自然流产患者血硒和谷胱甘肽过氧化物酶水平变化

目的对自然流产妇女血硒和谷胱甘肽过氧化物酶水平变化进行研究。方法分别检测30例自然流产妇女、30例健康妊娠妇女和30例未妊娠妇女的血浆硒和谷胱甘肽过氧化物酶活性及红细胞谷胱甘肽水平,并进行比较和统计。结果自然流产组妇女血浆硒水平与健康妊娠组差异无统计学意义,但比未妊娠组显著性降低,差异有统计学意义(P<0.01)。与健康妊娠组和未妊娠组比较,自然流产组妇女血浆谷胱甘肽过氧化物酶活性均显著性降低,差异有统计学意义(P<0.01),而其红细胞谷胱甘肽水平则显著性增高,差异也有统计学意义(P<0.01)。结论谷胱甘肽过氧化物酶活性的降低可能在自然流产发生中扮演了重要角色,但尚无定论,仍需进一步探讨。     

原因不明复发性流产患者外周血Th17和Treg细胞频率及其细胞因子水平变化

目的:探讨原因不明复发性流产(URSA)患者外周血Thl7和Treg细胞频率及其细胞因子水平变化.方法:应用流式细胞技术检测URSA患者外周血Thl7和Treg细胞频率;应用ELISA方法检测URSA患者外周血Thl7细胞因子(IL-17、IL-23)和Treg细胞因子(TGFβ1和IL-10)水平.结果:URSA患者Thl7细胞在外周淋巴细胞和CD4+T细胞中的频率显著高于正常早孕者(P<0.01);而URSA患者Treg细胞在外周淋巴细胞和CD4+T细胞中的频率显著低于正常早孕者(P<0.01).URSA患者血清中IL-17、IL-23水平明显高于正常早孕者,而TGF-β1、IL-10水平显著低于正常早孕者(P<0.01).结论:URSA的发生与外周血中Thl7和Treg细胞密切相关.     

阿魏酸钠与还原型谷胱甘肽对糖尿病患者抗氧化酶活性的影响

目的:探讨阿魏酸钠(SF)与还原型谷胱甘肽(GSH)对2型糖尿病患者血抗氧化酶活性和C反应蛋白(CRP)的影响。方法:71例2型糖尿病患者分为SF组、GSH组,SF组每日静滴SF0.3g2周,GSH组每日静滴GSH1.8g2周,两组治疗前后查血脂、超敏C反应蛋白(sCRP)、内皮素(ET)及血清抗氧化酶。结果:SF、GSH均能明显降低总胆固醇、甘油三酯、低密度脂蛋白-胆固醇、ET、sCRP的浓度(P<0.01,P<0.05),提高血液过氧化氢酶、超氧化物歧化酶及谷胱甘肽过氧化物酶活性(P<0.01、P<0.05)。结论:SF和GSH能改善乙型糖尿病患者的抗氧化酶活性,降低CRP水平。     

还原型谷胱甘肽抗再灌注损伤及治疗急性脑梗死临床研究

目的:观察还原型谷胱甘肽(GSH)对急性脑梗死的临床疗效和作用机制。方法:将67例急性脑梗死患者按随机数字表法随机分为两组,GSH组35例采用GSH合用血栓通治疗,对照组32例单纯采用血栓通治疗,观察治疗前后血超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)、丙二醛(MDA)、纤维蛋白原(FIB)的变化,同时进行神经功能缺损评价。结果:(1)GSH组治疗7、14d后神经功能缺损评分与治疗前比较均有非常显著改善(P<0.01);(2)GSH组治疗7、14d后显效率均高于对照组(P<0.05);(3)GSH组治疗3、7d后血SOD、GSH-PX、MDA、FIB与治疗前比较均有统计学意义(P<0.01)。结论:GSH通过清除氧自由基保护脑缺血再灌注损伤治疗急性脑梗死比单用改善脑微循环药物有效。     

