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浙江大学学报（医学版） 2017年第3期46卷 305-314页

作者：张晓群王启闻汪欣徐肖磊朱建华浙江大学医学院附属第一医院心脏介入中心浙江杭州310003

目的:比较莫司类药物洗脱支架(LES)与紫杉醇洗脱支架(PES)在冠状动脉小血管病变患者中的疗效。方法:通过PubMed、Web of Science、ClinicalTrials、中国生物医学文献数据库、中国知网、万方数据和维普数据库对与本次研究主题相关的文献... 详细信息

目的:比较莫司类药物洗脱支架(LES)与紫杉醇洗脱支架(PES)在冠状动脉小血管病变患者中的疗效。方法:通过PubMed、Web of Science、ClinicalTrials、中国生物医学文献数据库、中国知网、万方数据和维普数据库对与本次研究主题相关的文献进行检索,对纳入的文献进行方法学质量评价。采用RevMan 5.2及Stata 14.0软件进行相关的统计学分析。结果:八项研究共4738例患者纳入此研究。与PES比较,植入LES能减少主要心血管不良事件(RR=0.64,95%CI:0.53~0.77,Z=4.59,P<0.01)、心肌梗死(RR=0.61,95%CI:0.45~0.82,Z=3.24,P<0.01)、支架内血栓(RR=0.22,95%CI:0.13~0.37,Z=5.71,P<0.01)以及靶病变血运重建(RR=0.56,95%CI:0.44~0.71,Z=4.72,P<0.01)的发生率。与PES比较,LES不能减少心因性死亡(RR=1.08,95%CI:0.62~1.88,Z=0.26,P>0.05)和靶血管血运重建事件的发生率(RR=0.80,95%CI:0.45~1.44,Z=0.74,P>0.05)。结论:对于冠状动脉小血管病变行经皮冠脉介入支架植入术的患者,LES较PES有更好的长期疗效,可作为该类患者的首选支架。

关键词：冠状动脉疾病/治疗冠状动脉疾病/病理学西罗莫司/治疗应用西罗莫司/类似物和衍生物紫杉酚/治疗应用药物洗脱支架预后 meta分析

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冠心病患者外周血内皮祖细胞的数量和功能变化

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浙江大学学报（医学版） 2005年第2期34卷 163-166页

作者：刘燕荣陈君柱王兴祥朱军慧谢旭东孙坚浙江大学医学院附属第一医院心内科暨心血管病研究所浙江杭州310003

目的观察冠心病患者外周血内皮祖细胞(endothelialprogenitorcells,EPC)数量和功能的改变。方法选择冠心病患者和非冠心病患者各20例,用密度梯度离心法从外周血获取单个核细胞,将其接种在人纤维连接蛋白(fibronectin)包被培养板,培养7d... 详细信息

目的观察冠心病患者外周血内皮祖细胞(endothelialprogenitorcells,EPC)数量和功能的改变。方法选择冠心病患者和非冠心病患者各20例,用密度梯度离心法从外周血获取单个核细胞,将其接种在人纤维连接蛋白(fibronectin)包被培养板,培养7d后贴壁细胞进行细胞化学分析。激光共聚焦显微镜鉴定FITC-UEA-和DiI-acLDL双染色阳性细胞为正在分化的EPC。采用MTT比色法、改良的Boyden小室和粘附能力测定实验,观察EPC的增殖能力和迁移能力及粘附能力。结果冠心病患者外周血EPC数量明显减少(31.8±7.7vs59.5±10.6EPCs/×200视野,P<0.05),且冠心病患者外周血EPC的粘附能力和迁移能力及增殖能力也明显受损。结论冠心病患者外周血内皮祖细胞数量减少、功能减退。

关键词：内皮祖细胞冠状动脉疾病/病理学冠心痛激光共聚焦显微镜

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兔髂动脉损伤修复过程中磁化支架周围血管壁超微结构变化

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中国临床康复 2004年第27期8卷 5812-5814,i001页

作者：郭新红贾国良吕安林赵新国李飞解放军第二○五医院干诊科辽宁省锦州市121001 解放军第四军医大学西京医院心血管内科陕西省西安市710032

目的:观察兔髂动脉损伤修复过程中血管壁超微结构的变化,探讨磁化支架对再狭窄的防治作用。方法:新西兰白兔20只(解放军第四军医大学提供),随机分为磁化支架组及普通支架组,每组10只。分别于左髂动脉行磁化NIR支架及普通NIR支架置入术... 详细信息

