高血压病和脑卒中患者内源性VitC,E的测定及其意义

目的：探讨高血压病和脑卒中患内源性维生素C,E的抗氧化作用。方法：应用紫外分光光度法测定23例高血压病患,30例高血压性脑出血患,25例缺血性脑卒中患和20例正常对照组的血清维生素C,E,超氧化物歧化酶（SOD）和丙二醛（MDA）的含量。结果：与正常对照组相比,高血压病组,维生素C,E,SOD,MDA水平无明显改变：脑出血,脑缺血组急性期;维生素C,E,SOD含量明显降低（P＜0．01）,MDA水平明显升高（P＜0．01）,恢复期,维生素C,E含量恢复正常,SOD含量仍降低（P＜0．05）,MDA仍增高P＜0．05）。结论：在脑卒中急性期患维生素C,E水平明显降低,但随着病情好转逐渐恢复正常,同时伴随SOD,MDA水平改变。     

肝病血清丙二醛及超氧化物歧化酶测定的临床意义

目的:研究血清丙二醛及超氧化物歧化酶在肝病中的临床意义.方法:采用放免法和硫代巴比妥酸比色法测定53例肝病患者和26例正常对照组的血清丙二醛(MDA)和超氧化物歧化酶(SOD)水平.结果:急性肝炎组MDA高于正常对照组(P<0.01),差异显著,SOD低于正常对照组(P<0.01),差异显著.慢性肝炎组MDA明显高于正常对照组(P<0.002),差异非常显著.肝硬化组MDA显著高于正常组(P0.05),但均较正常组低.结论:肝病患者发病后均出现氧自由基代谢紊乱,而且随病变加重而自由基水平升高.因此,观察血清MDA和SOD水平的变化对临床上判断肝细胞的损害程度、病情发展、评估预后有一定的意义,同时为肝病的治疗提出了一条新途径及理论基础.     

急性脑出血时依达拉奉对一氧化氮、超氧化物歧化酶等的影响

目的探讨依达拉奉治疗急性脑出血时对一氧化氮（NO）、超氧化物歧化酶（SOD）等的影响及其临床意义。方法对82例急性脑出血患者分成依达拉奉治疗组与常规治疗组在治疗前后检测其血清NO、过氧化脂质（LPO）、谷胱甘肽过氧化物酶（GP）及SOD的含量,并与20例健康成人测定结果对比。同时采用直线回归和相关、逐步回归分析患者临床神经功能缺损程度积分（NDS）,以及与上述指标的关系。结果（1）急性脑出血患者NO、LPO显著升高（NOP〈0.01,LPOP〈0.05）,SOD、GP显著降低（P〈0.01）。（2）治疗后患者NO、LPO显著降低（P〈0.01）,SOD、GP显著升高（P〈0.01）。依达拉奉治疗组明显优于常规治疗组（P〈0.01）③逐步回归分析发现患者NDS与NO、LPO值密切相关。结论急性脑出血患者体内其自由基反应病理性加剧,氧化、抗氧化作用严重失衡,宜早期应用依达拉奉治疗,以减轻并防止继发性脑损伤,促进细胞功能的恢复。     

不稳定型心绞痛血运重建后氧化和抗氧化指标的动态变化

目的 :探讨不稳定型心绞痛 (UAP)患者经皮冠状动脉介入治疗后丙二醛 (MDA)和超氧化物歧化酶(SOD)水平的变化规律及临床意义。方法 :连续观察 2 5例UAP患者 (A组 )经皮冠状动脉治疗术前及术后 1、2 4、72h血液中MDA和SOD的变化。另设单纯行冠状动脉造影的UAP患者 (B组 ) 2 0例和健康者 2 0例作对照 ,MDA和SOD分别用硫代巴比妥酸法和黄嘌呤氧化酶法测定其血清含量 ,并随访术后 3个月心血管事件的发生情况。结果 :UAP患者中MDA浓度明显高于健康者 ,介入治疗后 1h进一步升高 ,持续至 2 4h(P <0 .0 5 ) ,72h回落至术前水平 ;B组术前与术后无明显改变。UAP患者中SOD的浓度明显低于健康者 (P <0 .0 5 ) ,介入治疗后进一步降低。结论 :UAP患者介入治疗后MDA和SOD在 72h内有动态变化 ,可能是术后早期心血管事件的危险因素     

