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1.
急性胰腺炎患者血清ICAM-1、TNF-α和P选择素浓度与病情严重程度的关系 总被引:2,自引:0,他引:2
目的研究急性胰腺炎患者血清ICAM-1、TNF-α和P选择素浓度和疾病严重程度的关系。方法选择重症急性胰腺炎(SAP)10例,轻症急性胰腺炎(MAP)10例,健康对照组10例,分别在患者入院后第1、3、5天抽取血清,检测血清中TNF-α、ICAM-1、P选择素水平。结果SAP患者第1天ICAM-1, TNF-α,P选择素血清水平与MAP患者及对照组之间无显著性差异,而第3、5天SAP患者ICAM-1,TNF- α,P选择素血清水平与MAP患者及对照组之间均有显著性差异(P<0.05)。结论ICAM-1、TNF-α、P 选择素浓度升高与急性胰腺炎的严重程度有关。 相似文献
2.
目的研究急性胰腺炎患者血清ICAM-1、TNF-α和P选择素浓度和疾病严重程度的关系.方法选择重症急性胰腺炎(SAP)10例,轻症急性胰腺炎(MAP)10例,健康对照组10例,分别在患者入院后第1、3、5天抽取血清,检测血清中TNF-α、ICAM-1、P选择素水平.结果 SAP患者第1天ICAM-1,TNF-α,P选择素血清水平与MAP患者及对照组之间无显著性差异,而第3、5天SAP患者ICAM-1,TNF-α,P选择素血清水平与MAP患者及对照组之间均有显著性差异(P < 0.05).结论 ICAM-1、TNF-α、P选择素浓度升高与急性胰腺炎的严重程度有关. 相似文献
3.
目的通过动态检测急性胰腺炎(AP)患者外周血清C反应蛋白(CRP)、脂肪酶(LPS)、白细胞介素(IL)1β和细胞间黏附分子(ICAM)1的水平及变化,评价多种指标联合检测在AP临床诊断中的价值。方法收集2010年1月-2012年12月在中国医科大学附属第四医院进行治疗的AP患者86例,其中重症急性胰腺炎(SAP)患者39例,轻症急性胰腺炎(MAP)患者47例。于入院第1、3、5、7天分别采集患者血清,另选取12例同期健康体检者作为对照。采用ELISA法检测血清中CRP、IL-1β和ICAM-1水平,干片速率法测定血清LPS的浓度。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验。结果 MAP组患者入院第1天的CRP、IL-1β和LPS水平明显高于对照组,差异均有统计学意义(t值分别为-74.126、-60.135、-364.153,P值均0.001);SAP组患者入院第1天的CRP、ICAM-1、IL-1β、LPS水平均明显高于对照组,差异亦有统计学意义(t值分别为-121.355、-25.728、-89.422、-415.840,P值均0.001);各检测指标浓度的峰值出现在入院第1天或第3天,且随着治疗时间的延长,浓度呈进行性下降;与MAP患者相比,SAP患者血清中CRP、LPS、IL-1β和ICAM-1水平均较高,差异均有统计学意义(P值均0.05)。结论联合检测患者血清CRP、LPS、IL-1β和ICAM-1水平对于AP严重程度的早期判断具有一定的临床参考价值。 相似文献
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目的:探讨血清肿瘤坏死因子-α水平与急性胰腺炎肝损害的关系.方法:急性胰腺炎组63(男44例,女19例),正常对照组30(男20名,女10名),应用7600-020型自动分析仪(日本日立)测定治疗前后血清白蛋白、谷草转氨酶(AST)、谷丙转氨酶(ALT)、碱性磷酸酶(ALP)、总胆红素(STB)水平,应用放射免疫分析法测定治疗前后血清肿瘤坏死因子-α(INF-α)水平.结果:在63例急性胰腺炎中,合并肝损害38例(60.3%);45例轻症急性胰腺炎(MAP)有21例发生肝损害(发生率46.7%),18例重症急性胰腺炎(SAP)有17例发生肝损害(94.4%).肝损害的表现:AST升高31例(MAP 14例,SAP17例),ALT升高31例(MAP14例,SAP17例),ALP升高18例(MAP5例,SAP13例),STB升高29例(MAP13例,SAP16例).与MAP患者比较,治疗前SAP患者的血清白蛋白明显降低(P<0.01),血清AST,ALT,ALP,STB,TNF-α水平显著增高(P<0.01).