难治性胃溃疡患者血浆Endothelin-1浓度检测的意义

目的:检测难治性胃溃疡患者血浆Endothe lin-1水平,探讨其在难治性溃疡发病中的作用。方法:64例胃溃疡病患者给予正规抗溃疡病治疗,其中34例12周后经胃镜证实溃疡未愈合(难治性溃疡组);30例痊愈(溃疡愈合组)。分别检测两组患者治疗前后的血浆ET-1水平,20例健康体检者作为对照组。结果:治疗前,难治性溃疡组的平均血浆浓度(62.71±12.38)μg/L,显著低于溃疡愈合组(96.39±15.25)μg/L及健康对照组(86.29±11.23)μg/L),差异均有显著性(P<0.05),溃疡愈合组与对照组间差异无显著性。两组患者治疗前后的ET-1水平均无显著性变化。结论:难治性溃疡患者的ET-1水平偏低,可能导致新生血管的形成不足使得溃疡久治不愈。     

Plasma endothelin-1 levels in liver cirrhosis

The role of circulating endothelin- , a potent vasoconstricting peptide, in liver cirrhosis is still controversial. It has been postulated that endothelin-1 may play a role in the circulatory derangement occurring in cirrhotic subjects, and increased plasma endothelin-1 levels have been reported in these patients. In this study we looked for a relationship between the severity of the liver disease according to Child's classification and plasma endothelin-1 concentrations in a group of cirrhotic patients compared with a healthy control group. Twenty-two cirrhotic patients and 10 healthy controls, matched for sex and age, were selected for study after informed consent. The etiology of cirrhosis was posthepatitis B in 8 of 22 cases, posthepatitis C in 13 of 22 cases, and alcoholism in 1 patient. According to Child's classification, 6 patients were in class A, 6 in class B, and 10 in class C. Plasma endothelin-1 was measured by a commercial RIA kit (Amersham UK). Mean +/- SD plasma endothelin-1 levels were 8.8 +/- 0.9 pg/ml in controls and 9.2 +/- 1.1 pg/ml in all cirrhotic patients (P > 0.05). In each sub-group of cirrhotics, plasma endothelin- was 8.6 +/- 1.2 pg/ml in Child A, 8.9 +/- 1.9 pg/ml in Child B, and 10.6 +/- 1.5 pg/ml in Child C groups, respectively. There were no statistical differences between control subjects and Child A and B cirrhotic patients (P > 0.05). A significant increase in endothelinl was observed only in the Child C group versus either group A or B (P = 0.004). Our results show that alterations of circulating endothelin-1 do not occur in all cirrhotic patients; higher plasma levels than controls are only detectable in patients with more-severe hepatic failure. We do not know whether increased endothelin-1 levels are a consequence of hemodynamic disorders occurring in the advanced phase of liver cirrhosis or play a pathogenic role.     

供肝灌洗液中内皮素-1与供肝质量关系的实验研究

目的探讨供肝冷保存后灌洗液中内皮素-1（ET-1）水平与供肝质量之间的关系，为供肝植入前评价供肝质量寻求一种可能的方法。方法建立大鼠肝移植的供肝切取的动物模型，切取供肝后0～4℃冷保存，测定冷保存0、4、8、12、16和20h后，肝脏灌洗液中ET-1、丙氨酸氨基转移酶（ALT）及天门冬氨酸氨基转移酶（AST）含量，取少许肝左中叶组织做病理学检查，观察供肝肝窦内皮细胞（SEC）超微结构变化。结果（1）在热缺血时间相同的情况下，大鼠供肝灌洗液中ET-1含量随冷保存时间延长逐渐升高，但是冷保存早期变化不明显（冷保存4h与冷保存0h组相比，P〉0.05），冷保存8h后有显著差异（与冷保存0h组相比，P〈0.01）。（2）ALT及AST水平随着冷保存时间的延长逐渐升高，但是冷保存早期上述指标变化不明显（冷保存8h、4h与冷保存0h组相比，P〉0.05），冷保存中晚期12h后有显著差异（与冷保存0h组相比，P〈0．01）。（3）随着保存时间的延长，肝窦内皮细胞发生明显的形态学的改变。结论大鼠供肝灌洗液中ET-1含量变化与肝窦内皮细胞形态学的改变明显相关，肝脏冷保存末期灌洗液中ET-1的含量可反映移植前肝窦内皮细胞的损伤程度及肝脏质量，对早期评价大鼠供肝质量有重要的价值。     

