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1.
目的分析血浆8-异前列腺素F2α(8-iso-PGF2α)水平动态变化对评估感染性休克患者病情及短期预后的临床价值。方法选择我院就诊的78例感染性休克患者作为研究对象,均予以积极临床治疗,于治疗前、治疗第1、3、7天分别检测每位患者血浆8-iso-PGF2α、血清超敏C反应蛋白(hs-CRP)、白介素(IL)-1、肿瘤坏死因子(TFN-α)水平,同时评估感染相关器官功能衰竭评分(SOFA)以及急性生理和慢性健康状况评分(APACHEⅡ)。分析每个时间点血浆8-isoPGF2α水平与SOFA及APACHEⅡ的相关性。随访半年,根据患者预后结局分为生存组和死亡组。应用多元Logistic回归分析随访半年感染性休克患者预后的危险因素;应用ROC曲线评估血浆8-iso-PGF2α对感染性休克患者随访半年预后评估特异性和灵敏度。结果随着治疗时间增加,两组患者血浆8-iso-PCF2α及hs-CRP、IL-1、TFN-α水平进行性下降(P<0.05);而同时间点生存组患者的血浆8-iso-PGF2α水平均显著小于死亡组(P<0.05),但两组血清hs-CRP、IL-1及TFN-α差异无统计学意义(P>0.05)。各时间点的血浆8-iso-PGF2α水平与SOFA及APACHEⅡ均为正相关(P <0.05)。多元Logistic回归分析,血浆8-iso-PGF2α水平是随访半年感染性休克患者预后危险因素(P<0.05)。ROC曲线评估血浆8-iso-PGF2α水平对随访半年感染性休克患者预后不良有显著预测价值(P <0.05),且判定血浆8-iso-PGF2α水平切点为28. 7ng/mL时对预测随访半年感染性休克患者预后不良有85. 6%的灵敏度和78. 8%的特异性。结论血浆8-iso-PGF2α随治疗进行而降低,且对感染性休克患者预后判断有较高价值。  相似文献   

2.
目的 评估血浆凝溶胶蛋白(GSN)动态变化对重症多发性创伤患者预后结局判断的临床价值.方法 选择我院就诊的67例多发性创伤患者,按创伤严重程度评分(ISS)分为:重症组:31例,ISS评分大于25分;轻症组:36例,ISS评分不大于25分.于治疗的第1、3、7、14d分别检测并比较两组的血浆GSN、降钙素(PCT)、肿瘤坏死因子(TFN-α)、超敏C反应蛋白(hs-CRP)及白介素(IL)-1.随访6月,比较两组的APACHEⅡ评分以及阳性症状量表Ⅱ (SAPSⅡ)分值差异.依据预后结局分为:死亡组和生存组,比较两组上述指标的差异.应用多元Logistic回归分析上述指标与生存率的相关性.结果 两组患者的TFN-α、hs-CRP及IL-1各时间点数值差异无统计学意义(P>0.05),两组血浆GSN均随着治疗时间增加而增加(P<0.05),而血清PCT随着治疗时间增加而降低(P<0.05).与轻症组相比,重症组PCT、TFN-α、hs-CRP及IL-1水平在各时间均较高,而GSN水平在各时间均较低(P<0.05).随访6月后,重症组APACHEⅡ及SAPSⅡ分值显著高于轻症组(P<0.05).与死亡组相比,存活组GSN显著较高,而PCT、TFN-α及IL-1水平显著较低(P<0.05).血浆GSN是重症多发性创伤患者生存率的保护性因素,而PCT及APACHEⅡ是重症多发性创伤患者生存率的危险因素(P<0.05).结论 血浆GSN动态变化能有效评估重症多发性创伤患者预后结局.  相似文献   

