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1.
目的:探讨术后早期应用肠内高营养治疗对晚期胃癌患者白细胞介素(IL)-2系统水平的影响.方法:98例晚期胃癌术后患者随机分成早期肠内高营养组和常规输液对照组,采用酶联免疫吸附测定(ELISA)等方法检测两组患者治疗前后的外周血清IL-2、IL-2受体(IL-2R)α及可溶性IL-2R(sIL-2R)水平.结果:早期肠内高营养组患者治疗1周后,机体IL-2和IL-2Rα水平较治疗前显著上升,sIL-2R水平明显下降(治疗前:IL-2 24.83U/ml±2.10U/ml,IL-2Rα 17.8%±2.8%,sIL-2R 347.9 U/ml±57.8 U/ml,治疗后:IL-2 79.82 U/ml±6.88 U/ml,IL-2Rα27.5%±4.0%,sIL-2R 157.9 U/m1±24.3 U/ml);而常规输液对照组患者的IL-2水平较治疗前呈下降趋势,IL-2Rα和sIL-2R水平变化不明显(治疗前:IL-2 21.87 U/ml±1.98 U/ml,IL-2Rα 18.3%±3.8%,sIL-2R 479.3 U/m1±69.8 U/ml;治疗后:IL-211.34 U/ml±0.89 U/ml,IL-2Rα 17.4%±2.7%,sIL.2R 481.2 U/m1±70.4 U/m1),两组治疗后结果相比有显著差异.结论:早期应用肠内高营养治疗晚期胃癌术后患者,有利于尽快恢复患者的机体免疫调节功能,为今后临床开展该项治疗提供了证据.  相似文献   

2.
朱金水  邹静 《胃肠病学》2000,5(3):156-157
目的:探讨术后早期应用肠内高营养治疗对晚期胃癌患者白细胞介素(IL)-2系统水平的影响。方法:98例晚期胃癌术后患者随机分成早期肠内高营养组和常规输液对照组,采用酶联免疫吸附测定(ELISA)等方法检测两组患者治疗一的外周血清IL-2、IL-2受体(IL-2R)α及可溶性IL-2R(sIL-2R)水平。结果:早期肠内高营养组患者治疗1周后,机体IL-2和IL-2Rα水平较治疗前显著上升,sIL-2  相似文献   

3.
肝癌、肝硬化患者血清TNF-α,IL-2,sIL-2R检测的临床意义   总被引:6,自引:0,他引:6  
目的:了解原发性肝癌、代偿期肝硬化、失代偿期肝硬化患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)、可溶性白细胞介素-2受体(sIL-2R)水平的变化,探讨其临床意义。方法:原发性肝癌33例,肝炎后肝硬化60例。分为肝癌组33例,肝硬化代偿期组30例,肝硬化失代偿期组30例。采用双抗体夹心酶联免疫法检测血清TNF-α、IL-2、sIL-2R水平。肝癌组织患者追踪2月至2年,观察其变化情况。结果:1.原发性肝癌组血清TNF-α、sIL-2R水平明显高于各期肝炎后肝硬化组,而血清IL-2水平较各期肝炎后肝硬化组显著降低。2.肝硬化失代偿期组血清TNF-α、sIL-2R水平明显高于肝硬化代偿期组,而肝硬化失代偿期组IL-2水平低于肝硬化代偿期组。3.原发性肝癌组经有效手术治疗及导管化疗者血清TNF-α及sIL-2R水平较治疗前明显降低,,IL-2则较前升高,而未经有效治疗或治疗时已是晚期者TNF-α及sIL-2R水平逐渐升高,IL-2则逐渐降低。结论:本文提示原发性肝癌及肝炎后肝硬化与TNF-α、IL-2及sIL-2R有密切相关性。TNF-α、IL-2及sIL-2R水平的变化有助于了解肝硬化的进展情况,早期发现恶性肿瘤并决定治疗的预后。  相似文献   

