慢性阻塞性肺疾病患者血清维生素A和视黄醇结合蛋白-4水平及其与营养状况的关系

目的 探讨COPD患者血清维生素A和视黄醇结合蛋白-4(RBP_4)水平及其与营养状况的关系.方法 2006年9月至2007年9月在中国医科大学附属第一医院门诊随访的110例COPD稳定期患者为COPD组,同期90例健康体检者为对照组,采用高效液相色谱法测定所有研究对象的血清维生素A水平,采用酶联免疫吸附试验检测COPD组中62例和对照组中20例的血清RBP_4水平.计数资料采用X~2检验,两组间均数比较采用t检验,多组间比较采用单因素方差分析及SNK-q检验,影响因素分析采用直线相关和多元逐步回归分析.结果 COPD组血清维生素A和RBP_4水平分别为(275±11)μg/L和(7.4±2.6)mg/L,明显低于对照组的(338±13)μg/L和(11.4±4.1)mg/L;COPD营养不良组血清维生素A和RBP_4水平分别为(246±18)μg/L和(6.4±1.0)mg/L,明显低于COPD营养正常组的(290±14)μg/L和(8.2±3.2)mg/L.COPD患者血清维生素A和RBP_4水平均与体重指数和上臂围呈显著正相关(r值为0.210～0.469,均P<0.05和P<0.01).体重指数和上臂围是COPD)患者血清维生素A的独立影响因素.结论 COPD稳定期患者血清维生素A和RBP_4水平均明显降低,营养状况是其主要影响因素.     

不稳定型心绞痛与血胆红素的关系

目的:探讨血清胆红素水平与不稳定型心绞痛的关系。方法:心内科住院患者98例,经冠状动脉造影分成两组,冠心病(CHD)组65例,其中不稳定型心绞痛(UAP)组35例,稳定型心绞痛(SAP)组30例;非CHD组33例。均采用2,4-二氯苯胺重氮盐(DCA)比色法测定血清胆红素水平。结果:UAP组血清总胆红素(15.17±4.10)μmol/L、间接胆红素(11.31±3.12)μmol/L水平明显低于SAP组[(18.69±5.48)μmol/L,(14.27±4.06)μmol/L]和对照组[(17.86±3.53)μmol/L,(14.08±2.58)μmol/L,P0.01],而SAP组与对照组相比无显著性差异(P0.05)。结论:血清胆红素水平与不稳定型心绞痛有关,有可能成为评价不稳定型心绞痛患者的生化标志物。     

妊高征患者监测血清Hcy、叶酸、维生素B_(12)水平的价值

目的:探讨对妊娠高血压综合征患者监测血清同型半胱氨酸(Hcy)、叶酸、维生素B_(12)水平的价值。方法:选择本院收治的100例妊娠高血压综合征患者为妊高征组,选择同时期正常妊娠妇女80例为正常孕妇组,选择100例同时期正常体检妇女为正常对照组,检测各组血清Hcy、叶酸、维生素B_(12)水平并进行比较。结果:与正常对照组、正常孕妇组相比,妊高征组患者Hcy[(7.3±2.9)μmol/L、(9.1±2.1)μmol/L比(13.1±3.5)μmol/L]水平明显升高,叶酸[(6.4±3.0)ng/L、(6.5±2.9)ng/L比(3.5±1.6)ng/L]、维生素B12[(274±184)ng/L、(227±116)ng/L比(178±135)ng/L]水平明显降低(P0.05或0.01);正常孕妇组的Hcy水平较正常对照组的显著升高(P0.01),而叶酸、维生素B_(12)水平在正常对照组与正常孕妇组间无显著差异(P均0.05)。结论:血清同型半胱氨酸、叶酸和维生素B_(12)水平是评估妊娠高血压综合征病情的有效指标。     