不明原因反复流产者T细胞中PD-1的表达及其临床意义

目的探讨不明原因反复流产(URSA)者T细胞中程序性细胞死亡分子-1(PD-1)的表达及其临床意义。方法选择2018年5月至2019年5月收治的URSA患者20例(URSA组),选择同期行人工流产的正常健康早孕妇女20例作为对照组。检测2组外周血和蜕膜组织中T细胞中PD-1的表达,及外周血白细胞介素4(IL-4)、白细胞介素10(IL-10)、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)水平。结果与对照组比较,URSA组外周血及蜕膜组织CD3~+PD-1~+T细胞的表达水平、IL-4、IL-10水平更低,IFN-γ、TNF-α水平更高,(P<0.05);经Pearson相关性检验,URSA与外周血PD-1、蜕膜PD-1、IL-4、IL-10呈负相关(r=-0.869～-0.619,P<0.05),与IFN-γ、TNF-α呈正相关(r=0.864、r=0.435,P<0.05)。结论 PD-1通过调节多种细胞因子而影响免疫平衡,参与URSA的发病,可为治疗URSA潜在靶点提供理论依据。     

不明原因复发性自然流产患者外周血淋巴细胞亚群特征的研究

目的 探讨不明原因复发性自然流产患者外周血免疫细胞亚群的特征.方法 将34例早孕难免流产患者分为不明原因复发性自然流产(URSA)和偶发性自然流产(SA)两组,采用流式细胞术检测患者外周血免疫细胞的特征,将两组的检测结果进行比对研究.结果 Th/Ts两组均见异常升高,URSA组为(2.77±5.16),SA组为(3.67±6.12);NK细胞比例URSA组为(15.57±6.45)%明显升高,而SA组仅为(11.38±3.66)%,两组差异有统计学意义(P<0.05).结论 URSA组与SA组均存在一定的免疫紊乱,共同的表现是特异性免疫方面均有Th/Ts异常升高,不同的表现是URSA组在非特异性免疫方面NK细胞比例增高较SA组更为明显.     

正常成人和癌肿患者的红细胞还原型谷胱甘肽和血清尿酸含量

用改良二硫双硝基苯甲酸法观测46名和34名正常男、女成人及43例癌肿患者治疗前的红细胞还原型谷胱甘肽(GSH)含量,分别为2.27±0.31,2.16±0.39和3.28±0.26mg/gHb;男、女测定值差异无显著性;癌肿患者较正常组明显增高(p<0.01)。用Henry法检测同组标本血清尿酸含量,3组分别为0.294±0.040,0.236±0.030和0.413±0.042mmol/L。癌肿患者与正常组差异有显著性(p<0.01)。红细胞GSH和血清尿酸含量,对癌肿的诊断和疗效有一定临床价值。     

精神分裂症LPO、GPX和VE含量测定

对56例精神分裂症患者和42例正常对照组的血清过氧化脂质(LPO)、谷胱甘肽过氧化物酶(GPX)和维生素E(VE)水平进行了测定,结果表明:LPO含量明显高于对照组(P<0.05),GPX活性和VE含量明显低于对照组(P<0.01);LPO与病程呈正相关(γ=0.361,<0.01),GPX和VE与病程呈负相关(γ±-0.383～-0.403,P<0.01);LP0与GPX和VE呈负相关(γ=-0.378～-0.411,P<0.01)。结合文献,认为自由基代谢异常在本病的发病机制中具有一定作用。     

围产期妇女血清一氧化氮水平变化及临床意义

目的:探讨围产期妇女不同时期血清一氧化氮水平及其临床意义.方法:分别检测非妊娠期及围产期妇女不同时期血清一氧化氮浓度并进行比较.结果:血清一氧化氮浓度在非妊娠期妇女明显低于早、中、晚孕与妊娠足月待产妇女(P均<0.01),也低于足月妊娠临产妇女,但差异无统计学意义(P>0.05);中期妊娠妇女较早孕妊娠妇女明显升高(P<0.01),晚期妊娠妇女有所下降;而临产妇女较足月妊娠待产妇女明显降低(P<0.01),产后妇女明显低于妊娠不同时期(P<0.01).结论:妊娠期妇女血清一氧化氮水平较非妊娠期升高,且随孕期的发展而变化,参与妊娠的调节作用.     

