Lowering of Blood Lipid Levels with a Combination of Pitavastatin and Ezetimibe in Patients with Coronary Heart Disease:A Meta-Analysis

Objectives:According to the findings of randomized controlled trials,blood lipid levels in patients with coronary heart disease(CHD)can be significantly decreased through a combination of pitavastatin and ezetimibe;however,the effects and clinical applications of this treatment remain controversial.This meta-analysis was aimed at objectively assessing the efficacy and safety of pitavastatin and ezetimibe in lowering blood lipid levels.Design:Relevant studies were retrieved from electronic databases,including PubMed,Cochrane Library,Embase,China National Knowledge Infrastructure,VIP,and WanFang Data,from database inception to June 8,2022.The lev-els of low-density lipoprotein cholesterol,total cholesterol,triglycerides,and high-density lipoprotein cholesterol in patients’serum after treatment were the primary endpoint.Results:Nine randomized controlled trials(2586 patients)met the inclusion criteria.The meta-analysis indi-cated that pitavastatin plus ezetimibe resulted in significantly lower levels of LDL-C[standardized mean difference(SMD)=−0.86,95%confidence interval(CI)(−1.15 to−0.58),P<0.01],TC[SMD=−0.84,95%CI(−1.10 to−0.59),P<0.01],and TG[SMD=−0.59,95%CI(−0.89 to−0.28),P<0.01]than pitavastatin alone.Conclusions:Pitavastatin plus ezetimibe significantly decreased serum LDL-C,TC,and TG levels in patients with CHD.

Effects of SNPs at Newly Identified Lipids Loci on Blood Lipid Levels and Risk of Coronary Heart Disease in Chinese Han Population:A Case Control Study

Associations between ＂lipid-related＂ candidate genes,blood lipid concentrations and coronary artery disease（CHD） risk are not clear.We aimed to investigate the effect of three newly identified lipids loci from genome-wide association studies on CHD and blood lipid levels in Chinese Han population.The genotypes of SNPs at three newly identified lipid loci and blood lipids concentrations were examined in 1360 CHD patients and 1360 age-and sex-frequency matched controls from an unrelated Chinese Han population.Allele T of rs16996148 occurred less frequently in CHD patients with the odds ratio（OR） being 0.64（95% CI 0.50 to 0.81）,after adjusting for conventional risk factors and was associated with a 33% decreased CHD risk（P0.01） comparing with the major allele G.Individuals with GT genotype had the lowest CHD risk.No associations were found between the polymorphisms of other two loci with CHD risk and all three SNPs had no effect on lipid profile in this population.SNP rs16996148 on chromosome 19p13 is significantly associated with lower risk for CHD in Chinese Han population.However,it remains unresolved why these lipid-related loci had significantly less effects than the correspondingly expected effects on blood lipids levels in this population.

Relationship between estrogen receptor gene polymorphism and clinical indexes associated with coronary heart disease

Objective: To investigate the relationship between estrogen receptor(ER) gene and the clinical indexes associated with coronary heart disease (CHD). Methods: By means of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), we analyzed ER gene polymorphism in 84 CHD patients and 61 healthy subjects and non-CHD inpatients. The clinical indexes associated with CHD were analyzed in relation to the three ER genotypes. Results: There were significant differences in the incidence of hypertension (58.62%), fibrinogen (Fib) concentration (3.5±0.8 g/L), body mass index (BMI, 25.1±3.2), HDL-C concentration (1.0±0.2 mmol/L) between PP genotype group and other genotype groups (P<0.05). Conclusion: ER gene polymorphism may affect ER-mediated cardiovascular protective effect by modulating the expression of ER.