谷氨酸与缺血性脑卒中早期进展关系的研究

目的探讨血清谷氨酸与缺血性脑卒中早期进展的关系。方法选择缺血性脑卒中患者120例,分为进展性脑卒中组60例,非进展性脑卒中组60例。另选择同期住院非脑卒中患者30例作为对照组。采用高效液相色谱法检测发病1、3、7d的谷氨酸水平。结果与对照组比较,进展性脑卒中组和非进展性脑卒中组1、3、7d血清谷氨酸水平明显升高,差异有统计学意义(P<0.05)。与非进展性脑卒中组比较,进展性脑卒中组发病1、3d血清谷氨酸水平明显升高[(105.8±13.3)μmol/L vs(96.7±11.3)μmol/L,(116.0±13.3)μmol/L vs(101.1±11.2)μmol/L,P<0.05]。结论在缺血损伤早期,血清谷氨酸水平变化可预测缺血性脑卒中的进展。     

血清D-二聚体、同型半胱氨酸及尿酸含量与高血压的关系

目的:探讨血清D-二聚体(D-D)、同型半胱氨酸(hcy)、血尿酸含量与老年高血压患者血压分级的关系。方法:80例老年高血压患者根据中国高血压防治指南分为,高血压1级组(25例)、2级组(28例)、3级组(27例),另选24例老年健康体检者作为正常对照组。测定各组血清D-D、hcy、血尿酸水平。结果:高血压2、3级组患者血清D-D水平[(0.66±0.24)μg/ml,(0.81±0.62)μg/ml]明显高于正常对照组[(0.26±0.17)μg/ml,P均0.05],高血压1、2、3级组患者血清hcy水平[(12.48±4.81)μmol/L,(17.28±4.52)μmol/L,(30.75±8.55)μmol/L]均显著高于对照组[(8.25±2.43)]μmol/L,P均0.05];高血压2、3级组患者血清血尿酸水平[(306.14±55.05)μmol/L,(334.07±69.47)μmol/L]高于正常对照组[(264.00±69.22)μmol/L,P均0.05]。此外,血清D-D、hcy、血尿酸水平均与高血压分级呈正相关(r=0.423、0.807、0.291,P0.05～0.001)。结论:血清D-二聚体、同型半胱氨酸、血尿酸水平与老年高血压患者血压分级相关,随血压的升高呈现聚集现象。     

非酒精性脂肪肝患者同型半胱氨酸浓度及叶酸与维生素B12浓度变化及相关性

目的:探讨非酒精性脂肪性肝病(NAFLD)患者同型半胱氨酸浓度、叶酸与维生素B_(12)浓度变化及其关系.方法:对199例健康体检人群行B超检查,其中NAFLD 67例,正常对照组132例,分别检测血浆Hcy、叶酸与维生素B_(12)浓度并进行相关性分析.结果:NAFLD患者血Hcy水平高于正常对照组(18.64±11.2μmol/L vs 12.49±6.4μmol/L,P<0.01),并且Hcy与叶酸、维生素B_(12)呈直线负相关(r=-0.381,P<0.01;r=-0.561,P<0.001)结论:NAFLD患者血Hcy增高,高Hcy血症可能是NAFLD一个新的危险因素.     

血清胆红素水平与冠状动脉病变程度的关系

目的:研究血清胆红素水平与冠状动脉病变严重程度的关系,为冠心病(CHD)的防治提供新思路和新途径。方法:200例患者按照冠状动脉造影结果被分为CHD组(149例)和非CHD组(51例),采用钒酸氧化法测定两组患者的血清胆红素水平,比较两组血清胆红素水平差异,采用直线相关分析冠脉病变积分与血清胆红素水平的关系。结果:CHD组血清总胆红素[TBIL,(8.97±1.16)μmol/L∶(11.58±1.24)μmol/L]、直接胆红素[DBIL,(2.90±0.78)μmol/L∶(3.78±0.84)μmol/L]水平明显低于非CHD组(P均0.01),冠状动脉病变积分与TBIL和DBIL均呈负相关(r=-0.460,-0.772,P均0.01)。结论:血清胆红素水平与冠状动脉病变严重程度呈负相关,低血清胆红素水平是冠状动脉粥样硬化的危险因素。     

