目的 探讨原发性高血压(EH)及左室肥厚(LVH)患者检测儿茶酚抑素(CST)、脑钠肽(BNP)、同型半胱氨酸(Hcy)的临床意义.方法 选取2017年8月-2018年7月收治的EH患者120例纳入研究,其中LVH组53例、非LVH(NLVH)组67例,1级高血压48例、2级高血压52例、3级高血压20例,另选取同期健康体检者50例为对照组.所有受试者于晨起安静状态下采用超声心动仪测定左室重量指数(LVMI),于晨起空腹抽取静脉血,测定血浆CST,血清BNP及Hcy水平.结果 NLVH和LVH组LVMI、GST、BNP、Hcy均高于对照组(P均<0.01);NLVH组LVMI、GST、BNP均高于LVH组(P均<0.01).1级高血压LVMI、BNP均高于对照组(P均<0.05),2级高血压、3级高血压LVMI、GST、BNP、Hcy均高于对照组(P均<0.01);1级高血压、2级高血压、3级高血压间LVMI、GST、BNP、Hcy比较差异有统计学意义(P均<0.01).结论 EH患者外周血中GST、BNP、Hcy水平检测可用于判断LVH严重程度.

Objective To investigate the correlation of serum cytokines (vascular endothelial growth factor B and interleukin-32) and vasoactive substances (protein-related phospholipase A2 and catestatin) with the prognosis of patients with acute myocardial infarction. Methods Totally 294 cases of acute coronary syndrome in our hospital were collected, including 189 cases of AMI and 105 cases of UA. The general condition was recorded and the levels of serum VEGF-B, Lp-PLA2, CST and IL-32 were detected, meanwhile, the index of heart function of AMI patients was assessed, and the occurrence of major adverse cardiac events were followed up for 6 months. The relationship between levels of VEGF-B, Lp-PLA2, CST and IL-32 and the prognosis of AMI was investigated. Results Before treatment, there was no significant difference in serum VEGF-B between the two groups (P ＞ 0. 05); the levels of Lp-PLA2 and CST in AMI group were higher than those of UA group (P＜0. 05), while the level of IL-32 was lower (P＜0. 05). There was no significant difference in the above indexes between the two groups after treatment (P ＞ 0. 05). No significant difference was found in the VEGF-B among groups with KiliipⅠ ～ Ⅳ (P ＞ 0. 05); the levels of Lp-PLA2 and CST showed an upward trend along with the deterioration of cardiac function, meanwhile, the content of IL-32 was reduced. At the end of follow-up, the incidence of total MACE in patients with AMI was 42. 33％. The serum levels of VEGF-B and IL-32 in patients with poor prognosis were lower than those of good prognosis group (P＜0. 05), and contents of Lp-PLA2 and CST were higher (P＜0. 05). Conclusion High levels of CST and Lp-PLA2 indicate the poor prognosis of patients with AMI and UA, while the levels of VEGF-B and IL-32 were negatively correlated with the prognosis of MACE.

