目的 探究植物雌激素(PE)在心血管领域的研究热点、前沿及未来研究趋势.方法 在Web of Science Core Collection(WoSCC)数据库中检索相关文献,以纯文本的格式导出检索文献的全记录与引用的参考文献,运用CiteSpace V对这些文献的国家、机构、作者、学科领域、共被引文献、关键词、聚类、突发词进行可视化分析.结果 1048篇文献由个74国家(地区)、1329个机构、5207例作者完成.发文量最多的国家和机构分别是美国和中国医学科学院,中国的陈裕明与意大利的Alessandra Bitto为最具生产力的作者.饮食与营养学、药理学、内分泌代谢学与心脏病学为该领域的主要学科.大豆异黄酮、金雀异黄素、绝经后女性、心血管疾病、冠心病、动脉粥样硬化、血压等为高频关键词,NFκB、炎症、凋亡、多酚、胰岛素抵抗等为突现词.结论 PE在心血管领域的研究涉及多国家、多机构、多学科的多位学者,本研究分析得到了目前该领域的研究热点和未来的研究趋势.未来仍需要更多的随机双盲对照试验及系统评价来探索PE对心血管系统的影响.

Objective To evaluate the efficacy and safety of coenzyme Q10 in the adjuvant treatment of heart failure.Methods Databases such as PubMed,The Cochrane Library,Embase,Web of science,CNKI,SinoMed,VIP and Wanfang Data were consulted to obtain randomized controlled trials(RCTs)concerning the use of coenzyme Q10 in treating heart failure from the beginning to February 2023.After literature screening,relevant effective information extraction and deviation risk included in the evaluation study,the two researchers used RevMan 5.4.1 analysis tool for meta-analysis.Results A total of 27 RCTs were collected,and the total number of patients was 3 222.Meta-analysis results revealed that:The mortality rate of coenzyme Q10 adjuvant treatment group was lower than that of the control group[RR=0.62,95％CI(0.47,0.82),P=0.000 6],and the ejection fraction was higher than that of the control group[MD=3.62,95％CI(2.53,4.71),P＜0.000 01],NYHA cardiac function grade was lower than control group[MD=-0.31,95％CI(-0.40,-0.22),P＜0.000 01],and 6-minute walking test(6MWT)was superior to the control group[MD=35.36,95％CI(23.00,47.72),P＜0.000 01],adverse reactions were lower than those in control group[RR=0.73,95％CI(0.50,1.06),P=0.10].Conclusion The evidence currently available suggests that coenzyme Q10 has the potential to reduce mortality,NYHA cardiac function grade,and increase ejection fraction and 6-minute walking test in those with heart failure,without any major adverse effects.Nevertheless,due to the limited number of studies included,these conclusions must be further corroborated by more high-quality studies.

目的:探讨焦虑和(或)抑郁对经皮冠状动脉介入治疗(PCI)术后病人主要心血管不良事件(MACE)的影响.方法:检索中国知网(CNKI)、万方、维普(VIP)数据库自建库至2020年8月所有焦虑和(或)抑郁对冠心病PCI术后病人MACE影响的相关文献,用RevMan 5.3进行统计分析.结果:纳入12篇文献,均为队列研究,Meta分析结果显示,焦虑抑郁组PCI术后病人MACE发生率高于对照组,差异有统计学意义[OR=2.59,95％CI(1.59,4.21),P=0.0001];抑郁组PCI术后病人MACE发生率高于对照组,差异有统计学意义[OR=2.62,95％CI(2.05,3.34),P<0.00001].结论:现有证据表明,焦虑和(或)抑郁会增加PCI术后病人MACE发生率,但仍需高质量、大样本的研究进一步验证.

目的 系统评价曲美他嗪治疗微血管心绞痛(CMVA)的临床疗效和安全性.方法 检索中国学术期刊数据库(CNKI)、万方数据库(Wanfang)、中国生物医学文献服务系统(SinoMed)、维普中文期刊全文数据库(VIP)、PubMed和Web of Science(WOS)数据库从建库至2022年5月有关曲美他嗪治疗CMVA的临床随机对照试验(RCT),采用ReviewManager5.3软件进行Meta分析.结果 共纳入12项RCTs,包括1195例患者,其中试验组609例、对照组586例.Meta分析结果显示,与对照组比较,试验组的心绞痛症状临床疗效提高,心绞痛症状改善的总有效例数增加[OR=4.63,95％CI(3.20,6.72),P＜0.000 01]、显效例数增加[OR=1.94,95％CI(1.40,2.68),P＜0.000 01]:平板运动试验总运动时间延长[MD=1.31,95％CI(1.02,1.60),P＜0.000 01],平板运动试验心电图ST段压低0.1 mV时间延长[MD=1.28,95％CI(0.98,1.59),P＜0.00001],平板运动试验心电图ST段最大压低幅度降低[SMD=-1.19,95％CI(-1.72,-0.65),P＜0.000 01].结论 曲美他嗪可以改善CMVA患者心绞痛症状,延长CMVA患者平板运动时间和平板运动试验中心电图ST段压低0.1 mV所需时间、降低ST段压低的最大幅度.

