多发性脑梗塞痴呆患者部分抗氧化指标检测及临床意义

检测配对设计的５４例多发性脑梗塞痴呆患者的５４例健康老年人血浆维生素Ｃ、血浆维生素Ｅ含量及血浆和红细胞超氧化物歧化酶活性、血浆和红细胞过氧化脂质、Ｅ－ＳＯＤ值均显著降低（Ｐ＜０．００１），平均Ｐ－ＬＰＯ和Ｅ－ＬＰＯ含量均显著升高；５４例患者的Ｐ－ＶＣ、Ｐ－ＶＥ含量均与Ｐ－ＳＯＤ、Ｅ－ＳＯＤ值呈直线正相关，均与Ｐ－ＬＰＯ、Ｅ－ＬＰＯ含量呈直线负相关；患者病程与Ｐ０ＶＣ、Ｐ－ＶＥ、Ｅ－ＳＯＤ值呈直线负     

脑梗塞与红细胞胆固醇、血液超氧化物歧化酶、过氧化脂质水平关系探讨

检测１０９例脑梗塞患者和１００例健康对照者红细胞胆固醇（Ｅ－Ｃｈ）含量、血浆和红细胞超氧化物歧化酶（Ｐ－ＳＯＤ、Ｅ－ＳＯＤ）活性及血浆和红细胞过氧化脂质（Ｐ－ＬＰＯ、Ｅ－ＬＰＯ）含量的结果表明，患者组Ｅ－Ｃｈ、ＰＬＰＯ、Ｅ－ＬＰＯ平均含量皆显著高于对照组（Ｐ＜０．０５～０．００１），Ｐ－ＳＯＤ、Ｅ－ＳＯＤ平均活性皆显著低于对照组（Ｐ＜０．００１）；患者病情随Ｅ－Ｃｈ含量升高而加重，呈直线相关；患者Ｅ－Ｃｈ含量随Ｐ－ＳＯＤ、Ｅ－ＳＯＤ活性下降而升高，随Ｐ－ＬＰＯ、Ｅ－ＬＰＯ含量上升而升高，均呈直线相关。提示脑梗塞患者红细胞膜内脂质代谢异常与体内氧自由基反应和脂质过氧化反应病理性加剧有一定程度的相关性。     

Therapeutic efficacy of high-dose vitamin C on acute pancreatitis and its potential mechanisms

AIM: To observe the therapeutic efficacy of high-dose Vitamin C 0/it. C) on acute pancreaUtis (AP), and to explore its potential mechanisms. METHODS: Eghty-four AP patients were divided into treatment group and control group, 40 healthy subjects were taken as a normal group, In the treatment group, Vit. C (10 g/day) was given intravenously for 5 days, whereas in the control group, Vit. C (1 g/day) was given intravenously for 5 days. Symptoms, physical signs, duration of hospitalization, complications and mortality rate were monitored. Meanwhile, serum amylase, urine amylase and leukocyte counts were also determined. The concentration of plasma vitamin C (P-VC), plasma lipid peroxide (P-LPO), plasma vitamin E (P-VE), plasma β-carotene (P-β-CAR), whole blood glutathione (WB-GSH) and the activity of erythrocyte surperoxide dimutase (E-SOD) and erythrocyte catalase (E-CAT) as well as T lymphocyte phenotype were measured by spectrophotometry in the normal group and before and after treatment with Vit. C in the treatment and the control group. RESULTS: Compared with the normal group, the average values of P-VC, P-VE, P-β-CAR, WB-GSH and the activity of E-SOD and E-CAT in AP patients were significantly decreased and the average value of P-LPO was significantly increased, especially in severe acute pancreatitis (SAP) patients (P<0.05. P-VC, P=0.045; P-VE, P=0.038; P=0.041;P-β-CAR, P=0.046; WB-GSH, P=0.039; E-SOD, P=0.019;E-CAT, P=0.020; P-LPO, P=0.038). Compared with the normal group, CD3 and CD4 positive cells in AP patients were significantly decreased. The ratio of CD4/CD8 and CD4 positive cells were decreased, especially in SAP patients (P<0.05. CD4/CDs, P=0.041; CD4, P =0.019). Fever and vomiting disappeared, and leukocyte counts and amylase in urine and blood become normal quicker in the treatment group than in the control group. Moreover, patients in treatment group also had a higher cure rate, a lower complication rate and a shorter in-ward days compared with those in he control group. After treatment, the average value of P-VC was significantly higher and the values of SIL-2R, TNF-α, IL-6 and IL-8 were significantly lower in the treatment group than in the control group (P<0.05 P-VC, P=0.045; SIL-2R, P=0.012; TNF-α, P=0.030; IL-6, P=0.015,and IL-8, P=0.043). In addition, the ratio of CDJCD8 and CD4 positive cells in the patients of treatment group were significantly higher than that of the control group after treatment (P<0.05. CD4/CDs, P =0.039; CD4, P=0.024). CONCLUSION: High-dose vitamin C has therapeutic efficacy on acute pancreatitis. The potential mechanisms include promotion of anti-oxidizing ability of AP patients, blocking of lipid peroxidation in the plasma and improvement of cellular immune function.     

