Correlation of serum adiponectin levels and hepatic steatosis in hepatitis c virus genotype 1 infection

Steatosis is an important cofactor in hepatitis C virus (HCV) because it is associated with fibrosis and reduces early and sustained virologic response. Recent studies suggest that HCV genotype 1 is not steatogenic if additional risk factors are not present. Because hypoadiponectinemia was found to be a feature of nonalcoholic steatohepatitis (NASH) independent of insulin resistance, its level in patients with hepatitis C genotype can reveal the optimal therapeutic strategy. This study was conducted to determine the role of the relationship between steatosis and serum adiponectin levels in the progression of liver damage in HCV genotype 1 without known risk factors for NASH. Patients (n=50) with biopsy-proven chronic hepatitis C (CHC), positive HCV RNA, and raised alanine aminotransferase were enrolled. They were carefully selected to rule out possible confounding factors for the presence of steatosis and additional systemic or liver disease. Associations between serum adiponectin levels and grade of steatosis, histologic activity index (HAI), fibrosis grade of liver biopsies, patient age, HCV viral load, and serum transaminase activities were studied. Also, adiponectin levels were compared with those of a control group of 30 healthy volunteers with normal ultrasound findings of the upper abdomen who had no known NASH risk factors. The investigators found that adiponectin levels in patients with CHC genotype 1 were similar to those in healthy subjects. No significant association was found between adiponectin levels and severity of steatosis, HCV RNA levels, HAI, transaminases, and fibrosis. Steatosis was present in 41 patients (82%) with CHC. Multivariate analysis of data on 50 patients revealed that severity of steatosis was independently related to age alone (P=.03). A correlation between HCV RNA load and HAI was observed (P=.02; r=0.712). HAI also was associated with stage of fibrosis (P=.00;r= 0.612). In cases of chronic HCV genotype 1 hepatitis, steatosis is a common histologic feature, although no risk factors are known. Results presented here cannot establish an association between adiponectin and severity of steatosis when risk factors for steatosis are unknown. Additional studies are needed to discover a metabolic treatment that would seek to improve the progression of hepatic steatosis in CHC infection.     

非酒精性脂肪肝患者血清同型半胱氨酸水平的研究

目的探讨非酒精性脂肪肝(NAFLD)患者血清同型半胱氨酸(HCY)水平的变化及其临床意义。方法选取经过肝脏穿刺活检确诊为NAFLD患者31例(试验组),其中单纯性非酒精性脂肪肝(NAFL)患者15例,非酒精性脂肪性肝炎(NASH)患者16例,同时选取22名健康人作为对照组,记录2组性别、年龄、体质量指数(BMI)等基本资料,分别测定2组对象血清中HCY、叶酸、维生素B12、胰岛素水平,并计算稳态模型胰岛素抵抗指数(HOMA-IR)。结果试验组与对照组血清HCY水平无显著性差异[(13.5±2.7)mmol.L-1vs(12.8±4.6)mmol.L-1,P=0.533),同样,2组对象血清叶酸、维生素B12水平也无显著性差异。虽然NAFL与NASH患者的平均年龄,BMI,血清叶酸、维生素B12等指标差异不明显,但NASH患者血清HCY水平显著低于NAFL患者[(11.3±2.6)mmol.L-1vs(15.7±3.1)mmol.L-1,P=0.013)。血清中HCY水平随肝脏纤维化程度、脂肪变区域以及汇管区炎症程度的增加而呈现降低趋势(P值分别为0.005、0.021和0.029)。在Logistic回归分析中,将年龄、性别、BMI、天冬氨酸转移酶(AST)、血糖以及HOMA-IR等变量进行校正后,发现HCY是NASH的独立预测因素(P=0.045)。结论 NASH患者血清HCY水平较NAFL患者低,且HCY是NASH的独立预测指标。血清HCY或许可以成为NAFLD的非侵入性诊断指标之一。     