Coronary heart disease:Significance of liver X receptor α genomics

Crosstalk between lipid peroxidation and inflammation is known to be a pathognomonic feature for the development of coronary heart disease(CHD).In this regard ligand activated liver X receptor(LXR)-α has emerged as a key molecular switch by its inherent ability to modulate an array of genes involved in these two fundamental cellular processes.In addition,LXR-α has also been found to play a role in hepatic lipogenesis and innate immunity.Although several lines of evidence in experimental model systems have established the atheroprotective nature of LXR-α,human subjects have been reported to possess a paradoxical situation in which increased blood cellular LXR-α gene expression is always accompanied by increased coronary occlusion.This apparent paradox was resolved recently by the finding that CHD patients possess a deregulated LXR-α transcriptome due to impaired ligand-receptor interaction.This blood cellular mutated LXR-α gene ex- pression correlated specifically with the extent of coro- nary occlusion and hence need is felt to devise new synthetic ligands that could restore the function of this mutated LXR-αprotein in order to modulate genes involved in reverse cholesterol transport and suppression of the inflammatory response leading to the effective treatment of CHD.

Lipid Profile of Coronary Heart Disease Patients: A Prospective Observational Study

Background: Coronary heart disease (CHD) remains the major cause of mortality and morbidity in the entire world population despite therapeutic advances that control many risk factors. Lipid profile is regarded as an important factor in the development of coronary heart disease. There have been numerous studies confirming the association of hyperlipidemias with coronary heart disease in most of the Western as well as Asian countries of the world. But we have very little data on the relation between CHD and lipid profile. Aim of the Study: The aim of this study was to assess abnormal lipid levels and their association with coronary heart disease. Methods: This comparative observational study was conducted at the Department of Cardiology in M. Abdur Rahim Medical College, Dinajpur, Bangladesh from January 2019 to December 2019. Properly written consent was taken from all the participants before starting the main part of the investigation. Obeying inclusion and exclusion criteria of the study, a total of 131 participants were finalized as the study population. Among them, the Case Group was formed with 90 patients who had CHD, and with 41 healthy people, the Control Group was formed. All necessary data were collected, analyzed, and disseminated by several programs of MS-Office and SPSS version 23. Result: The study was conducted with 90 case group participants and 41 control group participants. Among the case group, 78% were male and 22% were female. Among the male case group participants, 44.29% were from 51 - 60 years of age, 35.71% were from 41 - 50 years of age and the rest 20% were above 60 years of age. On the other hand, among the female participants of Case Group, 45% were from 51 - 60 years of age, 30% from 41 - 50 years of age, and 25% were over 60 years of age. Regression analysis between the male and the female showed the P-value of 0.242. Serum cholesterol concentration and HDL concentration were significant between the Case and Control groups in all age groups and the P-value was <0.0001 in every age group. Triglyceride concentration was significant between the Case and Control groups in 41 - 50 and 51 - 60 years age groups with a P-value of <0.0001. But in the >60 years age group, we did not find any significant correlation and there the P-value was 0.478. LDL concentration between the groups showed significant correlations between the Case and Control groups in 41 - 50 and 51 - 60-years’ age groups where the P values were found, <0.0001 and 0.0002 respectively. But in the >60 years’ age group, we did not find any significant correlation and there the P- value was 0.515. Conclusion: In this study, it was found that the total cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol concentrations were significantly higher in coronary heart disease (CHD) patients.

Novel Imaging Approaches for the Diagnosis of Stable Ischemic Heart Disease in Women

Conventional recommendations for diagnostic testing for the evaluation of stable ischemic heart disease in women have largely paralleled those in men.Although they are designed primarily for the identifi cation of obstructive coronary artery disease(CAD),traditional approaches can lead to overtesting in women without differentiating who is truly at risk.Several unique factors related to the presentation,diagnosis,and underlying pathophysiology of stable ischemic heart disease in women necessitate a more specific approach to the assessment of their risk,complete with separate guidelines when appropriate.This overview highlights how advanced noninvasive imaging tools,including cardiac computed tomography angiography,positron emission tomography,and cardiac magnetic resonance imaging,are enabling very sensitive assessments of anatomic atherosclerotic plaque burden,macrovessel-and microvessel-related ischemia,and myocardial fi brosis,respectively.Moving forward,effective diagnostic testing will need to identify women at high risk of adverse cardiovascular events(not anatomically obstructive CAD per se)without overtesting those at low risk.Judicious application of novel imaging approaches will be critical to broadening the defi nitions of CAD and ischemia to better refl ect the whole spectrum of pathological phenotypes in women,including nonobstructive CAD and coronary microvascular dysfunction,and aid in the development of needed evidence-based strategies for their management.

