血浆可溶性晚期糖基化终末产物受体在妊娠期高血压性心脏病的表达及其临床意义

目的:探讨可溶性晚期糖基化终末产物受体(s RAGE)在妊娠期高血压性心脏病中的表达和临床意义。方法:选择2013-06至2016-07我院收治的57例符合妊娠期高血压性心脏病诊断标准的患者作为观察组,并收集同期正常妊娠患者57例作为对照组;将观察组患者根据纽约心脏协会(NHYA)心功能Ⅰ~Ⅳ级又分为四个亚组,根据28 d生存与否分为存活组(n=49)和死亡组(n=8)两个亚组。采用酶联免疫吸附法(ELISA)检测患者入院24 h内血浆s RAGE,同时进行B型利钠肽(BNP)水平测定。比较各组间患者s RAGE水平变化差异及分析s RAGE对妊娠期高血压性心脏病患者预后的判断价值。结果:观察组患者血浆s RAGE浓度显著高于对照组[(939.2±184.3)pg/ml vs(467.3±116.2)pg/ml,P0.05];观察组患者血浆s RAGE水平与NYHA心功能分级呈正相关关系(r=0.76,P0.001),随着心功能分级增加,血浆s RAGE浓度亦呈升高趋势(P0.05);观察组患者中死亡组的血浆s RAGE浓度明显高于生存组[(1647.6±249.7)pg/ml vs(776.9±146.2)pg/ml,P0.05];s RAGE和BNP诊断妊娠期高血压性心脏病的受试者操作特征曲线下面积分别为0.91和0.88,差异有统计学意义(P0.05)。结论:妊娠期高血压性心脏病患者血浆s RAGE水平升高,血浆s RAGE水平与心力衰竭严重程度相关,可作为患者预后的早期预测指标。     

慢性心力衰竭患者血浆BNP、IL-27水平及其临床意义

目的探讨血浆脑钠肽(BNP)、白介素-27(IL-27)的水平变化在慢性心力衰竭(chronic heart failure,CHF)发生发展中的临床意义。方法选取50例CHF患者作为观察组,50例健康人作对照组。采用酶联免疫吸附法检测血浆中BNP、IL-27水平变化,观察不同程度CHF患者左心室射血分数(LVEF)与血浆BNP、IL-27的关系。结果观察组血浆BNP的表达水平[(512.42±324.43)pg/ml]明显高于对照组[(30.50±20.30)pg/ml](P0.05),血浆IL-27表达水平[(0.58±0.21)pg/ml]低于对照组[(0.89±0.43)pg/ml],且BNP与IL-27的表达水平呈负相关(r=-0.54,P0.05)。血浆BNP水平从心功能Ⅱ级[(756.45±184.82)pg/ml]、心功能Ⅲ级[(1090.78±220.32)pg/ml]、心功能Ⅳ级[(2130.26±265.89)pg/ml]依次上升,差异有统计学意义(P0.05);IL-27表达水平从心功能Ⅱ级[(0.51±0.18)pg/ml]、心功能Ⅲ级[(0.32±0.15)pg/ml]、心功能Ⅳ级[(0.18±0.10)pg/ml]依次降低,差异有统计学意义(P0.05);LVEF与血浆BNP、IL-27相关性分别为(r=-0.51,r=0.61,P0.05)。结论血浆BNP、IL-27水平变化均可反映CHF程度,而BNP表达的更为敏感,且两者之间有一定影响。     

