Left atrial area index predicts adverse cardiovascular events in patients with unstable angina pectoris

Background The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index （LAAI） has predictive value for prognosis in patients with unstable angina pectoris （UAP）. This study was aimed to assess the association between LAAI and outcomes in UAP patients. Methods We enrolled a total of 391 in-hospital patients diag- nosed as UAP. Clinical and echocardiographic data at baseline were collected. The patients were followed for the development of ad- verse cardiovascular （CV） events, including hospital readmission for angina pectoris, acute myocardial infarction （AMI）, congestive heart failure （CHF）, stroke and all-cause mortality. Results During a mean follow-up time of 26.3±8.6 months, 98 adverse CV events occurred （84 hospital readmission for angina pectoris, four AMI, four CHF, one stroke and five all-cause mortality）. In a multivariate Cox model, LAAI [OR： 1.140, 95% CI： 1.01±1.279, P = 0.026], diastolic blood pressure （OR： 0.976, 95% CI： 0.956-0.996, P = 0.020） and pulse pressure （OR 1.020, 95% CI： 1.007-1.034, P = 0.004） were independent predictors for adverse CV events in UAP patients. Conclusions LAAI is a predictor of adverse CV events independent of clinical and other echocardiographic parameters in UAP patients.

Effects of systematic cardiac rehabilitation training in elderly patients with unstable angina following cardiac stent implantation

BACKGROUND Coronary stent implantation is usually used to treat unstable angina to alleviate stenosis or occlusion,promoting blood flow restoration and alleviating symptoms such as myocardial ischemia.And postoperative cardiac rehabilitation is essential for enhancing recovery and prognosis.Nevertheless,conventional rehabilitation lacks specificity,particularly for elderly patients with multiple comorbidities and poor compliance,rendering it less effective.AIM To investigate the effects of systematic cardiac rehabilitation training in elderly patients with unstable angina following coronary stenting intervention.METHODS A retrospective enrollment was conducted comprising fifty-four elderly patients with unstable angina pectoris who underwent systematic cardiac rehabilitation training after receiving coronary intervention as the rehabilitation group,while fifty-three elderly patients who received basic nursing and rehabilitation guidance measures after coronary intervention were assigned to the control group.Differences in Seattle Angina Questionnaire scores,survival quality(SF-36)scores,cardiopulmonary exercise function assessment index,echocardiographic cardiac function index,and adverse cardiovascular events were compared between the two groups.RESULTS After intervention,the rehabilitation group observed greater VO2 Max,maximum metabolic equivalent,eft ventricular ejection fraction,left ventricular end-diastolic diameter and smaller left ventricular end-systolic diameter.And the rehabilitation group observed greater scores of physical activity limitation,stable angina pectoris,treatment satisfaction,and SF-36 score.The incidence of adverse cardiovascular events in the two groups,showed no significant difference.CONCLUSION Systematic cardiac rehabilitation following coronary stenting in elderly patients with unstable angina pectoris can enhance cardiac function recovery,consequently enhancing both quality of life and cardiopulmonary exercise tolerance.

Effects of Ginkgo Leaf Extract on Function of Dendritic Cells and Th1/Th2 Cytokines in Patients with Unstable Angina Pectoris

Objective： To investigate the effects of Ginkgo leaf extract （GLE） on function of dendritic cells （DO） and Th1/Th2 cytokines in patients with unstable angina pectoris（UAP）. Methods： Fifty-four patients with UAP were equally assigned into two groups, the treated group and the control group, both treated with conventional Western medicine, but with GLE given additionally to the treated group. Blood of all patients was taken before and 4 weeks after treatment to prepare the peripheral mononuclear cells, then which were incubated in the completed medium containing granulocyte-macrophage colony stimulatory factor （GMCSF） and interleukin-4 （IL-4） to induce mature DO. The expression of co-stimulating factor CD86 （B7-2） on the surface of DC was detected by flow cytometry, and the stimulating capacity of DC was determined by mixed lymphocyte reaction （MLR）. The blood levels of cytokines, interferon-γ （IFN-γ）, and IL-4, were analyzed by ELISA, and blood C-reactive protein （CRP） level by turbidimetry. Moreover, the direct effect of Ginkgolide B on CD86 expression on DO were also tested in vitro. Results： After treatment, CD86 expression on DO, the stimulating capacity of DO as well as levels of IFN-γ and ORP were lowered in both groups （P〈0.05 or P〈0.01）, but the changes were much more significant in the treated group than those in the control group. Ginkgolide B showed a direct inhibitory effect on the CD86 expression on DO. Conclusion： The inhibition of GLE on DO and thereby the suppression on inflammatory reaction may be one of the mechanisms of GLE in treating patients with UAP.

