PEDF对低氧状态下人支气管上皮细胞表达VEGF的影响

目的:研究色素上皮衍生因子(PEDF)对低氧状态下人支气管上皮细胞(HBE)分泌血管内皮生长因子(VEGF)的影响,并探讨该作用与缺氧诱导因子1α(HIF-1α)的相关性?方法:体外培养的HBE细胞取第3~7代用于实验,氯化钴(CoCl2)100 ?滋mol/L模拟缺氧状态?实验分为4组:正常对照组(A组)?氯化钴干预组(B组)?氯化钴 + PEDF 50 ng/ml干预组(C组)及氯化钴 + PEDF 200 ng/ml干预组(D组)?RT-PCR法检测各组细胞HIF-1α及VEGF 在mRNA水平上的表达差异;ELISA及Western blot法检测各组细胞VEGF蛋白表达水平;细胞免疫荧光染色法(IF)检测各组细胞HIF-1α蛋白在细胞质和细胞核中的表达情况?结果:①B组VEGF的mRNA水平较A组显著升高[为A组的(8.56 ± 0.67)倍,P < 0.01],C组与D组的VEGF mRNA水平较B组明显下降(P < 0.01);B组 HIF-1α mRNA的表达水平较A组明显升高(P < 0.01),B?C?D 3组间HIF-1α mRNA无统计学差异;②细胞培养基上清中B组VEGF表达量[(1 370.10 ± 42.98)pg/ml]较A组[(670.00 ± 23.35) pg/ml]明显升高(P < 0.01),且B组与C组[(816.19 ± 37.05) pg/ml]及D组[(646.47 ± 22.70)pg/ml]比较差异有统计学意义(P < 0.01)?③Western blot结果显示B组VEGF的蛋白表达量为A组的(3.99 ± 0.37)倍,差异有统计学意义(P < 0.01);C组与D组VEGF的蛋白表达水平较B组明显下降,差异有统计学意义(P < 0.05)?④IF结果显示,B组HIF-1α的表达水平及核内转移较A组和D组明显升高?结论:PEDF对低氧状态下HBE细胞高表达的VEGF具有一定抑制作用,且该抑制作用可能与PEDF调控HIF-1α有关?     

急性心肌梗死患者血管紧张素Ⅱ水平对外周血内皮祖细胞的影响

目的:急性心肌梗死(acute myocardial infraction,AMI)患者外周血中血管紧张素Ⅱ(angiotensin Ⅱ,Ang-Ⅱ)水平对内皮祖细胞(endothelial progenitor cells,EPCs)的数目变化的影响?方法:入选的28例AMI患者(实验组)和30例冠状动脉造影阴性患者(对照组),用ELISA法检测AMI患者急性期?恢复期以及对照组血清中Ang-Ⅱ?基质细胞衍生因子-1α(stromal cell-derived factor-1α,SDF-1α)的水平,同时用密度梯度离心法获得单个核细胞,用CD34?VEGF和CD133抗体标定EPCs,用流式细胞仪检测外周血中EPCs占单个核细胞的比率?结果:AMI患者急性期Ang-Ⅱ水平(90.40 ± 6.39)pg/ml明显高于恢复期 (72.57 ± 2.42)pg/ml和对照组(69.14 ± 3.73)pg/ml (P = 0.002 4),同时AMI患者急性期EPCs占外周血单个核细胞的比率为为(0.043 ± 0.004)%,明显高于恢复期(0.024 ± 0.010)% 和对照组(0.012 ± 0.001)%(P < 0.000 1),但AMI患者急性期SDF-1α的水平(171.1 ± 35.81) pg/ml同恢复期(130.30 ± 28.84) pg/ml及对照组(116.50 ± 29.19) pg/ml之间无明显差异(P = 0.370 3)?在AMI患者急性期外周血中EPCs和Ang-Ⅱ水平呈负相关,而与SDF-1α水平无明显相关性?结论:AMI患者急性期循环中的Ang-Ⅱ水平及EPCs数量均升高,但是Ang-Ⅱ抑制了EPCs的数量?     

