冠心病患者血清可溶性OX40配体和CRP水平的临床意义

目的探讨不同类型冠心病患者血清可溶性OX40配体(sOX40L)和C反应蛋白(Creactive protein,CRP)水平的临床意义。方法分别采用ELISA法和免疫透射比浊法检测458例疑似或诊断为冠心病患者血清sOX40L和CRP的浓度,采用冠脉造影术和ACC/AHA评分法判定冠状动脉病变程度。结果急性冠脉综合征(ACS)组患者血清sOX40L和CRP水平及冠脉评分均明显高于稳定型心绞痛(SAP)组和正常对照(CT)组(P<0.01);sOX40L与CRP及冠脉评分均呈正相关(P<0.01),CRP与冠脉评分亦呈正相关(P<0.01)。结论血清sOX40L和CRP水平与冠心病患者的病情严重程度及冠状动脉病变程度密切相关,sOX40L有望与CRP一样,作为炎症指标预测冠心病的发生和预后。     

缺血性和出血性脑卒中患者血清镁的水平与严重程度、预后及高血压关系

目的:镁(Mg)作为神经系统的重要元素,是脑卒中的重要因子。我们旨在确定缺血性和出血型卒中患者的血清Mg水平与患者卒中严重程度、预后及高血压的关系。方法:选取2018年01月～2019年12月本院收治的223例脑卒中患者作为研究对象,根据脑卒中的严重程度及预后根据NIH脑卒中量表(NIHSS)以及入院时血清Mg水平及是否有高血压。通过对比缺血性及出血性脑卒中患者Mg,NIHSS评分及是否高血压,从而得出结论。结果:缺血性患者的Mg水平(1.63±0.42 mg/dl)与出血性脑卒中Mg水平(1.31±0.37 mg/dl)差异具有统计学意义(P≤0.001),且缺血性患者Mg水平与患者预后有关(P0.001)。高血压(HTN)在缺血性及出血性脑卒中患者之间存在显著差异,同时也作为缺血性及出血性脑卒中患者影响血清Mg的因素之一。结论:缺血性患者中的Mg含量高于出血性脑卒中患者,血清Mg水平与缺血性和出血性脑卒中患者的严重程度无明显相关性。血清Mg水平与缺血性脑卒中患者预后有相关性,但与出血性脑卒中患者预后无明显关系,所以血清Mg水平可作为缺血性卒中预后的预测指标,且Mg含量与导致脑卒中的高血压危险因素有关。     

C反应蛋白对冠脉病变稳定性评估

目的探讨C反应蛋白(CRP)与冠脉病变稳定性的关系。方法选择稳定性心绞痛25例,不稳定性心绞痛35例,入院后即刻0、6、24、48h和7d检验CRP和肌钙蛋白(TnT),根据患者是否发生心脏不良事件(MACE)进行分类研究。结果不稳定性心绞痛患者CRP的水平明显高于稳定性心绞痛患者,P<0.01,发生心脏不良事件的患者其CRP和TnT水平在任何时点均高于未发生者,P<0.01。结论 C反应蛋白与冠脉病变稳定性相关,CRP和TnT联合检验可用于急性冠脉综合症的危险分层。     

C反应蛋白在急性冠脉综合征中的临床意义

目的探讨C反应蛋白(CRP)与急性冠脉综合征(Acute coronary syndromesACS的)关系。方法测定经冠脉造影确诊的冠心病患者60例(其中急性冠脉综合征患者30例,非急性冠脉综合征的冠心病患者30例)和冠脉造影排除冠心病患者30例的血CRP浓度。结果ACS患者组(A组)血CRP浓度为(14.53±16.87)mg/dL;非ACS患者组(B组)血CRP浓度为(4.07±4.56)mg/dL;对照组(C组)血CRP浓度为(3.67±4.43)mg/dL,A组与B组之间CRP浓度有显著性差异(P<0.001);B组与C组之间CRP浓度无显著性差异。结论急性冠脉综合征患者血CRP浓度明显升高,提示炎症反应与急性冠脉综合征密切相关,CRP浓度测定可作为急性冠脉综合征的监测指标。     

C反应蛋白与动脉硬化的关系

C反应蛋白(CRP)一直被视为机体在炎症、感染和组织损伤后而产生的一种急性期反应蛋白。CRP增高意味着机体内存在着一定程度的炎性反应。90年代后期,由哈佛大学Ridker的研究小组发现CRP增高可强烈预测未来冠状动脉事件,从而激发广大医生的强烈兴趣。炎症过程在动脉硬化及其并发症的发生过程中起着关键性的作用。CRP的血浆水平有助于区分高危心血管事件,被视为预测未来心血管危险最有力的炎症标记物。     