关于经皮冠脉介入术后并发急性肺损伤的原因

目的:探讨经皮冠脉介入术(PCI)后并发急性肺损伤的原因,寻找防治方法。方法:175例PCI术后患者,根据血气分析、胸部影像学检查被分为急性肺损伤组(ALI组,62例)和非急性肺损伤组(非ALI组,113例);以高效液相色谱法测定围术期血浆肾上腺素(E)、去甲肾上腺素(NE)浓度,另测定血浆白介素(IL)-6水平、原降钙素(PCT)浓度;进行胸部CT影像学检查,以荧光免疫法测定血浆脑型利钠肽(BNP)水平评估心功能。结果:与非ALI组相比,术后1dALI组血浆NE[(2.51±0.31)nmol/L比(6.91±0.39)nmol/L]、E[(1.23±0.11)nmol/L比(6.03±0.37)nmol/L]水平明显升高(P均<0.01),血浆IL-6[(119.81±17.23)pg/ml比(252.28±34.23)pg/ml]、PCT[(0.88±0.01)pg/ml比(4.99±0.87)pg/ml]、血浆BNP[(927.82±89.72)pg/ml比(3936.55±131.78)pg/ml]水平明显升高(P均<0.01),胸部CT显示肺组织炎症病变严重。结论:经皮冠脉介入并发急性肺损伤与机体交感活性亢进、术后炎症、心功能状态等因素有关。     

急性冠状动脉综合征患者血浆胸腺基质淋巴细胞生成素的变化

目的:观察急性冠脉综合征(ACS)患者血浆胸腺基质淋巴细胞生成素(TSLP)水平。方法:经冠状动脉造影证实的冠心病患者98例,其中稳定型心绞痛(SAP)组40例,ACS组58例,另选取20例造影正常者作为对照组。采用ELISA法检测血浆TSLP水平,同时常规检测患者生化指标。结果:ACS组血浆TSLP浓度[(16.5±3.0)pg/ml]显著高于SAP组[(3.3±1.4)pg/ml]和对照组[(2.8±1.3)pg/ml](均P0.01);吸烟患者TSLP浓度[(27.9±14.6)pg/ml]显著高于非吸烟患者[(12.9±4.8)pg/ml](P0.01)。血浆TSLP浓度与血C反应蛋白及LDL正相关(分别r=0.23,P0.05和r=0.38,P0.01)。结论:TSLP介导的炎症反应可能与ACS发生有关。     

血浆N末端B型脑钠肽前体水平与脑梗塞预后之间的关系

目的:探讨血浆N末端B型脑钠肽前体(NT-proBNP)与脑梗塞预后的关系,为脑梗塞的预后判断提供参考。方法:选择我院确诊为急性脑梗塞的患者126例,健康体检者56例(健康对照组),根据是否存在意识障碍、脑梗塞面积、疾病是否好转进行分组,了解不同分组患者的血浆NT-proBNP水平,以评估脑梗塞预后。结果:入院检查结果显示,与健康对照组比较,脑梗塞组的血浆NT-proBNP水平[(165.78±68.74)pg/ml比(2386.27±556.87)pg/ml]明显升高,P=0.001;预后分析中,与非大面积梗塞、无意识障碍、好转组比较,大面积脑梗塞[(228.78±78.74)pg/ml比(4017.57±674.67)pg/ml]、意识障碍[(423.66±52.85)pg/ml比(5237.85±1023.58)pg/ml]、死亡[(688.74±123.85)pg/ml比(9583.75±1841.14)pg/ml]患者的血浆NT-proBNP水平明显升高(P均=0.001)。结论:脑梗塞患者的血浆NT-proBNP水平明显升高,且有意识障碍、梗塞面积越大、死亡等预后不良的患者该指标明显升高,因此可将血浆NT-proBNP水平作为评估急性脑梗塞预后的重要指标。     

