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Combined Effect of Smoking and Obesity on Coronary Heart Disease Mortality in Male Veterans:A 30-year Cohort Study 被引量:7
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作者 SAI Xiao Yong GAO Feng +5 位作者 ZHANG Wen Yu GAO Meng YOU Jing SONG Yu Jian LUO Ting Gang SUN Yuan Yuan 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 2021年第3期184-191,共8页
Objective Evidence is lacking regarding the combined effects of smoking and obesity on mortality from coronary heart disease in male veterans.This study aimed to explore the combined effect of smoking and obesity on c... Objective Evidence is lacking regarding the combined effects of smoking and obesity on mortality from coronary heart disease in male veterans.This study aimed to explore the combined effect of smoking and obesity on coronary heart disease mortality in male veterans in China.Methods A cohort of 1,268 male veterans from 22 veteran centers in Xi’an(Shaanxi Province,China)were followed up once every 2 years from February 1,1987 to October 30,2016.The endpoint was death from any cause.The hazard ratio(HR)of each risk factor and the 95%confidence interval(CI)were calculated using a multivariate Cox proportional hazard model.Results The total follow-up was 24394.21 person-years;each subject was followed up for a mean duration of 19.24 years.By the end of the study,of the 1,268 veterans,889 had died,363 were alive,and 16 were lost to follow-up.Cox regression analysis results revealed that current smoking(HR:1.552,95%CI:1.074–2.243),obesity(HR:1.625,95%CI:1.024–2.581),and the combined effect of the two factors(HR:2.828,95%CI:1.520–5.262)were associated with coronary heart disease mortality.Conclusion Our results suggest that obese veterans who smoke might be an important target population for coronary heart disease mortality control. 展开更多
关键词 SMOKING OBESITY coronary heart disease combined effect Cohort study
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Off-pump coronary artery bypass grafting versus on-pump coronary artery bypass grafting: which is better in patients with chronic obstructive pulmonary disease? 被引量:9
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作者 朱亚彬 许建屏 +3 位作者 刘志勇 杨丹宁 李旭东 李鸿雁 《Journal of Zhejiang University Science》 CSCD 2004年第8期1005-1008,共4页
To evaluate the clinic outcome of off-pump coronary bypass grafting (OPCABG) of patients with coronary heart disease and chronic obstructive pulmonary disease, we collected and analyzed 1998-2002 data on 28 patients w... To evaluate the clinic outcome of off-pump coronary bypass grafting (OPCABG) of patients with coronary heart disease and chronic obstructive pulmonary disease, we collected and analyzed 1998-2002 data on 28 patients with these two diseases who had received off-pump coronary bypass operation in our hospital, and compared with data on those who also had the same two diseases but received on-pump coronary artery bypass at same time. There were no operation-related death;one died of respiratory failure 14 days after operation while staying in hospital; there were more respiratory complications in the conventional coronary artery bypass grafting group (CCABG) than in the OPCABG group; and the PaO2/FiO2 in the CCABG group was higher than that in the OPCABG group during operation because of CPB, but lower than that in the OPCABG group 6-12 hours after operation. OPCABG seemed more suitable than CCABG for coronary artery disease patients with chronic obstructive pulmonary disease due to less damage to their oxygen-exchange capability and the fewer respiratory complications. 展开更多
