糜蛋白酶联合锡类散灌肠治疗溃疡性结肠炎的疗效及对患者炎症反应和免疫功能的影响

目的：观察糜蛋白酶联合锡类散保留灌肠疗法对溃疡性结肠炎（UC）的临床疗效,以及对血清炎症因子和外周血辅助性 T 细胞（Th17）、调节性 T 细胞（Treg）的影响。方法：收集 158 例 UC 患者临床资料,随机数字表法分为治疗组83 和对照组 75 例。对照组给予美沙拉嗪肠溶片口服、保留灌肠,同时灌肠液中加入庆大霉素、氟美松,治疗组在对照组基础上加用糜蛋白酶、锡类散保留灌肠。根据 Mayo 评分标准,两组患者分为轻、中、重度 3 个亚组。治疗两个疗程后评价两组患者临床有效率、Mayo 评分、内镜评分改善情况。检测正常人群和治疗前后两组患者血清炎症因子（ESR、CRP、TNF-α、IL-6）的表达,流式细胞仪检测 Th17 细胞和 Treg 细胞的表达。结果：治疗组患者总有效率为 94.0%,观察组为77.3%,治疗组有效率高于对照组（P<0.05）。治疗后治疗组患者 Mayo 评分、内镜 Baron 评分为（2.25±1.39）、（1.13±0.95）,对照组为（3.61±1.61）、（1.60±0.99）,治疗组变化更明显（P<0.05）。TNF-α 和 IL-6 表达水平、Th17 细胞数与 UC 分级呈显著正相关,Treg 细胞数与 UC 分级呈显著负相关（P<0.01）。治疗后血清 ESR、CRP、TNF-α、IL-6 表达值下降,治疗组为（11.17±8.01）mm/h、（6.55±5.47）mg/L、（56.42±19.97）ng/L、（154.81±32.29）ng/mL,观察组为（18.07±8.62）mm/h、（16.49±8.32）mg/L、（74.08±20.07）ng/L、（177.47±30.01）ng/mL。Th17 细胞数减少：治疗组（3.18±1.02）、观察组（4.20±1.08）;Treg 细胞数增加：治疗组（8.61±1.52）、观察组（7.50±1.67）;治疗组较对照组变化更明显（P<0.05）。结论：糜蛋白酶联合锡类散保留灌肠疗法治疗 UC 临床效果显著,能明显减轻 UC 患者炎症反应,调节免疫功能。     

补气平肠愈疡汤联合美沙拉嗪治疗溃疡性结肠炎的效果研究

目的:探讨补气平肠愈疡汤联合美沙拉嗪治疗溃疡性结肠炎的疗效及其对患者血清炎症因子的影响。方法:选取溃疡性结肠炎患者84例,采用随机数字表法分为观察组和对照组各42例。对照组给予美沙拉嗪口服,观察组在对照组的基础上给予补气平肠愈疡汤口服联合灌肠治疗。4周后评价两组疗效、症状积分改善、血清炎症因子(TNF-α、IL-6和IL-8)及复发情况有无差异。结果:对照组和观察组总有效率分别为69.0%和90.5%,观察组显著高于对照组(P0.05);治疗前两组患者腹痛、腹泻和黏液脓血便等症状积分无统计学差异(P0.05);治疗后两组腹痛、腹泻和黏液脓血便等症状积分均明显改善(P0.05),且观察组改善更为显著(P0.05),观察组治疗前后差值显著高于对照组(P0.05);治疗前两组患者血清炎症因子(TNF-α、IL-6和IL-8)无统计学差异(P0.05),治疗后观察组血清炎症因子(TNF-α、IL-6和IL-8)均显著低于对照组(P0.05),观察组治疗前后差值显著高于对照组(P0.05);对照组治愈后随访半年,复发7例,复发率为43.8%(7/16),观察组复发4例,复发率为18.2%(4/22),对照组复发风险显著高于观察组(HR=2.9,P0.05)。结论:美沙拉嗪联合补气平肠愈疡汤治疗溃疡性结肠炎,可提高疗效,减轻炎症反应和临床症状,降低复发风险。     

