血清脂肪酶和淀粉酶联合检测在急性胰腺炎诊断中的作用

目的探讨血清脂肪酶和淀粉酶联合检测在急性胰腺炎诊断中的作用。方法选取2016年3月至2016年12月在我院就诊的100例急性胰腺炎患者,分为轻度急性胰腺炎组(n=65),重度急性胰腺炎(n=35),另选取同期健康体检者100例作为对照组,比较三组血清脂肪酶(LPS)和血清淀粉酶(AMY)水平。结果重度急性胰腺炎组LPS和AMY水平均显著高于轻度急性胰腺炎组和对照组(P<0.05),轻度急性胰腺炎组LPS和AMY水平均显著高于对照组(P<0.05)。血清AMY和LPS联合检测的灵敏度、特异度和准确度显著高于单独AMY和LPA检测(P<0.05)。结论血清脂肪酶和淀粉酶联合检测可提高急性胰腺炎诊断的灵敏度、特异度和准确度,值得临床推广。     

联合检验血清淀粉酶、脂肪酶及C反应蛋白在急性胰腺炎诊断中的价值研究

目的研究联合检验血清淀粉酶、脂肪酶及C反应蛋白在急性胰腺炎诊断中的价值。方法将本院2017年1月至2017年12月接受的198例轻型急性胰腺炎患者设置为轻型组,将42例急性重型胰腺炎患者设置为重型组,选取同时期在我院接受健康体检的200例健康人群作为参照对象设置为对照组,观察两组血清淀粉酶、脂肪酶、C反应蛋白指标检测结果。结果轻型组和重型组血清淀粉酶、脂肪酶差异不明显(P>0.05),但C反应蛋白指标差异显著(P<0.05);轻型组和重型组各项指标均高于对照组(P<0.05)。结论联合血清淀粉酶、脂肪酶、C反应蛋白指标检测能够有效提高急性胰腺炎诊断的准确性,为医师临床诊断和治疗提供了重要的数据支撑。     

多层CT联合血清淀粉酶、脂肪酶浓度检测在急性胰腺炎诊断中的应用

目的 观察分析多层CT联合血清淀粉酶、脂肪酶浓度检查在急性胰腺炎诊断中的应用.方法 选取2010年3月至2015年8月收治的急性胰腺炎患者共计237例,根据患者病情分为轻型胰腺炎组(n =160)和重性胰腺炎组(n=77),另选取体检正常组患者98例作为对照组.比较患者的胰腺CT表现、应用不同检测方法对胰腺的检出率情况、血清中淀粉酶和脂肪酶含量以及体征和临床症状的缓解情况.结果 应用多层CT检查对胰腺的检出率(96.31％)明显高于应用超声影像检查对胰腺的检出率(83.87％),差异有统计学意义(P＜0.05).重型胰腺炎组和轻型胰腺炎组患者的血清淀粉酶和脂肪酶含量均显著高于对照组患者,且重型胰腺炎组患者的水平又明显高于轻型胰腺炎组患者,差异有统计学意义(P＜0.05).两项指标联合检测的特异性、灵敏性和准确度明显高于单独一项指标检测,差异有统计学意义(P＜0.05).重型胰腺炎组患者的症状体征恢复时间均长于轻型胰腺炎组患者,差异有统计学意义(P＜0.05).结论 多层CT、血清淀粉酶以及脂肪酶联合检测不仅能够提高诊断的准确度和阳性率,而且检查时间较短,有利于临床诊断.     