EFFECTS OF EXERCISE ON THE FIBRINOLYTIC ACTIVITY INPATIENTS WITH UNSTABLE ANGINA PECTORIS

Objective The purpose of this study was to evaluate the fibrinolytic response to exercise in patients with unstable angina pectoris(UAP) compared with an age - matched control group. Methods We measuredtissure- type plasminogen activator (t- PA) activity and plasminogen activator inhibitor 1(PAI- 1) activitybefore and after treadmill exercise test in 20 healthy subjects and 25 patients with UAP. ResultsResting t - PA activities were similar between two groups, but resting PAI- 1 activity was higher in UAP groupthan in control. Although both groups showed significant increase in t- PA activity with exercise, post - exerciset - PA activity was significantly lower in patients with UAP than in control (0.96± 0.45IU/ml vs 1.89± 0.68I U/ml,P<0.01), Post - exercise PAI- 1 activity was still much higher in UAP group than in control (8.20±2.28A U/ml vs4.21± 0.68A U/ml, P<0.01). Conclusion There existed impaired fibrinolysis in patients with UAP not only at restbut also alter exercise loading.

Comparative Study on the Effects of Small Dose of Aspirin Combined with Ginkgo-damole Injection(银杏达莫注射液) and the Effects of Conventional Dose of Aspirin in Treating Senile Unstable Angina Pectoris

Objective: To evaluate the therapeutic and adverse effect of small dose of aspirin (Asp) combined with Ginkgo-damole injection (GDI,银杏达莫注射液) in treating senile unstable angina pectoris (UA). Methods: One hundred and twenty old in-patients of coronary heart disease with UA were randomly divided into two groups. The 60 patients in the treated group were treated with oral administration of enteric soluble 50 mg Asp once a day and GDI 20 ml per day by intravenous dripping, with 14 days as one therapeutic course, while the other 60 in the control group were treated with enteric soluble Asp 100 mg alone once a day orally. Besides, isosorbide-5-mononitrate 20 mg twice a day was applied to both groups, and the β-ad-renoceptor blocker, blood lipids regulatory agents and nitroglycerin (10 mg by intravenous dripping) were given accordingly. The angina total improving rate, hemorrheologic indexes (whole blood viscosity, plasma viscosity, fibrinogen, platelet aggregation rate), comprehensive clinical terminal event and the total occurrence rate of adverse reaction in the two groups were observed. Results: After treatment, comparison between the two groups showed insignificant difference in aspects of angina total improving rate (75.00% vs 65.00%), hemorrheological indexes and comprehensive clinical terminal event rate (25.00% vs 31.67%), P>0.05, and the hemorrheological indexes were improved in both groups (P<0.05), but the total occurrence rate of adverse reaction in the treated group was lower than that in the control group (6. 67% vs 25.00%), showing significant difference (P<0.05). Conclusion: In treatment of senile UA, small dose of Asp combined with GDI showed therapeutic effect similar to that of conventional dose of Asp, but it has lower adverse reaction.

Effect of Chinese Herbs for Activating Blood Circulation,Removing Stasis and Supplementing Qi on the Circulating Endothelial Cells in Patients with Unstable Angina Pectoris