冠心病患者VEGF水平及其与冠状动脉病变程度的相关性研究

目的：探讨冠心病患者血管内皮生长因子（VEGF）水平与冠状动脉病变程度之间的相关关系。方法收集进行冠状动脉造影检查确诊的冠心病患者为研究对象,并以健康体检者为对照,测量并比较两组VEGF水平及其与冠状动脉狭窄程度之间的关系。结果冠心病患者组VEGF水平为（153.62＆#177;25.68）pg/mL,明显高于对照组的（82.34＆#177;15.24）pg/mL,两组比较差异有统计学意义（P＆lt;0.05）;多支病变组VEGF水平为（182.69＆#177;54.58） pg/mL,明显高于单支病变组的（126.62＆#177;31.58）pg/mL,两组比较差异有统计学意义（P＆lt;0.05）;冠心病患者血浆VEGF水平与冠状动脉病变程度Gensini评分相关性分析具有显著的线性相关关系（r=0.683,P=0.031）。结论冠心病患者冠状动脉狭窄程度与血清VEGF水平之间存在相关关系,VEGF可以作为病情严重程度的指标。     

Vascular endothelial growth factor expression in serum of patients with hepatocellular carcinoma

Objectives To determine the pre-therapeutic serum level of vascular endothelial growth factor (VEGF) in patients with hepatocellular carcinoma (HCC) and to elucidate the relation between the serum level and clinical characteristics and metastasis of HCC. Methods One-hundred and fifteen HCC patients, 40 patients with benign liver lesions, and 30 healthy control subjects were included in this study. The serum VEGF level was measured with the quantitative sandwich enzyme linked immunosorbent assay (ELISA, R&amp;D systems). Results The serum VEGF levels in the HCC group (465.62±336.24 pg/ml) was significantly elevated as compared with those in patients with benign liver lesions (159.54±120.58 pg/ml) and those in normal controls (123.53±51.84 pg/ml). The VEGF levels were not significantly different between the patients with benign liver lesions and the normal controls. The serum VEGF concentration showed a positive rate of 77.4%, 25%, and 3.3% in the HCC patients, benign liver lesion patients and normal controls, respectively. In the 115 HCC patients, the serum VEGF levels in patients with portal vein (PV) emboli (n=26, 582.76±441.89 pg/ml), with metastasis (n=43, 548.29±438.57 pg/ml) or with large HCC lesions (≥5 cm in diameter) (n=69, 554.43±369.99 pg/ml) were significantly higher than those without PV-emboli (n=89, 431.39±292.84 pg/ml), without metastasis (n=72, 416.24±247.27 pg/ml) or with small HCC lesions (n=42, 328.67±227.47 pg/ml). The serum VEGF levels in stage Ⅰ, Ⅱ, Ⅲ, Ⅳa and Ⅳb HCC patients were 340.6 pg/ml, 451.55±307.84 pg/ml, 397.44±257.18 pg/ml, 486.10±397.73 pg/ml and 647.93±344.56 pg/ml, respectively. Conclusion The pre-therapeutic serum VEGF levels in HCC patients appear to reflect the disease’s potential activity of vascular invasion and metastasis.     

肺癌细胞抑制CD4+T细胞 IFN-γ基因表达的机制研究

目的:研究肺癌细胞能否直接影响CD4+T 细胞干扰素-γ(IFN-γ)基因启动子甲基化水平?方法:ELISA法检测肺癌组(n = 30)及健康对照组(n = 30)血浆IFN-γ水平;免疫磁珠分选两组外周血CD4+T 细胞(n = 8),提取DNA后经亚硫酸氢盐修饰,PCR扩增 IFN-γ基因启动子进行TA克隆测序,测序结果采用生物信息学软件进行分析;建立健康人CD4+T 细胞与肺腺癌细胞株SPC-A1体外Transwell共培养体系(n = 6),并设健康人CD4+T 细胞单独培养为对照组,培养5 d后分别收集CD4+T 细胞?CD4+T 细胞按上述法进行TA克隆测序?同时CD4+T 细胞经anti-CD3?anti-CD28刺激6?24 h,ELISA法检测两组上清IFN-γ表达水平,RT-PCR检测CD4+T 细胞IFN-γ mRNA表达水平?结果:肺癌组血浆IFN-γ水平显著低于健康对照组[(69.30 ± 38.56) pg/ml vs (92.62 ± 34.75) pg/ml,P = 0.017];肺癌组CD4+T 细胞IFN-γ基因启动子甲基化水平显著高于健康对照组(84.6% vs 68.6%,P < 0.001);肺癌患者血浆IFN-γ水平与其基因启动子甲基化率呈负相关(r = -0.850 3,P = 0.010 7)?体外Transwell共培养实验中,与对照组相比,实验组CD4+T 细胞anti-CD3?anti-CD28刺激6?24 h,IFN-γ表达水平显著下降[6 h:(14.53 ± 7.12) pg/ml vs (36.14 ± 23.51) pg/ml,24 h:(7.81 ± 4.02) pg/ml vs (24.85 ± 15.58) pg/ml],6 h对照组CD4+T 细胞IFN-γ mRNA表达水平为实验组的2.37倍?实验组CD4+T 细胞IFN-γ基因启动子甲基化水平显著高于对照组(85.4% vs 70.9%)?结论:肺癌细胞可诱导CD4+T 细胞IFN-γ基因启动子发生高甲基化,进而导致IFN-γ基因表达下调,可能对肺癌患者的免疫抑制起重要作用?     

