血浆TRAF-3表达在炎症性肠病中的意义

目的分析血浆肿瘤坏死因子受体相关因子-3(tumor necrosis factor receptor-associated fac-tor-3,TRAF3)水平对于炎症性肠病的诊断价值以及与内镜下疾病活动性的相关性。方法应用酶联免疫吸附试验(Enzyme-Linked ImmunoSorbent Assay,ELISA)分析炎症性肠病患者和正常对照者血浆中TRAF3蛋白的表达,受试者工作特征曲线(receiver-operating characteristic,ROC)分析血浆TRAF3水平对于克罗恩病和溃疡性结肠炎的诊断价值,应用Pearson相关分析研究血浆TRAF3水平与内镜下疾病活动性的相关性。数据处理使用GraphPad Prism 5。结果克罗恩病患者(P=0.000)和溃疡性结肠炎患者(P=0.000)血浆TRAF3水平显著高于正常对照者,同时TRAF3对区分克罗恩病患者和正常对照者(P=0.000)以及区分溃疡性结肠炎患者和正常对照者(P=0.000)具有显著的诊断价值,克罗恩病患者(r=-0.093,P=0.473)以及溃疡性结肠炎患者(r=0.043,P=0.733)血浆TRAF3表达水平和内镜下疾病活动指数均无显著的相关性。结论炎症性肠病患者血浆TRAF3水平增高,对区分炎症性肠病患者和正常对照者具有诊断价值,但血浆中TRAF3的水平不能反应内镜下疾病活动程度。     

炎症性肠病患者外周血TRAF-5表达及与内镜下疾病活动性的相关性

目的 探讨肿瘤坏死因子受体相关因子-5(tumor necrosis factor receptor-associated factor-5,TRAF-5)在炎症性肠病患者外周血单个核细胞和血浆的表达,比较炎症性肠病患者TRAF-5表达和正常对照者的差异,分析血浆TRAF-5表达与内镜下疾病活动性的相关性.方法 应用酶...     

炎症性肠病患者外周血单个核细胞和血浆中肿瘤坏死因子受体相关因子-6的激活

目的探讨肿瘤坏死因子受体相关因子-6（tumor necrosis factor receptor—associated factor-6,TRAF-6）在炎症性肠病患者外周血单个核细胞和血浆的表达,及其与内镜下疾病活动性的相关性。方法应用酶联免疫吸附试验（ELISA）分析炎症性肠病患者和正常对照者血浆中TRAF-6蛋白的表达,SYBR—green real time PCR方法分析炎症性肠病患者和正常对照者外周血单个核细胞中TRAF-6 mRNA的表达。数据处理使用Graph Pad Prism 5。结果克罗恩病患者（P=0．000）和溃疡性结肠炎患者（P=0．000）血浆TRAF-6水平显著高于正常对照者,但是克罗恩病患者（r=-0．114,P=0．377）以及溃疡性结肠炎患者（r=0．044,P=0．727）血浆TRAF-6表达水平和内镜下疾病活动指数均无显著的相关性。克罗恩病患者（P=0．000）和溃疡性结肠炎（P=0．000）患者外周血单个核细胞TRAF-6 mRNA表达均显著高于正常对照者外周血单个核细胞中mRNA的表达。结论炎症性肠病患者血浆和外周血单个核细胞中均存在TRAF-6的激活,但血浆TRAF-6的高表达不能反映内镜下的疾病活动程度。     

炎症性肠病患者血浆Frat1水平及其临床意义

进展期T细胞淋巴瘤常见重排蛋白1（Frat 1）作为Wnt信号转导通路的激活蛋白在胚胎发育、肿瘤发生等过程中发挥作用,而Wnt信号通路异常与炎症性肠病（IBD）的发病相关.目的：探讨活动性IBD患者血浆Frat 1水平及其临床意义.方法：纳入2009年6月-2010年5月上海华东医院42例克罗恩病（CD）患者、55例溃疡性结肠炎（UC）患者和56名正常对照者,应用酶联免疫吸附测定（ELISA）检测血浆Frat 1水平,以受试者工作特征（ROC）曲线分析血浆Frat 1水平对IBD的诊断价值,应用Pearson相关分析研究血浆Frat 1水平与临床疾病活动性的相关性.结果：UC患者血浆Frat 1水平显著低于正常对照组（6.55 pg/ml对17.81 pg/m1,P〈0.001）,CD患者血浆Frat 1水平与正常对照组相比差异无统计学意义（P=0.8995）.ROC曲线分析表明血浆Frat 1水平对鉴别UC患者和正常对照者无意义（P=0.2736）.UC患者血浆Frat 1水平与红细胞沉降率（P=0.5994）,C反应蛋白（P=0.4685）和Mayo评分（P=0.3663）之间均无相关性.结论：UC患者血浆Frat 1水平降低,可能与UC的发生存在潜在的联系.     