Objective To observe the changes of the level of plasma catechins in patients with different types of atrial fibrillation (AF), and analyze the significance of catechin level in the occurrence of atrial fibrillation, and to explore its possible mechanism. Methods Totally 78 patients with atrial fibrillation treated in the Department of Cardiology of our hospital from June 2015 to December 2016 were retrospectively analyzed and served as atrial fibrillation group (AFgroup), and the patients were divided into paroxysmal atrial fibrillation group (PAFgroup, n = 49) and chronic atrial fibrillation group (CAFgroup, n = 29) according to the types of atrial fibrillation. Another 50 sinus rhythm patients with similar disease but without the history of atrial fibrillation in the same period were selected as control group. The patients' data on admission and the related examination indexes were recorded and the level of plasma catechin was detected. At the same time, the indexes of echocardiography and plasma catechin levels in patients after 1 month were followed up. Patients in AFgroup were divided into converted group (group C) and unconverted group (group D) according to whether atrial fibrillation was converted at follow-up. Results Compared with the control group, the heart rate of AFgroup was increased (P＜0. 05); systolic blood pressure and left ventricular ejection fraction (LVEF) were decreased, while left anterior and posterior diameter (LAD) was increased (P＜0. 05); Nterminal brain natriuretic peptide precursor (NT-proBNP) was increased (P＜0. 05). The plasma catechin level in AFgroup was significantly lower than that of control group (P＜0. 05), while there was no significant difference between CAFgroup and PAFgroup (P ＞ 0. 05). After 1 month of treatment, the left ventricular ejection fraction (LVEF) in the convered group was significantly higher than that of AFgroup (P＜0. 05). There was no significant difference in plasma catechin level between the two groups (P ＞ 0. 05). After 1 month of treatment, the LVEFin group Cwas significantly higher than that of group D (P＜0. 05), but there was no significant difference in plasma catestatin levels between the two groups (P ＞ 0. 05). There was no significant difference in LVEFbetween group Cand control group (P ＞ 0. 05), and the level of catechin in group Cwas lower than that of control group, the difference being statistically significant (P＜ 0. 05). Conclusion Changes in plasma catechin level may affect the occurrence of atrial fibrillation, the decrease in plasma catechin may be a potential independent predictor of atrial fibrillation formation, and the relationship between atrial fibrillation and catechin is not affected by left ventricular ejection fraction.

目的：观察瓜蒌延胡汤对稳定型心绞痛的临床疗效及对血浆炎性因子的影响。方法稳定型心绞痛患者138例随机分为对照组和治疗组，每组69例，对照组失访3例，共66例纳入，对照组采用西医常规治疗，治疗组在对照组基础上加服瓜蒌延胡汤4～6周，治疗中及治疗后评价临床疗效，并于治疗前后检测血浆中肿瘤坏死-α（ TNF-α）、白介素-1β（ IL-1β）、超敏C-反应蛋白（ hs-CRP）水平。结果治疗组治疗心绞痛总有效率与对照组比较，差异有统计学意义（ P ＜0．01），2组治疗后血浆TNF-α、IL-1、hs-CRP均降低（ P ＜0．05），且治疗组治疗后低于对照组（ P ＜0．05）。结论瓜蒌延胡汤联合西医常规治疗治疗稳定型心绞痛疗效优于单纯西医治疗，其可能为通过降低机体炎性因子水平而发挥治疗作用。

Objective To investigate the levels of plasma inflammatory factors in patients with stable angina and explore its clinical significance.Methods Totally 203 patients with stable angina from June 2013 to June 2015 were enrolled and followed up to November 2015,acute coronary syndrome (ACS) was defined as the end point event.According to the follow-up result,199 patients (4 patients were lost in follow-up) were divided into ACS group (41 cases) and non-ACS group (158 cases).The levels of tumor necrosis factor α(TNF-α),interleukin-1β (IL-1β) and high-sensitivity C-reactive protein (hs-CRP) in plasma were compared,the correlations of them were analyzed.Result The levels of TNF-α,IL-1β and hs-CRP in ACS group were significantly higher than those in non-ACS group [(20 ± 13) ng/L vs (17 ± 9) ng/L,(17 ± 11) ng/L vs (13 ± 8) ng/L,(9 ± 5) mg/L vs (5 ±4) mg/L] (P ＜ 0.05);there was significant positive correlation between one and any of the other two inflammatory factors (P ＜ 0.05).Conclusion High levels of inflammatory factors may play an important role in progress of stable angina to ACS.

