间质性肺疾病患者血清和支气管肺泡灌洗液中内皮素1活性的变化

目的评价内皮素对肺纤维化发生、发展作用的影响。方法利用同位素放射免疫直接测定法,检测１０例肺结节病和８例特发性肺纤维化（ＩＰＦ）患者外周血和支气管肺泡灌洗液（ＢＡＬＦ）中内皮素１（ＥＴ１）的活性,并与８名健康非吸烟者进行对照。结果肺结节病和ＩＰＦ患者血清和ＢＡＬＦ中的ＥＴ１活性分别为（６２±２９）ｎｇ／Ｌ,（１７０±２４）ｎｇ／Ｌ和（７７±７１）ｎｇ／Ｌ、（１０±３）ｎｇ／Ｌ,与正常对照组（２０±８）ｎｇ／Ｌ、（４０±０６）ｎｇ／Ｌ比较,差异有显著性（Ｐ＜００１）;血清中ＥＴ１活性与动脉血氧分压（ＰａＯ２）呈明显负相关（ｒ＝－０５３８,Ｐ＜００１）;结节病组和ＩＰＦ组ＢＡＬＦ中的ＥＴ１水平与ＢＡＬＦ中细胞总数呈正相关（ｒ＝０６４９,Ｐ＜００１）,肺结节病患者、ＩＰＦ患者ＢＡＬＦ中ＥＴ１与淋巴细胞、中性粒细胞呈正相关（ｒ＝０７１２,０８１３,Ｐ均＜００１）。结论ＥＴ１在肺结节病和ＩＰＦ发病机制中起着重要作用,并可作为疾病活动性判定的一项重要参考指标。     

间质性肺疾病支气管肺泡灌洗液中性粒细胞趋化因子和肿瘤坏 …

OBJECTIVE: To investigate the relationship between the level of the neutrophil chemotactic factor(NCF), tumor necrosis factor-alpha(TNF-alpha) in patients with interstitial lung disease(ILD) and the activity of ILD. METHOD: The NCF activities in the BALF and in the serum from 11 patients with sarcoidosis, 7 with idiopathic pulmonary fibrosis (IPF) and 8 normal subjects were determined using the membrane filter and radio-immunoassay. The level of TNF-alpha was also detected. RESULT: In the 7 IPF patients, the level of NCF and TNF-alpha (203 +/- 44 cells/10 HP, 11.7 +/- 2.9 ng/L) in the BALF was higher than that in 8 control patients (83 +/- 45 cells/10 HP, 6.5 +/- 1.4 ng/L, P < 0.01). The level of NCF and TNF-alpha in the BALF from 11 patients with sarcoidosis (186 +/- 50 cells/10 HP, 12 +/- 3 ng/L) was highet than those in 8 control patients (P < 0.01). The level of NCF and TNF-alpha in the BALF from patients with IPF was positive correlated with the percentage of neutrophil (NCF: r = 0.89, P < 0.01; TNF-alpha: r = 0.86, P < 0.05). The level of NCF and TNF-alpha in the BALF of patients with sarcoidosis was positive correlated with the percentage of lymphocyte (NCF: r = 0.78, P < 0.01; TNF-alpha: r = 0.73, P < 0.01. CONCLUSION: The level of NCF and TNF-alpha in the BALF from patients with IPF and sarcoidosis can act as the marker of the activity of alveolitis of IPF and sarcoidosis.     

间质性肺疾病支气管肺泡灌洗液胶原基质成份研究

为了进一步研究特发性肺纤维化 (ＩＰＦ)和结节病 (Ｓａｒｃ)发病机制 ,探寻疾病活动性标志 ,我们采用双盲对照方法检测 1组间质性肺疾病 (ＩＬＤ)患者支气管肺泡灌洗液 (ＢＡＬＦ)中胶原基质含量 ,探讨其临床研究价值。对象与方法　 (1)研究对象 :门诊与住院ＩＬＤ病例共 30例 ,包括ＩＰＦ和Ｓａｒｃ两组。ＩＰＦ组 :18例 ,男 11例 ,女 7例。平均年龄 49± 14岁。根据特发性肺纤维化诊断及治疗 (试行方案 ) [1] ,所有病例均符合ＩＰＦ确诊标准。做ＢＡＬ检查前病程 1～ 36个月 ,吸烟者 4例。Ｓａｒｃ组 :12例 ,男 7例 ,女 5例 ,平均年龄 39…     

