慢性肾功能衰竭大鼠下丘脑组织和血浆食欲素A及神经肽Y水平的变化及其意义

目的　探讨大鼠慢性肾功能衰竭 (CRF)动物模型的下丘脑组织和血浆食欲素A及神经肽Y(NPY)水平的变化及其意义。方法　将 41只 2 0 0～ 2 50 g雄性Wister大鼠分为 :正常组、假手术组和CRF组。术后 4、 8、 1 2周分批断头处死大鼠 ,取血浆和下丘脑组织标本。用放射免疫法测定血浆和下丘脑组织食欲素A和NPY。用生化自动分析仪测定血清肌酐。结果　CRF大鼠术后4、 8和 1 2周血肌酐水平均高于假手术组。其术后 1 2周的血浆食欲素A水平高于假手术组 (2 64pg/ml± 62pg/mlvs 1 83pg/ml± 56pg/ml,P =0 0 39)。CRF大鼠术后 1 2周的下丘脑食欲素A水平明显低于假手术组 (1 0 5fmol/mg± 2 7fmol/mg湿重vs 1 7 4fmol/mg± 3 9fmol/mg湿重 ,P =0 0 2 3)。CRF大鼠术后 8周 (7 1 pmol/ml± 1 7pmol/mlvs 5 0 pmol/ml± 0 5pmol/ml,P =0 0 1 )和1 2周 (7 9pmol/ml± 1 1pmol/mlvs 4 8pmol/ml± 1 1 pmol/ml,P =0 0 0 0 8)的血浆神经肽Y水平高于假手术组 ,其术后 1 2周的下丘脑神经肽Y水平明显低于假手术组 (70fmol/mg± 2 3fmol/mgvs1 1 3fmol/mg± 31fmol/mg湿重 ,P =0 0 33)。 结论　 (1 )CRF大鼠血浆食欲素A和NPY水平有逐渐增高趋势 ,肾功能减退可能导致食欲素A和NPY排泄障碍。 (2 )CRF时下丘脑组织食欲素     

冠心病患者血浆尾加压素Ⅱ的临床研究

OBJECTIVE: To investigate the changes in plasma urotensin II(U II) expression levels in patients with coronary heart disease (CHD). METHODS: Plasma U II levels in 50 CHD patients with coronary stenosis indicated by coronary angiography and 20 healthy subjects were determined by radio immunoassay. RESULTS: Venous plasma U II levels were significantly lowered in CHD patients in comparison with the healthy subjects (1.61+/-1.02 pg/ml vs 3.70+/-1.30 pg/ml, P=0.000). In the CHD patient group, significantly differences were noted in the U II levels between patients with stable angina (2.62+/-1.20 pg/ml), unstable angina (1.39+/-0.80 pg/ml) and acute myocardial infarction (AMI, 1.04+/-0.45 pg/ml, P=0.004). CHD patients with coronary artery occlusion and those with only coronary stenosis had comparable venous plasma U II levels (1.29+/-1.02 pg/ml vs 1.76+/-1.00 pg/ml, P=0.131), whereas the patients with restenosis after percutaneous transluminal coronary angioplasty (PTCA) had higher U II levels than the other subjects in the CHD patient group (2.28+/-0.94 pg/ml vs 1.40+/-0.96 pg/ml, P=0.008), and the femoral plasma U II levels were significantly elevated after PTCT, increasing from 1.18+/-1.14 pg/ml to a postoperative level of 2.22+/-1.77 pg/ml (P=0.001). CONCLUSION: U II might play a role in the pathophysiological process of CHD and can be involved in the restenosis after angioplasty.     

SERUM LEVELS OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN PATIENTS WITH ANGINA PECTORIS AND ACUTE MYOCARDIAL INFARCTION

