血必净注射液对大面积烧伤患者炎性介质和凝血功能的影响

目的观察血必净对大面积烧伤患者血清肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)以及血小板计数(PLT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)的影响。方法近4年总面积30%的烧伤患者24例,随机分为常规治疗组和血必净组,每组12例;常规治疗组根据体重、烧伤面积、烧伤深度行补液复苏,抗感染以及保护各脏器功能等对症支持治疗;血必净组在常规治疗组的基础上加用血必净注射液50mL配伍生理盐水100mL静脉滴注,2次/d。检测两组患者治疗第1、2、5和7天血清中TNF-α、IL-6浓度变化;第7天PLT、PT、TT、FIB、APTT的变化。结果 (1)治疗第1、2和5天,常规治疗组和血必净组TNF-α和IL-6均明显高于正常值(P0.05);治疗第5天和第7天,血必净组TNF-α和IL-6水平明显低于常规治疗组(P0.05);治疗第7天,常规治疗组TNF-α和IL-6水平显著高于正常值(P0.05),而血必净组和正常值比较差异无统计学意义(P0.05)。(2)常规治疗组PLT和FIB明显低于正常值和血必净组,而血必净组与正常值之间差异无统计学意义(P0.05)。常规治疗组APTT、PT和TT明显延长,与正常值相比有统计学意义(P0.05),血必净组APTT、PT和TT较常规治疗组显著缩短(P0.05),与正常值相比无统计学意义(P0.05)。结论血必净注射液可有效的抑制大面积烧伤患者血清中TNF-α和IL-6的释放,减轻APTT、PT和TT的异常。     

苦参素联合恩替卡韦治疗失代偿期乙型肝炎肝硬化疗效分析

目的：分析苦参素联合恩替卡韦治疗失代偿期乙型肝炎肝硬化的临床疗效。方法选择我院2012年2月~2014年2月收治的64例失代偿期乙型肝炎肝硬化患者为研究对象,随机数字法将其分为两组,对照组患者给予苦参素治疗,实验组患者行苦参素联合恩替卡韦治疗,对两组患者治疗前后肝功能指标及HBV-DNA变化进行比较。结果实验组患者治疗后ALB、AST、ALT、TBIL及HBV-DNA明显优于治疗前、对照组,差异有统计学意义,<0.05。结论苦参素联合恩替卡韦治疗能明显改善患者肝功能,抑制HBV-DNA复制,值得在失代偿期乙型肝炎肝硬化治疗中进一步应用。     

血必净注射液对重症蝮蛇咬伤患者免疫功能的影响

目的 研究血必净注射液对重症蝮蛇咬伤患者对机体免疫调节功能的影响。方法 对2014年7月~2017年10月本院急诊科收治的重症蝮蛇咬伤患者46例,常规治疗组按照经典的毒蛇治疗法,观察组使用血必净注射液治疗;健康对照组选择为同期体检正常人。分析各组在治疗前、治疗第1天、第3天及第7天,检测其血清促炎介质IL-6和抗炎介质IL-10水平,代表性评估患者的免疫功能。结果 治疗前和治疗第1天,2个治疗组IL-6无明显区别,但均高于对照组,两治疗组于治疗第3天、第7天IL-6水平均降低,差异有统计学意义（P＜0.05）,但观察组较常规治疗组下降（P＜0,05）;各组IL-10水平在治疗前与治疗第1天,差异无统计学意义（P＞0.05）,但第3天、第7天,治疗组则高于健康对照组（P＜0.05）,两治疗组间,差异无统计学意义（P＞0.05）。结论 重症蝮蛇咬伤患者的免疫功能可出现紊乱,表现为早期促炎介质占优势,后期抗炎介质升高明显,血必净注射液可下调促炎介质（IL-6）水平,在一定程度上调节机体免疫功能。     

