初诊急性心肌梗死患者血浆FGF-21水平及临床意义

目的 探讨初诊急性心肌梗死患者血浆成纤维细胞生长因子21(FGF-21)水平及其与血糖、血脂以及心肌梗死事件的关系.方法 应用ELISA方法测定初诊55例急性心肌梗死患者(急性心肌梗死组)及正常人52例(正常对照组)的血浆FGF-21水平,比较不同人群血浆FGF-21水平,分析初诊急性心肌梗死患者血浆FGF-21水平与体重指数(BMI)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、尿素氮(BUN)、血肌酐(SCr)、SUA(血尿酸)、血脂[三酰甘油(TG)、高敏C-反应蛋白(Hs-CRP)、门冬氨酸转移酶(AST)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)]以及急性心肌梗死事件等的关系.结果 急性心肌梗死伴有2型糖尿病组BMI、TG、BUN、SCr、SUA、Hs-CRP、AST、FBG、HbA1c、FGF-21均高于正常对照组,TC、HDL-C、LDL-C均低于正常对照组,差异均有统计学意义(P<0.05).急性心肌梗死未伴有2型糖尿病组BUN、SCr、SUA、AST、FBG、HbA1c、FGF-21均高于正常对照组,TC、HDL-C、LDL-C均低于正常对照组,差异均有统计学意义(P<0.05).急性心肌梗死伴有2型糖尿病组年龄、BUN、SCr、FBG、HbA1c、BNP、CKMB均高于急性心肌梗死未伴有2型糖尿病组,差异均有统计学意义(P<0.05).初诊急性心肌梗死患者患者FGF-21水平与TG呈正相关(r=0.627,P=0.000).健康人群中,血浆FGF-21水平与TG呈正相关(r=0.318,P=0.0016).多元Logistic回归显示,年龄、HbA1c、FGF-21是的急性心肌梗死的独立危险因素.结论 心肌缺血而引起心肌损伤时,患者血浆FGF-21存在代偿性的分泌量增加,可能在心肌保护过程中起了作用.     

瑞舒伐他汀短期强化治疗对急性冠状动脉综合征患者经皮冠状动脉介入术后的作用

目的 探究急性冠状动脉综合征（ACS）患者经皮冠状动脉介入治疗（PCI）后,采用瑞舒伐他汀短期强化治疗对患者心功能、心肌损伤情况及炎症水平的影响。方法 选择2015年1月—2017年12月渭南市中医医院行PCI治疗的ACS患者85例,按照入院先后顺序分为两组,对照组（n=43）行抗凝治疗、抗血小板治疗以及抗血管治疗等,根据患者情况增加血管紧张素转换酶抑制剂或β受体阻滞剂等;观察组（n=42）在上述基础上给予瑞舒伐他汀强化治疗,每天1次,每次剂量为20 mg,须在睡前进行口服,连续治疗1个月。治疗1个月后,观察患者的心功能、心肌损伤及血清炎症因子水平等指标。结果 治疗1个月后,两组治疗后左心室射血分数（LVEF）、房室瓣EA峰比值（E/A）升高,左心室收缩末径（LVSD）、左心室舒张末径（LVDD）降低,但差异均无统计学意义,观察组心功能指标与对照组无显著差异。治疗1个月后,两组患者心肌肌钙蛋白I（cTnI）、肌酸激酶同工酶（CK-MB）均显著升高,同组治疗前后比较差异有统计学意义（P<0.05）;且观察组cTnI、CK-MB显著低于对照组,组间差异有统计学意义（P<0.05）。治疗1个月后,两组患者脑尿钠肽（BNP）、超敏C反应蛋白（hs-CRP）水平均显著下降,同组治疗前后比较差异有统计学意义（P<0.05）;且观察组炎症因子水平明显低于对照组,组间差异有统计学意义（P<0.05）。结论 对行PCI术后的ACS患者采用瑞舒伐他汀短期强化治疗,可有效改善患者心肌损伤情况,降低炎症水平。     

Resveratrol exerts anti-obesity effects via mechanisms involving down-regulation of adipogenic and inflammatory processes in mice

Resveratrol is a natural polyphenolic stilbene derivative found in a variety of edible fruits, including nuts, berries, and grape skin. Although resveratrol has been suggested to improve thermogenesis in the brown adipose tissues of obese animals, there have been no reports on the anti-adipogenic and anti-inflammatory effects of resveratrol in the white adipose tissues of obese animals. The primary aim of this study was to investigate whether resveratrol attenuates high-fat diet (HFD)-induced adipogenesis and inflammation in the epididymal fat tissues of mice and to explore the underlying mechanisms involved in this attenuation. In comparison with HFD-fed mice, mice fed with a 0.4% resveratrol-supplemented diet (RSD) showed significantly lower body weight gain (−48%), visceral fat-pad weights (−58%), and plasma levels of triglyceride, FFA, total cholesterol, glucose, tumor necrosis factor (TNF) α, and monocyte chemoattractant protein-1 (MCP1). Resveratrol significantly reversed the HFD-induced up-regulation of galanin-mediated signaling molecules (GalR1/2, PKCδ, Cyc-D, E2F1, and p-ERK) and key adipogenic genes (PPARγ2, C/EBPα, SREBP-1c, FAS, LPL, aP2, and leptin) in the epididymal adipose tissues of mice. Furthermore, resveratrol significantly attenuated the HFD-induced up-regulation of pro-inflammatory cytokines (TNFα, IFNα, IFNβ, and IL-6) and their upstream signaling molecules (TLR2/4, MyD88, Tirap, TRIF, TRAF6, IRF5, p-IRF3, and NF-κB) in the adipose tissues of mice. The results of this study suggest that resveratrol inhibits visceral adipogenesis by suppressing the galanin-mediated adipogenesis signaling cascade. It may also attenuate cytokine production in the adipose tissue by repressing the TLR2- and TLR4-mediated pro-inflammatory signaling cascades in HFD-fed mice.