原因不明反复自然流产患者血小板功能检测的意义

目的探讨原因不明反复自然流产(URSA)患者血小板最大聚集率(PAR)及血小板α颗粒膜蛋白(GMP-140)的变化,为URSA诊断和治疗提供有效的检测指标。方法用比浊法及ELISA法检测42例URSA妊娠、68例URSA未妊娠、30例健康妊娠和30例健康未妊娠妇女的PAR及血浆GMP-140水平,并进行统计学分析。结果健康妊娠组ADP及花生四烯酸(AA)诱导的PAR均显著高于健康未妊娠组(P<0.05);血浆GMP-140差异无统计学意义(P>0.05);URSA组PAR及GMP-140均显著高于健康妊娠组(P<0.01);URSA妊娠组与URSA未妊娠组比较,PAR及GMP-140差异均无统计学意义(P>0.05)。结论 URSA与血栓前状态密切相关,监测其PAR及GMP-140水平,有助于URSA的病因诊断,指导抗血小板药物治疗。     

Tumor necrosis factor-alpha and oxidant status are essential participating factors in unexplained recurrent spontaneous abortions.

BACKGROUND: Many factors have been implicated in the pathogenesis of unexplained recurrent spontaneous abortion (URSA). The current study was conducted to determine the possible role of antioxidant status and tumor necrosis factor-alpha (TNF-alpha) in URSA. METHODS: Reduced glutathione (GSH), glutathione reductase (GSH-R), glutathione peroxidase (GSH-PX), catalase (CAT), superoxide dismutase (SOD), nitric oxide (NO), malondialdehyde (MDA) and TNF-alpha were assayed in women suffering unexplained first-trimester abortions. Two groups were included, the first represented by 24 women with URSA (number of abortions 3-5) and the second included 16 women with URSA (number of abortions >5). The control group included 20 women within their first trimester of pregnancy and 20 non-pregnant healthy females within their follicular phase. RESULTS: We observed that the antioxidant levels measured were significantly lower in URSA groups than in the control group (p<0.05 for each comparison). Higher TNF-alpha, MDA and NO production were detected in URSA groups compared to controls (p<0.05 for each comparison). URSA 3-5 was associated with significantly higher levels of antioxidants and lower levels of TNF-alpha compared to levels in URSA >5. CONCLUSIONS: Impaired antioxidant defense and an increase in oxidative reactive species may be responsible for recurrent abortion due to possible damage produced by their generation. In addition, the level of TNF-alpha apparently contributes to the pathogenesis of URSA.     

复发性流产患者易栓症指标筛检的意义

目的探讨易栓症相关指标与不明原因复发性流产(URSA)的相关性,为URSA患者的病因排查和治疗提供参考。方法选取2016年11月—2018年3月上海交通大学医学院附属国际和平妇幼保健院104例流产次数≥2次的URSA患者作为URSA组,以45例健康经产妇作为对照组,检测所有研究对象血浆狼疮抗凝物(LA)阳性率、抗心磷脂抗体(ACA)阳性率、蛋白C(PC)活性、蛋白S(PS)活性、抗凝血酶(AT)活性、凝血因子Ⅻ(FⅫ)活性和D-二聚体(DD)水平。结果URSA组LA阳性率、PC活性、PS活性、AT活性、FⅫ活性、DD水平与对照组比较差异均有显著统计学意义(P<0.05)。结论LA阳性、PS缺陷、FⅫ缺陷和DD增高与URSA密切相关。LA、PS、FⅫ、DD是URSA患者体内高凝状态较好的筛查指标,联合检测AT、PC,对预测URSA血栓形成有临床指导意义。     

Relationship between neurological outcome and early oxidative changes in erythrocytes in head injury patients.