依达拉奉联合用法舒地尔治疗88例缺血性脑卒中疗效观察

目的观察依达拉奉联合法舒地尔治疗缺血性脑卒中的临床疗效。方法对治疗组88例患者,对照组40例患者均给予脑梗死常规治疗,治疗组在此基础上加用依达拉奉联合盐酸法舒地尔,观察记录2组患者治疗前后症状、体征,神经功能缺损程度评分等各项指标。结果本研究中,2组患者接受治疗后均有明显疗效,但治疗组在神经功能缺损程度评分、有效患者例数和总有效率上均明显优于对照组(P<0.05)。结论依达拉奉联合法舒地尔治疗缺血性脑卒中可清除自由基,使脑梗死区域缺血半暗带的神经细胞功能得以恢复,减轻神经功能的损伤,有效的治疗缺血性脑卒中,效果明显,且无明显不良反应,适合在脑梗死临床治疗上推广。     

血清C反应蛋白水平与脑梗死的相关分析

目的探讨C反应蛋白水平在不同类型急性脑梗死(ACL)患者血清中的变化规律及其临床意义。方法采用酶联免疫吸附法(ELISA法)对100例本院住院的脑梗死(发病1周内)进行CRP水平测定,其中大动脉粥样硬化梗死24例,小动脉闭塞性脑梗死27例,心源性栓塞性脑梗死2例,其他病因明确性脑梗死34例,不明病因性脑梗死13例,并进行对照分析。结果以CO中毒为主要危险因素组,其次冠心病组;高血压组与糖尿病组组间对比无明显差异。结论血清CRP可能在ACI患者的发生、发展中起一定作用,且水平随卒中类型的不同而变化。     

C反应蛋白、白细胞计数和分类计数的联合检测在新生儿感染中的临床价值

目的探讨和评价血清C反应蛋白(CRP)、外周血白细胞计数(WBC)和白细胞分类计数(DC)的联合检测在新生儿感染中的诊断价值。方法回顾调查已确诊有感染的150例新生儿患儿(观察组)和30例出生3d的健康新生儿(对照组)的血清CRP定量测定,根据测定值将观察组分成3个类组;对观察组和对照组还进行外周血白细胞计数和白细胞分类计数的联合检测。结果150例患儿血CRP值升高。范围从8～876mg/L不等,其中17例患儿血CRP值>100mg/L,其临床表现多有持续高热或伴惊厥、昏迷等严重感染征象。患儿感染的严重程度与血CRP值、外周血白细胞计数(WBC)和白细胞分类计数(DC)呈正相关。结论血清C反应蛋白(CRP)、外周血白细胞计数(WBC)和白细胞分类计数(DC)的联合检测对新生儿感染的早期诊断以及抗感染治疗的效果评价有重要临床指导意义。     

依达拉奉治疗急性脑出血疗效观察

目的探讨依达拉奉治疗急性脑出血的临床疗效。方法选取我院2006年3月至2009年7月收治的60例急性脑出血患者的临床资料,随机分为治疗组(30例)和对照组(30例),治疗组患者应用常规治疗,对照组在常规治疗的基础上加用依达拉奉,连续治疗2周,在治疗前后对患者进行神经功能评分,疗效评定和超敏C反应蛋白(HsCRP)浓度测定。结果治疗组患者神经功能评分明显优于对照组患者,2组患者疗效比较差异有统计学意义(P<0.05)。治疗组患者恢复疗效优于对照组患者。治疗组超敏C反应蛋白浓度低于对照组患者。结论依达拉奉治疗急性脑出血能明显改善患者的临床症状,减轻患者的炎性反应,降低患者的神经功能损伤程度,疗效满意值得在临床推广。     

CRP检测在小儿呼吸道感染中的诊断价值研究

目的探讨C反应蛋白(CRP)检测在小儿呼吸道感染中的诊断价值。方法分别检测急性呼吸道细菌感染、病毒感染、健康儿童的血清CRP含量,运用统计学进行综合分析。结果细菌感染组血清CRP异常率明显高于病毒感染组和健康体检组,差异具有统计学意义(P<0.01)。结论 CRP检测可作为鉴别呼吸道感染病原类型的重要辅助指标,在儿童呼吸道感染性疾病中的应用价值显著。     

急性脑卒中与便秘57例分析

目的探讨急性脑卒中与便秘的关系。方法57例脑卒中患者分成动脉粥样硬化血栓性脑梗死(ATI)组23例;腔隙性梗死(LI)组23例;脑出血(ICH)组11例,观察各组便秘发生率并进行比较。结果脑卒中者第1周便秘发生率50.88%,显著高于正常老年人对照组(P<0.05)。基底节区脑卒中者便秘发生率57.1%,明显高于非基底节卒中者(P<0.05)。结论脑卒中患者急性期常发生便秘,基底节区脑卒中者便秘发生率较非基底节区脑卒中者高。     