胃癌患者血清IL-6、CA724、VEGF联合检测的临床意义

目的:研究胃癌患者血清白细胞介素-6(IL-6)?血清糖类抗原724(CA724)?血管内皮生长因子(vascular endothelial growth factor,VEGF)的检测在胃癌诊断中的临床意义?方法:采用ELISA 法测定80例胃癌患者及40例正常对照组血清IL-6?CA724?VEGF 的水平?结果:对照组患者血清IL-6?CA724?VEGF检测值均低于胃癌组[(48.12 ± 28.02) vs (149.62 ± 43.00)ng/ml,(4.53 ± 3.47) vs (15.29 ± 3.64)U/ml,(64.86 ± 17.67) vs (212.78 ± 125.61)pg/ml, P均< 0.01)]?胃癌患者血清IL-6?CA724?VEGF的联合检测的阳性率达到76.3%,明显高于各单项标记物的检测阳性率(分别为33.8%?43.8%?52.5%)?胃癌肝转移患者IL-6?CA724?VEGF检测值明显高于无肝转移患者[分别为(168.43 ± 54.03) vs (130.81 ± 10.00)ng/ml?(16.20 ± 4.57) vs (14.39 ± 2.05)U/ml?(289.47 ± 140.61) vs (136.09 ± 11.22)pg/ml,P 均< 0.05)],IL-6?CA724?VEGF 阳性率高于无肝转移患者(分别为50.0% vs 17.5%,P < 0.05;55.0% vs 32.5%,P > 0.05;65.0% vs 40.0%,P > 0.05)?结论:IL-6?CA724?VEGF 可用于胃癌及肝转移诊断?预后判断,联合检测可提高诊断率?     

人血浆组织激肽释放酶结合蛋白Kallistatin与冠状动脉病变程度相关性研究

目的:分析组织激肽释放酶结合蛋白(kallistatin,KS)在冠心病患者血浆中水平的差异以及与Gensini评分的相关性,揭示血浆KS水平与冠状动脉病变严重程度的相关性?方法:选取151例行冠脉造影检查的患者作为研究对象,统计其临床数据及造影结果?①根据冠脉病变分支结果分成4组:正常对照组?单支病变组?双支病变组?三支病变组,应用ELISA法测定患者血浆中KS含量;②根据Gensini评分评估其冠脉病变程度,将患者分为4组:A组(0分)?B组(>0~≤20分)?C组(>20~≤40分)?D组(>40~?艽160分),两两比较各组间患者血中KS含量的差异,并探究KS水平与Gensini评分间的相关性?结果:①根据冠脉病变分支结果分的4组中,血浆KS量分别为:对照组(95.35 ± 32.00)μg/mL?单支病变组(78.19 ± 25.27)μg/mL?双支病变组(66.19 ± 25.93)μg/mL?三支病变组(51.84 ± 23.26)μg/mL,各组间均具有统计学差异(P < 0.01),KS水平与冠脉病变支数呈负相关;②根据Gensini评分分的A?B?C?D 4组中,KS含量分别为(101.66 ± 36.50)μg/mL?(77.73 ± 25.13)μg/mL?(61.58 ± 23.06)μg/mL?(53.80 ± 23.92)μg/mL,KS含量在各组间的差异有统计学意义(P <0.01);③KS含量与Gensini评分存在统计学上有显著的相关性(r=-0.371,P < 0.001)?结论:冠心病患者血浆KS含量明显低于正常人群,且KS含量与Gensini评分存在显著的相关性?提示KS可能作为一个潜在的血管保护因子参与动脉粥样硬化性心脏病的发生发展过程?     