关键词 Chronic obstructive pulmonary disease coronary artery heart disease Off-pump bypass On-pump bypass Respiratory function
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Impact of Tobacco Smoking on Health Care Utilization and Medical Costs in Chronic Obstructive Pulmonary Disease,Coronary Heart Disease and Diabetes 被引量:3
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作者 Bei-zhu YE Xiao-yu WANG +4 位作者 Yu-fan WANG Nan-nan LIU Min XIE Xiao GAO Yuan LIANG 《Current Medical Science》 SCIE CAS 2022年第2期304-316,共13页
Objective To determine the impact of smoking on disease-specific health care utilization and medical costs in patients with chronic non-communicable diseases(NCDs).Methods Participants were middle-aged and elderly adu... Objective To determine the impact of smoking on disease-specific health care utilization and medical costs in patients with chronic non-communicable diseases(NCDs).Methods Participants were middle-aged and elderly adults with chronic NCDs from a prospective cohort in China.Logistic regressions and linear models were used to assess the relationship between tobacco smoking,health care utilization and medical costs.Results Totally,1020 patients with chronic obstructive pulmonary disease(COPD),3144 patients with coronary heart disease(CHD),and 1405 patients with diabetes were included in the analysis.Among patients with COPD,current smokers(β:0.030,95%CI:−0.032-0.092)and former smokers(β:0.072,95%CI:0.014-0.131)had 3.0%and 7.2%higher total medical costs than never smokers.Medical costs of patients who had smoked for 21-40 years(β:0.028,95%CI:−0.038-0.094)and≥41 years(β:0.053,95%CI:−0.004β0.110)were higher than those of never smokers.Patients who smoked≥21 cigarettes(β:0.145,95%CI:0.051-0.239)per day had more inpatient visits than never smokers.The association between smoking and health care utilization and medical costs in people with CHD group was similar to that in people with COPD;however,there were no significant associations in people with diabetes.Conclusion This study reveals that the impact of smoking on health care utilization and medical costs varies among patients with COPD,CHD,and diabetes.Tobacco control might be more effective at reducing the burden of disease for patients with COPD and CHD than for patients with diabetes. 展开更多
关键词 tobacco smoking chronic obstructive pulmonary disease coronary heart disease DIABETES health care utilization medical costs
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Clinical characteristics of Danshen Ligustrazine injection in the treatment of coronary heart disease with hypertension-A real world study
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作者 SUN Lin-xi Gao Yang +3 位作者 XIE Yan-ming Zhang Li-dan XU Hong-yan ZHUANG Yan 《Journal of Hainan Medical University》 2022年第17期39-46,共8页
Objective:To explore the characteristics and rules of Danshen Ligustrazine Injection in the treatment of coronary heart disease with hypertension.Methods:From the information systems of 12 tertiary tier-one hospitals ... Objective:To explore the characteristics and rules of Danshen Ligustrazine Injection in the treatment of coronary heart disease with hypertension.Methods:From the information systems of 12 tertiary tier-one hospitals across the country,we extracted the medical data of the application of Danshen Ligustrazine Injection in the treatment of patients with coronary heart disease and hypertension.After normalization,the model was established by Apriori algorithm,and the association rules were analyzed by Clementine 12.0 software.Results:Most of the 1928 patients were between 75 and 90 years old(54.26%).There were more males than females,most with type 2 diabetes,cerebral infarction,etc.Each dose was