白细胞介素-6抑制白细胞介素-1β诱导的兔纤维环细胞凋亡的研究

目的探讨白细胞介素(IL)-6对IL-1β在体外诱导兔纤维环细胞凋亡作用的影响。方法以10μg/L浓度的IL-1β诱导体外培养的原代兔纤维环细胞发生凋亡,然后分别加入10μg/ L和100μg/L的IL-6以影响纤维环细胞凋亡进程。对细胞行Annexin-V-PI染色和Caspase-9功能染色,采用流式细胞仪检测结果。结果IL-1β诱导下,凋亡纤维环细胞比例由(2.67±1.08)%上升至(20.37±1.57)%,而在两种浓度IL-6的干预下,细胞凋亡比例分别为(18.17±4.68)%和(9.42±1.27)%,与IL-1β诱导退变的纤维环细胞差异有统计学意义(P＜0.05)。而Caspase-9功能阳性细胞也由(19.40±0.98)%分别降至(15.13±1.45)%和(10.17±2.50)%(P＜0.05)。结论IL-6对IL-1β诱导的体外兔纤维环细胞凋亡有明显的抑制作用,这种抑制作用可能是通过抑制纤维环细胞内Caspase-9的激活实现的。对IL-6抑制作用的进一步研究,将有助于明确椎间盘细胞凋亡的调控途径,为椎间盘退变的治疗寻找新切入点。     

白细胞介素-6蛋白在间质性膀胱炎组织的表达及其临床意义

目的 观察白细胞介素-6(IL-6)蛋白表达及钾离子敏感试验(PST)与间质性膀胱炎(IC)的关系.方法 12例IC患者为实验组(男6例,女6例),12例Ⅲ型前列腺炎患者为对照组.分别比较2组PST评分、膀胱黏膜肥大细胞的数目、IL-6蛋白表达的差异.结果 实验组PST评分数(3.75±0.62)高于对照组(0.17 ±0.39),差异有统计学意义(P＜0.05).实验组标本中肥大细胞数目明显高于对照组,且多存在于黏膜下层.实验组IL-6免疫组织化学评分(IHS,5.08±1.78)高于对照组(1.08±0.29),差异有统计学意义(P＜0.05).结论 IL-6高表达和PST高评分可以有效提示IC存在.     

IL-17A及Th17在炎症性肠病中的作用

目的:检测IL-17A、IL-10、IFN-阍诨航馄谘字⑿猿觃(inflammatory bowl disease,IBD)患者中的表达,探讨诸炎症因子及Th17在炎症性肠病的发病及治疗中的作用.方法:应用ELISA检测12例Crohn病(Crohn disease,CD)、46例溃疡性结肠炎患者(ulcerative colitis,uc)和20例健康人(正常对照组)血清中IL-17A、IL-10和IFN-愕乃剑⒂妹庖咦橹炸检测CD、UC及正常对照组结肠黏膜局部IL-17A的表达.结果:正常对照组结肠黏膜局部未检测到IL-17A的表达,而UC和CD组在结肠黏膜活组织中均检测到IL-17A的表达.同样UC和CD组血清中IL-17A明显增高,而正常对照组血清未检出IL-17A;UC和CD组患者血清IL-10水平均较对照组升高(P<0.05),且CD组明显高于UC组(P<0.05);CD、UC组与正常对照组血清中IFN-愕谋泶锊钜煳尥臣蒲徕襙(P>0.05).结论:IL-17A不仅在缓解期IBD患者结肠黏膜局部表达,同时在其血清中高表达,提示Th17及其分泌的IL-17A在缓解期IBD患者的发病过程中起重要作用,并伴随促炎因子和抑炎性因子失调.     