The Role of Thromboxane in the Course and Treatment of Ischemic Stroke: Review

Cardiovascular diseases are currently among the leading causes of morbidity and mortality in many developed countries. They are distinguished by chronic and latent development, a course with stages of worsening of symptoms and a period of improvement, and a constant potential threat to life. One of the most important disorders in cardiovascular disease is ischemic stroke. The causes of ischemic stroke can be divided into non-modifiable and modifiable causes. One treatment modality from a neurological point of view is acetylsalicylic acid (ASA), which blocks cyclooxygenase and, thus, thromboxane synthesis. The legitimacy of its administration does not raise any doubts in the case of the acute phase of stroke in patients in whom thrombolytic treatment cannot be initiated. The measurement of thromboxane B2 (TxB2) in serum (a stable metabolic product of TxA2) is the only test that measures the effect of aspirin on the activity of COX-1 in platelets. Measurement of thromboxane B2 may be a potential biomarker of vascular disease risk in patients treated with aspirin. The aim of this study is to present the role of thromboxane B2 in ischemic stroke and to present effective therapies for the treatment of ischemic stroke. Scientific articles from the PubMed database were used for the work, which were selected on the basis of a search for “thromboxane and stroke”. Subsequently, a restriction was introduced for works older than 10 years, those concerning animals, and those without full text access. Ultimately, 58 articles were selected. It was shown that a high concentration of TXB2 may be a risk factor for ischemic stroke or ischemic heart disease. However, there is insufficient evidence to suggest that thromboxane could be used in clinical practice as a marker of ischemic stroke. The inclusion of ASA in the prevention of stroke has a beneficial effect that is associated with the effect on thromboxane. However, its insufficient power in 25% or even 50% of the population should be taken into account. An alternative and/or additional therapy could be a selective antagonist of the thromboxane receptor. Thromboxane A2 production is inhibited by estrogen; therefore, the risk of CVD after the menopause and among men is higher. More research is needed in this area.     

缺血性中风高龄患者头痛特点与影响因素分析

目的头痛是急性脑血管疾病中常见的症状,其发生率各组报道不同,缺血性中风高龄患者的发病机制更是说法不一,本文旨在探讨缺血性中风高龄患者头痛的临床特征及相关影响因素。方法收集门急诊和住院无意识障碍的急性缺血性中风病人300例,其中脑梗死病人200例,TIA100例,发生头痛的病人有75例,对发生头痛病人采用回顾性分析方法进行分析。结果300例无意识障碍的急性缺血性中风病人有头痛的75例,占25%。通过临床分析,发现缺血性中风初期的头痛与发病时病人年龄、既往偏头痛病史、人院时的血压、受累的循环系统及病灶的位置有关,而与血管性危险因素、急性缺血性中风(AIS)的严重性无关。结论在临床实践中,对于老年偏头痛病人,如头痛的性质、部位、持续时间与先前不同,而无局灶神经功能障碍,应该进一步详细检查,避免误诊为复杂性偏头痛,引发不良后果。     

26例进展性脑梗死的危险因素分析

目的探讨进展性脑梗死的危险因素。方法进展性脑梗死26例和稳定性脑梗死26例临床资料进行对比分析。结果进展性脑梗死患者合并血管狭窄、高血压、糖尿病、高脂血症及高纤维蛋白原血症的例数明显高于对照组(P<0.01)。结论血管狭窄、高血压、糖尿病、高血脂及高纤维蛋白原血症是进展性脑梗死患者的危险因素。吸烟、感染、发热也是相关因素。     

急性缺血性脑卒中静脉溶栓临床观察与探讨

目的评价急性缺血性脑卒中发病3h内行静脉溶栓的疗效及安全性。方法将61例急性缺血性脑卒中患者分为溶栓组31例,对照组30例,予以低分子肝素。按改良爱丁堡斯堪的那维亚评分标准(CSS),分别于治疗前及治疗后6h、24h、3d、7d及14d记录患者神经功能缺损,并于治疗后1个月及3个月随访患者日常生活能力(ADL量表)。结果溶栓治疗组神经功能改善明显优于对照组(P<0.01),出血并发症无明显增加(P>0.05)。结论 Rt-PA用于急性缺血性脑卒中超早期(3h)治疗疗效肯定,安全性相对较高。     

Clinical neuroprotective drugs for treatment and prevention of stroke

Stroke is an enormous public health problem with an imperative need for more effective therapies. In therapies for ischemic stroke, tissue plasminogen activators, antiplatelet agents and anticoagulants are used mainly for their antithrombotic effects. However, free radical scavengers, minocycline and growth factors have shown neuroprotective effects in the treatment of stroke, while antihypertensive drugs, lipid-lowering drugs and hypoglycemic drugs have shown beneficial effects for the prevention of stroke. In the present review, we evaluate the treatment and prevention of stroke in light of clinical studies and discuss new anti-stroke effects other than the main effects of drugs, focusing on optimal pharmacotherapy.     