ＩＮＴＲＯＤＵＣＴＩＯＮ　　Ｖａｓｃｕｌａｒｅｎｄｏｔｈｅｌｉａｌｇｒｏｗｔｈｆａｃｔｏｒ (ＶＥＧＦ)ｏｒｖａｓｃｕｌａｒｐｅｒｍｅａｂｉｌｉｔｙｆａｃｔｏｒ (ＶＰＦ)ｃｏｎｓｉｓｔｓｏｆａｆａｍｉｌｙｏｆｐｏｌｙｐｅｐｔｉｄｅｉｓｏｆｏｒｍｓｔｈａｔｓｐｅｃｉｆｉｃａｌｌｙｒｅｇｕｌａｔｅｅｎｄｏｔｈｅｌｉａｌｃｅｌｌｆｕｎｃｔｉｏｎ ,ｉｎｃｌｕｄｉｎｇｅｎｈａｎｃｅｍｅｎｔｏｆａｎｇｉｏｇｅｎｅｓｉｓ( 1) ,ｅｎｈａｎｃｅｍｅｎｔｏｆｍｉｃｒｏｖａｓｃｕｌａｒｐｅｒｍｅａｂｉｌｉｔｙ ( 2 ) ,ａｎ…     

氯沙坦对高血压血浆神经肽Y含量的干预研究

目的 观察应用氯沙坦前后高血压患者血浆神经肽Y(NPY)含量的变化,探讨血管紧张素Ⅱ(AⅡ)受体拮抗剂与NPY的相关性。方法 采用放免法测定40例高血压患者应用氯沙坦前后血浆NPY的含量及AⅡ水平,同期测定另外40例高血压患者应用美托洛尔前后血浆NPY的含量及AⅡ水平。结果40例高血压患者应用氯沙坦前后血浆NPY水平分别为(152.4±12.3)pg/ml、(125.5±9.5)pg/ml,P<0.01;血浆AⅡ水平分别为(49.6±7.1)pg/ml、(62.4±7.8)pg/ml,P<0.01。40例高血压患者应用美托洛尔前后血浆NPY水平分别为(144.1±11.3)pg/ml、(140.6±12.2)pg/ml,P>0.05;血浆AⅡ水平分别为(45.5±5.8)pg/ml、(48.3±7.2)pg/ml,P>0.05。治疗后2组之间比较,NPY、AⅡ水平均有非常显著性差异(P<0.01)。结论 氯沙坦能影响血浆NPY水平,提示该药降压的过程中有NPY参与的因素,而美托洛尔却不影响血浆NPY水平。     

急性心肌梗死患者血浆神经肽Y的变化及其临床意义

目的:探讨神经肽Y(NPY)在急性心肌梗死(AMI)发生和发展中的意义。方法:用放射免疫方法测定AMI患者发病第1、3、7天血浆NPY含量变化,并与正常人作对照。结果:AMI患者发病第1、3天血浆NPY含量显著高于正常对照组(P<0.05),合并心衰者显著高于无心衰者(P<0.05)。结论:NPY可能在AMI发生和发展过程中起一定的作用;作为一项监测指标,对判断AMI患者的预后有一定的意义。     

心肌缺血大鼠血浆8-异前列腺素F2α水平及N-乙酰半胱氨酸干预作用

OBJECTIVE: To examine the correlation between 8-iso-prostaglandin F2alpha (8-iso-PGF2alpha) levels in the plasma and myocardial tissue of rats with myocardial ischemia and observe the intervention effect of N-acetylcysteine (NAC), for the purpose of assessing the value of 8-iso-PGF2alpha in estimating the extent of free radical damage and implementing possible interventions. METHODS: Forty-five Wistar rats were divided into ischemia, ischemia+NAC and control groups, and in the former 2 groups, acute myocardial ischemia models were produced by pituitrin. Elevated ST segment in ECG served as the indicator for myocardial ischemia. Rats in ischemia+NAC group were pre-treated with NAC (0.1 g/kg x d) for three weeks before the ischemia 8-iso-PGF2alpha levels in the plasma and myocardial tissue were determined by enzyme-linked immunosorbent assay (ELISA). RESULTS: In ischemia group, the 8-iso-PGF2alpha levels in the plasma and myocardial tissue were 187.4+/-45.8 pg/ml and 259.3+/-47.5 pg/g, respectively, higher than those in the control group (60.4+/-13.7 pg/ml and 88.6+/-16.9 pg/g, respectively, P<0.01) and those in ischemia+NAC group (88.2+/-16.4 pg/ml and 109.4+/-24.7 pg/g, respectively, P<0.01). A positive correlation was noted between the 8-iso-PGF2alpha levels in the plasma and myocardial tissue (r=0.865, P<0.01). In comparison with the control group, elevation of the ST segment of ECG in rats with myocardial ischemia was obvious, and the peak elevation occurred 45 min after ischemia (0.34+/-0.05 mV, P<0.01). Pre-treatment with NAC proved to help alleviate the subsequent ischemia, with ST segment elevation of only 0.18+/-0.05 mV. CONCLUSION: In condition of acute myocardial ischemia in rats, 8-iso-PGF2alpha levels tend to increase, which can be indicative of the degree of myocardial ischemia. NAC pre-treatment can alleviate the ischemic condition by offsetting the damage caused by the free radicals.     

