不同类型的急性冠脉综合征患者血清热休克蛋白60浓度比较研究

目的:了解急性冠脉综合征(ACS)发作时热休克蛋白60(HSP60)及其抗体的血清浓度变化情况。方法:测定各类不稳定性心绞痛(UA,n=32)、S-T段抬高性心肌梗死(STEMI,n=16)和非ST段抬高性心肌梗死(NSTEMI,n=8)和健康对照(n=38)血清HSP60及其抗体的浓度并作统计学比较。结果:各型ACS患者血清HSP60和抗体水平均显著高于对照组(P<0.05),且STEMI患者血清HSP和抗体水平显著高于UA和NSTEMI患者(P<0.05)。结论:测定患者血清HSP60水平可以用于协助ACS诊断和疾病进程监测。     

急性ST段抬高心肌梗死的急救护理

急性冠脉综合征（ACS）包括不稳定型心绞痛（UA）和急性心肌梗死（AMI）,而后者又可分为ST段抬高心肌梗死（STEMI）和非ST段抬高心肌梗死（NSTEMI）。STEMI是ACS中最常见最严重的一种类型,急性期病死率极高,及时、     

血小板/淋巴细胞比值评估急性冠脉综合征冠脉病变严重程度的临床价值

目的:探讨血小板淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)评估急性冠脉综合征(acute coronary syndrome,ACS)冠脉病变严重程度中的临床价值。方法:回顾性分析2015年3月至2017年3月在南京市第一医院心血管内科行冠脉造影的168例ACS患者的临床资料,其中不稳定型心绞痛(unstable angina,UA)52例,非ST段抬高型心肌梗死(non-ST-segment elevation myocardial infarction,NSTEMI)54例,ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)62例,根据冠脉造影结果进行Gensini评分,采用Spearman相关分析对PLR和Gensini评分进行相关性分析。结果:三组白细胞总数、淋巴细胞计数以及LDL比较差异均有统计学意义(P0.05),STEMI组白细胞总数、淋巴细胞计数明显高于UA组及NSTEMI组,LDL显著低于UA组及NSTEMI组,且NSTEMI组白细胞总数、淋巴细胞计数明显高于UA组,LDL显著低于UA组。此外,NSTEMI和STEMI组PLR和Gensini评分显著均高于UA组(P0.05)。Spearman相关性分析显示PLR与Gensini评分呈正相关(r=0.2205,P=0.0114)。多元逐步回归分析结果显示PLR和白细胞总数均是Gensini评分的影响因素。结论:PLR在评估ACS患者冠脉病变严重程度中具有一定的价值,其值越高,冠脉病变越重。     

不同类型急性冠脉综合征患者心电图改变及临床意义研究

目的:研究不同类型急性冠脉综合征(ACS)患者的心电图改变及其临床意义。方法:选取我院心血管科收治的ACS患者285例,分为非ST段抬高性心肌梗死组(NSTEMI,153例)和ST段抬高性心肌梗死组(STEMI,132例)。记录两组患者心电图发生ST段改变导联数,利用冠状动脉造影确定受累血管数及狭窄程度。结果:NSTEMI组患者单支血管受累比例低于STEMI组,多支血管受累比例高于STEMI组,差异具有统计学意义(P0.05);两组患者血管狭窄程度无明显差异(P0.05)。NSTEMI组发生ST段改变的导联数与冠脉血管受累数目存在正相关(r=0.355,P=0.000),与血管狭窄程度无明显相关性(r=0.576,P=0.176)。STEMI组发生ST段改变的导联数与冠脉血管受累数目及血管狭窄程度均无明显相关性(r=-0.005,0.153;P=0.927,0.221)。结论:非ST段抬高性心肌梗死患者以多支血管受累为主,且发生ST段改变的导联数越多,发生多支血管受累的几率越大,ST段抬高性心肌梗死患者以单支血管受累为主。     