Efficacy of Danlou Tablet in the Treatment of Coronary Heart Disease with Phlegm and Blood Stasis Syndrome and Its Effects on Serum Inflammatory Factors

[Objectives] To explore the efficacy of Danlou Tablet( DLT) in the treatment of coronary heart disease( CHD) with phlegm and blood stasis syndrome and its effects on serum inflammatory factors. [Methods]One hundred and ninety-seven patients with CHD and phlegm and blood stasis syndrome in our hospital from January 2016 to January 2018 were selected and randomly divided into two groups: control group( n =98) treated with aspirin plus atorvastatin,and research group( n =99) treated with DLT and aspirin plus atorvastatin for one month. The clinical efficacy and incidence of adverse reactions were observed. Serum secretory phospholipase A2( s PLA2),lipoprotein-associated phospholipase A2( LP-PLA2),oxidized low-density lipoprotein( ox-LDL),monocyte chemoattractant protein-1( MCP-1) and World Health Organization Quality of Life( WHOQOL-100) scores were compared before and after one month of treatment. [Results] The total effective rate was93. 94% in the research group,which was higher than that in the control group( 79. 59%,P < 0. 05);the levels of serum s PLA2,LP-PLA2,ox-LDL and MCP-1 in the research group were lower than those in the control group after one month of treatment( P < 0. 05). There was no statistical significance of the difference in the total incidence of adverse reactions between the research group and the control group( P > 0. 05).After one month of treatment,WHOQOL-100 scores were higher in two groups,which were higher in the research group than that in the control group( P < 0. 05). [Conclusions]DLT can significantly reduce the level of serum inflammatory factors,improve the quality of life in patients with CHD and phlegm and blood stasis syndrome.

Correlation of CT coronary angiography plaque properties with platelet function and serum biochemical indexes in patients with coronary heart disease

Objective:To study the correlation of CT coronary angiography plaque properties with platelet function and serum biochemical indexes in patients with coronary heart disease.Methods:Patients who received CT coronary angiography examination and were diagnosed with coronary heart disease in Tianmen First People's Hospital between March 2015 and October 2017 were selected as the research subjects and divided into those with soft plaque, mixed plaque and calcified plaque according to the CT results;the serum levels of platelet function indexes as well as blood lipid and inflammation biochemical indexes were determined. Results: Serum PAF, CD62P, sTLT-1, LDL, Lp-a, PCSK9, TNF-α, IFN-γ, IL-17A, CD40L and sICAM1 levels as well as platelet surface EMMPRIN and GPVI fluorescence intensity of patients with soft plaque and mixed plaque were significantly higher than those of patients with calcified plaques whereas serum HDL levels were lower than that of patients with calcified plaque, and serum PAF, CD62P, sTLT-1, LDL, Lp-a, PCSK9, TNF-α, IFN-γ, IL-17A, CD40L and sICAM1 levels as well as platelet surface EMMPRIN and GPVI fluorescence intensity of patients with soft plaque were significantly higher than those of patients with mixed plaque whereas serum HDL level was lower than that of patients with mixed plaque. Conclusion: The changes of CT coronary angiography plaque properties in patients with coronary heart disease are closely related to platelet aggregation, lipid metabolism disorder and inflammatory response activation.