目的 研究并探讨腹型肥胖以及代谢紊乱对原发性高血压患者左室质量指数的实际影响.方法 选取我院住院部体检中心2014年1月~2016年1月检出的高血压患者50例、高血压合并腹型肥胖患者50例、高血压合并代谢紊乱综合征患者50例,分别设置为高血压组、肥胖组、代谢紊乱组,并选取同期进行健康体检的体检正常者40例作为对照组.所有受检者均接受超声心动图检测,记录其左心室结构的各项参数,比较各组受检者的左室质量指数,并计算左室质量指数与血压、腰围、代谢紊乱之间的相关性.结果 各组受检者的左室质量指数相比,差异有统计学意义(P<0.05),从高至低依次为代谢紊乱组、肥胖组、高血压组、对照组.左室质量指数与血压、腰围、代谢紊乱均具有相关性,且均呈正相关.结论 腹型肥胖、代谢紊乱对高血压患者的左室质量指数具有严重影响,会促使左室质量指数增高,提示腹型肥胖、代谢紊乱与左心室肥厚的发展和发展进程有关.

Objective To observe and study the effect of astragalus injection on the vascular function state of patients with primary hypertension.Methods A total of 90 patients with primary hypertension admitted in the Affiliated People′s Hospital of Hebei United University in Tangshan City from Jun .2011 to Oct.2013 were divided into two groups by random number table method:patients in the control group ( 45 cases) received conventional western medicine treatment and patients in the observation group (45 cases) received conventional western medicine treatment and astragalus injection.The vascular function evaluation indexes of two groups before treatment and at the first,third and sixth week after treatment were compared. Results The pulse wave velocities of carotid femoral,brachial ankle,ankle brachial and femoral neck in the observation group at the first,third and sixth week after treatment were all lower than the those in the control group(P<0.05),while the vascular endothelial function indexes in the observation group, including brachial artery diameter after compression (D1),brachial artery endothelium-dependent diastolic function and reactive hyperemia,were higher than those in the control group respectively.And among the arterial elasticity related indexes,C1 and C2 of the observation group were higher than those of the control group respectively,while stiffness βand elastic coefficient Ep were lower than the control group(P<0.05).Conclusion The astrag-alus injection can significantly improve the vascular function state of patients with primary hypertension ,so it has great clinical application value in the treatment for the disease .

ObjectiveTo observe the effect of atorvastatin calcium in the treatment of patients with coronary artery disease, and to analyze its effect on serum cytokines tumor necrosis factor alpha (TNF-α), C reactive protein (CRP), interleukin-4 (IL-4) and interleukin-10 (IL-10).Methods Selected 78 patients with coronary heart disease treated in the hospital in October 2013-April 2014 as the objects of study with heart function grade NYHAⅠ-Ⅱ grade, they were randomly divided into two groups, the control group took amlodipine treatment, the observation group was given amlodipine combined with Atorvastatin Calcium Tablets treatment, all were treated for 8 weeks, then to compare curative effect between the two groups, and TNF-α, CRP, IL-4 and IL-10 were measured, then to compare the level. Results The total efficiency in the observation group were 92.3% (36 cases) and was significantly higher than the control group (χ2=5.571,P<0.05). The observation group’s TC, TG, LDL-C levels after treatment were (3.01±0.27) mmol/L, (1.87±0.21) mmol/L, (2.02±0.15) mmol/L and were lower than the control group (P<0.05); but HDL-C level was higher than the control group (P<0.05). The observation group’ TNF-α, CRP, IL-4 levels were (54.7±21.1) pg/ml, (3.1±1.1) mg/L, (22.1±7.8) ng/L and were lower than the control group (P<0.05); but IL-10 level was higher than the control group (P<0.05).Conclusion Atorvastatin calcium in the treatment of patients with coronary artery disease has better effect and better lipid regulating effect, also it can improve the abnormal changes of cytokines, so it has important clinical value.