脑灵颗粒治疗血管性痴呆及对SOD、MDA、NO水平的影响

目的 :探讨脑灵颗粒治疗血管性痴呆及对SOD、MDA、NO水平的影响。方法 :选择血管性痴呆病人 80例 ,随机分为治疗组和对照组各 40例 ,治疗组口服脑灵颗粒 ,每次 1包 ,沸水调服 ,每日 3次 ;对照组用脑通片 10mg ,每日 3次口服 ,疗程 3个月。结果 :治疗组临床疗效、智力、生活能力改善均优于对照组 ,经比较有统计学意义 (P <0 .0 5 ) ,治疗组治疗前后SOD、MDA、NO水平比较均有统计学意义 (P <0 .0 1) ,SOD升高 ,MDA、NO下降。结论 :脑灵颗粒剂治疗血管性痴呆有较好的治疗效果。     

丁苯酞联合阿托伐他汀治疗对急性脑梗死患者血流动力学及血清SOD、GSH-Px、NO水平的影响

【】目的：观察丁苯酞联合阿托伐他汀治疗急性脑梗死患者的疗效及对患者血流动力学及血清超氧化物岐化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、一氧化氮(NO)水平的影响。方法：选取2014年4月~2016年8月我院神经内科收治的急性脑梗死患者112例,按数字随机表法分为试验组和对照组,各56例,对照组患者在常规治疗的基础上给予阿托伐他汀钙片治疗,试验组患者给予丁苯酞软胶囊和阿托伐他汀钙片治疗。比较两组治疗效果,并分别于用药治疗前和治疗14d后采集肘静脉血,检测血流动力学指标和血清SOD、GSH-Px、NO水平,详细记录两组患者用药后不良反应发生情况。结果：试验组治疗有效率为92.86%(52/56),对照组为78.57%(44/56),组间差异具有统计学意义(P＜0.05);与治疗前比较,治疗后14d两组患者血浆黏度、全血高切黏度、全血低切黏度、红细胞压积、红细胞变形指数等血流动力学指标均明显改善,且试验组患者在上述指标的改善程度较对照组患者更为明显(P＜0.05);与治疗前比较,治疗后14d两组患者血清SOD、GSH-Px水平均明显升高,NO水平明显降低,且试验组患者在上述指标的升高或降低程度较对照组患者更为明显(P＜0.05);两组患者用药治疗后均未出现药物相关不良反应。结论：丁苯酞联合阿托伐他汀治疗急性脑梗死患者的临床疗效显著,可有效改善患者血流动力学和氧化应激水平,且安全性高,值得临床推广应用。     

32例Oddi括约肌功能障碍患者临床病理分析

目的提高对Oddi括约肌功能障碍的认识,探讨本病的临床病理特征,以提高对Oddi括约肌功能障碍诊治水平.方法对32例因上腹部疼痛无其他原因解释而行内镜下逆行胰胆管造影或内镜下乳头括约肌切开术患者进行了乳头黏膜组织的活检,对活检标本常规石蜡包埋,HE染色,显微镜下观察,记录其病理改变.同时记录经内镜逆行胰胆管造影（ERCP）下乳头黏膜的病理变化.结果内镜下乳头黏膜主要为充血水肿（90.6%）、糜烂（78.1%）、出血（56.2%）等.ERCP见胆总管扩张,合并十二指肠乳头旁憩室者占59.4%.病理组织学表现为乳头黏膜慢性炎症、急性炎症、腺体增生、黏膜下纤维组织增生等.结论Oddi括约肌功能障碍的病因和病理尚不清楚,其乳头组织的病理改变主要为炎性反应,炎症反应在Odd括约肌功能障碍的发病中具有重要的意义,这可能为诊断和治疗本病提供新的靶点.     

