慢性肾小球疾病患者外周血P-选择素和ICAM-1的表达及意义

本文研究慢性肾小球肾炎 (CGN )、原发性肾病综合征 (PNS )和慢性肾衰 (CRF )等慢性肾小球疾病患者外周血血小板P 选择素和淋巴细胞的细胞间粘附分子 1(ICAM 1)的变化 ,并探讨其与治疗效果之间的关系。采用流式细胞仪对 3 0例CGN、 3 4例PNS和 3 4例CRF的外周血血小板P 选择素和淋巴细胞ICAM 1的表达水平进行定量检测。结果 ,( 1)CGN、PNS和CGF患者的P 选择素阳性细胞百分率与正常对照组比较 ,有显著性差异 (P <0 0 1) ;CGN、PNS和CGF患者的ICAM 1阳性细胞百分率与正常对照组比较 ,也有显著性差异 (P <0 0 1) ;( 2 )CGN、PNS和CGF患者中病情好转者 ,治疗后的P 选择素阳性细胞百分率较治疗前有明显的下降 (P <0 0 5 ) ;而ICAM 1于PNS、CRF组有明显下降 (P <0 0 1) ,于CGN组无明显变化 (P >0 0 5 )。 3组患者中病情无明显好转者 ,治疗前后的P 选择素和ICAM 1的阳性细胞百分率 ,均无显著性差异 (P >0 0 5 )。CGN、PNS和CRF等慢性肾小球疾病患者P 选择素和ICAM 1的表达水平增高 ,提示P 选择素和ICAM 1参与了这些慢性肾小球疾病的病理过程 ;P 选择素和ICAM 1表达水平的高低还与这些慢性肾小球疾病的治疗效果有密切关系 ,因此它们还可作为在临床判断治疗效果的指标。     

血浆血管内皮生长因子及血管紧张素Ⅱ与糖尿病肾病的关系

目的:检测糖尿病患者血浆血管紧张素Ⅱ(ATⅡ)和血管内皮生长因子(VEGF)浓度变化,并探讨二者之间关系及其在糖尿病肾病发生、发展过程中的作用。方法:98例Ⅱ型糖尿病患者分为两组,43例为糖尿病肾病组(DN),55例为糖尿病非肾病组(NDN)。分别测定各组患者血浆中血管紧张素Ⅱ、血管内皮生长因子、糖化血红蛋白(GHbAlc)及尿微白蛋白(UmALB)的含量。结果:DN组和NDN组患者ATⅡ、VEGF、GHbAlc及UmALB水平均明显高于正常对照组(P＜0.01);DN组ATⅡ、VEGF及UmALB明显高于NDN组(P＜0.01),但是GHbAlc水平在两组之间无显著差异(P＞0.05);各组糖尿病患者血浆ATⅡ和VEGF水平呈显著正相关(r=0.465,P＜0.05),血浆VEGF水平与尿微白蛋白呈高度正相关(r=0.540,P＜0.01)。结论:糖尿病患者血浆ATⅡ和VEGF明显升高,二者之间存在相互作用关系,可能共同参与糖尿病肾病的发生和发展过程。     

急性冠脉综合征患者血浆CRP,IL-6水平分析

目的 :通过对急性冠脉综合征 (ACS)患者与稳定型心绞痛 (SAP)患者血浆炎症标志物C反应蛋白(CRP)、白介素 6 (IL - 6 )水平的对比分析 ,探讨CRP、IL - 6与ACS的关系。方法 :选择ACS患者 5 7例分为急性心肌梗死组 (AMI组 ) 2 1例与不稳定型心绞痛组 (UAP组 ) 36例 ,其中不稳定型心绞痛组患者根据其病情的严重程度按Braunwald分级分成三组 :Ⅰ级 1 1例 ,Ⅱ级 1 0例 ,Ⅲ级 1 5例 ;对照组为稳定型心绞痛患者 4 8例。采用免疫比浊法测定患者血浆CRP水平 ,采用放射免疫分析法测定患者血浆IL - 6水平 ,并进行对比分析。结果 :AMI组和UAP组患者血浆CRP、IL - 6水平均高于对照组 (P <0 .0 1 ) ,且AMI组和UAP组两组间比较无显著性差异(P >0 .0 5 ) ;各组内CRP、IL - 6水平呈直线正相关 (P <0 .0 1 ,P <0 .0 5 )。结论 :ACS组患者血浆CRP、IL - 6水平显著升高并与疾病的严重程度有关 ,提示炎症在ACS的发病中可能起着重要作用     