治疗后SAP患者血清白蛋白升高(P<0.05),MAP和SAP血清AST,ALT,ALP,STB,TNF-α水平均明显下降(P<0.05或P<0.01),SAP组的AST,ALT,TNF-α仍明显高于MAP组(P<0.01).急性胰腺炎肝损伤组和非肝损伤组的TNF-α水平在治疗前均显著高于对照组(P<0.01),治疗后均明显低于治疗前(P<0.01),且与对照组比较无显著差异.治疗前肝损伤组的TNF-α明显高于非肝损伤组(P<0.01),治疗后二者之间无显著性差异.MAP肝损伤患者和SAP肝损伤患者的TNF-α水平均显著高于对照组,治疗后TNF-α水平均低于治疗前(P<0.01),但SAP患者仍高于对照组(P<0.01),而MAP组已接近正常.急性胰腺炎肝损伤患者的血清TNF-α水平与血清AST、ALT正相关(r=0.68,P<0.01;r=0.64,P<0.01),与碱性磷酸酶、总胆红素无相关性.结论:急性胰腺炎的肝脏损害发生率较高,SAP肝损伤的发生率明显高于MAP,急性胰腺炎肝损伤患者血清TNF-α水平明显升高,且升高程度与病情严重程度正相关. 相似文献
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目的 观测急性胰腺炎(acute pancreatitis,AP)患者外周血清白介素-1β(interleukin-1β,IL-1β)和可溶性E-选择素(soluble E-selectin,sE-selectin)水平的变化,探讨其对AP病情严重程度判断的价值.方法 41例AP患者分为重症急性胰腺炎组(SAP,19例)和轻症急性胰腺炎组(MAP,22例),于入院后1、3、7、14 d采集血清,以ELISA法检测血清IL-1β和sE-selectin水平.另选择20例健康者作为对照.结果 对照组血清IL-1β浓度为(18.71±2.43)ng/L;MAP组1、3、7 d分别为(61.18±7.47)ng/L、(33.03±5.85)ng/L、(20.73±4.07)ng/L;SAP组1、3、7、14 d分别为(86.91±13.32)ng/L、(81.35±12.71)ng/L、(64.93±5.99)ng/L、(21.40±49.13)ng/L.SAP组入院后1、3、7 d的IL-1β浓度较对照组和MAP组均显著升高(P<0.05),14 d与对照组无显著差异.对照组血清sE-selectin浓度为(10.69±2.51)ng/ml;MAP组1、3、7 d分别为(41.60±6.85)ng/ml、(14.90±3.51)ng/ml、(9.85±2.88)ng/ml;SAP组1、3、7、14 d分别为(84.73±15.37)ng/ml、(95.65±13.06)ng/ml、(39.41±3.73)ng/ml、(12.25±2.29)ng/ml.SAP组入院后1、3、7 d的sE-selectin浓度较对照组和MAP组均显著升高(P<0.05),14 d与对照组无显著差异.AP患者入院第1天的血清IL-1β含量和sE-selectin含量存在正相关关系(r=0.851,P<0.01).结论 AP患者血清IL-1 β和sE-selectin的检测有助于判断病情的严重程度. 相似文献
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联合检测血清淀粉样蛋白A和C-反应蛋白对重症急性胰腺炎早期预测的临床意义 总被引:1,自引:0,他引:1
目的 探讨联合检测血清淀粉样蛋白A(SAA)和C-反应蛋白(CRP)变化作为重症急性胰腺炎(SAP)早期预测指标的可行性.方法 采用乳胶增强散射比浊法测定18例重症急性胰腺炎患者(SAP组)和24例轻症急性胰腺炎患者(MAP组)急性期血清SAA和CRP水平,并与31名对照组比较.结果 SAP组SAA与CRP水平显著高于MAP组和对照组(P<0.01);SAP组与MAP组血清SAA水平比较差异有统计学意义(467.8±123.6 vs 181.0±58.6,P<0.01),而血清CRP水平比较差异无统计学意义(102.4±33.3 vs 80.1±26.2,P>0.05).SAP组和MAP组急性期血清SAA/CRP比值分别为4.77±1.34和2.36±0.82,与对照组(1.61±0.70)比较,差异有显著性(P<0.01).直线回归分析结果表明,急性胰腺炎患者血清S从与CRP水平呈正相关(r=0.567,P<0.01).结论 血清SAA较CRP更敏感,提示胰腺病变严重程度.联合检测血清S从和CRP水平可作为重症急性胰腺炎的早期预测指标. 相似文献
