Correlation of Traditional Chinese Medicine Syndrome Types of Hypertension with Carotid Artery Intima-media Thickness and Plasma Lp-PLA2 Expression / 广州中医药大学学报

Objective To explore the correlation of traditional Chinese medicine (TCM) syndrome types of hypertension with carotid artery intima-media thickness (IMT) and plasma lipoprotein-associated phospholipase A2 (Lp-PLA2),so as to provide a TCM therapy for early prevention and treatment of hypertension and its complications in clinic.Methods We collected a total of 170 cases of hypertension patients,55 with kidney-essence insufficiency syndrome,50 with ascendant hyperactivity of liver yang syndrome,and 65 with phlegm-damp retention in middle energizer syndrome.IMT was measured by the carotid Doppler ultrasound,and plasma Lp-PLA2 expression was examined by enzyme-linked immunosorbent assay.And then the differences of IMT and Lp-PLA2 expression among the three groups were compared and analyzed.Results There were significant differences of carotid artery IMT and Lp-PLA2 among the three groups(P＜ 0.01),and the number of patients with carotid atherosclerosis and the expression level of Lp-PLA2 in the group of phlegm-damp retention in middle energizer syndrome were higher than those intheothertwogroups(P＜0.01).Conclusion Differentiation treatment based on phlegm may be more conducive to the prevention and treatment of hypertension and its complications.

The relationship between the thrombospondin-1 and the carotid atherosclerosis in patients with type 2 diabetic / 天津医药

Objective To investigate the relationship between the thrombospondin-1 (TSP-1) and carotid atherosclerosis and its related indicators in patients with type 2 diabetes mellitus (T2DM). Methods A total of 101 T2DM patients were divided into T2DM group (A group, n=52) and T2DM with carotid artery atherosclerosis group (B group, n=49) according to whether complicated with carotid artery atherosclerosis, and 50 normal healthy persons were used as the normal group (C group , n=50). The TSP-1 and other clinical indicators were detected including fasting blood sugar (FPG), fasting insulin (FINS), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fibrinogen (Fib) and homocysteine (homocysteine). The differences between TSP-1 and other related indicators were analyzed. Results There were no significant differences in diastolic blood pressure (DBP) and body mass index (BMI) between the 3 groups (P>0.05). The level of systolic blood pressure (SBP) was significantly higher in group B than that of group A and group C (P<0.01), but there was no significant difference between group A and group C (P>0.05). There were no significant differences in TC, TG and HDL-C between three groups (P>0.05). The values of TSP-1 and Hcy were increased sequentially in group B, group A and group C (P <0.05). There were significant differences in FPG, HbA1c, Fib, FINS and LDL-C between three groups (P<0.05). TSP-1 was positively correlated with FPG, FINS, HbA1c, Fib and Hcy (r= 0.585, 0.341, 0.701, 0.409 and 0.351, P < 0.05). Linear regression analysis showed that TSP-1 was affected by FINS, HbA1c and Fib, and HbA1c was more important. Conclusion TSP-1 is associated with the occurrence and development of diabetic macrovascular complications. It has good clinical value for early detection, early treatment and delaying the progress of diabetic macrovascular diseases.

The dynamic change of plasma Pentraxin 3 levels in Acute Ischemic Stroke and its association with the Carotid Artery Atherosclerosis unstable plaques / 中国神经精神疾病杂志