运动训练对大鼠心肌内皮素含量及受体分型的影响

目的探讨运动训练对大鼠心肌组织内皮素-1（ET—1）含量、ET受体分型及受体特征的影响。方法选用健康雄性SD大鼠进行跑台运动训练，采用放射免疫法测定大鼠心肌ET-1含量，采用放射性配基结合受体分析法测定心肌组织ETAR及ETBR的变化情况。结果大鼠经运动训练后，其心肌细胞膜的ET—1含量下降（P〈0．01），心肌细胞膜ETAR最大结合量降低（P〈0．05），解离常数Kd值无显著改变；ETBR的最大结合容量升高（P〈0．01），解离常数Kd值显著降低（P〈0．01）。结论运动训练主要通过调节ET不同亚型受体的比例、亲和力及结合容量，从而对ET—1的生成、清除及与受体的结合能力产生影响，使ET的作用效力发生改变，从而增强心脏的调节功能。     

Effects of endothelin-1 on portal-systemic collaterals of common bile duct-ligated cirrhotic rats

BACKGROUND/AIMS: Endothelin-1 (ET-1) may induce intrahepatic vasoconstriction and consequently increase portal pressure. Endothelin-1 has been shown to exert a direct vasoconstrictive effect on the collateral vessels in partially portal vein-ligated rats with a high degree of portal-systemic shunting. This study investigated the collateral vascular responses to ET-1, the receptors in mediation and the regulation of ET-1 action by nitric oxide and prostaglandin in cirrhotic rats with a relatively low degree of portal-systemic shunting. METHODS: The portal-systemic collaterals of common bile duct-ligated (BDL) cirrhotic rats were tested by in situ perfusion. The concentration-response curves of collaterals to graded concentrations of ET-1 (10(-10)-10(-7) m) with or without BQ-123 (ET(A) receptor antagonist, 2 x 10(-6) m), BQ-788 (ET(B) receptor antagonist, 10(-7) m) or both were recorded. In addition, the collateral responses to ET-1 with preincubation of N(omega)-nitro-L-arginine (NNA, 10(-4) M), indomethacin (INDO, 10(-5) M) or in combination were assessed. RESULTS: Endothelin-1 significantly increased the perfusion pressures of portal-systemic collaterals. The ET-1-induced constrictive effects were inhibited by BQ-123 or BQ-123 plus BQ-788 but not by BQ-788 alone. The inhibitory effect was greater in the combination group. Pretreatment of NNA or NNA plus INDO equivalently enhanced the response of ET-1 while pretreatment of INDO alone exerted no effect. CONCLUSION: Endothelin-1 has a direct vasoconstrictive effect on the collaterals of BDL cirrhotic rats, mainly mediated by ET(A) receptor. Endogenous nitric oxide may play an important role in modulating the effects of ET-1 in the portal-systemic collaterals of BDL cirrhotic rats.     

内皮素—1在大肠癌中的表达及其临床意义

目的 研究ＥＴ－１含量与大肠癌分化,淋巴结转移及预后的关系,方法 对６９例经５年以上随访的大肠癌手术切除标本及１５例正常大肠粘膜活检标志进行免疫组化染色及图像分析,结果 大肠癌及正常大肠粘膜上皮细胞中均有ＥＴ－１阳性表达,但大肠癌细胞的阳性表达率,阳性强度及ＥＴ－１的含量均高于正常大肠粘膜细胞（Ｐ〈０．０１）,大肠癌中高,中,低分化癌组之间的阳性反应也不相同,分化低者阳性率最高,阳性强度最大,含量     

内皮素-1在卵巢肿瘤中的表达和临床意义

目的探讨内皮素-1(ET-1)在卵巢肿瘤组织中的表达和临床意义。方法应用免疫组织化学法检测56份卵巢癌,19份良性卵巢肿瘤和17份正常卵巢组织中ET-1的表达。结果ET-1在卵巢肿瘤中的表达明显高于正常卵巢组织(P<0.05),在卵巢癌中的表达明显高于卵巢良性肿瘤(P<0.05),但和卵巢癌的病理类型及病理分级、临床分期无关(P>0.05)。结论ET-1和卵巢肿瘤的发生有关系。     