炎症性肠病血浆Prickle1水平的鉴别意义

目的 研究炎症性肠病患者血浆Prickle1水平对于鉴别诊断的价值.方法 应用酶联免疫吸附试验(Enzyme-Linked ImmunoSorbent Assay,ELISA)分析克罗恩病患者、溃疡性结肠炎患者和正常对照者血浆中Prickle1蛋白的表达.受试者工作特征曲线(receiver-operating cha...     

炎症性肠病患者肠黏膜白细胞分化抗原-14的表达及意义

目的: 探讨炎症性肠病患者肠黏膜CD14的表达及与该病的关系.方法: 收集活动性溃疡性结肠炎(ulcerative colitis, UC)患者25例及克罗恩病(Crohn's disease, CD)患者15例;20例对照来自于非炎症性肠病患者手术切除的正常结肠组织(肠镜及肠黏膜病理组织学检查结果均正常).炎症性肠病的临床诊断均依据于常规影像学、内镜学及组织学标准.采用免疫组织化学方法检测肠黏膜组织中CD14表达量.结果: 肠黏膜固有层单个核细胞表达CD14.UC患者CD14阳性细胞百分数高于CD患者,但二者差异无统计学意义(P>0.05);UC患者较正常对照有显著性差异(t=4.404, P<0.01),CD患者较正常对照亦见显著性差异(t=3.324,P<0.01).CD14的表达与疾病活动度(diseaseactivity index, DAI)相关, UC组轻、中、重度比较有显著性差异(F=56.709, P<0.01);CD组轻、中、重度比较亦有显著性差异(F=12.880, P<0.01).结论: CD14参与了炎症性肠病的发病过程, 其表达强度反映了该病的程度.     

炎症性肠病患者血浆差异蛋白质的筛选

目的 应用表面增强激光解析电离飞行质谱技术(SELDI-TOF-MS)寻找溃疡性结肠炎(UC)和克罗恩病(CD)患者的血浆差异表达蛋白,建立筛选模型.方法 采用CM10芯片对24例UC、25例CD和25例正常对照者血浆进行分析,从蛋白表达图谱中发现差异蛋白,建立区分CD和正常对照、UC和正常对照、UC和CD以及炎症性肠病(IBD)和正常对照的决策树分析模型,并进行盲法筛选.结果 在质荷比(m/z)2000～30 000范围内,CD和正常对照之间、UC和正常对照之间、IBD和正常对照之间具有2倍以上差异的蛋白峰数分别为9个、5个和11个(P＜0.05),软件自动选取m/z为8208、8837的蛋白质建立区分CD和正常对照的决策树模型,m/z为6985的蛋白质建立区分UC和正常对照的决策树模型,m/z为8208、1752、28 840和1702的4个蛋白质建立IBD和正常对照的决策树模型,3个决策树模型的灵敏度分别为96%、82%、91%,特异度分别为100%、85%、100%.结论 m/z 8208对于CD筛选价值高,特异度好,值得进一步探索.     

炎症性肠病患者骨代谢状况评估

目的 了解炎症性肠病(IBD)患者骨代谢生化指标的变化特点,评估其与骨质疏松和(或)骨量减少间的关系,探寻IBD患者发生骨质疏松和(或)骨量减少的危险因素.方法 选取2007年收治的IBD患者69例(IBD组,其中CD 49例、UC 20例)以及年龄、性别相匹配的20名体检健康人群(对照组)为研究对象,根据CD活动指数(AI)以及Truelove-Witts评分判定疾病活动度,酶联免疫分析法检测骨钙素(OC)、25-羟维生索D3[25-(OH)D3] 、Ⅰ型胶原交联氨基末端肽(NTX)等骨代谢相关指标水平,测定骨密度(BMD)及体重指数(BMI).结果 IBD组25-(OH)D3水平[CD:(44.45±39.38)nmol/L、UC:(34.67±23.79)nmol/L] 较对照组[(98.42±25.84)nmol/L] 显著降低(P<0.05),NTX水平则显著升高[CD:(58.41±15.15)nmol BCE/mmol肌酐值、UC:(57.67±10.75)nmol BCE/mmol肌酐值、对照:(30.38±13.35)nmol BCE/mmol肌酐值,P<0.01] .使用皮质类同醇激素者OC和25-(OH)D3水平[分别为(17.31±13.43)ng/ml和(26.99±9.12)nmol/L] 较未使用皮质类固醇激素者[分别为(27.33±16.86)ng/ml和(45.33±39.03)nmol/L] 显著降低(P<0.05).根据BMD检测结果,CD组和UC组骨质疏松发病率分别为7/49(14.3%)和3/20,骨量减少发病率分别为19/49(38.8%)和7/20,两组间差异均无统计学意义(P>0.05).使用皮质类固醇激素者腰椎T值(-1.19±0.93)较未使用者(-0.80±1.29)显著降低(P<0.05),股骨颈T值两组间差异无统计学意义(P>0.05).高龄和低BMI是CD患者发生骨质疏松和(或)骨量减少的危险因素.结论 IBD患者BMD显著降低,易发生骨质疏松,高龄和低BMI是CD患者发生骨质疏松和(或)骨量减少的危险因素.25-(OH)D3、NTX对评价IBD患者骨代谢状况有一定价值.     