Assessment of serum lipid metabolism index and cytokine levels in patients with type 2 diabetes mellitus complicated by coronary heart disease after telmisartan combined with lipid-lowering drug treatment

Objective:To study the effect of telmisartan combined with lipid-lowering drug therapy on serum lipid metabolism index and cytokine levels in patients with type 2 diabetes mellitus complicated by coronary heart disease.Methods:A total of106 patients with type 2 diabetes mellitus complicated by coronary heart disease who were treated in our hospital between September 2013 and October 2016 were collected and then divided into the control group (n=55) who received conventional treatment + lipid-lowering drug treatment and the observation group (n=51) who received conventional treatment + lipid-lowering drug + telmisartan treatment after the therapies were reviewed. Before and after treatment, serum levels of lipid metabolism indexes, inflammatory mediators and oxidative stress indexes were compared between two groups of patients.Results:Before treatment, the differences in serum levels of lipid metabolism indexes, inflammatory mediators and oxidative stress indexes were not statistically significant between two groups of patients. After treatment, serum TG and LDL-C levels in observation group were lower than those in control group while HDL-C level was higher than that in control group;serum inflammatory mediators IL-6, IL-8, HMGB1 and TNF-α levels were lower than those in control group;serum oxidative stress indexes MDA and ROS levels were lower than those in control group while GSH-Px level was higher than that in control group.Conclusion:Telmisartan combined with lipid-lowering drug therapy can effectively optimize the lipid metabolism and reduce the systemic inflammatory response and oxidative stress response in patients with type 2 diabetes mellitus complicated by coronary heart disease.

内皮脂肪酶和脂蛋白酶在冠状动脉粥样硬化发生及发展中的作用研究进展

冠心病是主要由冠状动脉粥样硬化导致的心肌缺血性病变。动脉壁僵硬、脂质代谢异常导致动脉内膜脂质类物质聚集、纤维组织增生和钙质沉积,斑块形成,从而影响血液运输。内皮脂肪酶(EL)是一种磷脂酶,可水解血浆高密度脂蛋白胆固醇,具有促进脂肪分解代谢的作用。脂蛋白酶(LPL)是溶解脂蛋白的关键酶,其特定的酶分子结构可水解甘油三酯,参与人体内脂蛋白代谢。因此,了解EL、LPL在冠状动脉粥样硬化发生及发展中的作用对早期防治冠心病至关重要。现对EL和LPL的结构、生物学特点以及在冠状动脉粥样硬化形成中的作用进行综述。

IL-35下调CD36表达减少巨噬细胞内脂质积累缓解动脉粥样硬化的机制研究

目的分析冠状动脉粥样硬化性心脏病(CHD)患者血清白细胞介素-35(IL-35)水平与血脂四项的相关性,探究IL-35抑制人髓系白血病单核细胞(THP-1)泡沫化机制。方法选取2022年6月—2023年6月在泰州人民医院就诊的疑似CHD患者154例,分为对照组和CHD组,空腹采血后用酶联免疫吸附试验检测两组血清IL-35水平,分析与血脂四项的相关性。采用油红染色和胆固醇检测试剂盒对比IL-35刺激THP-1细胞前后细胞内胆固醇含量变化;Western blotting检测CD36、SR-A、Lox-1、p38、p-p38蛋白的表达;实时荧光定量聚合酶链反应检测CD36、SR-A和Lox-1 mRNA的表达。结果CHD组血清IL-35水平低于对照组(P<0.05)。CHD患者血清IL-35水平与TC、LDL-C、TG呈负相关(r_(s)=-0.321、-0.218和-0.215,P=0.003、0.044和0.047),与HDL-C呈正相关(r_(s)=0.322,P=0.003)。对照组与实验组THP-1细胞2、4、6、8和10 h的荧光强度(FI)比较,结果:(1)不同时间点FI比较,差异有统计学意义(F=726.726,P=0.000);(2)实验组与对照组FI比较,差异有统计学意义(F=8.102,P=0.012),实验组FI较低;(3)两组FI变化趋势比较,差异有统计学意义(F=111.061,P=0.000)。oxLDL组和实验组CD36、SR-A、Lox-1蛋白和mRNA相对表达量均高于对照组和IL-35组(P<0.05),实验组CD36蛋白和mRNA相对表达量低于oxLDL组(P<0.05)。oxLDL组和实验组p-p38/p38蛋白相对表达量均高于对照组和IL-35组(P<0.05),实验组p-p38/p38蛋白相对表达量低于oxLDL组(P<0.05)。oxLDL组、实验组、P79350组CD36蛋白相对表达量均高于对照组(P<0.05),oxLDL组和P79350组CD36蛋白相对表达量均高于实验组(P<0.05)。结论CHD患者血清IL-35与血脂四项有相关性,IL-35可能通过抑制p38 MAPK信号通路介导巨噬细胞CD36表达下调,减少细胞内脂质。