3.
为探讨急性呼吸窘迫综合征肺泡炎症中IL-17A的表达及意义,选择急性呼吸窘迫综合征肺泡炎症患者98例,根据病情严重程度分为A组(轻度,36例)、B组(中度,32例)及C组(重度,30例),均进行IL-17A水平及中性粒细胞计数检测,比较3组患者血清IL-17A水平、中性粒细胞计数、急性生理学与慢性健康状况评分系统Ⅱ(acute physiology and chronic health evaluation scoring systemⅡ,APACHEⅡ)评分、序贯器官功能衰竭(sequential organ failure assessment,SOFA)评分及治疗前后血清IL-17A水平,分析不同预后患者血清IL-17A水平及其价值。结果显示,C组患者血清IL-17A水平、中性粒细胞计数、APACHEⅡ评分及SOFA评分均高于A组和B组,且B组高于A组(P0.05);3组患者治疗后血清IL-17A水平均低于治疗前,但C组血清IL-17A水平仍高于A组和B组,且B组高于A组(P0.05);经Pearson分析,IL-17A水平与APACHEⅡ评分、SOFA评分呈正相关(P0.05);经28 d随访,98例患者中存活60例,死亡38例,存活者血清IL-17A水平明显低于死亡者(P0.05);经受试者工作特征(receiver operating characteristic,ROC)曲线分析,AUC为0.859。研究提示,急性呼吸窘迫综合征肺泡炎症患者IL-17A的表达水平升高,动态监测IL-17A水平可判断病情进展及预后。  相似文献   

4.
蔡宏彩 《中国免疫学杂志》2022,38(24):3039-3043
目的:分析脓毒症患者血清穿透素-3(PTX-3)、胱抑素C(CysC)及IL-27水平变化及其与心肌损伤、病情严重程度及预后的相关性。方法:回顾性分析2014年3月至2019年12月于恩施州土家族苗族自治州中心医院接受诊疗的100例脓毒症患者临床资料,根据治疗前病情严重程度分为三组:常规组、严重组、休克组,依次为38、40、22例,比较三组血清PTX-3、CysC、IL-27水平,序贯器官衰竭评分(SOFA),心肌酶[肌酸激酶同工酶(CK-MB)、肌钙蛋白Ⅰ(cTnⅠ)]以及预后(ICU住院时间、机械通气时间及28 d死亡情况),并分析PTX-3、CysC、IL-27与心肌酶及预后的关系。结果:三组治疗前后PTX-3、CysC、IL-27、CK-MB、cTnⅠ水平以及ICU住院时间、机械通气时间水平由低至高均依次为常规组、严重组、休克组,三组间比较差异具有统计学意义(P<0.05);Spearman相关性分析显示,治疗前血清PTX-3、CysC、IL-27及SOFA评分与cTnⅠ、CK-MB均呈正相关(P<0.05);COX多因素分析显示急性心理学与慢性健康状况评分Ⅱ(APACHEⅡ)得分、ICU住院时间、机械通气时间及治疗前血清PTX-3、CysC、IL-27及SOFA评分水平与28 d病死率密切相关(P<0.05)。结论:血清PTX-3、CysC及IL-27与脓毒症患者病情程度、心肌损伤及预后紧密相关,建议临床密切监测以指导临床诊断及治疗。  相似文献   

5.
齐蕊 《四川生理科学杂志》2022,44(10):1868-1871
目的:分析本院急诊重度患者住院转归的影响因素.方法:选取2019年1月至2021年2月本院接收的急诊重度患者89例作为研究对象,依据患者30 d预后结局分为死亡组(n=30)与生存组(n=59).回顾性分析患者临床基线资料,多因素Logistic回归分析影响急诊重度患者住院转归的独立危险因素,受试者特征曲线(Receiver operating characteristic curve,ROC)分析各预后指标预测急诊重度住院患者病情转归的价值.结果:死亡组与生存组患者机械通气时间、血糖、C反应蛋白(c-reactive protein,CRP)、乳酸(Lactic acid,Lac)、急性生理与慢性健康评分Ⅱ(Acute physiology and chronic health evaluation Ⅱ,APACHE Ⅱ)、简化急性生理学评分Ⅱ(Simplified acute physiology score-Ⅱ,SAPSⅡ)、急诊脓毒症死亡风险评分(Mortality in emergency department sepsis,MEDS)、序贯器官衰竭评分(Sepsis-related organ failure assessment,SOFA)及格拉斯哥昏迷评分(Glasgow coma scale,GCS)比较均具有显著差异(P<0.05);多因素Logistic回归分析结果显示,Lac、GCS评分、SAPS Ⅱ评分、APACHE Ⅱ评分、MEDS评分为影响急诊重度患者死亡的独立危险因素(P<0.05);ROC曲线分析显示,Lac、GCS评分、SAPS Ⅱ评分、APACHEⅡ评分、MEDS 评分预测患者死亡的 AUC 分别为 0.720、0.784、0.665、0.739、0.753(P<0.05).结论:Lac、GCS评分、SAPSⅡ评分、APACHEⅡ评分、MEDS评分为影响急诊重度患者死亡的危险因素,临床可据此预测患者病情,采取个体化应对措施以改善预后.  相似文献   