Objective The aim of this study was to examine the association between plasma Pentraxin 3(PTX3) levels with acute ischemic stroke and carotid artery atherosclerosis.Methods We enrolled 103 patients with acute ischemic stroke (AIS)and 83 control subjects.The levels of plasma PTX3 were measured by using Enzyme-linked immunosorbent assay (ELISA) at admission and after 7 days treatment in the AIS group.The carotid artery plaques in the AIS group were detected by using Color Doppler Ultrasound.Patients with AIS were divided into two groups according to the stability of carotid artery atherosclerosis plaques.The association between plasma PTX3 levels with acute ischemic stroke and the stability of carotid artery atherosclerosis plaques was examined.Results ① The plasma PTX3 levels were significantly higher in the AIS group than in the control group (P＜0.05).After 7 days standard treatment,the plasma PTX3 levels in AIS group were significantly decreased (P＜0.05),but still higher than those in control group (P＜0.05).Multivariable logistic regression suggested that the plasma PTX3 levels had a close relationship with AIS (OR=15.043,95％CI:3.46～65.45,P＜0.001).② In the AIS group,the plasma PTX3 levels before and after treatment were significantly higher in unstable plaque group than in no plaque and stable plaque group(P＜0.05).Conclusion The plasma PTX3 levels are higher in patients with acute ischemic stroke.The plasma PTX3 levels are significantly higher in AIS group with unstable plaque.The plasma PTX3 levels are closely associated with acute ischemic stroke.

Relationship between serum homocysteine level and oxidative stress in carotid artery atherosclerosis patients with essential hypertension / 中国基层医药

Objective To detect the levels of carotid intima-media thickness(CAIMT),serum homocysteine(HCY),malondialdehyde(MDA) and superoxide dismutase(SOD) activity,in order to investigate the correlation between carotid atherosclerosis(CAS) and serum HCY and oxidative stress in essential hypertension(EH) patients.Methods 50 patients with EH and 266 healthy controls were enrolled in this study.The color Doppler ultrasonography was used to detect CAIMT,and circulating enzyme method was used to detect serum HCY,and MDA levels were detected by TBA and SOD activity was detected by colorimetric assay of and the results of the examination were statistically analyzed.Results The incidence rate of CAS in EH patients was 62.8%(167/266),associated with age,disease and related course,and there was no significant difference in gender.In EH concurrent CAS group,the serum HCY level,MDA level and SOD activity were (28.06±6.94)μmol/L,(13.10±2.75)μmol/L and (69.73±6.51)U/mL,respectively,which of the control group were (11.74±3.62)μmol/L,(4.71±1.18)μmol/L and (136.07±10.16)U/mL,respectively,the levels of serum HCY and MDA in EH complicated CAS group were significantly higher than those in the control group(t=7.118,6.326,all P<0.05),and the activity of SOD was significantly decreased.The serum HCY level was positively correlated with MDA level(r=0.493,t=9.207,P<0.05),and negatively correlated with serum SOD activity(r=-0.562,t=11.040,P<0.05).Conclusion EH patients have high levels of HCY,MDA and SOD activity of low levels.HCY level is significantly increased and oxidative stress is increased in CAS patients.Oxidative stress is associated with serum HCY level.

Association of Carotid Atherosclerosis and the Plasma Level of RAS / 医学研究杂志

Objective To investigate the relationship of carotid artery atherosclerosis and the plasma level of RAS in hypertension patients.Methods We retrospectively analyzed clinic data of essential hypertension patients treated in the department of cardiology department between Jan 2015 and Mar 2016.Results Carotid artery plaque was associated with age,blood sugar,total cholesterol,low density lipoprotein-cholesterol,and uric acid.The prevalence of carotid artery atherosclerosis increased with increasing level of plasma erect and decubitus position angiotensin Ⅱ and erect position renin (P ＜ 0.05).Logistic regression analysis indicted that age,decubitus position angiotensin Ⅱ,TC,UA was positively associated with carotid atherosclerosis,HDL-C was negatively correlated with carotid atherosclerosis(P ＜ 0.05).Conclusion Carotid artery atherosclerosis is independently associated with Ang Ⅱ.