严重烫伤大鼠休克期淋巴循环动力学及淋巴液中肿瘤坏死因子α和白细胞介素6、8水平的变化

目的观察严重烫伤大鼠休克期淋巴管运动变化及淋巴液中肿瘤坏死因子(TNF)α、白细胞介素(IL)6 、IL-8水平的变化. 方法将36只雄性Wistar大鼠造成30%TBSAⅢ度烫伤后,随机分为补液组(18只)和未补液组(18只);另设对照组(6只,不烫伤).用放射免疫分析法检测各组大鼠淋巴液中TNF-α、IL-6、IL-8水平,利用倒置显微镜及录像系统观察大鼠伤后6、24、48 h的肠系膜淋巴管运动变化,计算淋巴管收缩频率.经乳糜池插管收集淋巴液,计算淋巴液流速并行组织学观察. 结果伤后6 h两组烫伤大鼠TNF-α、IL-6增多,24 h达高峰,此时补液组TNF-α(1.61±0.27)μg/L,IL-6(398±67)ng/L;未补液组TNF-α(1.86±0.34)μg/L,IL-6(572±97)ng/L,两组间比较差异,有统计学意义(P<0.01),且各时相点浓度均显著高于对照组(P<0.01).伤后24 h两组烫伤大鼠IL-8浓度开始升高,直至48 h升高更明显,此时补液组为(540.29±0.32)ng/L,未补液组为(863.48±0.16)ng/L,两组间比较差异有统计学意义(P<0.01),且显著高于对照组(P<0.01).两组烫伤大鼠淋巴管收缩频率较低,尤以伤后24 h为明显(P<0.01) , 淋巴液流速各时相点均升高(P<0.01) ;镜下见小肠绒毛中央乳糜管扩张. 结论严重烫伤大鼠休克期淋巴管扩张,运动频率减少,但淋巴液流速加快,淋巴液中TNF-α、IL-6、IL-8的水平升高.液体复苏能够改善淋巴循环.     

白细胞介素-23和白细胞介素-15在过敏性紫癜患者血清中的表达及临床意义

目的:探讨白细胞介素-23(IL-23)、白细胞介素-15(IL-15)在过敏性紫癜(HSP)患者血清中的表达及临床意义.方法:选取2014年3月-2016年12月我院41例HSP患者(观察组),同期体检健康者37例设为对照组.观察组于入院后第二天清晨、对照组于体检当日取空腹静脉血检测血清IL-23和IL-15水平.41例HSP患者于治疗2周后,根据临床疗效分为有效组(n=29)与无效组(n=12),再取血清测定IL-23和IL-15水平进行比较.结果:观察组血清IL-23、IL-15水平高于对照组,差异有统计学意义(P＜0.05):治疗2周后,有效组患儿血清IL-23、IL-15水平显著低于无效组,差异有统计学意义(P＜0.05).结论:IL-23与IL-15可能参与了HSP发病过程,检测血清IL-23、IL-15水平有利于辅助临床有效评估HSP治疗效果.     

白细胞介素-17和白细胞介素-6在肝内胆管细胞癌的表达及其临床意义

目的 探讨肝内胆管细胞癌(ICC)白细胞介素-17(IL-17)和白细胞介素-6(IL-6)表达的临床意义.方法 采用免疫组织化学Envision二步染色法检测69例ICC肿瘤组织和63例癌旁组织IL-17和IL-6的表达,分析两者的关系及其与临床病理特征和预后的关系.结果 肿瘤和癌旁组织中IL-17+细胞密度中位值分别为36.0/HP(每高倍视野)和8.0/HP;肿瘤组织IL-17低表达组和高表达组IL-6阳性表达率分别为46.9％和75.0％;IL-17和IL-6的表达呈正相关(r=0.256,P＜0.05);肿瘤组织IL-17低表达组术后生存时间较长(P＜0.01),Cox多因素分析提示肿瘤组织IL-17表达水平( HR=2.462,P＜0.05)是ICC患者术后的独立预后因素.结论 ICC肿瘤组织IL-17表达与IL-6表达呈正相关,与ICC患者术后生存呈负相关,可作为预测患者预后的指标.     