心力衰竭患者血清尿酸水平的变化

目的探讨心力衰竭患者血清尿酸水平的变化规律及其临床意义.方法比较97例心力衰竭患者与60例健康对照组的血清尿酸水平;比较心力衰竭患者(97例)不同心功能状态下的血尿酸水平;比较80例患者心衰控制前、后血清尿酸水平的变化;比较入院时未用过利尿剂与已用过利尿剂的心衰患者的血清尿酸水平.结果心力衰竭组与健康对照组的血清尿酸水平分别为(488.79 23.78)μmol/L和(256.62 26.24)μmol/L,两者之间差异有统计学意义(P＜0.05);心力衰竭组心功能分级Ⅱ、Ⅲ、Ⅳ级的血尿酸水平分别为(348.97 25.90)μmol/L、(450.17 16.09)μmol/L和(561.05 26.71)μmol/L,其两两比较,差异有显著性意义(P＜0.05);80例患者心衰控制前后的血清尿酸水平分别是(509.27±10.74)μmol/L和(402.01 29.70)μmol/L,差异有统计学意义(P＜0.05);入院时未用过利尿剂与已用过利尿剂的心衰患者的血清尿酸水平差异无统计学意义(P＞0.05).结论心力衰竭患者血清尿酸水平随心功能加重而升高,血清尿酸水平不受服用利尿剂的影响.血清尿酸水平是反映心衰患者病情严重程度的一个指标.     

老年期痴呆患者血浆同型半胱氨酸的临床观察

目的　了解老年期痴呆患者同型半胱氨酸 (Homocysteine,HCY)水平并探讨二者之间的关系。方法　老年性痴呆 (AD) 33例 ,血管性痴呆 (VD) 4 3例 ,健康老年人 2 8例 (对照组 )。对所有研究对象 ,空腹取血检测血浆 HCY,同时检测血叶酸和维生素 B1 2 。结果　老年期痴呆患者的HCY平均水平为 1 3.1 2± 4.64μmol/ L (AD)和 1 5.33± 5.0 6μmol/ L(VD) ,对照组 (1 2 .45± 3.0 5μmol/ L ) ,F值分别为 3.972 ,1 0 .82 1和 6.62 5(P<0 .0 5)。血清 HCY与叶酸及维生素 B1 2 水平呈负相关 ,相关系数分别为 0 .2 92和 0 .2 7(P<0 .0 5)。结论　老年期痴呆者有高水平的血清 HCY和低水平的血叶酸。     

血尿酸水平与冠状动脉病变程度的关系

目的:探讨血清尿酸水平与冠脉病变程度的关系. 方法:216例经过冠脉造影确诊为冠心病的患者,以冠脉病变程度分组,同时检测空腹血尿酸水平.结果:冠状动脉正常组血尿酸水平为(293.98±74.49)μmol/L,冠状动脉单支病变组血尿酸水平为(309.65±50.98)μmol/L,冠状动脉双支病变组血尿酸水平为(358.28±79.08)μmol/L,冠状动脉多支病变组血尿酸水平为(366.71±92.24)μmol/L.狭窄组患者的血尿酸水平(348.45±)μmol/L明显高于对照组(293.98±74.49)μmol/L,P＜0.01,差异有统计学意义.血尿酸水平与冠心病的病变血管数目呈正相关(r=0.324,P＜0.01).结论:随着冠状动脉病变程度的增加,血尿酸水平也逐渐升高.     

Relationship between serum calcium and CA 19-9 levels in colorectal cancer

AIM: To examine the calcium metabolism of colorectal cancer (CRC) in patients with colorectal cancer and control patients. METHODS: Seventy newly diagnosed CRC patients were included. The healthy control group was age and gender matched (n=32). Particular attention was devoted to the relationship between serum calcium of patients, and levels of AFP, CEA, carbohydrate antigen 19-9 (CA 19-9) (that could be considered as prognostic factors). Furthermore, the Ca-sensing receptor (CaSR) gene A986S polymorphism was investigated in these patients, as well as the relationship between different CaSR genotypes and the data stated above. RESULTS: A lower level of ionized calcium (also corrected for albumin) was found in the serum of CRC patients with normal 25(OH) vitamin D levels. The ionized calcium concentration was inversely correlated with the serum level of CA 19-9. There was no difference in the distribution of CaSR genotypes, between CRC patients and general population. The genotypes did not correlate with other data examined. CONCLUSION: Based on these results, lower levels of serum calcium might be a pathogenic and prognostic factor in colorectal cancer.     

