慢性肝病患者血清sCR1及HA水平变化及其临床意义

对72例慢性肝病及22例肝硬化患者采用双抗体夹心ELISA法测定血清sCR1浓度、放射免疫法测定血清透明质酸（HA）水平。结果慢性肝病患者血清sCR1浓度显著高于正常人（P〈0．01）．肝硬化患者血清sCR1浓度显著高于慢性肝病患者（P〈0．01）;血清sCR1与HA密切相关（r=0．83）。提示血清sCR1与肝脏损伤严重程度密切相关，可作为反映肝脏代偿功能的重要指标。     

肝病患者血清中TIMP-1与HA、PC Ⅲ、CⅣ、LN水平的相关性

目的 了解肝病患者血清中基质金属蛋白酶组织抑制物-1（TIMP-1）与透明质酸（HA）、Ⅲ型前胶原（PCⅢ）、Ⅳ型胶原（CⅣ）和层粘连蛋白（LN）的相互关系及临床意义。方法 425例肝病患者和110例正常对照者采用双抗体夹心酶联免疫吸附方法（ELISA）测定血清TIMP-1，放射免疫分析法测定HA、PCⅢ、CⅣ和LN和全自动酶法测定血清总胆汁酸（TBA）、丙氨酸氨基转移酶（ALT）。结果 与健康正常人对照比较，肝病患者五项指标均有不同程度的升高，除慢性肝炎轻度组CⅣ含量水平与对照组无统计学意义外，其余各组均与对照组有显著性差异（P〈0．01）。其中唯有TIMP-1血清含量水平从急性肝炎至肝硬化依次进行性升高，慢性肝炎轻度组与急性肝炎组相比，t=2．603，P〈0．01。血清TIMP-1与HA、PCⅢ、CⅣ和LN呈显著正相关（P〈0．01），与TBA、ALT呈正相关（P〈0．05），并随肝脏病损纤维化程度加重而检出阳性率逐渐增高（P〈0．005）。结论 五项指标均可不同程度的反映肝脏的纤维化程度，其中以血清TIMP-1更为可靠、有效。     

老年脂肪肝患者血清免疫球蛋白和肝纤维化指标水平的临床评价

目的 探讨老年脂肪肝病人血清免疫球蛋白（Ig）水平与肝纤维化的关系。方法 采用免疫散射比浊法检测108例老年脂肪肝患者血清IgA、IgG、IgM含量及采用放射免疫吸附试验（RIA）测定血清透明质酸（HA）、Ⅳ型前胶原肽（IVC）及层黏连蛋白（LN）水平，并分析其相关性。结果 老年脂肪肝患者血清IgA、IgG、IgM含量明显高于对照组（P〈0．01），肝纤维化指标HA、IVC、LN水平明显高于对照组（P〈0．01），而且患者血清IgA、IgG、IgM与HA、IVC、LN之间呈显著正相关（P〈0．01或P〈0．05）。结论 老年脂肪肝有较为明显的肝纤维化倾向。检测其血清IgA、IgG、IgM与HA、IVC、LN含量，对于脂肪肝纤维化的诊断及评估预后具有重要的临床意义。     

老年充血性心力衰竭患者血清Fas/Apo-1和sICAM-1检测的临床意义

目的观察老年充血性心力衰竭（CHF）患者血清中细胞凋亡抑制因子（Fas／Apo-1）和可溶性细胞间黏附分子-1（sICAM-1）的水平，并探讨其与CHF患者心功能的关系。方法采用酶联免疫法检测53例老年CHF息者治疗前后及25例健康老年人血清中Fas／Apo-1和sICAM-1水平。通过彩色多普勒超声心动图测定左室射血分数（LVEF）值。结果老年CHF患者血清中Fas／Apo-1和sICAM-1水平显著高于对照组（P〈0．01），且随着心功能损害程度加重而升高，在心功能各组间比较有显著性差异（P〈0．05），老年CHF患者血清中Fas／Apo-1和sICAM-1水平与LVEF值呈显著负相关（r=-0．608，P〈0．01；r=-0．667，P〈0．01）。绪论Fas／Apo-1和sICAM-1在老年CHF发病机制中起重要作用，血清中Fas／Apo-1和sICAM-1水平可反映老年CHF的程度，其可作为判断老年CHF严重程度及预后的指标。     

