ObjectiveTo study the correlation between neck artery vascular sclerosis and homocysteine levels in hypertensive patients. MethodsA total of 2 132 patients with hypertension participated in the program of "Stroke screening and prevention in Dongying city" were included from Sep. 2012 to Jan. 2013. Questionnaire, physical examination, biochemical blood tests and carotid artery ultrasound were conducted in all included patients. According to the level of homocysteine (Hcy), patients were divided into three groups:716 patients with Hcy level less than 12.3 mm/L were in Group 1, 703 patients with Hcy level 12.3 to 16.5 mm/L were in Group 2, and 713 patients with Hcy level more than 16.5 mm/L were in Group 3. The influence of Hcy levels on carotid atherosclerosis was analyzed. Results① The prevalence rate for carotid plaques in Groups 1, 2, and 3 were 50.28%, 60.03% and 65.36%, respectively. The prevalence rate for carotid plaques in Group 2 was higher than that in Group 1 with a statistical difference (OR=1.485, 95% CI 1.203 to 1.833, P=0.000). The prevalence rate in Group 3 was also higher than that in Group 1 with a statistical difference (OR=1.866, 95% CI 1.508 to 2.308, P=0.000). ② The prevalence rate for carotid plaques was 62.24% in the rural population, and 52.39% in the urban population. The difference between urban and rural populations was statistically significant (OR=1.500, 95% CI 1.259 to 1.788, P=0.000). ③ Using the presence of carotid plaques as a dependent variable and Hcy level as a covariant, logistic regression analysis found that the plaque formation in Group 2 was 1.491 times than in Group 1 and the plaque formation in Group 3 was 1.752 times than in Group 1. After adjusting the risk factors (gender, age, BMI, TG, TC, LDL-C, HDL-C and blood sugar level), the results showed that the plaque formation in Group 2 was 1.388 times than in Group 1, and the plaque formation in Group 3 was 1.452 times than in Group 1. ConclusionThere is a correlation between the increased incidence of carotid plaque and homocysteine levels in patients with hypertension. The incidence of carotid plaque in the rural population with hypertension is higher than that in the urban population. In the population with hypertension, high homocysteine level is an independent risk factor for the formation of carotid plaques.
Objective To observe the protective effects of simvastatin at different stages on monocrotaline (MCT) induced pulmonary arteral hypertension (PAH) in rats and evaluate the early preventive effect of simvastatin. Methods Twenty-four male SD rats were randomized into a control group, a PAH group, an early intervention group, and a late intervention group, with 6 rats in each group. The rats in the control group received intraperitoneal injection of normal saline (NS) on d0. The rats in the PAH group received one-off intraperitoneal injection of MCT (50 mg/kg) on d0. The rats in the early intervention group were pretreated with oral gavage of simvastatin (20 mg·kg–1·d–1)(d–7––1) before the intraperitoneal one-off injection of MCT (50 mg/kg, d0) and continued with oral gavage of simvastatin for 14 days (d1~14). The rats in the late intervention group received one-off intraperitoneal injection of MCT (50 mg/kg)(d0) and oral gavage of simvastatin (20 mg·kg–1·d–1) for the next 21 days (d15~35). Thirty-five days after the MCT injection (d36), mean pulmonary arterial pressure (mPAP) and right ventricular systolic pressure (RVSP) were measured by right heart catheter. Then the rats were sacrificed for separating the heart and lung, the right ventricular hypertrophy index (RVHI) and percentage of small pulmonary arteries media thickness (WT%), the inflammation score around the small pulmonary arterial were recorded. Results Compared with those in the PAH group, RVSP, mPAP, RVHI and WT% in two simvastatin interventiongroups got much better (P＜0.01), and the inflammation score around the small pulmonary arterial declined (P＜0.05). Compared with those in the late intervention group, RVSP, mPAP in the early intervention group improved (P＜0.05) and WT% decreased more significantly (P＜0.01). However RVHI and the inflammation score around the small pulmonary arterial were not different between two simvastatin intervention groups. Conclusions Both early intervention and late intervention with simvastatin can reduce RVSP, mPAP and WT% in MCT induced PAH rats. Compared with later intervention, early intervention can prevent PAH more remarkably.
ObjectiveTo analyze the incidence of heart disease, its clinical manifestations and risk factors in patients with polymyositis (PM) and dermatomyositis (DM). MethodWe collected the clinical data of 138 PM (n=78) and DM (n=60) patients treated between January 2008 and March 2014, among whom there were 64 males and 74 females with an average age of (48.5±19.6) years old, and an average disease course of (84.5±6.9) months. We analyzed their incidence of heart disease, its clinical manifestations and the risk factors. Subsequently, we adopted single-factor analysis to analyze such factors as age, gender, disease course, kinds of disease, creatine kinase (CK), CK-MB, CK-MB/CK, troponin T, antinuclear antibodies, anti-SSA antibody, erythrocyte sedimentation rate, C-reactive protein, disease activity score, muscle force, pulmonary interstitial lesions and pulmonary artery hypertension. ResultsThere were 59 (42.7%) patients with heart disease, 48 (34.8%) with abnormal electrocardiogram, and 52 (37.7%) with abnormal color Doppler ultrasound results. Logistics multiple factors regression analysis found that the course of the disease (OR=1.669, P=0.010), myositis disease activity score (OR=7.456, P<0.001), pulmonary interstitial lesions (OR=4.568, P=0.014) were risk factor for heart disease in PM/DM patients. ConclusionsLong disease course duration, high myositis activity score and pulmonary interstitial lesions are strong predictors for heart damage in PM/DM patients.
ObjectiveTo investigate the correlation of synovial fluid uric acid, the serum and synovial fluid interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α with knee osteoarthritis (KOA). MethodsThe clinical data of 130 patients with KOA treated between January and December 2013 and 30 patients with gouty arthritis (GA) treated at the same period were collected. The clinical symptoms, Western Ontario and McMaster Universities Osteoarthritis Index score, the serum and synovial fluid IL-1β, IL-6, and TNF-α, uric acid levels, radiographic joint stenosis score, and bone hyperplasia score of the patients were compared using t-test analysis and Spearman correlation analysis. ResultsIn the KOA group, the synovial fluid uric acid and joint stenosis score (r=0.31, P=0.037), bone hyperplasia score (r=0.38, P=0.027) were positively correlated; serum and synovial fluid uric acid gradient and hypnalgia were positively correlated (r=0.34, P=0.031); the synovial fluid IL-6 and joint stenosis score (r=0.33, P=0.029), bone hyperplasia score (r=0.37, P=0.032) were positively correlated; the synovial fluid IL-1β and joint stenosis score (r=0.39, P=0.023), bone hyperplasia score (r=0.34, P=0.034) were positively correlated; and the synovial fluid uric acid and IL-1β (r=0.26, P=0.003), IL-6 (r=0.21, P=0.016) were positively correlated. ConclusionSynovial uric acid, IL-1β and IL-6 play a role in the inflammatory progress of knee osteoarthritis.