血液透析患者血清SF、TSAT水平与营养状况的相关性分析

目的分析维持性血液透析(MHD)患者血清铁蛋白(SF)、转铁蛋白饱和度(TSAT)水平与营养状况的关系。方法选取MHD患者92例(MHD组)和健康体检者50例(对照组),所有受试对象均完成营养状况评估[改良主观综合营养评估法(MQSGA)]、营养生化指标检测[血清白蛋白(Alb)、血红蛋白(Hb)],并行血清SF、TSAT测定。根据MQSGA评分将MHD组进一步分为重度营养不良亚组、轻中度营养不良亚组、营养正常亚组。结果相较于对照组,MHD组BMI、TSF、MAC、HGS及血清A1b、血清Hb均明显降低(P <0.05),MQSGA评分明显增高(P <0.05)。MHD组血清SF明显高于对照组(P <0.05), TSAT明显低于对照组(P <0.05)。MHD患者不同营养状况亚组血清SF、TSAT水平比较差异有统计学意义(P <0. 05),随着营养不良状况越严重,患者血清SF逐渐增高(P <0. 05),TSAT逐渐降低(P <0.05)。相关性分析显示,MHD患者MQSGA评分与血清SF水平呈正相关(r=0.468,P<0.05),与TSAT水平呈负相关(r=-0.394,P<0. 05)。结论 MHD患者血清SF明显增高,TSAT明显降低,血清SF、TSAT水平可能与MHD患者营养不良相关。     

冠状动脉粥样硬化性心脏病细胞间黏附分子1基因 K469E多态性的研究

目的探讨细胞间黏附分子1(intercellularadhesionmolecule1,ICAM1)基因K469E多态性及其血浆水平与中国汉族冠状动脉粥样硬化性心脏病(简称冠心病)之间的关系。方法利用巢式PCR和免疫酶联吸附测定技术对160例冠心病患者和164名非冠心病对照进行ICAM1基因K469E多态性及其血浆水平的检测和对比分析。结果冠心病组K等位基因频率、ICAM1血浆水平均高于非冠心病对照组(P<0·05);含K等位基因的个体ICAM1血浆水平(344.34±128.59μg/L)高于不含K等位基因的个体(303·54±108·74μg/L),差异有统计学意义(P=0.008);且其患冠心病(心肌梗塞)的危险性升高(P=0.006,OR=2·158,95%CI:1.250~3.727);K等位基因与吸烟在影响冠心病发生危险性方面有协同作用。结论在中国汉族人群中存在ICAM1基因K469E多态性,其中K等位基因有可能是冠心病的遗传危险因素。     

阿托伐他汀对冠状动脉介入术后血管内皮功能的影响

目的 探讨阿托伐他汀对冠状动脉介入治疗后血管内皮功能的影响.方法 64例稳定型心绞痛患者随机分为阿托伐他汀治疗组(简称实验组,34例)和常规治疗组(简称对照组,30例),两组病例在冠脉介入治疗前后次日采血,用酶联免疫吸附试验( ELISA) 测定血浆假血友病因子表达水平;用放射免疫测定法测定血浆内皮素1(ET-1)的表达水平;用酶法测定血浆一氧化氮(NO) 的含量.结果 与本组PCI术前比较,两组血浆vWF、ET-1表达水平在介入治疗术后均有不同程度的升高(P < 0.05),血浆NO水平有所下降(P < 0.05);与对照组比较,实验组血浆vWF、ET-1表达水平在介入治疗术后均有不同程度的下降(P < 0.05),血浆NO水平有所升高(P < 0.05).结论 冠状动脉介入术前给予阿托伐他汀治疗可以保护血管内皮功能.     