血必净对恙虫病患者多器官功能障碍的保护作用及机制

目的探讨血必净注射液对恙虫病患者多器官功能障碍的保护作用及其机制。方法将19例恙虫病患者随机分为常规治疗组（9例）和血必净治疗组（10例）,两组患者均给予氯霉素和左氧氟沙星治疗,血必净治疗组在此基础上加用血必净注射液。观察两组治疗前和治疗后第5天血清丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、内毒素（LPS）、肿瘤坏死因子（TNF）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、氧合指数（PaO2/FiO2）、凝血酶原时间（PT）、部分凝血酶原时间（APTT）、血小板（PLT）、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分的水平变化。结果常规治疗和血必净治疗组的治愈率分别为22.22%、60%（P〈0.05）。血必净治疗5d后,AST、ALT分别从（102.5±24.5）U/L、（101.3±23.4）U/L下降为（43.3±10.2）U/L、（39.2±6.5）U/L（P〈0.05）,PLT、PaO2/FiO2分别从（98.2±42.2）×109/L、（225.0±19.0）mmHg升高为（278.3±15.6）×109/L、（352.0±6.0）mmHg（P〈0.05）,APACHEⅡ显著下降（P〈0.01）;LPS、INF、IL-6、IL-8显著降低（P〈0.05）。结论血必净注射液可以提高对恙虫病患者的治愈率,对多器官功能损害具有保护作用;其机制为主要通过减少炎症介质分泌来实现。     

拉米夫定初始联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化1年的疗效评价

目的 观察拉米夫定(LMV)初始联合阿德福韦酯(ADV)治疗失代偿期乙型肝炎肝硬化1年的疗效和可能的肾功能异常.方法 36例无核苷类似物治疗史的乙型肝炎肝硬化失代偿期患者,随机分为2组,对照组(n=18)给LMV 100 mg/d单药抗病毒,观察组(n=18)给LMV 100 mg/d+ADV 10 mg/d,同时均予常规护肝及对症、支持治疗,疗程1年;观察治疗前后肝功能、Child-Pugt评分和血清肌酐变化,病毒学应答率和病毒学反弹发生率,统计学比较组同差异.结果 (1)基线时两组患者性别、年龄、HBeAg状况、HBV载量、血肌酐和Child-Pugh评分均无统计学差异(P>0.05).(2)治疗结束时2组均无死亡发生,自身前后对比肝功能改善、Cllild-Pugh评分下降、HBV-DNA水平显著下降,观察组疗效优于对照组(P<0.01)、病毒学应答率高于对照组(88.89%vs 66.67%,P<0.05).(3)观察组无病毒学反弹发生,对照组3例(16.67%)发生病毒学反弹,HBV P区基因测序均系rtM204V变异.(4)2组患者均无血肌酐增高发生.结论 乙型肝炎肝硬化失代偿期LMV初始联合ADV 1年治疗在肝功能改善、病毒学应答和HBV耐药变异等方面均优于LMV单药治疗,且肾脏安全性良好.     

拉米夫定初始联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化1年的疗效评价

目的 观察拉米夫定(LMV)初始联合阿德福韦酯(ADV)治疗失代偿期乙型肝炎肝硬化1年的疗效和可能的肾功能异常.方法 36例无核苷类似物治疗史的乙型肝炎肝硬化失代偿期患者,随机分为2组,对照组(n=18)给LMV 100 mg/d单药抗病毒,观察组(n=18)给LMV 100 mg/d+ADV 10 mg/d,同时均予常规护肝及对症、支持治疗,疗程1年;观察治疗前后肝功能、Child-Pugt评分和血清肌酐变化,病毒学应答率和病毒学反弹发生率,统计学比较组同差异.结果 (1)基线时两组患者性别、年龄、HBeAg状况、HBV载量、血肌酐和Child-Pugh评分均无统计学差异(P>0.05).(2)治疗结束时2组均无死亡发生,自身前后对比肝功能改善、Cllild-Pugh评分下降、HBV-DNA水平显著下降,观察组疗效优于对照组(P<0.01)、病毒学应答率高于对照组(88.89%vs 66.67%,P<0.05).(3)观察组无病毒学反弹发生,对照组3例(16.67%)发生病毒学反弹,HBV P区基因测序均系rtM204V变异.(4)2组患者均无血肌酐增高发生.结论 乙型肝炎肝硬化失代偿期LMV初始联合ADV 1年治疗在肝功能改善、病毒学应答和HBV耐药变异等方面均优于LMV单药治疗,且肾脏安全性良好.     