Oxidative DNA damage and total antioxidant status in serum of patients with esophageal squamous cell carcinoma

BACKGROUND/AIMS: Oxidative stress is connected with activation of somatic mutations and rates of cell proliferation existing in cancer tissue. High level of reactive oxygen species is a mutagenic factor for DNA damage. Antioxidants are the components of the cellular defense mechanism against reactive oxygen molecules. The aim of our study was to analyze DNA peroxidation products' concentration and total antioxidant level in serum of the patients with esophageal squamous cell carcinoma before and after esophagectomy. We examined these parameters as markers of cancer development. METHODOLOGY: We tested 18 patients (2 woman and 16 men, mean age 59.4 years) with esophageal squamous cell cancer before and after esophagectomy and 12 healthy people as a control group. Concentrations of 8-OHdG and enzymatic antioxidants level were analyzed in serum. Data were statistically analyzed by Mann-Whitney test. RESULTS: We observed statistically significant higher concentrations of 8-OHdG and significant lower levels of enzymatic antioxidants in the patients with cancer in comparison to the control group. After esophagectomy we observed normalization of these parameters. In four patients the level of total antioxidants was low and 8-OHdG concentration was high during the whole time of treatment. These patients had disease progression. CONCLUSIONS: Estimation of serum 8-OHdG concentration and total antioxidant status may be helpful for monitoring cancer therapy in patients with esophageal squamous cell cancer.     

Involvement of serum retinoids and Leiden mutation in patients with esophageal, gastric, liver, pancreatic, and colorectal cancers in Hungary

AIM: To analyze the serum levels of retinoids and Leiden mutation in patients with esophageal, gastric, liver, pancreatic, and colorectal cancers. METHODS: The changes in serum levels of retinoids (vitamin A, α-and β-carotene, α-and β-cryptoxanthin, zeaxanthin, lutein) and Leiden mutation were measured by high liquid performance chromatography (HPLC) and polymerase chain reaction (PCR) in 107 patients (70 males/37 females) with esophageal (0/8), gastric (16/5), liver (8/7), pancreatic (6/4), and colorectal (30/21 including 9 patients suffering from in situ colon cancer) cancer. Fifty-seven healthy subjects (in matched groups) for controls of serum retinoids and 600 healthy blood donors for Leiden mutation were used. RESULTS: The serum levels of vitamin A and zeaxanthin were decreased significantly in all groups of patients with gastrointestinal (GI) tumors except for vitamin A in patients with pancreatic cancer. No changes were obtained in the serum levels of α-and β-carotene, α-and β-cryptoxanthin, zeaxanthin, lutein in patients with GI cancer. The prevalence of Leiden mutation significantly increased in all groups of patients with GI cancer. CONCLUSION: Retinoids (as environmental factors) are decreased significantly with increased prevalence of Leiden mutation (as a genetic factor) in patients before the clinical manifestation of histologically different (planocellular and hepatocellular carcinoma, and adenocarcinoma) GI cancer.     

Antioxidant potential in esophageal,stomach and colorectal cancers

BACKGROUND/AIMS: The gastrointestinal tract is particularly susceptible to reactive oxygen species attack which lead to carcinogenesis. An important role in defense strategy against reactive oxygen species is played by antioxidants. The present study aims at examining antioxidant parameters and malondialdehyde--the product of lipid peroxidation as well as the marker of cancer progression--and cancer procoagulant in esophageal, gastric and colorectal cancer patients. METHODOLOGY: The activity of superoxide dismutase, catalase, glutathione peroxidase and reductase and the level of glutathione, vitamin C, malondialdehyde and cancer procoagulant were determined in tumors and normal mucous from 18 patients with esophageal cancer, 18 patients with stomach tumor and 62 patients with colorectal cancer. RESULTS: In esophageal tumor the activity of all enzymes has been increased compared with normal mucous. Stomach tumor has been also characterized by an increase in antioxidant enzymes activity except glutathione peroxidase and reductase whose activities have been decreased. However in colorectal tumor the activity of enzymes has been increased apart from catalase. In all cases the glutathione level has been increased while the vitamin C content has been significantly decreased. Tumor malondialdehyde level was significantly increased, too. The level of cancer procoagulant also increased in cancer tissues as well as in the serum. CONCLUSIONS: Antioxidant potential in all cases of gastrointestinal tract cancer has been unbalanced which has lead to increase in reactive oxygen species action and enhancement of lipid peroxidation and cancer procoagulant generation.     