Ⅱ型糖尿病患者房水中VEGF和IL-6含量的检测

目的：检测Ⅱ型糖尿病患者眼房水中血管内皮生长因子（vascular endothelial growth factor，VEGF）和白细胞介素-6（interleukin-6，IL-6）的含量，并探讨其临床意义。方法:采用双抗体夹心酶联免疫吸附（ELISA）法测定64例Ⅱ型糖尿病患者房水中VEGF和IL-6的含量，根据散瞳眼底检查和眼底荧光素血管造影检查后，实验组分为：无糖尿病视网膜病变组（NDR）21例、单纯型糖尿病性视网膜病变组（BDR）25例、增生型糖尿病性视网膜病变组（PDR）18例，对照组为健康的老年性白内障患者20例。结果：NDR组、BDR组、PDR组的房水VEGF含量分别为(220.27±25.69)pg/ml、（284.31±58.92）pg/ml、（459.07±90.90）pg/ml, IL－6 含量分别为(154.09±32.76)pg/ml、（221.81±60.52）pg/ml、（387.95±90.22）pg/ml，对照组房水VEGF含量为（135.50±25.69）pg/ml、IL-6含量为（78.71±20.37）pg/ml，对照组与实验组比较差异均有统计学意义（F=108.72,P＜0.01;F=102.532,P＜0.01）。 4组房水VEGF和IL 6含量有明显增加的趋势。房水中的VEGF含量与相应的IL 6含量有相关性（r=0.995, P＜0.01）；房水中VEGF、IL-6含量与糖尿病患者的病程及糖尿病视网膜病变的严重程度有相关性（r=0.722,P＜0.01; r=0.716,P＜0.01）、（r=0.869,P＜0.01;r=0.865, P＜0.01）。结论：VEGF、IL-6在糖尿病视网膜病变的形成过程中有重要作用，且两者之间有相关性。     

N末端脑利钠肽前体与冠脉病变程度的关系

目的:观察N末端脑利钠肽前体与冠状动脉病变程度的关系。方法:选取因心绞痛症状住院且左室射血分值≥50%的患者120例,接受冠脉造影检查后根据造影结果将患者分为冠心病组及对照组。并根据病变累及血管数目分为正常冠脉组,单支血管病变组、双支血管病变组及三支血管病变组。分别比较各组之间血浆NT-proBNP水平。结果:冠心病组血浆NT-proBNP(139.6±48.4pg/ml)显著高于对照组(79.8±31.5pg/ml,P<0.01)。正常冠脉组、单支血管病变组、双支血管病变组、三支血管病变组血浆NT-proBNP分别为79.8±31.5、96.3±39.9、131.7±57.6、163.3±50.4pg/ml。同前一组相比较,后一组血浆NT-proBNP均明显升高(P<0.05)。结论:心功能正常的稳定型冠心病患者血浆NT-proBNP升高,且升高的程度与冠脉病变程度呈正相关。     

良性贫血病人血浆中血管内皮生长因子水平的研究

采用ELISA法检测38例良性贫血病人血浆中血管内皮生长因子(VEGF)浓度,并选择20例健康对照。贫血病人血浆中VEGF浓度平均值为(341.56±102.29)pg/m l,对照者为(187.32±62.78)pg/m l,两组之间存在十分显著性差异(P<0.01)。Hb≥60 g/L组和Hb<60 g/L组血浆VEGF浓度分别为(297.17±108.72)pg/m l和(366.48±98.63)pg/m l,二者相比存在统计学差异(P<0.05)。贫血本身能够增加血浆中VEGF浓度,贫血程度越重,VEGF浓度越高。     

Predictive Value of Serum Vascular Endothelial Growth Factor and Pigment Epithelium-derived Factor in Ovarian Hyperstimulation Syndrome