急性脑梗死患者可溶性细胞间黏附分子-1和某些凝血指标的变化及其意义

目的：探讨急性脑梗死患者血清可溶性细胞间黏附分子-1（sICAM-1）和某些凝血指标的变化及其意义.方法：用双抗夹心酶联免疫吸附法测定69例急性脑梗死患者和30名健康对照者sICAM-1含量，并检测他们的某些凝血指标，包括血小板计数、凝血酶原时间（PT）、活化的部分凝血激酶时间（aPTT）、凝血酶时间和纤维蛋白原（FIB）含量。结果：脑梗死患者血清sICAM-1和FIB含量明显高于对照组（P〈0．01），PT较正常对照组明显延长（P〈0．05），sICAM-1含量与梗死面积显著相关（P〈0.01）。结论：急性脑梗死患者血清sICAM-1和FIB浓度显著增高，前者与脑梗死面积相关。     

乙型病毒性肝炎患者血清sFas水平检测及其临床意义

用ELISA法检测了107例病毒性乙型肝炎（乙肝）患者血清可溶性Fas（sFas）水平。结果各期肝炎患者血清sFas水平均显著高于正常人（P〈0．01），由低到高依次为慢乙肝、肝炎肝硬化、急性乙肝、慢性重型乙肝；血清sFas与总胆红素呈显著正相关（P〈0．01），与白蛋白、凝血酶原活动度均呈负相关（P〈0．01），与HBeAg的表达和HBV-DNA的复制无相关性（P〉0．05）。     

ACS患者血清sICAM-1、sVCAM-1、可溶性P选择素的水平变化及意义

目的探讨血清可溶性细胞间黏附分子1（sICAM-1）、可溶性血管细胞间黏附分子1（sVCAM-1）、可溶性P选择素（sP选择素）在急性冠脉综合征（ACS）发生、发展中的作用。方法采用ELISA法测定50例ACS患者（ACS组）、40例稳定型心绞痛（SAP）患者（SAP组）及26例正常人（对照组）sICAM-1、sVCAM-1、sP选择素水平。结果ACS组血清sICAM-1、sVCAM-1、sP选择素水平显著高于SAP组和对照组（P均〈0．01）。ACS组血清sICAM-1、sVCAM-1与sP选择素呈显著正相关（r=0．432、0．501,P均〈0．05）。结论ACS患者血清sICAM-1、sVCAM-1和sP选择素共同作用促进ACS的发生、发展。     

肝硬化患者血清激活素A测定及其意义

采用ELISA法分别测定34例肝硬化患者（肝硬化组）及18例健康人（对照组）血清激活素A（ACTA）水平。结果肝硬化组ACTA水平显著高于对照组，P〈0．05；随Child—Pugh分级程度加重而升高，各级间比较，P均〈0．05。肝硬化组ACTA与ALT、AST正相关（r分别为0．534、0．541，P均〈0．05）。提示肝硬化患者ACTA水平升高，并与肝损伤程度相关。     