急性脑缺血大鼠血浆内皮素1动态变化及尼莫地平治疗的实验研究

目的 研究血浆内皮素１（ＥＴ－１）在急性脑缺血大鼠中的作用,评价尼莫地平地ＥＴ－１的拮抗作用,方法 应用大脑中动脉阻断法（ＭＣＡｏ）制备急性脑缺血（ＡＣｌ）大鼠模型,利用放射免疫分析法（ＲＩＡ）测定ＡＣＩ大鼠急性期血浆ＥＴ－１含量以及尼莫地平治疗后ＥＴ－１的变化。结果 手术组急性期血浆ＥＴ－１含量与对照组比较差别显著（Ｐ〈０．０５）,手术组与治疗组血浆ＥＴ－１含量比较差别不显著。结论 急性脑梗死大     

Effects of endothelin-1 on circulating adhesion molecules in man

Several studies point to a role for endothelin-1 (ET-1) in enhancing adhesion molecule expression and leucocyte adhesion. We thus hypothesized that ET-1 would induce expression of adhesion molecules by endothelial cells and by leucocytes in humans, and hence compared with placebo the effect of a continuous 6-h ET-1 infusion on plasma levels of circulating (c)E-selectin, cP-selectin, intercellular and vascular cell adhesion molecule 1. In addition, we investigated the effects of ET-1 on expression of the leucocyte adhesion molecules CD11b/CD18 and L-selectin on monocytes and neutrophils. After an open pilot study to evaluate the safety of a 6-h ET-1 infusion of 0.4 pmol kg⁻¹ min⁻¹ ( n  = 4), the main study was conducted as a randomized, double-blind, two-way, cross-over trial in 12 additional young healthy male volunteers, who received the same treatment and were observed over a period of 24 h. ET-1 infusion decreased renal plasma flow by 43% (CI 35–51%; P  < 0.001) and increased the filtration fraction by 80% (CI 20–110%; P  < 0.001). Heart rate decreased by −10% (CI −4% to −15%) at 6 h under ET-1 infusion in the cross-over trial ( P  = 0.012 between periods). Although ET-1 infusions increased plasma levels of ET-1 by about 300%, ET-1 elicited no relevant changes in any circulating adhesion molecules or leucocyte adhesion molecules measured. In the placebo period small diurnal changes were observed for cP-selectin (–8%, CI −14 to −3%, P  = 0.008) and cE-selectin (–6%, CI −10 to −3%, P  = 0.003) at 12 h (20.45 h). In sum, ET-1 does not regulate circulating adhesion molecules in healthy men. Circadian variations may exist for plasma levels of cP-selectin and cE-selectin.     

通心络对急性冠状动脉综合征患者血浆C-反应蛋白和内皮素-1的影响

目的 探讨通心络胶囊对急性冠状动脉综合征(ACS)患者血浆C-反应蛋白(CRP)和内皮素-1(ET-1)的影响.方法 将100例ACS患者随机分为常规组和通心络组(常规治疗+通心络胶囊),观察治疗前及第7、14天血浆CRP和ET-1的变化.结果 与治疗前相比,第7、14天通心络组血浆CRP和ET-1水平均显著下降,差异有统计学意义(P＜0.05、P＜0.01);而常规组仅第14天有显著变化,与治疗前比较差异有统计学意义(P＜0.05).通心络组CRP和ET-1水平与常规组比较差异有统计学意义(P＜0.01).结论 通心络可能通过抑制CRP和ET-1减少血管内膜的炎症反应等途径改善血管内皮功能,从而达到对血管内皮的保护作用.     

