简介:目的:研究射频消融术(RFCA)对血凝状态及肌钙蛋白I(cTnI)含量的影响.方法:60例行RFCA的病人分别测定电生理检查术(EPS)术前、后,消融术前,消融术后即刻,4、12、24小时D-二聚体(DD),血小板α颗粒膜糖蛋白(GMP-140),cTnI含量.结果:血清DD,GMP-140水平在EPS及RFCA后升高,而cTnI水平仅在RFCA后升高.峰值cTnI与峰值DD,GMP-140呈直线正相关(r=0.48,0.39,P<0.001,<0.005).结论:RFCA可损伤心肌并改变血凝状态,心肌损伤可诱发血小板聚集,促进血栓形成.
简介:随机对照试验(RCT)被公认为评价医疗干预措施效果的金标准[1,2]。但在研究罕见病、慢性疾病及涉及伦理学或长期疗效观察等问题上,随机对照试验的可行性较低,而队列研究、病例对照研究等非随机对照研究(NRSI)更易达到研究目标,并且也是评估干预疗效的重要方法[3-6]。且一些学者在对RCT和观察性研究进行对比后,认为一个大样本的试验设计完善的非随机研究比一个小样本的设计不佳的RCT更加可取[7,8]。目前,许多评价观察性研究方法学质量的工具已被系统评价采用[9,10],而Newcastle-Ottawa[11]和Downs-Black[12]工具是其中应用最广泛的两种。虽然两者都具有完善的方法学的条目清单,但是每一个条目同时涉及内部有效性和外部有效性,并且缺乏综合性的手册。
简介:ObjectivesToinvestigatetheeffectandmechanismofendovaseularbraehytherapywith^192IronexpressionoftypeIcollagen,metalloproteinases-1(MMP-1)andthetissueinhibitor(TIMP-1)afterangioplasty.MethodsRestenotiemodelofdomesticmieroswinewasemployedandtheiliaearterieswererandomizedtoradiationgroup(n=12),whichweretreatedwith20-25Gyof^192Ir,andnon-radiationgroup(n=36)afterangioplasty.Thetargetvesselswereharvestedintheendof3monthsand6monthsafterangioplasty.Im-munohistochemistryandinsituhybridizationwereusedtodetectproteinsoftypeIcollagen,MMP-1andTIMP-1,andmRNAexpressionoftypeIcollagen.ResultsTheproteinandmRNAoftypeIcollagen,theratiosofTIMP-1/MMP-1weresignificantlylowerinradiationgroupthaninnon-radiationgroup(P<0.05or0.01).ThepeakoftranscriptionoftypeIcollagenmRNAwasat6monthsand3monthsinnon-radiationgroupandradiationgrouprespectively.ConclusionsEndovascularbrachytherapywith^192IrmightmodifythemetabolismofextracellularmatrixafterangioplastybyinhibitingthesynthesisoftypeIcollagenandtheactivitiesofMMP-1andTIMP-1.
简介:1资料与方法74例2002年8月~2004年10月因突发头痛、胸闷收入我科的住院患者,均行头颅CT及磁共振成像(MRI)检查,确诊为急性缺血性脑卒中(符合第四届全国脑血管疾病会议制定的诊断标准),其中男49例,女25例,年龄48~80(62±11)岁,70例有高血压病史,21例合并糖尿病,17例合并血脂异常.所有患者于入院当天行常规12导联心电图(ECG)检查,对ECG异常患者采静脉血检测肌钙蛋白I(cTnI),2例患者入院后ECGST-T改变明显行急诊冠状动脉造影,其余择期行冠状动脉造影.住院治疗两周后复查头颅CT或MRI检查、ECG及cTnI.
简介:BackgroundTreatmentofratswiththebeta-adrenergicagonistIsoprenaline(ISO)resultsincardiachypertrophyandmyocardialfibrosis.Inthepresentwork,weaimedtostudytheinvivoeffectsofISOonserumlevelsofmonocytechemoattractantprotein-1andtissueinhibitorofmatrixmetalloproteinasestypeIinWistarrats.MethodsISO(5mg·kg-1)orSalinewereinjectedsubcutaneouslyintoWistarratsonceadayfor3or7consecutivedays.Ventricularremodelingandcardiacfunctionwereevaluatedbyechocardiography.Sectionsofheartwerestainedwithhematoxylin-eosin(HE)forhistopathologyorwithMassonstrichromeforcollagenvisualization.Inaddition,hearttissueimmunohistochemistryforɑ-SMAwasalsoanalyzed.TheserumlevelsoftissueinhibitorofmatrixmetalloproteinasestypeI(TIMP-1)andmonocytechemoattractantprotein-1(MCP-1)weredeterminedbyLuminexmultiplextechnology.ResultsISOinducedcardiacdysfunctioninratsafter3or7daysoftreatment.ISOcausedsignificantincreaseofmyocardialdisorderandfibrosiswithincreasedɑ-SMAexpression.ISOtreatedaatsshowedasignificantincreaseintheserumlevelsofTIMP-1andMCP-1.ConclusionsOurstudysuggeststhatISOinducesprofoundcardiacremodelingaccompaniedwithincreaseofserumTIMP-1andMCP-1.