瘦素和转化生长因子β_1对非酒精性脂肪性肝炎患者肝纤维化的促进作用研究

目的针对非酒精性脂肪性肝炎（NASH）患者体内转化生长因子β1（TGF-β1）和瘦素与肝纤维化之间的相关性进行研究,从而阐述两者对肝纤维化的促进作用。方法检测NASH患者血清瘦素水平以及TGF-β1水平,同时检测NASH患者的血清肝纤维化指标透明质酸（HA）、板层素（LN）、Ⅲ型前胶原肽（PCⅢ）等,其结果与单纯性脂肪肝患者及健康对照者进行组间比较,最后对血清瘦素、TGF-β1与肝纤维化指标进行相关性分析。结果 NASH患者血清瘦素水平以及TGF-β1水平明显高于对照组,差异有显著性,并且NASH患者血清瘦素水平、TGF-β1水平以及肝纤维化指标之间呈正相关。结论瘦素和TGF-β1是NASH进展为肝纤维化过程中的重要因子,但其分子机制需进一步深入研究。     

瘦素和转化生长因子β1对非酒精性脂肪性肝炎患者肝纤维化的影响

目的Ⅲ型前胶原对非酒精性脂肪性肝炎（NASH）患者血清中转化生长因子13,（TGF—β1）和瘦素水平进行检测,并分析两者之间的相关性,从而探讨两者对肝纤维化的影响。方法检测32例NASH患者血清瘦素水平以及TGF—β1水平,同时选取31例单纯性脂肪肝,24例健康人作为对照组进行比较,同时检测NASH患者的血清肝纤维化指标透明脂酸（HA）、层黏蛋白（LN）、Ⅲ型前胶原（PC Ⅲ）,并对血清瘦素水平以及TGF—β1水平、肝纤维化指标进行相关性分析。结果NASH患者血清瘦素水平以及TGF-β1水平明显高于对照组,差异有显著性,并且NASH患者血清瘦素水平、TGF—β1水平以及肝纤维化指标之间呈正相关。结论瘦素在NASH发病中具有独立的致病作用,并可能是通过TGF—β1系统而导致肝纤维化形成。     

High-sensitivity C-reactive protein (hs-CRP): a promising biomarker for the screening of non-alcoholic steatohepatitis (NASH)

Nonalcoholic fatty liver disease (NAFLD) encompasses a histological spectrum ranging from simple steatosis to nonalcoholic steatohepatitis (NASH) that may progress eventually to cirrhosis. Any clinically useful serum biomarkers have never been reported to distinguish patients with NASH from those with simple steatosis. The serum CRP concentration, formerly used as a marker of acute-phase reaction, has been revealed to be a strong predictor of coronary event after the introduction of the high-sensitivity assay method. Patients with metabolic syndrome also have been reported to have higher high-sensitivity CRP(hs-CRP) concentration. We showed patients with more active form of NASH (grade2-3) have higher concentration of hs-CRP than those with quiescent form of NASH (grade1) or simple steatosis. hs-CRP may be a promising biomarker for screening of NASH, a hepatic manifestation of metabolic syndrome.     

慢性心力衰竭患者血清APN与NT—proBNP相关性研究

【目的】研究慢性心力衰竭（CHF）患者血清脂联素（APN）与N末端B型脑钠钛前体（NT—proBNP）水平的变化及相关性,探讨其与心功能不全严重程度的关系。【方法】选取CHF患者63例,根据1994年纽约心脏病协会心功能分级标准（NYHA）分为Ⅱ级17例,Ⅲ级28例,Ⅳ级18例,另选取同期健康体检者37例作为对照组。分别检测其身高、体重、血脂、APN、NT—proBNP,计算体重指数,并对数据进行统计学分析。【结果ICHF患者血清APN和NT—proBNP水平明显高于健康对照组,且随着NYHA分级的增加而明显升高,心功能Ⅱ级、Ⅲ级、Ⅳ级组间比较差异均有显著性（P〈0．01）;CHF患者治疗前与治疗后血清APN、NT—proBNP水平比较差异有显著性（P〈0．01）;对数转换的血清APN水平与血清NT—proBNP呈明显正相关（r=0．7u,P〈0．01）。【结论】联合监测血清APN和NT—proBNP水平对于判断CHF患者的病情及预后具有重要的临床应用价值。     