6.
目的:探讨老年重症肺炎患者PCT、IL-18、PLT水平变化及其死亡的危险因素.方法:选取104例2018年10月~2019年12月我院收治的老年重症肺炎患者作为研究对象,根据患者入院28 d存活情况将其分为存活组(n=69)和死亡组(n=35).比较两组临床资料,并采用多因素Logistic回归分析法分析老年重症肺炎患者存活情况的影响因素.结果:104老年重症肺炎患者,入院28 d后69例存活,35例死亡,死亡率为33.65%.第1 d、第4 d、第7 d,死亡组血清PCT、IL-18水平升高,存活组血清PCT、IL-18水平降低,死亡组高于存活组(P<0.05).多因素Logistic分析结果显示,年龄高、APACHEⅡ评分高、有吸烟史、合并糖尿病、PCT升高、IL-18升高是老年重症肺炎患者死亡危险因素(OR=2.077;1.919;1.626;1.718,2.077,1.919,P<0.05),PaO2/FiO2升高是老年重症肺炎患者死亡的保护因素(OR=0.596,P<0.05).结论:老年重症肺炎患者死亡率较高,且老年重症肺炎患者死亡的危险因素与其年龄高、APACHEⅡ评分高、有吸烟史、血清PCT水平、血清IL-18水平升高、合并糖尿病、PaO2/FiO2降低等密切相关,临床可据此给予老年重症肺炎患者针对性治疗及干预措施,以改善老年重症肺炎患者预后情况.  相似文献   

7.
目的: 探讨B型钠尿肽(BNP)水平联合急性生理和慢性健康状况评分Ⅱ(APACHE Ⅱ)在评价危重病患者预后中的意义。方法: 对2009年10月至2010年2月期间进入暨南大学附属第一医院中心ICU病房的62例危重症患者在24 h内进行APACHE Ⅱ评分及测定血清BNP水平,分析两者与危重症患者的病死率、住院时间、机械通气的发生率及通气时间等主要预后指标的关系。结果: 62例患者存活44例,死亡18例,病死率为29.0%。其中死亡组APACHE Ⅱ评分值和血清BNP浓度均明显高于存活组(P<0.01)。APACHE Ⅱ评分、呼吸机使用率及病死率随BNP水平升高而升高。结论: BNP和APACHE Ⅱ评分的升高对危重症患者的存活、机械通气的发生率及通气时间、住院时间等主要预后指标的预测有重要意义。  相似文献   

8.
目的:探讨脓毒症患者血浆N末端脑钠肽前体(NT-proBNP)水平与患者预后的相关性。方法50例脓毒症患者为研究对象,检测血浆NT-proBNP、乳酸、C反应蛋白(CRP)水平,评估入院24h急性生理和慢性健康状态评分Ⅱ(APACHEⅡ)评分,比较不同病变程度及不同预后患者各指标差异,并比较各指标间相关性。结果严重脓毒症组、脓毒症休克组患者血浆NT-proBNP、乳酸、APACHEI、CRP均明显高于一般脓毒症组(<0.05);死亡组血浆各指标值均高于存活组(<0.05);NT-proBNP水平与乳酸、APACHE I 评分、CRP间呈正相关,相关系数分别为0.356,0.525,0.537(<0.05)。结论血浆NT-proBNP与患者预后密切相关,检测NT-proBNP水平有助于判断患者预后。  相似文献   