BACKGROUND: Experimental data indicate that destructive oxidative events reach their peak within the first 24 h after trauma in head injury (HI) and that brain damage occurring due to this impact can be the cause of death or irreversible permanent disabilities in affected patients. METHODS: Venous blood samples were obtained from 50 HI patients within 24 h of trauma onset and from 30 age- and sex-matched normal controls (NC). Patients were divided into three different neurological outcome groups: those who died within 10 days of trauma (D), and those with severe neurological deficits (SD) or mild/no neurological deficits (MD) at 90 days after trauma. Early oxidative changes in erythrocytes were assessed by estimating an indicator of lipid peroxidative damage - thiobarbituric acid-reactive substances (TBARS) - and antioxidants [reduced glutathione (GSH) levels and superoxide dismutase (SOD) activity]. RESULTS: In the D group, erythrocyte TBARS levels were significantly higher compared to the NC, SD and MD groups (p<0.001); GSH levels were significantly lower compared to the NC (p<0.001) and MD (p<0.01) groups and SOD activity was significantly higher than in the NC (p<0.01) and MD (p<0.01) groups. In the SD group, TBARS levels were significantly higher than in the NC (p<0.001) and MD (p<0.05) groups; GSH levels were significantly lower than in the NC (p<0.001) and MD (p<0.01) groups and SOD activity was higher compared to the NC and MD (p<0.01) groups. In the MD group, TBARS levels were significantly higher and GSH levels significantly lower compared to the NC group (p<0.001). However, we did not observe any significant change in SOD activity compared to the NC group. CONCLUSIONS: These findings indicate that early oxidative changes may reflect the severity of neurological insult and provide an early indication of patient outcome in traumatic HI.     

Clinical

Objective: To investigate the oxidative state of glutathione and glutathione peroxidase (GSH-Px'), glutathione reductase (GSSG-R), and glucose-6-phosphate dehydrogenase (G-6-PD) levels in patients with chronic renal failure (CRF) and controls.

Results: Erythrocyte GSH levels of patients were decreased, but GSSG was not significantly different from that of controls. Also, plasma GSH levels were not different, although GSSG was increased. GSSG/GSH ratios in erythrocyte and plasma were significantly higher in CRF patients. Erythrocyte GSSG-R activity was high, but G-6-PD and GPX were low.

Conclusions: The findings suggest that: 1. Low GSH is related to decreased G-6-PD activities. 2. The reduction of peroxides with GPX are decreased by low GSH and low GPX activity. 3. GSSG may react with hemoglobin and causes protein aggregation in erythrocytes. These alterations cause hemolysis and could play a role in the pathogenesis of anemia in hernodialyzed patients.     

程序性细胞死亡分子1与原因不明复发性流产关系研究

目的探讨程序性细胞死亡分子1（programmedcelldeath-1,PD-1）在原因不明复发性流产（unexplainedrecurrentspontaneousabortion,URsA）孕妇外周血CD4＋T淋巴细胞的表达及意义。方法采用流式细胞术检测70例URSA孕妇（URSA组）和30例正常孕妇（对照组）外周血CD4＋PD-1＋T细胞的表达情况。结果URSA组CD4＋PD-1＋T细胞阳性率（15．77±0．14）％低于对照组（16．92±0．23）％（P〈0．01）;URSA组早期流产（孕龄〈12周）孕妇外周血CD4＋PD-1＋T细胞阳性率低于晚期流产孕妇（孕龄≥12周）（P％0．01）;初次流产年龄〈30岁孕妇CD4＋PD-1＋T细胞阳性率高于初次流产年龄≥30岁孕妇（P〈0．05）。结论CD4＋PD-1＋T细胞在URSA的发生、发展中起一定作用。     

原因不明复发性流产患者蜕膜组织中蛋白激酶的表达及其与细胞凋亡的相关性研究

目的观察并分析蛋白激酶在原因不明复发性流产(URSA)患者蜕膜组织中的表达情况,及其与胎盘蜕膜细胞凋亡的相关性。方法回顾性分析本院就诊的140患者,将其分成80例流产组和60例对照组。采用免疫组织化学染色法分别测定SGK在2组URSA患者蜕膜组织中的表达情况,同时采用DNA末端原位标记染色法(TUNEL法)分别检测流产组和对照组的细胞凋亡指数(AI)。结果流产组患者蜕膜组织中SGK的阳性表达率为25.0%,明显低于对照组的93.3%,2组比较差异具有统计学意义(P0.05);流产组的平均细胞凋亡指数为明显高于对照组,2组比较差异具有统计学意义(P0.05)。结论 URSA患者蜕膜组织中蛋白激酶的表达降低,与组织细胞凋亡明显增加存在相关性。     