Lipid peroxidation in cerebral tumors

BACKGROUND: Serum and tissue concentrations of tumor markers or some metabolites are considered to be helpful in diagnosis and follow-up of the central nervous system (CNS) disease. However, markers currently available are not sufficiently sensitive and specific to be used as actual diagnostic tools. Differentiation between the malignant and benign lesions of the CNS is very important, both for determining the optimum therapeutic approach and to predict morbidity and mortality of the disease. Accurate diagnosis of a malignant disease is mostly performed through a surgical resection and histopathologic evaluation. Free oxygen radicals (FOR) are thought to take part in oncogenesis and cellular differentiation. We explored whether FORs can be used as diagnostic tumor markers. METHODS: We investigated the concentration of malondialdehyde (MDA) in the serum and tumor tissue of patients with glial tumor. We have studied 30 patients with malign glial tumor (grades III and IV astrocytoma), 30 patients with low grade glial tumor, 28 healthy individuals, and 10 patients with nontumorous lesions (lobectomy for epilepsy). RESULTS: Patients with CNS tumors showed higher serum MDA concentration compared to control groups (epilepsy patients and healthy subjects). These patients had a higher tumor tissue MDA concentration compared to lobectomy tissue from epilepsy patients. Serum and tissue MDA concentrations were also higher in the malignant glial tumor group compared to the low grade glial tumor group. CONCLUSIONS: Although not specific, tissue and serum concentrations of FORs can be used as a marker to detect the presence and grade of CNS tumors. Further studies are needed to determine the optimum cutoff value for use of serum and tissue MDA concentrations in brain tumors.     

Oxidative stress and antioxidant defenses in serum of patients with non-alcoholic steatohepatitis

OBJECTIVES: Oxidative stress is an important pathophysiological mechanism in non-alcoholic steatohepatitis (NASH). We aimed to evaluate serum xanthine oxidase (XO) (as a generator of reactive oxygen species), superoxide dismutase (SOD), glutathione peroxidase (GSHPx), paraoxonase (PON1) activities, nitric oxide (NO) and thiol levels in patients with NASH. DESIGN AND METHODS: A total of 35 patients with NASH and 31 age-and-gender-matched healthy subjects were enrolled in the study as control group. Serum levels of XO, NO, SOD, GSHPx, PON1 and thiol were determined by spectrophotometric methods. RESULTS: Serum XO activities were higher in the patients with NASH than the controls (p<0.001). Serum NO levels, SOD, GSHPx, PON1 activities and thiol levels were lower in the patients with NASH than the controls (p<0.031, p<0.019, p<0.001, p<0.001, p<0.001, respectively). CONCLUSIONS: Increased oxidative stress in patients with NASH may result in a pro-oxidation environment, which in turn could result in decreased antioxidant enzyme activities and NO levels. Therefore effective antioxidant therapy to inhibit oxidative stress is necessary and agents to increase antioxidant enzyme may be a therapeutic option in NASH.     

血清前白蛋白和总胆汁酸在诊断肝硬化分级中的价值

目的探讨血清前白蛋白(PA)和总胆汁酸(TBA)在诊断肝硬化分级中的意义。方法试验组由96例肝硬化患者组成,对照组由95例健康体检者组成。分别检测试验组(按肝硬化Child-Pugh分级,A、B、C三级分别为30例、33例、33例)和对照组血清中血清前白蛋白(PA)与总胆汁酸(TBA)水平,采用统计软件对结果进行处理。结果试验组血清前白蛋白水平明显低于对照组,有显著统计学差异(P﹤0.01),且A、B、C三级之间比较有统计学差异;试验组总胆汁酸水平明显高于对照组比较,差异性明显(P﹤0.05),且A、B、C三级之间比较,有显著性差异(P﹤0.01)。结论血清前白蛋白、总胆汁酸能较准确地反映出肝硬化的程度,敏感地判断肝硬化等级。     