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目的对血清白介素-6(IL-6)、白介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)等细胞因子在早期诊断重症急性胰腺炎(severe acute pancreatitis,SAP)中的价值进行研究.方法以Ranson和APACHE-Ⅱ评分为标准,把36例急性胰腺炎患者分成轻症胰腺炎组(MAP)及重症胰腺炎组(SAP)两组,选择年龄匹配的13名健康志愿者为对照组(Con);在患者入院24 h内采静脉血并检测血清中IL-6、IL-8和TNF-α水平.结果三种细胞因子血清水平均为SAP组最高,Con组最低,其中IL-6水平在三组之间、两两之间均有显著差异,IL-8和TNF-α水平在Con组与SAP组之间、MAP组与SAP组之间有显著差异,而Con组与MAP组之间无显著差异.结论IL-6、IL-8、TNF-α对早期诊断鉴别轻症胰腺炎和重症胰腺炎均有重要的临床意义. 相似文献
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目的 检测急性胰腺炎患者血清晚期氧化蛋白产物(AOPP)的水平,结合IL-6及反映急性胰腺炎(AP)严重程度的指标及相关临床资料,探讨AOPP与AP严重程度的关系.方法 回顾性分析我院2010年ll月-2012年9月临床上确诊的AP患者58例.其中,重症急性胰腺炎(sever acute pancreatitis,SAP) 18例,轻症急性胰腺炎(mild acute pancreatittis,MAP)40例.应用酶联免疫吸附试验(ELISA)方法检测AP患者入院24 h内的血清AOPP和IL-6含量.同时检测患者血常规、肝功能、血钙(Ca)、血糖(GLU)、乳酸脱氢酶(LDH).结果 SAP组血清白细胞(WBC)、GLU、LDH高于MAP组,差异有统计学意义(P<0.05),白蛋白(ALB)、血Ca低于MAP组,差异有统计学意义(P <0.05);SAP组、MAP组血清AOPP含量分别为(38.12± 11.67) ng/ml和(29.40±14.19) ng/ml,两组比较差异有统计学意义(P<0.05);SAP组、MAP组血清IL-6含量分别为(211.01±107.98) pg/ml和(129.72±56.53) pg/ml,两组比较差异有统计学意义(P<0.05).AP患者血清AOPP与WBC、GLU呈正相关性(P<0.05),与LDH、血Ca、ALB无明显相关性(P>0.05).结论 血清AOPP增高可能与AP的严重程度有关;AOPP可能参与AP发生、发展中的炎症反应过程. 相似文献
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血清IL-6、IL-8和TNF—α在重症急性胰腺炎早期诊断中的临床意义 总被引:4,自引:1,他引:4
目的 对血清白介素-6(IL-6)、白介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)等细胞因子在早期诊断重症急性胰腺炎(severe acute pancreatitis,SAP)中的价值进行研究。方法 以Ranson和APACHE—Ⅱ评分为标准,把36例急性胰腺炎患者分成轻症胰腺炎组(MAP)及重症胰腺炎组(SAP)两组,选择年龄匹配的13名健康志愿者为对照组(Con);在患者入院24h内采静脉血并检测血清中IL-6、IL-8和TNF-α水平。结果 三种细胞因子血清水平均为SAP组最高,Con组最低,其中IL-6水平在三组之间、两两之间均有显著差异,IL-8和TNF—α水平在Con组与SAP组之间、MAP组与SAP组之间有显著差异,而Con组与MAP组之间无显著差异。结论 IL-6、IL-8、TNF—α对早期诊断鉴别轻症胰腺炎和重症胰腺炎均有重要的临床意义。 相似文献
10.