支气管肺泡灌洗液在结缔组织病相关间质性肺疾病中的应用

<正>多种结缔组织疾病(connective tissue disease-interstitial lung disease,CTD-ILD)都可以出现肺部间质改变,如类风湿性关节炎(rheumatoid arthritis,RA)、系统性硬化(systemic sclerosis,SSc)、系统性红斑狼疮(systemic lupus erythematosus,SLE)、多发性肌炎和皮肌炎(polymyositis/dermatomyositis,PM/DM)、干燥综合征(Sjogren syndrome,SS)等,其发生率为19%~85%~([1]),并且ILD可能是CTD首发且唯一的临床表现。支气管肺泡灌洗(bronchoalveolar     

支气管肺泡灌洗液细胞分析在间质性肺疾病中的临床价值

胸部高分辨率CT已经成为间质性肺疾病重要的诊断手段,支气管肺泡灌洗作为胸部影像的补充,其在间质性肺疾病的诊断中仍然具有一定的价值.除了某些少见的间质性肺疾病,单独应用支气管肺泡灌洗液细胞学分析不足以诊断间质性肺疾病的特异类型,但是结合临床和影像表现,支气管肺泡灌洗液分析可以支持某种特异性的诊断,使患者一定程度上避免外科肺活检.     

间质性肺疾病支气管肺泡灌洗液的酶活性研究

目的探讨支气管肺泡灌洗液（ＢＡＬＦ）多项酶活性与间质性肺疾病（ＩＬＤ）的关系。方法检测３０例ＩＬＤｓ：包括特发性肺纤维化（ＩＰＦ）１８例和结节病（Ｓａｒｃ）１２例与９例正常对照者的ＢＡＬＦ中超氧化歧化酶（ＳＯＤ）、谷胱甘肽过氧化物酶（ＧＳＨ－ＰＸ）、血管紧张素转换酶（ＡＣＥ）和乳酸脱氢酶（ＬＤＨ）活性，并分类计数ＢＡＬＦ细胞成份。结果（１）ＩＰＦ组ＢＡＬＦ中各项酶活性均与对照组间差异有显著性（ＳＯＤ和ＧＳＨ－ＰＸ降低，ＡＣＥ和ＬＤＨ升高）（Ｐ＜０．０５）；而Ｓａｒｃ组仅见ＡＣＥ明显增高（Ｐ＜０．０５）。（２）ＢＡＬＦ－ＡＣＥ与Ｓａｒｃ组淋巴细胞百分比及ＣＤ＋４／ＣＤ＋８比值均有显著线性相关（Ｐ＜０．０５）。结论ＢＡＬＦ中ＳＯＤ、ＧＳＨ－ＰＸ、ＡＣＥ和ＬＤＨ活性测定，有助于进一步探讨ＩＬＤ发病机理和提供辅助诊断依据，ＢＡＬＦ－ＡＣＥ对判断Ｓａｒｃ活动性有重要临床意义。     

间质性肺疾病支气管肺泡灌洗前后肺功能及血气的改变

目的探讨支气管-肺泡灌洗(BAL)对肺生理功能的影响.方法对42例间质性肺疾病(实验组)灌洗前和灌洗后进行肺功能和动脉血气检测,并与7例无肺疾病非吸烟者做对照(对照组).结果实验组肺活量占预计值百分比(VC%)由灌洗前的(74±17)%,下降到灌洗后(64±19)%.一秒钟用力呼气容积占预计值百分比(FEV1%)由(72±9)%下降到(65±12)%.动脉血氧分压(PaO2)由(77±11)mmHg下降到(63±11)mmHg.对照组灌洗后上述指标虽有所下降,但统计学分析差异无显著性.结论BAL对间质性肺疾病患者的肺功能和动脉血气有一定影响.     

间质性肺疾病支气管肺泡灌洗液中纤维连接素和Ⅲ型前胶原的研究

间质性肺疾病支气管肺泡灌洗液中纤维连接素和Ⅲ型前胶原的研究赵洪文陈佰义李振华候显明于润江材料与方法：研究对象见表１。其中非特发性肺纤维化组包括结节病５例，过敏性肺炎４例，药物引起肺纤维化１例，干燥综合症伴肺纤维化２例。按常规方法进行支气管肺泡灌洗（Ｂ...     