Objective To explore whether the serum concentrations of vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) could serve as the predictors of ovarian hyperstimulation syndrome (OHSS) in patients undergoing in vitro fertilization-embryo transfer (IVF-ET). Methods Enzyme-linked immunoadsordent assay (ELISA) was employed to measure the serum concentrations of VEGF and PEDF on the day of hCG administration, oocyte retrieval and embryo transfer, respectively. Based on OHSS classification of the criteria of Golan, 85 patients were divided into three groups. Patients in group A (n=10) showed symptoms of severe OHSS and patients in group B (n=13) suffered from moderate OHSS. The control group (group C, n=62) contained patients without symptoms of OHSS as well as patients with mild OHSS. Results In groups A, B and C, serum concentrations of PEDF on the day of hCG administration (h-PEDF)(166.54 ± 102.81 pg/ml, 159.45 ± 136.77 pg/ml, 172.05 ± 170.95 pg/ml, P=0.48), oocyte retrieval (o-PEDF)(176.91 ± 103.37 pg/ml, 122.52 ± 92.54 pg/ml, 179.82 ± 177.47 pg/ml, P=0.27) and embryo transfer (e-PEDF)(169.02 ± 240.08 pg/ml, 136.80 ± 139.21 pg/ml, 157.38 ± 222.54 pg/ml, P=0.95), h-VEGF (175.55 ± 103.54 pg/ml, 218.84 ± 179.70 pg/ml, 153.39 ± 145.06 pg/ml, P=0.36) and o-VEGF (171.93 ± 128.55 pg/ml, 220.36 ± 149.82 pg/ml, 138.74 ± 139.30 pg/ml, P=0.15) showed no significant differences. There was a statistical difference in serum concentration of e-VEGF between group A (197.04 ± 156.63 pg/ml) and group C(110.69 ± 49.55 pg/ml)(P=0.008). The serum level of estradiol showed a positive correlation with the count of large follicles (r=0.744). The ratios of h-VEGF/h-PEDF, o-VEGF/o-PEDF and e-VEGF/e-PEDF were calculated and showed a clear difference among groups A, B and C (4.04 ± 3.39, 2.10 ± 2.14, 1.05 ± 4.80, P<0.001; 4.54 ± 5.69, 2.29 ± 1.67, 0.94 ± 0.59, P<0.001; 5.43 ± 6.16, 1.81 ± 1.36, 2.42 ± 2.60, P=0.04). Conclusion While neither serum concentrations of VEGF nor PEDF can be used as an OHSS predictor, the ratios of h-VEGF/h-PEDF, o-VEGF/o-PEDF and e-VEGF/e-PEDF may have great predictive value.     

心包腔内注入腺病毒-血管内皮生长因子165基因治疗心肌缺血的实验研究

目的:探讨经心包腔途径转染血管新生基因对缺血心肌的血管生成及舒缩功能的影响。方法:第一部分:随机将12头中国小型猪分为实验组和对照组,每组6头。两组猪均采用球囊堵塞前降支第一对角支远端以建立心肌梗死模型,心肌梗死模型建立后即刻,采用经皮剑突下穿刺方法,将中心静脉导管插入心包腔内转染Ad-LacZ。以胶原酶1200 u及透明质酸酶3000u预处理心包后,在心包腔内注射含Ad-LacZ基因2.0×109pfu。对照组心包腔内注射生理盐水。分别于注射后3天、7天及28天处死动物,对缺血心肌进行染色及病理观察。第二部分:随机将20头中国小型猪分为实验组和对照组,每组10头,每组又分3天(n=2)、7天(n=6)及28天(n=6)三个亚组。注射后3天、7天及28天分别用免疫组化、超声心动图对缺血心肌血管新生情况进行检测,并以酶联免疫吸附试验(ELISA)检测血浆、心包及心肌组织中Ad-VEGF165的表达。第三部分:20头小型猪随机分为心包转染组(心包组)和冠脉转染组(冠脉组)。心包组和冠脉组均注射Ad-VEGF1651.0 ml(2×109pfu),于注射前及其后3、7、28天分别测定组织内VEGF水平、微血管密度(MVD)、心功能。结果:①实验组注射Ad-LacZ基因后第3天、第7天及28天后X-gal染色有阳性细胞,以第7天最明显,对照组无阳性细胞。②Ad-VEGF165基因经心包腔转染缺血心肌组织后,在心包及组织中成高表达,于7天达到高峰,28天降至基线水平,血浆中无目的基因的表达;28天时,实验组缺血心肌微血管密度(MVD)、心功能均明显高于对照组[MVD,517.0±75.7/mm2vs 226.5±54.1/mm2,P=0.009;LVEF72.11±5.2%vs 55.14±4.37%,P=0.005]。③心包组和冠脉组的心脏均表达有VEGF165基因,组织内VEGF水平在7天时达高峰,28天时降至基线水平,前组高于后组(702±85pg/ml vs 592±59 pg/ml,P=0.026)。而两组的MVD、心功能随转染时间延长均明显增加,但心包组优于冠脉组(28d,MVD,517.0±75.7/mm2vs 326.4±24.1/mm2,P=0.001;FS,32.9±2.2%vs 30.6±2.1%,P=0.049;LVEF,72.11±5.2%vs 65.87±2.16%,P=0.034)。结论:①应用球囊堵塞法可成功建立猪急性心肌梗死模型,胶原酶及透明质酸酶预处理心包后,腺病毒载体可转染缺血心肌,并持续表达4周。②用胶原酶及透明质酸酶预处理心包腔后,经其转染Ad-VEGF165可以诱导急性心肌梗死模型局部VEGF蛋白表达,促进缺血心肌组织血管新生并能改善心功能。③导管介导的心包腔与冠脉转染Ad-VEGF165基因治疗心肌缺血是有效的、切实可行的,而前者可能是更有前途的新方法。     