The evaluation of bone mineral density in patients with nonalcoholic fatty liver disease

BACKGROUND AND AIM: Nonalcoholic fatty liver diseases (NAFLD) are a clinical spectrum of disorders, of which nonalcoholic steatohepatitis (NASH) is the most strongly associated with inflammation. Inflammation is a known risk factor for low bone mass in the body. The primary goal of the present study was to evaluate the association between bone mineral density and liver function in patients with NASH. MATERIALS AND METHODS: Consenting patients with a diagnosis of NAFLD were included in the study. Extent of fatty change was graded based on ultrasonographic appearance (Grade 1, mild; Grade 2, moderate; Grade 3, severe). Bone mineral density was measured using the dual-energy x-ray absorptiometry method. ALT and hs-CRP were considered as noninvasive marker of NASH. According to ALT levels, patients were divided into two subgroups. RESULTS: A total of 102 patients with NAFLD and 54 healthy controls participated in the study. None of the patients with NAFLD had an abnormal bone mineral density. Furthermore, there was no difference between groups with regard to serum vitamin D levels. A subgroup analysis revealed that female patients with elevated serum ALT level had significantly lower bone mineral densities and higher hsCRP levels than female patients with normal ALT levels. The difference in vitamin D levels and body mass indices between the same subgroups was statistically insignificant. CONCLUSIONS: Simple steatosis of the liver does not affect bone mineral density. However, in a subgroup of patients with NAFLD, the presence of elevated serum ALT and hs-CRP levels, which are suggestive of NASH, was associated with lower bone mineral densities. Better understanding of the biological basis and the complex interactions between NAFLD and bone mass may help guide the clinical management of bone diseases associated with inflammation of the liver.     

Role of liver biopsy in the diagnosis of NASH

Liver biopsy interpretation remains the gold standard for diagnosis of NASH. It also permits determination of disease severity and may provide insight into prognosis. The histopathologic criteria for NASH generally include the presence of hepatic steatosis, lobular inflammation, and hepatocyte ballooning degeneration. The system proposed by Brunt remains the best known and most frequently used method for the grading and staging of NASH. Recently a histologic scoring system (NAFLD activity score (NAS)) has been proposed that can assist in diagnosis of NAFLD and may be useful for assessing the response to therapy. In our hospital, informed consent about liver biopsy was obtained from 65(56%) of 116 consecutive NAFLD patients with elevated ALT levels: 35% (23/65) had NASH, 59% (38/65) had simple steatosis, and 6% (4/65) had normal liver histology. Sampling variability continues to be a limitation of liver biopsy in staging NASH.     

原发性高血压患者血清hs-CRP和ET-1、NO检测的意义

【目的】探讨原发性高血压（EH）患者血清超敏C反应蛋白（hs-CRP）和内皮素-1（ET-1）;一氧化氮（N0）变化的临床意义。【方法】对60例EH患者进行血清hs-CRP和ET-1、NO测定,并与健康对照组作比较分析。【结果】与对照组比较,EH组血清hs-CRP、ET-1明显升高,且随高血压分级升高而逐渐升高（P〈0．01）;血浆NO明显降低,且随高血压分级升高而逐渐降低（P〈0．01）。【结论】高血压病与炎症活动及血管内皮功能紊乱有关,血清hs-CRP和ET-1、NO是反映EH患者代谢异常的重要指标,可用于评估其病情的严重程度。     