间质性肺疾病支气管肺泡灌洗液中性粒细胞趋化因子和肿瘤坏死因子水平及其临床意义

目的探讨间质性肺疾病（ＩＬＤ）时中性粒细胞趋化因子（ＮＣＦ）和肿瘤坏死因子（ＴＮＦα）与ＩＬＤ活动性的关系。方法用膜滤过和放射免疫法检测１１例结节病、７例特发性肺间质纤维化（ＩＰＦ）患者和８名健康者血清及支气管肺泡灌洗液（ＢＡＬＦ）中ＮＣＦ活性及ＴＮＦα水平。结果７例ＩＰＦ患者ＢＡＬＦ中ＮＣＦ、ＴＮＦα分别为２０３±４４ｃｅｌｓ／１０ＨＰ、１１７±２９ｎｇ／Ｌ，明显高于８名对照组（８３±４５ｃｅｌｓ／１０ＨＰ、６５±１４ｎｇ／Ｌ、Ｐ＜０．０１）；１１例结节病患者ＢＡＬＦ中ＮＣＦ、ＴＮＦα分别为１８６±５０ｃｅｌｓ／１０ＨＰ、１２±３ｎｇ／Ｌ，明显高于８名对照组（Ｐ＜０．０１）。ＩＰＦ组ＢＡＬＦ中ＮＣＦ、ＴＮＦα均与中性粒细胞百分比呈正相关（ＮＣＦ：ｒ＝０．８９，Ｐ＜０．０１，ＴＮＦα：ｒ＝０．８６，Ｐ＜０．０５），结节病组ＢＡＬＦ中ＮＣＦ、ＴＮＦα均与淋巴细胞百分比呈正相关（ＮＣＦ：ｒ＝０．７８，Ｐ＜０．０１；ＴＮＦα：ｒ＝０．７３，Ｐ＜０．０１）。结论ＩＰＦ和结节病患者ＢＡＬＦ中ＮＣＦ、ＴＮＦα水平可做为肺泡炎活动性的标志     

肺结节病支气管肺泡灌洗液中肿瘤坏死因子和中性粒细胞趋化 …

OBJECTIVE: To evaluate the role of cytokines released by the inflammatory cells and immunocytes from patients in pathogenesis of developing sarcoidosis. METHODS: With well- microchemotaxis and allergy immunology, the level of tumor necrosis factor-alpha (TNF-alpha) and neutrophil chemotactic factor (NCF) was measured in the serum and BALF of 11 sarcoidosis and 7 IPF and 8 normal subjects (non-smokers). RESULTS: The levels of TNFalpha (11.9 +/- 3.2, 11.7 +/- 3.0 ng x L(-1)) and NCF (191 +/- 51, 203 +/- 44 cell x 10HP(-1)) of BALF in the patients with sarcoidosis and IPF were significantly higher than these in control group (P < 0.01) and were higher than those in serum. The level of TNF-alpha in the BALF of patients with sarcoidosis was positively correlated with the percentage of lymphocytes (r = 0.73, P < 0.01). The activity of NCF in the BALF of patients with IPF was positively correlated with the percentage of neutrophils (r = 0.89, P < 0.01). CONCLUSIONS: It indicated that TNF-alpha and NCF might play an important role in the pathogenetic process of the sarcoidosis and IPF, and can act as the marker of activity of these diseases.     

慢性阻塞性肺疾病急性加重期血清MMP-9、TIMP-1变化的临床意义

目的探讨慢性阻塞性肺疾病（COPD）急性加重期血清基质金属蛋白酶-9（MMP-9）、基质金属蛋白酶组织抑制剂-1（TIMP-1）变化的临床意义。方法选取COPD急性加重期患者55例（COPD组）、查体健康者20例（对照组）,根据COPD组肺功能及病情程度分为轻度组15例、中度组22例、重度组18例。采用酶联免疫吸附法检测各组血清MMP-9及TIMP-1;行肺功能通气检查,记录第1秒钟用力呼吸容积（FEV1）/用力肺活量（FVC）及FEV1占预计值的百分比（FEV1%）。分析COPD组血清MMP-9、TIMP-1水平与病情严重程度的相关性。结果 COPD组血清MMP-9、TIMP-1明显高于对照组,且随病情加重逐渐升高（P〈0.01或〈0.05）;直线相关分析显示,COPD组血清MMP-9、TIMP-1水平与FEV1%呈负相关（r分别为-0.783、-0.776,P均〈0.01）。结论血清MMP-9、TIMP-1水平与COPD病情程度相关,病情越重,MMP-9、TIMP-1越高,且与FEV1%呈负相关;提示血清MMP-9、TIMP-1变化可作为判定COPD病情严重程度的指标之一。     

老年前列腺癌患者血清尿酸水平变化及临床意义

目的:探讨血清尿酸水平在老年前列腺癌患者与前列腺增生患者之间是否存在差异。方法:本研究回顾性分析2010年2月至2019年6月在商丘市第一人民医院诊断为前列腺癌的患者300例,同期诊断为前列腺增生患者240例,前列腺大小正常的老年男性400例作为对照组,检测3组患者血清尿酸水平、血清前列腺特异性抗原(PSA)、C反应蛋...     