脑钠肽、尿微量白蛋白在心力衰竭患者中的临床诊断价值

目的:观察不同心力衰竭患者血浆脑钠肽(BNP)和尿微量白蛋白(UMA)水平及其相关性。方法:选择180例心内科住院病人为研究对象,根据NYHA心功能分级和左室功能,患者被分为无心衰对照组(32例)、舒张性心力衰竭(DHF)组(72例)和收缩性心力衰竭(SHF)组(76例)。测定比较以上三组心功能组的血浆BNP和尿UMA水平,并分析二者的相关性。结果:与无心衰对照组比较,DHF组和SHF组的血浆BNP[(15.42±8.04)pg/ml比(69.48±55.16)pg/ml比(456.23±386.19)pg/ml]和尿UMA水平[(27.92±6.51)mg/L比(72.19±26.35)mg/L比(142.39±35.41)mg/L]均显著升高;且SHF组血浆BNP和尿UMA水平显著高于DHF组,P均0.01。随着NYHA心功能等级的升高(Ⅰ,Ⅱ,Ⅲ,Ⅳ),血浆BNP[(45.42±8.04)pg/ml比(127.23±79.64)pg/ml比(418.35±187.36)pg/ml比(1257.62±454.26)pg/ml]和尿UMA水平[(47.92±16.51)mg/L比(74.68±27.02)mg/L比(131.05±33.68)mg/L比(263.14±104.69)mg/L]也逐渐升高,各组间比较均有显著差异,P0.05或0.01。简单线性回归分析显示血浆BNP与尿UMA水平呈显著正相关(r=0.544,P=0.001)。结论:血浆脑钠肽和尿微量白蛋白浓度随心衰的程度的加重而升高,且呈正相关关系,对诊断、评估严重程度、预后等均有较高价值。     

慢性充血性心力衰竭患者血浆白介素-15与NT-proBNP水平的相关性

目的:探讨慢性充血性心力衰竭(CHF)患者血浆白介素15(IL-15)与N末端B型利钠肽前体(NTproBNP)水平的相关性。方法:序贯纳入205例诊断为CHF的患者作为CHF组,同期行健康体检的52例健康成年人作为健康对照组。根据NYHA心功能分级,CHF组又被进一步分为II级组(55例),III级组(87例)和IV级组(63例)。测量比较各组间血浆IL-15水平,分析CHF患者血浆NT-proBNP、左室射血分数(LVEF)与血浆IL-15水平的相关性。结果:与健康对照组比较,CHF组血浆NT-proBNP水平[(71±33)pg/ml比(5884±1379)pg/ml]显著升高,LVEF[(57±7)%比(31±8)%]显著降低,P均=0.001。CHF组的血浆IL-15水平显著高于健康对照组[(18.35±6.42)ng/L比(7.78±3.11)ng/L],P=0.001;与II级组相比,III级、IV级血浆IL-15水平[(10.24±3.61)ng/L比(20.17±6.35)ng/L比(21.94±7.32)ng/L]显著升高(P均=0.001),而III级与IV级组间无显著差异(P=0.187)。Pearson相关分析显示,CHF患者血浆IL-15水平与血浆NT-proBNP水平显著正相关(r=0.172,P=0.038)。结论:CHF患者血浆IL-15水平与血浆NT-proBNP水平呈显著正相关,NT-proBNP可能成为预测CHF的一种新型标志物。     

Stanford A型主动脉夹层患者血浆骨桥蛋白的表达及临床意义

目的探讨Stanford A型主动脉夹层患者血浆骨桥蛋白(OPN)表达水平及其临床意义。方法入选51例Stanford A型主动脉夹层患者(其中合并高血压29例,未合并高血压22例),同时选取14例单纯高血压患者及11名健康者作为对照。ELISA法检测血浆OPN水平。结果与健康对照者相比,主动脉夹层患者的血浆OPN水平显著升高[(234.9±20.5)pg/ml比(26.0±25.9)pg/ml,P<0.001]。与单纯高血压组[(24.6±21.9)pg/ml]及健康对照组[(26.0±25.9)pg/ml]相比,合并[(274.4±164.6)pg/ml]及未合并高血压的主动脉夹层患者[(182.8±99.5)pg/ml]的血浆OPN水平均显著升高(均为P<0.05)。Spearman相关性分析发现,主动脉夹层患者的血浆OPN水平与炎症指标C反应蛋白之间无显著相关性(r~2=0.06,P=0.09)。结论 OPN可能参与Stanford A型主动脉夹层的发生发展,但与血清C反应蛋白水平无相关性,其深入机制有待进一步研究。     