more than 10 mL(52.78%).Aspirin enteric-coated tablets(67.63%),L-carnitine injection(58.77%),and atorvastatin calcium capsules(50.93%)were often used in combination with safflower yellow pigment(22.20%),Shexiang Baoxin Pill(16.55%),Suxiao Jiuxin Pill(15.09%);the most commonly used combination of western medicine was anticoagulant thrombolytic and antiplatelet drugs(85.84%),and the type of Chinese medicine was Huoxuehuayu(72.98%);The most common combination of two western medicines was L-carnitine injection+aspirin enteric-coated tablets,with a support of 41.9%;The most common combination of two Chinese and western medicines is western medicine·anti-anginal medicine+western medicine·anticoagulant thrombolytic and antiplatelet drugs with a support of 67.6%.Conclusion:Danshen Ligustrazine injection is mainly used in elderly patients with coronary heart disease and hypertension,with many comorbidities.The dosage standard needs to be optimized.The combination of drugs and guidelines should coordinate with each other,which provide clues for clinical diagnosis and treatment and optimization of medication. 展开更多
关键词 Real world Danshen Ligustrazine Injection coronary heart disease HYPERTENSION Combination medication
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Advances in Research on Treatment of Heart Failure with Yangxinshi Tablet 被引量:1
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作者 Jian LI Zhixiao WANG +1 位作者 Xinling ZHOU Yihong JIANG 《Medicinal Plant》 CAS 2020年第2期16-20,共5页
The advances in the treatment of heart failure with Yangxinshi tablet are reviewed in this paper.Yangxinshi tablet has effects of nourishing myocardia,improving myocardial metabolism,reducing myocardial oxygen consump... The advances in the treatment of heart failure with Yangxinshi tablet are reviewed in this paper.Yangxinshi tablet has effects of nourishing myocardia,improving myocardial metabolism,reducing myocardial oxygen consumption,dilating coronary artery,improving cardiac blood supply,reducing blood viscosity and improving microcirculation,and it can improve the functions of heart and curative effect of heart failure. 展开更多
关键词 Yangxinshi TABLET heart FAILURE Advance Mechanism Qi deficiency and blood STASIS type coronary heart FAILURE pulmonary heart disease ANEMIC CARDIOPATHY
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Prevalence, risk factors, and survival associated with pulmonary hypertension and heart failure among patients with underlying coronary artery disease: a national prospective, multicenter registry study in China 被引量:5
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作者 Li Huang Lingpin Pang +13 位作者 Qing Gu Tao Yang Wen Li Ruilin Quan Weiqing Su Weifeng Wu Fangming Tang Xiulong Zhu Jieyan Shen Jingzhi Sun Guangliang Shan Changming Xiong Shian Huang Jianguo He 《Chinese Medical Journal》 SCIE CAS CSCD 2022年第15期1837-1845,共9页
Background: Coronary artery disease (CAD) is the commonest cause of heart failure (HF), whereas pulmonary hypertension (PH) has not been established or reported in this patient population. Therefore, we assessed the p... Background: Coronary artery disease (CAD) is the commonest cause of heart failure (HF), whereas pulmonary hypertension (PH) has not been established or reported in this patient population. Therefore, we assessed the prevalence, risk factors, and survival in CAD-associated HF (CAD-HF) complicated with PH.Methods: Symptomatic CAD-HF patients were continuously enrolled in this prospective, multicenter registry study. Echocardiography, coronary arteriography, left and right heart catheterization (RHC), and other baseline clinical data were recorded. Patients were followed up and