阿托伐他汀对稳定型心绞痛患者冠状动脉介入治疗术后内皮微粒的影响

目的评价阿托伐他汀对稳定型心绞痛（SAP）行冠状动脉介入治疗（PCI）患者循环血中内皮微粒（EMP）和可溶性细胞间黏附分子-1（sICAM-1）的影响。方法将初诊慢性稳定型心绞痛行PCI治疗的患者56例随机分为阿托伐他汀组和对照组,阿托伐他汀组于计划行PCI前7d开始给予阿托伐他汀40mg／d治疗。于阿托伐他汀治疗前、PCI后24h采集静脉血,采用流式细胞术测定患者血浆EMP水平,酶联免疫吸附法测定血清sICAM-1水平。结果两组在阿托伐他汀治疗前EMP和sICAM-1水平无统计学差异（P〉0．05）;PCI后24h阿托伐他汀组EMP和sICAM-1水平均明显低于对照组（P〈0．05）。EMP与sICAM-1呈显著正相关（r-=0．854,P〈0．01）。结论阿托伐他汀可明显降低SAP患者PCI术后EMP和sICAM-1水平;EMP可作为评价PCI术后冠脉内皮炎症反应和损伤程度的指标。     

不同剂量瑞舒伐他汀钙对腔隙性脑梗死患者血管内皮功能的影响

目的观察不同剂量瑞舒伐他汀钙对腔隙性脑梗死患者血管内皮功能的影响和调脂效应。方法将180例腔隙性脑梗死患者随机分为A、B两组,分别在常规治疗的基础上加用瑞舒伐他汀钙10mg和20mg。治疗前后检测两组肱动脉内皮细胞依赖性舒张功能（FMD）、内皮细胞非依赖性舒张功能、血脂、血清一氧化氮（NO）、超氧化物歧化酶（SOD）、可溶性细胞问黏附分子-1（sICAM-1）及血脂水平。结果治疗后A、B组FMD均显著改善,B组较A组改善更为显著（P〈0．01）;两组血清NO、SOD显著升高,sICAM-1显著降低,B组较A组血清NO、SOD显著升高（P〈0．05）;两组TC、HDL-C均显著降低（P〈0．01）,组问比较无统计学差异（P〉0．05）。相关分析显示,FMD与血清NO、SOD呈正相关（r=0．74、0．56;P〈0．01）,与血清sICAM-1呈负相关（r=-0．83,P〈0．05）。结论瑞舒伐他汀钙可改善腔隙性脑梗死患者肱动脉FMD,增加血清NO含量及SOD活性,降低血清sICAM-1含量,且有剂量依赖性;其改善内皮功能的作用具有剂量依赖性,与其调脂效应无显著相关性。     

Soluble intercellular adhesion molecule-1 in serum in chronic hepatitis B and C

Intercellular adhesion molecule-1 (ICAM-1) is expressed on the hepatocyte membrane in patients with chronic hepatitis B and C. We assayed levels of the soluble form of this molecule (sICAM-1) in serum by an enzyme-linked immunosorbent assay method; we then analyzed the results in relation to hepatitis activity. Fifty-one patients with chronic hepatitis (22 with type B and 29 with type C) and 10 normal controls were examined. The serum levels of sICAM-1 in hepatitis B and C were significantly higher (P<0.01) than in normal controls. The serum level of sICAM-1 was correlated with serum glutamic-pyruvic transaminase level (P<0.01), and the level of sICAM-1 in patients in whom exacerbation was seen was significantly higher (P<0.05) than that in patients in a remission. There was no relationship between the serum level of sICAM-1 and the degree of ICAM-1 expression on the hepatocyte membrane. These results suggest that the serum level of sICAM-1 reflects the degree of activity of chronic hepatitis B and C.     

慢性乙型肝炎肝组织ICAM-1 mRNA和ICAM-1表达及意义

目的探讨肝组织间粘附分子-1(ICAM-1)表达在慢性乙型肝炎(CHB)发病机理中的作用。方法用原位杂交和免疫组织化学技术检测11例正常人和50例慢性HBV感染者肝内ICAM-1 mRNA和ICAM-1表达情况。结果正常人和慢性无症状HBsAg携带者肝细胞无ICAM-1mRNA和ICAM-1表达,CHB患者肝细胞ICAM-1 mRNA和ICAM-1表达增强,阳性肝细胞多分布在汇管区周围和腺泡内炎症坏死区域;重度CHB患者肝细胞ICAM-1 mRNA和ICAM-1表达显著强于中、轻度CHB患者(P<0.05);肝细胞ICAM-1表达强度与肝组织炎症活动度呈显著正相关,p<0.01;肝细胞ICAM-1表达强的患者肝功能显著差于ICAM-1表达弱者,P<0.05。结论肝细胞ICAM-1表达在慢性乙型肝炎肝细胞坏死中起重要作用,肝细胞ICAM-1表达水平能较好反映其肝损害程度和肝功能状况。     