急性ST段抬高型心肌梗死患者血清Lp(a)、UA、GGT与冠状动脉病变和PCI术后主要心血管不良事件的关系研究

摘要 目的：探讨急性ST段抬高型心肌梗死（STEMI）患者血清脂蛋白(a)[Lp(a)]、尿酸（UA）、γ-谷氨酰转移酶（GGT）与冠状动脉病变和经皮冠状动脉介入治疗（PCI）术后主要心血管不良事件（MACE）的关系。方法：选取2019年1月～2022年7月安徽医科大学第二附属医院心血管内科收治的100例接受PCI术治疗的急性STEMI患者为STEMI组,根据Gensini积分将其分为非重度病变组56例和重度病变组44例,PCI术后随访3个月,根据是否发生MACE分为MACE亚组和非MACE亚组,另选取同期50名冠脉造影检查排除冠心病者为对照组。收集急性STEMI患者的临床资料,并检测血清Lp(a)、UA、GGT水平。分析急性STEMI患者血清Lp(a)、UA、GGT水平与Gensini评分的相关性及PCI术后MACE的影响因素。结果：与对照组比较,STEMI组血清Lp(a)、UA、GGT水平升高（P＜0.05）。重度病变组血清Lp(a)、UA、GGT水平高于非重度病变组（P＜0.05）。Spearman相关系数分析显示,急性STEMI患者血清Lp(a)、UA、GGT水平与Gensini评分呈正相关（P＜0.05）。随访3个月,100例急性STEMI患者PCI术后MACE发生率为21.00％（21/100）。多因素Logistic回归分析显示,年龄增加、KILLIP心功能分级≥Ⅲ级和Lp(a)、UA、GGT升高为PCI术后MACE的独立危险因素,左心室射血分数（LVEF）升高为独立保护因素（P＜0.05）。结论：急性STEMI患者血清Lp(a)、UA、GGT水平升高,与冠状动脉病变严重程度和PCI术后MACE密切相关,可能成为急性STEMI患者PCI术后MACE的辅助预测指标。     

冠心病患者介入治疗前后血清IL-18、sCD40L和hs-CRP水平的变化及其意义

目的：探讨冠心病患者血清白介素18（Interleukin-18,IL-18）、白细胞分化抗原40配体（CD40L）、及高敏C反应蛋白（hs-CRP）水平在经皮冠状动脉介入术治疗前后的变化和意义。方法：选择经冠状动脉造影确诊的冠心病患者85例,根据病变程度分为单支病变组（n=32）、双支病变组（n=28）和多支病变组（n=25）,采用双抗体夹心ELISA法测定PCI术前术后血清IL-18、CD40L和hs-CRP水平。结果：血清IL-18水平测定结果：多支病变组高于双支病变组,双支病变组高于单支病变组;支架置入术后显著高于术前,差异均有统计学意义（P〈0.01）。血清CD40L水平测定结果：多支病变组高于双支病变组和单支病变组,差异均有统计学意义（P〈0.01）,双支病变组与单支病变组间差异无统计学意义（P〉0.05）;支架置入术后较术前显著升高,差异有统计学意义（P〈0.01）。血清hs-CRP水平测定结果：多支病变组高于双支病变组,双支病变组高于单支病变组;支架置入术后显著高于术前,差异均有统计学意义（P〈0.01）。结论：冠心病患者血清IL-18、CD40L和hs-CRP与冠脉病变程度密切相关,介入治疗可使冠心病患者血清IL-18、CD40L和hs-CRP水平升高,监测血清中IL-18、CD40L和hs-CRP水平变化可了解治疗效果和炎症程度。     

急性心肌梗死患者新发心房颤动的危险因素及血清氨基末端脑钠尿肽前体、尿酸的预测价值分析

摘要 目的：探讨影响急性心肌梗死患者新发心房颤动的危险因素以及血清氨基末端脑钠尿肽前体（NT-proBNP）、尿酸（UA）对急性心肌梗死患者新发心房颤动的预测价值。方法：选择2019年10月至2021年5月在徐州医科大学附属医院接受诊治的急性心肌梗死患者110例,根据患者住院期间是否新发心房颤动分为房颤组（患者住院期间新发心房颤动,n=30）和无房颤组（患者住院期间未新发心房颤动,n=80）。另选择50例同期在徐州医科大学附属医院体检的健康者作为健康对照组,比较房颤组、无房颤组、健康对照组三组研究对象血清NT-proBNP、UA水平差异。收集患者各项临床资料,多因素Logistic回归分析影响急性心肌梗死患者新发心房颤动的危险因素。采用受试者工作特征（ROC）曲线分析血清NT-proBNP、UA单独以及联合检测对急性心肌梗死患者新发心房颤动的预测价值。结果：房颤组患者血清NT-proBNP、UA水平均明显高于健康对照组和无房颤组,且无房颤组高于健康对照组（P<0.05）。多因素Logistic回归分析显示,高NT-proBNP以及UA水平、高龄、左房增大、合并糖尿病、Killip心功能分级≥Ⅱ级是影响急性心肌梗死患者新发心房颤动的危险因素（P<0.05）。血清UA、NT-proBNP单独及联合预测急性心肌梗死患者新发心房颤动的曲线下面积（AUC）分别为0.730、0.737、0.840。结论：血清NT-proBNP、UA水平对急性心肌梗死患者新发心房颤动的发生具有一定预测价值,且两者联合应用的预测价值最高,除高NT-proBNP以及UA水平外,高龄、左房增大、合并糖尿病、Killip心功能分级≥Ⅱ级亦是新发心房颤动的危险因素。     