脑中风与红细胞胆固醇,过氧化脂质和超氧化物歧化酶水平关系的研究

检测１０９例脑梗塞、１０５例脑出血患者和１００例健康对照者红细胞胆固醇（Ｅ－Ｃｈ）、血浆和红细胞过氧化脂质（Ｐ－ＬＰＯ、Ｅ－ＬＰＯ）含量及超氧休物歧化酶（Ｐ－ＳＯＤ、Ｅ－ＳＯＤ）活性的结果表明，与对照组比较，脑梗塞组Ｅ－Ｃｈ显著升高，脑出血组Ｅ－Ｃｈ显著降低；２患者组Ｐ－ＬＰＯ、Ｅ－ＬＰＯ显著升高，Ｐ－ＳＯＤ、Ｅ－ＳＯＤ显著降低；Ｅ－Ｃｈ与脑梗塞患者病情及Ｐ－ＬＰＯ、Ｅ－ＬＰＯ、Ｐ－ＳＯＤ、Ｅ－Ｓ     

老年心绞痛患者银杏叶黄酮治疗前后的自由基变化

以邻苯三酚自氧化抑制法和硫代巴比妥酸反应产物比色分析法检测经用“天保宁”(银杏叶制剂)治疗50例心绞痛患者前后红细胞超氧化物歧化酶(E—SOD)活性及血浆过氧化脂质(P—LPO)和红细胞过氧化脂质(E—LPO)含量的结果表明,与治疗前相比,治疗后的E-SOD平均活性显著升高(P<0.01),P—LPO和E—LPO平均含量均显著降低(P<0.01)。提示老年心绞痛患者体内的病理性氧自由基反应和脂质过氧化反应在治疗后明显减缓,银杏叶黄酮具有较强的抗氧自由基损伤和抗脂质过氧化损伤作用。     

NO和脂质过氧化与老年矽肺关系的研究

目的　探讨ＮＯ和脂质过氧化与老年矽肺的关系。方法　检测８５ 例老年矽肺患者和８０ 例健康老年人的血浆ＮＯ（Ｐ－ＮＯ）、过氧化脂质（Ｐ－ＬＰＯ）及红细胞超氧化物歧化酶（Ｅ－ＳＯＤ）、过氧化氢酶（Ｅ－ＣＡＴ）、谷胱甘肽过氧化物酶（Ｅ－ＧＳＨ－Ｐｘ）、过氧化脂质（Ｅ－ＬＰＯ）值。结果　与对照组比较,患者组Ｅ－ＳＯＤ、Ｅ－ＣＡＴ、Ｅ－ＧＳＨ－Ｐｘ 均值显著降低,Ｐ－ＮＯ、Ｐ－ＬＰＯ、Ｅ－ＬＰＯ 均值显著升高（Ｐ＜ ０．００１）;直线回归和相关分析表明上述各检测值与患者病程均有相关;逐步回归表明患者病情、肺功能状态与Ｐ－ＮＯ、Ｅ－ＳＯＤ、Ｅ－ＬＰＯ 值相关最密切。结论　矽肺患者体内ＮＯ 代谢异常,氧化抗氧化平衡严重失调,氧化和脂质过氧化反应病理性加剧。     