目的:观察兔髂动脉损伤修复过程中血管壁超微结构的变化,探讨磁化支架对再狭窄的防治作用。方法:新西兰白兔20只(解放军第四军医大学提供),随机分为磁化支架组及普通支架组,每组10只。分别于左髂动脉行磁化NIR支架及普通NIR支架置入术。两组动物术前3d始予阿司匹林25mg/d至处死动物。术后皮下注射肝素2500U/d,连续7d。术后7d和30d处死动物。用光镜、透射电镜及免疫组化染色技术观察损伤部位血管壁变化。结果:术后30d光镜检查发现磁化支架组髂动脉新生内膜平滑肌细胞(smoothmusclecell,SMC)的增生程度犤(127.59±22.18)μm犦明显低于普通支架组犤(189.45±28.42)μm犦,差异有显著性意义(t=3.43,P=0.014)。电镜检查显示,术后7d普通支架组较磁化支架组可见较多从外膜向中膜及内膜迁移的肌纤维母细胞,中膜及内膜大量以合成型为主的SMC,细胞外基质(extracellularmatrix,ECM)以胶原及弹性纤维为主。30d时磁化支架组内膜下SMC已转化为收缩型,ECM较少,以胶原及弹性纤维为主;而普通支架内膜下SMC仍为典型合成型表现,周围大量ECM,以糖氨多糖为主。结论:磁化支架通过抑制SMC增生、迁移及ECM合成对再狭窄形成有显著的防治作用。

关键词：冠状动脉疾病/病理学血管成形术,经腔,经皮冠状动脉肌平滑支架磁力学细胞外基质

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冠心病同型半胱氨酸与其相关酶基因MTHFR、CBS多态性关系的研究

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陕西医学杂志 2005年第12期34卷 1457-1459,1463页

作者：方显明唐耀平郑德俊广西中医学院附属瑞康医院南宁530011

目的:探讨冠心病血浆同型半胱氨酸(Hcy)水平与其代谢相关酶MTHFR、CBS基因型的关系。方法:采用试剂盒法提取人基因组DNA;采用聚合酶链反应-限制性片段长多态性(PCR-RFLP)法检测MTHFR基因型,采用扩增阻滞实变体系法(ARMS)检测CBS基因型... 详细信息

目的:探讨冠心病血浆同型半胱氨酸(Hcy)水平与其代谢相关酶MTHFR、CBS基因型的关系。方法:采用试剂盒法提取人基因组DNA;采用聚合酶链反应-限制性片段长多态性(PCR-RFLP)法检测MTHFR基因型,采用扩增阻滞实变体系法(ARMS)检测CBS基因型。结果:冠心病患者MTHFR基因型异常者Hcy水平明显高于MTHFR基因型正常者,有显著差异(P<0.05);在本研究中没有检测出CBS基因突变者。结论:MTHFR基因突变是引起血浆Hcy水平升高的主要原因。

关键词：冠状动脉疾病/病理学半胱氨酸/血液 @亚甲基四氢叶酸还原酶 @胱硫醚-β-合成酶基因

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CD28-B7-mediated T cell costimulation in chronic cardiac allograft rejection -: Differential role of B7-1 in initiation versus progression of graft arteriosclerosis

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AMERICAN JOURNAL OF PATHOLOGY 2001年第3期158卷 977-986页

作者： Kim, KS Denton, MD Chandraker, A Knoflach, A Milord, R Waaga, AM Turka, LA Russell, ME Peach, R Sayegh, MH Harvard Univ Brigham & Womens Hosp Sch Med Lab Immunogenet & TransplantatRenal Div Boston MA 02115 USA Univ Penn Dept Med Philadelphia PA 19104 USA Univ Penn Inst Human Gene Therapy Philadelphia PA 19104 USA Pochon CHA Univ Pundang CHA Gen Hosp Dept Internal Med Pochon South Korea Parexel Int Waltham MA USA Bristol Myers Squibb Co Pharmaceut Res Inst Princeton NJ 08543 USA