血清sACE2、Lp-PLA2与老年ST段抬高型心肌梗死患者心功能、心室重构及预后的关系研究

摘要 目的：探讨血清可溶性血管紧张素转化酶2（sACE2）、脂蛋白相关磷脂酶A2（Lp-PLA2）与老年ST段抬高型心肌梗死（STEMI）患者心功能、心室重构及预后的关系。方法：回顾性分析2018年1月至2021年12月期间本院收治的92例老年STEMI患者的临床资料,根据术后是否发生主要不良心血管事件（MACE）分为预后良好亚组和预后不良亚组,并纳入同期50例非心肌梗死患者作为对照组。采用酶联免疫吸附法检测血清sACE2水平,采用化学发光法检测血清Lp-PLA2水平,根据中位值水平为为低水平亚组和高水平亚组,比较亚组间心功能和心室重构指标[左室射血分数（LVEF）、左室收缩期内径（LVIDS）、左室短轴缩短率（LVFS）]差异,并进行Pearson相关性分析。采用受试者工作特征（ROC）曲线分析老年STEMI患者血清sACE2、Lp-PLA2水平预测MACE发生的效能。结果：（1）STEMI组患者血清sACE2和Lp-PLA2水平均显著高于对照组（P＜0.05）。（2）高sACE2亚组和高Lp-PLA2水平亚组患者LVEF显著低于低sACE2水平亚组和低Lp-PLA2水平亚组,LVFS、LVEDd和LVEDs显著大于低sACE2水平亚组和低Lp-PLA2水平亚组（P<0.05）。（3）血清sACE2、Lp-PLA2水平与STEMI患者LVEF呈显著负相关关系,与LVFS、LVEDd和LVEDs呈显著正相关关系（P<0.05）。（4）预后不良亚组患者血清sACE2和Lp-PLA2水平均显著高于预后良好亚组（P<0.05）。（5）血清sACE2和Lp-PLA2水平预测STEMI患者发生不良预后的AUC分别为0.885（95%CI：0.802~0.969）、0.907（95%CI：0..847~0.967）,最佳诊断Cut-off值分别为血清sACE2≥6355.48 pg/mL、血清Lp-PLA2≥292.73 ng/mL。结论：血清sACE2和Lp-PLA2水平与STEMI患者心功能和心室重构有密切关系,高水平表达对MACE发生具有良好的预测价值。     

老年冠心病患者伴有心梗史对围术期发生心血管事件的影响

目的：探讨有或无心梗史对老年冠心病患者围术期发生心血管事件的影响。方法：择期行非心脏手术的老年冠心病患者128例,按照有无心梗史分为心梗史组（n=63）和无心梗史组（n=65）。监测麻醉前15min、术中、术后30min ECG,统计sT-T改变和各型心律失常,记录术后急性心肌梗死的发生。结果：术中心梗史组ST-T改变发生率、sT段抬高的最大幅度、心律失常总发生率、房颤和室内传导阻滞（完左、完右）的发生率均高于无心梗史组（P〈0．05,P〈0．01）;术后ST-T改变发生率、ST段压低最大幅度、ST段抬高的最大幅度以及心梗发生率均大于无心梗史组（P〈0．05,P〈0．01）;且术后4～7d心梗发生率较高（P〈0．05）。结论：有心梗病史是老年冠心病手术患者心血管事件的危险因素。     