their survival was recorded.Results: One hundred and eighty-two CAD-HF patients were enrolled, including 142 with HF with a preserved ejection fraction (heart failure with preserved ejection fraction [HFpEF];left ventricular ejection fraction [LVEF] ≥50%) and 40 with a reduced ejection fraction (heart failure with reduced ejection fraction [HFrEF];LVEF < 50%). PH was diagnosed with RHC in 77.5% of patients. Patients with PH showed worse hemodynamic parameters and higher mortality. HFrEF-PH patients had worse survival than HFpEF-PH patients. CAD-HF patients with an enlarged left ventricular end-diastolic diameter and reduced hemoglobin were at higher risk of PH. Nitrate treatment reduced the risk of PH. Elevated creatinine and mean pulmonary arterial pressure (mPAP), diastolic pressure gradient (DPG) ≥7 mmHg, and previous myocardial infarction (MI) entailed a higher risk of mortality in CAD-HF patients with PH.Conclusions: PH is common in CAD-HF and worsens the hemodynamics and survival in these patients. Left ventricle enlargement and anemia increase the risk of PH in CAD-HF. Patients may benefit from nitrate medications. Renal impairment, elevated mPAP, DPG ≥7 mmHg, and previous MI are strong predictors of mortality in CAD-HF-PH patients.Trial Registration: ClinicalTrials.gov, NCT02164526. 展开更多
关键词 coronary artery disease heart failure pulmonary hypertension Registry study
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Acute myocardial injury in patients with COVID-19:Possible mechanisms and clinical implications 被引量:1
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作者 Iulia Rusu Malina Turlacu Miruna Mihaela Micheu 《World Journal of Clinical Cases》 SCIE 2022年第3期762-776,共15页
Severe acute respiratory syndrome coronavirus 2 infection affects not only the lungs,but also the cardiovascular system,having a major impact on patients’outcomes.Myocardial injury(MI)occurs in the context of coronav... Severe acute respiratory syndrome coronavirus 2 infection affects not only the lungs,but also the cardiovascular system,having a major impact on patients’outcomes.Myocardial injury(MI)occurs in the context of coronavirus infectious disease 2019(COVID-19)and is associated with a higher risk of severe clinical outcome and mortality.COVID-19-related MI can have various clinical manifestations,of which the main ones are myocarditis,stress cardiomyopathy,acute coronary syndrome,and pulmonary embolism.The exact mechanisms of how MI occurs in these patients are not yet fully known.Direct injury,through direct viral myocardial invasion,and indirect injury,through interaction with angiotensin I converting enzyme 2,increased inflammation,and thrombocyte and endothelial dysfunction,could be involved in acute MI in patients with COVID-19.A better understanding of these multiple potential mechanisms may help to develop new targeted therapeutic strategies.The purpose of this review is to provide the current understanding of the potential mechanisms involved in MI induced by COVID-19 and to discuss the current progress in the therapeutic strategies. 展开更多
关键词 Myocardial injury MYOCARDITIS Stress cardiomyopathy Acute coronary syndrome pulmonary embolism Coronavirus infectious disease SARS-CoV-2
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心肺联合康复对冠心病介入治疗后患者血脂、心肺功能的影响 被引量:1
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作者 马卉 牛静 +3 位作者 侯萍 辛薇 王苏 马利祥 《武警医学》 CAS 2024年第7期558-561,566,共5页