血清白三烯B4水平与急性冠脉综合征发病风险和易患因素的相关性分析

目的:观察急性冠状动脉综合征(ACS)患者血清白三烯(leukotriene,LT)B4水平的变化及其与易患因素的相关性,探讨其在ACS中可能的临床意义。方法:采用酶联免疫吸附法测定403例ACS患者和132例非冠心病患者(对照组)血清LTB4水平。结果:血清LTB4水平在急性心肌梗死(AMI)组和不稳定型心绞痛(UAP)组分别为(477.97/370.52 pg/ml)和(352.52/255.48 pg/ml),显著高于对照组(200.57/236.65 pg/ml)(P<0.001);且AMI组的血清LTB4水平显著高于UAP组(P<0.001)。ACS患者的血清LTB4与吸烟呈正相关(P<0.05),与男性、高龄、高血压、糖尿病、高血脂无关(P>0.05)。结论:ACS患者血清LTB4水平增高;LTB4水平与吸烟呈正相关。     

高血压患者血浆神经肽Y含量的临床意义

目的:探讨高血压病患者血浆神经肽Y(NeuropeptideY,NPY)变化的临床意义。方法:用放射免疫法测定了我院高血压患者140例的NPY。结果:对照组NPY为(73.3±47.1)pg/ml,明显低于高血压患者(131.5±30.2)pg/ml,P<0.01。结论:NPY的血浆含量变化为原发性高血压病的诊断提供一个有益的辅助指标。     

经皮冠状动脉腔内成形术与冠脉内支架安放术前后血清白细胞介素6、肿瘤坏死因子α水平的变化

目的 :探讨冠脉成形术引起早期炎性反应的机制。方法 :观察 3 7例冠脉成形术病人术前及术后 4小时血清白细胞介素 6(IL -6)、肿瘤坏死因子α(TNF -α)水平。对成形术中球囊阻断冠脉引起的缺血的强度进行量化。结果 :有侧支循环者 (有侧支循环组 ,n =10 )与无侧支循环者 (无侧支循环组 ,n =2 7)术前IL -6、TNF -α无显著差异 (P >0 0 5 )。有侧支循环组与无侧支循环组术后 4小时IL -6、TNF -α水平均显著高于术前。有侧支循环组术后IL -6、TNF -α显著低于无侧支循环组。从手术情况看 ,有侧支循环组缺血强度低于无侧支循环组 ,机械损伤则大于无侧支循环组。等级相关分析显示 ,冠脉成形术后IL -6、TNF -α水平升高幅度之间 ,以及升高幅度与缺血强度之间相关性良好 (P均 <0 0 1)。结论 :IL -6、TNF -α是反映PTCA术后早期炎性反应的敏感指标。PTCA诱发早期炎性反应的主要机制为术中球囊操作造成的心肌缺血 /再灌注。应尽可能减少PTCA术中的缺血刺激     

冠心病患者血浆尾加压素Ⅱ的临床研究

目的 探讨血管活性物质尾加压素Ⅱ(UⅡ)在冠心病患者体内的表达及其变化。方法 采用放射免疫法测定50例冠心病患者及20例健康体检者的血浆UⅡ的水平。结果 (1)健康对照组静脉血浆UⅡ含量为3.70±1.30 pg/ml,冠心病患者的血浆UⅡ含量为1.61±1.02 pg/ml,两者有统计学差异(P=0.000)。冠心病患者中稳定性心绞痛者血浆UⅡ含量为2.62±1.20 pg/ml,不稳定心绞痛者UⅡ含量为1.39±0.80 pg/ml,急性心肌梗死者UⅡ含量为1.04±0.45 pg/ml,3组之间有显著性差异(P=0.004)。(2)冠心病患者中冠脉血管有闭塞组静脉血浆UⅡ含量为1.29±1.02 pg/ml,单纯狭窄组UⅡ含量为1.76±1.00 pg/ml,两者无统计学差异(P=0.131)。(3)经皮腔内冠状动脉成型术(PTCA)及支架植入术后,出现再狭窄患者组血浆UⅡ含量为2.28±0.94 pg/ml,而其他病人的血浆UⅡ含量为1.40±0.96 pg/ml,两者有统计学差异(P=0.008)。(4) PTCA治疗前后,股动脉血浆UⅡ的含量分别为1.18±1.14、2.22±1.77 pg/ml,两者有统计学差异(P=0.001)。结论 UⅡ可能参与了冠心病的发病;在PTCA治疗后出现支架内再狭窄中可能起作用。     