慢性肝病患者血清可溶性细胞间粘附分子-1和转化生长因子β1检测的临床意义

目的探讨血清可溶性细胞间粘附分子-1(sICAM-1)和转化生长因子β1(TGF-β1)与肝纤维化及肝损害的关系.方法采用酶联免疫吸附法(ELISA)检测正常人、慢性肝炎、肝硬变患者血清sICAM-1、TGF-β1.结果慢性肝病患者各组血清sICAM-1、TGF-β1均显著高于正常人,各组间存在显著性差异.两者与透明质酸(HA)呈正相关,与血清草酰乙酸转氨酶(AST)、总胆红素(TBil)、球蛋白(G)呈显著正相关;与血清白蛋白(A)呈显著负相关.结论慢性肝病患者血清sICAM-1和TGF-β1可以作为判断肝纤维化及肝损伤程度的指标.     

Serum intercellular adhesion molecule-1 levels in chronic hepatitis C: association with disease activity and response to interferon alpha.

Soluble intercellular adhesion molecule-1 (sICAM-1) is probably released from a variety of cells, including leukocytes and endothelial cells at sites of inflammation or in the circulation, and serum levels may therefore be used to give an indication of immune activation and inflammatory processes. In the present study, an ELISA was used to measure serum ICAM-1 levels in 43 patients with chronic hepatitis C and these were correlated with histological changes in the liver and the response to interferon alpha treatment. Serum ICAM-1 levels were significantly higher in patients with chronic hepatitis C infection than in normal subjects and correlated positively with the grade of histological activity, in particular the degree of portal, periportal, and lobular inflammation, but not with the presence of lymphoid aggregates. There was also a weak but significant positive correlation between sICAM-1 and serum aspartate aminotransferase activities, and sICAM-1 levels were substantially greater in patients with than those without cirrhosis. Serum ICAM-1 levels fell significantly in 11 responders out of 19 patients treated with interferon alpha, whereas levels remained unchanged in the non-responder group. sICAM-1 levels correlate with the clinical status of patients with chronic hepatitis C infection and fall with successful interferon treatment.     

老年COPD合并呼衰患者血清CysC、VEGF、ACTA水平与病情严重程度的相关性

目的分析老年慢性阻塞性肺疾病(chronic obstructive pulmonary diseases, COPD)合并呼吸衰竭(respiratory failure, RF)患者血清胱氨酸蛋白酶抑制剂C(cystatin protease inhibitor C, CysC)、血管内皮生长因子(vascular endothelial growth factor, VEGF)、激活素A(activin A, ACTA)水平与病情严重程度的相关性。 方法选择四川大学华西医院住院治疗的106例老年COPD合并RF患者为RF组,按动脉血氧分压(PaO₂)将患者分为轻度组36例、中度组41例和重度组29例,另选取医院相同时间段收治的47例单纯COPD患者为非RF组,比较各组患者血清CysC、VEGF、ACTA水平及一秒钟用力呼气容积占预计值百分比(FEV₁)、一秒钟用力呼气容积占用力肺活量百分比(FEV₁/FVC)差异,并分析血清CysC、VEGF、ACTA水平与FEV1%、FEV₁/FVC相关性。 结果RF组患者血清CysC、ACTA水平高于非RF组(P<0.05),VEGF水平、FEV1%、FEV₁/FVC低于非RF组(P<0.05);老年COPD合并RF患者病情越严重,血清CysC、ACTA水平越高,VEGF水平、FEV1%、FEV₁/FVC越低,轻度组、中度组和重度组患者组间存在显著差异(P<0.05);Pearson相关检验结果显示,老年COPD合并RF患者血清CysC与FEV1%、FEV₁/FVC均呈负相关(r＝-0.530,P<0.01;r＝-0.594,P<0.01);VEGF与FEV1%、FEV₁/FVC均呈正相关(r＝0.571,P<0.01;r＝0.668,P<0.01);ACTA与FEV1%、FEV₁/FVC均呈负相关(r＝-0.604,P<0.01;r＝-0.557,P<0.01)。 结论老年COPD合并RF患者血清CysC、VEGF、ACTA水平与其病情严重程度存在密切相关性,有助于对患者及时作出病情评估。     