Objective: To observe the effect and clinical significance of circulating endothelial cells (CEC) in the pathogenesis of coronary heart disease with unstable angina pectoris (CHD-UAP), and to explore the protective effect of Chinese herbs for activating blood circulation, removing stasis and supplementing Qi (CH) on CHD-UAP patient's CEC. Methods: Sixty patients with diagnosis of CHD-UAP confirmed and differentiated to be Qi-deficiency and blood stasis by TCM were randomly divided into two groups and treated, on the basis of Western drug-therapy, with Tongxinluo capsule (通心络胶囊, TXL) and Huoxue Tongmai capsule (活血通脉胶囊, HXTM) respectively by way of oral taking three times a day, 3 capsules every time, with 1 month as one therapeutic course. The number of CEC in patients' blood circulation was counted before and after treatment. Besides, the number of CEC in 30 healthy persons was also counted for control. Results: The number of CEC in CHD-UAP patients was significantly higher than that in the healthy persons (P<0.01). After the patients were treated with CH, either TXL or HXTM, it significantly decreased (P<0.01)with insignificant difference between the two treated groups. Conclusion: CEC in CHD-UAP patients is severely damaged and endothelial function in disorder, Chinese herbs have protective effect on patients' CEC.

Effects of Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy on platelet function, inflammatory response and lipid metabolism in patients with unstable angina pectoris

Objective: To study the effects of Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy on platelet function, inflammatory response and lipid metabolism in patients with unstable angina pectoris. Methods: A total of 96 patients who were diagnosed with unstable angina pectoris for the first time in Beijing Shunyi District Hospital of Traditional Chinese Medicine between February 2015 and January 2018 were chosen and randomly divided into two groups, the observation group received Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy, and the control group only accepted antiplatelet drug and statin therapy. Platelet function parameters, inflammatory response parameters and lipid metabolism parameters were determined before treatment and after 2 months of treatment. Results: Compared with those of same group before treatment, PAF, P-selectin, PDGF, E-selectin, Gal-3, TNF-α, IFN-γ, LDL-C, PCSK9, Chemerin and Visfatin contents in serum as well as C3aR and C5aR contents in peripheral blood platelets of both groups of patients were decreasing whereas sFGL2, TGF-β1, APN and Vaspin contents in serum were increasing after treatment, and PAF, P-selectin, PDGF, E-selectin, Gal-3, TNF-α, IFN-γ, LDL-C, PCSK9, Chemerin and Visfatin contents in serum as well as C3aR and C5aR contents in peripheral blood platelets of observation group after treatment were lower than those of control group whereas sFGL2, TGF-β1, APN and Vaspin contents in serum were higher than those of control group. Conclusion: Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy for unstable angina pectoris can more effectively inhibit the platelet aggregation and improve the inflammatory response and lipid metabolism.

The Study of hemodynamics and coronary arteriography of Patients with Different Types of Unstable Angina Pectoris

Objectives To explore the basic heart functional state and cardiac reserve function of patients with different types of unstable angina pectoris (UAP) and observe the relations between the heart function and severity of coronary arterial disease. Methods 70 cases with UAP were enrolled including 25 patients with angina decubitus (AD), 23 patients with mixed angina (MA) , and 22 patients with accelerated effort angina (AEA). All patients underwent a series of examination such as UCG, ECT, hemodynamics and volume-loading test. The patients were divided into three groups in light of the results of the hemodynamic examination: ① diastolic dysfunction group ② systolic dysfunction group ③ normal heart function group. We assessed the basic heart function and cardiac reserve function of patients with different types of UAP and also observed the relations between coronary arteriography and heart function. Results ① Under basic conditions, patients with angina decubitus suffered from the systolic (36%) or diastolic dysfunction (48%). 43 percent of the patients with mixed angina had systolic dysfunction and other 43 percent of them had normal cardiac function. However, patients with accelerated effort angina (AEA) were characterized by diastolic dysfunction (31%) or normal heart function (60%). ② In hemodynamic examination, the pulmonary capillary wedge pressure of positive patients rose, at the same time cardiac index fell to the extreme instantaneously after loading in volume-loading test and then they restored to the basic level until 60 minutes. However, both PCWP and CI of the negative patients reach the peak momentarily after loading. They returned to the basic level within 30 minutes. ③ coronary arteriography show: there are 41% of patient with three-vessel disease, 50% with two-vessel disease, 9% single vessel disease and left main narrowing 22. 7% in AEA. There are separately 76%, 24%, 0% and 36% in AD; and 26.1% , 43.4% , 21.7% , 43.4% in MA. ④ Constituent ratio of the AEA and MA were separately compared with AD, AEA/AD: P < 0.05(P = 0.031); MA/AD: P < 0.01 (P = 0.000313). Conclusions Most of patients with the above three types of unstable angina pectoris suffered from the basic heart dysfunction and cardiac reserve dysfunction which might participate in the occurrence and development of unstable angina pectoris. In angiography, there are the most three-vessel diseases in AD that are, therefore, the most severe UAP.