脑梗死患者血清可溶性黏附分子的变化及临床意义

目的　了解急性脑梗死患者血清可溶性黏附分子的变化及临床意义。　方法　采用双抗体夹心ELISA法测定了 77例脑梗死患者血清可溶性黏附分子 ,并与 36例脑出血和 30例健康人对照比较。　结果　脑梗死患者 2 4h内血清可溶性黏附分子水平〔sICAM 1:(4 80 3± 2 6 1) μg/L ,sVCAM 1:(1197± 81) μg/L ,sELAM 1:(5 0 4 4± 2 6 9) μg/L〕明显高于脑出血和健康对照组 (P <0 0 1) ,至第 14天仍高于脑出血组和健康对照组 ;大梗死灶组血清可溶性黏附分子水平〔sICAM 1:(5 0 81± 30 4 ) μg/L ,sVCAM 1:(12 2 3± 4 9) μg/L ,sELAM 1:(5 2 4 4± 2 89) μg/L)明显高于中梗死灶组和小梗死灶组。脑梗死后并发感染患者在 14d内血清可溶性黏附分子水平明显高于无并发感染者。　结论　可溶性黏附分子与急性脑梗死密切相关 ,可溶性黏附分子可作为脑梗死治疗时 ,特别是进展性卒中治疗的重要监测指标之一。     

非酒精性脂肪性肝病患者血清铁代谢指标的变化及临床意义

目的观察非酒精性脂肪性肝病(NAFLD)患者血清铁代谢指标变化及其临床意义。方法收集2014年7月-2016年4月上海市第八人民医院收治的68例NAFLD患者(NAFLD组),另选取健康体检者70例(健康对照组)。68例NAFLD患者中单纯NAFLD患者24例,伴ALT异常者44例。检测所有研究对象的AST、ALT、TC、TG水平及铁代谢指标[血清铁(SI)、血清铁蛋白(SF)、血清铁调素(HEPC)]水平,观察NAFLD患者ALT异常与血清铁代谢指标的相关性。计量资料组间比较采用独立样本t检验,计数资料组间比较采用χ~2检验,两变量间的相关性采用Pearson相关系数分析。结果 NAFLD组患者的BMI、ALT、AST、TC、TG水平均显著高于健康对照组(t值分别为9.8、8.6、8.5、9.2、2.7,P值均0.05);铁代谢指标SI、SF水平显著高于健康对照组[SI:(21.7±7.1)μmol/L vs(18.7±6.9)μmol/L,t=2.3,P=0.02;SF:(340.2±257.6)μg/L vs(119.1±81.2)μg/L,t=6.7,P0.01)],HEPC显著低于健康对照组[(12.2±5.3)μg/L vs(22.2±6.5)μg/L,t=9.9,P0.01)]。伴ALT异常NAFLD患者的血清ALT、SI、SF水平显著高于单纯NAFLD患者[ALT:(89±58)U/L vs(26±8)U/L,t=7.1,P0.01;SI:(23.4±6.2)μmol/L vs(19.6±7.9)μmol/L,t=2.2,P=0.03;SF:(406.2±290.0)μg/L vs(219.4±112.0)μg/L,t=3.7,P0.01),血清HEPC水平显著低于单纯NAFLD患者[(7.4±4.9)μg/L vs(16.1±7.8)μg/L,t=4.7,P0.01)]。Pearson相关性分析结果显示,SF与ALT、AST呈显著正相关(r值分别为0.28、0.34,P值分别为0.02、0.01)。结论 NAFLD患者存在显著铁超载,且在伴ALT异常的NAFLD患者中表现更为明显。SF与ALT、AST呈显著正相关。血清铁蛋白能在一定程度上反映NAFLD患者肝损伤严重程度。     

Clinical significance of MCP-1 levels in BALF and serum in patients with interstitial lung diseases.