急性心肌梗死患者脑钠肽水平与血管病变的关系

目的:探讨急性心肌梗死患者血浆脑钠肽(BNP)水平与梗死相关动脉及病变血管的关系。方法:选取2010.7-2011.7于上海市第一人民医院诊断为急性心肌梗死的患者。分为ST抬高型心梗患者和非ST抬高型心梗患者两组,比较BNP水平与血管病变的关系。结果:(1)两组患者的年龄、男女比例、高血压病与糖尿病患病率、吸烟患者比例之间无显著差异。NSTEMI患者中,既往心梗和既往经皮冠状动脉成形术(PTCA)的比例和左室射血分数明显高于STEMI患者。(2)NSTEMI患者多支血管病变比例显著高于STEMI患者并且梗死相关动脉为左回旋支(LCX)的比例显著高于STEMI患者。(3)病变血管支数与心梗患者BNP水平无关,STEMI患者左冠状动脉前降支(LAD)为IRA的患者BNP水平显著高于LCX和右冠状动脉(RCA)分别为IRA的患者。NSTEMI患者LAD、LCX和RCA分别为IRA的患者其BNP水平无显著差异。结论:STEMI患者前壁心梗BNP水平较高,NSTEMI患者BNP水平对血管病变支数和IRA无预测价值。     

One-year health status outcomes of unstable angina versus myocardial infarction: a prospective, observational cohort study of ACS survivors

Background

Unstable angina (UA) patients have lower mortality and reinfarction risks than ST-elevation (STEMI) or non-ST elevation myocardial infarction (NSTEMI) patients and, accordingly, receive less aggressive treatment. Little is known, however, about the health status outcomes (angina, physical function, and quality of life) of UA versus MI patients among survivors of an ACS hospitalization.

Methods

In a cohort of 1,192 consecutively enrolled ACS survivors from two Kansas City hospitals, we evaluated the associations between ACS presentation (UA, NSTEMI, and STEMI) and one-year health status (angina, physical functioning and quality of life), one-year cardiac rehospitalization rates, and two-year mortality outcomes, using multivariable regression modeling.

Results

After multivariable adjustment for demographic, hospital, co-morbidity, baseline health status, and treatment characteristics, UA patients had a greater prevalence of angina at 1 year than STEMI patients (adjusted relative risk [RR] = 1.42; 95% CI [1.06, 1.90]) and similar rates as NSTEMI patients (adjusted RR = 1.1; 95% CI [0.85, 1.42]). In addition, UA patients fared no better than MI patients in Short Form-12 physical component scores (UA vs. STEMI score difference -0.05 points; 95% CI [-2.41, 2.3]; UA vs. NSTEMI score difference -1.91 points; 95% CI [-4.01, 0.18]) or Seattle Angina Questionnaire quality of life scores (UA vs. STEMI score difference -1.39 points; 95% CI [-5.63, 2.85]; UA vs. NSTEMI score difference -0.24 points 95% CI [-4.01, 3.54]). Finally, UA patients had similar rehospitalization rates as MI patients (UA vs. STEMI adjusted hazard ratio [HR] = 1.31; 95% CI [0.86, 1.99]; UA vs. NSTEMI adjusted HR = 1.03; 95% CI [0.73, 1.47]), despite better 2-year survival (UA vs. STEMI adjusted HR = 0.51; 95% confidence interval (CI) [0.28, 0.95]; UA vs. NSTEMI adjusted HR = 0.40; 95% CI [0.24, 0.65]).

Conclusion

Although UA patients have better survival rates, they have similar or worse one-year health status outcomes and cardiac rehospitalization rates as compared with MI patients. Clinicians should be aware of the adverse health status outcome risks for UA patients and consider close monitoring for the opportunity to improve their health status and minimize the need for subsequent rehospitalization.     