曲马多术后镇痛对腹腔镜胆囊切除术患者血清白细胞介素-2和白细胞介素-6水平的影响

目的 研究通过曲马多用于腹腔镜胆囊切除术患者静脉自控镇痛(patient-controlled intravenous analgesia,PCIA),观察其术后视觉模拟评分(visual analogue score,VAS),镇静(Ramsay)评分以及对血清白细胞介素-2(IL-2)及白细胞介素-6(IL-6)水平的影响,探讨曲马多用于静脉自控镇痛效果及对机体免疫功能的影响.方法 选择40例行择期腹腔胆囊切除术的的患者,ASA Ⅰ或Ⅱ级,用信封法随机分为两组,每组20例:Ⅰ组(芬太尼组),Ⅱ组(曲马多组).观察记录术后2、4、24 hVAS评分,Ramsay评分,以及血清IL-2,IL-6水平,并记录副作用. 结果 两组患者术后2、4、24 hVAS、Ramsay评分、PCIA有效按压次数差异无统计学意义(P＞0.05).与诱导前比较Ⅰ组为(12.4±2.0),Ⅱ组为(12.1±2.1),Ⅰ、Ⅱ组血清IL-2水平术后2h明显升高,Ⅰ组为(16.8±2.4),Ⅱ组为(17.4±2.6)(P＜0.05),持续至术后24 h(P＜0.05),两组组间比较差异无统计学意义(P＞0.05).与诱导前比较,Ⅰ、Ⅱ组血清IL-6水平比较差异无统计学意义(P＞0.05),两组患者术后不同时间点血清IL-6水平比较差异无统计学意义(P＞0.05). 结论 与本研究中芬太尼剂量相比,曲马多用于腹腔镜胆囊切除手术术后镇痛能产生良好的镇痛效果,促进机体的免疫功能并有效地抑制术后应激反应.     

高容量血液滤过对外周血细胞因子的影响

目的研究高容量血液滤过(HVHF)对外周血肿瘤坏死因子(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素6(IL-6)的清除作用。方法18例重症急性肾功能衰竭(ARF)患者,随机选择10例行HVHF,另8例为对照组,行血液透析(HD)。酶联免疫法检测治疗前和治疗1h、2h、4h、6h和8h时血、超滤液及透析液中TNF-α、IL-1β、IL-6的浓度(单位均为ng/L)。结果(1)HVHF组9/10例、HD组6/8例患者肾功能恢复正常;(2)HVHF组治疗前血TNF-α1784±437、IL-1β960±173、IL-61320±325分别与治疗后4h1267±401、519±127、761±259比较,差异有显著性意义,P＜0.01;超滤液中未能检测出TNF-α,但可持续检测到IL-1β、IL-6;(3)HD组治疗过程中TNF-α、IL-1β、IL-6血中浓度无明显变化,透出液中未检测出上述细胞因子。结论HVHF可通过对流作用清除大量的细胞因子;AN69滤器对细胞因子有吸附作用。     

Increase of interleukin-6 plasma levels after elective craniotomy: Influence of interleukin-10 and catecholamines

Summary Accidental and operative trauma are able to induce a systemic reaction of the organism characterized by fever, leukocytosis, catabolism, and an activation of the coagulation system. Interleukin-6 (IL-6) has been found to be an important mediator of this acute-phase response. In this study the influence of elective craniotomy on IL-6 plasma levels was evaluated. Blood samples were obtained from 20 patients undergoing elective craniotorny for vascular or tumorous diseases of the brain. IL-6 increased significantly (p < 0.05) from the pre-operative (0 (0–5.4) pg/ml) to the intraoperative (180 min after beginning of surgery) time-point (10.6 (0–18.5) pg/ml). The maximum was reached on the first postoperative morning (13.9 (4.3–45.0) pg/ml). Interleukin-10 (IL-10) is an anti-inflammatory cytokine which suppresses IL-6 synthesis in vitro in various cell lines. IL-10 plasma concentrations showed no alterations throughout the study period. Epinephrine plasma concentrations increased significantly from pre-operative values (15 (0–74) pg/ml) to the postoperative time-point (57 (9–459) pg/ml). A 4.5-fold increase (p < 0.05) of norepinephrine plasma concentrations was found when comparing the data obtained 60 min after beginning of surgery with the data of the first postoperative morning. In monocytes, which are a major source of plasma IL-6, an elevation of intracellular cAMP stimulates the IL-6 synthesis. The postoperative maximum of IL-6 in plasma could be due to a release of catecholamines. In conclusion this study demonstrated an elevation of IL-6 plasma concentrations during and after elective craniotomy. Increased plasma catecholamine concentrations as well as a damage in the blood-brain barrier due to the surgical trauma with a spill-over of IL-6 from brain tissue into plasma could have contributed to this result.     