应用2008年WHO新分类分析骨髓增生异常综合征患者186例

目的:应用2008年WHO髓系肿瘤新分类法,对既往诊断的骨髓增生异常综合征(MDS)患者重新分类,了解各亚型的临床和实验室检查特点。方法:回顾性分析186例MDS患者初发病时的临床表现、血常规、骨髓象、骨髓病理学和细胞遗传学等方面的临床特点。RCUD34例,RARS19例,RCMD22例,RAEB-162例,RAEB-237例,MDS-U9例,5q-3例。并进行电话随访,追踪其临床病情进展情况。对随访结果结合临床资料应用SPSS13.0软件包进行数据处理。结果:按照新分型标准,34例RCUD中,RA12例,RN19例,RT13例,186例MDS患者中位发病年龄为62岁,资料齐全的随访病例123例,中位生存期30.2个月,各亚型中位生存期分别为RCUD84个月,RARS50个月,RCMD40个月,RAEB-117个月,RAEB-211个月,MDS-U69个月,RCUD、RARS、RCMD及MDS-U的中位生存期与RAEB-1、RAEB-2差异有统计学意义(P<0.05)。已确诊转化为急性髓系白血病共14例,其中12例死亡,转白后中位生存期仅4个月。结论:新分型标准中RCUD包含原有的RA亚型,新增加RN、RT亚...     

Correlation of serum HCV core concentration with blood level of lipid and antioxidants in various forms of liver diseases

BACKGROUND/AIMS: The present study was designed to investigate the effect of hepatitis C virus (HCV) core protein expression on the blood level of lipids, lipoproteins and apolipoprotein in various forms of liver diseases. At the same time, effect of HCV core protein was also studied on the level of antioxidants in these patient groups. The aim behind this study was to explore the possibility of HCV core induced lipid changes and ensuing oxidative liver damage in these liver diseases. METHODOLOGY: We studied a total number of 130 patients including 50 patients with acute viral hepatitis (AVH), 30 with chronic hepatitis (CH), 30 with hepatic cirrhosis and 20 patients with fulminant hepatic failure (FHF). Sera from all these patients were analyzed for hepatitis viral markers and HCV core protein using EIA assays. Sera/plasma from them were simultaneously analyzed for total cholesterol, triglyceride, low density lipoprotein (LDL), high density lipoprotein (HDL), apolipoprotein A-1 and B, and also for antioxidants. RESULTS: Analysis of data demonstrated the presence of viral hepatitis B, C and E infections in these cases. Hepatitis A and D infections were absent in all the patients. When data on lipid and lipoprotein were analyzed in relation to HCV core expression, we could not observe a significant change in the serum level of total cholesterol, triglyceride, LDL, HDL, apolipoprotein A-1 and apoprotein B in core positive patients as compared to core negative cases. However, lipoprotein (a) [Lp(a)] level was significantly reduced in core positive patients as compared to core negative cases. Furthermore, analysis of Superoxide dismutase (SOD), Total antioxidant (TAO) and Uric Acid in these patients demonstrated only a minor change in SOD and TAO levels in relation to HCV core, though at the same time, Uric Acid was found raised in all the groups. CONCLUSIONS: These observations clearly indicate that core expression does not bring a significant change in serum level of lipids, lipoprotein and apoproteins. Similarly, HCV core expression also does not show a major change in SOD and TAO levels suggesting an insignificant impact of core on oxidative stress during liver diseases.     

Sphincter of Oddi manometry using guide-wire-type manometer is feasible for examination of sphincter of Oddi motility

Background

Sphincter of Oddi manometry (SOM) is recognized as the standard diagnostic modality for sphincter of Oddi dysfunction (SOD). However, SOM is not commonly performed because of its technical difficulty and the high incidence of post-procedural pancreatitis. To diminish post-procedural pancreatitis, we tried to develop a new method of SOM. This study examined the feasibility of SOM with a guide-wire-type manometer, which is commonly used to measure the arterial pressure for coronary angiography, for the assessment of SO motility.