热休克蛋白70（HSP70）对HBV复制及抗原分泌的影响

目的了解慢性乙型肝炎患者（CHB）血清中热休克蛋白70（HSP70）与HBV—DNA的关系,并探讨HSP70能否影响乙型肝炎病毒（HBV）的复制与抗原分泌。方法选择安徽医科大学第二附属医院住院和门诊CHB患者60例为研究对象,并以30例健康体检人群为对照者,采用酶联免疫技术（ELISA）分析CHB患者和对照者血清HSP70表达水平,运用荧光定量PCR技术分析CHB患者血清HBV—DNA复制水平;以RNA干扰（RNAi）技术抑制HepG2．2．15细胞中HSP70基因的表达,同时分析细胞培养上清中HBVDNA以及相关抗原的表达情况。结果CHB患者血清中HSP70的表达水平明显高于其在健康对照者血清中的表达水平（P〈0．05）,且与HBV—DNA拷贝数呈正相关性（r=0．540,P〈0．05）;其中HBeAg阳性的CHB患者血清中HSPT0的表达水平也显著高于HBeAg阴性CHB患者血清中的表达水平（P〈0．05）。以RNAi技术特异性降低HSP70在HepG2．2．15细胞中的表达,HepG2．2．15细胞培养上清中HBV—DNA和相关抗原的分泌量明显降低（P〈0．05）。结论HSP70蛋白很可能在HBV的生命周期中发挥重要作用,从而影响HBV的复制和乙型肝炎的进展。     

血清同型半胱氨酸及尿酸水平检测对冠心病的临床价值研究

目的:探讨血清同型半胱氨酸(Hcy)和尿酸(UA)水平检测对冠心病的临床价值。方法:选择经冠状动脉造影确诊为冠心病的182例患者,分为以下3组,稳定型心绞痛(SAP)组78例,不稳定型心绞痛(UAP)组56例,急性心肌梗死(AMI)组48例。另外,随机选择单纯性高血压患者60例作为对照组,比较各组血清Hcy和UA水平并分析二者与各临床类型冠心病之间的关系。结果:⑴冠心病组的血清Hcy和UA水平明显高于单纯性高血压组(P0.05);⑵AMI组的血清Hcy和UA水平均明显高于UAP组和SAP组(P0.05);⑶Spearman相关分析显示:在AMl组中血清Hcy和UA水平呈高度正相关(P0.01);⑷Logistic风险回归显示:血清Hcy和血清UA升高是冠心病的危险因素(P0.05),而血清Hcy升高是急性心肌梗死的独立危险因素(P0.05)。结论:高Hcy与高UA血症是冠心病发病的重要危险因素,联合监测二者对预防冠心病尤其是急性心肌梗死具有重要的临床意义。     

罗格列酮对2型糖尿病合并急性冠脉综合征患者血清TGF—β1及IL-1β的影响

目的：观察罗格列酮对2型糖尿病合并急性冠脉综合征患者血清转化生长因子-β1（TGF—β1）及白细胞介素-1β（IL-1β）的影响。方法：116例2型糖尿病合并急性冠脉综合征患者,随机分为罗格列酮治疗组（n=58）和常规治疗组（n=58）。检测两组患者治疗前后空腹血糖、血脂及血清TGF-β1、IL-1β的变化。结果：治疗前两组患者空腹血糖、血脂及血清TGF-β1、IL-1β的水平无显著差异（P〉0．05）;治疗4月后,两组患者空腹血糖、血脂无显著差异,血清IL-1β较治疗前下降（P〈0．01）,罗格列酮组较常规治疗组下降明显,两组间差异显著（P〈0．05）;治疗后血清TGF—β1较治疗前上升（P〈0．05）,罗格列酮组与常规治疗组比较,差异显著（P〈0．05）。结论：罗格列酮能调控糖尿病合并急性冠脉综合征患者炎症介质和抗炎因子的分泌,可能具有改善动脉粥样硬化的作用。     

冠状动脉TF/TFPI与急性冠脉综合征关系的研究

目的：研究急性冠脉综合症患者冠状循环局部血液TF/TFPI改变。方法：入选40名冠状动脉造影患者,其中不稳定心绞痛（Unstable pectoris,UP）20例,稳定性心绞痛（Stable pectoris,SP）和正常对照组各10例。所有受试者在冠状动脉造影时,同时经导管抽取主动脉根部、冠状静脉窦和股静脉血样,采用ELISA法测定血浆TF、TFPI水平,计算TF/TFPI比值。结果：三组受检者基本情况均相似,UA组和SA组冠心病危险因素无统计学差异。股静脉血中TF、TFPI浓度及TF/TFPI比值比较：UA组和SA组血TF水平显著高于对照组,UA组血TF水平显著高于SA组。UA组血TFPI水平低于SA组及对照组;SA组血TFPI水平略低于对照组,但未达到统计学意义;UA组血TF/TFPI比值显著高于对照组和SA组,SA组与对照组比较差异无统计学意义。不同部位血TF、TFPI水平及TF/TFPI比值比较：UA组冠状静脉窦血中TF水平较主动脉根部显著升高,CS-AO差值显著高于FV-AO差值;UA组冠状静脉窦血TFPI水平较主动脉根部有升高趋势,但差异无统计学意义,而TF/TFPI比值较主动脉根部升高,差异有统计学意义,CS-AO差值显著高于FV-AO差值。血TF、TFPI水平及TF/TFPI比值在股静脉与主动脉根部之间差异无统计学意义（P〉0.05）。SA组和对照组血TF、TFPI水平及TF/TFPI比值三部位间差异无统计学意义。结论：冠脉循环TF/TFPI比值能较敏感地反映ACS的情况。     