盐敏感性高血压病患者血浆血栓素B2、6-酮-前列腺素F1α水平的变化及意义

目的探讨盐敏感性高血压病患者血浆血栓素B2(TXB2)、6-酮-前列腺素F1α(6-k-PG-F1α)水平的变化及意义.方法采用改良的Sullivan急性口服盐水负荷试验的方法将60例高血压病患者分为盐敏感性(SS,28例)和非盐敏感性(NSS,32例)两组.30例正常人为对照组.采用放射免疫法测定其血浆TXB2和6-k-PGF1α水平.结果SS高血压病组血浆TXB2水平[(48.76±21.34)pg/ml]显著高于NSS高血压病组[(31.67±5.30)pg/ml]及正常组[(30.01±7.72)pg/ml](P均＜0.01);SS高血压病组血浆6-k-PGF1α水平[(62.67±17.14)pg/ml]明显低于NSS高血压病组[(92.70±33.72)pg/ml]及正常组[(93.40±20.40)pg/ml](P均＜0.01);NSS高血压病组与正常组间血浆TXB2和6-k-PGF1α水平均无显著性差异(P均＞0.05).结论SS高血压病患者存在血管内皮功能受损和血小板活性增强.     

HBV相关慢加急性肝衰竭患者血清IL-32和IL-10水平变化及意义

目的探讨HBV相关慢加急性肝衰竭(HBV-ACLF)患者血清IL-32和IL-10水平的变化规律及临床意义。方法选取2012年9月-2014年3月在苏州大学附属第一医院住院治疗的38例HBV-ACLF患者、20例慢性乙型肝炎(CHB)患者及20例健康对照者,采用ELISA法动态监测血清IL-32和IL-10水平变化,同时比较HBV-ACLF早中晚期、感染组与非感染组、存活组与死亡组IL-32、IL-10水平。计量资料2组间比较采用t检验,多组间比较采用方差分析,进一步2组间比较采用SNK-q检验。结果 HBV-ACLF组IL-32水平[(500.98±152.33)pg/ml]显著高于CHB组[(281.72±99.28)pg/ml]及健康对照组[(178.16±50.54)pg/ml](P值均<0.05);HBV-ACLF组IL-10水平[(4.82±1.03)pg/ml]显著高于CHB组[(3.15±0.98)pg/ml]及健康对照组[(1.62±0.43)pg/ml](P值均<0.05)。动态监测HBV-ACLF组IL-32水平显示,HBV-ACLF早期高于中期[(540.69±155.71)pg/ml vs(498.43±135.56)pg/ml,P<0.05],中期高于晚期[(498.43±135.56)pg/ml vs(450.77±102.33)pg/ml,P<0.05];比较IL-10水平,HBV-ACLF早期低于中期[(1.94±0.44)pg/ml vs(2.83±0.97)pg/ml,P<0.05],中期低于晚期[(2.83±0.97)pg/ml vs(3.69±1.23)pg/ml,P<0.05]。HBV-ACLF感染组IL-32水平高于非感染组[(553.41±158.65)pg/ml vs(482.54±110.16)pg/ml,P=0.021];HBV-ACLF存活组IL-32水平低于死亡组[(481.95±100.67)pg/ml vs(540.62±112.45)pg/ml,P=0.011],存活组IL-10高于死亡组[(4.21±1.27)pg/ml vs(3.61±1.05)pg/ml,P=0.038]。结论细胞因子网络在HBV-ACLF发病机制中发挥重要作用,血清IL-32及IL-10参与疾病的进展过程,动态监测其水平有助于判断预后。     