雌激素替代疗法对老年高血压动脉硬化患者血浆内皮素与降钙素基因相关肽含量影响

目的　探讨老年高血压动脉硬化患者内皮功能损伤 ,血浆内皮素 (ET)、降钙素基因相关肽含量变化及雌激素替代疗法加服维生素 C、E联合治疗 ,对血浆 ET、降钙素基因相关肽 (CGRP)、血压、血脂 (TC、LDL C)含量影响。方法　测定 3 5例女性老年高血压动脉硬化患者女性激素 (E2 ) CGRP、ET、血脂 TC、CDLC含量 ,观察血压变化。以 2 8例女性健康老年人为正常对照组。用雌激素替代疗法 ,疗程 12周。结果　治疗前高血压组血浆 ET较对照组明显升高血压 (P<0 .0 5 ) TC、L DL C升高、血压升高。治疗后 ,高血压组 ET明显降低 (P<0 .0 5 )血压下降 ,CGRP、E2 升高 ,TC、 L DL C下降 ,结论　雌激素替代疗法可能对老年高血压动脉硬化患者血管内皮具有保护作用     

性早熟女童血清性激素,IGF-Ⅰ,Leptin含量及其意义

目的 :探讨血清雌二醇 (E2 )、促黄体生成素 (LH)、促卵泡刺激素 (FSH)、胰岛素样生长因子Ⅰ (IGF -Ⅰ )、瘦素 (Leptin)水平在女童特发中枢性性早熟 (ICPP)诊断中的价值。方法 :采用化学发光免疫分析 (CLIA)和放射免疫分析 (RIA)测定 35例以乳房早发育为主诉的性早熟女童血清E2 、LH、FSH、IGF -Ⅰ、Leptin水平。结果 :ICPP组血清E2 、LH、FSH、IGF -Ⅰ、Leptin水平明显高于SPT组 ,且差异有显著性 (P <0 .0 5 ,P <0 .0 1或P <0 .0 0 1 ) ,以基础LH/FSH >0 .2为阳性界限 ,用于诊断ICPP的阳性率为 86 6 % (1 3/ 1 5 ) ,SPT的阳性率为 2 0 % (4 /2 0 )。血清IGF -Ⅰ水平与E2 水平呈正相关 (r =0 .4 7,P <0 .0 1 )。血清Leptin水平与E2 、IGF -Ⅰ水平不相关。结论 :测定血清E2 、LH、FSH、IGF -Ⅰ、Leptin水平对ICPP早期诊断有较好的价值     