Relationship Between Serum Creatine Kinase Isoenzyme MM Subbands and the Gradation of Coronary Stenosis in Patients with Unstable Angina Pectoris

Objective To observe the relationship between serum creatine kinase isoenzyme MM sub-bands (CKMM3/MM1 ratio) and the gradation of coronary stenosis and provide a simple, reliable, and economical method for identifying high-risk unstable angina pectoris (UAP). Mehtods Blood samples were drawn at different time after onset of chest pain in 21 patients with UAP and only once in 20 each volunteers for control. CKMM3/MM1 ratio was detected by nonserial buffer agarose gel electrophoresis. CKMB and CK were observed by velocity method. An emergent coronary arteriography was performed as soon as patients were admitted into hospital. Results Patients with UAP were divided into two subgroups: patients with elevated serum enzyme [P( + )] and patients with normal serum enzyme [P( - ) ] according to CKMM3/MM1 ratio < 0. 5. Patients with UAP( + ) had higher serum CKMM3/MM1 ratios from 0.5 to 12hrs and serum CKMB from 2 to 12 hrs than those with UAP( - ) and control ( P < 0. 05) . Serum enzyme concentrations of patients with UAP whose coronary lumen had 90% or more than 90% stenosis were significantly higher than those whose coronary lumen had less than 90% stenosis ( P <0. 01) . Any CK-MM3/MM1 ratio was less than 1. 0 and CK within the normal range in patients with UAP( + ) group. Conclusions CKMM3/MM1 ratios in patients with UAP can reflect severity of myocardial ischemia. SerumCKMM3/MM1 ratio provides a simple, reliable, and economical method for identifying high-risk UAP.

Effects of XUEZHIKANG on Oxidized Low Density Lipoprotein,C - Reactive Protein, Fibrinogen in Unstable Angina Pectoris Patients

Objectives To study the effects of XUEZHIKANG on lipid modulating and the level of oxidized low density lipoprotein(OX - LDL), C -reactive protein(CRP), fibrinogen(FIB) in serum. Methods XUEZHIKANG was given to patients with unstable angina pectoris and hyperlipidemia at a dose of 0. 6 gram bid for 2 months and with half -dose for another 2 months. Vitamin E was given to unstable angina pectoris patients with normal lipid at the dose of 0. 1 gram bid for 4 months respectively. Then compared the level of lipid and OX - LDfL, CRP, FIB in serum at beginning, first - month and second -month. Results XUEZHIKANG can reduce the serum level of total cholesterol, low density lipoprotein in 1 month , and gained better effect in 2 months. It can also reduce triglyceride and increase high density lipoprotein in 2 months. Compared with vitamin E XUEZHIKANG can reduce the level of OX - LDL, CRP, FIB significantly after treatment for 2 months. Conclusions XUEZHIKANG has significant effect in lipid modulating , and it can also inhibit the development of inflammation in coronary plaque.

Effect of Yixinkangtai Capsule combined with diltiazem on endothelial function, blood viscosity and lipid metabolism in patients with unstable angina pectoris

Objective: To discuss the effect of Yixinkangtai Capsule combined with diltiazem on endothelial function, blood viscosity and lipid metabolism in patients with unstable angina pectoris. Methods: A total of 150 patients with unstable angina pectoris who were treated in the hospital between February 2014 and February 2017 were divided into the control group (n=75) and the research group (n=75) according to the random number table method. Control group received clinical conventional therapy, research group received Yixinkangtai Capsule combined with diltiazem therapy on the basis of conventional therapy, and both groups received 3 months of treatment. Differences in endothelial function, blood viscosity and lipid metabolism were compared between the two groups of patients before and after treatment. Results: Before treatment, the differences in serum levels of endothelial function indexes, blood viscosity indexes and lipid metabolism indexes were not statistically significant between the two groups. After 3 months of treatment, serum NO level of research group was higher than that of control group while ET-1 level was lower than that of control group;serum blood viscosity index TXB2 content of research group was lower than that of control group while PGI2 content was higher than that of control group;serum lipid metabolism indexes TG, TC and LDL-C contents of research group were lower than those of control group while HDL-C content was higher than that of control group. Conclusion: Yixinkangtai Capsule combined with diltiazem therapy can effectively optimize the endothelial function, reduce the blood viscosity and balance the lipid metabolism in patients with unstable angina pectoris.