三维适形放疗对食管癌患者的临床疗效观察及血清血管内皮生长因子的变化

目的探讨三维适形放疗(3DCRT)对食管癌患者的临床疗效及血管内皮生长因子(VEGF)的变化水平。方法选取2011年7月-2013年7月十堰市太和医院收治的75例食管癌患者作为研究组,另选体检中心体检的健康人群50例作为对照组。食管癌患者行3DCRT,评价患者的疗效及安全性;采用酶联免疫吸附试验双抗体夹心法检测两组血清VEGF的变化水平,探讨其在放疗中的意义。结果食管癌患者放疗前后血清VEGF水平均显著高于对照组,组间相比,差异有统计学意义(P0.05);食管癌患者放疗4周、放疗后1周血清VEGF水平较放疗前明显降低,差异具有统计学意义(P0.05);放疗有效组放疗4周及放疗后1周血清VEGF水平显著低于放疗前,差异具有统计学意义(P0.05);无效组放疗前后血清VEGF水平相比,差异无统计学意义(P0.05)。结论 3DCRT治疗食管癌疗效确切,不良反应低;VEGF可以作为评估、预测放疗敏感性的生化指标,在食管癌的治疗和预后中有重要意义。     

CYPIA1, GSTs and mEH polymorphisms and susceptibility to esophageal carcinoma： Study of population from a high- incidence area in north China

AIM: To characterize cytochrome P4501A1 (CYPIA1), glutathione S-transferases (GSTs) and microsomal epoxide hydrolase (mEH) polymorphisms in Chinese esophageal cancer patients. METHODS: Multiplex polymerase chain reaction (PCR) and PCR based restriction fragment length polymorphisms (PCRRFLP) were used to detect polymorphism changes of CYP,GSTs and mEH on esophageal cancerous and precancerous lesions as well as in case control group. All the examination samples were obtained from Linzhou (formerly Linxian), Henan Province, the highest incidence area for esophageal. RESULTS: The frequency of CYP1A1 3‘‘ polymorphism in case control group (26/38, 68 %) was significantly higher than in esophageal squamous cell carcinoma~roup (ESCC) (29/62, 47 %) (P&lt;0.05). A significant difference in the incidence of mEH slow allele variant was observed between case control group (15/38, 39 %) and esophageal dysplasiagroup (22/32, 69 %) or ESCC group (39/62, 63 %) (P&lt;0.05). However, no significant difference was observed among different groups in the polymorphisms of CYPIA1 exon 7, GSTM1, GSTT1, GSTP1 and mEH fast allele. CONCLUSION: The present results suggest that CYPIA1 3‘‘ polymorphism may be one of the promising protectivef actors and its wild gene type may be an indicator for higher susceptibility to esophageal cancer, mEH slow allele variant,associated with the progression of esophageal precancerous lesions, may conthbute to the high susceptibility to esophageal carcinoma.     

Decrease in serum levels of vitamin A and zeaxanthin in patients with colorectal polyp.

OBJECTIVE: Several retrospective and prospective epidemiological investigations have demonstrated that a diet rich in carotenoids could prevent the development of pre-cancerous and neoplastic lesions of the digestive tract. The aim of this examination was to analyse the correlation between colorectal polyps with different histological classifications and serum carotenoid levels. DESIGN AND METHODS: A 10 ml blood sample was taken from all of the patients after the colonoscopic diagnosis. The serum levels of vitamin A, lutein, zeaxanthin, alpha- and beta-cryptoxanthin, alpha- and beta-carotene were measured in patients with adenomatous colorectal polyp (n = 59, 35 males, 24 females) by high-pressure liquid chromatography (HPLC) and compared with those in healthy subjects (n = 20, 10 males, 10 females). The patients were separated into four groups depending on their histological findings. RESULTS: The serum levels of vitamin A and zeaxanthin were significantly lower in all patients with polyps (vitamin A: 0.913 +/- 0.112 micromol/l, zeaxanthin: 0.071 +/- 0.012 micromol/l) than in the control healthy group (vitamin A: 2.036 +/- 0.354 micromol/l, zeaxanthin: 0.138 +/- 0.048 micromol/l). The lowest levels were found in patients with focal adenocarcinoma in the polyp. There were no significant differences in the serum levels of other carotenoids. The serum levels of cholesterol, haemoglobin, total protein and albumin were normal in these patients. CONCLUSIONS: There are close and inverse correlations between the serum level of carotenoids and colorectal polyps with different histological grades. The low mean carotenoid levels in patients with adenocarcinoma in the polyp indicate that deficiency of carotenoids may be an important factor in the development of colorectal cancer.     