从肾阴虚论治女性绝经后冠心病的研究进展

绝经后女性冠心病的发病率明显上升。近年来关于中医药补肾阴法治疗绝经后冠心病的研究越来越多,包括中药单体、单味药、中药复方等,其可上调绝经后女性雌激素水平,改善脂质代谢紊乱,抑制血管炎症反应,并保护血管内皮和平滑肌来防治冠心病的发生,同时无明显不良反应。通过对绝经后冠心病的病因病机、中医药治疗的基础研究和临床研究等方面进行全面综述,为临床治疗提供理论依据。

冠心病临界病变患者残余胆固醇/高密度脂蛋白胆固醇比值水平与冠脉CT血流储备分数的相关性

【目的】探讨冠状动脉粥样硬化性心脏病(冠心病)临界病变患者残余胆固醇/高密度脂蛋白胆固醇比值水平对冠脉CT血流储备分数(FFRct)的影响。【方法】本研究回顾性分析2022年1月1日-2022年12月31日中山大学附属第三医院心内科收治住院并行CCTA显示存在冠状动脉临界病变(管腔狭窄50%~70%)的219例患者为研究对象,其中临界病变血管304条。对以上纳入的冠脉临界病变血管行FFRct检查。FFRct以0.8为界,分为缺血组(FFRct≤0.8,N=108例)与非缺血组(FFRct>0.8,N=111例)。采用多因素Logistic回归分析探究冠心病临界病变患者FFRct≤0.8的影响因素;绘制受试者工作特征(ROC)曲线评估RC/HDL-C对FFRct≤0.8的预测价值;并通过Pear-son相关分析评估RC/HDL-C与FFRct之间是否存在相关性。【结果】缺血组中有糖尿病病史患者比例显著增高(P<0.001)。与非缺血组相比,缺血组患者RC、RC/HDL-C比值、Non-HDL-C、APOB、HbA1c、FPG水平显著增高(P<0.05)。Pearson相关性分析显示,RC/HDL-C比值、RC、Non-HDL-C、TC、TG、LDL-C、HDL-C、LP(a)、HbA1c、FPG均与FFRct值呈显著负相关(P<0.05)。单因素Logistic回归分析结果显示,糖尿病、RC、RC/HDL-C比值、Non-HDL-C、TG、LP(a)、HbA1c、FPG均与FFRct≤0.8均呈显著相关(P<0.05)。多因素Logistic回归分析表明,RC/HDL-C比值是FFRct≤0.80的预测因子(OR=4.682,95%CI 1.197~18.316,P<0.05)。【结论】冠状动脉粥样硬化性心脏病临界病变患者RC/HDL-C比值水平与FFRct≤0.8独立相关,RC/HDL-C比值可能成为评估冠状功能性缺血的潜在指标。

阿托伐他汀及瑞舒伐他汀治疗冠心病患者的早期临床效果研究

目的探讨阿托伐他汀及瑞舒伐他汀治疗冠状动脉粥样硬化性心脏病(Coronary Heart Disease,CHD)患者的早期临床效果的差异。方法选取2021年6—12月沛县人民医院收治的74例CHD患者为研究对象。根据抛硬币法将其分为A、B两组,各37例。A、B两组的调脂药分别采用阿托伐他汀、瑞舒伐他汀治疗。对比两组患者治疗后血清超敏C反应蛋白、血脂水平、心功能及复发性心绞痛发生率。结果两组患者治疗后血清中超敏C反应蛋白、总胆固醇、左室收缩末期内径、三酰甘油、左室舒张末期内径、低密度脂蛋白胆固醇均低于治疗前,且B组患者降低更明显,差异有统计学意义(P均<0.05)。B组血清中高密度脂蛋白水平(1.12±0.22)mmol/L及左室射血分数(55.92±5.62)%均高于A组(1.02±0.14)mmol/L、(53.16±5.95)%,差异有统计学意义(t=-2.333,-2.051,P均<0.05)。两组患者复发性心绞痛的发生率比较,差异无统计学意义(χ^(2)=0.753,P>0.05)。结论阿托伐他汀及瑞舒伐他汀均可有效治疗CHD,但其中瑞舒伐他汀较阿托伐他汀治疗效果更佳。

