The present study aimed to investigate the effect of Apelin-13 on nicotine-induced injuries of cardiomyocytes. To establish an H9c2 cell model of nicotine-induced apoptosis, H9c2 cells were divided into the control group, nicotine group, and Apelin-13+nicotine group. The apoptosis rate of H9c2 cells was then detected by flow cytometry. Later, the expressions of indicators related to apoptosis, oxidative stress, and inflammatory responses were measured via Western blotting and quantitative real-time polymerase chain reaction (qRT-PCR). The results revealed that the expression of B-cell lymphoma-2 (Bcl-2) was remarkably down-regulated (P<0.01), while the apoptosis rate and the expressions of apoptosis-related proteins (Bcl-2-associated X protein (Bax) and cysteinyl aspartate specific proteinase-3 (Caspase-3)) were significantly up-regulated (P<0.01) in the nicotine group. However, the variation trends of Bcl-2, Bax, and Caspase-3 in the Apelin-13+nicotine group were contrary to those in the nicotine group (P<0.01). Additionally, the expressions of interleukin-1 beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) obviously declined (P<0.01), while those of superoxide dismutase 1 (SOD1) and SOD2 dramatically rose in the Apelin-13+nicotine group (P<0.01). Furthermore, Apelin-13 treatment evidently elevated the expressions of phosphorylated protein kinase B (p-AKT) and phosphorylated phosphatidylinositol 3-kinase (PI3K). In conclusion, Apelin-13 inhibits nicotine-induced apoptosis and oxidative stress in H9c2 cells via the PI3K/AKT signaling pathway.

目的 探讨远程缺血预处理(RIPC)预防急性冠状动脉综合征(ACS)患者择期经皮冠状动脉介入(PCI)术中无复流的临床价值.方法 选取 2019 年 5 月至 2021 年 5 月温州市中医院收治的行择期PCI术的ACS患者 160 例,按照随机数字表法分为对照组和观察组各 80 例,分别给予现代医学常规治疗和现代医学常规治疗联合RIPC治疗.比较两组患者PCI术前及术后心肌梗死溶栓试验(TIMI)血流分级、TIMI心肌灌注分级(TMPG)、校正TIMI血流桢数(CTFC)及术中无复流、再灌注心律失常发生率,分析两组患者PCI术前及术后血清血管性血友病因子(vWF)、可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞黏附分子-1(sVCAM-1)、髓过氧化物酶(MPO)、超氧化物歧化酶(SOD)、左心室射血分数(LVEF)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)变化及PCI术后出血事件和主要不良心血管事件(MACE)发生情况.结果 观察组PCI术后TIMI血流分级和TMPG分级均优于对照组(χ2=12.104、13.976,P<0.05).观察组PCI术中无复流、再灌注心律失常发生率明显低于对照组(χ2=5.331、6.632,P<0.05),PCI术后CTFC明显低于对照组(t=15.494,P<0.01).两组PCI术后24 h血清vWF、sICAM-1、sVCAM-1、MPO较PCI术前明显升高(P<0.05),但对照组升高较观察组更为显著(t=3.231、4.330、2.566、4.333,P<0.05);两组PCI术后24 h血清SOD较PCI术前明显降低(P<0.05),但对照组降低较观察组更为显著(t=4.880,P<0.05).两组PCI术后30 d LVEF较PCI术前明显升高(P<0.05),且观察组升高较对照组更为显著(t=2.587,P<0.05);两组PCI术后 30 d LVEDV、LVESV较PCI术前明显降低(P<0.05),且观察组降低较对照组更为显著(t=7.294、4.049,P<0.05).两组患者随访期间出血事件和MACE发生率无统计学差异(P>0.05).结论 ACS患者行择期PCI术前接受RIPC治疗可降低术中无复流发生率,改善心肌微血流灌注和心功能,减轻PCI术后氧化应激反应和血管内皮损伤,且并未增加短期出血事件和MACE发生率.