IgA肾病合并高尿酸血症的临床分析

目的：探讨血清尿酸对IgA肾病临床,病理及预后的影响,为临床治疗和预后评估提供依据。方法：分析我院2011年1月-2012年1月149例经肾穿活检确诊为原发性IgA肾病患者的临床和病理资料。采用t检验和X2检验进行统计学处理。结果：（1）伴高尿酸血症IgA肾病的发病率为30.2%,男性偏多,男女发病率无统计学差异（P〉0.05）。（2）女性高尿酸血症组BUN、Cys-C、Scr水平显著高于尿酸正常组（P〈0.05）,男性两组间无显著差异（P〉0.05）,而血清UA水平无论男女高尿酸血症组均显著高于尿酸正常组（P〈0.05）;尿酸正常组血清BUN、UA、Cys-C、Scr水平男性显著高于女性（P〈0.05）,高尿酸血症组血清UA水平男性显著高于女性（P〈0.05）;血清IgA、C3、IgA/C3比值无论男女,高尿酸血症组与尿酸正常组均无显著差异（P〉0.05）。（3）高尿酸血症组病理改变以Ⅳ-Ⅴ多见（57.8%）,而正常尿酸组则以Ⅰ-Ⅱ为主（46.2%）,血尿酸正常组与高尿酸血症组Lee＇s分级构成比差异具有统计学意义（P〈0.05）。结论：伴有高尿酸血症的IgA肾病患者男性血尿酸水平高于女性,但血尿酸水平升高对女性肾功能影响更大;高尿酸血症对血清IgA,C3水平的变化影响不大;伴高尿酸血症IgA肾病病理改变程度较尿酸正常组更加严重。     

Pregnancy-associated plasma protein A and proform eosinophilic major basic protein in the detection of different types of coronary artery disease

Kryptor system was proven to be a rapid, standard method for pregnancy-associated plasma protein A and proform eosinophilic major basic protein (PAPP-A/proMBP) complex detection in coronary artery disease (CAD). No age and/or gender differences in 51 controls and 110 stable coronary artery disease (SCAD) patients were found. SCAD patients did not differ from controls and no difference in PAPP-A/proMBP levels with regards to the number of affected vessels was found. In 21 unstable angina pectoris (UAP), in 35 without and 66 with ST elevation acute myocardial infarctions (NSTEMI, STEMI respectively) patients PAPP-A/proMBP levels were increased (P=0.004 and P<0.0005, respectively). PAPP-A/proMBP levels did not correlate with cardiac troponin I (cTnI) in STEMI and NSTEMI patients. PAPP-A/ proMBP increase was more frequent than cTnI (P=0.036) within the early phase of STEMI. In NSTEMI patients PAPP-A/proMBP positivity was present in 50 % of cTnI negative cases. Receiver operating characteristic (ROC) analysis revealed the highest diagnostic accuracy of PAPP-A/proMBP (0.919) in STEMI cTnI positive cases. The highest specificity/sensitivity PAPP-A/proMBP levels for particular acute coronary syndrome (ACS) types were 10.65-14.75 mIU/l. Combination of PAPP-A/proMBP with cTnI increases their diagnostic efficacy within the early phase of ACS. Our results suggest that PAPP-A/proMBP complex is involved in processes preceding vulnerable plaque development in ACS.     