化瘀通脉汤对冠心病血运重建术后心绞痛患者血脂、血液流变学水平的影响

目的 研究化瘀通脉汤对冠心病血运重建术后心绞痛患者血脂、血液流变学水平的影响。方法 选取2019年1月—2020年12月期间濮阳市中医医院收治的冠心病血运重建术后心绞痛患者96例纳入研究,通过随机数字表法分为对照组和观察组,每组各48例。两组患者均给予低脂饮食、休息等常规干预。对照组给予西医常规药物治疗,观察组在对照组基础上给予化瘀通脉汤治疗。治疗1个月后,观察比较两组患者临床疗效、不良反应发生情况,治疗前后中医症状积分、血脂指标[三酰甘油(Triglyceride,TG)、总胆固醇(Total cholesterol,TC)、高密度脂蛋白(High density lipoprotein cholesterol,HDL-C)、低密度脂蛋白(Low density lipoprotein cholesterol,LDL-C)]水平、血液流变学指标[全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原]水平。结果 治疗后观察组总有效率93.75%(45/48)明显高于对照组79.17%(38/48),差异有统计学意义(P<0.05)。治疗后两组患者胸痛、胸闷、心悸、食少纳呆、胃脘痞满积分较治疗前降低,差异有统计学意义(P<0.05);且观察组明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者TG、TC、LDL-C水平较治疗前降低,HDL-C水平较治疗前升高,差异有统计学意义(P<0.05);且观察组TG、TC、LDL-C水平明显低于对照组,HDL-C水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原水平较治疗前降低,差异有统计学意义(P<0.05);且观察组明显低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 化瘀通脉汤对冠心病血运重建术后心绞痛患者有较好疗效,能够有效缓解患者临床症状,并改善其血脂、血液流变学水平,同时安全性较高,具有临床应用价值。

基于肠道菌群与冠心病的关系探讨“阴火”科学内涵

肠道菌群与冠心病之间有密切的生理病理联系,肠道菌群结构及产物影响冠心病的发生发展。近年来,中医药领域高度关注肠道菌群对疾病的影响,而肠道菌群主要通过炎症损伤血管内皮、造成脂质代谢紊乱、促进血栓形成及氧化应激损伤血管内膜等机制影响冠心病,通过类比发现此机制与中医脾胃失调、元气失养、阴火内生病机过程相通。因此,从“阴火”理论可指导调节肠道菌群,进而治疗冠心病,这将为冠心病的中医药临床防治和科学研究带来新思路。