不育症患者精浆IL-1β、IL-4、IL-10含量测定及临床意义

目的 :观察男性不育症患者精浆中白细胞介素 1β(IL 1β)、白细胞介素 4 (IL 4 )、白细胞介素 10 (IL 10 )含量 ,及其与精子的各项功能指标之间的相互关系。　方法 :应用放射免疫分析 (RIA)技术 ,对 12 6例男性不育症和 2 0例正常生育者精浆中IL 1β、IL 4、IL 10含量进行检测。根据精子密度将不育症患者分为A组 (精子密度≥ 2 0× 10 6/ml)、B组 (精子密度 <2 0× 10 6/ml)和C组 (无精子症者 ) 3组 ;根据精子活动力、活动率将A组分别分为精子活动力正常组和不良组 ,精子活动率正常组和下降组 ;根据不育症患者血清抗精子抗体 (AsAb)检测结果、精液中WBC多少分为AsAb阳性组和阴性组 ,WBC精液组和非WBC精液组。根据生育组检测结果 ,将不育A组和B组分为精子穿透力正常组和下降组 ,精子顶体完整率正常组和下降组 ,精子尾部肿胀率正常组和下降组。　结果 :不育症组精浆IL 1β含量显著高于生育组 (P <0 .0 1) ,IL 4、IL 10含量显著低于生育组 (P <0 .0 1)。不育症组精浆中IL 1β、IL 4、IL 10含量在WBC精液组与非WBC精液组、血清AsAb阳性组与阴性组之间差异均有显著性 (P <0 .0 5或P <0 .0 1) ;IL 4含量在不育症组精子活动力、活动率、精子穿透力、顶体完整率、尾部肿胀率正常与减少之间差异均有显著性 (P <0     

不同严重程度急性胰腺炎大鼠IL-17、IL-23的表达及其相关性

目的探讨不同严重程度的急性胰腺炎(acute pancreatitis,AP)中白细胞介素-17(interleukin-17,IL-17)和白细胞介素-23的表达及其相关性。方法 SD大鼠72只,随机分为4组(n=6):重症急性胰腺炎组(severeacute pancreatitis,SAP)、轻型急性胰腺炎组(mild acute pancreatitis,MAP)、SAP+地塞米松组和假手术组(shamoperation,SO)。造模成功后3h、6h和12h分批处死各组大鼠,采用酶联免疫吸附试验(ELISA)法检测各组鼠血清IL-17、IL-23表达水平。结果与SO组相比,SAP组、MAP组和SAP+地塞米松组在各个时间点均出现了不同程度的急性胰腺炎的病理变化,造模成功。与MAP组及SAP+地塞米松组相比,各个时间点SAP组的血清IL-17、IL-23表达水平显著增高,差异有统计学意义(P0.05);相关性分析结果提示血清IL-17、IL-23和AP严重程度呈显著正相关(r=0.866,P0.01;r=0.855,P0.01)。结论 IL-17、IL-23的表达水平能较准确地预测急性胰腺炎的严重程度,对临床上重症急性胰腺炎的早期诊断具有一定的价值。     

Comparison of surgical stress between laparoscopy and open surgery in the field of urology by measurement of humoral mediators

BACKGROUND: Recently, laparoscopic procedures have become more common in urological surgery, and are suggested to be less stressful compared with open surgery; however, little data on objective evaluation of surgical stress after laparoscopic surgery are available. The objective of this study was to compare surgical stress between laparoscopic and open surgery in the field of urology by measurement of humoral mediators. METHODS: Blood samples were obtained from 25 patients who underwent laparoscopic surgery (laparoscopic radical prostatectomy, 10; retroperitoneoscopic nephrectomy or nephroureterectomy, seven; laparoscopic adrenalectomy, five; and hand-assisted laparoscopic radical nephrectomy, three) and 10 who underwent open surgery (retropubic radical prostatectomy, four; radical cystectomy, three; and radical nephrectomy, three), 48 h before surgery, during surgery, and 24, 48 and 96 h after surgery. Serum levels of interleukin (IL)-6, IL-10 and granulocytic elastase in these samples were measured, and the results were analyzed with respect to several clinical factors. RESULTS: In both groups, IL-6 and granulocytic elastase levels increased during surgery and reached maximum levels 24 h after surgery; the increase in granulocytic elastase tended to be prolonged compared with that of IL-6. Changes in IL-10 levels in the open surgery group were similar to those of IL-6 and granulocytic elastase levels, whereas IL-10 levels in the laparoscopic surgery group reached a maximum level during surgery and then decreased to the same level as at 48 h before surgery, on the first postoperative day. The maximum levels of these three mediators in the laparoscopic surgery group were significantly lower than those in the open surgery group. IL-6 was closely associated with the interval of fasting and duration of hospitalization after surgery. CONCLUSION: Although the present study was based on retrospective and non-randomized analysis, the findings suggest that serum levels of IL-6, IL-10 and granulocytic elastase are useful as objective markers of surgical stress, and that laparoscopic surgery is markedly less stressful than open surgery.     