Changes in plaque stability, cell apoptosis and coagulation indexes after patients with unstable angina pectoris accept adjuvant salvianolate therapy

Objective:To investigate the effect of adjuvant salvianolate therapy on plaque stability, cell apoptosis and coagulation indexes in patients with unstable angina pectoris.Methods: 92 patients with unstable angina pectoris treated in our hospital between May 2011 and August 2015 were collected, and after the treatment process and auxiliary examination results were retrospectively analyzed, they were divided into the control group (n=45) who accepted conventional treatment and the observation group (n=47) who accepted adjuvant salvianolate treatment. Before and after treatment, diasonograph was used to evaluate the plaque stability parameters of two groups of patients;ELISA was used to detect apoptosis-related molecule levels;immunoturbidimetry was used to detect blood coagulation indexes.Results: Before treatment, differences in plaque stability parameters, cell apoptosis molecules and coagulation indexes were not statistically significant between two groups of patients (P>0.05). After treatment, the plaque stability parameters plaque thickness, enhanced intensity, rise time and time to peak of observation group were significantly lower than those of control group (P<0.05);serum sFas, sFasL, fibrinogen (Fib), platelet (PLT), and D-Dimer (D-D) levels of observation group were significantly lower than those of control group while Bcl-2, prothrombin time (PT) and activated partial thromboplastin time (APTT) levels were significantly higher than those of control group (P<0.05).Conclusions: Adjuvant salvianolate treatment can increase the plaque stability, also inhibit myocardial cell apoptosis and improve the coagulation function in patients with unstable angina pectoris.

Effect of St. John＇s wort extract on depressive disorder in elderly patients with unstable angina

The elderly patients with coronary heart disease （CHD） are often accompanied with depression. This study aimed to assess the effect of St. John＇s wort extract （SWE） on depressive disorder in elderly patients with unstable angina pectoris. Altogether 170 patients who met the set criteria were enrolled in this prospective study. They were randomly divided into SWE group （44 patients）, Deanxit group （44）, psychotherapy group （42）, and control group （40）. The effectiveness of SWE was evaluated by reduced percentage of Hamilton depression （HAMD） scale and reduced frequency of angina pectoris attack, which were measured before and at 12 weeks after the treatment with SWE. The reduced percentages of HAMD scale were 79.5%, 56.8% and 57.1% in the SWE, Deanxit and psychotherapy groups, respectively. Compared with the control, the three groups had significant differences in the percentages （P〈0.001）. The improvement after the treatment was more significant in the SWE group than in the Deanxit or psychotherapy group （P〈0,05）. The improvement of angina pectoris evaluated by the Canadian Cardiac Society Classification was significantly better in the treatment groups （88.7%, 65.9%, 57.1%） than in the control group, and it was marked in the SWE group （P〈0.001）. Angina pectoris attack, its frequencies, durations and electrocardiographic changes were significantly improved in the treatment groups than in the control group （F=6.05, 4.58, 5.12, P〈0.01）. They are markedly improved in the SWE group （P〈0.05）. SWE can improve depressive symptoms more significantly in elderly patients with unstable angina pectoris than Deanxit or psychotherapy, proving that SWE contributes to better treatment of angina attack as well.