急性脑梗死患者血浆维生素E、维生素C、β-胡萝卜素含量变化及其临床意义

目的　观察急性脑梗死患者 (ABI)血浆自由基清除剂含量的变化。方法　采用分光光度比色法 ,分析检测 1 2 0例急性脑梗死患者和 5 0例健康成人血浆维生素 E、维生素 C、β-胡萝卜素的含量。结果　急性脑梗死组血浆Vit E、Vit C、β-CAR含量的平均值 (AV)均显著低。结论　血浆 Vit E、Vit C、β-CAR显著降低与急性脑梗死有关 ,早期应用 Vit E、 Vit C、β-CAR有可能阻止脑组织因自由基激活的氧化损伤     

Response to changing plasma concentrations of isosorbide-bound NO2 during acute and sustained treatment with isosorbide dinitrate in patients with coronary artery disease

BACKGROUND: The mechanisms behind development of tolerance to nitrate effects during sustained, asymmetric isosorbide dinitrate (ISDN) therapy are not fully understood. HYPOTHESIS: The study was undertaken to investigate the changes of the relationships between left ventricular (LV) function and plasma concentrations of ISDN and its vasoactive metabolites (2- and 5-ISMO) during acute and sustained, asymmetric ISDN therapy. METHODS: Left ventricular function and plasma concentrations of ISDN, 2- and 5-isosorbide mononitrates (P-ISDN, P-2- and 5-ISMO) were measured at rest and at supine exercise before and for 4 h after peroral 30 mg ISDN in 15 patients with coronary artery disease, all with initial exercise pulmonary artery wedge pressure (PAWP) > 25 mmHg. Seven patients were untreated (acute group), while eight received 30 mg ISDN b.i.d. for 2 weeks before the invasive study. P-ISDN and the concentration of available isosorbide-bound nitrate (NO2) in plasma (P-ISDN.2 + P-2-ISMO + P-5-ISMO) (P-NO2) were used as measures of the nitric oxide (NO) offer to the tissues. RESULTS: Throughout the study, after administration of medication, all plasma concentrations, in particular P-ISDN, were higher in the chronic than in the acute group. Peak P-ISDN was reached after 15 min in the chronic group and after 25 min in the acute group, while P-2- and 5-ISMO reached maximum only after 40 min in both groups. At rest, the full effect on PAWP was observed after 10 min in both groups, but at markedly higher levels of P-ISDN and P-NO2 in the chronic group. Afterward, no further changes in PAWP were observed. During exercise, 1 h after medication, PAWP and stroke index to PAWP ratio (SI/PAWP) were normal in both groups. Thereafter, at slowly declining P-NO2, PAWP rose and SI/PAWP declined toward the initial level in the chronic group, but remained unchanged in the acute group, in spite of higher P-NO2 and greater NO release in the former. CONCLUSIONS: Patients receiving sustained, asymmetric 30 mg ISDN b.i.d. dosing had the same immediate beneficial effects on LV function during exercise after a morning dose as did untreated patients. However, in spite of higher P-NO2 and higher rate of NO release during sustained treatment, the effects deteriorated gradually 2 to 3 h after medication. The changes in metabolism and/or distribution of isosorbide-bound NO2 may possibly be part of the tolerance induced by long-term treatment, even with asymmetric dosing.     

The effect of zinc supplements on lipoproteins and copper status

As part of a study to determine the effect of 150 mg zinc/day on plasma lipoproteins, healthy young female (n = 26; mean age 27 years) and male (n = 21; mean age 28 years) volunteers took part in a double-blind cross-over trial lasting 12 weeks. During 6 weeks of supplementation, plasma Zn rose significantly in both groups, indicating compliance. Plasma total cholesterol remained unchanged in both males and females. However, mean LDL-cholesterol decreased from 2.38 to 2.17 mmol/1 in females and there was a trend for total HDL-cholesterol to be redistributed in that HDL₂ rose and HDL₃ fell slightly. In parallel with these changes in females, Zn supplements reduced the ferroxidase activity of serum caeruloplasmin (from 13.0 to 11.3 U/ml) and the antioxidant activity of erythrocyte superoxide dismutase (E-SOD) (from 4557 to 3638 U/g Hb) and CuZn E-SOD (from 2184 to 1672 U/g Hb). Plasma Cu and haematocrit were unaffected. No such changes were seen in males in either lipoproteins or these indicators of Cu status. Since the females were lighter than the males but received the same dose, a dose-response effect rather than a sex difference cannot be ruled out. Overall, Zn supplements significantly decrease a major risk factor for CHD in females but reduced their Cu status.     