非传统脂质参数与2型糖尿病合并冠心病的关系

目的:通过检测2型糖尿病(T2DM)与合并冠心病(CHD)病人的非传统脂质指标,寻找预测T2DM合并CHD风险更灵敏的脂质参数,为临床预测T2DM病人并发CHD提供更有力的参数指标。方法:收集2022年6月-12月于山西白求恩医院内分泌科及心血管内科住院的T2DM病人303例,根据冠状动脉造影结果分为两组,即单纯T2DM组(150例)和T2DM合并CHD组(153例)。记录两组一般临床资料及实验室指标等,同时根据传统血脂参数计算非传统脂质参数。采用Logistic回归分析及受试者工作特征(ROC)曲线评价非传统脂质参数与T2DM合并CHD的相关性。结果:与单纯T2DM组相比,T2DM合并CHD组病人传统血脂参数高密度脂蛋白胆固醇(HDL-C)水平较低(P<0.05)。然而,非传统脂质参数如总胆固醇(TC)/HDL-C、低密度脂蛋白胆固醇(LDL-C)/HDL-C、血浆致动脉粥样硬化指数(AIP)在T2DM合并CHD组均高于单纯T2DM组(P<0.05)。单因素Logistic回归分析显示,HDL-C为T2DM合并CHD的保护因素(OR=0.191),而非传统脂质参数LDL-C/HDL-C(OR=1.376)、AIP(OR=2.215)、脂蛋白联合指数(LCI)(OR=1.009)为T2DM合并CHD的危险因素。进一步行多因素Logistic回归分析显示,HDL-C为T2DM合并CHD的独立保护因素(OR=0.077),而非传统脂质参数LCI为T2DM合并CHD的危险因素(OR=1.023)。ROC曲线显示,HDL-C、TC/HDL-C、LDL-C/HDL-C、AIP的ROC曲线下面积(AUC)分别为0.386,0.601,0.578,0.572,其中非传统脂质指标预测能力强于传统脂质。同时,LCI联合单因素Logistic回归分析中差异有统计学意义的HDL-C、LDL-C/HDL-C、AIP进行检测时AUC则增大,说明传统HDL-C和非传统脂质参数联合检测进一步提高了T2DM合并CHD的诊断效能。结论:HDL-C、LDL-C/HDL-C、AIP与LCI为T2DM合并CHD的影响因素。LCI为T2DM并发CHD的危险因素。非传统脂质指标对T2DM病人发生CHD的预测能力强于传统血脂参数,同时通过传统脂质参数HDL-C和非传统脂质参数的联合检测进一步提高了T2DM合并CHD的诊断效能。

氨氯地平联合阿托伐他汀钙片治疗高血压合并冠心病的临床疗效

目的 分析氨氯地平联合阿托伐他汀钙片对高血压合并冠心病患者的康复所起到的积极作用。方法 78例高血压合并冠心病患者,采用随机数字表法分为对照组与观察组,每组39例。对照组采用氨氯地平治疗,观察组采用氨氯地平联合阿托伐他汀钙片治疗。对比两组血压、血脂、临床治疗效果、并发症发生率、自我护理能力[自我护理能力量表(ESCA)评分]及生活质量水平[生活质量量表(QOL)评分]。结果 治疗后,两组收缩压和舒张压均较治疗前降低,且观察组收缩压(122.23±10.74)mm Hg(1 mm Hg=0.133 kPa)和舒张压(87.58±9.86)mm Hg低于对照组的(137.69±12.56)、(95.86±8.05)mm Hg,差异显著(P<0.05)。观察组总胆固醇(3.06±0.36)mmol/L、低密度脂蛋白胆固醇(1.51±0.21)mmol/L、甘油三酯(1.54±0.14)mmol/L均低于对照组的(4.14±0.74)、(1.87±0.16)、(2.03±0.06)mmol/L,高密度脂蛋白胆固醇(1.54±0.14)mmol/L高于对照组的(1.25±0.13)mmol/L,差异显著(P<0.05)。观察组治疗总有效率94.87%显著高于对照组的74.36%,差异显著(P<0.05)。观察组不良反应发生率7.69%显著低于对照组的28.21%,差异显著(P<0.05)。治疗后,观察组ESCA评分(123.45±12.63)分及QOL评分(57.56±6.13)分高于对照组的(108.23±10.65)、(48.52±6.22)分,差异显著(P<0.05)。结论 氨氯地平联合阿托伐他汀钙片用于高血压合并冠心病治疗中,取得了良好的疾病治疗效果。