氯沙坦对高血压血浆神经肽Y含量的干预研究

目的 观察应用氯沙坦前后高血压患者血浆神经肽Y(NPY)含量的变化,探讨血管紧张素Ⅱ(AⅡ)受体拮抗剂与NPY的相关性。方法 采用放免法测定40例高血压患者应用氯沙坦前后血浆NPY的含量及AⅡ水平,同期测定另外40例高血压患者应用美托洛尔前后血浆NPY的含量及AⅡ水平。结果40例高血压患者应用氯沙坦前后血浆NPY水平分别为(152.4±12.3)pg/ml、(125.5±9.5)pg/ml,P<0.01;血浆AⅡ水平分别为(49.6±7.1)pg/ml、(62.4±7.8)pg/ml,P<0.01。40例高血压患者应用美托洛尔前后血浆NPY水平分别为(144.1±11.3)pg/ml、(140.6±12.2)pg/ml,P>0.05;血浆AⅡ水平分别为(45.5±5.8)pg/ml、(48.3±7.2)pg/ml,P>0.05。治疗后2组之间比较,NPY、AⅡ水平均有非常显著性差异(P<0.01)。结论 氯沙坦能影响血浆NPY水平,提示该药降压的过程中有NPY参与的因素,而美托洛尔却不影响血浆NPY水平。     

Impact of primary percutaneous coronary intervention on blood perfusion in nonculprit artery in patients with anterior ST elevation myocardial infarction

Background Recent studies have demonstrated that epicardial flow in nonculprit arteries,which has been assumed to be normal,was slowed in the setting of ST-elevation myocardial infarction (STEMI).Howev...     

血清VEGF、PAPP-A及P联合测定对早期诊断异位妊娠及稽留流产的临床价值

目的 探讨血清血管内皮生长因子(VEGF)、妊娠相关蛋白A(PAPP-A)、孕酮(P)联合测定[即公式VEGF/(PAPP-A×P)]在早期诊断异位妊娠及稽留流产中的应用价值.方法 选择深圳沙井医院妇产科于2015年1月至2016年12月期间收治的宫内早孕、稽留流产及异位妊娠各40例作为研究对象,检测并比较三组受检者血清血管内皮生长因子(VEGF)、妊娠相关蛋白A(PAPP-A)、孕酮(P)水平,计算VEGF/(PAPP-A×P),比较三组上述指标的差异.结果 异位妊娠组患者的血清VEGF为(298.1±32.6)pg/mL,明显高于稽留流产组的(224.5±30.2)pg/mL和宫内早孕组的(211.4±24.7)pg/mL,差异均有统计学意义(P<0.05);稽留流产组与异位妊娠组患者的血清PAPP-A及P分别为(243.2±22.4)pg/mL、(36.4±15.3)nmol/L和(234.3±23.5)pg/mL、(32.6±13.6)nmol/L,差异均无统计学意义(P>0.05),但均明显低于宫内早孕组的(291.6±32.7)pg/mL、(66.2±19.4)nmol/L,差异均有统计学意义(P<0.05);VEGF/(PAPP-A×P)在异位妊娠组、稽留流产组、宫内早孕组分别为(0.096±0.032)、(0.056±0.023)、(0.024±0.005),三组间逐渐下降,两两比较差异均有统计学意义(P<0.05);VEGF/(PAPP-A×P)=0.086为界值,其对异位妊娠诊断敏感性93.8%,特异性92.1%.结论 运用公式VEGF/(PAPP-A×P)对异位妊娠及稽留流产具有较好的早期诊断及鉴别作用,优于VEGF、PAPP-A、P的单项测定.     