Hemodynamic changes induced by laparoscopy and their endocrine correlates: effects of clonidine

Objectives. We investigated endocrine correlates of the hemodynamic changes induced by carbon dioxide pneumoperitoneum (PNO). We then studied whether clonidine might modulate the hemodynamic changes induced by PNO by reducing release of catecholamines and vasopressin.Background. Both mechanical and neurohumoral factors contribute to the hemodynamic changes induced by carbon dioxide PNO. Several mediators have been proposed, but no study has correlated hemodynamic changes with changes in levels of these potential mediators.Methods. We conducted two studies, each including 20 healthy patients scheduled for elective laparoscopic cholecystectomy. In the first study serial measurements of hemodynamics (thermodilution technique) were done during laparoscopy and after exsufflation. Plasma concentrations of cortisol, catecholamines, vasopressin, renin, endothelin and prostaglandins were measured at the same time points. In the second study patients were randomly allocated to receive 8 μg/kg clonidine infused over 1 h or placebo before PNO. Hemodynamics and plasma levels of cortisol, catecholamines and vasopressin were measured during PNO and after exsufflation.Results. Peritoneal insufflation resulted in a significant reduction of cardiac output (18 ± 4%) and increases in mean arterial pressure (39 ± 8%) and systemic (70 ± 12%) and pulmonary (98 ± 18%) vascular resistances. Laparoscopy resulted in progressive and significant increases in plasma concentrations of cortisol, epinephrine, norepinephrine and renin. Vasopressin plasma concentrations markedly increased immediately after the beginning of PNO (before PNO 6 ± 4 pg/ml; during PNO 129 ± 42 pg/ml; p < 0.05). The profile of vasopressin release paralleled the time course of changes in systemic vascular resistance. Prostaglandins and endothelin did not change significantly. Clonidine significantly reduced mean arterial pressure, heart rate and the increase in systemic vascular resistance. Clonidine also significantly reduced catecholamine concentrations but did not alter vasopressin and cortisol plasma concentrations.Conclusions. Vasopressin and catecholamines probably mediate the increase in systemic vascular resistance observed during PNO. Clonidine before PNO reduces catecholamine release and attenuates hemodynamic changes during laparoscopy.     

Glutathione-peroxidase and glutathione-reductase activities of normal and pathologic human liver: relationship with age

Liver glutathione-peroxidase (L-GSH-Px) and glutathione-reductase (GSSG-Red) activities were measured in supernatants of liver tissues obtained from a total of 36 subjects. Sixteen of these patients had a functionally normal liver (control group), whereas of the remaining 20 patients, 10 were cirrhotic and 10 had a liver disease other than cirrhosis. The mean value of L-GSH-Px of the control group was 33.12 +/- 12.66 U/g protein, a value similar to that found in patients with liver disease. The L-GSH-Px of the control group was positively correlated with the age of the subjects (r = 0.620; p less than 0.02). In contrast, in patients with liver disease an opposite behaviour of the two parameters was noted (r = -0.497; p less than 0.05). L-GSH-Px activity tended to be higher in males than in females, whereas the erythrocyte glutathione-peroxidase (E-GSH-Px) of the same patients was higher in females, albeit not significantly. L-GSH-Px and E-GSH-Px were not correlated either in normal or in liver disease. The mean GSSG-Red of the control group was 40.63 +/- 11.10 U/g protein, which is not different from that of the group of liver patients. GSSG-Red was not correlated with L-GSH-Px or with the age of patients. In two patients with hepatoma, the GSH-Px activity of the cancer tissue was low and the GSSG-Red activity high.     

Magnesium dynamics and sympathetic nervous system activity in patients with chronic heart failure.