《世界华人消化杂志》2016,(14)
目的:探讨血清铁调素(hepcidin,HEP)在急性胰腺炎(acute pancreatitis,AP)患者中的浓度变化和临床价值.方法:轻症急性胰腺炎(mild acute pancreatitis,MAP)104例、重症急性胰腺炎(severe acute pancreatitis,SAP)45例,分别于入院时、入院后1、3、7 d用酶联免疫分析法检测HEP浓度,以50例健康体检者为对照,分析HEP与A P的临床相关性,并绘制受试者工作特征曲线.结果:AP患者入院时HEP浓度高于对照组(P0.05);入院后1、3、7 d SAP组HEP浓度高于MAP组(P0.05);入院时轻症、SAP组间HEP浓度无明显差异;HEP与血清C反应蛋白、APACHE-Ⅱ评分浓度正相关(P=0.004、0.000),与血钙浓度负相关(P=0.003).以入院后第3天A P H E P浓度绘制的R O C曲线下面积为0.802,以H E P浓度大于133 ng/m L为临界值,以HEP诊断SAP的敏感度为95.6%,特异度为61.5%.结论:HEP与AP严重程度密切相关,可能成为AP病情监测以及SAP早期识别的重要指标. 相似文献
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AIM: To determine if serum inter-cellular adhesion molecule 1 (ICAM-1) is an early marker of the diagnosis and prediction of severe acute pancreatitis (SAP) within 24 h of onset of pain, and to compare the sensitivity, specificity and prognostic value of this test with those of acute physiology and chronic health evaluation (APACHE) II score and interleukin-6 (IL-6).METHODS: Patients with acute pancreatitis (AP) were divided into two groups according to the Ranson’s criteria: mild acute pancreatitis (MAP) group and SAP group. Serum ICAM-1, APACHE IIand IL-6 levels were detected in all the patients. The sensitivity, specificity and prognostic value of the ICAM-1, APACHE IIscore and IL-6 were evaluated.RESULTS: The ICAM-1 level in 36 patients with SAP within 24 h of onset of pain was increased and was significantly higher than that in the 50 patients with MAP and the 15 healthy volunteers (P < 0.01). The ICAM-1 level (25 ng/mL) was chosen as the optimum cutoff to distinguish SAP from MAP, and the sensitivity, specificity, positive predictive value, negative predictive value (NPV), positive likelihood ratio and negative likelihood ratio were 61.11%, 71.42%, 0.6111, 0.7142, 2.1382 and 0.5445, respectively. The area under the curve demonstrated that the prognostic accuracy of ICAM-1 (0.712) was similar to the APACHE-IIscoring system (0.770) and superior to IL-6 (0.508) in distinguishing SAP from MAP.CONCLUSION: ICAM-1 test is a simple, rapid and reliable method in clinical practice. It is an early marker of diagnosis and prediction of SAP within the first 24 h after onset of pain or on admission. As it has a relatively low NPV and does not allow it to be a stand-alone test for the diagnosis of AP, other conventional diagnostic tests are required. 相似文献
12.