The Combined Impact of Neutrophil-to-Lymphocyte Ratio and Type 2 Diabetic Mellitus on Significant Coronary Artery Disease and Carotid Artery Atherosclerosis

BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) has recently emerged as a new important inflammatory marker for predicting cardiovascular events. This study aimed to evaluate the combined impact of NLR and type 2 diabetes mellitus (T2DM) on significant coronary artery disease (CAD) and carotid artery atherosclerosis. METHODS: This study includes a total of 828 patients evaluated by coronary angiography and carotid ultrasonography. Significant CAD was defined as at least one vessel with stenosis greater than 50%. We employed logistic regression models to investigate the association of NLR and T2DM with significant CAD. The goodness-of-fit and discriminability of the models were assessed by the loglikelihood ratio test and C-index, respectively. Also, we investigated the clinical relevance of the categorized NLR that classifies patients into three risk groups (low, intermediate, high). RESULTS: According to logistic regression analysis, both NLR {adjusted odds ratio (OR) 1.31, p 2) showed the greater prevalence of significant CAD and carotid artery atherosclerosis compared with patients without T2DM or type 2 diabetic patients assigned into the low risk group (NLR ≤ 1). CONCLUSION: Our results suggest that type 2 diabetic patients with high inflammatory state would be more vulnerable to significant CAD and carotid artery atherosclerosis.

The relationship of hypersensitive C reactive protein with carotid atherosclerosis and serum calcium and phosphorus in elderly patients with type 2 diabetes mellitus with hypertension and increased homocysteine / 中国糖尿病杂志

Objective To investigate the relationship of hypersensitive C reactive protein with carotid atherosclerosis and serum calcium and phosphorus in elderly patients with type 2 diabetes mellitus plus hypertension and increased homocysteine . Methods A total of 105 subjects were enrolled .Carotid intima-media thickness(CIMT) was determined by doppler ultrasound .All the participants were divided into three groups :control group (n=30 ,CIMT0.05).The levels of lipoproteins (LP) and HbA1 c were significantly higher in common carotid sclerosis group and common carotid plaque group than in the control group (P<0.05).The TC was higher in common carotid plaque group than in the control group[(4.32 ± 1.10) vs (3.69 ± 0.67)mmol/L , P<0.05].Pearson correlation analysis showed than CIM T was positively associated with hsC‐RP and Hcy (r=0.560 ,0.452 ,P<0.01). Logistic regression analysis showed that CIMT is independently associated with hsC‐RP and Hcy(OR=1.501 ,1.523 ,P<0.01). Conclusion The levels of serum hsC‐RP and Hcy were not only independent risk factors for carotid artery atherosclerosis but also related to the stability of atherosclerosis plaque in the patients with type 2 diabetes mellitus with hypertension .

Value of ratio of apolipoprotein B and apolipoprotein A1 in predicting occurrence risk of ischemic cerebral infarction / 国际检验医学杂志

Objective To investigate the levels and clinical significance of the ratio of apolipoprotein B(apoB)and apolipoprotein A1(apoA1)in the patients with cerebral infarction,and to determine the critical value of apoB/apoA1 inthe patients with ischemic cerebral infarction.Methods 126 inpatients with cerebal infraction diagnosed by MRI enhancement scanning of the head in our hos-pital.From November 1,2012 to May 15,2013 were selected.Among them,51 cases were common carotid artery intima-media thickening(carotid artery intima-media >0.9 mm)and 75 cases were carotid artery intima-media non-thickening by the color ultra-sonic examination;81 cases had atherosclerosis plaque and 45 cases had no atherosclerosis plaque.57 individuals with healthy physi-cal examination were selected as the control group.The fasting serum samples were collected from all the research subjects.The in-dexes of TG,CHOL,HDL-C,LDL-C,apoB,apoA,etc.were detected.Then the independent t-test was adopted to analyze and com-pare the ratio of apoB/apoA1 and others related indictors(including TG,AIP,apoB,apoA1,etc.)in the various groups.The ROC curves were made,the area under the curve was read and the specificity and sensitivity of apoB/apoA1 for diagnosing ischemic cere-bral infarction were calculated.Results (1)AIP and the ratio of apoB/apoA1 in the ischemic cerebral infarction patients were high-er than those in the control group,the rise rate of apoB/apoA1 ratio in the ischemic cerebral infarction patients was 5.43 times of that in the control group,especially the patients with carotid atherosclerosis or carotid artery intima-media thickenning were more significant,while TG and apoB had no obvious changes.(2)the ratio of apoB/apoA1 had no obvious difference between the carotid artery intima-media thickening group and the carotid artery intima-media non-thickening group,while which in the atherosclerotic plaques group was significantly increased compared with no carotid atherosclerosis group and 1.6 times of that in the normal control group.So it could be considered that the apoB/apoA1 ratio was a specific indicator for atherosclerosis.(3)In the diagnosis of ische-mic cerebral infarction,the area under the apoB/apoA1ROC curve was 0.86.its specificity and sensitivity were higher than other in-dexes.Conclusion The apoB/apoA1 ratio is the most specific and sensitive index in the patients with ischemic cerebral infarction and has good correlation with ischemic cerebral infarction,especially in the presence of carotid atherosclerosis plaque it is more sen-sitive,and is a good index of laboratory diagnosis of ischemic cerebral infarction.