Provision of adequate T cell costimulation is critical for the development of acute and chronic allograft rejection. We have previously reported that early blockade of CD28-B7 T cell costimulation prevents the development of graft arteriosclerosis, in the LEW into F344 rat cardiac transplant model. In this study, we used the same model to examine the requirement for CD28-B7-mediated T cell costimulation in the progression of established chronic rejection and examined the individual roles of B7-1 (CD80) and B7-2 (CD86) costimulatory molecules. Late blockade of CD28-B7 T cell costimulation by the fusion protein CTLA4Ig, which binds both CD80 and CD86, attenuated the development of transplant arteriosclerosis, mononuclear cell infiltration, and parenchymal fibrosis in this model. Selective blockade of CD80 using the mutant fusion protein Y100F mas as effective as CTLA4Ig in this regard. In contrast to CTLA4Ig, blockade of CD80 alone by Y100F was ineffective at preventing early graft loss and prolonging graft survival when given early after transplantation. This study is the first to demonstrate that late blockade of CD28-B7 T cell costimulation interrupts chronic cardiac allograft rejection, and it indicates the importance of continued T cell activation in this process. This study further defines functional differences between CD80 and CD86 costimulatory molecules in vivo.

关键词：抗原 CD 抗原 CD28/免疫学抗原 CD80/免疫学抗原分化/投药和剂量抗原分化/遗传学抗原分化/治疗应用 CD4阳性T淋巴细胞/药物作用 CD4阳性T淋巴细胞/免疫学颈动脉损伤/病因学颈动脉损伤/病理学细胞分裂冠状动脉疾病/病因学冠状动脉疾病/病理学冠状血管/病理学用药计划表纤维化/病理学移植物排斥/药物疗法移植物排斥/免疫学移植物排斥/病理学移植物存活免疫轭合物免疫抑制剂/投药和剂量免疫抑制剂/治疗应用淋巴细胞活化/药物作用突变心肌/病理学大鼠 Sprague-Dawley 时间因素移植同种血管内膜/病理学动物男(雄)性大鼠

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Linking genotype to aorto-coronary atherosclerosis: a model using familial hypercholesterolemia and aorto-coronary calcification

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ANNALS OF HUMAN GENETICS 1999年第6期63卷 511-520页

作者： Jensen, JM Kruse, TA Brorholt-Petersen, JU Christiansen, TM Jensen, HK Kolvraa, S Faergeman, O Aarhus Amtssygehus Univ Hosp Dept Cardiol DK-8000 Aarhus Denmark Univ Aarhus Inst Human Genet DK-8000 Aarhus C Denmark Aarhus Amtssygehus Univ Hosp Dept Radiol DK-8000 Aarhus Denmark

Most studies of the pathogenesis of coronary heart disease occur between gene variants and biochemical or physiological variables known to be atherogenic. In many situations, however, the gene products are not necessarily known. We studied 17 families (n = 122) with mutations in the lon density lipoprotein (LDL) receptor gene as a model in which to test formally for linkage directly between an atherogenic genotype and ischemic heart disease (IHD) or aorto-coronary calcified atherosclerosis. In each family one of three different mutations was found: the Trp(66)-Gly mutation, the Trp(23)-Stop mutation, or a tell kilobase deletion removing exons 3-6 of the LDL receptor gene. Genomic DNA was used to determine these mutations by either enzymatic cleavage assays or Southern blotting. Aorto-coronary calcification n as significantly associated with age and plasma cholesterol. Sex, hypertension, BMI and smoking were not, associated with aorta-coronary calcification. Nonparametric analysis indicated significant linkage of the LDL receptor gene locus to aortic (p < 0.00005) and to aorto-coronary calcified atherosclerosis (p < 0.00001), Assuming a dominant mode of inheritance, significant linkage n as detected for aortic (LOD = 3.89) and aorto-coronary calcified atherosclerosis (LOD = 4.10). We suggest that the at atherogenicity of variations in other genes could be assessed LS a similar approach.

关键词：主动脉疾病/病因学主动脉疾病/遗传学主动脉疾病/病理学动脉硬化/病因学动脉硬化/遗传学动脉硬化/病理学钙质沉着症/并发症钙质沉着症/遗传学心肌疾病/病因学心肌疾病/遗传学心肌疾病/病理学冠状动脉疾病/病因学冠状动脉疾病/遗传学冠状动脉疾病/病理学基因连锁基因型杂合子高胆固醇血症Ⅱ型/并发症高胆固醇血症Ⅱ型/遗传学模型遗传学突变受体 LDL/遗传学成年人女(雌)性人类男(雄)性中年人