目的 探讨增强型体外反搏联合曲美他嗪对行经皮冠状动脉介入术(PCI)后冠心病患者心功能的影响.方法 选取2017年6月至2018年6月在温州市中医院和温州医科大学附属第二医院行PCI术后的缺血性心脏病伴左心室射血分数(LVEF)低下患者90例,随机分为对照组、观察组1和观察组2,每组各30例.三组患者均行常规药物治疗,观察组1在对照组治疗基础上加用曲美他嗪进行干预,观察组2在观察组1的治疗基础上,联合增强型体外反搏治疗.比较三组患者治疗前后LVEF、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD),N-末端B型利钠肽前体(NT-proBNP)值及血清肌酸激酶同工酶(CK-MB)、血清心肌肌钙蛋白I(cTnI)浓度,6min步行试验(6MWT)的步行距离及随访半年内的心血管不良事件的发生情况.结果 两组观察组在干预30d后,其EF值、NT-proBNP、6MWT的变化均优于对照组(P<0.05),且观察组2优于观察组1(P<0.05),同时并未升高CK-MB、cTnI(P>0.05),说明并不造成心肌的损伤.随访半年后,观察组2的心血管事件发生率远低于其他两组(P<0.05).结论 增强型体外反搏联合曲美他嗪干预行PCI术后缺血性心脏病患者,可以改善患者的心功能,减少心脏不良事件.

Objective To investigate the effect of Buyang Huanwu Tang combined with distal ischemic preconditioning on the quality of life and prognosis of patients after stent implantation. Methods 120 patients with ischemic heart disease after stent implantation were divided into observation group and control group with 60 cases in each group.On the basis of routine drug treatment,the control group received distal ischemic preconditioning for 30 minutes. The observation group was treated with Buyang Huanwu Tang.The changes of TCM blood stasis syndrome score,clinical efficacy of TCM and Seattle angina score were observed in the two groups,and the occurrence of adverse cardiovascular events such as angina pectoris,myocardial infarction and death were observed after 6 months of follow-up. Results After one month of treatment,the score of blood stasis syndrome in the observation group was significantly lower than that in the control group(P<0.05). The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).On the Seattle Angina Scale,compared with the control group,the observation group had a significant improvement in the degree of physical activity limitation and the frequency of angina pectoris after 1 month and 6 months of treatment(P<0.05). In terms of disease awareness,after 6 months of treatment,the observation group was higher than the control group(P<0.05).At 6 months follow-up, 1 case died in the observation group and 3 cases died in the control group. There was no significant difference between the two groups(P<0.05);3 cases of recurrent myocardial infarction in the observation group and 10 cases in the control group were significantly lower than those in the control group(P<0.05);16 cases of recurrent angina in the observation group were significantly lower than 28 cases in the control group(P<0.05). Conclusion Buyang Huanwu Tang combined with distal ischemic preconditioning can significantly improve the quality of life of patients with ischemic heart disease after stent implantation and reduce cardiovascular endpoint events.

目的 探讨远端缺血预处理对择期行PCI患者的心肌保护作用及远期预后影响.方法 选择择期行PCI的缺血性心脏病患者122例,采用随机对照表法分为观察组和对照组,各61例.2组均常规药物治疗,观察组在PCI术前1h予远端缺血预处理30 min.观察2组患者术后16h高敏肌钙蛋白I(hs-cTnI)＞0.12、＞0.16、＞0.20、＞0.24、＞0.28、＞0.36和＞0.48 μg/L所占比例及4a型心肌梗死发生率,随访6和12个月时再发心绞痛、再发心肌梗死和死亡等主要不良心血管事件发生情况.结果 观察组不同hs-cTnI水平比例均明显低于对照组(＞0.12μg/L,54.1％ vs 78.7％,P=0.004;＞0.16 μg/L,49.2％vs 68.9％,P=0.039),观察组4a型心肌梗死发生率显著低于对照组(41.0％ vs 59.0％,P=0.046).术后6个月随访时,观察组较对照组再发心绞痛和再发心肌梗死发生率虽有下降,但差异无统计学意义(9.8％ vs 21.3％,x 2=3.055,P=0.080;0 vs 3.3％,x2=2.033,P=0.154),术后12个月随访时,观察组较对照组再发心绞痛和再发心肌梗死发生率明显下降(13.1％ vs 32.8％,x2=6.675,P=0.010;1.6％ vs 11.5％,x2 =4.816,P=0.028).2组随访期间均无死亡患者.结论 远端缺血预处理可显著降低择期行PCI患者术后hs-cTnI水平,保护心肌,降低4a型心肌梗死发生率,并改善患者预后.

目的 调查分析心血管内科患者对心脏康复的需求,以此为依据改善医院的诊疗服务.方法 选取2015年1月至2018年1月于我院心血管内科接受治疗的60例心脏病患者,使用我院自制的心血管内科患者心脏康复需求调查表进行问卷调查,分析调查结果.结果 大部分心脏病患者在住院时及出院后希望得到科学的心脏康复治疗与护理支持,且希望医护人员能对其进行合理的心脏康复指导.结论 医院心血管内科在对患者进行治疗与护理时应加强心脏康复护理专业团队建设,加强心脏康复支持,以保障身心健康,促进快速康复.