组织因子和组织因子途径抑制物1对无复流作用的实验研究

目的 观察缺血再灌注时兔心肌组织和血浆中组织因子(TF)和组织因子途径抑制物1(TFPI-1)水平的变化,研究外源性TFPI-1对无复流严重程度的影响,探讨TF激活的外源性凝血系统及TFPI-1抑制途径在无复流发病过程中的作用.方法 40只新西兰大白兔随机分为4组(每组10只):缺血再灌注组(IR组,结扎回旋支120 min,再灌注60 min)、缺血再灌注TFPI-1组(TFPI-1组,再灌注时rTFPI-1 100 ng/kg静脉注射,1ng·kg~(-1)·min~(-1)静脉滴注)、缺血组(结扎回旋支180 min)和假手术组,每组10只.用硫磺素S和Evan's蓝活体染色区分无复流区和缺血区.无复流严重程度用无复流面积/缺血面积表示.用逆转录-聚合酶链反应方法测定无复流区、缺血区及正常区心肌组织TF和TFPI-1 mRNA表达水平,ELISA方法测定开胸前、冠状动脉结扎前即刻及结扎120 min、再灌注10和60 min血浆TF和TFPI-1水平.结果 开胸前、冠状动脉结扎前即刻及结扎120 min,各组血浆TF、TFPI-1水平差异无统计学意义(P>0.05);再灌注10和60 min时,IR组血浆TF水平均显著高于缺血组和假手术组[10min:(20.7±4.1)pg/ml比(13.9±2.2)pg/ml(P<0.001),(20.7±4.1)pg/ml比(13.2±2.6)pg/ml(P<0.001);60 min:(15.8±2.6)pg/ml比(13.5±1.6)pg/ml(P<0.05),(15.8±2.6)pg/ml比(12.1±0.7)Pg/ml(P<0.001)].再灌注10 min时,IR组血浆TFPI-1水平较缺血组及假手术组无明显变化(P>0.05);60 min时,血浆TFPI-1水平[(9.7±1.6)ng/ml]反而显著低于缺血组[(11.6±1.6)ng/ml,P<0.05]及假手术组[(10.1±1.3)ng/ml,P<0.01].IR组无复流区心肌组织TF mRNA表达高于缺血组及假手术组(P<0.05或P<0.001);TFPI-1 mRNA表达较缺血组无明显变化(P>0.05).TFPI-1组无复流严重程度明显低于IR组(0.39±0.11比0.54±0.06,P<0.01).结论 无复流区心肌组织TF转录水平及再灌注过程中TF血浆蛋白水平表达明显上调;而无复流区心肌组织TFPI-1转录水平无明显变化,再灌注过程中血浆蛋白水平反而相对降低;外源性rTFPI-1可以减轻无复流严重程度.TF激活的外源凝血途径在无复流发病过程中起到重要作用.     

血浆脑钠肽水平与首发急性脑梗死预后的关系

目的 探讨脑钠肽(brain natriuretic peptide,BNP)对急性脑梗死患者的预后价值.方法 纳入65例首发急性脑梗死患者和32名正常对照者.病例组神经功能缺损采用中国卒中量表(Chinese Stroke Scale,CSS)评价.血浆BNP浓度采用荧光免疫定量法检测.病例组死亡和复发性卒中事件进行随访.比较事件组与非事件组血浆BNP浓度,分析血浆BNP浓度与预后不良的关系.结果 急性腩梗死患者血浆BNP浓度为(238.7±131.6)pg/ml,显著高于健康对照组的(38.7±23.8)pg/ml(P<0.01).随访期间有9例(13.8%)患者死亡,8例(12.3%)复发非致死性卒中.死亡/复发性卒中事件组患者基线血浆BNP浓度为(304.0±134.9)pg/ml,显著高于非事件组的(214.4±120.9)pg/ml(P<0.01).血浆NBP浓度与CSS评分之间存在显著相火性(r=-0.359,P<0.05).对各种危险凶素进行多变量分析表明,BNP水平(OR=3.5,95%CI 2.1～5.8;P<0.01)、高龄(OR=4.1,95%CI 1.7～9.2;P<0.01)和CSS评分(OR=2.6,95%CI 1.6-4.3;P<0.01)均为转归不良的独立预测因素.结论 血浆BNP水平升高是急性脑梗死患者近期死亡和复发的独立预测因素.     