目的 探讨同型半胱氨酸(HCY)、肿瘤坏死因子(TNF)-α和白细胞介素(IL)-6与急性胰腺炎(AP)病情严重程度的相关性以及对AP患者预后的评估价值.方法 选取AP患者64例,将其分为轻症AP组41例(MAP组)、重症AP组23例(SAP);另选取健康体检者72例作为对照组.分别于入院第1、3和7天抽取静脉血检测血清HCY、TNF-α和IL-6水平,同时进行急性生理和慢性健康评分标准Ⅱ(APACHEⅡ)评分.结果 与对照组比较,入院第1天MAP组和SAP组血清HCY、TNF-α和IL-6水平均升高(P<0.01),其中SAP组升高更加明显(P<0.01);入院第3天时MAP组和SAP组血清HCY、TNF-α和IL-α水平均明显升高达到峰值;经常规治疗后(入院第7天),两组HCY、TNF-α和IL-6水平均明显下降.HCY、TNF-α和IL-6水平与APACHEⅡ评分呈正相关(P<0.01).结论 血清HCY、TNF-α和IL-6水平与AP的发生、发展相关,早期密切观察血清HCY、TNF-α和IL-6水平变化对评估AP的严重程度和判断预后有一定的临床价值. 相似文献
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目的 探究血清促炎细胞因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及高迁移率族蛋白B-1(HMGB1)水平在早期评估急性胰腺炎(AP)患者严重程度及预后的价值.方法 以33例重症急性胰腺炎(SAP)和38例轻症急性胰腺炎(MAP)患者为研究对象,另以51名健康体检者作为对照组.采用酶联免疫吸附试验(ELISA)检测血清IL-6、TNF-α及HMGB1水平,分析三者与患者Ranson评分、APACHEⅡ评分、Bahhazar CT评分、血清生化指标及预后的关系.结果 SAP组、MAP组、健康对照组血清IL-6水平分别为(553.72±175.76)pg/ml、(265.73±179.95)pg/ml和(16.43±3.32)pg/ml,三组间差异均有统计学意义(P均<0.01).SAP组、MAP组、健康对照组血清TNF-α水平三组间差异均无统计学意义(P均>0.05).SAP组、MAP组、健康对照组血清HMGB1水平分别为(11.48±6.94)μg/L、(6.13±5.80)μg/和(1.82±0.64)/μg/L,三组间HMGB1值差异均有统计学意义(P均<0.05).患者血清HMGB1水平与IL-6,TNF-α的相关系数分别为0.896和0.724(P<0.01).血清IL-6水平与Ranson评分、APACHE Ⅱ评分、Balthazar CT 评分均呈正相关;血清TNF-α水平与APACHEⅡ评分呈正相关;血清HMGB1水平与Ranson评分、Balthazar CT评分呈正相关.三者血清水平均与肌酐值呈正相关.病程中出现局部和(或)全身并发症者血清IL-6水平显著高于无并发症者.结论 血清IL-6、TNF-α、HMGB1水平与胰腺炎病情的严重程度显著相关,三者参与AP时急性肾功能不全的发生,血清IL-6水平升高与并发症发生显著相关.Abstract: Objective To explore the value of serum level of interleukin 6 (IL-6),tumor necrosis factor alpha (TNF-α) and high mobility group box-1 protein( HMGB1) in early assessment the severity and prognosis of acute pancreatitis (AP). Methods Thirty-three severe acute pancreatitis (SAP) patients and 38 mild acute pancreatitis (MAP) patients were selected as study objects;and 51healthy individuals were set as control group. Serum IL-6,TNF-α and HMGB1 concentrations were determined by enzyme-linked immunosorbent assay (ELISA),the association of them and the scores of Ranson,APACHE Ⅱ . Balthazar CT,serum biochemical parameters and prognosis was analyzed.Results The serum IL-6 levels of SAP group,MAP group and healthy control group were (553. 72±175.76) pg/ml,(265. 73±179. 95) pg/ml and (16. 43±3. 32) pg/ml;and there were statistical significance of these three groups (all P<0. 01). There was no significant difference of TNF-α in the three groups (all P>0. 05). The serum HMGB1 levels of SAP group,MAP group and healthy control group were (11. 48±6. 94)μg/L,(6. 13±5. 80)μg/L and (1. 82±0. 64)μg/L respectively,and there were statistical significant of these three groups (all P<0. 05). The correlation coefficient of serum HMGB1 with IL-6 and TNF-α were 0. 896 and 0. 724 (P<0. 01) respectively. The IL-6 level was positively correlated with the scores of Ranson,APACHE Ⅱ and Balthazar CT. The TNF-αconcentration was positively correlated with APACHE Ⅱ score,and the HMGB1 concentration positively correlated with scores of Ranson and Balthazar CT. The levels of IL-6,TNF-α and HMGB1were all positively correlated with the serum creatinine concentration. The IL-6 levels of patients with local and/or systemic complications were significantly higher than those without complications.Conclusion The serum levels of IL-6,TNF-α and HMGB1 are significantly correlated with the severity of pancreatitis,all of them take part in the development of acute renal insufficiency. The high level of serum IL-6 significantly correlated with complications. 相似文献