This study was undertaken in patients with heart failure to investigate the relation between plasma norepinephrine (NE) concentration and Mg dynamics. The study subjects comprised 16 patients with chronic heart failure (mean age 64.9+/-10.0 years). Cardiopulmonary exercise testing was performed on all patients, and anaerobic threshold (AT), peak oxygen uptake (peak VO2) and peak exercise time were measured. Resting and peak values of plasma NE concentration and serum and erythrocyte magnesium concentration were also measured. The results were as follows: the serum Mg concentration was increased significantly immediately after exercise (p<0.01), and the erythrocyte Mg concentration showed a tendency to decrease (p<0.1). The resting plasma NE level was inversely correlated with AT (p<0.05, r=-0.57), peak VO2 (p<0.05, r=-0.55) and peak exercise time (p<0.01, r=-0.62). When the plasma NE concentration at rest was analyzed in 2 groups of patients, ie, those with higher than average and those with lower than average concentrations, the resting erythrocyte Mg concentration was significantly lower in the high-NE group (2.2+/-0.3 mg/dl) than in the low-NE group (2.7+/-0.5 mg/dl) (p<0.05). The data indicate that patients with chronic heart failure associated with high NE levels at rest who showed low exercise tolerance have intracellular hypomagnesemia, which may be caused by Mg migration from intracellular to extracellular spaces.     

临界高血压转归与红细胞内Na~＋及血浆内源性洋地黄样物质的关系

目的：探讨临界高血压转归与细胞内Ｎａ＋、Ｋ＋及血浆内源性洋地黄样物质（ＥＤＬＳ）的关系。方法：对汉中市心血管病防治区１１０例年龄３０～６０岁临界高血压患者及１０６例血压正常对照组随访１１年，此期间测定了红细胞Ｎａ＋、Ｋ＋（火焰光度法）及血浆内源性洋地黄样物质（地高辛免疫法）含量。结果：经１１年随访，临界高血压转归为确诊高血压者占３０．９％，而对照组仅占４．０％（Ｐ＜０．０１）；临界高血压转归为确诊高血压者与其它各转归组比较，红细胞Ｎａ＋、血浆内源性洋黄样物质含量显著偏高，而红细胞Ｋ＋明显偏低（Ｐ＜０．０１或Ｐ＜０．０５）；红细胞Ｎａ＋、血浆内源性洋地黄样物质偏高者，以后演变为确诊高血压的危险性增大（ＲＲ＝１．９６及３．０７）。结论：临界高血压转归与细胞内Ｎａ＋、Ｋ＋及血浆内源性洋地黄样物质有关，Ｎａ＋、内源性洋地黄样物质增高对临界高血压的转归具有预测意义。     

Response of oxidative stress biomarkers to a 16-week aerobic physical activity program,and to acute physical activity,in healthy young men and women

Physical activity (PA) is associated with a reduced risk of coronary heart disease, and may favorably modify the antioxidant-prooxidant balance. This study assessed the effects of aerobic PA training on antioxidant enzyme activity, oxidized LDL concentration, and LDL resistance to oxidation, as well as the effect of acute PA on antioxidant enzyme activity before and after the training period. Seventeen sedentary healthy young men and women were recruited for 16 weeks of training. The activity of superoxide dismutase in erythrocytes (E-SOD), glutathione peroxidase in whole blood (GSH-Px), and glutathione reductase in plasma (P-GR), and the oxidized LDL concentration and LDL composition, diameter, and resistance to oxidation were determined before and after training. Shortly before and after this training period they also performed a bout of aerobic PA for 30 min. The antioxidant enzyme activity was also determined at 0 min, 30 min, 60 min, 120 min, and 24 h after both bouts of PA. Training induces an increase in GSH-Px (27.7%), P-GR (17.6%), and LDL resistance to oxidation, and a decrease in oxidized LDL (-15.9%). After the bout of PA, an increase in E-SOD and GSH-Px was observed at 0 min, with a posterior decrease in enzyme activity until 30-60 min, and a tendency to recover the basal values at 120 min and 24 h. Training did not modify this global response pattern. Regular PA increases endogenous antioxidant activity and LDL resistance to oxidation, and decreases oxidized LDL concentration; 30 min of aerobic PA decreases P-GR and B-GSH-Px activity in the first 30-60 min with a posterior recovery.     