乌司他丁对急性重症胰腺炎患者血清ZO-1、occludin、IL-18水平影响的多中心研究

目的 通过多中心研究,探究乌司他丁对急性重症胰腺炎患者血清ZO-1、occludin、IL-18水平的影响.方法 选取2012年4月～ 2014年6月河北省承德医学院附属医院、隆化县医院以及平泉县医院内科收治的急性重症胰腺炎患者150例,采用随机数字表法分为2组.对照组76例,予西医常规治疗;实验组74例,在常规药物治疗的基础上,加用乌司他丁治疗,比较2组患者治疗前后血清ZO-1、occludin、IL-18水平的变化以及患者疼痛、发热等临床症状.结果 治疗后,2组患者血清ZO-1蛋白均有所增加,且实验组(+++)显著高于对照组(+),差异有统计学意义(P＜0.05).治疗后,2组患者血清occludin含量均有所升高,且实验组(128.36±18.21) ng/L显著高于对照组(115.21±12.51)ng/L,差异有统计学意义(P＜0.05).治疗后,2组患者血清IL-18水平均有所下降,实验组为(36.79±10.31) ng/L,显著优于对照组的(42.69±12.35) ng/L,差异有统计学意义(P＜0.05).治疗后,2组患者腹痛、发热症状均有所改善,实验组有效率分别为90％、88％,显著高于对照组的83％、80％,差异有统计学意义(P＜0.05).结论 乌司他丁可有效改善急性重症胰腺炎患者血清ZO-1、occludin、IL-18水平,改善患者腹痛、发热症状,是治疗急性重症胰腺炎的有效药物.     

血清淀粉酶、脂肪酶与C反应蛋白联合检测在急性胰腺炎早期诊断中的价值分析

目的探讨在急性胰腺炎患者早期诊断中联合检测血清淀粉酶(AMY)、脂肪酶(LPS)、C反应蛋白(CRP)的临床价值。方法选择医院于2017年9月至2018年9月收治的70例急性胰腺炎患者为观察组进行研究,另选同期40名进行体检的健康者为对照组。检测观察组与对照组研究对象的AMY、LPS和CRP水平,并进行相关分析。结果观察组的血清AMY、LPS和CRP水平明显高于对照组,具有统计学意义(P <0.05)。轻型组急性胰腺炎患者与重型组急性胰腺炎患者的血清AMY、LPS水平比较无统计学意义(P> 0.05);但轻型组的CRP水平明显低于重型组,具有统计学意义(P <0.05)。结论在急性胰腺炎的早期诊断中,血清AMY、LPS和CRP水平联合检测的诊断效果更好,检测CRP水平能够评判急性胰腺炎患者病情的严重程度,具有在临床中应用的价值。     

急性胰腺炎诊断中血清淀粉酶、脂肪酶及C反应蛋白联合检验的应用价值分析

目的：探讨血清淀粉酶、脂肪酶及C反应蛋白联合检验在急性胰腺炎诊断中的价值。方法：选择2014年5月至2016年7月来我院就诊的急性胰腺炎患者89例为观察组研究对象,选择同时期健康体检者50例作为对照组研究对象,对两组受试者均进行血清淀粉酶、脂肪酶及C反应蛋白检测,并进行统计学分析。结果：急性胰腺炎患者各项指标含量远远高于健康者（P<0.05）,并且重型胰腺炎患者高于轻型患者（P<0.05）,三者联合检测的敏感度均远远高于单独检测（P<0.05）。结论：血清淀粉酶、脂肪酶及C反应蛋白可作为急性胰腺炎的诊断指标,三者联合检测能够显著提高其准确性。     

奥曲肽联合乌司他丁对急性轻症胰腺炎患者四种血清IL水平的影响观察

目的观察四种血清IL水平在急性轻症胰腺炎患者中的检测结果,并探讨奥曲肽联合乌司他丁对血清IL水平的影响。方法选取35例急性轻症胰腺炎患者为观察组,同时选取健康体检的35例受试者为对照组,其中观察组患者给予奥曲肽联合乌司他丁治疗,对比分析两组患者四种血清IL水平。结果观察组治疗前IL-15、IL-18、、IL-17、IL-22与对照组均有显著差异(P<0.05),在治疗后各指标均有显著改善,且治疗6d后患者各项指标水平与对照组无显著差异(P>0.05)。结论 IL-15、IL-17、IL-18、IL-22四种因子在急性轻症胰腺炎诊断与预后评估中有重要的应用价值。     

经内镜逆行性胰胆管造影术后早期进食血清淀粉酶水平的影响

目的观察进食因素对经内镜逆行性胰胆管造影术(ERCP)后血清淀粉酶水平的影响,探讨ERCP后早期进食的可行性。方法将符合标准的132例患者随机分为实验组和对照组各66例,实验组术后6h开始进食,对照组术后24h开始进食,观察ERCP后6、8、12、24、48、72h血清淀粉酶水平。结果实验组发生急性胰腺炎2例,对照组发生急性胰腺炎3例,2组比较差异无显著性(P>0.05),且均与进食无明显关系;2组患者术后6、8、12、24、48、72h淀粉酶水平差异均无显著性(P>0.05)。结论ERCP后并发急性胰腺炎与进食时间无关,早期进食不会增加胰腺炎的危险。     