肥胖儿童食欲素、瘦素和神经肽Y水平及其相互关系

目的分析肥胖儿童血中食欲素(O rex ins)、瘦素(L eptin、LEP)和神经肽Y(neuropeptide Y,NPY)水平及其相互关系,探讨O rex ins,LEP和NPY在儿童肥胖发生中的作用及三者存在的相互作用关系。方法以放射免疫法测定98名肥胖〔BM I男(29.24±1.87)kg/m2,女(28.12±2.30)kg/m2〕和104名正常对照〔BM I男(20.49±1.95)kg/m2,女(19.59±1.51)kg/m2〕儿童血中的LEP、O rex ins和NPY浓度。结果肥胖儿童血中LEP浓度〔男(26.00±14.66)ng/mL;女(33.59±14.63)ng/mL〕高于对照组儿童〔男(6.65±4.49)ng/mL;女(10.48±5.52)ng/mL,P<0.01〕;肥胖儿童血中O rex inA浓度〔男(3.23±1.86)pg/mL;女(3.38±1.80)pg/mL〕低于对照组〔男(4.52±1.52)pg/mL;女(4.71±1.53)pg/mL,P<0.05〕;两组间LEP与NPY皆呈负相关关系(对照组r=-0.310;肥胖组r=-0.302,P均<0.01),但斜率不同(对照组-2.969;肥胖组-0.809);NPY与O rex inA为正相关关系r=0.207 P<0.05,肥胖组儿童相对于对照组O rex inA的波动范围明显变小。结论肥胖儿童与对照组相比血中LEP与O rex inA浓度水平相反,儿童肥胖的发生与LEP、O rex inA、NPY和它们之间的相互作用有关。     

Serum basic fibroblast growth factor levels in exercise-induced myocardial ischemia more likely a marker of endothelial dysfunction than a marker of ischemia?

Increased levels and activity of fibroblast growth factor (FGF) have been documented in a variety of diseases, including ischemia. Both acute coronary syndromes and exercise are situations that stimulate FGF release. Since experimental studies have demonstrated that FGFs are involved in myocardial preconditioning, it has been suggested that cardiac and circulating FGFs may play a cardioprotective role in ischemic diseases. However, the profile of basic FGF (bFGF) release during transient myocardial ischemia remains uncertain. We sought to determine whether circulating bFGF might be changed in patients with demonstrated coronary artery disease and evidence of ischemia in exercise scintigraphy (Isch +; n = 21). Serum from 22 age-matched patients with no coronary artery disease and no isotopic ischemia (Isch-) were used as controls. Three blood samples were obtained to determine bFGF at different times: baseline (bFGF-A); maximal exercise (bFGF-B), and isotopic redistribution (bFGF-C). An enzyme-linked immunoassay specific for bFGF was used (limit of detection, 1.0 pg/ml). Circulating bFGF was increased at maximal exercise in both Isch + and control patients. However, serum levels of bFGF were elevated up to more than two-fold in Isch-patients compared to Isch+ patients (8.67 +/- 2.10 pg/ml in Isch+ vs 17.83 +/- 2.97 pg/ml in Isch- patients; p<0.01). According to previous data, these findings suggest that bFGF serum levels could be considered more likely a marker of endothelial dysfunction occurring in patients with coronary artery disease, rather than a marker of acute ischemia. This situation could be different in the clinical setting of chronic myocardial ischemia.     