Oxidants and antioxidants in myocardial infarction (MI): Investigation of ischemia modified albumin,malondialdehyde, superoxide dismutase and catalase in individuals diagnosed with ST elevated myocardial infarction (STEMI) and non-STEMI (NSTEMI)

BackgroundCoronary ischemia can lead to myocardial damage and necrosis. The pathogenesis of cardiovascular diseases often includes increased oxidative stress and decreased antioxidant defense. The study aimed to assess levels of ischemia modified albumin (IMA), malondialdehyde acid (MDA), superoxide dismutase (SOD), and catalase in individuals diagnosed with ST elevated myocardial infarction (STEMI) and non-STEMI.MethodsThe present study prospectively included 50 STEMI patients, 55 NSTEMI patients, and 55 healthy subjects. Only patients who were recently diagnosed with STEMI or NSTEMI were included in this study. IMA, MDA, SOD, and catalase activities were measured spectrophotometrically. Significant coronary artery lesions were determined by angiography.ResultsPatients with ACS had significantly greater IMA and MDA values than the healthy controls (p<0.001). Besides, patients with STEMI had IMA levels that were significantly greater than those of the patients with NSTEMI (p<0.001), while the reverse was true for MDA levels (p<0.001). The healthy controls had the highest levels of SOD and catalase levels, followed by patients with STEMI and patients with NSTEMI, respectively (p<0.001). There was a significant negative correlation among MDA and SOD with catalase levels (r = -0.771 p<0.001 MDA vs catalase; r = -0.821 p<0.001 SOD vs catalase).ConclusionsData obtained in this study reveals that compared to healthy controls, STEMI and NSTEMI patients had increased levels of MDA and IMA and decreased levels of SOD and catalase.     

Genetic Variants on Chromosome 1p13.3 Are Associated with Non-ST Elevation Myocardial Infarction and the Expression of DRAM2 in the Finnish Population

Myocardial infarction (MI) is divided into either ST elevation MI (STEMI) or non-ST elevation MI (NSTEMI), differing in a number of clinical characteristics. We sought to identify genetic variants conferring risk to NSTEMI or STEMI by conducting a genome-wide association study (GWAS) of MI stratified into NSTEMI and STEMI in a consecutive sample of 1,579 acute MI cases with 1,576 controls. Subsequently, we followed the results in an independent population-based sample of 562 cases and 566 controls, a partially independent prospective cohort (N = 16,627 with 163 incident NSTEMI cases), and examined the effect of disease-associated variants on gene expression in 513 healthy participants. Genetic variants on chromosome 1p13.3 near the damage-regulated autophagy modulator 2 gene DRAM2 associated with NSTEMI (rs656843; odds ratio 1.57, P = 3.11 × 10⁻¹⁰) in the case-control analysis with a consistent but not statistically significant effect in the prospective cohort (rs656843; hazard ratio 1.13, P = 0.43). These variants were not associated with STEMI (rs656843; odds ratio, 1.11, P = 0.20; hazard ratio 0.97, P = 0.87), appearing to have a pronounced effect on NSTEMI risk. A majority of the variants at 1p13.3 associated with NSTEMI were also associated with the expression level of DRAM2 in blood leukocytes of healthy controls (top-ranked variant rs325927, P = 1.50 × 10⁻¹²). The results suggest that genetic factors may in part influence whether coronary artery disease results in NSTEMI rather than STEMI.     

子宫内膜异位症患者血清可溶性B7-H4的水平及意义

目的:探讨子宫内膜异位症患者血清可溶性B7-H4(sB7-H4)的水平及其临床意义。方法:用ELISA夹心法检测43例子宫内膜异位症患者术前血清sB7-H4的水平及40例子宫内膜异位症患者术后血清sB7-H4的水平,同时选取30例体检健康妇女血清sB7-H4水平作为对照。结果:子宫内膜异位症患者血清sB7-H4水平为(36.23±5.67)μg/L,体检健康者血清sB7-H4水平为(31.24±4.56)μg/L,两者比较差异有统计学意义(P0.01)。手术前,子宫内膜异位症患者血清sB7-H4水平为(36.23±5.67)μg/L,明显高于术后(32.54±4.27)μg/L(P0.05)。子宫内膜异位症患者血清sB7-H4水平与CA125水平呈显著正相关(r=0.531,P0.01)。结论:血清可溶性B7-H4可能与子宫内膜异位症的发病有关,检测血清中可溶性B7-H4水平对内异症的辅助诊断和疗效观察可能具有一定的临床意义。