血浆microRNA-21水平与左室射血分数保留的心力衰竭相关性肺高压的关系

目的:探讨血浆微小RNA-21(miR-21)水平与左室射血分数保留的心力衰竭(HFpEF)相关性肺高压(PH-HFpEF)的关系。方法:选择2014年1月～2017年2月在江西省人民医院心内科就诊的HFpEF患者102例,通过三尖瓣反流压差法估测肺动脉收缩压(pulmonary artery systolic pressure,PASP),并按PASP分为PH-HFpEF组(n=36,PASP≥50 mmHg)和HFpEF组(n=40,PASP 50 mmHg),另选年龄和性别相应的同期健康体检者作为对照组(n=36),比较各组患者的临床资料,血浆miR-21水平与临床资料的相关性用Spearman相关分析,血浆miR-21水平预测PH-HFpEF准确性用受试者工作特征(ROC)曲线分析。多因素logistic回归分析与PH-HFpEF相关的危险因素。结果:PH-HFpEF组患者年龄、血浆内皮素1(ET-1)、血浆白细胞介素6(IL-6)、脑钠尿肽(BNP)和左房直径(LAD)均高于HFpEF组(P 0. 05)。PH-HFpEF组血浆miR-21表达明显高于HFpEF组及健康对照组(P 0. 05)。Spearman相关分析显示,血浆miR-21与PASP (r=0. 267,P=0. 000)、血浆IL-6 (r=0. 302,P=0. 013)和左心室重量指数(LVMI)(r=0. 515,P=0. 036)相关;血浆IL-6与ET-1正相关(r=0. 622,P=0. 002);PASP分别与血浆IL-6 (r=0. 36,P=0. 023)、ET-1 (r=0. 76,P=0. 004)、BNP (r=0. 43,P=0. 031)及LAD (r=0. 39,P=0. 044)正相关。血浆miR-21诊断PH-HFpEF的ROC曲线分析显示,曲线下面积为0. 8。多因素logistic回归分析显示,血浆miR-21相对表达水平、LAD、BNP与HFpEF患者肺高压相关。结论:血浆miR-21水平与PHHFpEF呈正相关,是HFpEF患者出现肺高压的独立预测因素。血浆miR-21可能是PH-HFpEF的标志物。     

丙型肝炎患者红细胞免疫功能与脂质过氧化物和补体受体(CR1)粘附活性相关的研究

目的 :研究丙型肝炎患者红细胞免疫功能与脂质过氧化物和补体受体CR1水平的关系。方法 :应用红细胞酵母花环法测定红细胞免疫功能 ,化学法测定血浆丙二醛 (MDA)、超氧化物歧化酶 (SOD)、谷胱甘肽过氧化物酶 (GSH -PX)含量 ,红细胞免疫粘附法测定CR1含量 ,并与 35名正常健康人比较。结果 :5 8例丙型肝炎患者RBC -IC花环率和MDA水平明显高于正常人组 (P <0 .0 1) ,而RBC -C3b、SOD ,GSH -PX、CR1水平明显低于正常 (P <0 .0 1) ,相关分析显示 :RBC -C3b花环、CR1的水平与MDA呈显著的负相关 (r =- 0 .4 0 12 ,P <0 .0 5 ) ,RBC -IC与MDA呈正相关 (r =0 .6 12 4 ,P <0 .0 1)。结论 :丙型肝炎患者红细胞免疫粘附功能降低和CR1水平的下降与活性氧代谢紊乱密切相关。     

Circulating levels of vascular endothelial markers in obstructive sleep apnoea syndrome. Effects of nasal continuous positive airway pressure

Introduction

Obstructive sleep apnoea syndrome (OSAS) is an important risk factor in cardiovascular disorders. Although the exact mechanism remains to be elucidated, the endothelial dysfunction process seems to be implicated.

Material and methods

In order to test this hypothesis, blood circulating levels of endothelial markers were measured at baseline and 1 year after treatment with continuous positive airway pressure (CPAP). We studied 37 males using polysomnography: 20 subjects with OSAS and a 17-subject control group. An OSAS-validated sleep questionnaire covering the most important cardiovascular risk factors was applied to all subjects. Furthermore, patients received a complete general physical examination and biochemistry test with lipid profile. The specific markers measured were intercellular cell adhesion molecule-1 (ICAM-1), E-selectin, endothelin-1, von Willebrand factor (vWF) and plasminogen activator inhibitor-1 (PAI-1).

Results

Obstructive sleep apnoea syndrome patients presented higher circulating levels of ICAM-1, endothelin-1 and PAI-1 than the control group. On the other hand, no differences were found in E-selectin and vWF. After 1 year of CPAP treatment, there was a significant decrease in circulating levels of ICAM-1 and PAI-1. On the other hand, no differences were found in endothelin-1, E-selectin and vWF.