急性心肌梗死介入术后发生心肌缺血/再灌注损伤的危险因素分析

目的研究分析急性心肌梗死(AMI)介入术后发生心肌缺血/再灌注损伤(MIRI)的危险因素。方法选择本院2009年6月至2010年12月184例接受经皮冠状动脉介入术且手术成功的AMI患者的临床资料,采用多因素Logistic回归模型分析MIRI的危险因素。结果 MIRI出现的危险因素包括AMI发病时间≤6 h、下壁梗死、多支血管病变,其中发病时间≤6 h(P=0.021)、下壁梗死(P=0.007)是独立性危险因素,多支血管病变(P=0.056)是危险因素。梗死前的心绞痛(P=0.004)起到保护作用,是独立性保护因素。结论临床上发病时间短、下壁梗死、多支血管病变的AMI患者冠状动脉介入治疗后发生MIRI的危险性较高,而心肌梗死前有心绞痛对MIRI有保护作用,临床对该类患者应引起重视,注意预防。     

缺血性脑血管病患者颈动脉粥样硬化程度与血浆神经肽Y水平的相关性分析

目的分析缺血性脑血管病患者颈动脉粥样硬化程度与血浆神经肽Y（NPY）水平的相关性。方法采用放射免疫法检测缺血性脑血管病患者[包括急性脑梗死、短暂性脑缺血发作（TIA）和颈动脉粥样硬化患者]和健康体检者（对照组）血浆NPY水平;采用彩色多普勒超声检测缺血性脑血管病患者颈动脉内膜中层厚度（IMT）。结果缺血性脑血管病患者NPY水平较对照组明显升高（P〈0.01）;随着颈动脉粥样硬化程度加重,血浆NPY水平呈现增高趋势;颈动脉重度狭窄患者NPY水平与轻、中度狭窄患者相比差异有统计学意义（P〈0.05）;急性脑梗死和TIA患者较单纯颈动脉粥样硬化患者血浆NPY明显升高（P〈0.05）。缺血性脑血管病患者中血浆NPY水平与IMT值呈正相关关系（r=0.163、0.245、0.179,P〈0.05）。结论 NPY可反映颈动脉粥样硬化的程度且参与颈动脉粥样硬化的病理生理过程。     

血清MCP-1水平与MCP-1-2518G/A多态性和急性心肌梗死的相关性

目的:探索中国苏南地区汉族人群血清单核细胞趋化蛋白(MCP)-1水平与该蛋白基因 -2518G/A多态性和急性心肌梗死(AMI)的相关性.方法:对94例AMI患者(AMI组)和73例经冠脉造影检查证实非冠心病者(对照组)采用PCR-RFLP法检测MCP-1 -2518G/A多态性,采用ELISA法检测血清MCP-1水平...     

针对Toll样受体4基因的小发夹结构RNA对RAW264.7细胞炎症因子分泌的抑制作用

目的构建针对Toll样受体(TLR)4 mRNA的小发夹结构RNA(shRNA)真核表达载体pEGFP-siRNA/TLR4,检测该shRNA诱导的RNA干扰(RNAi)对脂多糖刺激RAW264.7细胞分泌炎症因子的抑制作用,以探讨针对TLR4基因的RNAi对RAW264.7细胞炎症反应的抑制作用.方法构建携带增强型绿色荧光蛋白(EGFP)及shRNA克隆位点的质粒pEGFP-H1/siRNA,运用网络工具siRNA Wizard(http//www.simawizard.com/)设计针对TLR4 mRNA的寡核苷酸片段.将其克隆入pEGFP-H1/siRNA,构建表达EGFP及TLR4-shRNA的真核表达质粒pEGFP-H1/TLR4-siRNA.运用脂质体转染技术将pEGFP-H1/TLR4-siRNA转染至培养的小鼠巨噬细胞系RAW264.7,观察细胞系中荧光蛋白的表达强度;再运用脂多糖刺激转染的RAW264.7细胞,运用ELISA方法检测该细胞系分泌炎症因子水平的变化.结果质粒pEGFP-H1/siRNA及pEGFP-H1/TLR4-siRNA分别用Bbs Ⅰ和MluⅠ酶切电泳后,前者出现4.9 kb和340 bp的的条带,后者出现5.0 kb和220 bp的条带,与实验设计的质粒长度一致,且测序证实克隆序列正确.将pEGFP-H1/TLR4-siRNA转染至RAW264.7细胞后,EGFP的表达率为50%±8%.用脂多糖刺激后,TLR4-SiRNA转染组细胞培养液TNF-α水平(2 h825 pg/ml±136 pg/ml;8 h2190 pg/ml±359 pg/ml)明显低于对照siRNA转染组(2 h1179 pg/ml±240 pg/ml;8 h4720 pg/ml±227 pg/ml,均P＜0.01).结论针对TLR4 mRNA的shRNA可能通过RNAi机制对脂多糖诱导的RAW264.7细胞炎症因子的分泌有明显的抑制作用.     