失代偿期肝硬化治疗的临床研究

目的探讨促肝细胞生成素和还原型谷胱苷肽联合治疗失代偿期肝硬化的临床疗效。方法133例失代偿期肝硬化患者随机分为治疗组66例及对照组67例,治疗组应用促肝细胞生成素80 mg及还原型谷胱苷肽1500 mg静脉滴注,对照组采用还原型谷胱苷肽1500 mg静脉滴注,两组给予相同的支持治疗,疗程共4周,观察治疗后患者症状、体征及肝功能等变化。结果治疗组患者症状、体征及肝功能状况的改善均明显优于对照组。结论促肝细胞生成素与还原型谷胱苷肽联合治疗失代偿期肝硬化有较好疗效。     

拉米夫定初始联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化1年的疗效评价

目的观察拉米夫定（LMV）初始联合阿德福韦酯（ADV）治疗失代偿期乙型肝炎肝硬化1年的疗效和可能的肾功能异常。方法36例无核苷类似物治疗史的乙型肝炎肝硬化失代偿期患者,随机分为2组,对照组（n=18）给LMV 100mg／d单药抗病毒,观察组（n：18）给LMV 100mg／d＋ADV10mg／d,同时均予常规护肝及对症、支持治疗,疗程1年;观察治疗前后肝功能、Child-Pugh评分和血清肌酐变化,病毒学应答率和病毒学反弹发生率,统计学比较组间差异。结果（1）基线时两组患者性别、年龄、HBeAg状况、HBV载量、血肌酐和Child．Pugh评分均无统计学差异（P〉0．05）。（2）治疗结束时2组均无死亡发生,自身前后对比肝功能改善、Child-Pugh评分下降、HBV-DNA水平显著下降,观察组疗效优于对照组（P〈0．01）、病毒学应答率高于对照组（88．89％VS66．67％,P〈0．05）。（3）观察组无病毒学反弹发生,对照组3例（16．67％）发生病毒学反弹,HBVP区基因测序均系rtM204V变异。（4）2组患者均无血肌酐增高发生。结论乙型肝炎肝硬化失代偿期LMV初始联合ADV1年治疗在肝功能改善、病毒学应答和HBV耐药变异等方面均优于LMV单药治疗,且肾脏安全性良好。     

酒精性肝硬化患者血清内毒素、IL-6、IL-8和PRL检测的临床意义

目的:探讨了酒精性肝硬化患者血清内毒素、IL-6、IL-8和PRL水平的变化及临床意义。方法:采血鲎试验、放射免疫分析对31例酒精性肝硬化患者进行了血清内毒素、IL-6、IL-8和PRL的检测,并与35名正常人作比较。结果:酒精性肝硬化患者血清内毒素、IL-6、IL-8和PRL水平均非常显著地高于正常人组(P<0.01),且血清内毒素水平与IL-6、IL-8和PRL水平呈正相关(r=0.4788、0.5126.0.6137,P<0.01)。结论:检测酒精性肝硬化患者血清内毒素、IL-6、IL-8和PRL水平的变化,对该病的诊断、治疗和预后观察均有一定的临床实用价值。     