简介:目的探讨广谱氯离子通道阻滞剂4,4’-二异硫氰基芪-2,2’-二磺酸(DIDS)对大鼠缺血再灌注损伤心肌细胞凋亡的影响及其机制。方法雄性SD大鼠36只随机分为3组:缺血再灌注组(A组)、DIDS处理组(B组)和LY294002预处理组(C组)。伊文兰和TTC染色测定心肌梗死范围,TUNEL方法定性和定量检测心肌细胞凋亡指数,Westernblot测定蛋白激酶B(Akt)的表达。结果与A组比较,B组心肌梗死范围和心肌细胞凋亡指数明显降低[(38.8±7.7)%”(54.2±10.8)%,(8.9±1.8)%”(17.6±3.5)%.P〈0.01];磷酸化Akt表达水平明显增加(P〈0.01)。与A组比较,C组梗死面积、凋亡指数无明显减小,磷酸化Akt水平无明显变化(P〉0.05)。结论DIDS能够抑制大鼠缺血再灌注所致的心肌细胞损伤,可能是通过信号分子磷脂酰肌酶三羟基激酶/Akt的调节。
简介:目的探讨ABCD^3-I评分法对短暂性脑缺血发作(TIA)患者早期脑卒中风险的预测价值。方法选取颈内动脉系统TIA患者182例,分别采用ABCD2、ABCD^3、ABCD^3-I评分标准进行评分,其中ABCD^3-I危险分层分为低危40例,中危74例,高危68例,并观察TIA后7d内脑梗死的发生率。结果ABCD2、ABCD^3与ABCD^3-I评分法预测TIA后7d内脑梗死风险的ROC曲线下面积分别为0.625、0.713、0.831。TIA患者7d内进展为脑梗死27例(14.8%)。ABCD^3-I评分低危、中危和高危患者7d内脑梗死的发生率分别为0、6.8%、32.4%,中危和高危脑梗死发生率明显高于低危患者,高危脑梗死发生率明显高于中危患者,差异有统计学意义(P〈0.01);ABCD^3-I评分与7d内脑梗死发生率呈正相关(r=0.486,P〈0.01)。除年龄因素外,ABCD^3-I评分法中各个评分项目对TIA后7d内脑梗死发生率均有明显影响(P〈0.05)。结论ABCD^3-I评分法能更有效地预测TIA患者早期发生脑梗死的风险,可作为常规应用于临床,指导TIA危险分层评价和治疗。
简介:BackgroundAldosteroneblockerscouldreducetheincidenceofventriculararrhythmiasinmyocardialinfarction(MI)patientsbyregulatinghyperpolarization-activatedcyclicnucleotide-gatedchannel(HCN)expression.ButthemechanismunderlingHCNexpressionisunclear.MethodsEighteenratssurviving24hourspostMIwererandomlydividedinto3groups:MI,spironolactone,andspironolactone+antagomir-133(miRNA-133suppression).Shamgroupratshadasuturelooselytiedaroundtheleftcoronaryartery,withoutligation.HCN2andHCN4proteinandmRNAlevel,andmiRNA-133levelintheborderzoneofpost-MI1weekmyocardiumweremeasured.ResultsSpironolactonesignificantlyincreasedmiRNA-133levelsanddown-regulatedHCN2andHCN4atbothmRNAandproteinlevelsinpost-MIborderzonemyocardium.Antagomir-133reducedtheeffectsofspironolactoneonHCN2andHCN4proteinlevels.ConclusionsTheresultssuggestthatmiRNA-133isinvolvedinspironolactoneinducedHCNexpression,andpartiallycontributedtopost-MIventriculararrhythmias.
简介:BackgroundThemyocytedysfunctionmaybepresentinaorticstenosis(AS)patientswithpreservedleftventricularejectionfraction(LVEF).Earlyaorticvalvereplacement(AVR)canreversetheLVhypertrophyandimproveLVsystolicperformanceandclinicaloutcome.StrainimaginghasdemonstratedtobethemostappropriatemethodtoevaluateLVmyocardialcontractility.However,4D-strainimagingechocardiographyforthedetectionofsubclinicalleftventriculardysfunctioninASpatientswithpreservedLVEFisseldomstudied.MethodsWeprospectivelyenrolled30consecutivemoderatetosevereASpatientswithpreservedLVEF,and30healthycontrols.Conventionalechocardiographyand4D-strainimagingechocardiographywereundergoneintwogroups.The4Dstrainechocardiographicanalyseswereundertakenbyusing4DAutoLVQsoftware.ResultsComparedwiththehealthycontrols,themoderatetosevereASpatientswithpreservedLVEFhadsignificantlydecreasedglobalradialstrain(GRS),globallongitudinalstrain(GLS),globalareastrain(GAS)and4Dstrain(P<0.05),hadsignificantlyincreasedleftventricularend-diastolicvolumeindex(LVEDVI)andleftventricularmassindex(LVMI)(P<0.05),andhadlowerglobalcircumferentialstrain(GCS)(P>0.05).ConclusionsImpairedLVmyocardialcontractilityexistsinmoderatetosevereASpatients,althoughLVEFispreserved.4D-strainimagingechocardiographycandetectearlyleftventriculardysfunctioninASpatientswithpreservedLVEF.