Receptor for advanced glycation end-products is a marker of type I cell injury in acute lung injury

RATIONALE: Receptor for advanced glycation end-products (RAGE) is one of the alveolar type I cell-associated proteins in the lung. OBJECTIVES: To test the hypothesis that RAGE is a marker of alveolar epithelial type I cell injury. METHODS: Rats were instilled intratracheally with 10 mg/kg lipopolysaccharide or hydrochloric acid. RAGE levels were measured in the bronchoalveolar lavage (BAL) and serum in the rats and in the pulmonary edema fluid and plasma from patients with acute lung injury (ALI; n = 22) and hydrostatic pulmonary edema (n = 11). MAIN RESULTS: In the rat lung injury studies, RAGE was released into the BAL and serum as a single soluble isoform sized approximately 48 kD. The elevated levels of RAGE in the BAL correlated well with the severity of experimentally induced lung injury. In the human studies, the RAGE level in the pulmonary edema fluid was significantly higher than the plasma level (p < 0.0001). The median edema fluid/plasma ratio of RAGE levels was 105 (interquartile range, 55-243). The RAGE levels in the pulmonary edema fluid from patients with ALI were higher than the levels from patients with hydrostatic pulmonary edema (p < 0.05), and the plasma RAGE level in patients with ALI were significantly higher than the healthy volunteers (p < 0.001) or patients with hydrostatic pulmonary edema (p < 0.05). CONCLUSION: RAGE is a marker of type I alveolar epithelial cell injury based on experimental studies in rats and in patients with ALI.     

慢性心力衰竭患者血浆尾加压素Ⅱ水平的变化及其临床意义

目的 本文旨在研究尾加压素Ⅱ（urotensinⅡ,UⅡ）在慢性心力衰竭患者中含量变化及其临床意义。方法 入选20例正常人（对照组）、88例心力衰竭患者（心力衰竭组：心功能Ⅱ级23例、Ⅲ级29例、Ⅳ级36例）为研究对象,采用放射免疫分析法测定血浆UⅡ浓度,竞争酶免疫分析法测定血浆BNP浓度,超声心动图测定左室射血分数（EF）、左室质量指数（LVMI）等参数。结果 正常对照组和心力衰竭组间年龄、性别等基线资料无明显差异;心力衰竭组血浆UⅡ浓度显著低于正常对照组（分别为3.45±0.97 pg/ml和5.73±0.69 pg/ml,P〈0.001）,而血浆BNP浓度显著高于正常对照组（分别为512±233pg/ml和65±26pg/ml,P〈0.001）;血浆UⅡ浓度与LVEF呈显著正相关（r=0.62,P〈0.001）,与血浆BNP浓度呈显著负相关（r=-0.79,P〈0.01）,与左心室质量指数（LVMI）显著负相关（r=-0.36,P〈0.01）。结论慢性心力衰竭患者血浆UⅡ浓度显著降低,并且与左室射血分数正相关,左心室质量指数负相关。     

Decreased plasma levels of soluble receptor for advanced glycation end-products in patients with essential hypertension

