable.TheestimatedT1-basedparametersquantifiedona“map”demonstratethespatiallocalizationofthesechangeswherebyeachpixelexpressesthequantitativevalueofthatparameter.Thisquantificationpermitsdetectionofdiffusediseaseevenifitisnotdirectlyvisible.Ratherthanrelyingonnonspecificfunctionalmeasures,T1mappingfocusesonintrinsicchangesofmyocardialcompositionthatadvancesunderstandingaboutspecificdiseasepathways.Thesechangesinmyocardialtissuecompositioninformdiagnosisandprognosis.T1mappingencompassestwokeyparameters:native(i.e.,precontrast)T1andextracellularvolumefraction(ECV)derivedfromadditionalpostcontrastT1andbloodT1measurements.Theseadvancesintroducenewtoolstodetectfocalanddiffusemyocardialderangementsoccurringincardiacdiseasethatcanbeotherwisedifficulttodetect.T1andECVmappingfosterprecisionmedicineandpersonalizedcare,promisingtoimprovepatientoutcomesthroughtargetedtherapy.CapitalizingontheopportunitiesintroducedbyT1mappingandECVrequiresfurtherinvestigation.
简介:BackgroundCoronarymicroembolization(CME)ischaracterizedbydistalmicrovascularocclusion.However,theinflammatorymechanismsandtherapeutictargetsofCMEarelargelyunknown.MethodsAtotalof11GuangxiBamaminiatureswinesweredividedintotwogroups:sham(n=5)andCME(n=6).MicrosphereswereinjectedintotheleftanteriordescendingarteryoftheCMEgrouptomakeananimalmodelofCME.TheexpressionsofmicroRNA-146a(miR-146a)andIRAK1,TRAF6,andAUF1inthemyocardiumweredetectedbyqPCR.ResultsIntheCMEgroup,microspheres,microinfarction,andinflammatorycellinfiltrationwerefoundunderanopticalmicroscope.TheexpressionlevelsofmiR-146awerelowinbothgroups.AfterCME,theexpressionlevelsofIRAK1,TRAF6,andAUF1intheCMEgroupwereupregulatedcomparedwiththoseintheshamgroup(P<0.01;P<0.05;P<0.05,respectively).ConclusionsAUF1,IRAK1andTRAF6,butnotmiR-146a,couldbeinvolved,inmyocardiuminflammationfollowingCME.
简介:BackgroundEssentialhypertension(EH)hasbecomethemostcommonchronicnon-infectiousepidemicandisoneofthemostcommonriskfactorsforthedamagetoheart,brain,kidneyandotherorgans.TheserumlevelsofICAM-1,IGF-1andIL-8playimportantrolesinthepathogenesisofEH.MethodsInthemedicalcheck-upcenteroftheAffiliatedHospitalofQingdaoUniversityMedicalCollege,sixtynormaloffspringwithafamilyhistoryofEHwererandomlyrecruitedintotwogroups:30offspringwithafatherormothersufferingfromEHassingle-parentgroup,and30offspringwithbothparentssufferingfromEHasdouble-parentgroup,andanother30normaloffspringwhoseparentsdidnotsufferfromEHascontrolgroup.TheserumlevelsofICAM-1,IGF-1andIL-8weredeterminedbyenzyme-linkedimmunosorbentassay(ELISA).ResultTheserumlevelsofICAM-1,IGF-1andIL-8weresignificantlyhigherinbothsingle-parentgroupanddouble-parentgroupthaninthecontrolgroup(P<0.05),andtheserumlevelsofICAM-1,IGF-1andIL-8werehigherinthedouble-parentgroupthaninthesingle-parentgroup(P<0.05).TheserumlevelsofICAM-1,IGF-1andIL-8werepositivelycorrelatedwiththeseverityofbloodpressureelevation(r=0.375,r=0.465,r=0.326,P<0.05,P<0.01,P<0.05respectively).ConclusionsDuetotheinfluenceofheredity,theseruminflammatoryfactorcontentsinnormaloffspringwithEHfamilyhistorymayincreasebeforebloodpressurerise.DetectionofseruminflammatoryfactorsinhealthyoffspringwithafamilyhistoryofEHcouldpredictoccurrenceofhypertension,andprovideamorereliablebasisfortheprimarypreventionofhypertension.
简介:目的回顾近二十年来各类心血管疾病住院病死患者死因及临床特征的变迁。方法将本院1978年1月1日~1997年12月31日共二十年的心血管疾病住院死亡病人分为前后各十年共二个阶段,按导致死亡疾病的第一诊断分类,资料输入电子计算机,以SPSS统计软件包进行统计分析。结果前后二个阶段比较显示,心血管疾病总住院病死率有明显下降(11.2%vs7.8%,X~2=82,P<0.001);死亡患者中,疾病构成比有显著差异(X~2=19.3,P<0.05),其中冠心病、高血压病、心性猝死所占比例增加,肺源性心脏病、风湿性心脏病所占比例有所下降;后十年冠心病(73.4±9.0vs68.9±9.9,P<0.05)、感染性心内膜炎(38.8±16.7vs23.5±15.1,P<0.05)死亡年龄明显延迟,其它各种疾病前后无明显变化。结论在心血管疾病死亡患者中的冠心病、高血压病所占比重有所增加,反映了当前心血管病流行病学的趋势。