Objective To investigate and analyze the correction between the plasma catestatin,VEGF, MMP,TIMP and congestive heart failure. Methods 48 patients with congestive heart failure in our hospital from September 2011 to August 2013 were selected as observation group,48 healthy persons with the same age were the control group,then the plasma catestatin,VEGF,MMP and TIMP of two groups were detected and compared,then the detection levels of observation group with different cardiac functional grading were compared too,and the correction between the detection indexes and disease was analyzed by Logistic analy-sis. Results The plasma catestatin,VEGF,MMP-2,MMP-9 and TIMP-1 of observation group were all higher than those of control group,and the detection levels of patients with higher cardiac functional grading were all higher than those of patients with lower cardiac functional grading(P<0. 05). Logistic analysis showed that the 5 indicators were predictive factors for congestive heart failure(P<0. 05). Conclusion The plasma cat-estatin,VEGF,MMP and TIMP of patients with congestive heart failure all show increasing trend,and the car-diac functional grading higher,the detection levels higher.

目的：探讨阿托伐他汀预治疗对老年急性冠脉综合征(ACS)患者行经皮冠状动脉介入(PCI)术后炎症因子及心血管事件的影响。方法选择我院2010年1月—2012年12月162例拟行PCI的老年ACS患者,随机分为对照组48例,试验A组55例,试验 B组59例,术前所有患者常规服用阿司匹林肠溶片、氯吡格雷等药物。对照组术前不给予阿托伐他汀口服；试验 A组在此基础上于手术前1个月开始给予20 mg阿托伐他汀钙片,1次/日,维持1个月；试验 B组术前1个月开始给予40 mg/d阿托伐他汀钙片口服,1次/日,维持1个月。术后所有患者均给予40 mg/d阿托伐他汀口服(1次/日)及其他常规药物,直至患者出院。比较3组患者术前与术后白介素6(IL 6)、中性粒细胞计数、超敏 C反应蛋白(hs CRP)、肌钙蛋白 I(cTnI)、肌酸激酶同工酶(CK MB)水平,并观察围术期患者心血管事件发生情况。结果 PCI术后试验 A组、试验 B组患者 IL 6、中性粒细胞、hs CRP、cTnI及 CK MB水平均较术前及对照组显著改善(P<0.05),且试验 B组较试验 A组改善更明显,差异有统计学意义(P<0.05)；试验 B组患者心肌梗死发生率低于试验 A组,差异有统计学意义(P<0.05)。结论阿托伐他汀术前口服可显著改善患者术后炎症情况及保护心肌功能,且40 mg剂量效果为佳。

目的:观察糖尿病肾病患者血清NT-proBNP,Hcy和cTnI的水平变化情况,分析其与心血管疾病发生的关系,为临床提供指导依据.方法:选择我院2012年3月至2013年9月收治的152例糖尿病肾病患者,根据合并心血管疾病的情况,将所选患者分为并发症组(83例)和无并发症组(69例),另选择同期在我院接受健康体检的志愿者(72例)作为对照组.检测三组对象血清中NT-proBNP,Hcy与cTnI的水平,以及糖尿病肾病患者的肾功能指标.结果:对照组NT-proBNP,Hcy与cTnI水平显著低于其他两组,并发症组患者NT-proBNP,Hcy与cTnI水平高于无并发症组,差异有统计学意义(P＜0.05).并发症组患者的BUN,UA及CysC水平显著高于无并发症组,差异有统计学意义(P＜0.05).结论:NT-proBNP,Hcy和cTnI在合并心血管疾病的糖尿病肾病患者血清中显著升高,并在一定程度上影响患者的肾功能.