胎粪吸入综合征患儿一氧化氮和内皮素-1水平变化及意义

目的探讨胎粪吸入综合征(MAS)患儿支气管肺泡灌洗液及血中一氧化氮(NO)和内皮素-1(ET-1)水平变化规律,为临床治疗提供依据。方法采用硝酸盐还原法和放射免疫法分别测定29例重度MAS患儿血及肺泡灌洗液中NO和ET-1浓度、31例轻度MAS患儿和32名正常新生儿血中NO和ET-1浓度。结果与健康新生儿相比,MAS患儿病程初期血中NO浓度降低而ET-1浓度升高(P<0.05),轻度MAS患儿随病情好转NO和ET-1浓度逐渐恢复正常,但重度MAS患儿随病程出现NO的异常增高而ET-1降低(P<0.05),然后又逐渐恢复正常,支气管肺泡灌洗液中NO浓度呈现先低后渐升高趋势(P<0.05),而ET-1浓度呈现先高后渐降低趋势(P<0.05),与血中变化趋势一致。结论NO和ET-1参与了MAS早期肺部病理生理变化,使肺血管过度收缩导致肺动脉高压,恢复期NO异常升高可能与持续的肺部炎症及损伤有关,病程的不同时期应采用适宜的治疗手段。     

急性肺损伤肺组织和血浆NO、ET-1变化的研究

目的 探讨急性肺损伤（ＡＬＩ）时肺组织和血浆一氧化氮（ＮＯ）、皮内素－１（ＥＴ－１）和白细胞介素８（ＩＬ－８）水平的变化和作用。方法 采用间隔２４ｈ两次注射大肠杆菌内毒素（ＬＰＳ）的方法,复制家兔内毒素急性肺损伤模型。结果 ＡＬＩ组浆、肺组织均浆及支气管肺泡灌洗液（ＢＡＬＦ）中ＮＯ、ＥＴ－１和ＩＬ－８水平显著升高（Ｐ〈０．０１）,ＢＡＬＦ内中性料细胞（ＰＭＮ）明显增多,肺系数（ＬＰＬ）、肺水含量     

左旋精氨酸对急性心肌缺血/再灌注损伤大鼠内皮素-1的影响

目的 探讨内皮素-1(ET-1)在大鼠心肌缺血/再灌注(I/R)损伤过程中的变化规律及左旋精氨酸(L-Arg)的影响.方法 采用结扎冠状动脉前降支0.5h复制Wistar大鼠心肌I/R损伤模型.110只大鼠按随机数字表法分为假手术组(C)、缺血0.5h组(I)、缺血0.5h+再灌注0.5h组(R0.5)、缺血0.5h+再灌注1h组(R1)、缺血0.5h+再灌注2h组(R2)、L-Arg+假手术组(L+C)、L-Arg+缺血0.5h组(L+I)、L-Arg+缺血0.5h+再灌注0.5h组(L+R0.5)、L-Arg+缺血0.5h+再灌注1h组(L+R1)、L-Arg+缺血0.5h+再灌注2h组(L+R2).用酶联免疫吸附法测定各组大鼠血清肌酸激酶(CK)、乳酸脱氢酶(LDH)活性;用放射免疫法测量血清ET-1水平;用逆转录-聚合酶链反应(RT-PCR)、蛋白质免疫印迹法(Western blotting)检测各组心肌组织中ET-1 mRNA和蛋白表达.结果 Ⅰ组和R组血清CK、LDH、ET-1均较C组明显升高,且R组较Ⅰ组升高明显.R组ET-1 mRNA和蛋白表达均较C组明显升高,以R2组最为显著(ET-1mRNA:0.775±0.029比0.310±0.076;ET-1蛋白:0.773±0.055比0.340±0.099,均P＜0.05);而静脉给予L-Arg预处理可明显降低ET-1 mRNA和蛋白表达(ET-1 mRNA:0.340±0.049比0.775±0.029;ET-1蛋白:0.390±0.094比0.773±0.055,均P＜0.05).结论 在心肌I/R损伤的某些阶段可试用L-Arg进行干预,降低ET-1的表达.     

