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Objective:To explore influence of simultaneous coronary artery bypass grafting (CABG) and heart valve replacement (HVR) therapy on ICU stay time,cardiac function and long-term prognosis in patients with coronary heart disease (CHD) complicated heart valve disease (HVD).Methods:A total of 94 CHD + HVD patients were selected from our hospital.They were randomly and equally divided into non-simultaneous treatment group (NST group) and simultaneous treatment group (ST group),according received CABG and HVR simultaneously.Postop-erative cardiac function,related indexes during and after operation,survival rate within five years and incidence rate of adverse reactions were compared between two groups.Results:Compared with NST group after operation,there were significant rise in LVEF [ (44.23 ± 11.03)% vs.(49.58 ± 11.39)%],left ventricular early diastolic peak flow velocity/late diastolic peak flow velocity (E/A) [ (0.87 ± 0.09) vs.(0.94 ± 0.12)] and percentage of NYHA classⅡ(46.81% vs.70.21%),and significant reductions in left atrial diameter (LAD) [ (39.47 ± 10.16) mm vs.(34.46 ± 8.72) mm],left ventricular end-diastolic dimension (LVEDd) [ (58.49 ± 10.65) mm vs.(53.17 ± 9.13) mm],left ventricular end-systolic dimension (LVESd) [ (48.69 ± 8.73) mm vs.(42.07 ± 8.36) mm],cardiotho-racic ratio (CTR) [ (0.66 ± 0.14) vs.(0.54 ± 0.09)],percentage of NYHA class Ⅲ(34.04% vs.12.77%),as-cending aorta block time,extracorporeal circulation time,ventilator assist time,ICU stay and hospitalization time in ST group,P＜0.05 or ＜0.01.Compared with NST group after five-year follow-up,there was significant reduction in incidence rate of major adverse cardiovascular events (40.43% vs.19.15%),and significant rise in five-year sur-vival rate (44.68% vs.68.08%) in ST group,P＜0.05 both.Conclusion:Simultaneous CABG and HVR can signifi-cantly shorten ICU stay time etc.postoperative observation index,improve cardiac function and long-term survival rate,reduce incidence rate of adverse reactions in CHD + HVD patients.
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Objective:To explore relationship among expressions of CC type chemokine ligand 2 (CCL2) and its re-ceptor (CCR2) and platelet aggregation rate in patients with acute myocardial infarction (AMI).Methods:A total of 60 AMI patients treated in our coronary care unit were regarded as AMI group,another 60 healthy subjects un-dergoing physical examination were enrolled as normal control group.Plasma CCL2 level,expressions and location of platelet CCL2 and CCR2 in coronary thrombus tissue were measured in two groups.Changes of activated glyco-protein Ⅱb/Ⅲa compound (PAC-1) and CD62p levels,and influence of different CCL2 level on platelet aggregation rate (PAR) were compared in normal control group before and after CCL2 stimulus.Results:Compared with nor-mal control group,there were significant rise in plasma CCL2 level [ (159.63 ± 54.32) pg/ml vs.(218.79 ± 76.34) pg/ml],expressions of platelet CCL2 [ (0.86 ± 0.38) vs.(2.05 ± 0.59)] and CCR2 protein [ (0.93 ± 0.42) vs.(2.67 ± 0.51)] in AMI group (P＝0.001 all),co-location expression relationship existed between CCL 2/CCR2 and CD62p in AMI patients.Compared with before CCL2 stimulus,there were significant rise in expressions of PAC-1 [ (9.83 ± 3.14)% vs.(18.96 ± 4.25)%] and CD62p [ (5.08 ± 1.16)% vs.(8.33 ± 1.89)%] in normal control group after CCL2 stimulus,P＝0.001 both.When CCL2 ≥100ng/ml,maximum PAR was significantly higher than that of CCL2＝0ng/ml level,P＝0.001 all.Conclusion:Expression of CCL2/CCR2 is closely associated with plate-let aggregation rate in AMI patients.CCL2/CCR2 may be involved in disease progress via affecting platelet aggrega-tion rate.
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Objective :To explore relationship between procalcitonin (PCT) level and spontaneous recanalization (SR) of infarct related artery in patients with myocardial infarction (MI).Methods :The 109 MI patients from our coro-nary care unit (CCU) were divided into SR group (n＝45 ,TIMI blood flow grade 2～3) and no SR group (n＝64 , TIMI blood flow grade 0 －1) according to TIMI blood flow grade .General data ,biochemical indexes were com-pared between two groups ,influencing factors of infarct related artery SR were analyzed ,and ROC curve of PCT level predicting infarct related artery SR was drawn .Results :Compared with no SR group ,there were significant reductions in levels of LDL-C [ (2.57 ± 0. 61 ) mmol/L vs.(2.13 ± 0.62 ) mmol/L ] , lipoprotein a (Lp (a )) [ (234.16 ± 72.67) mg/L vs.(182.62 ± 69.35) mg/L] ,PCT [ (0.12 ± 0.05) μg/L vs .(0.07 ± 0.04) μg/L] , hsCRP [ (6.05 ± 3.68) mg/L vs.(3.12 ± 2.53) mg/L] and creatine kinase isoenzyme MB (CK-MB) [ (85.56 ± 23.67) U/L vs.(74.36 ± 22.65) U/L] in SR group , P＜0.05 or ＜0.01. Logistic multi-factor regression analysis indicated that PCT level was independent predictive factor for coronary SR (OR＝0.661 , P＝0.001).Area under ROC curve was 0.760 for PCT predicting coronary SR , P＝0.001 ,95% CI 0.645－0.874 ,optimal cutoff point was 0.085μg/L ,and sensitivity and specificity was 84.4% and 65.4% respectively .Conclusion :PCT is independent predictive factor for infarct related ar-tery SR in MI patients.When PCT level ＜0.085μg/L ,artery SR rate tends to increase .