低剂量睾酮对心衰雄性大鼠血清白介素-10水平的影响

目的:观察低剂量十一酸睾酮(TU)对心肌梗死后慢性心力衰竭(HF)雄性大鼠血清白介素-10(IL-10)水平的影响。方法:对120只健康雄性SD大鼠随机行冠状动脉结扎(n=105)或假手术(PS,n=15)。6周后将存活的44只模型鼠随机分为2组:心力衰竭+TU治疗组(HF+TU组,n=22)给予TU 5 mg/kg.2周肌肉注射;心力衰竭组(HF组,n=22),给予安慰剂。用药12周后测定血清睾酮(T)及IL-10浓度。结果:HF组雄鼠血清T水平明显低于PS组(153.91±77.45 vs 475.28±161.37 ng/d1,P<0.05),HF+TU组T浓度与PS组无显著性差异(415.50±59.22 vs 475.28±161.37 ng/dl,P>0.05)。HF组较PS组血清IL-10浓度明显下降(4.90±1.32 vs 7.30±2.14 pg/ml,P<0.05)。HF+TU组较HF组血清IL-10浓度显著升高(6.55±2.11 vs4.90±1.32 pg/m1,P<0.05)。HF+TU组与PS组血清IL-10浓度无显著性差异(6.55±2.11 vs 7.30±2.14 pg/m1,P>0.05)。结论:低剂量睾酮可提高心肌梗死后慢性心衰雄性大鼠血清IL-10水平。     

Role of tumor necrosis factor-alpha in the pathogenesis of atrial fibrillation

Background  Tumor necrosis factor-alpha (TNF-α) is a pleiotropic proinflammatory cytokine and contributes to many kinds of cardiovascular diseases via its receptors (TNFR1/TNFR2). We hypothesize that TNF-α plays a role in the pathogenesis of chronic atrial fibrillation (AF).

Methods  Sixty-seven consecutive patients who were scheduled to have cardiac surgery were enrolled into the study. Thirty-one patients with rheumatic heart disease (RHD) and AF were enrolled as study group (AF group). The sinus rhythm (SR) control groups consisted of 20 patients with RHD and 16 patients with coronary artery disease (CAD). Peripheral blood sample was collected before the operation. About 5 mm3 left atrial tissue was disserted during the operation and was separated into three parts for Western blotting, real time polymerase chain reaction (RT-PCR) and immunohistochemistry (IHC) analysis.

Results  Compared with the controls (RHD SR and CAD SR), the levels of TNF-α ((14.40±5.45) pg/ml vs. (4.20±3.19) pg/ml vs. (2.68±2.20) pg/ml, P=0.000) and its soluble receptor 1 (sTNFR1) ((1623.9±558.6) pg/ml vs. (1222.3±175.6) pg/ml vs. (1387.5±362.2) pg/ml, P=0.001) in plasma were higher in patients with AF. TNF-α level had positive correlation with the left atrial diameter (LAD) (r=0.642, P=0.000). Western blotting analysis showed that the protein levels of TNF-α (0.618±0.236 vs. 0.234±0.178 vs. 0.180±0.103, P=0.000) were higher in patients with AF. The RT-PCR analysis results demonstrated that the mRNA expression of TNF-α (0.103±0.047 vs. 0.031±0.027 vs. 0.023±0.018, P=0.000) increased in patients with AF. IHC analysis displayed that, comparing to the SR, the expression of TNF-α (0.125±0.025 vs. 0.080±0.027 vs. 0.070±0.023, P=0.000) increased in the AF group. The protein level and mRNA expression of TNF-α also had positive correlation with left atrium diameter (LAD) (r=0.415, P=0.000 and r=0.499, P=0.000).

Conclusions  The results revealed that TNF-α elevated in the plasma and left atrial tissue and had positive correlation with LAD in patients of chronic AF. TNF-α might involve in the pathogenesis of chronic AF.