Methods

A total of 35 procedures were performed in 8 patients with biliary type III SOD and 14 patients with other disease. We performed SOM using the guide-wire-type manometer on SOD cases and other cases [amplitude, duration, frequency and the area under the curve (AUC) of SO contractions].

Results

The mean time required for the measurement was 7.5 ± 4.1 min. The amplitude, frequency and AUC of SO contractions were significantly larger in the SOD cases than in other diseases (147.2 vs. 92.8 mmHg, p = 0.042; 10 vs. 5/min, p = 0.007; 2,837 vs. 1,122 mmHg s, p = 0.003, respectively). In 6 patients who underwent endoscopic sphincterotomy (EST), the SO amplitude decreased dramatically after EST. In this study, mild pancreatitis was observed in only one patient.

Conclusions

SOM using a guide-wire-type manometer is safe, reliable and easy to apply for the clinical assessment of SO motility. The guide-wire-type manometer may become a new method to measure SO function for the diagnosis of SOD.     

Characterization of functional biliary pain and dyspeptic symptoms in patients with sphincter of Oddi dysfunction： Effect of papillotomy

INTRODUCTION Sphincter of Oddi (SO) dysfunction is thought toresponsible for postcholecystectomy abdominal pain in up to 13% of patients[1]. Endoscopic sphincter of Oddi manometry (ESOM) is considered the gold standard for the diagnosis of sphincter of Od…     

冠状动脉扩张症患者的临床特征及新分型指导介入治疗的效果观察

目的:总结51例冠状动脉扩张症(CAE)患者新分型临床特点及指导介入治疗的临床疗效.方法:回顾性分析我院2015年1月至2019年1月出院诊断含CAE且冠状动脉造影结果均符合CAE诊断标准患者51例.收集临床资料,按CAE新分型分类,随访主要不良心血管事件(MACE),其定义为全因死亡、心原性死亡、心肌梗死、血运重建的...     

甲亢性心脏病68例入院时临床特点分析

目的 :了解因甲亢性心脏病 (甲亢心 )入院患者的临床情况 ,分析其特点 ,为甲亢心的诊断、防治工作提供参考。方法 :搜集分析本院既往 11年因甲亢心入院患者的各项资料。结果 :入选者共6 8例 (男 31,女 37)。临床表现主要包括 :心律失常 5 1例 (以心房纤颤多见 )、心力衰竭 5 0例 (以全心衰最常见 )。结论 :甲亢心临床表现无特异性 ,需仔细与其他心血管疾病鉴别     

细胞膜脂质流动性和超氧化物歧化酶在肺结核和肺癌鉴别…

研究细胞膜脂质流动性和超氧化物歧化酶在肺结核和肺癌鉴别诊断中的价值。     

应用搏动性体外循环患者血浆丙二醛和超氧化物歧化酶的动态变化

对２０例心脏直视手术病人分别应用搏动性与非搏动性体外循环，动态观察体内丙二醛（ＭＤＡ）和超氧化物歧化酶（ＳＯＤ）变化。结果显示搏动组患者体外循环期间主动脉阻断及开放后血中ＳＯＤ升高，而ＭＤＡ无明显变化。提示搏动性灌注可能通过提高机体的抗氧自由基能力而改善组织的氧代谢。     

Predictors of outcomes after biliary and pancreatic sphincterotomy for sphincter of oddi dysfunction