血清炎性因子PCT、IL-6、CRP联合检测对老年肝功能失代偿期肝癌患者发生感染的预测效能分析

目的:探讨血清炎性因子降钙素原(Procalcitonin,PCT)、白细胞介素-6(Interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)联合检测对老年肝功能失代偿期肝癌患者发生感染的预测效能.方法:选取我院 2019年 9 月至 2021 年9 月就诊的 158 例肝功能失代偿期肝癌患者作为研究组,另选取同期 79 名健康体检者作为对照组.入院时,抽取患者外周静脉血,全自动微生物分析仪分离并鉴定病原菌感染和分布情况,电化学发光法测定患者血清PCT水平;免疫比浊法测定患者血清CRP水平,酶联免疫吸附法测定患者血清IL-6 水平,比较研究组、对照组及研究组中感染患者、未感染患者血清PCT、IL-6、CRP水平,Logistic回归方程分析上述指标与发生感染的关系,受试者工作特征曲线(Receiver operating characteristic,ROC)及曲线下面积(Area under the ROC curve,AUC)分析其对发生感染的预测价值.结果:入院时,研究组血清PCT、IL-6、CRP水平高于对照组(P＜0.05);研究组中共 43例发生感染,感染病原菌以金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌为主,分别占 22.92％、27.08％、18.75％;研究组中感染患者血清PCT、IL-6、CRP水平高于未感染患者(P＜0.05);Logistic回归分析显示,入院时血清PCT、IL-6、CRP水平与失代偿期肝癌患者发生感染具有显著相关性(OR=12.346、8.682、10.554,P＜0.05);入院时血清PCT、IL-6、CRP水平对失代偿期肝癌患者发生感染的预测AUC分别为 0.872、0.789、0.848,联合预测AUC为 0.923,联合预测AUC大于单一指标.结论:血清PCT、IL-6、CRP水平变化与老年肝功能失代偿期肝癌患者发生感染密切相关,临床可通过联合检测血清PCT、IL-6、CRP水平可早期预测失代偿期肝癌是否发生感染,以针对性制定干预措施.     

The extended IL-10 superfamily: IL-10, IL-19, IL-20, IL-22, IL-24, IL-26, IL-28, and IL-29

Cytokines are involved in virtually every aspect of immunity and inflammation. A cascade of responses evolves after cytokine activation, although optimal function might ultimately involve several complementary cytokines. Understanding the function of individual cytokines is complicated because their role can vary depending on the cellular source, target, and phase of the immune response. In fact, numerous cytokines have both proinflammatory and anti-inflammatory potential, with the contrasting outcome observed being determined by the immune cells present and their state of responsiveness to the cytokine. These issues make the study of cytokine biology daunting, particularly so for IL-10 and IL-10-related genes. The IL-10 superfamily is highly pleiotropic. These genes are linked together through genetic similarity and intron-exon gene structure. Significant commonality exists not only through shared receptors but also through conserved signaling cascades. However, its members mediate diverse activities, including immune suppression, enhanced antibacterial and antiviral immunity, antitumor activity, and promotion of self-tolerance in autoimmune diseases.     

Proinflammatory cytokines (IL-17, IL-6, IL-18 and IL-12) and Th cytokines (IFN-gamma, IL-4, IL-10 and IL-13) in patients with allergic asthma

Allergen-reactive T helper type-2 (Th2) cells and proinflammatory cytokines have been suggested to play an important role in the induction and maintenance of the inflammatory cascade in allergic asthma. We compared the plasma concentrations of novel proinflammatory cytokines IL-17 and IL-18, other proinflammatory cytokines IL-6 and IL-12, Th2 cytokines IL-10 and IL-13, and intracellular interferon-gamma (IFN-gamma) and IL-4 in Th cells of 41 allergic asthmatics and 30 sex- and age-matched health control subjects. Plasma cytokines were measured by enzyme-linked immunosorbent assay. Intracellular cytokines were quantified by flow cytometry. Plasma IL-18, IL-12, IL-10, IL-13 concentrations were significantly higher in allergic asthmatic patients than normal control subjects (IL-18: median 228.35 versus 138.72 pg/ml, P < 0.001; IL-12: 0.00 versus 0.00 pg/ml, P = 0.001; IL-10: 2.51 versus 0.05 pg/ml, P < 0.034; IL-13: 119.38 versus 17.89 pg/ml, P < 0.001). Allergic asthmatic patients showed higher plasma IL-17 and IL-6 concentrations than normal controls (22.40 versus 11.86 pg/ml and 3.42 versus 0.61 pg/ml, respectively), although the differences were not statistically significant (P = 0.077 and 0.053, respectively). The percentage of IFN-gamma-producing Th cells was significantly higher in normal control subjects than asthmatic patients (23.46 versus 5.72%, P < 0.001) but the percentage of IL-4 producing Th cells did not differ (0.72 versus 0.79%, P > 0.05). Consequently, the Th1/Th2 cell ratio was significantly higher in normal subjects than asthmatic patients (29.6 versus 8.38%, P < 0.001). We propose that allergic asthma is characterized by an elevation of both proinflammatory and Th2 cytokines. The significantly lower ratio of Th1/Th2 cells confirms a predominance of Th2 cells response in allergic asthma.     