乌司他丁治疗急性重症胰腺炎的疗效及对血清炎症因子水平的影响

目的研究分析乌司他丁治疗急性重症胰腺炎的临床效果及对血清炎症因子水平的影响。方法 86例急性重症胰腺炎患者,随机分为对照组和观察组,各43例。对照组给予基础治疗,观察组给予乌司他丁治疗,对比两组临床治疗效果。结果观察组治疗后7 d的急性生理与慢性健康评分(APACHEⅡ评分)降低程度显著优于对照组,差异具有统计学意义(P<0.05);观察组治疗1、7 d的白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)和肿瘤坏死因子-α(TNF-α)等血清炎症因子水平均显著优于对照组,差异均具有统计学意义(P<0.05)。结论乌司他丁治疗急性重症胰腺炎效果显著,能够显著提高治疗效果,改善血清炎症因子水平,值得推广。     

谷氨酰胺联合乌司他丁对急性胰腺炎患者血清指标的影响及最佳用药剂量分析

目的:观察谷氨酰胺联合乌司他丁治疗急性胰腺炎对患者血清指标的影响，分析最佳用药剂量。方法:选取焦作市第二人民医院2021年1月—2023年1月收治的急性胰腺炎患者123例为研究对象，通过电脑随机分组法将入组患者分为对照组、观察A组、观察B组3组，每组41例。对照组予以20万单位的常规剂量乌司他丁联合谷氨酰胺治疗，观察A组予以40万单位的中剂量乌司他丁联合谷氨酰胺治疗，观察组B组予以60万单位的高剂量乌司他丁联合谷氨酰胺治疗，比较3组患者治疗前后血清炎症因子、免疫指标、应激指标变化情况及用药后不良事件发生情况。结果:治疗前，3组患者血清炎症因子、免疫指标、应激指标比较差异无统计学意义(P>0.05);治疗后，观察A组和观察B组血清淀粉酶(AMY)[(60.24±10.33)U/L和(58.33±10.15)U/L]、二胺氧化酶(DAO)[(3.25±0.12)U/L和(3.04±0.27)U/L]、血清脂肪酶(LSP)[(165.44±20.76)U/L和(160.12±20.35)U/L]均低于对照组[(67.22±10.15)U/L、(4.33±1.25)U/L、(182.33...     

白血病化疗患者外周血血清铁蛋白、转铁蛋白以及转铁蛋白受体与临床疗效的关系

目的探讨白血病化疗患者外周血血清铁蛋白、转铁蛋白、转铁蛋白受体等铁代谢相关指标与化疗的临床疗效的关系。方法我科收治的白血病化疗患者36例,所有患者分别在治疗前、治疗后4周抽取外周静脉血采用化学发光法以及散射比浊法检测血清铁蛋白、转铁蛋白、转铁蛋白受体表达水平。收集患者临床资料与铁代谢指标进行相关性分析。结果治疗开始前,患者血清铁蛋白、转铁蛋白以及转铁蛋白受体分别为519.71±157.38ng·mL-1,3.63±0.51g·L-1,2.87±0.76mg·L-1,均明显高于正常水平,有统计学意义差异（P〈0.05）。复发与未缓解患者三项指标的均值明显高于初发组以及缓解组（P〈0.05）。结束后4周检测铁代谢指标,血清铁蛋白、转铁蛋白、转铁蛋白受体均值均显著降低,差异有统计学意义（P〈0.05）。其中,血清铁蛋白水平仍高于正常均值（P〈0.05）,转铁蛋白与转铁蛋白受体均值低于正常均值（P〈0.05）。完全缓解与部分缓解组铁代谢指标显著低于未缓解组,差异有显著性（P〈0.05）。结论铁代谢指标与白血病患者化疗的临床疗效间有着正相关的联系。     

糖尿病微血管病变患者血清脂联素水平变化及与脂质过氧化的关系

目的:观察糖尿痛合并微血管病变患者血清脂联素(APN)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平的变化,探讨其关系及其在糖尿病微血管痛变发病中的可能作用.方法:按WHO诊断标准随机选择2007年3月～2008年9月在佳木斯大学附属第一医院内分泌科住院的合并微血管病变的2型糖尿病患者50例,男25例,女25例,选择...     