BACKGROUND: There are few data on combined pancreatic and biliary sphincterotomy for sphincter of Oddi dysfunction (SOD), especially regarding clinical features that might predict outcomes. We sought to examine the relative importance of various clinical features and the presence or absence of objective biliary abnormalities in determining responses to endoscopic therapy. METHODS: A cohort of consecutive patients with suspected SOD was treated with biliary sphincterotomy, with additional pancreatic sphincterotomy at initial or subsequent endoscopic retrograde cholangiopancreatography if there was abnormal pancreatic manometry in conjunction with pain refractory to biliary sphincterotomy, continuous pain, or a history of amylase elevation. Repeat intervention was offered until response was achieved or complete ablation of all treated sphincters was achieved. Response was assessed by patients using a 5-point Likert scale, and multivariate logistic regression analysis used to identify predictors of response. RESULTS: Of 121 patients, 112 (92%) were female, 105 (87%) postcholecystectomy, and by modified Milwaukee biliary classification 18 (15%) were type I, 53 (44%) type II, and 50 (41%) type III. All patients underwent biliary sphincterotomy and 49 (40%) pancreatic sphincterotomy. Good or excellent response at final follow-up was reported by 83 (69%) of 121 patients, including 37 (61%) of 61 patients requiring repeated intervention. Response was not significantly different between biliary types I, II, and III. Patient characteristics (with adjusted odds ratios) that were significant predictors of poor response were normal pancreatic manometry (4.6), delayed gastric emptying (6.0), daily opioid use (4.0), and age <40 (2.7). Abnormal liver function tests or dilated bile duct were not significant. CONCLUSIONS: For the treatment of SOD incorporating pancreatic and biliary sphincterotomy, patient characteristics and pancreatic sphincter manometry may be more important predictors of outcome than the traditional classification based on liver chemistries and bile duct dilation.     

Method of dialysis therapy and selected markers of oxidative stress and endothelial injury in patients with chronic renal failure

Cardiovascular diseases (CVD), being mostly a clinical manifestation of atherosclerosis, are the main cause of mortality in patients with chronic renal failure (CRF). It is now generally accepted that the first step in atherosclerosis is endothelial dysfunction. Recently, oxidative stress (SOX) has been implicated as an important etiologic factor in atherosclerosis and vascular dysfunction both in general and uremic populations. The aim of the present study was to establish the effect of two different method of dialysis therapy: hemodialysis (HD) and continuous peritoneal dialysis (CAPD) on the markers of SOX: lipid peroxides, Cu/Zn superoxide dismutase (Cu/Zn SOD) and autoantibodies against oxidized LDL (OxLDL-Ab), and endothelial injury: antigen of the von Willebrand factor (vWF : Ag), soluble thrombomodulin (TM) and tissue factor pathway inhibitor (TFPI) in 43 patients with CRF. Compared with the control subjects, patients with CRF showed a significant increase in plasma concentrations of Cu/Zn SOD, which was more elevated in HD than in CAPD group. The lipid peroxide levels were increased only in the post-HD samples, whereas OxLDL-Ab were more elevated in HD than in CAPD group. Markers of endothelial injury were significantly higher in dialyzed patients relative to controls, and were positively correlated themselves as well as with Cu/Zn SOD levels. The patients on HD and CAPD are exposed to increased SOX as well as to endothelial injury. The association between Cu/Zn SOD and the endothelial injury markers suggests the possible effect of oxidative stress on endothelial dysfunction in CRF patients.     