IL-10 subfamily members: IL-19, IL-20, IL-22, IL-24 and IL-26

It has been reported that the CD4+ T cell is a very important source of interleukin 10 (IL-10), while CD8+ cells produce low amounts. IL-10 exerts several immune stimulating, as well as inhibitory effects. There are at least five novel human IL-10 family-related molecules: IL-19, IL-20, IL-22, IL-24, and IL-26. Activated T cells produce IL-19, IL-22 and IL-26, while IL-24 is produced by activated monocytes and T-cells. IL-20 induces cheratin proliferation and Stat-3 signal transduction pathway, while IL-22 induces acute-phase production by hepatocytes and neonatal lethality with skin abnormalities reminiscent of psoriasic lesions in humans. In addition, IL-22 mediates inflammation and binds class II cytokine receptor heterodimers IL-22 RA1/CRF2-4. This cytokine is also involved in immuno-regulatory responses. IL-26 (AK155) is a novel cytokine generated by memory cells and is involved in the transformed phenotype of human T cells after infection by herpes virus. All these new IL-10 subfamily member cytokines are strongly involved in immune regulation and inflammatory responses.     

血清中IL-6和IL-10变化与慢性乙肝急性发作导致肝衰竭的关系

目的通过分析急性发作慢性乙型肝炎（慢性乙肝）患者体内IL-6、IL-12、γ干扰素和IL-10的变化,探讨急性发作及病情严重程度与细胞因子变化的关系。方法对154例急性发作及免疫耐受慢性乙肝患者采用ELISA法检测IL-6、IL-12、γ干扰素和IL-10的水平,同时检测肝功能、HBV DNA定量等。结果处于急性发作的患者年龄较大,HBV DNA定量较低,促炎症因子和抗炎症因子的水平均高于处于免疫耐受的患者;重型肝炎组IL-6的水平（179.80±134.96）pg/ml高于非重型肝炎组（108.80±113.23）pg/ml（P〈0.05）,而IL-10的水平（12.80±4.96）pg/ml低于非重型肝炎组（20.33±7.35）pg/ml（P〈0.05）。结论慢性乙肝急性发作可能与炎症因子的激活相关,IL-6有促进肝损伤作用,而IL-10可能在避免过强免疫损伤中起重要作用。     

支气管哮喘病人胸导管淋巴液与血清IL-6、IL-8、 IL-10、IL-12、TNF-α水平的对比研究

目的：探讨哮喘病人胸导管淋巴液和血清IL-6、IL-8、IL-10、IL-12及TNF-α水平变化。方法：采用酶联免疫吸附试验（ELISA）检测31例行胸导管引流治疗的中、重度哮喘病人术后0 d、3 d、5 d淋巴液及0 d、5 d血清IL-6、IL-8、IL-10、IL-12以及TNF-α水平。结果：哮喘病人胸导管引流淋巴液中IL-6、IL-8、IL-10、TNF-α水平均高于正常对照组血清水平，而IL-12则明显低于正常血清水平；引流5 d淋巴液中IL-6、IL-8、IL-10及TNF-α明显低于，IL-12则显著高于引流0 d时水平；同时哮喘病人血清IL-10、TNF-α含量低于，血清IL-12则高达正常对照组水平。结论：哮喘病人淋巴液中存在以IL-12产生受抑和炎性细胞因子产生亢进为特征的细胞因子失调，且淋巴液中CK变化与血清变化大致平行。     