Effect of Atorvastatin on Carotid Artery Atherosclerotic Plaque / 医药导报

Objective To evaluate the effect of atorvastatin on human carotid plaque by high resolution nuclear magnetic resonance imaging(MRI 3. 0T). Methods Forty patients with carotid artery plaque were treated with atorvastatin at the dose of 20 mg daily for one year. Changes of the artery plaques were observed by MRI,and the levels of blood lipoproteins and C reactive protein( hs-CRP)were detected. Results After the treatment with atorvastatin for 6 months and 1 year,the number and average thickness of plaques were reduced. One year after the treatment,average thickness of stable plaques dropped from (2. 41±0. 54)mm to(2. 17±0. 49)mm,and the size of the unstable plaques decreased from(2. 38±0. 89)mm to(2. 01± 0. 32)mm,with significant differences(P﹤0. 05). The levels of TC,TG,LDL-C and Hs-CRP were significantly decreased(P﹤0. 05)and the level of HDL-C was increased. Conclusion High resolution nuclear magnetic resonance( MRI3. 0T)can clearly display the components of the atherosclerotic plaque and the degree of artery stenosis. Atorvastatin exerts a significant effect on carotid plaque by promoting the regression of the carotid atherosclerosis plaque.

The relationship between stabilization of carotid artery atherosclerosis plaques with different TCM syndromes / 国际中医中药杂志

Objective To study the relationship between stabilization of patients with carotid artery atherosclerosis plaques and different traditional Chinese medicine (TCM)syndromes.Methods 60 patients with carotid artery atherosclerosis plaques were undertaken TCM syndrome differentiation and carotid Color Doppler ultrasonography tested.Results The cases of insufficiency of kidney essence and insufficiency of vital energy and blood had occupied a larger ration in stabilization carotid artery atherosclerosis plaques; while sputum and blood stasis locking collaterals syndrome and blood stasis due to Qi deficiency syndrome had statistical significance in unstabilization carotid artery atherosclerosis plaques.Conclusion Different TCM syndromes had different stabilization of carotid artery atherosclerosis.Sputum and blood stasis locking collaterals syndrome and blood stasis due to deficiency syndrome are unstable.These two syndromes are high risk syndromes of carotid artcry atherosclerosis plaques.

Retrospective study on distribution rule of manifestations in patients with carotid artery atherosclerosis / 国际中医中药杂志

ObjectiveTo explore clinical distribution rule of manifestations in patients with CAS,to provide objective basis of standardization,clinical diagnosis and treatment.MethodsEpidemiological methods were used to investigate on guanan'men hospital patients with CAS.Altogether 298 records of CAS patients were enrolled in this study,the frequency of main syndromes and the distribution characteristics of accompanying symptoms were analyzed.ResultsThe main syndromes of CAS were sputum stasis syndrome,qi stagnation and blood stasis syndrome,and deficiency syndrome of both liver and kidney yin,all together accounted for 39.3％.The major symptoms were vertigo or dizziness (64.1％),chest distress (60.1％),dry mouth (63.8％),amnesia (58.7％),and insomnia (50.0％) separately.ConclusionSputum stasis syndrome,Qi stagnation and blood stasis syndrome and deficiency syndrome of both liver and kidney yin group were as a combine form in patients with CAS,and dizziness or vertigo was its main clinical manifestation.