目的 探究红花黄色素注射液对冠心病患者血浆大内皮素(big endothelin,Big ET)与脑钠肽(brain natriuretic peptide,BNP)水平的影响.方法 选取唐山市人民医院2012年6月～2014年2月心内科收治的冠心病患者80例,随机分为2组(n=40),予抗血小板聚集、减轻心肌耗氧、缓解疼痛、稳定斑块等常规治疗;实验组在常规治疗的基础上加用红花黄色素注射液100 mg,静脉滴注,1次/d.另选取同期本院门诊体检中心体检志愿者40例为空白组,追踪14 d.对比治疗前后患者Big ET及BNP变化及临床疗效.结果 治疗前,常规组、实验组与空白组相比,Big ET、BNP有显著性差异(P＜0.05);治疗后,常规组和实验组Big ET、BNP水平均显著下降,与常规组比较,实验组下降更明显,差异具有统计学意义(P＜0.05);治疗后实验组临床总有效率高于对照组,差异具有统计学意义(P＜0.05).结论 红花黄色素注射液可明显改善冠心病患者Big ET、BNP及临床症状,对临床具有指导意义.

目的 探讨新活素(重组人脑利钠肽新活素,rhBNP)对充血性心力衰竭(CHF)患者基质金属蛋白酶2(MMP-2)的影响.方法 选定60例CHF患者及正常对照组60例,将CHF组随机分为二组,rhBNP组(A组)和常规治疗组(B组)各30例,治疗前后分别测定血清MMP-2的浓度,并与临床症状的改善及彩色多普勒检测结果进行对照.结果 CHF组与正常对照组之间血清MMP-2测定值差异有统计学意义(P＜0.01),rhBNP组治疗后血清MMP-2与对照组水平差异有统计学意义(P＜0.05).结论 rhBNP可降低CHF患者血清MMP-2水平,从而改善左室重构及心脏功能.

目的 探讨血浆儿茶酚抑素水平变化与心力衰竭的关系及其临床意义.方法 选取心力衰竭患者41例设为心力衰竭组,健康对照组53例为同期健康体检者.采用酶联免疫分析法测定血浆儿茶酚抑素浓度.结果 心力衰竭组体重指数、腰臀比与健康对照组比较,差异无显著性.心力衰竭组血浆儿茶酚抑素与健康对照组比较,明显升高,差异有显著性;心力衰竭组中Ⅳ级者血浆儿茶酚抑素水平与NYHAⅡ级、Ⅲ级者比较,差异有显著性.心力衰竭组出院时血浆儿茶酚抑素水平与治疗前比较,差异有显著性.结论 心力衰竭患者血浆儿茶酚抑素水平显著升高,且随着心力衰竭程度的加重而升高.

ObjectiveTo investigate the effect of atorvastatin on heart function and plasma high sensitivity C reactive protein (hs-CRP) and N terminal pro brain natriuretic peptide (NT-proBNP) levels in coronary heart disease patients with heart failure.Methods 68 patients treated in the hospital in 2013 June-2013 year in December admitted to the coronary heart failure were selected as the research objects, all randomly were divided into two groups with 34 cases in each group, all patients were given correct drug treatment for heart failure, the control group adopted treatment of atorvastatin with dose of 10 mg, and observation group adopted 20 mg atorvastatin, once a day, 12 consecutive weeks, to compare changes between two groups of patients with cardiac function and plasma hs-CRP and NT-proBNP levels. ResultsThe total efficiency of heart function improved in the observation group was 33 cases (97.1%) and significantly higher than that of the control group of 27 cases (79.4%),χ2=5.100,P<0.05. The level of NT-proBNP, hs-CRP in the observation group respectively were (1.1±0.2)mg/L, (312.3±45.2)ng/ml and were lower than the control group’ (1.8±0.4)mg/L, (389.4±52.3)ng/ml,P<0.05. Left ventricular ejection fraction (LVEE) and mitral early diastolic peak velocity and diastolic peak velocity ratio (E/A) in the observation group were (45±1)%, 1.32±0.04 and were higher than the control group’ (41±2)%,1.09±0.05, P<0.05.Conclusion Atorvastatin can effectively improve heart function of coronary heart disease in&nbsp;patients with heart failure and can reduce the plasma level of hs-CRP and NT-proBNP, so it has important clinical value.