目的探讨心肺联合康复对冠心病介入治疗后患者血脂、心肺功能的影响。方法选择2022-11至2023-11秦皇岛市第一医院收治的接受介入治疗后的冠心病患者180例为研究对象,随机分为对照组(n=89)和试验组(n=91),对照组进行常规药物治疗,试验组... 目的探讨心肺联合康复对冠心病介入治疗后患者血脂、心肺功能的影响。方法选择2022-11至2023-11秦皇岛市第一医院收治的接受介入治疗后的冠心病患者180例为研究对象,随机分为对照组(n=89)和试验组(n=91),对照组进行常规药物治疗,试验组进行心肺联合康复治疗,干预时间均为3个月。对两组患者干预前后的血脂水平、心肺功能、运动功能、生活质量和自我管理能力进行比较。结果与干预前对比,两组干预后,三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、用力呼气量与用力肺活量比值(FEV/FVC%)、1 s用力呼气量(FEV_(1))、左心室射血分数(LVEF)、生理功能、躯体疼痛等均有明显改善,差异有统计学意义(P<0.05),试验组比对照组各项指标(LDL-C、FEV/FVC%、PEAKVO2等)改善更明显,差异有统计学意义(P<0.05)。结论心肺联合康复可降低冠脉介入术后患者的血脂水平,增强心肺功能及运动功能,提高生活质量。 展开更多
关键词 心肺联合康复 心脏康复 冠心病 生活质量 血脂
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代谢综合征合并冠心病案——仝小林院士教学查房实录 被引量:1
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作者 韦宇 逄冰 +4 位作者 田佳星 王涵 李修洋 赵林华 倪青 《长春中医药大学学报》 2024年第1期1-6,共6页
以广安门医院内分泌科1例代谢综合征合并冠心病患者为例邀请仝小林院士进行教学查房,对代谢综合征合并冠心病的中医辨治思路、疾病发展、诊疗要点进行阐述。强调辨别脾瘅与消瘅异同,把握疾病发展的不同趋势,脾瘅易合并大血管、微血管并... 以广安门医院内分泌科1例代谢综合征合并冠心病患者为例邀请仝小林院士进行教学查房,对代谢综合征合并冠心病的中医辨治思路、疾病发展、诊疗要点进行阐述。强调辨别脾瘅与消瘅异同,把握疾病发展的不同趋势,脾瘅易合并大血管、微血管并发症,消瘅则微血管并发症多见。注重脉络并治,从肝论治,注重运用态靶辨治体系,减少西药的使用。 展开更多
关键词 代谢综合征 冠心病 脾瘅 消瘅 脉络并治
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基于病证结合的冠心病动物模型制备研究进展与思考
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作者 董雨蓉 解存 +2 位作者 刘畅 赵佳 王朔 《天津中医药》 CAS 2024年第2期264-272,共9页
冠心病的临床研究和动物实验研究一直是心血管领域的常见病。病证结合动物模型体现了中西医结合的理念,不仅有西医的疾病特点,而且借助中医思维用不同实验方法来表现独特的中医证候特点,是中医药研究冠心病预防和治疗的有效工具。文章... 冠心病的临床研究和动物实验研究一直是心血管领域的常见病。病证结合动物模型体现了中西医结合的理念,不仅有西医的疾病特点,而且借助中医思维用不同实验方法来表现独特的中医证候特点,是中医药研究冠心病预防和治疗的有效工具。文章对常用冠心病中医证候的动物模型建立方法进行总结,并以冠心病痰瘀互结证动物模型为例提出思考。 展开更多
关键词 冠心病 动物模型 病证结合 痰瘀互结
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血清白介素-12p70、淀粉样蛋白A水平变化与慢性阻塞性肺疾病患者并发冠心病的关系
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作者 王尚宏 郑丽琴 +1 位作者 王耀勇 赵建玲 《疑难病杂志》 CAS 2024年第3期292-296,共5页
目的分析慢性阻塞性肺疾病(COPD)患者血清白介素-12p70(IL-12p70)、淀粉样蛋白A(SAA)水平变化及其与并发冠心病(CHD)的关系。方法选取2019年5月—2023年5月山西医科大学附属汾阳医院呼吸与危重症医学科诊治COPD患者150例,其中并发CHD患... 目的分析慢性阻塞性肺疾病(COPD)患者血清白介素-12p70(IL-12p70)、淀粉样蛋白A(SAA)水平变化及其与并发冠心病(CHD)的关系。方法选取2019年5月—2023年5月山西医科大学附属汾阳医院呼吸与危重症医学科诊治COPD患者150例,其中并发CHD患者58例纳入COPD-CHD组,未并发CHD患者92例纳入COPD组。检测血清IL-12p70、SAA水平;比较不同血清IL-12p70、SAA水平COPD患者并发CHD发生率;Logistic回归模型分析血清IL-12p70、SAA与COPD患者并发CHD的独立关系,受试者工作特征曲线(ROC曲线)分析血清IL-12p70、SAA预测COPD患者并发CHD的价值。结果COPD-CHD组吸烟史比例、糖尿病比例、纤维蛋白原及血清IL-12p70、SAA水平高于COPD组[χ^(2)(t)/P=4.696/0.030、4.801/0.029、2.629/0.010、6.111/<0.001、5.744/<0.001];随着血清IL-12p70、SAA水平升高,COPD患者并发CHD发生率呈升高趋势(χ^(2)/P=27.864/<0.001、31.346/<0.001);血清IL-12p70、SAA升高均是COPD患者并发CHD的独立危险因素[OR(95%CI)=3.350(2.002~5.607),3.658(2.268~5.899)];ROC曲线分析显示,血清IL-12p70、SAA联合预测COPD患者并发CHD的AUC为0.835,优于各自单独预测效能(Z/P=2.180/0.029,2.244/0.025)。结论COPD患者血清IL-12p70、SAA水平升高,尤其是并发CHD时升高更显著,二者均为COPD患者并发CHD的独立危险因素,临床可通过检测两指标水平判断COPD患者并发CHD风险。 展开更多
关键词 慢性阻塞性肺疾病 冠心病 白介素-12p70 淀粉样蛋白A
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妊娠合并房间隔缺损并发醒后卒中1例报道
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作者 钱海兰 曹小婷 +2 位作者 雷睿 周京江 袁军 《实用临床医药杂志》 CAS 2024年第2期60-62,77,共4页
妊娠期缺血性卒中发病率低、致死率高。本文通过回顾1例妊娠合并有房间隔缺损并发醒后卒中患者的临床及影像学检查资料,探讨妊娠相关卒中的影像学表现、发病机制和治疗策略,旨在提高临床医师对合并有房间隔缺损的孕妇并发急性脑卒中的认... 妊娠期缺血性卒中发病率低、致死率高。本文通过回顾1例妊娠合并有房间隔缺损并发醒后卒中患者的临床及影像学检查资料,探讨妊娠相关卒中的影像学表现、发病机制和治疗策略,旨在提高临床医师对合并有房间隔缺损的孕妇并发急性脑卒中的认识,为临床诊疗提供参考。 展开更多
关键词 妊娠 房间隔缺损 卒中 心源性脑栓塞 先天性心脏病 肺动脉高压
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基于高效通道注意力机制和特征融合网络的冠心病诊断算法研究
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作者 郭卫涛 帕孜来·马合木提 张洪春 《计算机应用与软件》 北大核心 2024年第1期190-197,共8页
针对冠心病重要特征不确定、诊断模型预测性能低等因素而导致冠心病早期诊断精度低的问题,提出一种基于高效通道注意力机制和特征融合的网络。通过XGBoost(eXtreme Gradient Boosting)来确定冠心病重要特征,设计数据生成图片的特征组合... 针对冠心病重要特征不确定、诊断模型预测性能低等因素而导致冠心病早期诊断精度低的问题,提出一种基于高效通道注意力机制和特征融合的网络。通过XGBoost(eXtreme Gradient Boosting)来确定冠心病重要特征,设计数据生成图片的特征组合算法以适用该模型;为提高诊断模型预测性能,采用可以提升模型学习能力和特征利用率的高效通道注意力机制模块和特征融合模块。实验结果表明,在UCI克利夫兰心脏病数据集上,与其他诊断算法相比,该算法优于传统机器学习方法,预测精度可达100%且稳定性好。 展开更多
关键词 冠心病 早期诊断 特征组合算法 特征融合 高效通道注意力
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七氟醚静脉-吸入复合麻醉对合并冠心病的老年腹腔镜手术患者麻醉质量心功能和心血管事件的影响 被引量:2