炎症性肠病患者肠黏膜炎症和非炎症组织CD27的激活表达

目的比较炎症性肠病患者肠黏膜炎症组织、非炎症组织及正常对照者肠黏膜CD27激活表达的差异,探讨CD27激活表达在炎症性肠病发病中的意义。方法共纳入32例克罗恩病患者、41例溃疡性结肠炎患者及40例正常对照者。分别应用West-ern blot试验和SYBR-green real time PCR方法分析炎症性肠病患者肠黏膜炎症组织、非炎症组织及正常对照者肠黏膜CD27蛋白及其mRNA的表达。数据处理使用GraphPad Prism 5软件。结果克罗恩病和溃疡性结肠炎患者肠黏膜炎症组织CD27蛋白及其mRNA表达均显著高于非炎症组织及正常对照组织(P均0.01);克罗恩病患者肠黏膜非炎症组织CD27蛋白及其mRNA表达显著高于正常对照组织(P=0.000);溃疡性结肠炎患者肠黏膜非炎症组织CD27蛋白表达显著高于正常对照组织(P=0.000)。结论炎症性肠病患者肠黏膜组织中存在CD27的激活表达,这种激活效应不仅出现在内镜表现为炎症性肠病的炎症组织中,甚至出现在炎症性肠病患者内镜表现为正常的肠黏膜中,CD27的激活表达是炎症性肠病发病的早期事件。     

白细胞介素-25在炎症性肠病患者中的表达及临床意义

目的 通过检测白细胞介素(IL)-25在炎症性肠病(IBD)患者肠黏膜及血清中的表达水平,探讨其在IBD发病过程中的作用及意义.方法 收集12例溃疡性结肠炎(UC)患者、16例克罗恩病(CD)患者及13例对照者的内镜肠黏膜活检标本,采用荧光定量PCR技术检测肠黏膜内IL-25 mRNA的表达情况,免疫组化技术分析IL-25在肠黏膜中的原位表达;同期收集20例UC、24例CD患者及20名健康对照者血清标本,采用酶联免疫吸附测定(ELISA)检测血清中IL-25水平.结果 与健康对照组相比,UC及CD患者肠黏膜组织内IL-25 mRNA表达显著降低(P＜0.05),UC及CD组间的表达量差异无统计学意义(P＞0.05).免疫组化分析显示IL-25阳性细胞在正常肠黏膜固有层内有较多表达,同时黏膜内的肠上皮细胞也存在IL-25低表达,UC及CD患者肠黏膜IL-25蛋白表达量显著降低(P＜0.05),UC及CD组间的表达量差异无统计学意义(P＞0.05).ELISA显示UC及CD患者血清中IL-25表达量显著低于健康对照组(P＜0.05).结论 IL-25在IBD患者肠黏膜及血清中表达显著降低,提示IL-25表达缺陷与IBD的发生发展密切相关,IL-25有可能成为IBD治疗的新靶点.     