超氧化物歧化酶及常用生物标志物检测对继发性肺结核并发呼吸衰竭的诊断价值

目的 分析超氧化物歧化酶(SOD)及临床常用生物标志物用于诊断继发性肺结核并发呼吸衰竭的应用价值。方法 收集首都医科大学附属北京胸科医院2015年3—12月确诊为继发性肺结核的143例患者的外周血标本,其中,继发性肺结核患者(肺结核组)71例,继发性肺结核并发呼吸衰竭患者(呼吸衰竭组)72例。检测并分析研究对象外周血标本SOD、超敏C反应蛋白(HCRP)、红细胞沉降率(ESR)及N末端-前脑钠肽(NT-proBNP)水平。结果 呼吸衰竭组的SOD水平为(524.16±225.97)mg/ml,低于肺结核组的(725.34±325.63)mg/ml;HCRP水平为(68.51±43.6)mg/L,高于肺结核组的(56.07±39.56)mg/L;ESR水平为(50.05±29.03)mm/1h,高于肺结核组的(37.13±27.58)mm/1h;NT-proBNP水平为(882.19±182.36)ng/L,高于肺结核组的(360.26±73.99)ng/L;差异均有统计学意义(t值分别为3.90、1.78、2.69、22.78,P值均<0.05)。经logistic多因素分析显示,肺结核患者的SOD水平≥300mg/ml时,发生呼吸衰竭的风险是SOD<300mg/ml时的89%(OR=0.89;95%CI=0.76~0.92);肺结核患者的NT-proBNP水平≥80 ng/L时发生呼吸衰竭的风险是NT-proBNP<80ng/L时的1.21倍(OR=1.21;95%CI=1.12~1.28)。SOD、ESR、HCPR、NT-proBNP在预测肺结核患者是否易发生呼吸衰竭的受试者工作特征曲线分析显示SOD的曲线下面积(AUC)值最高为0.862,敏感度为73.2%,特异度为93.1%,临界值(cut-off值)为478.51mg/ml。NT-proBNP的AUC值为0.764,敏感度72.5%,特异度82.7%,cut-off值为340.20ng/L。结论 继发性肺结核患者血浆中SOD及NT-proBNP水平对患者是否并发呼吸衰竭具有良好的辅助诊断价值。     

新型冠状病毒肺炎患者心肌损伤标志物初步探讨

目的:初步探讨不同临床分型新型冠状病毒肺炎(COVID-19)患者心肌损伤标志物特征。方法:本研究是一项回顾性单中心研究,纳入了2020年1月至2020年2月,共122例COVID-19确诊病例,其中轻型/普通型共92例,重型/危重型共30例。通过实时RT-PCR确诊病例,并收集流行病学,人口统计学,临床分析,放射学特征和实验室数据。结果:根据患者病情临床分型,将所有COVID-19患者分为两组,一组为轻型和普通型,另一组为重型/危重型患者。比较两组患者一般情况结果显示:重症/危重型COVID-19患者年龄、WBC、中性粒细胞百分比、血清淀粉样蛋白A、尿素氮、谷草转氨酶、心率、体温、呼吸次数、死亡率和肺部病变范围均高于轻型/普通型患者,而淋巴细胞数、淋巴细胞百分比和血氧饱和度则低于轻型/普通型患者(P<0.05)。比较不同病情分型COVID-19患者心肌损伤标志物水平和急性心肌受损的比例结果提示:重型/危重型患者心肌酶指标、心肌酶升高所占比例和hs-cTnI水平均高于轻型/普通型患者,急性心肌受损的比例(11.1%vs.42.3%)也明显升高(P<0.05)。结论:重症COVID-19患者发生急性心肌损伤的比例为42.3%;重症COVID-19患者心肌酶、hs-cTnI水平高于轻症患者。     

原发性高血压人群中亚临床靶器官受损与肥胖的关系

目的:探讨在原发性高血压人群中亚临床靶器官受损与肥胖的关系.方法:从社区体检中心按性别、年龄匹配抽取非肥胖高血压(单纯高血压)患者290例,单纯肥胖120例,肥胖伴高血压170例,调查评估其亚临床靶器官受损(颈动脉粥样硬化及尿微量白蛋白/肌酐比值)与肥胖、高血压的相关性.结果:单纯肥胖患者、肥胖伴高血压均较单纯高血压患者靶器官受损的比率明显升高,尤其是肥胖伴高血压患者较单纯高血压患者尿微量白蛋白的发生率明显升高(27%∶14%,P<0.01),但单纯肥胖与肥胖伴高血压患者之间靶器官受损差异无统计学意义.结论:伴肥胖的高血压患者亚临床靶器官受损的发生率更高.