Seminal Levels of IL-10, IL-12, and IL-17 in Men with Asymptomatic Chlamydia Infection

Chlamydia trachomatis, as an obligate intracellular parasite, usually causes asymptomatic genital tract infections in both men and women with several complications. The role of C. trachomatis infection in the secretion of a number of interleukins (ILs) from epithelial cells has been established by in vitro studies performed on various cell lines. The aim of this study was to detect the seminal levels of IL-10, IL-12, and IL-17 in men with asymptomatic chlamydia infection. Our case group study included 50 semen samples being PCR-positive for C. trachomatis from 585 semen samples and the ELISA method was applied for detection of IL-10, IL-12, and IL-17. Our results demonstrated that the semen levels of IL-10 and IL-17 were significantly increased, while IL-12 was decreased in C. trachomatis-infected patients. According to these results, it may be concluded that the increased and decreased semen levels of IL-10 and IL-12, respectively, lead to impaired immune responses against C. trachomatis. Increased semen levels of IL-17 may also be associated with the pathogenesis of C. trachomatis infection.     

丙型肝炎患者血清细胞因子水平与肝功能损伤的相关性探讨

目的：检测血清可溶性L-selectin（L-选择素）、sICAM-1（细胞粘附因子-1）、IL-6（白细胞介素-6）、IL-10（白细胞介素-10）、IL-18（白细胞介素-18）在丙型肝炎病毒感染造成肝功能损害过程中的作用。方法：应用酶联免疫吸附法（ELISA）对62例丙型肝炎患者进行了血清中L-selectia、sICAM-1、IL-6、IL-10、IL-18水平检测及相关的肝功能、生化指标进行相关分析,并与36例正常健康人作比较。结果：丙型肝炎患者血清L-selectin、sICAM-1、IL-6、IL-10、IL-18水平均非常显著地高于正常人组（P〈0．01）,且与ALT（谷丙转氨酶）、TBIL（总胆红素）水平呈明显的正相关。结论：检测丙型肝炎患者血清中L-selectin、sI—CAM-1、IL-6、IL-10、1L-18水平在一定程度上反映了机体的免疫功能状态和肝细胞损伤的程度,具有临床应用价值。     

Polymorphisms of IL-1B, IL-1RN, IL-2, IL-4, IL-6, IL-10, and IFN-gamma genes in the Korean population

Cytokines play a crucial role in regulating the immune and inflammatory responses. The collective influence of several cytokines can regulate immune responses as complex as those underlying allograft rejections or autoimmune diseases. Polymorphisms in the regulatory regions of the cytokine genes may influence their expression. Therefore, the polymorphisms of cytokine genes are potentially important as genetic predictors of the disease susceptibility or clinical outcome. In 311 unrelated healthy Korean individuals, we investigated the polymorphisms of cytokine genes (interleukin-1 [IL-1], IL-2, IL-4, IL-6, IL-10, and interferon-gamma [IFN-gamma]), which had been previously reported to be associated with a number of immune diseases, transplant complications, and direct or indirect influences on the level of expression and production. And we also compared the results to those published for other populations. The genotype distributions were consistent with the assumption of the Hardy-Weinberg equilibrium, with the exceptions of IL-1B +3954 and IL-6-174 polymorphisms. The polymorphisms examined in this study were almost similar to that observed in Asian populations. There were significant differences of the polymorphisms, except for IL-4 receptor alpha +1902, between Korean and other populations. Comparing the alleles associated with higher level of expression and production, IL-1B +3954*T, IL-2-330*G, and IL-4-590*T alleles were significantly higher, and IL-1RN*A2, IL-10-1082*G, and IFN-gamma*2 alleles were lower in Koreans than other populations. Especially in IL-6 promoter -174 polymorphism, we found only the G allele associated with higher plasma IL-6 levels. In haplotype analysis of IL-10 promoter polymorphisms, the GCC haplotype, associated with higher expression of IL-10, was significantly lower in Koreans. These results may be helpful for understanding transplant-related complications, immune or autoimmune diseases, and malignant diseases in the Korean population.