It has previously been reported that the expression of monocyte chemoattractant protein-1 (MCP-1) in the lung tissues of patients with idiopathic pulmonary fibrosis (IPF) was different from that in the tissues of patients with other interstitial lung diseases (ILDs). The aim of this study was to determine whether this difference reflects the amount of MCP-1 in the bronchoalveolar lavage fluid (BALF) or serum of patients with ILD, and whether such a correlation, if it exists, is clinically useful. MCP-1 concentrations in the BALF and sera were evaluated in 86 patients with ILDs including IPF, acute interstitial pneumonia, interstitial pneumonia with collagen vascular disease (IP-CVD), chronic interstitial pneumonia (CIP), bronchiolitis obliterans-organizing pneumonia, sarcoidosis, hypersensitivity pneumonitis, and in 10 normal healthy volunteers who were controls (NC). BALF MCP-1 levels were significantly elevated in the IPF, IP-CVD, CIP and sarcoidosis groups compared with the NC group. The level in the IPF group was significantly higher than that in any other patient group. Serum MCP-1 levels in the IPF, IP-CVD, CIP and sarcoidosis groups were significantly higher than the NC group. No statistical difference was found in serum MCP-1 levels between the IPF, IP-CVD and CIP groups. BALF MCP-1 levels were significantly higher than serum MCP-1 levels in the IPF group and lower than in the IP-CVD and CIP groups. Serum MCP-1 levels correlated with the clinical course of ILD treated with corticosteroid therapy. These results show that measurement of monocyte chemoattractant protein-1 levels in both bronchoalveolar lavage fluid and serum may be helpful in discriminating idiopathic pulmonary fibrosis from other types of interstitial lung disease and that monitoring of serum monocyte chemoattractant protein-1 may be useful for predicting the clinical course of interstitial lung diseases.     

颅脑损伤患者血清NF-L、TSP-1水平变化及临床意义

目的 探讨颅脑损伤患者血清神经丝蛋白轻链(NF-L)、血小板反应蛋白1(TSP-1)水平变化,分析其对颅脑损伤患者预后的预测价值。方法 选择106例颅脑损伤患者(颅脑损伤组),根据Fisher CT分级将患者分为1～2级组(47例)和3～4级组(59例),根据格拉斯哥昏迷评分(GCS)将患者分为轻型昏迷组(12～15分,34例)、中型昏迷组(7～11分,49例)和重型昏迷组(＜7分,23例),根据伤后30天格拉斯哥预后量表(GOS)将患者分为预后不良组(GOS评分1～3分,48例)和预后良好组(GOS评分4～5分,58例),另选择门诊体检部接诊的103例健康志愿者(对照组)。采用酶链免疫吸附试验检测血清NF-L、TSP-1水平。Spearman秩相关分析颅脑损伤患者血清NF-L、TSP-1水平与Fisher CT分级、GCS评分、GOS评分之间的相关性。Logistic回归分析影响颅脑损伤患者预后的危险因素,受试者工作特征(ROC)曲线分析血清NF-L、TSP-1水平预测颅脑损伤患者预后的价值。结果 颅脑损伤组血清NF-L、TSP-1水平均高于对照组(P＜0.05),Fisher CT分级3～4级组血清NF-L、TSP-1水平高于1～2级组(P＜0.05),重型昏迷组血清NF-L、TSP-1水平高于中型昏迷组和轻型昏迷组(P＜0.05),中型昏迷组血清NF-L、TSP-1水平高于轻型昏迷组(P＜0.05),预后不良组血清NF-L、TSP-1水平高于预后良好组(P＜0.05)。Spearman秩相关分析表明血清NF-L、TSP-1水平与Fisher CT分级呈正相关(r_s=0.622、0.593,P＜0.05),与GCS评分、GOS评分呈负相关(r_s=－0.589、－0.693;－0.629、－0.617,P＜0.05)。Logistic回归分析结果显示Fisher CT分级、GCS评分、NF-L、TSP-1与颅脑损伤患者预后相关(P＜0.01)。ROC曲线分析显示血清NF-L、TSP-1水平预测颅脑损伤患者预后的曲线下面积(AUC)分别为0.823、0.836,联合NF-L、TSP-1预测颅脑损伤患者预后的AUC为0.937,高于单独NF-L、TSP-1(P＜0.05)。结论 颅脑损伤患者血清NF-L、TSP-1水平显著升高,NF-L、TSP-1水平与颅脑损伤严重程度和预后密切相关,可作为预后评估的参考指标。