Interaction of vinblastine,vincristine and colchicine with serum proteins

Equilibrium dialysis has been used to demonstrate that vincristine (VCR), vinblastine (VLB) and colchicine (CLC) adsorb to serum proteins. In addition, there is about 19 per cent more binding of CLC to plasma than serum. The extent of adsorption for all three alkaloids is approximately proportional to both the free alkaloid concentration and the serum protein concentration, with no evidence of saturation at the concentrations used. At physiologic concentrations of protein, the per cent of drug bound to serum protein is about 75 per cent for VLB and VCR and 50 per cent for CLC, indicating that the drugs are not tightly bound, and that there is no impediment to rapid extravascular distribution. On a mole per g basis, VLB and VCR adsorb ten times more extensively to commercially obtained α- and β-globulins than to albumin or γ-globulin. CLC binds nonselectively to these components.     

癫痫患者血清、血清超滤液、唾液、脑脊液中苯妥英浓度的相关性和动力学研究

本文应用超滤法测定血清中游离苯妥英浓度的方法,并采用荧光酶免疫法对患者的血清、血清超滤液、唾液、脑脊液进行苯妥英浓度测定,研究它们的相关性。通过测定6名癫痫患者单剂量口服苯妥英钠后血清、血清超滤液、唾液中的药物浓度,计算其动力学参数。实验结果表明,血清超滤液、唾液、脑脊液中苯妥英浓度分别为血清药物浓度的11%、10%、11%,有良好的相关性。各样品测得的动力学数据基本一致,药物浓度—时间曲线变化相同。血清超滤液、唾液、脑脊液样品中苯妥英浓度均反映了患者体内游离药物浓度的情况,唾液样品收集方便、迅速,对患者无损伤,适用于临床进行治疗药物监测。     

Reversible binding of antidiabetic drugs, repaglinide and gliclazide, with human serum albumin

Mechanism of interaction of antidiabetic drugs, repaglinide and gliclazide, to human serum albumin has been studied using fluorescence spectroscopic technique. Repaglinide had much higher affinity for human serum albumin when compared with gliclazide. The order of association constants was 10(5) for both the drugs. The size, hydrophobicity and flexibility of the drug molecules play a major role in explaining the binding behaviour of these drugs. Hydrophobic interactions are predominantly involved in the binding. However, drugs do not share common sites with 1-anilinonaphthalene-8-sulphonate on the human serum albumin molecule. Both tyrosine and tryptophan residues participate in the interaction. Repaglinide and gliclazide are bound to site II on the human serum albumin molecule, and the aromatic ring of 411Tyr appears to be involved in binding within site II. Although they do not bind at site I, their binding at site II may cause conformational changes thereby affecting the binding of other ligands to site I. Site-specificity can be useful in predicting the competitive displacement of these drugs by other co-administered drugs, resulting in fluctuations of the blood glucose levels in diabetic patients. Stern-Volmer analysis of quenching data indicated that the tryptophan residues are not fully accessible to the drugs and predominantly dynamic quenching mechanism is involved in the binding.     

Design, synthesis, and biological evaluation of thio-containing compounds with serum HDL-cholesterol-elevating properties

A novel series of substituted sulfanyldihydroimidazolones (1) that modulates high-density lipoprotein cholesterol (HDL-C) has been reported to have HDL-elevating properties in several animal models. Concerns about the chemical and metabolic stability of 1 directed us to explore the structure-activity relationship (SAR) of a related series of substituted thiohydantoins (2). Expansion of the scope of the thiohydantoin series led to exploration of compounds in related thio-containing ring systems 3-7 and the N-cyanoguanidine derivative 8. Compounds were tested sequentially in three animal models to assess their HDL-C elevating efficacy and safety profiles. Further evaluation of selected compounds in a dose-response paradigm culminated in the identification of compound 2.39 as a candidate compound for advanced preclinical studies.     