Vitamin E malabsorption and neurological consequences after gastrectomy for gastric cancer

BACKGROUND/AIMS: In order to clarify vitamin E malabsorption after gastric surgery, we evaluated serum vitamin E level and neurological consequences in patients who had undergone gastrectomy for gastric cancer. METHODOLOGY: We studied forty-eight patients (30 men, 18 women) with a mean age of 68.0 years, who had previously undergone gastrectomy for gastric cancer and had no evidence of recurrence. The types of operation consisted of subtotal gastrectomy in 26 patients and total gastrectomy in 22 patients. We measured postoperative body weight, white blood cells, red blood cells, hemoglobin, hematocrit, platelets, and serum levels of vitamins E, vitamin B12, folic acid, total cholesterol, triglycerides, total protein, and albumin. RESULTS: Serum vitamin E level was decreased in 7 (14.6%) of the 48 patients. The occurrence of low vitamin E level was significantly more frequent in the total gastrectomy group than in the subtotal gastrectomy group. In relation to reconstruction procedures, the incidence of low vitamin E level was significantly higher in patients without food passage through the duodenum. The low vitamin E level was significantly associated with low total cholesterol level. The incidence of neuropathy was significantly higher in patients with low vitamin E level. CONCLUSIONS: We assume that vitamin E deficiency more likely occurs after the reconstruction procedure in which food does not pass through the duodenum. Transport disturbance with loss of passage through the duodenum consequently may be the major cause of malabsorption. Differential diagnosis of neurological symptoms in post-gastrectomy patients should include hypovitaminosis E.     

硒蛋白S基因G-254A位点多态性与食管癌发病风险的关联性

目的探讨内蒙古汉族人群硒蛋白(Sel)S基因G-254A位点多态性与食管癌发病风险的相关性。方法采用四引物扩增阻碍突变体系聚合酶链式反应检测124例内蒙古汉族食管癌患者和132例健康对照者的基因型和等位基因频率,并进行测序验证,分析两组SelS基因G-254A位点基因型和等位基因频率分布的差异,同时对食管癌发病风险进行分层分析和多因素Logistic回归分析。结果吸烟、饮酒和基因突变是食管癌发病的主要危险因素(OR分别为1.782、1.594、2.286,均P<0.1);SelS基因G-254A位点CT、CC、TT基因型和C、T等位基因频率在两组间存在统计学差异(均P<0.05)。内蒙古汉族人群中携带T等位基因的CT和(或)TT基因型者患食管癌的风险高于CC基因型者(OR=2.005,95%CI:1.36~2.591),携带T等位基因且吸烟的个体患食管癌的风险增加,是CC基因型的2.611倍(OR=2.611,95%CI:1.410~4.835)。结论吸烟、饮酒和基因突变是食管癌发病的主要危险因素,吸烟与SelS基因突变可交互作用增加食管癌发病风险。     

Serum vitamin B12 and folate levels, vitamin B12 and folic acid binding proteins in patients with primary carcinoma of the liver

Serum vitamin B12, folic acid, vitamin B12 and folic acid binding protein concentration were determined in 31 patients with primary carcinoma of the liver. Serum vitamin B12 level was found to be higher in 16 of 31 (52%) patients with carcinoma of the liver and the mean value was also significantly higher than that of the control group. There was no significant difference between the mean values of serum UBBC of these 2 groups. TCI and TCIII increased while TCII decreased considerably in the patient group. Serum folate level in patients with primary carcinoma of the liver was significantly lower than that of the control group. About 39% of these patients had serum folate level lower than the lowest value of the control group. Serum FABP in the former group was also significantly higher than that of the latter group.