4.
采用ELISA法或RIA法对26例骨髓增生性疾病(MPD)患者的肿瘤坏死因子(TNFα)、白细胞介素2-及其受体(IL-2/sIL-2R)、白细胞介素6及其受体(IL-6/sIL-6R)和β2-MD水平进行了检测。发现MPD患者血清IL-2、β2-MG显著高于正常对照组,TNFα有升高趋势,IL-6/sIL-6R水平与对照组无显著性差异。病情活动或转化为急性白血病时,IL-2/sIL-2R和β2-MG均显著升高,提示这三项指标可作为判断MDP病情活动的参数。  相似文献   

5.
目的观察肝动脉化疗栓塞联合经脾动脉间接性门静脉内灌注化疗药物治疗原发性肝癌患者血清TNF-α、sIL-2R和VEGF水平的变化。方法 45例肝癌患者行肝动脉化疗栓塞联合经脾动脉间接性门静脉内灌注化疗药物治疗,检测患者血清TNF-α、sIL-2R和VEGF水平的变化。结果双灌注治疗后患者血清TNF-α、sIL-2R和VEGF水平均低于治疗前(P0.01);生存期超过2年以上者与在2年以内的患者之间血清细胞因子存在差异(P0.01)。结论双灌注介入治疗后患者血清TNF-α、sIL-2R和VEGF水平的变化与预后相关。  相似文献   

6.
霉酚酸酯对系统性红斑狼疮患者免疫功能的影响   总被引:2,自引:1,他引:1  
目的 观察新型免疫抑制剂霉酚酸酯(MMF)对系统性红斑狼疮(SLE)免疫功能的影响。方法 应用ELISA法、间接免疫荧光法和流式细胞术观察MMF、环磷酰胺(CTX)治疗前后SLE患者血清IL-6、IL-8、NTFα、sIL-2R、ANA、A-dsDNA及淋巴细胞亚群的变化以及MMF、CTX对造血系统、肝脏、肾脏功能的影响。结果 SLE患者经MMF治疗3个月后血清IL-6、IL-8、TNF-α、sIL-2R、ANA、A-dsDNA水平显著下降,CD3^ 、CD4^ 、CD4^ 、CD45RA^ 细胞显著增高,CD8^ 、CD4?^ CD45RO^ 、CD86 CD45RA^ 、CD8^ CD45RO^ 细胞显著减少。对造血系统、肝脏、肾脏功能无明显损害。结论 MMF可选择性地抑制T、B淋巴细胞,是一种治疗SLE毒副作用较少的新型免疫抑制剂。  相似文献   

7.
目的观察肝动脉化疗栓塞联合经脾动脉间接性门静脉内灌注化疗药物治疗原发性肝癌的疗效,并探讨患者血清细胞因子的变化。方法30例原发性肝癌患者行肝动脉化疗栓塞,40例行肝动脉化疗栓塞联合经脾动脉间接性门静脉内灌注化疗药物,采用ELISA法测定患者术后血清TNF-α、IL-2、sIL-2R和VEGF水平。结果两组治疗后血清TNF-α、sIL-2R和VEGF水平均较治疗前降低(P〈0.01),而IL-2升高(R<0.01);双灌注治疗后1、2和3年生存率分别为72.5%、55%和25%,而TACE治疗组则分别为60%、30%和6.7%,两组间存在显著性差异(P〈0.05)。结论双灌注介入治疗原发性肝癌能改善机体的免疫状况,提高疗效。  相似文献   

8.
通腑逐瘀方对肝硬化患者血浆内毒素及细胞因子的影响   总被引:3,自引:1,他引:3  
目的:探讨通腑逐瘀方对肝硬化患者血浆内毒素度细胞因子的影响。方法:将92例肝硬化患者随机分成中药组和对照组,并分别服用中药通腑逐瘀方和微生态制剂培非康胶囊共30天,采用偶氮显色法检测血浆内毒素。酶联免疫吸附法测定血浆细胞因子TNF-α、IL-10、sIL-2R水平。结果:两组患者治疗后血浆内毒素及肝α、sIL-2R水平均有下降。中药组与对照组比较其水平下降更明显(P〈0.05)。结论:接通腑逐瘀法组方的中药在降低患者血浆内毒素及TNF-α、sIL-2R水平方面疗效优于培非康胶囊,该法对肝硬化患者肠源性内毒素血症有一定的防治作用。  相似文献   

