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1瑞舒伐他汀对不稳定型心绞痛患者血清Lp-PLA2、Lp(a)水平的影响显示文摘目的观察瑞舒伐他汀对不稳定型心绞痛(UA)患者血清脂蛋白相关磷脂酶A2(Lp-PLA2)、脂蛋白(a)[Lp(a)]的影响。方法选择住院治疗且经冠状动脉(冠脉)造影确诊UA患者64例,随机分为常规治疗组(瑞舒伐他汀10 mg/晚)和强化治疗组(瑞舒伐他汀20 mg/晚),两组患者在院期间均给予相同的抗凝、抗血小板聚集、改善冠脉循环及促心肌代谢等治疗;另选择30例冠脉造影证实无冠脉病变者作为对照组,不予瑞舒伐他汀治疗。治疗组于治疗前及治疗后30 d分别采用ELISA法检测Lp-PLA2、免疫透射比浊法检测Lp(a),对照组于入院时测定血清Lp-PLA2、Lp(a)。结果治疗前常规治疗组和强化治疗组血清Lp-PLA2、Lp(a)水平均显著高于对照组(P<0.05);常规治疗组和强化治疗组治疗后血清Lp-PLA2、Lp(a)水平较治疗前均明显下降(P均<0.05),但强化治疗组Lp-PLA2与Lp(a)水平降低更明显(P<0.05)。结论瑞舒伐他汀能降低UA患者血清Lp-PLA2、Lp(a)水平,且强化治疗更有效。牛川 王清 2015山东医药2015,55,17:11
2Association of arterial stiffness with coronary flow reserve in revascularized coronary artery disease patients显示文摘AIM: To investigate the association of arterial wave reflection with coronary flow reserve(CFR) in coronary artery disease(CAD) patients after successful revascularization.METHODS: We assessed 70 patients with angiographically documented CAD who had undergone recent successful revascularization. We measured(1) reactive hyperemia index(RHI) using fingertip peripheral arterial tonometry(RH-PAT Endo-PAT);(2) carotid to femoral pulse wave velocity(PWVc-Complior);(3) augmentation index(AIx), the diastolic area(DAI%) and diastolic reflection area(DRA) of the central aortic pulse wave(Arteriograph);(4) CFR using Doppler echocardiography; and(5) blood levels of lipoprotein-phospholipase A2(LpPLA2).RESULTS: After adjustment for age, sex, blood pressure parameter, lipidemic, diabetic and smoking status, we found that coronary flow reserve was independently related to AIx(b =-0.38, r = 0.009), DAI(b = 0.36, P = 0.014), DRA(b = 0.39, P = 0.005) and RT(b =-0.29,P = 0.026). Additionally, patients with CFR < 2.5 had higher PWVc(11.6 ± 2.3 vs 10.2 ± 1.4 m/s, P = 0.019), SBPc(139.1 ± 17.8 vs 125.2 ± 19.1 mm Hg, P = 0.026), AIx(38.2% ± 14.8% vs 29.4% ± 15.1%, P = 0.011) and lower RHI(1.26 ± 0.28 vs 1.50 ± 0.46, P = 0.012), DAI(44.3% ± 7.9% vs 53.9% ± 6.7%, P = 0.008), DRA(42.2 ± 9.6 vs 51.6 ± 11.4, P = 0.012) and Lp PLA2(268.1 ± 91.9 vs 199.5 ± 78.4 ng/m L, P = 0.002) compared with those with CFR ≥ 2.5. Elevated Lp PLA2 was related with reduced CFR(r =-0.33, P = 0.001), RHI(r =-0.37, P < 0.001) and DRA(r =-0.35, P = 0.001) as well as increased PWVc(r = 0.34, P = 0.012) and AIx(r = 0.34, P = 0.001). CONCLUSION: Abnormal arterial wave reflections are related with impaired coronary flow reserve despite successful revascularization in CAD patients. There is a common inflammatory link between impaired aortic wall properties, endothelial dysfunction and coronary flow impairment in CAD.Vlassis Tritakis Stavros Tzortzis Ignatios Ikonomidis Kleanthi Dima Georgios Pavlidis Paraskevi Trivilou Ioannis Paraskevaidis Giorgos Katsimaglis John Parissis John Lekakis 2016World Journal of Cardiology2016,8,2:4
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