Conclusions

Obstructive sleep apnoea syndrome is associated with elevated levels of ICAM-1 and PAI-1 and these levels normalize after treatment with CPAP.     

Human papillomavirus-16-E7 oncoprotein enhances the expression of adhesion molecules in cervical endothelial cells but not in human umbilical vein endothelial cells.

OBJECTIVES: E7 is one of the oncoproteins encoded by human papillomavirus-16 (HPV-16), the major etiologic factor responsible for cervical cancer. Human papillomavirus-16-E7 expressed by human uterine cervix carcinoma cells is also released in the extracellular compartment where it induces immune suppression. We investigated whether E7 was also responsible for the enhanced endothelial adhesiveness required in cancer progression. STUDY DESIGN/METHODS: We treated cervical microvascular endothelial cells (CrMVEn) and human umbilical vein endothelial cells (HUVEC) with E7, tumor necrosis factor-alpha (TNF-alpha), and hydrogen peroxide (H2O2) and measured the expression of E-selectin, intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1) by fluorescent-activated cell sorter analysis. RESULTS: E7 strongly induced the expression of E-selectin, ICAM-1, and VCAM-1 in CrMVEn, but not in HUVEC. Tumor necrosis factor-alpha further increased the endothelial expression of adhesion molecules in CrMVEn. Hydrogen peroxide pre-treatment resulted in an enhanced ICAM-1 and a decreased E-selectin and VCAM-1 expression. We also show indirect effects when endothelial cells were stimulated with the supernatant of E7-pretreated macrophages. CONCLUSIONS: These results show that HPV-16-E7 oncoprotein strongly induces adhesion molecules expression in organ-specific endothelial cells.     

Circulating adhesion molecules in sarcoidosis.

Sarcoidosis is a disease of unknown etiology characterized by non-caseating granulomata together with a number of systemic abnormalities. We have recently shown these include increased expression of the integrins CD11/CD18 on peripheral blood leucocytes. Here we have measured serum levels of the adhesion molecules intercellular adhesion molecule-1 (ICAM-1), E-selectin and vascular cell adhesion molecule-1 (VCAM-1) in 23 patients and 14 normal controls using antigen capture sandwich ELISAs. Median circulating E-selectin levels in the patients were nearly three times those of the controls (P < 0.0001, Mann-Whitney U-test), whilst ICAM-1 but not VCAM-1 levels were only slightly elevated. These results show that endothelial cell activation and shedding of E-selectin into the circulation are additional features of the pathology of sarcoidosis.     

流体切应力对内皮细胞粘附分子表达的影响

在动脉粥样硬化(Atherosclerosis,As)的发生发展中各种白细胞,包括单核细胞对内皮细胞的粘附可能起着较为重要的作用。在体内,血流切应力对内皮细胞的形态和功能有重要影响。为了阐明流体切应力对内皮细胞表面粘附分子表达的影响,本文研究了流体切应力(2.23～6.08dyne/cm     