急性河豚中毒患者脑氧供需平衡变化的临床研究

目的　探讨急性河豚毒素 (TTX)中毒患者颈静脉血氧饱和度 (SjO2 )、动脉 颈内静脉血氧含量差 (AVDO2 )、脑氧摄取 (CEO2 )变化与预后的关系。方法　观察 34例TTX中毒患者 6～ 12h、 2 4h、 4 8h、 72h、 7d各时间点SjO2 、AVDO2 、CEO2 的变化。结果　TTX中毒患者入院 6～ 12h时SjO2 、AVDO2 、CEO2 明显高于对照组 (P <0 0 5 ) ,入院 2 4h后TTX中毒患者SjO2 逐渐恢复正常 ,但重度组AVDO2 、CEO2 明显低于对照组 (P <0 0 1) ,当CEO2 低于 2 5 %时 ,患者预后差。结论　脑氧供需平衡变化反映了TTX中毒患者大脑神经细胞的机能和利用氧的能力 ,因此可将脑氧供需平衡变化作为判断TTX中毒预后的重要指标     

饲养的不同环境对局灶性脑梗死大鼠梗死灶周围IGF-1表达的影响

目的观察饲养的不同环境对局灶性脑梗死大鼠行为学恢复及梗死灶周围胰岛素样生长因子-1（IGF-1）表达的影响,为临床应用不同环境进行脑卒中康复治疗提供基础理论支持和实验依据。方法将实验动物随机分为假手术对照组（15只）和大脑中动脉阻塞（MCAO）（90只）。手术组用电凝法造成右侧大脑中动脉阻塞（MCAO）模型。术后标准笼中群居社交组,5只为一组,共30只;迷宫笼中居学习组,10只一组,共30只;30只居于丰富环境笼。术后剖颅取脑,采用石蜡包埋、切片,免疫组化染色,测梗死灶周围皮质胰岛素样生长因子-1（IGF-1）的表达情况,分别在术后28天、14天、7天、3天、1天随机在各组中选取5只进行,假手术组于术后1天、3天、7天随机选取大鼠5只处死。结果免疫组化结果：IGF-1阳性细胞表达：社交组MCAO术后3d可见梗死灶周围IGF-1表达增高（P〈0．05）,7d时表达略有下降,各手术组与假手术组没有明显差异（P〉0．05）。各手术组梗死灶周围皮质IGF-1阳性表达随时间延长逐渐增高,于MCAO术后第14天和28天时各手术组表达均高于假手术组（P〈0．05）,探索学习组、丰富环境组于MCAO术后IGF-1表达均明显优于社交组在14天和28天（P〈0．05）。结论在丰富环境及学习笼中的局灶性脑梗死大鼠,梗死灶周围皮层IGF-1的表达明显上调,可能为功能恢复的原因。     

冠心病患者血浆胆固醇与内皮素-1 C-反应蛋白及血小板可溶性P选择素相关性研究--附56例报告

目的 :了解冠状动脉粥样硬化性心脏病 (冠心病 )患者血浆胆固醇与内皮素 1、C反应蛋白 (C reactiveprotein ,CRP)及血小板可溶性P选择素 (solubleP selectin ,sP selectin)的关系。方法 :检测5 6例急性冠状动脉综合征 (acutecoronarysyndrome,ACS)、 2 3例慢性稳定型心绞痛 (chronicstableangina ,CSA)患者和对照组 10名正常人血浆总胆固醇、LDL C、内皮素 1、CRP和血小板sP selectin水平。结果 :ACS组血浆内皮素 1[(5 2± 10 )ng/L]、CRP水平 [(2 0± 9)mg/L]与CSA组 [(4 3± 4 )ng/L ,(13± 5 )mg/L]和正常对照组 [(36± 10 )ng/L ,(8± 2 )mg/L]比较差异均有统计学意义 ,均为P <0 0 1。血浆sP selectin水平ACS组 [(15 9± 5 8) μg/L]与CSA组 [(12 9± 1 9) μg/L]比较、CSA组与正常对照组[(6 7± 2 9) μg/L]比较 ,差异均有统计学意义 ,均为P <0 0 1。ACS组血浆总胆固醇、LDL C分别与内皮素 1、CRP、sP selectin呈正相关 [(r=0 2 9,P <0 0 5 ;r=0 5 6 ,P <0 0 1) ,(r=0 4 9,r =0 5 0 ,均为P<0 0 1) ,(r=0 30 ,P <0 0 5 ;r=0 5 4 ,P <0 0 1) ];CSA组血浆LDL C与CRP呈正相关 (r =0 4 7,P <0 0 5 )。结论 :ACS患者的血浆胆固醇可能有加重内皮功能障碍、刺激血管炎症反应和激活血     

