目的:观察冠心病患者血清脂蛋白相关磷脂酶A2(LP-PLA2)及游离脂肪酸(NEFA)水平,并分析该指标变化与冠状动脉病变特征和经皮静脉介入(PCI)术后预后的相关性。方法:选取心内科住院患者589例,根据冠脉造影结果将其分为对照组(189例)、单支...目的:观察冠心病患者血清脂蛋白相关磷脂酶A2(LP-PLA2)及游离脂肪酸(NEFA)水平,并分析该指标变化与冠状动脉病变特征和经皮静脉介入(PCI)术后预后的相关性。方法:选取心内科住院患者589例,根据冠脉造影结果将其分为对照组(189例)、单支病变组(117例)、双支病变组(126例)和多支病变组(157例)。其中有166例患者行PCI术,采集所有研究对象空腹肘静脉血,并分别采集行PCI术患者术前、术后6h、术后12h、术后24h和术后48h血液样本,采用全自动生化分析仪检测血清LP-PLA2和NEFA水平。比较各组患者以及PCI术患者不同时点血清LP-PLA2和NEFA水平差异。结果:血清LP-PLA2水平在单支病变组(351.77±103.26U/L)、双支病变组(409.14±196.34U/L)及多支病变组(823.65±369.94U/L)均高于对照组(209.34±87.32U/L),差异均有统计学意义(P<0.01),且呈多支病变组>双支病变>单支病变组,差异亦均有统计学意义(P<0.01)。血清NEFA水平在多支病变组(1.22±0.83mmol/L)、双支病变组(0.92±0.49mmol/L)和单支病变组(0.56±0.13mmol/L)均高于对照组(0.23±0.07mmol/L),差异均有统计学意义(P<0.01),且呈多支病变组>双支病变组>单支病变组,差异亦均有统计学意义(P<0.01)。LP-PLA2和NEFA与冠脉病变支数呈显著正相关(r=0.698、0.626,P<0.01)。行PCI术患者术后6h血清LP-PLA2水平较术前升高(644.64±361.34U/L vs 286.12±188.32U/L,P<0.01),术后12h下降(452.57±245.56U/L),术后24h(385.23±132.47U/L)和术后48h(325.78±144.97U/L)持续下降,各时点差异均有统计学意义(P<0.01)。PCI术患者各时点血清NEFA水平无显著差异(P>0.05)。结论:血清LP-PLA2和NEFA水平与冠心病患者冠脉病变累及支数相关,对评估冠状动脉病变的严重程度有重要的临床意义。展开更多
梁师从事老年病科临床工作多年,认为老年人患病,常病多且杂,但病机特点多以本虚标实为主,肝肾脾胃亏虚为本,痰湿、瘀血为标,本文讲述梁师以二陈汤为基础方加减运用于老年人痰湿证相关疾病,收效满意,现举例典型临床验案3则,为临床灵活运...梁师从事老年病科临床工作多年,认为老年人患病,常病多且杂,但病机特点多以本虚标实为主,肝肾脾胃亏虚为本,痰湿、瘀血为标,本文讲述梁师以二陈汤为基础方加减运用于老年人痰湿证相关疾病,收效满意,现举例典型临床验案3则,为临床灵活运用二陈汤治疗痰湿证相关疾病提供思路。Dr. Liang has been practicing geriatrics for many years, and believes that diseases in the elderly are common and complex, but its pathogenesis is mainly manifested as deficiency in the liver, kidney, spleen and stomach, and phlegm and blood stasis. This paper describes the experience of Master Liang’s flexible application of Erchen Decoction in the diseases related to phlegm-dampness syndrome in the elderly, and has obtained satisfactory results. At the same time, three typical clinical cases are listed to provide ideas for how to flexibly use Erchen decoction to treat diseases related to phlegm-dampness syndrome in clinic.展开更多
文摘目的:观察冠心病患者血清脂蛋白相关磷脂酶A2(LP-PLA2)及游离脂肪酸(NEFA)水平,并分析该指标变化与冠状动脉病变特征和经皮静脉介入(PCI)术后预后的相关性。方法:选取心内科住院患者589例,根据冠脉造影结果将其分为对照组(189例)、单支病变组(117例)、双支病变组(126例)和多支病变组(157例)。其中有166例患者行PCI术,采集所有研究对象空腹肘静脉血,并分别采集行PCI术患者术前、术后6h、术后12h、术后24h和术后48h血液样本,采用全自动生化分析仪检测血清LP-PLA2和NEFA水平。比较各组患者以及PCI术患者不同时点血清LP-PLA2和NEFA水平差异。结果:血清LP-PLA2水平在单支病变组(351.77±103.26U/L)、双支病变组(409.14±196.34U/L)及多支病变组(823.65±369.94U/L)均高于对照组(209.34±87.32U/L),差异均有统计学意义(P<0.01),且呈多支病变组>双支病变>单支病变组,差异亦均有统计学意义(P<0.01)。血清NEFA水平在多支病变组(1.22±0.83mmol/L)、双支病变组(0.92±0.49mmol/L)和单支病变组(0.56±0.13mmol/L)均高于对照组(0.23±0.07mmol/L),差异均有统计学意义(P<0.01),且呈多支病变组>双支病变组>单支病变组,差异亦均有统计学意义(P<0.01)。LP-PLA2和NEFA与冠脉病变支数呈显著正相关(r=0.698、0.626,P<0.01)。行PCI术患者术后6h血清LP-PLA2水平较术前升高(644.64±361.34U/L vs 286.12±188.32U/L,P<0.01),术后12h下降(452.57±245.56U/L),术后24h(385.23±132.47U/L)和术后48h(325.78±144.97U/L)持续下降,各时点差异均有统计学意义(P<0.01)。PCI术患者各时点血清NEFA水平无显著差异(P>0.05)。结论:血清LP-PLA2和NEFA水平与冠心病患者冠脉病变累及支数相关,对评估冠状动脉病变的严重程度有重要的临床意义。
文摘梁师从事老年病科临床工作多年,认为老年人患病,常病多且杂,但病机特点多以本虚标实为主,肝肾脾胃亏虚为本,痰湿、瘀血为标,本文讲述梁师以二陈汤为基础方加减运用于老年人痰湿证相关疾病,收效满意,现举例典型临床验案3则,为临床灵活运用二陈汤治疗痰湿证相关疾病提供思路。Dr. Liang has been practicing geriatrics for many years, and believes that diseases in the elderly are common and complex, but its pathogenesis is mainly manifested as deficiency in the liver, kidney, spleen and stomach, and phlegm and blood stasis. This paper describes the experience of Master Liang’s flexible application of Erchen Decoction in the diseases related to phlegm-dampness syndrome in the elderly, and has obtained satisfactory results. At the same time, three typical clinical cases are listed to provide ideas for how to flexibly use Erchen decoction to treat diseases related to phlegm-dampness syndrome in clinic.