Blood micronutrient, oxidative stress, and viral load in patients with chronic hepatitis C

AIM: To assess the extent of micronutrient and oxidative stress in blood and to examine their linkages with viral loads in chronic hepatitis C patients. METHODS: Hepatitis C virus (HCV)-RNA levels were quantified in the serum from 37 previously untreated patients with chronic hepatitis C. The plasma and erythrocyte micronutrients (zinc, selenium, copper, and iron) were estimated, and malondialdehyde (MDA) contents were determined as a marker to detect oxidative stress. Antioxidant enzymes, superoxide dismutase (SOD), glutathione peroxidase (GPX) and glutathione reductase (GR) activities in blood were also measured. The control group contained 31 healthy volunteers. RESULTS: The contents of zinc (Zn), and selenium (Se) in plasma and erythrocytes were significantly lower in hepatitis C patients than in the controls. On the contrary, copper (Cu) levels were significantly higher. Furthermore, plasma and erythrocyte MDA levels, and the SOD and GR activities in erythrocytes significantly increased in hepatitis C patients compared to the controls. However, the plasma GPX activity in patients was markedly lower. Plasma Se (R=-0.730, P<0.05), Cu (r=0.635), and GPX (r= -0.675) demonstrated correlations with HCV-RNA loads. Significant correlation coefficients were also observed between HCV-RNA levels and erythrocyte Zn (r=-0.403), Se (r = -0.544), Cu (r= 0.701) and MDA (P=0.629) and GR (r =0.441). CONCLUSION: The levels of Zn, Se, Cu, and oxidative stress (MDA), as well as related anti-oxidative enzymes (GR and GPX) in blood have important impact on the viral factors in chronic hepatitis C. The distribution of these parameters might be significant biomarkers for HCV.     

Rheological properties of blood in patients with chronic liver disease

We analyzed rheologic parameters, including erythrocyte rigidity (ER), whole blood and plasma viscosity, erythrocyte and platelet count, hemoglobin, hematocrit, mean corpuscular volume (MCV), fibrinogen, erythrocyte sedimentation rate (ESR), cholesterol, triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), very-low density lipoprotein (VLDL), and gamma globulin levels in 18 patients with chronic liver disease and 20 healthy volunteers. Fifteen patients had cryptogenic cirrhosis while 3 had chronic active hepatitis. ER and MCV was significantly higher in the patient group than the control group while whole blood and plasma viscosities were significantly lower. There were significant correlations between ER and blood and plasma viscosity, ER and MCV, plasma and blood viscosity, HDL and plasma viscosity and a negative correlation between ER and ESR. Our results demonstrate that erythrocytes become more rigid in chronic liver disease. We suggest that erythrocytes with increased rigidity can impair hepatic microvascular circulation and thus contribute to liver dysfunction.     

Equivalence of the acute phase reactants C-reactive protein, plasma viscosity, and Westergren erythrocyte sedimentation rate when used to calculate American College of Rheumatology 20% improvement criteria or the Disease Activity Score in patients with early rheumatoid arthritis. Western Consortium of Practicing Rheumatologists.

OBJECTIVE: In an additive cohort of patients with early rheumatoid arthritis (RA), to determine the effect of substituting one acute phase reactant for another on the number of patients satisfying the American College of Rheumatology (ACR) 20% preliminary criteria for improvement, and on calculated Disease Activity Scores (DAS). METHODS: A total of 251 patients with 6.4 months average disease duration had detailed clinical assessments at entry and 6, 12, and 24 months in a multicenter prospective longterm observational study. Matched erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and plasma viscosity (PV) assays were done at 366 time points. Disease modifying antirheumatic drugs were not started until after the baseline evaluation. RESULTS: After 6, 12, and 24 months, 50%, 53%, and 57% of patients were responders, as defined by the ACR 20% improvement criteria. The difference in response rates when ESR, CRP, or PV was used as the acute phase reactant ranged from 0.4% at 12 months to 3% at 24 months. Percentile distributions of the 366 matched CRP, ESR, and PV values were used to prepare a nomogram that can be used to calculate the other acute phase reactant values if the value of one is known. When the nomogram was used to impute ESR values from observed PV or CRP values, average DAS scores calculated with the actual ESR values were not different from average DAS scores calculated from the imputed ESR values. CONCLUSION: ESR, CRP, and PV are equally useful in calculating ACR 20% response rates in patients with active early RA. A nomogram can be used to impute ESR values from CRP or PV values; use of the imputed ESR values is as accurate as use of the actual ESR values to calculate average DAS.     