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Expression of TREM-1 mRNA in acute pancreatitis 总被引:4,自引:0,他引:4
Wang DY Qin RY Liu ZR Gupta MK Chang Q 《World journal of gastroenterology : WJG》2004,10(18):2744-2746
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急性胰腺炎与内皮素及氧自由基关系的研究 总被引:5,自引:0,他引:5
目的:探讨内皮素(ET)及氧自由基(OFR)在急性胰腺炎(AP)发病中的作用及相互关系。方法:采用放射免疫分析法、硫代巴比妥酸法及黄嘌呤氧化酶法测定17例重症急性胰腺炎(SAP)、35例轻症急性胰腺炎(MAP)及30例正常对照(NC)组血浆ET、血清丙二醛(MDA)及超氧化物歧化酶(SOD)的含量。结果:SAP患者ET显著增高、MAP患者ET明显降低,两组比较具有显著差异(P<0.001)。AP患者MDA显著增高。而SOD明显降低,SAP与MAP两组患者MDA比较具有显著差异(P<0.001),而两组患者SOD比较无显著差异(P>0.05)。结论:OFR损伤是AP发病的重要因素之一,本文提示,ET水平增高协同OFR参与SAR发病机制,ET水平降低对MAP胰腺组织可能具有一定的保护作用。 相似文献
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Yin Jin Chun-Jing Lin Le-Mei Dong Meng-Jun Chen Qiong Zhou Jian-Sheng Wu 《World journal of gastroenterology : WJG》2013,19(25):4066-4071
AIM: To assess the value of plasma melatonin in pre-dicting acute pancreatitis when combined with the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and bedside index for severity in acute pancreatitis (BISAP) scoring systems. METHODS: APACHEⅡ and BISAP scores were calculated for 55 patients with acute physiology (AP) in the first 24 h of admission to the hospital. Additionally, morning (6:00 AM) serum melatonin concentrations were measured on the first day after admission. According to the diagnosis and treatment guidelines for acute pancreatitis in China, 42 patients suffered mild AP (MAP). The other 13 patients developed severe AP (SAP). A total of 45 healthy volunteers were used in this study as controls. The ability of melatonin and the APACHEⅡ and BISAP scoring systems to predict SAP was evaluated using a receiver operating characteristic (ROC) curve. The optimal melatonin cutoff concentration for SAP patients, based on the ROC curve, was used to classify the patients into either a high concen-tration group (34 cases) or a low concentration group (21 cases). Differences in the incidence of high scores, according to the APACHEⅡ and BISAP scoring sys- tems, were compared between the two groups. RESULTS: The MAP patients had increased melatonin levels compared to the SAP (38.34 ng/L vs 26.77 ng/L) (P = 0.021) and control patients (38.34 ng/L vs 30.73 ng/L) (P = 0.003). There was no significant difference inmelatoninconcentrations between the SAP group and the control group. The accuracy of determining SAP based on the melatonin level, the APACHEⅡ score and the BISAP score was 0.758, 0.872, and 0.906, respectively, according to the ROC curve. A melatonin concentration ≤ 28.74 ng/L was associated with an increased risk of developing SAP. The incidence of high scores (≥ 3) using the BISAP system was significantly higher in patients with low melatonin concentration (≤ 28.74 ng/L) compared to patients with high melatonin concentration (> 28.74 ng/L) (42.9% vs 14.7%, P = 0.02). The 相似文献
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目的 研究白细胞介素家族中的有关炎症反应因子和C-反应蛋白(CRP)在老年深静脉血栓(DVT)病人中的作用及其发病机理,探讨老年DVT病人的早期诊断和病程转归标志物。方法 选39例老年急性DVT病人。在治疗前2h和治疗后第1、3、7、14天,分别检测IL-2、sIL-2R、IL-4、IL-6、IL-8和CRP。结果 在急性DVT病人中sIL-2R、IL-6、IL-8和CRP在治疗前2h和治疗后第1天高于正常值(P〈0,01),该两个阶段之间差异无统计学意义(P〉0.05),与治疗后第3天,第7天和第14天差异有统计学意义(P〈0.01),IL-2在治疗前后呈现下降趋势(P〈0.01),IL-4治疗前后差异无统计学意义(P〉0.05)。结论 IL-2、sIL-2R、IL-6、IL-8和CRP,可作为老年DVT病人血液中早期炎症标志物的测定,也可以作为反映和病情转归的炎症标志物测定。 相似文献