Dissertation > Excellent graduate degree dissertation topics show

Effects of Distribution of Body Fat and Lipid-regulating Drugs on Coronary Heart Disease

Author: LiJian
Tutor: CongHongLiang
School: Tianjin Medical University
Course: Internal Medicine
Keywords: Coronary heart disease Body fat distribution Coronary intervention Myocardial injury Inflammation Oxidative Stress
CLC: R541.4
Type: Master's thesis
Year: 2011
Downloads: 22
Quote: 0
Read: Download Dissertation

Abstract

Objective: To study the different body fat measurement indicators and coronary heart disease incidence, the relationship of the type of lesion severity of fat distribution in coronary heart disease. Observed before, associated with different doses of atorvastatin and probucol accepted elective percutaneous coronary intervention treatment (percutaneous coronary intervention, PCI) in patients with perioperative myocardial injury protection role, and to explore its possible mechanism. Methods: Proposed 197 cases of patients with a diagnosis of coronary heart disease and coronary angiography, including 118 cases of male and female 79 cases. Which confirmed 52 cases of patients with acute myocardial infarction; 100 cases of patients with angina pectoris; 45 cases of the control group (non-CAD group). No lesions in all patients with single vessel disease, double vessel disease and three-vessel disease patients were 45 cases, 48 ??cases, 51 cases and 53 cases. Enrolled 101 patients receiving elective PCI in patients with angina pectoris, 24 cases were randomly divided into standard joint-dose group, atorvastatin The Ting night serving Dayton 20 mg and probucol 500 mg, 2 times / d: strengthen the joint group of 38 cases , atorvastatin The Ting night serving Dayton 40 mg and probucol 500 mg 2 times / d, 2h before serving Dayton atorvastatin 40 mg probucol 500 mg; intensive dose group, 39 cases, atorvastatin the night serving Dayton 40 mg 2h Dayton clothing preoperative atorvastatin of 40 mg. Selected cases blood complete biochemical tests, enzyme-linked immunosorbent assay (ELISA) was measured before treatment and 24 hours after serum matrix metalloproteinase -9 (MMP-9), myeloperoxidase (MPO) and oxidation of low-density lipoprotein protein (ox-LDL) levels. Measuring the observed object height, body mass, neck circumference (NC) and waist circumference (WC), calculate body mass index (BMI) = body quality (kg) · Height (m) -2. Grouping of selected cases, the clinical and angiographic results divided into a group of patients with acute myocardial infarction, angina and control groups; divided into no lesion group, single-vessel disease, double vessel disease group and three lesions in the coronary artery disease group. Logistic regression assessed the relationship of the various risk factors and the risk of coronary heart disease each body fat measure the degree of blood lipids and coronary heart disease. Results: 1. Different characteristics of male and female fat distribution, and coronary heart disease incidence and severity differences (p lt; 0.05). Acute myocardial infarction group compared with the control group and angina, body mass, waist circumference, the difference was statistically significant (p lt; 0.05); angina pectoris and acute myocardial infarction, neck circumference greater than the control group, p values ??were 0.009 and 0.000 3 are divided into four groups of patients with coronary artery lesions neck circumference, a statistically significant difference (p = 0.014), without coronary artery lesions neck circumference measured value is less than double vessel disease group and significantly less than three lesion group, p values ??were 0.011 and 0.002 4 NC, WC and BMI and other indicators of multiple correlation analysis: three with TG and vLDLc of of positive correlation p-lt; 0.05), WC with CHO positively correlated with HDLc negative Related (both p lt; 0.05); neck circumference and coronary heart disease type and coronary lesion count were significantly related (p = 0.000 and 0.002, respectively). Over 5 Logistic regression analysis showed: the relationship of BMI (beta = 0.162, p = 0.003); neck circumference (beta = 0.222, p = 0.000), diabetes (beta = 1.154, p = 0.047) and coronary heart disease occurred most close as an independent risk factor for coronary heart disease. CK-MB, the difference is smaller than the standard 6 strengthen joint dose group after preoperative joint-dose group (p = 0.032), its preoperative and postoperative TnI difference is smaller than the other two groups (p = 0.048 and 0.023); 7 different drug group patients with hyperlipidemia compared with preoperative reduced of lipids difference in the three groups was no significant difference (p gt; 0.05). MMP-9 levels compared with preoperative elevated after 8 enhanced dose group (p = 0.026), and the other two groups after PCI MMP-9 significantly increased; strengthen significantly lower the joint dose groups after ox-LDL levels compared preoperative (p = 0.008); reduce MPO level compared with the preoperative (p = 0.04) and the MPO the difference between PCI after preoperative dose group is less than the standard the joint dose group and strengthen the p-value of 0.023 and 0.033, respectively. Conclusion: the relationship between waist circumference and blood lipids compared with BMI and neck circumference closer; neck circumference to predict the diagnosis of coronary heart disease than waist circumference and BMI is more sensitive, and the correlation with the severity of coronary lesions; 3. Regression analysis BMI and neck circumference is an independent risk factor for coronary heart disease; fat distribution and content by comprehensive evaluation of the body fat measurement indicators, which make an accurate risk assessment for coronary heart disease. Atorvastatin statins probucol to strengthen combination therapy to reduce post-PCI myocardial injury; such post-PCI myocardial protective effect is not simply dependent on lipid lowering its possible mechanism is the inhibition PCI postoperative inflammation and oxidative shock response, improve microcirculation

Related Dissertations

CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Coronary arteries ( atherosclerosis ),heart disease (CHD)
© 2012 www.DissertationTopic.Net Mobile