肾综合征出血热患者血浆MCP-1水平及其临床意义

目的　分析肾综合征出血热（hemorrhagic fever with renal syndrome, HFRS）患者不同病期及不同临床型血浆单核细胞趋化蛋白-1（monocyte chemotactic protein-1, MCP-1）浓度变化与疾病相关性,为HFRS临床诊治提供参考依据。方法　以2012年10月—2014年1月期间在空军军医大学唐都医院住院就诊的81例HFRS患者及15例健康志愿者（正常对照组）作为研究对象,用酶联免疫吸附法分别检测其血浆中MCP-1水平,同步检测血常规、肾功能等指标,并分析MCP-1与临床常规检测指标的相关性。结果　在急性期,所有患者血浆MCP-1水平均明显升高,其中重型/危重型患者血浆MCP-1水平升高比轻型/中型更为显著;中型、重型、危重型患者血浆MCP-1水平急性期均高于恢复期及正常对照组（P均＜0.05）,恢复期与正常对照组比较差异无统计学意义（P＞0.05）。Spearman相关分析显示血浆MCP-1水平与白细胞、尿素氮、肌酐水平呈正相关,与血小板水平呈负相关。结论　HFRS患者血浆MCP-1水平与疾病严重程度及疾病进程密切相关。     

Obestatin与Ghrelin在炎症性肠病中的表达及临床价值

目的研究炎症性肠病患者血浆Obestatin和Ghrelin的表达水平,分析血浆Obestatin和Ghrelin表达水平对炎症性肠病的诊断和鉴别意义。方法应用酶联免疫吸附试验(Enzyme-linked immune-sorbent assay,ELISA)对克罗恩病患者、溃疡性结肠炎患者和正常对照者血浆中Obestatin及Ghrelin的表达进行分析。通过受试者工作特征曲线(receiver-operating characteristic,ROC)观察血浆Obestatin、Ghrelin水平及Obestatin/Ghrelin比值在克罗恩病和溃疡性结肠炎的诊断和鉴别价值,数据处理使用GraphPad Prism 5。结果溃疡性结肠炎患者(P<0.0001)和克罗恩病患者(P=0.0001)血浆Obestatin水平均显著高于正常对照者,并且溃疡性结肠炎患者血浆Obestatin水平显著高于克罗恩病患者(P=0.0003)。溃疡性结肠炎患者(P=0.0279)和克罗恩病患者(P=0.0192)血浆Ghrelin水平均显著高于正常对照者,但是溃疡性结肠炎患者和克罗恩病患者间血浆Ghrelin水平无显著性差异(P=0.9331)。溃疡性结肠炎患者血浆Ghrelin/Obestatin比值显著低于正常对照者(P=0.0487),但是克罗恩病患者血浆Ghrelin/Obestatin比值与溃疡性结肠炎患者(P=0.1076)和正常对照者(P=0.8136)无显著性差异。血浆Obestatin水平对于区分溃疡性结肠炎患者和正常对照者(AUC=0.8791,P<0.0001)、克罗恩病患者和正常对照者(AUC=0.7317,P=0.0001)以及溃疡性结肠炎和克罗恩病患者(AUC=0.7340,P=0.0001)具有显著的鉴别诊断价值。血浆Ghrelin水平对于区分克罗恩病患者和正常对照者具有显著的诊断价值(AUC=0.6660,P=0.0059)。但是,血浆Ghrelin/Obestatin比值对于区分溃疡性结肠炎和正常对照者无显著的鉴别诊断价值(AUC=0.5608,P=0.2923)。结论溃疡性结肠炎和克罗恩病患者血浆Obestatin及Ghrelin水平增高,综合评估溃疡性结肠炎和克罗恩病患者血浆Obestatin、Ghrelin以及Ghrelin/Obestatin比值对疾病的诊断和鉴别有一定意义。     

Serum gastrin levels in patients with inflammatory bowel disease

The aim of this study was to estimate the levels of serum gastrin in a group of patients with either ulcerative colitis or Crohn's disease and to compare the results with those of a group of normal controls. In 108 consecutive patients with IBD (66 with ulcerative colitis, 32 with Crohn's disease and 10 with indetermined colitis) serum levels of gastrin were measured by radioimmunoassay. One hundred and eight normal people were served as controls. The levels of serum gastrin were significantly elevated in patients with Crohn's disease compared to normal controls (74.4 +/- 43.9 pg/ml vs. 47.5 +/- 32.4 pg/ml, P<0.05), irrespectively of the activity of the disease. On the contrary, patients with ulcerative colitis exhibited no significant differences compared to normal controls. Differences between Crohn's disease and ulcerative colitis patients were statistically significant (P<0.001). The rate of infection by Helicobacter pylori in patients with inflammatory bowel disease was statistically significantly lower as compared with normal controls (31.7% vs. 55.1%, P<0.001). It is concluded that patients with active or inactive Crohn's disease have increased levels of serum gastrin. This may have implications concerning the high incidence of upper GI lesions found in patients with Crohn's disease despite the very low incidence of Helicobacter pylori infection.     