Changes in plasma levels of tissue plasminogen activator and its inhibitor in aged myocardial infarction patients.

Plasma levels of tissue plasminogen activator (tPA) antigen, tPA activity and plasminogen activator inhibitor (PAI) activity were determined in 40 cases of acute myocardial infarction (AMI) at the onset and 2-4 weeks after the onset of the disease. 24 healthy subjects served as controls. At the onset of AMI, mean plasma level of tPA antigen was significantly higher than that of control subjects (13.5 +/- 4.8 ng/ml vs 6.4 +/- 2.0 ng/ml), with the highest elevation in the group greater than 65 years of age. Mean plasma level of tPA activity was significantly lower than in the controls (1.1 +/- 0.4 IU/ml vs 1.6 +/- 0.4 IU/ml), especially in patients over 65 years of age. Mean plasma level of PAI activity was significantly higher than in the controls (17.5 +/- 12.0 AU/ml vs 9.0 +/- 4.6 AU/ml), especially in patients over 65 years of age. At 2-4 weeks, mean plasma levels of tPA and PAI activities of AMI patients had dropped to 1.5 +/- 0.6 IU/ml and 9.5 +/- 8.9 AU/ml, respectively, not significantly different from controls. The tPA antigen had come down to 11.0 +/- 5.4 ng/ml, but still higher than in the controls. The possible mechanism of these phenomena was discussed.

     

曲美他嗪对家兔心肌缺血再灌注损伤的保护作用

目的 :探讨曲美他嗪对家兔心肌缺血再灌注损伤的保护作用。方法 :家兔 4 0只 ,随机分为正常对照组、缺血对照组、缺血药物干预组、再灌注对照组、再灌注药物干预组。观察缺血 30 min和再灌注 30 min对血清肌酸磷酸激酶 (CPK)、丙二醛 (MDA)、超氧化物歧化酶 (SOD)的影响 ,心肌三磷酸腺苷 (ATP)含量 ,以及心肌电镜学改变。结果 :1缺血药物干预组与缺血对照组比较 ,除血清 MDA差异有显著性外 [(4 .0 9± 0 .4 0 vs4 .79± 0 .92 ) nmol/ ml,P<0 .0 1],血清 CPK[(132 2± 114 8vs14 98± 190 ) NU/ ml]、SOD[(32 4± 71vs2 88± 5 4) NU/ ml]差异均无显著性(P>0 .0 5 )。 2再灌注药物干预组与再灌注对照组比较 ,血清 CPK[(15 12± 2 2 6 vs190 4± 2 0 3) NU/ ml]、MDA[(6 .0 9± 0 .6 9vs7.4 3± 0 .2 0 ) nmol/ ml]、SOD[(2 13± 71vs119± 5 5 ) NU/ ml],及缺血区心肌 ATP含量 [(1.4 0 1± 0 .2 4 8vs0 .6 2 9± 0 .175 ) μmol/ g]差异均有显著性 (P<0 .0 0 1～ 0 .0 1)。 3电镜显示 :各药物干预组线粒体结构改变分别较各对照组减轻。结论 :曲美他嗪具有改善缺血再灌注损伤心肌线粒体的代谢和清除氧自由基的功能。     