9.
观察脓毒症急性肺损伤患者外周血Th17细胞水平与病情严重程度及预后的关系,探讨其在脓毒症急性肺损伤发生发展中的临床作用。以190例脓毒症患者为研究对象,按临床表现分为脓毒症普通组(110例)和脓毒症肺损伤组(80例)。根据脓毒症肺损伤患者病情严重程度将其分为低危组(29例)、中危组(28例)和高危组(23例);按脓毒症肺损伤患者临床结局将其分为存活组(64例)和死亡组(16例)。采用流式细胞仪检测各组外周血Th17细胞比例,同时记录急性生理学与慢性健康状况(APACHE Ⅱ)评分情况,分别比较各组外周血Th17细胞比例及APACHE Ⅱ评分水平的差异以及Th17细胞水平与APACHE Ⅱ评分的相关性,评价外周血Th17细胞水平对脓毒症肺损伤患者病情严重程度与临床预后的评估价值。结果显示脓毒症肺损伤组患者外周血Th17细胞及IL-17水平明显高于脓毒症普通组患者(P0.05);低危组、中危组及高危组间外周血Th17细胞水平、IL-17及APACHE Ⅱ评分的差异具有统计学意义(P0.05),其中,高危组外周血Th17细胞水平、IL-17及APACHE Ⅱ评分最高,中危组次之,低危组最低(P0.05);死亡组外周血Th17细胞水平、IL-17及APACHE Ⅱ评分显著高于存活组(P0.05)。相关性分析显示,血清外周血Th17细胞水平与APACHE Ⅱ评分(r=0.81,P=0.00)及死亡率(r=0.43,P=0.00)呈正相关。ROC曲线分析显示,外周血Th17细胞水平曲线下面积(ACU)为0.842(95%CI:0.784~0.908),其最佳工作点为7.0%,此时判断脓毒症肺损伤患者预后不良的敏感度和特异度分别为81.83%和86.82%。研究表明脓毒症急性肺损伤患者外周血Th17细胞水平的增加与其病情严重程度及预后密切相关,其可作为一项有效的预测指标,具有一定的临床应用价值。  相似文献   

10.
探讨不同种类液体复苏治疗对严重脓毒症患者血清炎性细胞因子及预后的影响。将患者分为正常对照组(A组)、乳酸林格液组(B组)、4%白蛋白组(C组)及20%白蛋白组(D组)。ELISA法检测复苏前后血清TNF-α、IL-6、IL-4与IL-10水平,跟踪随访至复苏后28d,记录住院时间及死亡例数、计算比较各组患者的死亡率。结果发现复苏后12h,4组的TNF-α与IL-6水平均降低,但C组、D组显著高于A组、B组(P0.05);复苏后72h,4组水平继续降低,但B组高于A组、C组及D组,A组高于C组、D组,差异有统计学意义(P0.05)。复苏后12h,4组的血清IL-4与IL-10水平均有所升高,但C组、D组显著高于A组、B组(P0.05);复苏后72h,4组水平继续升高,但D组高于A组、B组及C组,C组高于A组、B组,差异有统计学意义(P0.05)。住院时间上A组与B组显著高于C与D组(P0.05),A组与B组、C组与D组差异无统计学意义(P0.05);液体复苏后28d各组患者的死亡率差异无统计学意义(P0.05)。复苏后12h与72h,TNF-α、IL-6与APACHEⅡ评分及死亡率均呈正相关(P0.05),IL-4、IL-10与APACHEⅡ评分及死亡率均呈负相关(P0.05)。Logistic回归分析显示复苏液体种类与死亡无关,而年龄增加、复苏前进行机械通气、复苏前APACHEⅡ评分较高及复苏液体的总用量增加均为脓毒血症患者死亡的独立危险因素(P0.05)。因此认为,生理盐水、乳酸林格液、4%白蛋白及20%白蛋白对严重脓毒症患者死亡率的影响没有显著差异;而白蛋白比起生理盐水与乳酸林格液更能快速降低严重脓毒症患者血清促炎因子水平,提高抑炎因子水平,减轻疾病严重程度,尤以20%白蛋白效果最好。  相似文献   