Background: Phytoestrogens are a class of natural compounds that have structural similarities to estrogens. They have been identified to confer potent cardioprotective effects in experimental myocardial ischemia-reperfusion injury (MIRI) animal models. We aimed to investigate the effect of PE on MIRI and its intrinsic mechanisms. Methods: A systematic search was conducted to identify PEs that have been validated in animal studies or clinical studies as effective against MIRI. Then, we collected studies that met inclusion and exclusion criteria from January 2016 to September 2021. The SYRCLE's RoB tool was used to evaluate the quality. Data were analyzed by STATA 16.0 software. Results: The search yielded 18 phytoestrogens effective against heart disease. They are genistein, quercetin, biochanin A, formononetin, daidzein, kaempferol, icariin, puerarin, rutin, notoginsenoside R1, tanshinone IIA, ginsenoside Rb1, ginsenoside Rb3, ginsenoside Rg1, ginsenoside Re, resveratrol, polydatin, and bakuchiol. Then, a total of 20 studies from 17 articles with a total of 355 animals were included in this meta-analysis. The results show that PE significantly reduced the myocardial infarct size in MIRI animals compared with the control group (p < 0.001). PE treatment significantly reduced the creatine kinase level (p < 0.001) and cTnI level (p < 0.001), increased left ventricular ejection fraction (p < 0.001) and left ventricular fractional shortening (p < 0.001) in MIRI animals. In addition, PE also exerts a significant heart rate lowering effect (p < 0.001). Conclusion: Preclinical evidence suggests that PE can be multi-targeted for cardioprotective effects in MIRI. More large animal studies and clinical research are still needed in the future to further confirm its role in MIRI.

目的 通过网络药理学方法研究植物雌激素类中药单体治疗心肌缺血再灌注损伤(MIRI)的作用机制和潜在靶点.方法 通过检索PubMed、中国知网全文数据库(CNKI),在植物雌激素范畴内查找已通过实验验证的对心肌缺血再灌注损伤有积极干预作用的中药单体;通过PharmMapper数据库查询相关中药单体的靶点;利用GeneCard、OMIM数据库筛选疾病靶点;通过R语言绘制Venn图找到交集靶点;用Cytoscape 3.6.1软件绘制中药单体与交集靶点的网络图;用STRING数据库和Cytoscape 3.6.1绘制蛋白相互作用(PPI)网络图;利用R语言进行基因本体(GO)功能富集和京都基因和基因组百科全书(KEGG)信号通路分析.结果 检索得到10个植物雌激素类中药单体,分别是染料木素、槲皮素、三七皂苷R1、白藜芦醇、葛根素、丹参酮ⅡA、人参皂苷Rb1、人参皂苷Rb3、人参皂苷Re、人参皂苷Rg1.获得中药单体靶点515个、疾病靶点1069个,通过Venn图得到交集靶点57个.PPI示核心靶点有血清清蛋白(ALB)、表皮生长因子受体(EGFR)、胱天蛋白酶3(CASP3)、丝裂原激活的蛋白激酶1(MAPK1)等12个,GO富集分析主要涉及与内肽酶活性、核受体活性、配体激活转录因子活性等生物过程有关,KEGG富集分析主要涉及雌激素信号通路、流体剪切应力和动脉粥样硬化、细胞凋亡、白细胞介素-17(IL-17)信号通路、血管内皮生长因子(VEGF)信号通路等.结论 植物雌激素类中药单体作用机制可能是通过雌激素受体信号通路的两种途径以及其他信号通路多靶点、多通路地发挥抗心肌缺血再灌注损伤作用.可从该角度进行心肌缺血再灌注损伤的实验研究及临床用药提供思路与参考.

目的 探究阻塞性睡眠呼吸暂停(OSA)与心血管疾病相关领域的研究热点、前沿及趋势.方法 检索Web of Science Core Collection(WoSCC)数据库,获得从1985年至今的所有OSA与心血管疾病相关的文献,将文献的完整记录和引用的参考文献以纯文本形式导出,使用CiteSpace V依次对作者、机构、国家、共被引文献、关键词、突发词进行可视化分析.结果 共8736篇文献纳入研究,美国为发文量最多的国家,梅奥诊所为发文最多的机构,David Gozal是发文量最多的作者.与OSA最相关的心血管疾病有高血压、心力衰竭(心衰)、心房颤动(房颤)等,目前的研究热点是OSA的流行病学及持续气道正压通气.阻塞性睡眠呼吸暂停、气道正压、高血压等为该领域的高频关键词,心血管事件、随机对照试验、Meta分析是该领域的突发关键词.结论 许多国家、机构和作者都参与了OSA与心血管疾病的研究,并发表了大量文献.本研究揭示了OSA与心血管疾病的研究现状,并预测了其未来的发展趋势.目前,该领域正处于快速发展时期,具有很高的研究价值.