BNP联合cTnT对UAP合并CHF的诊断及术后不良心血管事件的预测

目的探讨脑钠肽(BNP)联合肌钙蛋白(cTnT)对冠心病不稳定型心绞痛(UAP)合并慢性心力衰竭(CHF)的诊断效能及介入术后不良心血管事件的预测价值。方法选取2020年5月—2023年5月天水市第一人民医院收治的患者,85例冠心病不稳定型心绞痛合并慢性心力衰竭患者作为慢性心力衰竭组,85例单纯冠心病不稳定型心绞痛未并发慢性心力衰竭患者作为非慢性心力衰竭组,体检的85名健康志愿者作为对照组。比较三组患者BNP、cTnT表达水平,并建立受试者特征(ROC)工作曲线分析BNP联合cTnT对冠心病不稳定型心绞痛合并慢性心力衰竭的诊断效能。随后将85例冠心病不稳定型心绞痛合并慢性心力衰竭PCI术后近期是否发生不良心血管事件(MACE)分为非MACE组(n=64)和MACE组(n=21),比较两组患者临床特征,并分析BNP、cTnT对冠心病不稳定型心绞痛合并慢性心力衰竭介入术后不良心血管事件的预测价值。结果三组受检者BNP、cTnT水平比较,差异有统计学意义(P<0.05)。慢性心力衰竭组BNP、cTnT水平明显高于非慢性心力衰竭组和对照组,差异有统计学意义(P<0.05)。BNP联合cTnT对冠心病不稳定型心绞痛合并慢性心力衰竭的诊断效能优于单一检测(P<0.05)。非MACE组与MACE组患者性别、BMI、合并基础疾病情况、饮酒史、吸烟史比较,差异无统计学意义(P>0.05);两组患者年龄、心功能分级、左室射血分数、TIMI评分、BNP以及cTnT表达水平比较,差异有统计学意义(P<0.05)。logistic回归分析结果表明:BNP、cTnT为冠心病不稳定型心绞痛合并慢性心力衰竭介入术后不良心血管事件的独立危险因素(P<0.05)。结论BNP联合cTnT可提升冠心病不稳定型心绞痛合并慢性心力衰竭的诊断效能,且BNP、cTnT为冠心病不稳定型心绞痛合并慢性心力衰竭介入手术后主要心血管事件的独立危险因素。提示临床上对于BNP、cTnT升高的冠心病不稳定型心绞痛合并慢性心力衰竭介入手术患者注意及时采取相关措施预防心血管不良事件的发生。

血红蛋白、血清蛋白对老年左室功能正常不稳定型心绞痛PCI术病人预后的预测价值

目的:探讨血红蛋白(Hb)和血清蛋白(ALB)对老年左室功能正常不稳定型心绞痛(UA)经皮冠状动脉介入(PCI)病人长期预后的评估价值。方法:选取2019年12月—2022年5月于首都医科大学附属北京同仁医院收治的左室功能正常的UA病人106例,均行超声心动图及冠状动脉造影检查确诊并接受PCI治疗。依据随访期间病人是否发生主要不良心血管事件(MACE)分为无MACE组(58例)和MACE组(48例),比较两组临床资料。采用多因素Logistic回归分析病人发生MACE的影响因素,采用平滑曲线拟合分析血清Hb、ALB与MACE的关系,并构建预测模型。结果:与无MACE组比较,MACE组高血压史、既往心肌梗死比例升高(P<0.05);血清肌酸激酶同工酶(CK-MB)、血尿酸、超敏C反应蛋白(hs-CRP)、N端脑钠肽前体(NT-pro BNP)、肌钙蛋白I(c TnI)升高(P<0.05或P<0.01),血清Hb、ALB水平及左室射血分数(LVEF)降低(P<0.01)。既往心肌梗死、血清hs-CRP升高、血清NT-pro BNP升高、血清Hb降低、血清ALB降低及LVEF降低为MACE发生的独立危险因素。Hb、ALB与MACE的发生呈线性负相关,当Hb≥117.8 g/L时,Hb每增加10 g/L,病人发生MACE的风险降低17%(P<0.05);当ALB≥34.70 g/L时,ALB每增加1 g/L,病人发生MACE的风险降低14%(P<0.05)。构建的列线图模型具有良好的区分度、准确性和临床有效性。结论:低血清Hb及ALB水平是老年左室功能正常的UA病人PCI术预后不良的独立危险因素,对该类病人的预后具有较好的预测价值。