9.
目的:评价早期免疫增强型肠内营养对重症急性胰腺炎(SAP)大鼠血浆细胞因子的影响。方法:将170只SD大鼠随机分为正常对照组、24h组、SAP对照组、传统肠外营养组(TPN组)、增强型肠外营养组(S-TPN组)、传统肠内营养组(EN组)和免疫增强型肠内营养组(S-EN组)。胰胆管逆行注射2.5%牛磺胆酸钠建立SAPR模型,检测各时点外周血浆TNF—α、IL—10水平变化。结果:建模第4d,S-EN组TNF-α、IL—10水平较EN组高,IL-10/TNF-α比值较EN组低;第7d,S-EN组上述指标最低。结论:早期免疫增强型肠内营养在调节SAP大鼠促抗炎平衡方面优于肠外和传统肠内营养,但过早应用可能不利于炎症控制。  相似文献   

10.
目的观察早期低脂肠内营养(EEN)治疗对急性胰腺炎(SAP)血清甘油三酯水平的影响。方法将34例SAP并发高脂血症患者随机分为实验组和对照组,给予内镜下置管早期肠内营养治疗,16例实验组患者给予低脂要素肠内营养,18例对照组患者给予标准营养液肠内营养治疗,观察治疗前后甘油三酯(TG)、白细胞(WBC)、C反应蛋白(CRP)、谷草转氨酶(AST)、血钙及血糖的变化。结果两组患者治疗前后甘油三酯水平均明显下降,但实验组甘油三酯水平下降更加显著,且白细胞(WBC)、C反应蛋白(CRP)、谷草转氨酶(AST)、血钙与对照组比较下降更加明显,治疗前后血糖下降显著,治疗后两组比较差异不显著,考虑与均采用胰岛素降糖治疗有关。结论低脂EEN能够有效降低SAP甘油三酯水平并降低炎症反应、改善病情。  相似文献   

11.
目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤,因其临床表现多样,导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用,拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点,以期有助于提高影像学的诊断准确率和降低漏诊率,尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料,检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例,通过查阅病例的方法,提取出胰岛素瘤的大小和解剖分布等数据,进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例,其中,男45例、女71例,年龄13~76岁,平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布:头颈部46例(39.7%),单发45例、多发1例;体尾部68例(58.6%),单发65例、多发3例;全胰腺多发2例(1.7%)。病变大小特点:最大径0.4~3.4 cm,平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例,≤3 cm 15例,>3 cm 3例。年龄与肿瘤的大小相关,≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm,P<0.05。头颈部的肿瘤大于体尾部的肿瘤,头颈部肿瘤平均大小(1.66±0.63)cm,体尾部(1.42±0.52)cm,P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发;绝大多数单发,但可以全胰腺多发;多数小于1.5 cm,肿瘤的大小与患者年龄和肿瘤的解剖分布相关。  相似文献   

12.
Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.  相似文献   

13.
Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.  相似文献   

14.
BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.  相似文献   

15.
氯硝柳胺悬浮剂的毒性评价   总被引:2,自引:2,他引:2  
目的评价氯硝柳胺悬浮剂的毒性,为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg,经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3,该药经口、经皮肤、经呼吸道毒性均属微毒类药物;兔眼用药后,观察期内无不良反应,对眼无刺激性;皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比,氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物,对鱼的毒性低于其乙醇胺盐可湿性粉剂,适合于现场应用。  相似文献   

16.
血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。  相似文献   

17.
目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。  相似文献   

18.
The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002  相似文献   

19.

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl−1•min−1 (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl−1•min−1 (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.  相似文献   

20.
治疗高血压药物的经济学评价   总被引:3,自引:0,他引:3  
重视高血压治疗中的经济学评价,对利用我国有限的卫生资源来遏制高血压对人民群众的危害有着重要的现实意义。药物经济学对于药物治疗的成本和治疗的结果给予同样的关注。因为治疗高血压的费用,不仅涉及药物价格,还包括患者的危险水平,降压疗效和对临床终点事件的影响,以及治疗的依从性和安全性。因此药物经济学更强调整体成本和价-效比。低危病人,若非药价低廉,治疗的价-效比不够理想。而在高危的患者,价-效比越小越经济而不是药费越便宜越好。  相似文献   

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