OBJECTIVES: Advanced glycation end-products (AGE) may cause vascular stiffening by forming crosslinks through the collagen molecule or by interaction with their cellular transductional receptor (RAGE). A secreted isoform of RAGE, termed soluble RAGE (sRAGE), may contribute to the removal/detoxification of AGE by acting as a decoy. Here we studied the plasma sRAGE levels in hypertensive and normotensive human subjects. We also investigated the relationship between blood pressure parameters and plasma sRAGE concentrations. DESIGN: A cross-sectional case-control study. SETTING AND PARTICIPANTS: The outpatient clinic of a university teaching hospital. Participants were 147 never-treated patients with essential hypertension (87 men and 60 women, aged 50 +/- 10 years) and 177 normotensive controls (118 men and 59 women, aged 49 +/- 10 years). MAIN OUTCOME MEASURES: Plasma sRAGE levels determined by enzyme-linked immunosorbent assay, systolic blood pressure (SBP), diastolic blood pressure, pulse pressure (PP) and mean arterial pressure. RESULTS: The plasma concentration of sRAGE [median (interquartile range)] was 1206 (879-1658) pg/ml in hypertensive subjects and 1359 (999-2198) pg/ml in normotensive controls (P = 0.002). Simple correlation analysis revealed that log-transformed sRAGE levels were inversely correlated with SBP (r = -0.11; P < 0.001) and PP (r = -0.23; P < 0.001). Forward-selection multiple regression analysis revealed that log-transformed sRAGE levels were determined more strongly by PP (F = 3.127, P < 0.001). CONCLUSIONS: Plasma sRAGE levels are decreased in patients with essential hypertension and are inversely related to PP. Our results raise the possibility that sRAGE may play a role in arterial stiffening and its complications.     

高血压左室肥厚患者血浆sTRAIL、sDR4、sDR5水平的变化(英文)

目的:测定高血压左室肥厚患者血浆肿瘤坏死因子相关的凋亡诱导配体(sTRAIL)、及其死亡受体(sDR4、sDR5)水平。方法:用酶联免疫吸附法(ELISA)分别检测50例高血压左室肥厚患者(高血压左室肥厚组)、50例高血压无左室肥厚患者(高血压组)和50例健康人(健康对照组)血浆sTRAIL、sDR4和sDR5水平。结果:①与健康对照组及高血压组比较,高血压左室肥厚组血浆sTRAIL[(0.95±0.11)ng/ml比(1.12±0.86)ng/ml比(1.74±1.19)ng/ml]、sDR4[(2.38±0.32)pg/ml比(5.63±1.05)pg/ml比(8.72±1.14)pg/ml]、sDR5[(<6 pg/ml)比(39.19±8.23)pg/ml比(78.21±11.2)pg/ml]水平均明显升高(P<0.01);且高血压组sDR4、sDR5水平明显高于健康对照组(P<0.01),sTRAIL水平与健康对照组无明显差异(P>0.05);②Pear-son相关分析表明,高血压左室肥厚患者sTRAIL、sDR4、sDR5间呈显著的正相关性(r=0.325～0.410,P<0.05或<0.01)。结论:血浆sTRAIL、sDR4、sDR5水平可能是预测高血压患者左室肥厚有价值的指标之一。     

血浆可溶型人类白细胞抗原-G在系统性红斑狼疮患者中的表达分析

目的 检测系统性红斑狼疮(SLE)患者血浆可溶性人类白细胞抗原-G(sHLA-G)水平,并分析其与SLE脏器受累及疾病活动性的关系,探讨sHLA-G在SLE发病机制中的可能作用.方法 酶联免疫吸附法(ELISA)检测96例SLE患者血浆sHLA-G水平,并与74名健康体检者对照.采用t检验,直线相关回归方法 和X2检验,P<0.05为差异有统计学意义.结果血浆sHLA-G水平在SLE患者为(230±192)U/ml;显著高于健康体检者的(118±38)U/ml(t=5.07,P=0.0001);血浆sHLA-G水平与SLE疾病活动性指数(SLEDIA)无明显相关性(r=0.157,P=0.141);但血浆sHLA-G水平增高的SLE患者较血浆sHLA-G水平正常患者SLEDAI高(11±5与8±5,P=0.027),易出现中枢神经系统受累(24.2%与4.8%,P=0.007).结论 血浆sHLA-G水平增高SLE患者病情较重、中枢神经系统受累较多,提示sHLA-G在SLE病理过程中可能发挥重要作用.     