冠心病慢性稳定性心绞痛患者应用温阳养心汤治疗的效果

目的 探讨冠心病慢性稳定性心绞痛应用温阳养心汤治疗的效果。方法 选取南京中医药大学附属南京市中医院2021年11月至2023年10月收治的冠心病慢性稳定性心绞痛患者89例,按随机数字表法分组,对照组44例接受西医治疗,观察组45例加用温阳养心汤治疗,对两组取得的治疗效果予以比较。结果 治疗后,与对照组比较,观察组治疗总有效率更高(P <0.05);胸闷、心悸、胸痛与气短症候积分更低(P <0.05);氨基末端脑钠肽前体(NT-proBNP)与超敏C反应蛋白(hs-CRP)水平更低(P <0.05);甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平更低,高密度脂蛋白胆固醇(HDL-C)水平更高(P <0.05);两组不良反应发生率差异无统计学意义(P> 0.05)。结论 冠心病慢性稳定性心绞痛应用温阳养心汤治疗,可取得更好的疗效,有利于减轻患者的中医症候,降低炎性反应,改善血脂水平。

毛蕊花糖苷对冠心病大鼠炎症及脂代谢的影响

目的 探讨毛蕊花糖苷(verbascoside, Verb)对冠心病(CHD)大鼠炎症及脂代谢的影响。方法 将SD大鼠随机分为对照组、模型组、毛蕊花糖苷低、中、高剂量组,每组12只。对照组大鼠正常饲料喂养,其他组大鼠高脂饮食联合腹腔注射垂体后叶素诱导冠心病模型。建模后,对照组和模型组大鼠均每天灌胃2 mL生理盐水,低、中、高剂量组大鼠分别每日灌胃2 mL剂量为20,40,80 mg/kg的毛蕊花糖苷,共灌胃4周。末次给药后24 h,分别检测各组大鼠的心功能指标[射血分数(EF)和短轴缩短率(FS)]、血清心肌损伤标志物[肌酸激酶同工酶MB(CK-MB)和乳酸脱氢酶(LDH)]、血清脂代谢指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和游离脂肪酸(FFA)]和血清炎症指标[肿瘤坏死因子-α(TNF-α)、细胞间黏附分子-1(ICAM-1)和单核细胞趋化因子-1(MCP-1)]。通过苏木素伊红(HE)染色观察心肌形态。通过qRT-PCR检测心肌组织中AMP激活的蛋白激酶α(AMPKα)、过氧化物酶体增殖物激活受体α和γ(PPAR-α和PPAR-γ)和PPAR-γ激活分子1α(PGC-1α)的mRNA水平。通过Western blot检测心肌组织中核因子-κB(NF-κB) p65和AMPKα的磷酸化水平。结果 与对照组比较,模型组大鼠的EF和FS降低(P<0.05),血清中CK-MB、LDH、TC、TG、LDL-C、FFA、TNF-α、ICAM-1和MCP-1水平升高(P<0.05),血清HDL-C水平降低(P<0.05),心肌组织中NF-κB p65的磷酸化水平升高(P<0.05),心肌组织中AMPKα、PPAR-α、PPAR-γ和PGC-1α mRNA水平和AMPKα的磷酸化水平降低(P<0.05)。与模型组比较,低、中和高剂量组大鼠的EF和FS升高(P<0.05),血清中CK-MB、LDH、TC、TG、LDL-C、FFA、TNF-α、ICAM-1和MCP-1水平降低(P<0.05),血清HDL-C水平升高(P<0.05),心肌组织中NF-κB p65的磷酸化水平降低(P<0.05),心肌组织中AMPKα、PPAR-α、PPAR-γ和PGC-1α mRNA水平和AMPKα的磷酸化水平升高(P<0.05)。与低剂量组比较,中和高剂量组大鼠的EF和FS升高(P<0.05),血清中CK-MB、LDH、TC、TG、LDL-C、FFA、TNF-α、ICAM-1和MCP-1水平降低(P<0.05),血清HDL-C水平升高(P<0.05),心肌组织中NF-κB p65的磷酸化水平降低(P<0.05),心肌组织中AMPKα、PPAR-α、PPAR-γ和PGC-1α mRNA水平和AMPKα的磷酸化水平升高(P<0.05)。结论 毛蕊花糖苷有效改善了冠心病大鼠的心功能,减轻了心肌损伤,其机制可能与抑制NF-κB介导的炎症反应和激活AMPK介导的脂代谢基因转录和表达有关。