肝纤维化患者肝纤维化程度与血清甲状腺激素水平关系的研究

目的探讨肝纤维化患者肝纤维化程度与血清甲状腺激素水平的关系。方法采用化学发光免疫分析技术检测240例肝纤维化患者（肝纤维化组）及80例体检健康者（对照组）的血清透明质酸（HA）、层黏连蛋白（LN）、Ⅳ型胶原（CIV）、前Ⅲ型胶原（PCⅢ）、促甲状腺激素（TSH）、3,5,3′-三碘甲状腺原氨酸（T3）、甲状腺素（T4）、游离甲状腺素3（FT3）、FT4。结果对照组中,≥45岁组的受检者血清HA、LN、CIV、PCⅢ水平明显高于45岁以下组,男性受检者明显高于女性（P〈0.05）;男性受检者血清TSH、T3、T4、FT3、FT4水平明显低于女性（P〈0.05）。随Child-Pugh分级级别的增加,肝纤维化组患者血清肝纤维化指标水平明显升高（P〈0.05）;而其甲状腺激素水平明显降低（P〈0.05）,T3、FT3尤为明显。A、B、C级患者血清HA、LN、CIV、PCⅢ水平明显高于对照组（P〈0.05）;B、C级患者血清T3、T4、FT3、FT4水平明显低于对照组（P〈0.05）。结论肝纤维化程度与血清甲状腺激素水平具有相关性。     

同型半胱氨酸转硫途径和维生素B6及内源性硫化氢在慢性阻塞性肺疾病急性加重期的作用

目的研究同型半胱氨酸转硫途径、维生素B6及内源性硫化氢在慢性阻塞性肺疾病急性加重期(AECOPD)中的作用。方法 2010年2月-4月间筛选AECOPD患者16例和健康志愿者(对照组)13例,测定AECOPD患者加重期、缓解期及对照组的肺功能、血清硫化氢(H2S)、丙二醛(MDA)、叶酸、维生素B12、C反应蛋白、白介素6、血浆同型半胱氨酸、胱硫醚、半胱氨酸和维生素B6的浓度。计算半胱氨酸转化率(半胱氨酸浓度/胱硫醚浓度)与胱硫醚转化率(胱硫醚浓度/同型半胱氨酸浓度)参与分析。结果①加重期血清MDA水平[(7.3±5.1)nmol/L]比缓解期[(3.0±1.4)nmol/L]和对照组[(3.0±2.2)nmol/L]均升高(P<0.01);血清MDA水平与第1秒用力呼气容积/用力肺活量(FEV1/FVC)、第1秒用力呼气容积占预计值百分比(FEV1%预计值)呈负相关。②加重期血清H2S水平与血浆维生素B6水平较缓解期与对照组降低(P<0.01);缓解期血清H2S水平[(47.2±5.1)μmol/L]高于对照组[(38.8±2.1)μmol/L],P<0.01;血清H2S水平、血浆维生素B6水平均与FEV1%预计值呈正相关(r=0.651、0.680,P<0.01),均与血清MDA水平呈负相关(r=0.334、0.448,P<0.05)。③加重期半胱氨酸转化率(3.97±2.41)低于缓解期(5.92±2.18)与对照组(6.14±3.15)差异有统计学意义(P<0.05);而胱硫醚转化率则相反。④叶酸与维生素B12水平各组间均无差异。结论提高AECOPD患者维生素B6及H2S浓度可能能促使AECOPD患者向稳定状态转归,减轻氧化应激损伤。维生素B6与H2S可能成为AECOPD患者的一个新的治疗点。     

Role of oxidative stress in non-alcoholic steatohepatitis

Oxidative stress plays an important role in the pathogenesis of non-alcoholic steatohepatitis (NASH). Reactive oxygen species (ROS) would derive from mitochondria, cytochrome P-450 2E1, peroxisome, and iron overload in the liver with steatosis. These excessive ROS is considered to cause simple steatosis to progress to NASH. On the other hand, oxidative stress exacerbates insulin sensitivity in hepatocytes, while hepatic steatosis causes oxidative stress. Thus, oxidative stress and insulin resistance might be interactive in NASH. Actually, we have found that the grade of steatosis correlates with serum thioredoxin level, a marker of oxidative stress, in NASH patients. Therefore, we propose that the feedback loop of oxidative stress, insulin resistance, and steatosis would play a significant role in the development of NASH.     