在充血性心力衰竭（ CHF ）的进展过程中，左心室重塑、扩张，泵功能失调是影响患者病情及预后的主要因素。心肌中基质金属蛋白酶（MMPs）可特异地降解细胞外基质（ECM），影响心室重塑〔1〕。心脉隆注射液是由美洲大蠊干品经过浸渍、减压浓缩、分离得到心脉隆浸膏再溶解后制得，有效成分为多肽、核苷及复合氨基酸等。体内外研究〔2〕表明，心脉隆注射液对心血管系统具有多方面作用，可以增加心肌收缩力、扩张血管、利尿、降低肺动脉压、抑制内皮素（ ET ）分泌等。本文旨在评价心脉隆注射液在慢性充心力衰竭（ CHF）治疗中的临床价值。

目的 探讨正常血压的原发性高血压患者子女血浆(Catestatin)水平的变化及其临床意义.方法 分为正常血压的原发性高血压子女组和健康对照组,测定两组血浆Catestatin、尿儿茶酚胺.结果 与对照组比较,正常血压的原发性高血压患者子女组血浆Catestatin水平下降(P＜0.01),尿儿茶酚胺水平升高(P＜0.01).结论 正常血压的原发性高血压患者子女血浆Catestatin水平的降低先于其血压的升高,提示Catestatin在原发性高血压的发生、发展过程起重要作用.

目的 探讨急性心肌梗死(AMI)患者血浆大内皮素(big ET-1)、N末端脑钠肽(NT-proBNP)水平和发生血流动力学障碍的关系及其临床意义.方法 对45例发生血流动力学障碍急性心肌梗死患者(血流动力学障碍组)、48例未发生血流动力学障碍的急性心肌梗死患者(对照组)以酶联免疫吸附分析(ELISA)法测定其血浆ET、NT-proBNP水平,分析、计算、对比血浆ET-1、BNP水平与血流动力学障碍的关系.结果 血流动力学障碍组患者血浆ET、NT-proBNP水平显著高于对照组,差异有统计学意义(P<0.01).结论 血浆big ET-1、NT-proBNP水平增高与AMI患者发生血流动力学障碍具有相关性,可作为AMI患者发生血流动力学障碍的预测性指标.

急性脑梗死易引起继发性心脏损害,表现为心脏功能的紊乱及心电活动的改变,这在临床上称为脑心综合症.已有一些研究表明,10％～ 27％急性脑梗死患者血清肌钙蛋白含量升高[1-3].为探讨急性脑梗死患者血清超敏肌钙蛋白含量升高与脑梗死的诊断和预后的关系.本文对66例急性脑梗死患者和50名健康查体者血清超敏肌钙蛋白hs-TNT含量进行了分析.资料与方法1一般资料2009年10月至2010年10月本院收治的发病48h内,经过颅脑CT确诊的66例急性脑梗死患者,符合1995年中华医学会第4次全国脑血管病学术会议确定的诊断标准[4].排除以下病例:近期心肌梗死、心力衰竭、心脏手术后、肾功能不全、怀孕妇女、严重痴呆.66例急性缺血性卒中患者为观察组,男43例,女23例,年龄43 ～ 81岁,平均年龄58.9±11.8岁.所有患者在首次采血前未使用抗炎、扩容、扩血管、溶栓等药物治疗.患者治疗10天后,58例再次检测hs -TnT含量.选择同期健康体检者50名为对照组,男25名,女25名,年龄41 ～78岁,平均年龄55.3 ±11.2岁,均无心、肝、脑、肾疾病和感染性疾病及糖尿病,头部CT检查无颅内疾病.

<正>大内皮素(ET)是目前已知最强的长效内源性血管收缩调节因子,广泛存在于各种组织和细胞中,主要由血管内皮细胞合成,在正常生理活动及某些疾病,尤其是血管病变有关的疾病的发生发展中起重要作用。我国高血压患者众多,严重威