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Interleukin-10 (IL-10) augments allograft arterial disease - Paradoxical effects of IL-10 in vivo

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AMERICAN JOURNAL OF PATHOLOGY 1999年第6期155卷 1929-1939页

作者： Furukawa, Y Becker, G Stinn, JL Shimizu, K Libby, P Mitchell, RN Harvard Univ Sch Med Brigham & Womens Hosp Dept PatholImmunol Res Div Boston MA 02115 USA Harvard Univ Sch Med Brigham & Womens Hosp Dept Med Boston MA 02115 USA

Interleukin-10 (IL-10) is an anti-inflammatory helper T cell type 2 (Th2) cytokine that modulates Th1-type cytokine production. Graft arterial disease (GAD) is a vascular obliterative process mediated via the Th1 cytokine interferon-gamma (IFN-gamma);allografts in IFN-gamma-deficient animals do not develop GAD, We investigated the effect of IL-10 and anti-IL-10 on GAD in murine heart transplants and whether anti-IL-10 reestablishes GAD in IFN-gamma-deficient hosts. Major histocompatibility complex class II-mismatched hearts were transplanted for 8 weeks into wild-type or IFN-gamma-deficient mice. In one set of experiments, wild-type hosts received daily administration of phosphate-buffered saline (PBS) or increasing IL-10;in a subsequent set of experiments, wild-type hosts received weekly PBS, rat IgG, or anti-IL-10 monoclonal antibody;IFN-gamma-deficient recipients received weekly PBS or anti-IL-10 monoclonal antibody. Explanted allografts were assessed for parenchymal rejection and GAD, cytokine profiles, and adhesion/costimulatory-molecule expression. Exogenous IL-10 resulted in increased Th2-like cytokine production;nevertheless, it exacerbated parenchymal rejection and GAD and increased CD8(+) infiltration. Anti-IL-10 did not significantly affect the extent of rejection or GAD, cytokine profiles, or immunohistology of the allografts in wild-type hosts. Adhesion molecule (CD54 and CD106) expression was not diminished by IL-10 treatment, and costimulatory-molecule (CD80 and CD86) expression was augmented by administration of exogenous IL-10. Allografts in IFN-gamma-deficient recipients showed mild refection and no GAD, regardless of anti-IL-10 treatment. IL-10 in vivo thus has markedly different effects than predicted from in vitro experience. Although allografts develop Th2-like cytokine profiles treatment with IL-10 causes exacerbated rejection and GAD.

关键词：动脉硬化闭塞性/病因学动脉硬化闭塞性/免疫学动脉硬化闭塞性/病理学冠状动脉疾病/病因学冠状动脉疾病/免疫学冠状动脉疾病/病理学疾病模型动物流式细胞术移植物排斥/病因学移植物排斥/免疫学移植物排斥/病理学免疫抑制法白细胞介素10/药理学白细胞介素10/生理学淋巴细胞培养试验混合小鼠近交C57BL 移植同种动物小鼠

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Plaque inflammation in restenotic coronary lesions of patients with stable or unstable angina

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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 2000年第4期35卷 963-967页

作者： Piek, JJ Van Der Wal, AC Meuwissen, M Koch, KT Chamuleau, SAJ Teeling, P Van Der Loos, CM Becker, AE Univ Amsterdam Acad Med Ctr Dept Cardiol NL-1105 AZ Amsterdam Netherlands Univ Amsterdam Acad Med Ctr Dept Cardiovasc Pathol NL-1105 AZ Amsterdam Netherlands

OBJECTIVES To evaluate immunohistochemically various parameters of inflammation in coronary atherectomy specimens obtained from restenotic culprit lesions of patients presenting with either stable or unstable angina (UA). BACKGROUND There is no information regarding the relationship between atherosclerotic plaque inflammation and the severity of the coronary syndromes in patients with restenotic coronary lesions. METHODS A total of 37 patients with either stable angina or UA underwent directional coronary atherectomy for restenotic coronary lesions. Cryostat sections of atherectomy specimen were immunohistochemically stained with monoclonal antibodies CD68 (macrophages [MACs]), CD3 (T-lymphocytes) and alpha-actin (smooth muscle cells [SMCs]). smooth muscle cell contents and MAC contents were planimetrically quantified as the percentage immunopositive tissue area of the total tissue area. T-lymphocytes were counted at 100-x magnification throughout the entire section and expressed as number of cells per mm(2). RESULTS Restenotic coronary lesions of patients with UA or stable angina showed no significant difference in SMC areas (31.9% +/- 16.3% vs. 38.5% +/- 18.8%, respectively, p = NS). However, restenotic coronary lesions of patients presenting with unstable angina contained significantly more MACs (24.4% +/- 15.1% vs. 10.5% +/- 5.8%, p = 0.001) and T-lymphocytes (18.8 cells/mm(2) +/- 15.1 cells/mm2 vs. 8.6 cells/mm(2) +/- 9.8 cells/mm(2);p = 0.034) than patients with stable angina. CONCLUSIONS These results suggested that inflammation appears to affect plaque instability in restenotic coronary lesions resulting in unstable coronary syndromes. (C) 2000 by the American College of Cardiology.