Spider angiomas in Patients with liver Cirrhosis:Role of vascular endothelial growth factor and basic fibrobalast growth factor

AIM: To investigate whether vascular endothelial growth factor (VEGF) and basic fibroblastic growth factor (bFGF) are associated with spider angiomas in patients with liver cirrhosis.METHODS: Eighty-six patients with liver cirrhosis were enrolled and the number and size of the spider angiomas were recorded. Fifty-three healthy subjects were selected as controls. Plasma levels of VEGF and bFGF were measured in both the cirrhotics and the controls.RESULTS: Plasma VEGF and bFGF were increased in cirrhotics compared with controls (L22±13 vs. 71±11 pg/mL, P=0.003for VEGF; 5.1±0.5 vs. 3.4-±0.5 pg/mL, P=0.022 for bFGF). In cirrhotics, plasma VEGF and bFGF were also higher in patients with spider angiomas compared with patients without spider angiomas (185±28 vs. 90±10 pg/mL, P=0.003 for VEGF;6.8±1.0 vs. 4.1±0.5 pg/mL, P=0.017 for bFGF). Multivariate logistic regression showed that young age and increased plasma levels of VEGF and bFGF were the most significant predictors for the presence of spider angiomas in cirrhotic patients (odds ratio [OR]=6.64, 95 % confidence interval [CI]=2.02-21.79, P=0.002; OR=4.35, 95 % CI=1.35-14.01,P=0.014; OR=5.66, 95 % CI=1.72-18.63, P=0.004, respectively).CONCLUSION: Plasma VEGF and bFGF are elevated in patients with liver cirrhosis. Age as well as plasma levels of VEGF and bFGF are significant predictors for spider angiomas in cirrhotic patients.     

Serum Interleukin-6, Soluble Interleukin-6 Receptor and Crohn’s Disease Activity

The relationship between plasma interleukin-6 (IL-6) concentration and its soluble receptor in Crohn’s disease (CD) is not well elucidated. Twenty healthy volunteers and 94 consecutive patients with CD (44 in relapse and 50 in remission) were studied. Plasma IL-6 concentrations in patients with active disease [80 ± 9 pg/ml; mean ± standard error of the mean (SEM)] were significantly higher than in patients with inactive disease (50 ± 4 pg/ml; P < 0.001) or controls (3 ± 1 pg/ml; P < 0.001). However, concentrations did not vary with the severity of CD attacks. Plasma concentrations of soluble interleukin-6 receptor (sIL-6R) in active-CD patients (77 ± 5 ng/ml) did not differ significantly from those with inactive disease (82 ± 5 ng/ml), while both groups had significantly raised concentrations compared with those of controls (58 ± 6 ng/ml; P < 0.03 and P < 0.01, respectively). Plasma IL-6 concentrations correlated significantly with serum C-reactive protein (CRP) (r = 0.34; P < 0.001), whereas plasma sIL-6R concentrations did not. Taken together, these data suggest that, although IL6 and sIL6-R are both involved in the inflammatory process of CD, they are poor markers of disease activity.     

血浆瘦素水平与脑出血预后的相关性分析

目的探讨脑出血患者血浆瘦素水平及其对脑出血预后的预测价值。方法收集高血压性基底节区出血患者为脑出血组共108例,同期健康体检人群为对照组共50例,采用ELISA法检测两组血浆瘦素水平,分析其与脑出血后3个月死亡的相关性。结果脑出血组血浆瘦素水平[(33.24±15.25)ng/ml]与对照组[(10.31±4.93)ng/ml]比较差异有统计学意义(P<0.01)。多因素分析显示,血浆瘦素水平是脑出血后3个月内死亡的独立危险因素(OR=1.31,95%CI=1.08~2.26,P<0.05)。ROC曲线分析显示,血浆瘦素水平对脑出血后3个月内死亡有显著预测价值(曲线下面积=0.86,95%CI=0.78~0.92,P<0.01),且判定血浆瘦素水平大于41.73ng/ml,对预测脑出血后3个月内死亡的灵敏度为71.43%和特异度为87.50%。结论脑出血后血浆瘦素水平升高,检测血浆瘦素水平有助于早期判断脑出血患者的死亡。