The Role of Biomarkers in Atherothrombotic Stroke—A Systematic Review

Stroke represents the primary debilitating disease in adults and is the second-highest cause of death worldwide. Atherosclerosis, the most prevalent etiology for vascular conditions, is a continuous process that gradually creates and develops endothelial lesions known as atherosclerotic plaques. These lesions lead to the appearance of atherothrombotic stroke. In the last decades, the role of biological biomarkers has emerged as either diagnostic, prognostic, or therapeutic targets. This article aims to create a list of potential biomarkers related to atherothrombotic stroke by reviewing the currently available literature. We identified 23 biomarkers and assessed their roles as risk factors, detection markers, prognostic predictors, and therapeutic targets. The central aspect of these biomarkers is related to risk stratification, especially for patients who have not yet suffered a stroke. Other valuable data are focused on the predictive capabilities for stroke patients regarding short-term and long-term prognosis, including their influence over the acute phase treatment, such as rt-PA thrombolysis. Although the role of biomarkers is anticipated to be of extreme value in the future, they cannot yet compete with traditional stroke neuroimaging markers but could be used as additional tools for etiological diagnosis.     

Lysophosphatidic Acid level and the incidence of silent brain infarction in patients with nonvalvular atrial fibrillation

Lysophosphatidic acid (LPA), which is proposed to play an important role in normal physiological situations such as wound healing, vascular tone, vascular integrity and reproduction, may be involved in the etiology of some diseases such as atherosclerosis, cancer, obesity or myocardial infarction. Abnormal findings, including silent brain infarction (SBI), are frequently observed by magnetic resonance imaging (MRI) in patients with nonvalvular atrial fibrillation (NVAF). However, whether there is a relationship between LPA level and the prevalence of SBI has not been extensively studied. In the present study, the association between them was investigated. 235 patients with NVAF, 116 cases of SBI without NVAF and 120 cases of healthy volunteers (control group), who did not receive any antithrombotic therapy, were enrolled in this study. Plasma LPA levels in the NVAF with SBI group were significantly higher than that in the control group (p < 0.01), NVAF without SBI group (p < 0.01) and SBI without NVAF group (p < 0.01). The LPA levels are lower in the control group than in the NVAF without SBI and SBI without NVAF groups (p < 0.01), however, the latter two groups did not significantly differ from each other for LPA levels (p > 0.05) There were significant differences in the positive rate of platelet activation between each of the groups (p < 0.01). The positive rate of platelet activation was significantly higher in the NVAF with SBI group. We suggest that LPA might be a novel marker for estimation of the status of platelet activation and the risk factor for SBI onset in NVAF patients. We expected that plasma LPA levels could predict the occurrence of SBI in NVAF patients.     

Post-Stroke Social Isolation Reduces Cell Proliferation in the Dentate Gyrus and Alters miRNA Profiles in the Aged Female Mice Brain

Social isolation and loneliness are risk factors for stroke. Elderly women are more likely to be isolated. Census data shows that in homeowners over the age of 65, women are much more likely to live alone. However, the underlying mechanisms of the detrimental effects of isolation have not been well studied in older females. In this study, we hypothesized that isolation impairs post-stroke recovery in aged female mice, leading to dysregulated microRNAs (miRNAs) in the brain, including those previously shown to be involved in response to social isolation (SI). Aged C57BL/6 female mice were subjected to a 60-min middle cerebral artery occlusion and were randomly assigned to either single housing (SI) or continued pair housing (PH) immediately after stroke for 15 days. SI immediately after stroke led to significantly more brain tissue loss after stroke and higher mortality. Furthermore, SI significantly delayed motor and sensory recovery and worsened cognitive function, compared to PH. A decrease in cell proliferation was seen in the dentate gyrus of SI mice assessed by bromodeoxyuridine (BrdU) labeling. miRNAome data analysis revealed changes in several miRNAs in the brain, such as miR-297a-3p and miR-200c-3p, which are known to regulate pathways involved in cell proliferation. In conclusion, our data suggest that SI can lead to a poor post-stroke recovery in aged females and dysregulation of miRNAs and reduced hippocampal cell proliferation.