Predicting the glomerular filtration rate from serum creatinine, serum cystatin C and the Cockcroft and Gault formula with regard to drug dosage adjustment

OBJECTIVES: To compare the accuracy of the classification of the degree of decrease in glomerular filtration rate (GFR), measured exactly (as inulin clearance) on the basis of serum concentrations of creatinine (Scr), cystatin C (Scyst) and creatinine clearance predicted according to Cockcroft and Gault (CG), and to establish whether any of the above methods is more accurate than the other 2. SUBJECTS: The study was conducted in 126 patients (52 men, 74 women) aged 18 to 64 years with various chronic renal diseases (predominantly various forms of glomerulonephritis and tubulointerstitial nephritis). The study subjects were divided into 3 subgroups according to GFR levels. Subgroup A (n = 41) included individuals with GFR >50 ml/min/1.73 m2, subgroup B (n = 56) was made up by individuals with GFR of 20-50 ml/min/1.73 m2, while subgroup C (n = 29) comprised individuals with GFR <20 ml/min/1.73 m2. METHODS: GFR was determined on the basis of renal inulin clearance (Cin) under conditions of stable plasma levels and water loading. Each individual had his/her Scr, Scyst values measured and CG was calculated. Results were evaluated using discrimination analysis. RESULTS: Mean values and SD of the monitored markers in the subgroups were as follows. Subgroup A: Scr 102.4 (38.3) micromol/l, Scyst 1.46 (0.42) mg/l, CG 80.0 (19.2) ml/min/1.73 m2. Subgroup B: Scr 161.2 (45.6) micromol/l, Scyst 2.01 (0.55) mg/l, CG 46.1 (16.7) ml/min/1.73 m2. Subgroup C: Scr 314.9 (58.3) micromol/l, Scyst 3.41 (0.96) mg/l, CG 24.8 (7.6) ml/min/1.73 m2. The percent of correct classifications and the respective confidence intervals (95%) for the methods used were as follows. Subgroup A: Scr 79.3 (64.6, 94.0), Scyst 75.9 (60.3, 91.5), CG 86.2 (73.6, 98.8). Subgroup B: Scr 51.8 (35.5, 68.1), Scyst 57.1 (41.5, 72.7), CG 64.3 (48.6, 80.0). Subgroup C: Scr 90.2 (81.0, 99.2), Scyst 80.5 (68.1, 92.9), CG 87.8 (77.8, 97.8). The percent of correct classifications established on the basis of Scr, Scyst and CG in subgroup B is significantly lower than that of correct classifications in subgroups A and C (p < 0.05-0.001). The percent of correct classifications using Scr, Scyst and CG, estimated separately for each subgroup (A, B, C) does not differ significantly. CONCLUSIONS: The findings support the assumption that estimation of the decrease in GFR using Scr, Scyst and CG is, as regards their utilization in everyday practice, suitable for individuals with severely decreased GFR (<20 ml/min/1.73 m2) and for individuals with a decrease in GFR to levels >50 ml/min/173 m2. Estimation of the decrease in GFR using the above subgroups did not demonstrate significant differences among Scr, Scyst and CG. Using the above markers, estimation of the decrease in GFR is the least reliable with GFR values in the range of 20-50 ml/min/1.73 m2.     

OSAHS患者血液血管内皮生长因子与血脂的变化及相关性探讨

目的探讨血清血管内皮生长因子(VEGF)与血脂参数在阻塞性呼吸睡眠暂停低通气综合征(OSAHS)患者的变化及两者相关性.方法检测经多导睡眠监测仪(PSG)确诊的50例OSAHS患者及30例健康人员血清的VEGF、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDl-C)水平;根据睡眠呼吸暂停低通气指数(AHI)分为轻、中、重3组.结果与健康对照组比较,OSAHS轻度、中度、重度组血清VEGF、TG、TC、LDL-C水平逐渐呈增高趋势(P＜0.05或P＜0.01或P＜0.001),其中重度组更为明显,而HDL-C则呈下降趋势(P＜0.05或P＜0.01);OSAHS患者血清VEGF水平与TG、TC、LDL-C呈正相关(r=0.542、0.795、0.854,P＜0.05或P＜0.01),与HDL-C呈负相关(R分别为-0.781,P＜0.01).结论OSAHS患者血清VEGF水平明显地升高;VEGF与血脂存在有较为密切的相关.