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作者 郭颖妮 金敬军 《中国药物与临床》 CAS 2024年第11期716-721,共6页
目的探究七氟醚静脉-吸入复合麻醉对合并冠心病的老年腹腔镜手术患者麻醉质量、心功能和心血管事件的影响。方法回顾性分析浙江省台州医院2020年7月至2023年8月收治的行腹腔镜手术的冠心病患者临床资料,从行丙泊酚麻醉的患者中随机抽取4... 目的探究七氟醚静脉-吸入复合麻醉对合并冠心病的老年腹腔镜手术患者麻醉质量、心功能和心血管事件的影响。方法回顾性分析浙江省台州医院2020年7月至2023年8月收治的行腹腔镜手术的冠心病患者临床资料,从行丙泊酚麻醉的患者中随机抽取40例纳入对照组,从行七氟醚静脉-吸入复合麻醉的患者中随机抽取40例纳入观察组。比较2组患者麻醉质量(麻醉时间、麻醉满意度、清醒时间、定向恢复时间)差异;记录不同时间点[术前(T0)、手术开始时(T1)、手术进行15 min(T2)、术后(T3)]的生命体征[心率、收缩压(SBP)、舒张压(DBP)];比较T0、T3时的心功能[心排量(CO)、左室射血分数(LVEF)、N末端脑钠肽前体(NT-proBNP)]、心肌酶水平[天冬氨酸转氨酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)]、氧化应激[血清去甲肾上腺素(NE)、皮质醇(Cor)、促肾上腺皮质激素(ACTH)]水平;比较2组患者不良心血管事件发生情况。结果观察组满意度评分均高于对照组(P<0.05),观察组麻醉时间、清醒时间、定向恢复时间均低于对照组(P<0.05);在T0、T3时,2组患者心率、SBP、DBP水平差异无统计学意义(P>0.05),T1、T2时,观察组心率、SBP、DBP水平均高于对照组(P<0.05);T3时,2组患者CO、LVEF水平均较T0时降低,且观察组高于对照组(P<0.05),2组患者NT-proBNP、AST、LDH、CK-MB、NE、Cor、ACTH水平均较T0时升高,且观察组低于对照组(P<0.05);观察组心血管不良事件发生情况低于对照组(P<0.05)。结论七氟醚静脉-吸入复合麻醉在合并冠心病的老年腹腔镜手术患者中具有较高的麻醉质量,能减少对心功能的损伤,且不会增加不良心血管事件的发生风险。 展开更多
关键词 腹腔镜检查 冠心病 七氟醚 静-吸复合麻醉 心脏功能
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益气活血开心汤改善冠心病合并抑郁大鼠抑郁样行为作用机制研究
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作者 毛美玲 卢健棋 +5 位作者 朱智德 庞延 谢丽钰 陈佳永 肖湘 黄溥玮 《辽宁中医药大学学报》 CAS 2024年第11期24-29,共6页
目的探讨益气活血开心汤是否通过p-CREB/BDNF途径改善大鼠冠心病(CHD)后抑郁症状以及是否能够抑制海马神经元的凋亡。方法将SD大鼠随机分为4组:空白组、模型组、中药组、西药组。采用结扎冠状动脉左前降支构建急性心肌梗死(AMI)模型,联... 目的探讨益气活血开心汤是否通过p-CREB/BDNF途径改善大鼠冠心病(CHD)后抑郁症状以及是否能够抑制海马神经元的凋亡。方法将SD大鼠随机分为4组:空白组、模型组、中药组、西药组。采用结扎冠状动脉左前降支构建急性心肌梗死(AMI)模型,联合慢性不可预知刺激(CUMS)21 d构建CHD合并抑郁模型;同时,中药组、西药组分别给予益气活血开心汤、氟西汀灌胃21 d。通过大鼠整体状态、体质量、旷场实验、强迫游泳和蔗糖偏好实验评估抑郁样行为;尼氏染色观察海马神经元的形态结构和凋亡情况;Western blot和免疫荧光评估海马复合体CA1区磷酸化的环磷酸腺苷反应元件结合蛋白(p-CREB)和脑源性神经营养因子(BDNF)的表达。结果大鼠的抑郁样行为经过益气活血开心汤和氟西汀治疗后得到明显改善(P<0.05,P<0.01);海马CA1区的p-CREB和BDNF的表达明显增多(P<0.05)。结论结果表明,益气活血开心汤可以明显改善CHD后抑郁大鼠的抑郁症状和神经功能,并能够抑制海马神经元的凋亡情况,且与氟西汀的改善作用无显著差异。 展开更多
关键词 冠心病合并抑郁 益气活血开心汤 脑源性神经营养因子 P-CREB 神经元凋亡
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冠心病合并睡眠呼吸暂停患者住院次数相关因素的研究
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作者 张璿 程德梅 +2 位作者 张喜维 刘旭洋 万钧 《心肺血管病杂志》 CAS 2024年第7期706-711,共6页
目的:探讨与冠心病合并睡眠呼吸暂停的患者住院次数相关的疾病因素。方法:选取2017年5月至2021年7月,于北京市安贞医院住院并确诊冠心病合并睡眠呼吸暂停的患者1738例,根据患者自述既往住院的次数将其分为多次住院组(518例)和首次住院组... 目的:探讨与冠心病合并睡眠呼吸暂停的患者住院次数相关的疾病因素。方法:选取2017年5月至2021年7月,于北京市安贞医院住院并确诊冠心病合并睡眠呼吸暂停的患者1738例,根据患者自述既往住院的次数将其分为多次住院组(518例)和首次住院组(1220例),比较两组患者合并高脂血症、高血压、糖尿病、低氧血症、高尿酸血症、脂肪肝、心功能不全、低钾血症及肺部感染等合并症的临床资料,分析与此类患者住院次数相关的疾病因素。结果:多次住院组与首次住院组合并高脂血症、高血压、糖尿病、低氧血症、高尿酸血症、心功能不全及肺部感染等,差异有统计学意义(P<0.05),其中多次住院组合并高血压、糖尿病、低氧血症、高尿酸血症、心功能不全、肺部感染的比例高于首次住院组[(80.7%vs.72.8%)、(45.9%vs.37.2%)、(19.7%vs.12.7%)、(11.8%vs.8.4%)、(23.7%vs.15.9%)、(5.0%vs.2.7%)],合并高脂血症的比例低于首次住院组(73.6%vs.81.3%)。Logistic回归分析结果显示,高脂血症、高血压、糖尿病、低氧血症、心功能不全是与冠心病合并睡眠呼吸暂停患者多次住院相关的疾病因素(均P<0.05)。结论:本研究表明高脂血症、高血压、糖尿病、低氧血症、心功能不全是与冠心病合并睡眠呼吸暂停患者多次住院相关的疾病因素,要加强患者出院后此类合并症的长期随诊和管理工作。 展开更多
关键词 冠状动脉粥样硬化性心脏病 睡眠呼吸暂停 住院次数 合并疾病
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Study of Serum Metabonomics and Formula-Pattern Correspondence in Coronary Heart Disease Patients Diagnosed as Phlegm or Blood Stasis Pattern Based on Ultra Performance Liquid Chromatography Mass Spectrometry 被引量:13
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作者 LU Xiao-yan XU Hao +1 位作者 ZHAO Tie LI Geng 《Chinese Journal of Integrative Medicine》 SCIE CAS CSCD 2018年第12期905-911,共7页