心力衰竭患者血尿酸与有创血液动力学监测指标、血浆N末端B型利钠肽原和高敏C反应蛋白的相关研究

目的 评价心力衰竭(心衰)患者血尿酸与有创血液动力学监测指标、血浆N末端B型利钠肽原(NT-proBNP)和高敏C反应蛋白(Hs-CRP)的相关性.方法 选择141例NYHA Ⅱ～Ⅳ级心衰患者,在入院12 h内行漂浮导管监测和血尿酸等常规检查,同时检测血浆NT-proBNP和Hs-ClIP.结果 高尿酸血症的比率为55.30%,肺毛细血管楔压(PCWP)在高尿酸血症总组及高尿酸血症A、B、C组均较正常血尿酸组显著增高(P<0.01,P=0.01,P<0.01,P<0.01).血浆NT-proBNP在高尿酸血症总组和高尿酸血症C组较正常血尿酸组显著增高(P=0.02,P<0.01).与PCWP<18mm Hg(1 mm Hg=0.133 kPa)组比较,高NT-proBNP和高尿酸血症比率在PCWP≥18 mm Hg、<28mm Hg组和PCWP≥28 mm Hg组均显著增高(P=0.01,P=0.02;P<0.01,P<0.01).偏相关分析表明,血尿酸分别与右房压、右室压、肺动脉压和PCWP相关(r=0.19,P=0.03;r:0.45,P<0.01;r=0.23,P=0.01;r=0.24,P=0.01).多元回归分析表明,血尿酸和血浆NT-proBNP分别与PC:WP独立相关(β=0.24,P=0.01;β=0.47,P<0.01).血浆Hs-CRP以及左室射血分数与血尿酸及PCWP均不相关.结论 心衰患者血尿酸水平与PCWP等有创血液动力学指标独立相关,与血浆NT-proBNP结合可能更有利于心衰患者的临床评价.     

Effect of pegylated interferon alpha 2b plus ribavirin treatment on plasma transforming growth factor-β1,metalloproteinase-1, and tissue metalloproteinase inhibitor-1 in patients with chronic hepatitis C

AIM: To evaluate the effect of antiviral treatment on plasma levels of transforming growth factor-β1 (TGF-β1),metalloproteinase 1 (MMP-1), and tissue inhibitor of metalloproteinase-1 (TIMP-1) in patients with chronic hepatitis C.METHODS: TGF-β1, MMP-1, and TIMP-1 plasma concentrations were measured by an enzyme immunoassay in 28 patients, during 48 wk of treatment with pegylated interferon-alpha 2b (PEG-IFN-α2b) plus ribavirin (RBV)and after 24 wk of follow-up. Patients were divided into two groups: responders (R) and non-responders (NR)related to achieved sustained virologic response. Normal values were evaluated in plasma samples of 13 healthy volunteers.RESULTS: Baseline plasma concentrations of TGF-β1and TIMP-1 (30.9±3.7 and 1506±61 ng/mL respectively)measured in all subjects significantly exceeded the normal values (TGF-β1:18.3±1.6 ng/mL and TIMP-1:1102±67 ng/mL). In contrast, pretreatment MMP-1mean level (6.5±0.9 ng/mL) was significantly lower than normal values (11.9±0.9 ng/mL). Response to the treatment was observed in 12 patients (43%). TGF-β1mean concentration measured during the treatment phase decreased to the control level in both groups.However at wk 72, values of NR patients increased and became significantly higher than in R group.TIMP-1 concentrations in R group decreased during the treatment to the level similar to normal. In NR group,TIMP-1 remained significantly elevated during treatment and follow-up phase and significant difference between both groups was demonstrated at wk 48 and 72. MMP-1levels were significantly decreased in both groups at baseline. Treatment caused rise of its concentration only in the R group, whereas values in NR group remained on the level similar to baseline. Statistically significant difference between groups was noted at wk 48 and 72.CONCLUSION: These findings support the usefulness of TGF-β1, TIMP-1, and MMP-1 in the management of chronic hepatitis C. Elevated TIMP-1 and low MMP-1plasma concentrations during antiviral therapy may indicate medication failure.