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正五聚蛋白3在急性冠状动脉综合征合并抑郁症诊断及治疗中的意义
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| 篇名： | 正五聚蛋白3在急性冠状动脉综合征合并抑郁症诊断及治疗中的意义 |
| TITLE： | |
| 摘要： | 目的：探讨正五聚蛋白3（PTX-3）在急性冠状动脉综合征（ACS）合并抑郁症诊断及治疗中的意义。方法：选取2015年12月－2018年3月我院收治的ACS、抑郁症、ACS合并抑郁症住院患者分别作为ACS组（84例）、抑郁症组（85例）、ACS合并抑郁症组[化学药治疗组（40例）和中成药治疗组（40例）]；选取同期于我院进行体检的健康受试者作为对照组（90例）。ACS组患者给予阿司匹林肠溶片（50～150 mg/次，qd）+通心络胶囊（2～4粒/次，tid），抑郁症组患者给予盐酸舍曲林片（50 mg/次，qd）+逍遥丸（9 g/次，bid），ACS合并抑郁症组患者分别给予化学药（阿司匹林肠溶片+盐酸舍曲林片，用法用量同前）和中成药（通心络胶囊+逍遥丸，用法用量同前），均连续治疗4周。回顾性分析各组受试者治疗前后血浆PTX-3含量及PTX-3 mRNA表达水平，并比较其疗效和不良反应发生情况。结果：治疗前，ACS组、抑郁症组、ACS合并抑郁症组患者血浆PTX-3含量及mRNA相对表达量均显著高于对照组，且ACS合并抑郁症组显著高于ACS组、抑郁症组（P＜0.01）。治疗后，ACS组、抑郁症组、ACS合并抑郁症化学药治疗组和中成药治疗组上述指标均较治疗前显著下降，且ACS合并抑郁症化学药治疗组上述指标治疗前后的差值均显著高于其他组（P＜0.01）。ACS组、ACS合并抑郁症化学药治疗组和中成药治疗组患者心血管症状的总有效率分别为80.9％、77.5％、72.5％，抑郁症组、ACS合并抑郁症化学药治疗组和中成药治疗组患者抑郁症状的总有效率分别为84.7％、82.5％、77.5％，组间比较差异均无统计学意义（P＞0.05）。除3例患者出现轻微胃肠道不适外，其余患者均未见明显不良反应发生。结论：ACS、抑郁症、ACS合并抑郁症患者体内PTX-3的表达均较健康受试者更高；药物治疗均可显著降低上述患者体内PTX-3的表达水平，且化学药的作用可能在短期内更明显。PTX-3可作为ACS合并抑郁症诊断及治疗的生物标志物。 |
| ABSTRACT： | OBJECTIVE： To investigate the significance of pentraxins 3 （PTX-3） in diagnosis and treatment of acute coronary syndromes （ACS） combined with depression. METHODS： The inpatients with ACS， depression or ACS combined with depression were selected from our hospital during Dec. 2015-Mar. 2018， and then divided into ACS group （84 cases）， depression group （85 cases）， ACS combined with depression group [by chemical drug treatment （40 cases） and by Chinese patent medicine treatment （40 cases）]. Healthy volunteers at the same period in our hospital were regarded as control group （90 cases）. ACS groups was given Aspirin enteric-coated tablets （50-150 mg every time， qd）+Tongxinluo capsules （2-4 capsules every time， tid）. Depression group was given Sertraline hydrochloride tablets （50 mg every time， qd）+Xiaoyao pills （9 g every time， bid）. ACS combined with depression group was given chemical drugs （Aspirin enteric-coated tablets+Sertraline hydrochloride tablets， same usage and dosage as above） and Chinese patent medicine （Tongxinluo capsules+Xiaoyao pills， same usage and dosage as above）， for consecutive 4 weeks. The contents of PTX-3 and its mRNA expression in plasma were analyzed retrospectively before and after treatment. Therapeutic efficacies and the occurrence of ADR were compared in each group. RESULTS： Before treatment， the plasma contents of PTX-3 and its mRNA expression in ACS group， depression group， ACS combined with depression group were significantly higher than control group， and ACS combined with depression group was significantly higher than ACS group and depression group （P＜0.01）. After treatment， above indexes of ACS group， depression group， ACS combined with depression by chemical drug treatment group and by Chinese patent medicine treatment group were all decreased significantly， compared with before treatment； and the difference of above indexes before and after treatment of ACS combined with depression by chemical drug treatment group were significantly higher than other groups （P＜0.01）. Total response rates of cardiovascular symptoms were 80.9％， 77.5％， 72.5％ in ACS group， ACS combined with depression by chemical drug treatment group and by Chinese patent medicine treatment group； total response rates of depression symptoms were 84.7％， 82.5％， 77.5％ in depression group， ACS combined with depression by chemical drug treatment group and by Chinese patent medicine treatment group， without statistical significance （P＞0.05）. Except for 3 patients with mild gastrointestinal discomfort， no obvious ADR was observed in other patients. CONCLUSIONS： The expression of PTX-3 in patients with ACS， depression， ACS combined with depression are higher than healthy volunteers. Drug treatment can significantly decrease the expression of PTX-3 in above patients； moreover， chemical drug may has more advantages in short period. PTX-3 can be regarded as a diagnosis and treatment biomarker of ACS combined with depression patients. |
| 期刊： | 2018年第29卷第24期 |
| 作者： | 陈松海，刘秋琼，林秋晓，李广华，黄革 |
| AUTHORS： | CHEN Songhai，LIU Qiuqiong，LIN Qiuxiao，LI Guanghua，HUANG Ge |
| 关键字： | 正五聚蛋白3；急性冠状动脉综合征；抑郁症；mRNA；表达；诊断；治疗；生物标志物 |
| KEYWORDS： | Pentraxins 3； Acute coronary syndrome； Depression； mRNA； Expression； Diagnosis； Treatment； Biomarker |
| 阅读数： | 321 次 |
| 本月下载数： | 2 次 |
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