Objectives: To study the characteristics of serum metabonomics in coronary heart disease (CHD) patients diagnosed as phlegm or blood stasis pattern and explore effects of formula-pattern correspondence treatment. M... Objectives: To study the characteristics of serum metabonomics in coronary heart disease (CHD) patients diagnosed as phlegm or blood stasis pattern and explore effects of formula-pattern correspondence treatment. Methods: A total of 102 stable CHD patients were enrolled and divided into phlegm group (P group, n=52) and blood stasis group (BS group, n=50) according to pattern identification. Gualou Xiebai Banxia Decoction (瓜萎薤白半夏汤, GXBD) and Xuefu Zhuyu Decoction (血府逐瘀汤, XZD) were used as drug interventions. Relevant indicators of metabonomics were observed by ultra performance liquid chromatography mass spectrometry (UPLC-MS) and pattern recognition. Results: Levels of amino acids and phosphatidylethanolamine (PE) in the CHD group were much higher than those in healthy control group, while the levels of unsaturated fatty acids, sphingosine, Lyso, phosphatidylcholine (PC) were significantly lower (P〈0.01). Most of the differential metabolites between the CHD and the healthy groups were also common metabolites of phlegm and blood stasis. 7(Z), 10(Z)- hexadecadienoic acid and DPA were decreased in the P group and increased in the BS group. According to the quantity of retraced metabolites, improvement in metabonomics by formula-pattern correspondence was superior to that without correspondence in the BS group. Based on the varieties of metabolites, GXBD could improve the levels of docosapentaenoic acid (DPA), sphingomyelin (SM) (d34:1), and L-Lactic acid and XZD could ameliorate the levels of sphingosine and Vit E in the P group, in the BS group, GXBD could improve vitamin E level and XZD could make improvements in the levels of octadecanoic acid, phosphoglycerol, and SM (d34:1). Conclusions: Phlegm and blood stasis in CHD patients present specific differential metabolites, and share common metabolites. Remarkable differences have been displayed in pathological properties and severity of phlegm and blood stasis. Patients with phlegm are more likely to have lipid metabolism disorders. However, in patients with blood stasis, problems mainly lie in glucose, protein and fat metabolism and the injury of vascular cell membrane is relatively severe. The metabolic disorder is more complicated in blood stasis pattem than that in phlegm pattem. Compared with non-correspondence, improvement of differential metabolites is more comprehensive and targeted in formulapattern correspondence with a better effect. 展开更多
关键词 ultra performance liquid chromatography mass spectrometry METABONOMICS phlegm/stasis pattern in coronary heart disease disease-pattern combination formula-pattern correspondence
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揿针联合中药治疗慢性阻塞性肺疾病急性加重期肺心病功能失代偿期合并冠心病水瘀互结证的临床疗效研究 被引量:1
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作者 宋棠 严国美 孙美娜 《中国实用医药》 2024年第17期19-24,共6页
目的观察揿针联合中药治疗慢性阻塞性肺疾病(COPD)急性加重期(AECOPD)肺源性心脏病(肺心病)功能失代偿期合并冠状动脉粥样硬化性心脏病(冠心病)水瘀互结证的临床疗效。方法40例AECOPD肺心病功能失代偿期合并冠心病水瘀互结证的住院患者... 目的观察揿针联合中药治疗慢性阻塞性肺疾病(COPD)急性加重期(AECOPD)肺源性心脏病(肺心病)功能失代偿期合并冠状动脉粥样硬化性心脏病(冠心病)水瘀互结证的临床疗效。方法40例AECOPD肺心病功能失代偿期合并冠心病水瘀互结证的住院患者,按照随机分配原则分为对照组和观察组,每组20例。对照组给予包括消炎、解痉、利尿、化痰、改善冠状动脉痉挛、营养支持、纠正水电解质紊乱等西医常规治疗,观察组在西医常规治疗基础上联合揿针及中药治疗。比较两组患者急性生理学及慢性健康状况(APACHEⅡ)评分、临床疗效、氧合指数、二氧化碳分压、D-二聚体、N末端B型利钠肽前体(NT-proBNP)、左心室射血分数(LVEF)、三尖瓣环收缩期位移(TAPSE)、治疗周期内额外增加呋塞米注射液剂量和雾化液使用次数。结果治疗7 d,两组患者APACHEⅡ评分较治疗前下降,且观察组患者APACHEⅡ评分(8.10±1.65)分低于对照组的(10.30±1.08)分,有显著性差异(P<0.05)。观察组临床总有效率为85%,略高于对照组的75%,但无显著性差异(P>0.05)。治疗7 d,两组患者氧合指数较治疗前升高,二氧化碳分压、D-二聚体、NT-proBNP水平较治疗前均降低,且观察组患者二氧化碳分压(53.00±6.06)mm Hg(1 mm Hg=0.133 kPa)、D-二聚体(0.82±0.14)μg/ml、NT-proBNP(801.70±130.19)pg/ml均低于对照组的(58.55±5.05)mm Hg、(1.12±0.24)μg/ml、(945.15±248.94)pg/ml,有显著性差异(P<0.05);但两组患者氧合指数比较,无显著性差异(P>0.05)。治疗7 d,对照组LVEF(47.35±4.34)%高于治疗前的(43.90±3.97)%,有显著性差异(P<0.05),TAPSE(9.65±1.90)mm与治疗前的(9.85±1.84)mm比较,无显著性差异(P>0.05)。观察组治疗7 d LVEF(51.80±5.13)%、TAPSE(12.95±2.65)mm均高于治疗前的(43.15±3.15)%、(9.05±1.36)mm,且高于同期对照组,有显著性差异(P<0.05)。治疗7 d内,观察组额外增加呋塞米注射液剂量(40.75±11.04)mg和雾化液使用次数(5.55±1.90)次均低于对照组的(51.50±19.00)mg、(7.25±3.11)次,有显著性差异(P<0.05)。结论揿针联合中药治疗AECOPD肺心病失代偿期合并冠心病水瘀互结证作用机制有缓解气道痉挛、增强心脏收缩功能、加强利尿等作用,疗效确切,临床运用方面值得推广。 展开更多