Clinical study on the relationship between plasma level of homocysteine and progressive ischemic stroke of carotid artery system as well as carotid artery atherosclerosis / 中国综合临床

Objective To explore the role of plasma level of homocysteine ( Hey ) in progressive ischemic stroke (PIS)of carotid artery system and to investigate the relationship between Hcy and carotid artery atherosclerosis(AS).Methods Plasma Hcy concentrations were measured in 68 patients with progressive ischemic stroke of carotid artery system (PIS group)and 72 patients with non-progressive ischemic stroke of carotid artery system ( non-PIS group ).Plasma Hcy level and carotid artery intima-media thickness ( IMT ) were compared among PIS group and non-PIS group as well as normal control group.The linear correlation between plasma Hcy level and IMT in PIS group was analyzed.Results Plasma Hcy concentrations was respectively (22.52 ± 5.26) μmol/L,( 16.38 ± 4.23) μmol/L and( 10.13 ± 2.16) μmol/L in PIS group,non-PIS group and normal control group( F =56.87,P ＜ 0.01 ).Compared PIS group and non-PIS group with normal control group,the differences were statistically significant ( P ＜ 0.01 ).And there was also significant difference on plasma Hcy levels between PIS group and non-PIS group( P ＜ 0.01 ).The thickness of carotid artery IMT was respectively(1.12 ± 0.34)mm,(0.96 ± 0.27)mm and(0.43 ± 0.21 )mm in PIS group,non-PIS group and normal control group( F =28.47,P ＜ 0.01 ).Compared PIS group and non-PIS group with normal control group,the differences were statistically significant( P ＜ 0.01 ).And there was also significant difference on IMT between PIS group and non-PIS group ( P ＜ 0.01 ).In PIS group plasma Hcy level was positively correlated with the carotid artery IMT ( r =0.687,P ＜ 0.01 ).Conclusion The plasma Hcy level is closely related to the occurrence and development of carotid artery atherosclerosis and PIS of carotid artery system,detection of plasma Hcy level helps to predict the occurrence of PIS of carotid artery system and provide an evidence for the therapy decision.

The relativity analysis of carotid artery atherosclerosis and various coronary artery disease / 中国医师杂志

Objective To determine the relationship between the aggravation of CAAS and coronary atherosclerosis (CAS) ;and to summarize the pathologic character of CAAS of the patients with various coronary artery disease. Methods Review the result of coronary angiography and carotid artery ultrasonography and the related risk factors of the patients who were diagnosed as CAD through coronary angiography ( CAG). The patients were divided into the scleratheroma group and the non scleratheroma group. The patients were divided into stable angina pectoris( AP) group, unstable angina pectoris(UAP) group and acute myocardial infarction (AMI) group according to the criterion of coronary artery disease of WHO. The patients were divided into group A (coronary artery of single vessel lession) ,group B( coronary artery of double vessel lession ) , group C( coronary artery of triple vessel lession )and group D(left main vessel lession ).The aggravation of CAAS was graded. Results There were 198 patients with various CAAS among 228 patients with coronary artery disease ( 86. 8%). CAAS was much related with hypertension and non-related with age, sex, BMI, smoking, drinking, hyperlipoidemia, hyperuricosuria and diabetes mellitus. The aggravation of CAAS much graver with much graver CAS. But only the plaque number of Group A was more than Group D( P ＜0. 05). The grading integral and Crouse integral of CAAS of AP group was not remarkable less than UAP group. The grading integral of CAAS of AP group was less than AMI group and the Crouse integral of AP group was more. But there was no remarkable difference. The number of all plaque,plaque and plaque of AP group was not remarkable less than UAP group and AMI group. There was the plaque among the three group. Conclusion Carotid artery atherosclerosis (CAAS) is relative to coronary artery disease ( CAD).