联合应用氨溴索与小剂量肝素对急性肺损伤ICAM-1和EP-selectin的影响

目的: 制作急性肺损伤(ALI)模型并检测细胞间黏附分子-1(ICAM-1)、E-选择素和P-选择素在实验兔血清、肺组织及支气管肺泡灌洗液(BALF)中的变化情况以探讨三者在ALI中的作用并观察联合应用氨溴索与小剂量肝素对其的影响。方法: 24只健康兔随机分成3组:对照组(NC组),油酸损伤组(OA组),氨溴索＋小剂量肝素治疗组(AH组)。采用耳缘静脉法静注油酸复制兔ALI模型,检测各组动脉氧分压(PaO₂),ELISA法检测ICAM-1和E-选择素,TUNEL法检测凋亡指数(AI),免疫组化检测P-选择素,电镜观察肺组织超微结构变化并测定湿干重比值(W/D)。结果: 与NC组比较, OA组和AH组PaO₂显著降低(P<0.01),但AH组显著高于OA组(P<0.01); ICAM-1、E-选择素的浓度(血清、肺组织及BALF中)、肺组织AI和W/D升高(P<0.05或P<0.01),但AH组低于OA组(P<0.05或P<0.01)。与同组给予治疗药物前0 h比较,NC组无差异(P>0.05),OA组各时点PaO₂显著降低(P<0.01),ICAM-1和E-选择素浓度显著升高(P<0.01),AH组各时点PaO₂降低(P<0.05)、ICAM-1和E-选择素浓度升高(P<0.05)。肺组织中P-选择素在OA组表达较为广泛:主要为炎症细胞、毛细血管的内皮细胞和血管内的血浆等,NC组呈低水平表达,AH组的表达介于两者之间。细胞凋亡以OA组最为明显,NC组未见细胞凋亡或偶有凋亡,AH组凋亡的细胞明显比OA组减少。结论: 在OA致ALI时,ICAM-1、E-选择素和P-选择素明显增高,参与了ALI的发生、发展;联合应用氨溴索与小剂量肝素可以降低ICAM-1、E-选择素和P-选择素的水平,减轻肺脏细胞的损伤、改善肺通气和换气功能、减轻肺水肿,从而发挥对ALI的防治作用。     

阻塞性睡眠呼吸暂停低通气综合征患者细胞粘附分子水平的研究

目的探讨细胞粘附分子在阻塞性睡眠呼吸暂停低通气综合症(OS-AHS)发病中的作用。方法应用酶联免疫吸附法(ELISA)检测30例老年OSAHS患者及30例老年健康对照者血清可溶性细胞间粘附分子-1(ICAM-1)、血管细胞粘附分子-1(VCAM-1)和E-选择素的含量。结果OSAHS组血清ICAM-1、VCAM-1、E-选择素含量分别为245.22±71.19ng/ml、24.01±4.79ng/ml、和86.58±48.02ng/ml,均明显高于健康对照组(P<0.01),且随OSAHS程度的加重而明显升高。ICAM-1、E-选择素水平与睡眠呼吸暂停低通气指数(AHI)呈明显正相关(P<0.01);I-CAM-1水平与最低血氧饱和度(SaO2min)呈明显负相关(P<0.01)。结论OSAHS患者血清中可溶性粘附分子ICAM-1、VCAM-1和E-选择素水平可作为反映OSAHS严重程度的敏感指标。     

切应力和溶血磷脂酰胆碱对内皮细胞表面黏附分子表达的影响

在体内 ,内皮细胞的功能不仅受化学因子的调节 ,而且还受力学因素的影响。为探讨流体切应力和溶血磷脂酰胆碱 ( L ysophosphatidylcholine,L yso- PC)的双重作用对培养的人脐静脉内皮细胞 ( Hum an um bilical veinendothelial cells,HU VECs)表面黏附分子 ICAM- 1、VCAM- 1、E- selectin表达的影响 ,采用流式细胞仪技术检测了L yso- PC( 3 0 μg/m l)和流体切应力 ( 2 .2 3、4.2 0 dyne/cm2 )的协同作用下内皮细胞黏附分子表达的变化。结果显示 :在受剪切作用之前 ,用 L yso- PC孵育激活内皮细胞 ,或预先剪切后再用 L yso- PC孵育 ,内皮细胞的 ICAM- 1和VCAM- 1表达与两种刺激同时作用相比 ,显著增加 ( P<0 .0 5 ) ;切应力或 L yso- PC的单独作用 ,以及两种刺激同时存在对 HU VEC的 E- selectin表达无显著影响。而在受剪切作用之前 ,用 L yso- PC孵育激活内皮细胞 ,或预先剪切后再用 L yso- PC孵育 ,内皮细胞的 E- selectin表达与两种刺激同时作用相比 ,显著增加 ( P<0 .0 5 )。结论认为 :即使在不利于细胞黏附的力学环境中 ,流体切应力与 L yso- PC的协同作用 ,也可能是在炎症部位单核细胞对内皮细胞募集增加的重要原因之一     