关键词：心绞痛/病理学心绞痛/外科学心绞痛不稳定型/免疫学心绞痛不稳定型/病理学心绞痛不稳定型/外科学斑块切除术冠状动脉冠状动脉疾病/免疫学冠状动脉疾病/病理学冠状动脉疾病/外科学免疫酶技术炎症/免疫学炎症/病理学巨噬细胞/免疫学巨噬细胞/病理学复发 T淋巴细胞/免疫学 T淋巴细胞/病理学成年人老年人女(雌)性人类男(雄)性中年人

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Tissue characteristics of restenosis after percutaneous transluminal coronary angioplasty in diabetic patients

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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 1999年第4期34卷 1045-1049页

作者： Moreno, PR Fallon, JT Murcia, AM Leon, MN Simosa, H Fuster, V Palacios, IF Univ Kentucky Gill Heart Inst Lexington KY USA Mt Sinai Sch Med Dept Pathol New York NY USA Harvard Univ Sch Med Massachusetts Gen Hosp Cardiac Unit Boston MA 02114 USA Cardiovasc Inst New York NY USA

The purposes of this study were to analyze coronary specimens from patients with diabetes mellitus (DM) and to compare them with specimens from patients without DM. BACKGROUND Diabetes mellitus is associated with an increased incidence of restenosis after percutaneous transluminal coronary angioplasty (PTCA). Increased hypercellular smooth muscle cell proliferation with exaggerated intimal hyperplasia formation may be responsible for this predisposition. METHODS Eighteen coronary atherectomy specimens with restenosis after PTCA from patients with DM were compared with 18 coronary atherectomy specimens with restenosis after PTCA from patients without DMI. Total and segmental areas were quantified on trichrome-stained tissue of hypercellular tissue, collagen-rich sclerotic tissue, atheroma and thrombus. Demographic and angiographic data were similar in both groups. RESULTS The percentage of total plaque area composed of hypercellular tissue was lower in restenotic specimens from patients with DM than in restenotic specimens from patients without DM (19 +/- 6% vs. 44 +/- 5%;p = 0.003). The percentage of collagen-rich sclerotic tissue area was larger in restenotic specimens from patients with DM than in restenotic specimens from patients without DM (77 +/- 9% vs. 53 +/- 4%;p = 0.004). The percentages of atheroma and thrombus were similar in both groups. CONLUSIONS Intimal hypercellular tissue content is reduced in restenotic tissue from patients with DM. Collagen-rich sclerotic content is increased in restenotic lesions from patients with DM. These results suggest an accelerated fibrotic rather than a proliferative response in diabetic lesions from patients with restenosis after PTCA.. (J Am Cell Cardiol 1999;34:1045-9) (C) 1999 by the American College of Cardiology.

关键词：血管成形术气囊冠状动脉斑块切除术冠状动脉细胞分裂/生理学冠状动脉疾病/病理学冠状动脉疾病/治疗冠状动脉血栓形成/病理学糖尿病血管病变/病理学糖尿病血管病变/治疗纤维肌性发育不良/病理学肌平滑血管/病理学复发再治疗危险因素血管内膜/病理学老年人女(雌)性人类男(雄)性中年人

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Effect of 15-deoxyspergualine on coronary arteriosclerosis and platelet-derived growth factor-A mRNA expression in the transplanted heart

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TRANSPLANTATION PROCEEDINGS 1999年第3期31卷 1706-1709页

作者： Zhang, XL Hachida, M Lu, H Hoshi, H Koyanagi, H Tokyo Womens Med Coll Heart Inst Japan Dept Cardiovasc Surg Shinjuku Ku Tokyo 162 Japan

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