胃癌患者血清Chemerin水平的测定及临床意义

目的观察胃癌患者血清Chemerin的水平变化,并探讨其与胃癌临床病理特征的关系。方法共纳入胃癌组121例及健康对照组86例。用酶联免疫吸附试验（ELISA）测量每组患者的血清Chemerin水平。结果胃癌组患者血清Chemerin水平明显高于健康对照组[（1 879.51±262.65）与（1 135.28±152.72）ng/L],差异有统计学意义（P〈0.01）。血清Chemerin水平随着胃癌TNM分级的增加而升高并与TNM分级呈显著正相关（r=0.258,P〈0.05）。结论胃癌患者血清Chemerin水平显著升高且升高程度与肿瘤的TNM分级相关,Chemerin可能成为诊断胃癌发病及预测胃癌进展程度的重要血清学标记物。     

急性高脂血症性胰腺炎患者血清chemerin与降钙素原变化及意义

目的探讨急性高脂血症性胰腺炎（HLAP）患者中血清chemerin、降钙素原（PCT）水平变化及临床意义。 方法入选2016年1月至2018年7月在宿迁市第一人民医院住院的82例HLAP患者,按其病情程度分为重症急性胰腺炎(SAP)组（34例）、轻症急性胰腺炎(MAP)组（48例）,以50例体检健康者作为健康对照组。应用酶联免疫吸附试验法检测血清chemerin水平,采用荧光酶标免疫测试仪测定血清PCT水平。应用t检验对健康对照者和MAP组、SAP组患者的血清chemerin、PCT水平,HLAP死亡患者和未死亡患者的血清chemerin、PCT水平进行组间比较。应用Pearson法对HLAP患者血清chemerin、PCT水平的相关性,HLAP患者血清chemerin、PCT水平与血生化指标、AP严重程度的相关性进行分析。 结果健康对照者和MAP组、SAP组患者血清chemerin水平依次增高［（303.7±106.9）μg/L、（472.9 ± 158.6）μg/L、（653.4±229.3）μg/L］,两两比较差异均具有统计学意义（P均<0.01）。健康对照组、MAP组、SAP组血清PCT水平依次增高［（1.78±0.95）μg/L、（5.29±2.54）μg/L、（8.21±4.23）μg/L］,两两比较差异均具有统计学意义（P均<0.01）。HLAP患者血清chemerin水平和PCT水平呈正相关（r=0.325,P=0.018）。HLAP患者血清chemerin水平与血TG、总胆固醇、CRP水平呈正相关（r=0.521,0.378,0.423,P=0.003,0.005,0.005）,与血淀粉酶、乳酸脱氢酶无相关性（r=0.154、0.215,P均>0.05）;血清PCT水平与血CRP、乳酸脱氢酶呈正相关（r=0.420,0.430,P=0.004,0.004）,与血TG、总胆固醇、淀粉酶无相关性（r=0.182,0.144,0.210,P均>0.05）。HLAP患者血清chemerin水平与24 h急性生理与慢性健康评分（APACHE）Ⅱ、Ranson评分呈正相关（r=0.370、0.428,P=0.024,0.013）;血清PCT水平与24 h APACHE Ⅱ、Ranson评分呈正相关（r=0.376、0.320,P=0.018,0.021）。SAP组死亡患者6例,死亡患者血清chemerin、PCT水平与未死亡患者比较［（770.6±182.3）μg/L vs （678.3±246.5）μg/L,（10.60±3.87）μg/L vs （7.45±3.58）μg/L］,差异无统计学意义（P均>0.05）。 结论HLAP患者血清chemerin、PCT水平显著升高,且与病情严重程度呈正相关。血清chemerin和PCT可作为潜在的评估HLAP患者病情严重程度的指标。     