慢性肝病患者血清可溶性细胞间粘附分子-1和透明质酸水平及其意义

目的：探讨血清可溶性细胞间粘附分子－１和透明质酸（ＨＡ）与肝纤维经及肝损害的关系。方法：用ＥＬＩＳＡ法检测正常人、慢性直炎肝硬化血清ＳＩＣＡＭ－１。用ＲＩＡ法测定正常人、慢性肝炎肝硬化患者血清ＨＡ。结果：慢性肝病且血清ＳＩＣＡＭ＿１均显著高于正常人,各组间存在显著差异;血清ＨＡ水平在慢性肝炎中度组、重度组,肝硬化组明显高于正常人。在不同临床类型的慢性肝病患者中ＨＡ血清水平也存在显著差异,病情越重,     

Invasion and metastasis of liver cancer: expression of intercellular adhesion molecule 1

To study the relationship between intercellular adhesion molecule 1 (ICAM-1) and liver cancer metastasis and to find predicting factors that could indicate the growth and metastasis of liver cancer. Methods: ICAM-1 expression in fresh tissue of normal liver and hepatocellular cancer (HCC) was examined by immunoperoxidase staining. Serum soluble intercellular adhesion molecule 1 (sICAM-1) from patients with a benign HCC tumor, and the expression of ICAM-1 in the orthotopically transplanted LCI-D20 tumor of a nude mouse liver cancer metastasis model, and in human hepatoma, the tumor surrounding tissue and normal liver, was analyzed semiquantitatively by the immuno-dot blot method. Tissue ICAM-1 expression (mRNA level) was detected by Northern blotting. Results: ICAM-1 expression in LD1-20 D metastatic liver cancer had a positive correlation with tumor size and the time after implantation. It increased suddenly as metastasis occurred being 3.03 ± 0.51 before metastasis and 8.24 ± 0.95 after metastasis, P < 0.01, then remained high, appending on the number of sites involved (monosite metastasis 5.48 ± 0.49, multisite metastasis 10.05 ± 1.17, P < 0.05). All six cases of normal liver samples were negative in anti-ICAM-1 immunohistochemical staining, 80.0% (36/45) of the HCC showed some ICAM-1 expression. The rate of positive cells was a little higher in large tumors, tumors with an intact capsule and tumors with metastasis, but there was no significant difference. It was noticed that two cancer emboli also had high ICAM-1 expression. The ICAM-1 concentration in HCC (13.43 ± 0.09) was higher than that in tumor surrounding the liver (5.89 ± 0.17, P < 0.01) and that in normal liver (4.27 ± 0.21, P < 0.01). sICAM-1, like tissue ICAM-1, was higher in HCC patients than in patients (with benign liver tumor and normal controls. Both tissue ICAM-1 and sICAM-1 were higher in the metastasis group than in the group without metastasis (tissue ICAM-1 20.24 ± 0.30 vs 10.23 ± 0.12 P < 0.05; sICAM-1 12.18 ± 0.25 vs 9.77 ± 0.54 P < 0.05). Northern blot analysis revealed that ICAM-1 expression, as indicated by mRNA level, was also higher in HCC and in cancer emboli than in tumor surrounding liver and normal liver. Conclusions: Tissue ICAM-1 and serum sICAM-1 could indicate the stage of HCC, and the potential of hepatoma cells for invasion and metastasis. They may play an important role in the metastasis cascade. Received: 20 January 1998 / Accepted: 25 June 1998     

