目的 研究急性心肌梗死患者在接受经皮冠状动脉介入治疗(PCI)之后产生心力衰竭及其与糖化血红蛋白水平间的关系.方法 将300例急性ST段抬高型心肌梗死患者按照入院时检测到的糖化血红蛋白水平高低分成观察组和对照组,调查、测定并记录所有患者在入院时的一般资料、血糖水平等情况,并进行超声心动图检查,并对其相关的影响因素进行分析.结果 观察组中糖尿病病史人数多于对照组(P＜ 0.05);观察组的病变血管数、梗死相关血管开通时间及无复流患者人数所占比例均较对照组高(均P＜ 0.05);病变3个月后,观察组LVEF较对照组低(P＜0.05),而心力衰竭患者人数所占比例较对照组高(P＜0.05);经多因素分析发现,糖化血红蛋白水平是患者出现心力衰竭的独立危险因素.结论 糖化血红蛋白水平是患者在接受PCI术后3个月出现心力衰竭现象的独立危险因素,在临床治疗中可以根据糖化血红蛋白水平的变化对患者进行早期干预.

Objective To investigate clinical efficacy of fluvastatin com-bined with nitroglycerin injection on the treatment of acute heart failure analysis in elderly hypertensive patients with diabetes .Methods A total of 127 patients were randomly divided into treatment group ( n=65 ) and control group ( n =62 ) . All patients were treated with conventional symptomatic treatment.Patients in treatment group were given fluvastatin 80 mg, qn; combined with nitroglycerin injection starting dose 5-10 μg? min-1 , 5 -10 min intervals as appropriate dose increased 5-10 μg? min-1 .Patients in control group only received nitroglycerin . The treatment lasted 7 d.The blood glucose , heart rate , blood sugar , heart function and plasma N -terminal pro -brain natriuretic peptide ( NT-proBNP) and cardiac troponin I ( cTnI ) levels before and after treatment were observed in two groups .Results The diastolic blood pressure , systolic blood pressure , heart rate , fasting plasma glucose after treatment were all significantly decreased ( P<0.05 ) .After treatment ,the left ventricular ejection fraction and stroke volume (41.14 ±2.34 )%, (78.53 ±5.89 ) mL in treatment group were significantly higher than those of control group , which were (38.01 ±2.40)%, (71.13 ±5.76 ) mL, respectively. The central venous pressure in treatment group after treatment was (1.31 ±0.18 ) kPa, significantly lower than that in control group (1.62 ±0.20) kPa (P<0.05).After treatment, the plasma NT-proBNP and cTnI levels in treatment group were (518.62 ±159.13 ) pg? mL-1 , (0.13 ±0.04 ) ng? mL-1 , significantly lower than that those in control group, which were (878.71 ±209.31) pg? mL-1 and (0.25 ±0.05) ng? mL-1(P<0.05).Conclusion Fluvasta-tin and nitroglycerin can significantly improve cardiac function of elderly hypertensive patients with diabetes .

Objective To investigate the effect of microRNA- 34a (miR- 34a) on serum- free- induced apoptosis in car-diomyocytes and its mechanism. Methods Rat cardiomyocytes H9C2 were cultured in vitro and divided into three groups: in experimental group H9C2 cel s were transfected with miR- 34a inhibitor, blank control group had no transfection, in negative con-trol group cel s were transfected with randomly synthesised miRNA. H9C2 cel s were cultured in serum- free medium to induce apoptosis after transfection. Western blot was preformed to examine the expression of Caspase- 3 and Bcl- 2 protein. Results Western blot showed that compared with blank control and negative control groups, the expression of Caspase- 3 was signifi-cantly decreased in experimental group (P<0.05), while the expression of Bcl- 2 was significantly increased in the experimental group(P<0.05). Conclusion Transfection of miR- 34a inhibitor down- regulates miR- 34a expression, and inhibites serum- free-induced apoptosis in H9C2 cel s, which is associated with the up- regulation of Bcl- 2.

器质性心脏病、心衰可以导致心房电重构和解剖重构.由于心房纤维化的结果,导致心房增大、细胞解偶联,心房肌各向异性增加,心房传导将发生改变[1].既往研究中,心房传导性大多是利用侵入性心电生理检查确定的[2].彩色组织多普勒超声成像(DTI)检查,过去常用于评价局部心肌的收缩活动,已经证实其在评价心衰患者心室内、心室间不同步性方面的重要性[3-4].本研究利用DTI技术评价有心衰症状患者心房内和心房间不同步性,现报告如下.