Progress in computer-generated three-dimensional reconstruction

The expression of PECAM, ICAM-1, VCAM-1, and E-selectin was studied in 64 samples of human coronary arteries taken from 15 explanted hearts obtained within 5 min of transplantation. Normal artery (n=12), predominantly fibrous plaques (n=23), and plaques containing extracellular lipid (n=26) and three segments showing recanalization channels were studied. All endothelial cells strongly and equally expressed PECAM; positive staining was used to check that artefactual denudation of the endothelial surface had not occurred. PECAM was also present in some lipid-filled macrophages. Normal arteries showed no VCAM-1 staining but focal segments of the endothelium were positive for ICAM-1 and E-selectin. ICAM-1 was strongly and constantly expressed by the endothelium over all types of plaques and in macrophages. E-selectin expression was confined to endothelial cells and occurred on the surface in 35 per cent of fibrous and 22 per cent of lipid-containing plaques. VCAM-1 staining of surface endothelium occurred in 39 per cent of fibrous and 20 per cent of lipid-containing plaques. A population of spindle-shaped cells of macrophage type (positive for EMB11 antigen) expressed VCAM-1 in lipid-containing plaques. Adventitial vessels adjacent to plaques showed endothelial expression of ICAM-1 and E-selectin. VCAM-1 staining of adventitial vessel endothelium was associated with local lymphoid aggregation. In conclusion, the expression of cell adhesion molecules is an important element in the inflammatory component of atherosclerosis and contributes to both monocyte and lymphocyte activation and recruitment from advential vessels and the arterial lumen.     

Adhesion molecules (E-selectin, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1)) in sera from patients with Staphylococcus aureus bacteraemia with or without endocarditis

The aim of this prospective study was to evaluate if patients with endocarditis display a more extensive endothelial activation than those with bacteraemia but without endocarditis. Sixty-five patients with blood culture-verified Staphylococcus aureus bacteraemia were included and serum samples collected on admission were analysed by enzyme immunoassays. Elevated serum concentrations of adhesion molecules were found in most of the patients with S. aureus bacteraemia. Patients with endocarditis (n = 15) showed significantly higher serum E-selectin (median 156 ng/ml) and VCAM-1 (median 1745 ng/ml) concentrations compared with those with S. aureus bacteraemia but without endocarditis (80 ng/ml and 1172 ng/ml, respectively; P = 0.01 and P = 0.003). No significant difference was found between the groups concerning ICAM-1 (median 451 ng/ml versus 522 ng/ml). In addition, serum tumour necrosis factor-alpha (TNF-alpha) concentrations were significantly correlated (P < 0.002) to serum levels of E-selectin, ICAM-1 and VCAM-1.     

采用HA130型树脂灌流器血液灌流对维持性血液透析患者微炎症的影响

背景：研究发现维持性血液透析的尿毒症患者体内存在“微炎症状态”。 目的：观察采用HA130型树脂灌流器行血液灌流对维持性血液透析患者微炎症的影响。 方法：选取维持性血液透析治疗的尿毒症患者60例,随机分为2组,灌流组采用HA130型树脂灌流器串联血液透析器进行血液灌流加血液透析治疗;透析组行单纯血液透析治疗。采集治疗前后两组患者的血清,检测高敏C-反应蛋白、肿瘤坏死因子α和白细胞介素6水平。 结果与结论：灌流组血清高敏C-反应蛋白、白细胞介素6和肿瘤坏死因子α水平治疗后较治疗前显著降低(P < 0.05);透析组治疗后上述指标较治疗前略升高,差异无显著性意义。提示血液灌流可以降低维持性血液透析患者血清高敏C-反应蛋白、白细胞介素6和肿瘤坏死因子α水平,有利于减轻其微炎症反应。