可溶性细胞间粘附分子-1和透明质酸水平在肝硬化患者中的临床意义

探讨血清可溶性细胞间粘附分子-1(sICAM-1)和透明质酸(HA)与肝硬化及肝损害的关系。用ELISA法检测正常人、肝炎肝硬化活动性、静止性患者血清ICAM-1。用RIA法测定正常人、肝硬化各期患者血清HA.1．肝硬化组血清ICAM-1和HA均显著高于正常人，两组间存在显著差异。2．两组肝硬化患者中sICAM-1、HA血清水平也存在显著差异。病情越重、血清ICAM-1和HA水平越高。两者与血清ALT、AST、总胆红素(TBil)、γ-转肽酶(GCT)、球蛋白(G)呈显著正相关，与血清胆碱酯酶(ChE)、白蛋白呈显著负相关。肝硬化患者sICAM-1和HA水平可作为判定肝硬化及肝损伤程度的指标。     

慢性充血性心力衰竭患者血清可溶性细胞间粘附分子-1的变化及与C-反应蛋白的相关性分析

目的了解慢性充血性心力衰竭(心衰)患者血清可溶性细胞间粘附分子-1(sICAM-1)的变化及与C-反应蛋白(CRP)的相关性.方法测定60例心衰患者和20例健康人的血清sICAM-1及CRP水平.比较分析心衰患者及不同程度心衰患者之间sICAM-1、CRP水平的变化,以及sICAM-1与CRP的相关性.结果心衰患者血清sICAM-1及CRP水平明显高于健康对照组(P＜0.01),二者均随心衰程度加重而增高,呈高度正相关(r=0.68,P＜0.01).不同程度心衰患者之间血清sICAM-1及CRP水平差异有显著性(P＜0.05).结论心衰患者存在着免疫激活和心肌炎症反应,心衰程度愈重,炎症反应愈明显.     

Serum and bronchial lavage fluid concentrations of IL-8, SLPI, sCD14 and sICAM-1 in patients with COPD and asthma

BACKGROUND: Airway inflammation is associated with an increased expression and release of inflammatory reactants that regulate processes of cell migration, activation and degranulation. The purpose of this study was to quantify bronchial lavage (BAL) fluid and serum levels of chemokine (IL-8), secretory leukocyte protease inhibitor (SLPI), soluble intracellular adhesion molecules-1 (sICAM-1) and sCD14, as surrogate markers of inflammatory and immune response in asthma and chronic obstructive pulmonary disease (COPD) patients with similar disease duration time. METHODS: Biomarkers in serum and BAL fluid from asthma (n=13) and COPD (n=25) patients were measured using commercially available ELISA kits. RESULTS: We found that in asthma and COPD groups the concentrations of IL-8 and SLPI are significantly higher in BAL fluid than in serum, while levels of sICAM-1 and sCD14 in BAL fluid are significantly lower than in serum. Of these 4 measured biomarkers, only the BAL IL-8 was higher in COPD patients when compared to asthma (P<0.05). In both groups, BAL IL-8 correlated with SLPI (r=0.577, P<0.01 and r=0.589, P<0.05, respectively). In patients with COPD the BAL sICAM-1 correlated with sCD14 (r=0.576, P<0.01), while in asthma patients BAL sICAM-1 correlated with FEV(1)/FVC (r=0.418, P<0.01). Moreover, in asthma patients the serum SLPI correlated with sCD14 (r=0.688, P<0.01) and serum sICAM-1 negatively correlated with FEV(1)/FVC (r=-0.582, P<0.05). CONCLUSION: Our findings point to the importance of selecting a correct biological fluid when analyzing specific biomarkers, and also show that of 4 measured biomarkers, only the BAL IL-8 was higher in COPD patients when compared to asthma.