Lower prevalence of IL-4 receptor alpha-chain gene G variant in very-low-birth-weight infants with necrotizing enterocolitis

Background/purpose: Altered production of immunoregulatory cytokines is associated with the development of necrotizing enterocolitis (NEC) in preterm very low-birth-weight (VLBW) infants. According to data obtained in adults, functional genetic polymorphisms influence cytokine production capacity. The aim of this study was to evaluate whether functional polymorphisms of interleukin (IL)-1β, IL-4 receptor α-chain (IL-4ra), IL-6, and IL-10 genes might be associated with the risk of NEC in VLBW infants.Methods: Dried blood spot samples of 46 VLBW infants with NEC were analyzed using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) methods. Samples from 90 VLBW infants without NEC were used as controls.Results: Infants with NEC carried the mutant variant of IL-4ra less frequently than controls (0.125 v 0.224; P < .05) even after adjustment for risk factors of NEC. No significant differences were found in the allelic frequencies of IL-1β, IL-6, and IL-10 genes between NEC and control infants.Conclusions: Carrier state of IL-4ra mutant allele might be associated with lower risk of NEC in VLBW infants. This genetic variant is associated with enhanced IL-4 effect. IL-4 is a major regulator of Th1-Th2 shift. The authors hypothesize that infants carrying the IL-4ra mutant allele might have Th2 skewness that might defend against the development of NEC.     

血清白介素-6、白介素-10、C-反应蛋白对全关节置换术后早期感染的诊断价值

目的探讨血清白介素(IL)-6、IL-10、C-反应蛋白(CRP)对全关节置换术后早期感染的诊断价值。方法选择人工髋、膝关节置换术(观察组)患者38例,同时设立健康人员对照(对照组)34例,以化学发光免疫法测定IL-6、IL-10水平,采用免疫比浊法测定CRP水平,观察患者关节置换术前1 d及术后1、3、5、7d血清IL-6、IL-10、CRP水平的变化。结果对照组血清IL-6、IL-10、CRP水平分别为(3.24±0.56)ng/L、(8.15±2.28)ng/L、(1.68±0.31)mg/L。术前1 d观察组与对照组比较,IL-6、IL-10、CRP水平差异无统计学意义(P0.05)。术后1、3、5 d观察组IL-6、IL-10、CRP水平均明显高于对照组,差异有统计学意义(P0.05)。术后7 d观察组IL-6、IL-10水平与对照组比较无明显差异(P0.05),CRP水平明显高于对照组(P0.05)。观察组患者术后1 d血清IL-6、IL-10水平明显升高,术后3、5、7 d逐渐下降(P0.05),术后1、3 d血清CRP水平逐渐增加,术后5、7 d逐渐下降(P0.05),术后7d患者血清IL-6、IL-10水平与术前1 d比较差异无统计学意义(P0.05),术后7 d血清CRP水平高于术前1 d(P0.05)。结论血清IL-6、IL-10及CRP均能于早期反映全关节置换术后炎症状态,但IL-6、IL-10更敏感、准确率更高,对早期诊断全关节置换术后感染更有价值。     