慢性阻塞性肺疾病患者血清维生素D水平与肺功能的相关性研究

【目的】探讨慢性阻塞性肺疾病（c0PD）患者血清1,25羟-维生素D3[1,25（OH）2D3]水平与肺功能等指标的关系。【方法】选取年龄、性别、吸烟史及体重指数（BMI）具可比性的稳定期COPD患者133例及对照组（健康体检者）61例,测量受试者血清1,25（OH）2D3、血清钙水平及肺功能,比较COPD组与对照组,以及不同病情严重程度的cOPD患者间上述测量指标的差异。【结果】COPD组血清1,25（OH）2D3及血清钙值均低于对照组（P〈0．01）。按病情严重程度分级后,轻度cOPD患者1,25（OH）2D3水平与对照组无统计学差异（P〉0．05）,而中度、重度及极重度cOPD患者1,25（OH）2D3水平均低于对照组（P〈0．05）,且COPD患者1,25（OH）2D3水平随病情严重程度分级的增加而降低（各组间P〈0．05）。线性相关分析显示,COPD组患者第1秒用力呼气流量（FEV1％）与年龄、BMI无关（P〉0．05）,而与1,25（OH）2D3、血清钙水平相关（P〈0．01）。校正年龄、BMI、血清钙后,COPD组患者FEV1％与1,25（OH）2D3正相关（P〈0．01）。【结论】COPD患者血清1,25（OH）2D3水平低于健康对照者,并和病情严重程度相关。     

血清α1-抗胰蛋白酶和C反应蛋白水平与慢性阻塞性肺疾病的相关性研究

目的探讨慢性阻塞性肺疾病（COPD）患者血清c反应蛋白（CRP）和α1-抗胰蛋白酶（α1-AT）水平与COPD严重程度的相关性。方法采用免疫比浊法测定43例COPD急性加重期（AECOPD）患者、47例COPD稳定期患者及40名健康体检者（正常对照组）血清CRP和α1-AT水平,并作统计学分析。结果血清CRP和α1-AT水平均随患者病情加重而呈上升趋势;AECOPD组和COPD稳定期组CRP和α1-AT水平均高于正常对照组（P〈0．01）;AECOPD组CRP和α1-AT水平均高于COPD稳定期组（P〈0．05）。AECOPD组患者血清CRP与α1-AT呈正相关（r=0．704,P〈0．01）,而COPD稳定期组血清CRP与α1-AT水平无相关关系（r=0．232,P〉0．05）。结论COP]）患者气道炎症反应持续存在,CRP和α1-AT是COPD患者病情变化的敏感指标,且与气道的炎症程度呈正相关,AECOPD的CRP敏感性优于α1-AT,而α1-AT水平在COPD病情加重时并没有明显的升高。     

重度心衰患者高迁移率族蛋白B1水平变化研究

目的探讨重度心力衰竭(CHF)患者高迁移率族蛋白B1(HMGB1)的水平变化及其临床意义。方法利用彩色超声诊断仪等测定按纽约心脏病协会分级为Ⅲ～Ⅳ级的心功能不全患者,将心脏扩大、射血分数(EF)<35%的63例患者纳入研究组;另选25例正常体检者作为对照组。所有研究对象采用酶联免疫吸附法测定HMGB1、肿瘤坏死因子α(TNF-α)和白介素1(IL-1)水平;用彩色多普勒超声测定左室射血分数(EF值)及二尖瓣血流峰值速度/左室舒张晚期峰值速度(E/A值)。结果 CHF患者的HMGB1、TNF-α和IL-1均明显高于对照组(P<0.05);HMGB1与心衰的严重程度正相关。结论 CHF患者HMGB1水平明显升高,HMGB1可能参与了心力衰竭的过程,并可作为预测心衰严重性的参考指标。