风湿性心脏病合并心力衰竭患者内皮素及血管性血友病因子水平的变化

目的　探讨风湿性心脏病合并充血性心力衰竭 (RHD CHF)患者内皮素 (ET 1)及血管性血友病因子(vWF)的变化及其意义。方法　检测 31例CHF患者和 30名正常人ET 1、vWF ,并按心功能等级分组进行比较分析。结果　RHD CHF患者血浆ET 1、vWF水平与对照组比较明显升高 (P <0 .0 1) ,且心功能越差 ,ET 1、vWF水平越高 ,心功能Ⅲ、Ⅳ级与Ⅱ级比较显著升高 (P <0 .0 5 ,P <0 .0 1) ;患者血浆ET 1与vWF呈正相关 (r=0 .6 6 8,P <0 .0 1)。结论　RHD CHF的发生、发展与细胞内皮损伤有关 ,检测血浆中vWF和ET 1可作为评价CHF病情严重程度的指标之一。     

白介素-6和内皮素-1在慢性阻塞性肺疾病合并肺动脉高压患者中的表达

目的:研究白介素-6(IL-6)和内皮素-1 (ET-1)在慢性阻塞性肺疾病(COPD)合并肺动脉高压(PH)患者和COPD无PH患者中的表达水平.方法:66例COPD合并PH患者和64例COPD无PH患者,检测IL-6和ET-1水平,心脏多普勒检测肺动脉收缩压力(PASP),PASP≥36 mmHg为PH,检查肺功能、动脉血气、6 min步行距离.结果:COPD合并PH患者IL-6和ET-1水平高于COPD无PH患者,分别是中位数3.6 pg/L(四分位间距2.3 ～ 4.9 pg/L)与中位数2.3 pg/L(四分位间距1.2 ～ 3.7 pg/L),差异有统计学意义(z=-2.756,P＜0.01);中位数4.7 pg/L(四分位间距,1.8 ～ 7.9 pg/L)与中位数1.5 pg/L(四分位间距,0.9～3.7 pg/L),差异有统计学意义(z=-2.945,P＜0.01).所有患者IL-6和ET-1水平呈正相关(r=0.782,P=0.001);肺动脉压力水平与IL-6(r=0.381,P=0.001)和ET-1(r=0.529,P=0.001)水平有关;6 min步行距离分别和氧分压负相关(r=-0.728,P=0.032),和ET-1正相关(r=0.625,P=0.001),和IL-6正相关(r=0.461,P=0.001).结论:IL-6和ET-1可能与COPD并PH形成有关,具体机制有待进一步研究.     

Analysis of cardiovascular and pulmonary responses to endothelin-1 and endothelin-3 in the anesthetized cat

Cardiovascular and pulmonary responses to endothelin (ET)-1, ET-3 and neuropeptide Y (NPY) were investigated in the anesthetized cat. ET-1, 0.1 to 1 nmol/kg i.v., decreased or elicited biphasic changes in arterial pressure (AP), whereas ET-3, in the same doses, decreased AP. Both ETs increased cardiac output (CO) and, at the highest doses, a secondary decrease in CO was observed. NPY, 0.3 to 3 nmol/kg i.v., increased AP and at the highest dose decreased CO. All three peptides had inconsistent effects on right ventricular contractile force and increased central venous pressure. ET-1 at lower doses increased heart rate (HR) and, at 1 nmol/kg, caused a biphasic change. ET-3 increased HR, whereas NPY decreased HR. Systemic vascular resistance (SVR) was increased by NPY and decreased by ET-3, whereas ET-1 elicited biphasic changes. ET-1 and ET-3 increased pulmonary arterial pressure, left atrial pressure and caused biphasic changes in pulmonary vascular resistance (PVR). NPY had no significant effect on PAP or PVR. When pulmonary blood flow was maintained constant, ET-1 and ET-3 had only pulmonary vasoconstrictor activity, whereas NPY and the ET analog had no significant effect. The increase in SVR in response to NPY, the decrease in response to ET-3 or the biphasic change in response to ET-1 were not modified by meclofenamate, hexamethonium or propranolol. Increases in HR in response to ET-1 and ET-3 were reduced by the beta receptor and ganglionic blocking agents.(ABSTRACT TRUNCATED AT 250 WORDS)