11.
分子成像能以非侵入性的方式重现活体细胞的生理功能和生物学过程,提高疾病的早期和特异性诊断水平。纳米颗粒/材料具有物理性质可控性高、易于表面修饰、血液循环时间长和可功能化等优点,在疾病诊断与治疗中显示出巨大潜力。但如何阐明纳米材料多功能间的内在联系、解决其代谢及安全性等关键机制难题、实现纳米颗粒/材料多功能性到临床多功能...  相似文献   

12.
Circulating monocytes comprise functionally distinct regular (CD14bright+) and mature (CD141low+) cells. Cell surface receptors were determined by three colour flow cytometry in 8 healthy control subjects. Compared to regular monocytes, mature monocytes had lower levels of the high affinity Fcy receptor 1 (CD64), complement receptor 3 (CDllb), CD45RO and higher levels for HLA-DR, LFA-1 (CD11a/CD18), interleukin-2 receptor (CD25), CD45RA and the Fc receptor 3 (CD16). Both regular and mature monocytes were measured before and up to three hours after four different types of exercise (Ex) in endurance trained athletes (n=9-16). Immediately after anaerobic exercise of I min with a maximal lactate concentration (lamax) of I2.3 (SD I.4) mmol · l–1 and exhaustive exercise of 24 (SD 8) min with a maximal lactate concentration (lamax) of 7.4 (SD 2.6) mmol· l–1 mature monocytes increased more than regular monocytes. Exhaustive endurance exercise of 87 (SD 21) min [lamax 3.7 (SD I.0)] led to a similar increase of regular and mature monocytes. 15–33 min after a 100km run regular monocytes increased significantly, whereas mature monocytes decreased. Up to three hours after the end of all exercises mature monocytes fell below pre-exercise values. In conclusion, duration and intensity of exercise alter distinct maturation stages of monocytes differently. It is probable that the avidity of adhesion molecules like LFA-1 to their endothelial ligands is increased to enable the firm attachment to the endothelium.  相似文献   

13.

OBJECTIVES:

Declines in cognition and mobility are frequently observed in the elderly, and it has been suggested that the appearance of gait disorders in older individuals may constitute a marker of cognitive decline that precedes significant findings in functional performance screening tests. This study sought to evaluate the relationship between functional capacities and gait and balance in an elderly community monitored by the Preventive and Integrated Care Unit of the Hospital Adventista Silvestre in Rio de Janeiro, RJ, Brazil.

METHODS:

Elderly individuals (193 females and 90 males) were submitted to a broad geriatric evaluation, which included the following tests: 1) a performance-oriented mobility assessment (POMA) to evaluate gait; 2) a mini-mental state examination (MMSE); 3) the use of Katz and Lawton scales to assess functional capacity; 4) the application of the geriatric depression scale (GDS); and 5) a mini-nutritional assessment (MNA) scale.

RESULTS:

Reductions in MMSE, Katz and Lawton scores were associated with reductions in POMA scores, and we also observed that significant reductions in POMA scores were present in persons for whom the MMSE and Katz scores did not clearly indicate cognitive dysfunction. We also demonstrated that a decline in the scores obtained with the GDS and MNA scales was associated with a decline in the POMA scores.

CONCLUSIONS:

Considering that significant alterations in the POMA scores were observed prior to the identification of significant alterations in cognitive capacity using either the MMSE or the Katz systems, a prospective study seems warranted to assess the predictive capacity of POMA scores regarding the associated decline in functional capacity.  相似文献   

14.
Context: GnRH immunity can reduce the expression of pituitary GnRH levels, and cause the changes in reproductive behaviors. It is unclear whether triptorelin (TRI) and cetrorelix (CET) immunity influences uterine development and expression of follicle-stimulating hormone receptor (FSHR), luteinizing hormone receptor (LHR), and estradiol receptor 1 (ERS1) in the uterus.

Objective: The study investigated the effects of active immunity of GnRH agonist and antagonist on uterine development, microstructures, expression of hormone receptors mRNAs, and proteins in uteri.

Materials and methods: One hundred and five mice were assigned into CET, TRI, and control groups (CG). Mice in CET-1, CET-2, and CET-3 (n?=?15) were subcutaneously injected with 10, 20, and 40?μg CET antigens for seven days, respectively. Mice in TRI-1, TRI-2, and TRI-3 were injected with 10, 20, and 40?μg TRI antigens for seven days, respectively. The qPCR and Western blot were implemented to determine expressions of ESR1, LHR and FSHR mRNAs, and proteins.