     

冠心病患者血浆尾加压素Ⅱ的临床研究

OBJECTIVE: To investigate the changes in plasma urotensin II(U II) expression levels in patients with coronary heart disease (CHD). METHODS: Plasma U II levels in 50 CHD patients with coronary stenosis indicated by coronary angiography and 20 healthy subjects were determined by radio immunoassay. RESULTS: Venous plasma U II levels were significantly lowered in CHD patients in comparison with the healthy subjects (1.61+/-1.02 pg/ml vs 3.70+/-1.30 pg/ml, P=0.000). In the CHD patient group, significantly differences were noted in the U II levels between patients with stable angina (2.62+/-1.20 pg/ml), unstable angina (1.39+/-0.80 pg/ml) and acute myocardial infarction (AMI, 1.04+/-0.45 pg/ml, P=0.004). CHD patients with coronary artery occlusion and those with only coronary stenosis had comparable venous plasma U II levels (1.29+/-1.02 pg/ml vs 1.76+/-1.00 pg/ml, P=0.131), whereas the patients with restenosis after percutaneous transluminal coronary angioplasty (PTCA) had higher U II levels than the other subjects in the CHD patient group (2.28+/-0.94 pg/ml vs 1.40+/-0.96 pg/ml, P=0.008), and the femoral plasma U II levels were significantly elevated after PTCT, increasing from 1.18+/-1.14 pg/ml to a postoperative level of 2.22+/-1.77 pg/ml (P=0.001). CONCLUSION: U II might play a role in the pathophysiological process of CHD and can be involved in the restenosis after angioplasty.     

肝炎肝硬化患者血清胃泌素的变化

目的 探讨肝炎肝硬化患者外周血清胃泌素的变化特点,以及幽门螺杆菌(Hp)感染对血清胃泌素的影响及其临床意义.方法 选择首都医科大学附属北京佑安医院确诊的肝炎肝硬化患者165例[男113例,女52例,平均年龄(51.9±11.4)岁]及同期健康志愿者30例[男12例,女18例,平均年龄(44.9± 11.9岁)]作为研究对象.肝炎肝硬化组分为Child-PughA级(54例)、B级(60例)、C(51例).抽取外周静脉血3 ml、行14C-尿素呼气试验和电子胃镜检查(结果由两名以上专业人员诊断).根据胃镜下活检病理和14C-尿素呼气试验判断是否Hp感染.双抗体夹心酶联免疫吸附实验检测血清胃泌素浓度,并根据标准曲线计算胃泌素含量.以肝炎肝硬化患者胃泌素水平为因变量,Hp感染情况、性别、年龄、病毒载量、总胆红素、肌酐、白蛋白、血氨、血浆凝血酶原时间、溃疡情况、静脉曲张情况为自变量进行多元逐步回归分析.结果 165例肝炎肝硬化患者中Hp感染率48.5％(80/165);Child-Pugh A、B、C级Hp感染率分别为40.7％ (22/54)、50.0％(30/60)、54.9％ (28/51),差异无统计学意义(P=0.335).30例对照组Hp感染率20.0％(6/30),显著低于肝炎肝硬化组(P=0.004).肝炎肝硬化组血清胃泌素的浓度为(772.9±368.3)pg/ml,高于对照组(260.3±117.6)pg/ml,差异有统计学意义(P＜0.01).肝炎肝硬化Hp感染者血清胃泌素平均浓度(957.2±318.5)pg/ml显著高于未感染者(595.1±324.2)pg/ml,差异有统计学意义(P＜0.01).进一步分组比较,Child A、B、C各亚组Hp感染者比未感染者的血清胃泌素浓度均亦显著升高[(781.3±233.8)pg/ml vs.(398.0±159.3)pg/ml,(884.2±235.9)pg/ml vs.(617.6±301.8)pg/ml,(1 205.9±316.5)pg/ml vs.(816.6±334.9)pg/ml,P均＜0.01].多元逐步回归分析,Hp感染对肝炎肝硬化患者血清胃泌素水平的影响最大,白蛋白水平与胃泌素水平呈负相关.肝炎肝硬化并发消化性溃疡50例,占30.3％.肝炎肝硬化合并消化性溃疡患者与无溃疡者相比,其外周血胃泌素浓度显著升高[(909.4±340.8)pg/ml vs.(713.5±365.4)pg/ml,P=0.002].结论 肝炎肝硬化患者外周血清胃泌素升高,Hp感染可能在其中发挥了重要作用.血清胃泌素升高可能是肝炎肝硬化患者易发生消化性溃疡的原因之一.