重组人粒细胞集落刺激因子对兔颈动脉粥样硬化球囊损伤后再内皮化和内膜增生的影响

Objeelive To investigate the effect of rhG-CSF on mobilizing bone marrow-MSCs, reendothelialization and intima hyperplasia in carotid artery of rabbits post balloon catheter injury, nethods Rabbits were treated with rhG-CSF (25 μkg, twice daily, i. p, n =35) or saline (n =32) for 5 days, then, carotid arteries of rabbits were injured by balloon catheter. The number of peripheral MSCs was detected with FACS. The morphology of injuried artery was examined with hematoxylin and eosin stain, PCNA was determined with immunohistochemistry. Results (1) Number of peripheral MSCs was similar at baseline and significantly increased at 24 hours and peaked at 7 days and remained increased till 14 days post rhG-CSF. (2) Significant endothelial cell deletion was evidenced in the control group, while scatter endothelial cells was observed in the rhG-CSF group at 1 week post injury. Two weeks after injury, new endothelial area was significantly higher in rhG-CSF group compared to control group. At 4 weeks post injury, endothelial connection was evidenced and regularly displayed in rhG-CSF treated group. (3) PCNA-positive cells in the tunica intima were significantly lower in rhG-CSF treated rabbits at 7, 14 and 28 days compared that in control rabbits (all P ＜ 0.01). Conclusion rhG-CSF could mobilize the bone marrow-MSCs and promote re-endothelialization and attenuate intima hyperplasia post balloon catheter injury in carotid arteries of rabbits.     

单纯心肌桥72例临床分析

<正> 我们应用彩色多普勒超声心动图评价患者左心室舒张功能,并行24 h动态心电图筛查ST-T段缺血性改变,对单纯心肌桥与左心室舒张功能不全的相关性进行分析。     

急性下壁心肌梗死患者右心室功能变化的探讨

目的 应用组织多普勒(TDI)结合M型超声技术评价急性下壁心肌梗死(心梗)患者右心室功能变化. 方法 急性下壁心梗患者50例,男34例、女16例;正常对照组50例,男30例,女20例.急性心梗第4～7天行超声心动图检查,采用M型超声记录三尖瓣环右心室游离壁处运动曲线,测量收缩期、舒张早期和舒张晚期运动幅度(SD、DED和DAD)及DED/DAD比值;并应用TDI技术,记录该处速度曲线,测量右室收缩期、舒张早期和晚期最大运动速度Sm、Em和Am及Em/Am比值. 结果 急性下壁心梗患者三尖瓣环右室游离壁处SD、DED运动幅度、DED/DAD比值均较对照组显著降低[分别为(18.7±5.5)mm和(24.9±2.8)mm、(10.9±3.4)mm和(16.6±3.4)mm、1.5±0.6和2.3±0.9,t值分别为18.711、19.055、6.068,均P＜0.01]Sm、Em和Em/Am明显下降[分别为(12.9±2.8)cm/s和(15.9±2.7)cm/s、(12.3±3.4)cm/s和(16.7±4.7)cm/s、0.9±0.4和1.1±0.3,t值分别为11.851、14.781、2.127,P＜0.01或P＜0.05]. 结论 急性下壁心梗损害右室舒缩功能,表现为既有运动幅度下降又有最大运动速度下降,舒张功能降低以舒张早期性能下降为主.     

胰岛素抵抗在急性心肌梗死患者经皮冠状动脉介入治疗术后再狭窄中的作用

目的探讨胰岛素抵抗与非糖尿病患者急性心肌梗死经皮冠状动脉介入治疗(percutaneous coronary inter-vention,PCI)后再狭窄(restenosis,RS)的关系。方法非糖尿病急性心梗患者62例,据是否存在胰岛素抵抗(insulinresistance,IR)分为IR组(n=38)和非IR组(NIR组,n=24),均行PCI,每例患者植入1~2枚药物洗脱支架。采集清晨空腹静脉血,检测空腹血糖(FBG)、空腹胰岛素(FBI)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-c)、高密度脂蛋白胆固醇(HDL-c)、甘油三酯(TG)。用自我平衡模型分析法计算胰岛素敏感指数(insulin sensitivity index,ISI)。计算患者体质量指数(BMI)。术后6~8个月再次冠脉造影。测定冠脉病变长度和术前、支架植入后及复查造影时血管最小内径,计算RS发生率、血管管腔直径丢失值和血管内径丢失指数。结果2组患者在年龄、性别构成比、高血压患病率、BMI、血TC、TG、HDL-c、LDL-c、冠脉病变长度、支架术前最小管腔直径、支架术后即刻最小管腔直径和术后即刻管腔残留狭窄程度差异皆无统计...     