原因不明复发性流产病理妊娠患者外周血CD4+CD25+Treg、Foxp3mRNA的表达

目的探讨原因不明复发性流产(URSA)病理妊娠患者外周血CD4+CD25+调节性T细胞(Treg)及叉状头/翅膀状螺旋转录因子(Foxp3)mRNA的表达。方法采用流式细胞术测外周血CD4+CD25+Treg,半定量、实时荧光定量PCR分析外周血单个核细胞Foxp3转录水平;检测70例原因不明复发性流产史妇女(URSA未孕组)、20例病理妊娠妇女(URSA病理妊娠组)、22例正常妊娠妇女组(正常妊娠组)、20例正常非孕妇女组(对照组)外周血中CD4+CD25+Treg、Foxp3 mRNA的表达情况。采用酶联免疫吸附法检测血清白细胞介素-10(IL-10)水平。结果 URSA未孕组外周血CD4+CD25+Treg、Foxp3 mRNA、IL-10比例明显低于正常非孕妇女组,两组比较,差异均有统计学意义(t分别=3.61、4.18、2.71,P均<0.05);URSA病理妊娠组外周血中CD4+CD25+Treg、Foxp3 mRNA、IL-10低于正常妊娠妇女组,两组比较,差异均有统计学意义(t分别=3.79、12.56、4.42,P均<0.05)。结论外周血CD4+CD25+Treg、Foxp3 mRNA和IL-10表达水平降低可能与URSA病理妊娠患者的发病有关。     

原因不明复发性流产主动免疫治疗前后CD3~＋PD-1~＋T细胞表达水平研究

目的探讨外周血程序性细胞死亡分子-1（programmed death-1,PD-1）在原因不明复发性流产（unexplained recurrent spontaneous abortion,URSA）患者主动免疫治疗中作用。方法 140例URSA患者（URSA组）与73例正常生育妇女（对照组）,采用流式细胞术检测对照组与URSA组接受淋巴细胞主动免疫治疗前、后外周血CD3＋PD-1＋T细胞水平。结果主动免疫治疗前,URSA组外周血CD3＋PD-1＋T细胞占淋巴细胞比例（（14.26±1.34）%）明显低于对照组（（20.01±2.41）%）（P〈0.05）,主动免疫治疗后URSA组外周血CD3＋PD-1＋T细胞占淋巴细胞比例（（19.86±2.05）%）较治疗前明显增加（P〈0.05）,但与对照组比较差异无统计学意义（P〉0.05）;主动免疫治疗后妊娠成功者CD3＋PD-1＋T细胞占淋巴细胞比例（（21.22±2.18）%）明显多于妊娠失败者（（15.35±1.67）%）（P〈0.05）。结论主动免疫治疗可提高外周血CD3＋PD-1＋T细胞水平,PD-1可能是调控母胎免疫耐受形成的重要因素,可用于URSA患者主动免疫治疗效果的监测。     

Activities of erythrocyte antioxidant enzymes in cancer patients

We measured the activities of erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GPX) before therapy in 97 patients with cancer in various sites (gastrointestinal tract (GIT) (n=40), breast (n=30), and others (n=27)), and in 60 matched controls to assess antioxidant enzyme protection. Hemolysate hemoglobin (Hb) was measured spectrophotometrically. The activity of SOD (U/g Hb) was significantly lower in all sites (when all the cancer sites were considered as a group), GIT, breast, and other sites compared to the controls (P<0.0001, P<0.0001, P<0.0001 and P<0.0001, respectively). The activity of GPX (U/g Hb) was significantly decreased in all sites, GIT, and breast cancer sites than in the controls (P=0.024, P=0.033, and P=0.043, respectively). Age showed a weak negative correlation with enzyme activities in controls and patients. There was no significant association between SOD and GPX activities in either the controls or the patients. These results suggest that there may be a greater antioxidant burden for SOD than GPX in cancer, and that a weak association exists between the activities of the two enzymes in antioxidant protection.