Results: Compared with CG, the uterine weights of CET-1, CET-2, and CET-3 increased by 42.86, 62.86, and 10.00% on day 35 (p?p?p?p?p?Conclusions: CET immunity promoted the uterine development, improved EET and UWT, and also promoted the expressions of ESR1 and FSHR protein levels. It lessened the LHR protein levels. TRI immunity blocked EET and UWT, inhibited uterine growth and development. The efficacy of CET immunity was more obvious than TRI.  相似文献   

15.
国际韧带和肌腱研讨会(The International Symposium on Ligaments and Tendons,ISI&T)于2000年在美国佛罗里达州奥兰多市首次召开。研讨会的宗旨是引起对韧带和肌腱研究的重视,并为生物工程师、生物学家、临床医师提供一个可以分享、评论、讨论韧带和肌腱最新研究成果的论坛。从2000年起,国际韧带和肌腱研讨会已经开展了15届;每届研讨会上涌现了大量令人振奋的关于当前韧带和肌腱研究热点和未来挑战的讨论。多年来,韧带和肌腱领域内的研究数量大幅增加,研究质量不断提升。为纪念《医用生物力学》杂志创刊30周年,本文总结过去30年里韧带和肌腱研究的主要进展,包括组织力学、力学生物学、损伤与治愈机制、组织修复和再生。  相似文献   

16.
17.
Cytochemical reactions of blood leucocytes and thrombocytes from six species of fish, rainbow trout (Onchorhynchus mykiss), coho salmon (Onchorhynchus kisutch), white sturgeon (Acipenser transmontanus), goldfish (Carassius auratus), striped bass (Morone saxatulis), and channel catfish (Ictalurus punctatus) were determined. Because the staining reactions were generally similar to the reactions found in mammalian leucocytes with similar morphological features, it is reasonable to classify fish leucocytes using the same terminology as is used for mammalian leucocytes. However, in some species leucocytes with features similar to mammalian eosinophils or basophils were not found. In goldfish leucocytes were found that had segmented nuclei and unstained, moderately refractile cytoplasmic granules. These cells were classified as segmented, granular leucocytes. Although these cells do not appear similar to any mammalian or avian leucocyte, the pattern of positive cytoplasmic alkaline phosphatase staining and negative granular staining is similar to that of equine eosinophils.  相似文献   

18.
对113例男性乳腺发育症进行临床病理分析。同时检测其中30例乳腺组织中雌激素受体和孕激素受体分布情况,结果发现两者阳性率分别为80.0%和83.33%。结合文献讨论了男性乳腺发育症的发生与高血清激素浓度及乳腺组织高受体水平的关系。  相似文献   

19.
20.
Phaeochromocytoma and paraganglioma (PHEO/PGL) are rare tumours with an estimated annual incidence of 3 per million. Advances in molecular understanding have led to the recognition that at least 30–40% arise in the setting of hereditary disease. Germline mutations in the succinate dehydrogenase genes SDHA, SDHB, SDHC, SDHD and SDHAF2 are the most prevalent of the more than 19 hereditary genetic abnormalities which have been reported. It is therefore recommended that, depending on local resources and availability, at least some degree of genetic testing should be offered to all PHEO/PGL patients, including those with clinically sporadic disease. It is now accepted that that all PHEO/PGL have some metastatic potential; therefore, concepts of benign and malignant PHEO/PGL have no meaning and have been replaced by a risk stratification approach. Although there is broad acceptance that certain features, including high proliferative activity, invasive growth, increased cellularity, large tumour nests and comedonecrosis, are associated with an increased risk of metastasis, it remains difficult to predict the clinical behaviour of individual tumours and no single risk stratification scheme is endorsed or in widespread use. In this review, we provide an update on advances in the pathology and genetics of PHEO/PGL with an emphasis on the changes introduced in the WHO 2017 classification of endocrine neoplasia relevant to practising surgical pathologists.  相似文献   

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