Research of Serum Inflammatory Factors in Aged Carotid Artery Atherosclerosis Patients with Different Chinese Medicine Syndromes / 中国中医药信息杂志

Objective To study the level of serum ICAM-1, VCAM-1, E-selectin, P-selectin, IL-6 and CRP in different Chinese medicine syndrome patients with carotid artery atherosclerosis. Methods Blood sample were collected from 176 patients with carotid artery atherosclerosis. The concentration of ICAM-1, VCAM-1, E-selectin, P-selectin, IL-6 and CRP were tested by means of ELISA. The subjects were divided into 3 groups according to the Chinese medicine syndrome, and the concentrations of inflammatory factors were compared among the 3 groups. Results Compared with control group, the level of inflammatory factors in the patients with carotid atherosclerosis was higher, and the levels of ICAM-1 and VCAM-1 in phlegm group were higher than blood stasis group and marrow deficiency group (P

Relationship between the level of serum homocysteinaemia and carotid artery atherosclerosis and its change after intervention therapy / 临床神经病学杂志

Objective To explore the relationship between the level of serum homocysteinaemia(Hcy) and the carotid artery atherosclerosis(CAA),and its change after intervention therapy with folate acid and VitaminB12 (VitB12). Methods The levels of serum Hcy,folate acid and VitB12 were measured in 169 patients with cerebral infarction(CI group) and 110 normal controls(NC group). The condition of carotid arteries was checked by color dopper flow image in CI group. The relationship between the level of serum Hcy and folate acid,VitB12 and CAA condition were analysed. The change of serum Hcy level was observed after intervention treatment of folate acid and VitB12 for 4 weeks in CI patients with hyperhomocysteinaemia.Results Compared with the NC group,the level of serum Hcy was significant higher in CI group(P

Effect and its mechanism of Fluvastatin on carotid artery atherosclerotic plaque in elderly patients / 临床神经病学杂志

Objective To explore the effects and its possible mechanism of Fluvastatin on carotid artery atherosclerotic plaque(CAAP) in elderly patients.Methods 92 patients with CAAP detected by Color Doppler Ultrasonography were divided randomly into group A(48 cases) which treated with Fluvastatin 40 mg/d and group B(44 cases) which treated with 80 mg/d respectively for 40 weeks after a washout period(Fluvastatin 40 mg/d for 8 weeks).The changes of CAAP areas,the levels of serum total cholesterol(TC),low-density lipoprotein(LDL),high sensitivity C-reactive protein(hs-CRP) were observed between the before and after treatment.Results There were 40 cases in each group completed the Fluvastatin treatment for 48 weeks.After treatment,the CAAP areas in group A and B were significantliy decreased from(0.20?0.18)cm2 and(0.20?0.19)cm2 to(0.12?0.15)cm2 and(0.11?0.12)]cm2(allP

Effects of intervention with Simvastatin and Aspirin on carotid artery atherosclerosis / 临床神经病学杂志

Objective To observe the effects of intervention with Simvastatin and Aspirin on carotid artery atherosclerosis(CAA).Methods 120 patients with ischemic cerebrovascular disease and complicated CAA and blood-lipid abnormality were randomly divided into the Simvastatin group,Aspirin group,Simvastatin+ Aspirin group.Each group received corresponding therapy for 6 months.The changes of serum C-reactive protein(CRP) level,blood-lipid level,the carotid artery intimal and media thickness(IMT),the plaque areas before and after treatment and the recurrence rate of cerebrovascular event among the 3 groups were compared.Results Compared with before treatment,the levels of serum CRP were significantly decreased in the 3 groups after treatment(all P