复方丹参滴丸对冠心病PCI后血液流变学的影响

目的 观察复方丹参滴丸对冠心病患者PCI后血液流变学的影响,探讨复方丹参滴丸治疗冠心病的临床实用价值.方法 选择确诊冠心病行PCI治疗的患者160例,随机分为治疗组和对照组.对照组于PCI后给予常规用药,包括阿司匹林和氯吡格雷:治疗组在此基础上加用复方丹参滴丸口服,于术前和术后3个月,检测并分析其血液流变学指标.结果 与治疗前相比,两组患者在全血粘度高切、中切和低切方面明显降低(P<0.05),且复方丹参滴丸治疗组在治疗后全血粘度低切指标下降更明显,与对照组相比,P<0.05,有统计学差异;此外,治疗组在全血还原粘度、红细胞聚集和卡松曲服应力方面与治疗前相比,亦明显降低,具有统计学差异;而对照组治疗后虽有下降趋势,但无统计学差异.与对照组相比,复方丹参滴丸治疗组治疗后在全血还原粘度和卡松曲服应力方面水平低于对照组,具有统计学差异.结论 冠心病PCI后患者在常规用药基础上加用复方丹参滴丸,可明显改善其血流动力学指标,缓解心绞痛症状,具有临床应用价值.     

重组人粒细胞集落刺激因子对兔颈动脉粥样硬化球囊损伤后再内皮化和内膜增生的影响

Objeelive To investigate the effect of rhG-CSF on mobilizing bone marrow-MSCs, reendothelialization and intima hyperplasia in carotid artery of rabbits post balloon catheter injury, nethods Rabbits were treated with rhG-CSF (25 μkg, twice daily, i. p, n =35) or saline (n =32) for 5 days, then, carotid arteries of rabbits were injured by balloon catheter. The number of peripheral MSCs was detected with FACS. The morphology of injuried artery was examined with hematoxylin and eosin stain, PCNA was determined with immunohistochemistry. Results (1) Number of peripheral MSCs was similar at baseline and significantly increased at 24 hours and peaked at 7 days and remained increased till 14 days post rhG-CSF. (2) Significant endothelial cell deletion was evidenced in the control group, while scatter endothelial cells was observed in the rhG-CSF group at 1 week post injury. Two weeks after injury, new endothelial area was significantly higher in rhG-CSF group compared to control group. At 4 weeks post injury, endothelial connection was evidenced and regularly displayed in rhG-CSF treated group. (3) PCNA-positive cells in the tunica intima were significantly lower in rhG-CSF treated rabbits at 7, 14 and 28 days compared that in control rabbits (all P ＜ 0.01). Conclusion rhG-CSF could mobilize the bone marrow-MSCs and promote re-endothelialization and attenuate intima hyperplasia post balloon catheter injury in carotid arteries of rabbits.     

缺血后适应对急性心肌梗死患者心脏的保护作用

目的 探讨缺血后适应对心脏产生保护作用及与氧自由基和炎症反应的关系.方法 选取我院急性ST段抬高型心肌梗死（STEMI）患者42例,随机分为对照组（A组,n=22例）和缺血后适应组（B组,n=20例）.记录两组患者临床基本特征、冠脉病变情况以及支架置入情况;PCI术前、术后2h、1、2、3d抽取动脉血2 mL送我院检验科生化室检测血清肌酸激酶同工酶（CK-MB）水平;术前及术后2h抽取动脉血2 mL离心、保存于-80℃冰箱,待标本收集完后采用酶联免疫吸附测定法（ELISA）法检测血清丙二醛（MDA）、超氧化物歧化酶（SOD）及C反应蛋白（CRP）的水平.结果 两组患者临床基本特征、冠脉病变情况及支架置入情况比较无差异.B组术后2h血清MDA下降较A组明显（P＜0.05）,而B组血清SOD升高较A组明显（P＜0.001）,Pearson相关分析发现B组SOD和MDA的变化呈负相关（r=-0.438,P=0.04）,而A组呈正相关（r =0.301,P =0.05）;B组术后2h血清CRP值升高幅度明显低于A组（P＜0.05）,Pearson相关分析发现B组术后血清CRP伴随血清CK-MB下降幅度较A组明显（r=0.187,P＜0.01）.结论 缺血后适应通过降低STEMI患者直接PCI时氧自由基产生以及抑制炎症反应,对心脏发挥保护作用.     