高迁移率族蛋白1诱导内皮细胞释放细胞因子的作用及其与脂多糖对白细胞介素6释放的协同效应

目的观察高迁移率族蛋白1(HMGB1)对人脐静脉内皮细胞(HUVEC)释放细胞因子的影响及其对脂多糖(LPS)诱导细胞因子白细胞介素6(IL-6)表达的作用。方法用LiquiChip液相蛋白芯片系统检测重组HMGB1蛋白(15ng/ml)诱导HUVEC11种细胞因子/趋化因子的水平变化;检测不同浓度HMGB1(0~75ng/ml)刺激后不同时间点(0、1、3、6、12和24h)HUVEC分泌IL-6的水平以及HMGB1(15ng/ml)与LPS(10ng/ml)共同刺激对HUVEC分泌IL-6的影响。结果HMGB1刺激后HUVEC分泌粒细胞-巨噬细胞集落刺激因子(GM-CSF)、干扰素γ(IFN-γ)、IL-6、IL-8和单核细胞趋化蛋白1(MCP-1)的水平明显升高(均P<0.01),分别是对照(未加刺激)的5.7、4.2、27.8、12.8和5.4倍;HMGB1蛋白以时间和剂量依赖方式诱导IL-6的分泌,在刺激后3~6h,IL-6水平开始增加,在6h时IL-6由对照的32pg/ml±21pg/ml增加到75pg/ml±22pg/ml(P<0.01),12h(453pg/ml±78pg/ml)~24h(901pg/ml±184pg/ml)持续升高(P<0.01);随着HMGB1浓度的增加,IL-6的水平也明显增加,当HMGB1浓度为3、15、75ng/ml时,IL-6分别是155pg/ml±33pg/ml、901pg/ml±184pg/ml、1508pg/ml±378pg/ml,与基础值32pg/ml±21pg/ml相比,差异有统计学意义(P<0.01)。分别用LPS(10ng/ml)和HMGB1(15ng/ml)单独刺激HUVEC时,IL-6的含量从基础的32pg/ml±22pg/ml分别增加至289pg/ml±42pg/ml和901pg/ml±184pg/ml(均P<0.01);如果用二者共同刺激HUVEC,IL-6的生成量大大增加(2361pg/ml±299pg/ml),二者存在协同作用(F=69.405,P<0.01)。结论HMGB1蛋白可诱导HUVEC释放多种炎性细胞因子;HMGB1诱导IL-6的上调具有时效性和量效性关系,并可协同LPS刺激HUVEC释放IL-6,在脓毒症的发生和发展中起重要作用。     

肾上腺髓质素及尾加压素Ⅱ在先天性心脏病肺动脉高压中作用的研究

目的探讨先天性心脏病(CHD)合并肺动脉高压(PH)患者手术前后血浆肾上腺髓质素(ADM)及尾加压素Ⅱ(UⅡ)变化的临床意义。方法将52例患者按肺动脉收缩压分为3组:无PH组(<30 mm Hg)17例,轻度PH组(30~49 mm Hg)18例,中重度PH组(≥50 mm Hg)17例。测定3组术前、术后即刻及术后7 d ADM及UⅡ含量,并比较手术前后的变化;分析两者及其与肺动脉压(PAP)间的相互关系。结果(1)3组患者肺动脉压(PAP)与血浆ADM浓度呈正相关(术前r=0.8012,P<0.01;术后即刻r=0.6325,P<0.01;术后7 dr=0.7126,P<0.01)。(2)3组患者UⅡ浓度则与PAP无相关性(均P>0.05)。(3)无PH组术前ADM浓度为33 pg/m l±5 pg/m l、术后即刻为29 pg/m l±4 pg/m l、术后7 d为20 pg/m l±3 pg/m l;轻度PH组术前ADM浓度为44 pg/m l±8 pg/m l、术后即刻40 pg/m l±6 pg/m l、术后7 d为34 pg/m l±4 pg/m l;中重度PH组术前ADM浓度为60 pg/m l±10 pg/m l、术后即刻58 pg/m l±8 pg/m l、术后7 d为38 pg/m l±4 pg/m l。各组术后ADM浓度呈下降趋势,但只有术后7 d与术前比较差异有统计学意义(无PH组q=5.41,P<0.01;轻度PH组q=4.76,P<0.01;中重度PH组q=6.32,P<0.01)。(4)无PH组术前UⅡ浓度为2.2 pmol/L±0.5pmol/L、术后即刻为2.2 pmol/L±0.44 pmol/L、术后7 d为2.2 pmol/L±0.6 pmol/L;轻度PH组术前UⅡ浓度为2.7 pmol/L±0.6 pmol/L、术后即刻2.6 pmol/L±0.6 pmol/L、术后7 d为2.6 pmol/L±0.5pmol/L;中重度PH组术前UⅡ浓度为2.9 pmol/L±0.6 pmol/L、术后即刻2.6 pmol/L±0.7 pmol/L、术后7 d为2.8 pmol/L±0.4 pmol/L。3组患者手术前后UⅡ浓度差异无统计学意义(均P>0.05)。结论(1)ADM在PH形成和血管重建中发挥重要的作用。(2)UⅡ与PAP无相关性,但是不能排除UⅡ在PH形成和血管重建中有重要的作用。(3)血浆ADM水平可作为判断PH严重程度的指标之一。