基于网络药理学探讨速效救心丸联合复方丹参注射液治疗不稳定型心绞痛的机制

目的采用网络药理学和分子对接技术探索速效救心丸联合复方丹参注射液治疗不稳定型心绞痛的分子调控机制。方法中药系统药理学数据库与分析平台(TCMSP)、中医药百科全书平台(ETCM)、中药分子机制研究的生物信息学分析工具(BATMA-TCM)、本草组鉴平台(HERB)数据库结合成分检测文献筛选速效救心丸联合复方丹参注射液的成分和靶点,同时GeneCards、DisGeNET和OMIM数据库获取不稳定型心绞痛的靶点。用于进行基因本体和京都基因与基因组百科全书富集分析。结果本研究筛选出川芎嗪、丹参酮ⅡA、丹酚酸B等33种主要活性成分,得到前列腺素内过氧化物合成酶2、白细胞介素6(IL-6)等32个速效救心丸联合复方丹参注射液治疗不稳定型心绞痛的靶点。分子对接结果证明,本研究获得的活性成分与其对应的不稳定型心绞痛靶点间均有较高的亲和力。结论速效救心丸联合复方丹参注射液通过川芎嗪、丹参酮ⅡA、丹酚酸B等活性成分靶向IL-6、白细胞介素1β(IL-1β)、肿瘤坏死因子(TNF)等关键靶点发挥治疗不稳定型心绞痛的功效。

基于时机理论的家庭康复训练对不稳定型心绞痛患者PCI术后的影响

目的观察基于时机理论的家庭康复训练对不稳定型心绞痛(UAP)患者经皮冠状动脉介入治疗(PCI)术后的影响。方法84例行PCI治疗的UAP患者,按照住院先后顺序分为对照组和观察组,每组42例。对照组患者采用综合措施干预,观察组患者在对照组基础上予以基于时机理论的家庭康复训练干预。两组患者干预时间均为6个月。比较两组患者干预前后心功能指标[左室射血分数(LVEF)、6 min步行距离(6MWD)、纽约心脏病协会(NYHA)心功能分级]、生活质量评分及不良心血管事件(MACE)发生率。结果干预前,两组患者LVEF、6MWD、NYHA心功能分级比较,差异无统计学意义(P>0.05);干预后,两组患者LVEF、6MWD、NYHA心功能分级均明显优于本组干预前,且观察组患者LVEF(57.12±7.57)%高于对照组的(49.57±7.35)%,6MWD(436.91±24.76)m长于对照组的(417.17±23.93)m,NYHA心功能分级(1.37±0.35)级低于对照组的(1.71±0.42)级(P<0.05)。干预前,两组患者生活质量评分比较,差异无统计学意义(P>0.05);干预后,两组患者生活质量评分均高于本组干预前,且观察组患者心绞痛稳定状态、躯体活动受限程度、疾病认知程度、治疗满意程度、心绞痛发作情况评分分别为(83.51±9.12)、(81.96±8.57)、(81.95±8.75)、(81.73±9.12)、(81.07±9.15)分,均明显高于对照组的(70.17±8.13)、(71.35±7.84)、(72.06±7.92)、(71.74±8.01)、(70.45±8.74)分(P<0.05)。观察组患者MACE发生率(9.52%)明显低于对照组(26.19%)(P<0.05)。结论基于时机理论的家庭康复训练可改善UAP患者PCI术后心功能及生活质量,降低MACE发生率。