关键词 慢性阻塞性肺疾病急性加重期 肺源性心脏病功能失代偿期 冠状动脉粥样硬化性心脏病 水瘀互结证 揿针 中药
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Study on Correspondence between Prescription and Syndrome and the Essence of Phlegm and Blood Stasis Syndrome in Coronary Heart Disease Based on Metabonomics 被引量:8
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作者 鹿小燕 徐浩 +1 位作者 李耿 赵铁 《Chinese Journal of Integrative Medicine》 SCIE CAS 2014年第1期68-71,共4页
Studying the essence of a syndrome has been a key challenge in the field of Chinese medicine.Until now,due to limitations of the methods available,the progress towards understanding such complicated systems has been s... Studying the essence of a syndrome has been a key challenge in the field of Chinese medicine.Until now,due to limitations of the methods available,the progress towards understanding such complicated systems has been slow.Metabonomics encompasses the dynamics,composition and analysis of metabolites,enabling the observation of changes in the metabolic network of the human body associated with disease.Being from the point of view of the whole organism,metabonomics provides an opportunity to study the essence of a syndrome to an unprecedented level.Phlegm and blood stasis syndrome is the main syndrome associated with coronary heart disease(CHD),which bring difficulties in clinical treatment due to difficulties associated with differentiation of symptoms and signs.The fundamental differences of material between the two also need to be interpreted.The authors consider that we can use the method of combining a disease(in this case CHD)with associated syndromes(phlegm and blood stasis syndrome)to select patients with phlegm and blood stasis syndrome of CHD,and utilize metabonomics to explore the essence of the syndrome by difference analysis of metabolite spectra.Meanwhile,we can study the syndrome in CM,observe the change regularity of metabolism spectra after the treatment of corresponding and non-corresponding prescription and syndrome,in order to validate the material fundament in the progress of syndrome formation and their differences.This will not only have great significance in enhancing the ability to identify syndrome of phlegm and blood stasis in CHD and to establish the clinical curative criteria,but will also offer a new approach of studying the essence for a syndrome using metabonomics. 展开更多
关键词 METABONOMICS phlegm and blood stasis syndrome coronary heart disease combination of disease with syndrome correspondence between prescription and syndrome
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针对性护理干预联合精细化管理在老年稳定性冠心病合并卒中患者的应用效果 被引量:2
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作者 袭玉荣 《中国医药指南》 2024年第13期158-161,共4页
目的 观察对老年稳定性冠心病合并卒中患者给予针对性护理干预联合精细化管理的效果,以期为临床护理稳定性冠心病合并卒中患者提供依据。方法 选取2022年1月至2023年8月于我院接受治疗的老年稳定性冠心病合并卒中患者72例,根据随机数字... 目的 观察对老年稳定性冠心病合并卒中患者给予针对性护理干预联合精细化管理的效果,以期为临床护理稳定性冠心病合并卒中患者提供依据。方法 选取2022年1月至2023年8月于我院接受治疗的老年稳定性冠心病合并卒中患者72例,根据随机数字表法将患者分为观察组与对照组,各36例,观察组给予针对性护理干预联合精细化管理,对照组给予常规护理干预。对比两组研究对象治疗前后心理水平、血脂指标、心功能、神经功能以及日常生活能力的变化。结果 干预前,两组心理状态(HARS、PHQ9评分)、血脂水平(LDL-C、HDL-C、TC水平)、心功能(左心室舒张末期内径、左心室短轴缩短率、左心室射血分数)、神经功能(EDSS评分)、日常生活活动能力量表评分差异无统计学意义(均P> 0.05);干预后,观察组心理状态、血脂水平、心功能、神经功能、日常生活能力均优于对照组,均低于对照组,均高于对照组,评分均低于对照组,评分均高于对照组(均P <0.05)。结论 针对性护理干预联合精细化管理在老年稳定性冠心病合并卒中患者的应用效果确切,能够缓解患者负面心态,改善血脂指标及心功能,有助于促进神经功能的恢复。 展开更多
关键词 稳定性冠心病合并卒中 针对性护理干预 精细化管理 血脂指标 神经功能
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