骨髓间充质干细胞移植后颈动脉损伤球囊核转录因子κBp65和增殖细胞核抗原的表达

背景：炎症反应在经皮腔内冠状动脉支架置入后再狭窄的发生中起了重要作用。近年的研究发现,骨髓间充质干细胞具有较强的免疫调节特性。然而骨髓间充质干细胞对损伤血管炎症反应影响的报道较少。目的：观察骨髓间充质干细胞移植对兔颈动脉球囊损伤后核转录因子κBp65和增殖细胞核抗原表达的影响,分析其与内膜增殖作用的相关性。方法：制作颈动脉粥样硬化狭窄兔模型36只,随机分成2组,骨髓间充质干细胞移植组球囊损伤后接受4’,6-二脒基-2-苯基吲哚标记的骨髓间充质干细胞移植,对照组球囊损伤后接受等量的PBS液注射。造模前和细胞移植后7,14,28d分别抽取外周血,ELIAS法检测血清肿瘤坏死因子α和白细胞介素6的质量浓度;细胞移植后14d取血管组织,采用免疫组织化学分析法测定局部组织核转录因子κBp65和增殖细胞核抗原的表达,细胞移植后28d对血管组织行苏木精-伊红染色检测血管形态学变化。结果与结论：细胞移植后14d骨髓间充质干细胞移植组损伤血管局部核转录因子κBp65和增殖细胞核抗原的表达均较对照组明显减少（P〈0.05）。细胞移植后7,14,28d骨髓间充质干细胞移植组血清肿瘤坏死因子α和白细胞介素6质量浓度均较对照组显著降低（P〈0.05）。细胞移植后28d骨髓间充质干细胞移植组新生内膜面积、新生内膜/中膜面积及血管狭窄率均较对照组显著降低（P〈0.05）。提示骨髓间充质干细胞可能通过抑制损伤血管核转录因子κBp65活性,减轻炎症反应进而下调增殖细胞核抗原的表达,对抑制损伤血管新生内膜的增殖可能发挥有益作用。     

rhG-CSF和间充质干细胞移植治疗心肌梗死的比较研究

目的 比较分析rhG-CSF和MSCs移植对梗死心肌的修复作用,并分析其可能作用机制.方法 选择纯种大白兔45只(死亡10只),分为rhG-CSF组(n=12)、MSCs移植组(n=10)和对照组(n=13),于心肌梗死后30d,分别检测其心功能、梗死心肌的形态学以及新生毛细血管密度.结果 与对照组相比,rhG-CSF组和MSCs移植左心室收缩末期内径、舒张末期内径明显降低,心功能提高,室壁厚度增加,心肌梗死面积缩小,而梗死区和梗死边缘区新生毛细血管密度增加,具有统计学意义.结论 rhG-CSF应用和MSCS移植治疗兔心肌梗死,可明显改善心功能,缩小梗死面积,增加梗死心肌新生毛细血管密度.     

重组人粒细胞集落刺激因子对兔颈动脉粥样硬化球囊损伤后再内皮化和内膜增生的影响

Objeelive To investigate the effect of rhG-CSF on mobilizing bone marrow-MSCs, reendothelialization and intima hyperplasia in carotid artery of rabbits post balloon catheter injury, nethods Rabbits were treated with rhG-CSF (25 μkg, twice daily, i. p, n =35) or saline (n =32) for 5 days, then, carotid arteries of rabbits were injured by balloon catheter. The number of peripheral MSCs was detected with FACS. The morphology of injuried artery was examined with hematoxylin and eosin stain, PCNA was determined with immunohistochemistry. Results (1) Number of peripheral MSCs was similar at baseline and significantly increased at 24 hours and peaked at 7 days and remained increased till 14 days post rhG-CSF. (2) Significant endothelial cell deletion was evidenced in the control group, while scatter endothelial cells was observed in the rhG-CSF group at 1 week post injury. Two weeks after injury, new endothelial area was significantly higher in rhG-CSF group compared to control group. At 4 weeks post injury, endothelial connection was evidenced and regularly displayed in rhG-CSF treated group. (3) PCNA-positive cells in the tunica intima were significantly lower in rhG-CSF treated rabbits at 7, 14 and 28 days compared that in control rabbits (all P ＜ 0.01). Conclusion rhG-CSF could mobilize the bone marrow-MSCs and promote re-endothelialization and attenuate intima hyperplasia post balloon catheter injury in carotid arteries of rabbits.