不稳定型心绞痛患者血清长链非编码RNA OIP5-AS1和微小RNA-137水平与心功能及心血管不良事件的相关性分析

目的探讨不稳定型心绞痛(UA)患者血清长链非编码RNA(lncRNA)OIP5-AS1和微小RNA-137(miR-137)水平与心功能及心血管不良事件的相关性。方法选取2022年5月至2023年8月海南省第二人民医院收治的102例UA患者为观察组。另选取本院同期102名体检健康者为对照组。UA患者根据随访6个月心血管不良事件发生情况分为发生组(n=35)和未发生组(n=67)。采用实时荧光定量聚合酶链反应法检测血清lncRNA OIP5-AS1、miR-137水平;利用Pearson法分析UA患者血清lncRNA OIP5-AS1与miR-137的相关性及lncRNA OIP5-AS1、miR-137与心功能指标的相关性;Logistic回归模型分析影响UA患者发生心血管不良事件的潜在因素;受试者工作特征曲线评估血清lncRNA OIP5-AS1、miR-137水平预测UA患者发生心血管不良事件的效能。结果观察组患者血清miR-137水平、左心室舒张末期内径(LVEDD)均明显高于/大于对照组,血清lncRNA OIP5-AS1、左心室射血分数(LVEF)水平均明显低于对照组(均P<0.001)。发生组患者血清miR-137水平、LVEDD均明显高于/大于未发生组,血清lncRNA OIP5-AS1、LVEF水平均明显低于未发生组(均P<0.001)。血清lncRNA OIP5-AS1与miR-137呈负相关(r=-0.555,P<0.001)。血清lncRNA OIP5-AS1与LVEDD呈负相关(r=-0.441,P<0.001),与LVEF呈正相关(r=0.479,P<0.001);血清miR-137与LVEDD呈正相关(r=0.466,P<0.001),与LVEF呈负相关(r=-0.472,P<0.001)。miR-137、LVEDD升高是影响UA患者发生心血管不良事件的风险因素,而lncRNA OIP5-AS1、LVEF水平升高是其保护因素(均P<0.05)。血清lncRNA OIP5-AS1、miR-137水平单独预测与二者联合预测UA患者发生心血管不良事件的曲线下面积分别为0.845、0.832、0.924,二者联合优于血清lncRNA OIP5-AS1(Z=2.146、P=0.032)、miR-137(Z=2.114、P=0.035)各自单独预测。结论发生心血管不良事件的UA患者血清lncRNA OIP5-AS1水平降低、miR-137水平升高,血清lncRNA OIP5-AS1、miR-137是影响UA患者发生心血管不良事件的潜在因素,且二者联合在预测UA患者发生心血管不良事件方面展现出更高的效能。

他汀类药物对UAP患者PCI术后心肌损伤与炎性因子的影响比较

目的比较阿托伐他汀和瑞舒伐他汀对不稳定性心绞痛(UAP)患者经皮冠状动脉介入治疗(PCI)术后心肌损伤和炎性因子的影响。方法选取拟行PCI术的UAP患者96例,分为两组,在常规治疗的基础上,分别于PCI术前加用阿托伐他汀(20mg/d)和瑞舒伐他汀(20mg/d)治疗1周。在用药前、术前和术后24h时,检测患者血清肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、高敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、IL-6、IL-10的水平。结果术后24h时,瑞舒伐他汀组的CK-MB、cTnI、hs-CRP、TNF-α、IL-6的水平均显著低于阿托伐他汀组(P<0.05),而IL-10的水平则显著高于阿托伐他汀组(P<0.05)。结论 UAP患者PCI术前给予20mg/d的瑞舒伐他汀,可有效地降低心肌损伤和炎性因子的水平,效果优于同剂量的阿托伐他汀。

丹参川芎嗪注射液对老年UAP患者血流变学、hs-CRP及脂代谢的影响

目的通过观察丹参川芎嗪注射液对老年不稳定型心绞痛(UAP)患者血流变学、超敏C反应蛋白(hs-CRP)和血脂代谢的影响,探讨其对老年UAP患者的治疗作用。方法将106例老年UAP患者随机分为治疗组54例和对照组52例,对照组根据指南给予治疗,治疗组在对照组基础上加用丹参川芎嗪注射液10 mL加入0.9%生理盐水250 mL中静脉滴注,1次/d,连续15 d,比较两组治疗前后hs-CRP、血流变学及血脂各项指标的变化情况,同时分析两组治疗效果。结果治疗后两组患者临床疗效总有效率分别为96.30%、82.63%,两组比较差异有统计学意义(P<0.05)。治疗后两组患者hs-CRP均较治疗前下降,血流变学及血脂代谢各项指标较治疗前改善,但治疗组改善更明显,两组比较差异有统计学意义(P<0.05),两组患者均未出现严重不良反应。结论在常规治疗基础上加用丹参川芎嗪注射液治疗老年冠心病UAP患者临床疗效显著,与其可显著降低患者血清hs-CRP水平,并有效改善血流动力学及血脂代谢状况等有关。