IL-10、IL-8在慢性前列腺炎中的改变及意义

目的 :研究白细胞介素 10 (IL 10 )和IL 8在慢性前列腺炎 (CP)发病机制和诊断中的作用。　方法 :随机选择各种类型的CP患者 2 9例 ,通过详细询问前列腺炎相关病史和临床症状、直肠指检前列腺及前列腺按摩液 (EPS)分析、及对部分患者进行按摩前列腺前后的尿液培养 (PPMT)法来诊断CP。选择 11例生殖功能正常的健康男子作对照。双抗体夹心ELISA法定量分析按摩前列腺后获取的精确控制的前段尿液 (VB3)内的IL 10和IL 8水平。　结果 :具有临床症状的 8例CP患者VB3中IL 10水平 [(4 7.1± 4 .5 )pg/ml]明显高于 11例健康对照者 [(4 0 .8± 5 .7)pg/ml]和 2 1例不育症中的Ⅳ型前列腺炎者 [(4 2 .7± 6 .7)pg/ml],P <0 .0 5 ;具有临床症状的 8例CP患者VB3中IL 8水平 [(1386 .2± 85 2 .6 )pg/ml]和不育症中的 13例Ⅳ型CP患者IL 8水平 [(12 0 3.8± 80 7.8)pg/ml]明显高于 7例健康对照者 [(4 12 .1± 2 17.2 )pg/ml],P <0 .0 5。　结论 :IL 10和IL 8在CP发病机制和诊断中具有重要意义 ,并可以用VB3来代替EPS或精液进行检测。     

Pre-transplant elevations of interleukin-12 and interleukin-10 are associated with acute rejection after renal transplantation

BACKGROUND: Methods for predicting patients at higher risk for rejection before transplantation may help improve outcomes. We hypothesized that pre-transplant elevations of serum interleukin-12 (IL-12), a pro-inflammatory cytokine, would predict acute rejection, while pre-transplant IL-10, an immunoregulatory cytokine, would be down-regulated in patients subsequently experiencing acute rejection. MATERIALS AND METHODS: Thirty patients experiencing acute rejection after cadaveric renal allograft transplantation and a control group of 30 patients, undergoing the same procedure but without the occurrence of rejection, were identified. Serum samples taken before transplantation from each patient were then analyzed quantitatively for IL-12 and IL-10 using ELISA assays. RESULTS: The mean pre-transplant serum IL-12 level was higher in patients who subsequently underwent acute rejection vs. those who did not (181 +/- 143 pg/mL vs. 81.2 +/- 71.5 pg/mL, respectively, p = 0.007). Unexpectedly, pre-transplant serum IL-10 levels were also elevated in patients who underwent rejection (559 +/- 293 pg/mL vs. 332 +/- 163 pg/mL, respectively, p = 0.002). Multivariate analysis demonstrated that elevations of IL-12 and IL-10 were independent risk factors for rejection when adjusted for confounding variables. CONCLUSIONS: Pre-transplant elevations of IL-12 and, unexpectedly, IL-10 are associated with acute rejection after cadaveric renal transplantation and may be useful in predicting which patients are at increased immunological risk at the time of transplantation. Further studies are necessary to assess the role of occult systemic inflammation in contributing to poor outcomes after transplantation.     

Effects of intravenous anesthetics on interleukin (IL)-6 and IL-10 production by lipopolysaccharide-stimulated mononuclear cells from healthy volunteers

BACKGROUND: Surgical trauma has been shown to augment the plasma concentrations of proinflammatory cytokines, which are important mediators of host defense mechanisms and the systemic inflammatory response syndrome (SIRS). Recently, it has been shown that certain kinds of surgery provoke not only a proinflammatory response (SIRS) but also a concurrent anti-inflammatory response. The aim of this study was therefore to examine the effects of intravenous anesthetics on the synthesis of interleukin (IL)-6 (a proinflammatory cytokine) and IL-10 (an anti-inflammatory cytokine) by lipopolysaccharide (LPS)-stimulated mononuclear cells from healthy volunteers. METHODS: Peripheral blood mononuclear cells (PBMCs) from 17 healthy volunteers, separated by centrifugation on a Ficoll-Hypaque gradient, were washed and suspended in RPMI containing 10% heat-inactivated fetal calf serum (FCS). After adding RPMI-FCS containing various concentrations of intravenous anesthetics (propofol, thiopental, ketamine and midazolam), the PBMCs were incubated overnight in the presence of a submaximal concentration of LPS. The supernatants were collected and their IL-6 and IL-10 contents were assayed using enzyme-linked immunosorbent assay kits. RESULTS: Propofol inhibited both IL-6 and IL-10 production at 0.5 microg/mL, 5 microg/mL and 50 microg/mL. Conversely, thiopental induced IL-10 production at 2 microg/mL and 20 microg/mL. CONCLUSION: Propofol appears to inhibit both IL-6 and IL-10 production by LPS-stimulated PBMCs in vitro. Further study is required to clarify the mechanism of the suppressive effect of propofol.