Urotensin II levels in patients with inflammatory bowel disease

BACKGROUNDPatients with inflammatory bowel disease (IBD) are associated with increased cardiovascular risk and have increased overall cardiovascular burden. On the other hand, urotensin II (UII) is one of the most potent vascular constrictors with immunomodulatory effect that is connected with a number of different cardiometabolic disorders as well. Furthermore, patients with ulcerative colitis have shown increased expression of urotensin II receptor in comparison to healthy controls. Since the features of IBD includes chronic inflammation and endothelial dysfunction as well, it is plausible to assume that there is connection between increased cardiac risk in IBD and UII.AIMTo determine serum UII levels in patients with IBD and to compare them to control subjects, as well as investigate possible associations with relevant clinical and biochemical parameters.METHODSThis cross sectional study consecutively enrolled 50 adult IBD patients (26 with Crohn’s disease and 24 with ulcerative colitis) and 50 age and gender matched controls. Clinical assessment was performed by the same experienced gastroenterologist according to the latest guidelines. Ulcerative Colitis Endoscopic Index of Severity and Simple Endoscopic Score for Crohn’s Disease were used for endoscopic evaluation. Serum levels of UII were determined using the enzyme immunoassay kit for human UII, according to the manufacturer’s instructions.RESULTSIBD patients have significantly higher concentrations of UII when compared to control subjects (7.57 ± 1.41 vs 1.98 ± 0.69 ng/mL, P < 0.001), while there were no significant differences between Crohn’s disease and ulcerative colitis patients (7.49 ± 1.42 vs 7.65 ± 1.41 ng/mL, P = 0.689). There was a significant positive correlation between serum UII levels and high sensitivity C reactive peptide levels (r = 0.491, P < 0.001) and a significant negative correlation between serum UII levels and total proteins (r = -0.306, P = 0.032). Additionally, there was a significant positive correlation between serum UII levels with both systolic (r = 0.387, P = 0.005) and diastolic (r = 0.352, P = 0.012) blood pressure. Moreover, serum UII levels had a significant positive correlation with Ulcerative Colitis Endoscopic Index of Severity (r = 0.425, P = 0.048) and Simple Endoscopic Score for Crohn’s Disease (r = 0.466, P = 0.028) scores. Multiple linear regression analysis showed that serum UII levels retained significant association with high sensitivity C reactive peptide (β ± standard error, 0.262 ± 0.076, P < 0.001) and systolic blood pressure (0.040 ± 0.017, P = 0.030).CONCLUSIONIt is possible that UII is involved in the complex pathophysiology of cardiovascular complications in IBD patients, and its purpose should be investigated in further studies.     

Plasma thrombin-activatable fibrinolysis inhibitor and plasminogen activator inhibitor-1 levels in inflammatory bowel disease

BACKGROUND: Patients with inflammatory bowel disease (IBD) have an increased risk of thromboembolic events. Imbalance of fibrinolysis has been suggested as one of the possible pathogenetic mechanisms. As plasminogen activator inhibitor-1 (PAI-1) and thrombin-activatable fibrinolysis inhibitor (TAFI) are inhibitors of fibrinolysis, we studied TAFI as well as PAI-1 plasma levels in IBD patients compared with healthy controls. METHODS: A total of 132 IBD patients [68 ulcerative colitis (UC) and 64 Crohn's disease (CD)] and 50 healthy controls were enrolled. PAI-1 and TAFI plasma levels were assessed by commercially available enzyme-linked immunosorbent assay kits. Their relationship with clinical parameters of UC and CD was assessed. RESULTS: Mean plasma PAI-1 levels were significantly higher in both UC patients (3.9+/-1.3 IU/ml) and CD patients (4.0+/-1.5 IU/ml) compared with healthy controls (3.1+/-1.1 IU/ml) (P=0.01). On the other hand, mean plasma TAFI levels were significantly lower in both UC patients (14.7+/-3.1 microg/ml) and CD patients (13.3+/-3.4 microg/ml) compared with healthy controls (17.4+/-3.0 microg/ml) (P<0.0001). Patients with active disease had significantly higher PAI-1 levels compared with patients with inactive disease for both diseases (P=0.03 and P=0.01, respectively). No significant association between plasma TAFI levels and disease activity was also found. Plasma TAFI levels were significantly lower in patients with ileal CD compared with patients with colonic CD. CONCLUSION: PAI-1 plasma levels are increased whereas TAFI levels are decreased in IBD patients. These results suggest an imbalance of fibrinolysis in IBD.     

sCD40L在炎症性肠病中的表达及临床意义

目的:检测炎症性肠病(IBD)患者外周血清中可溶性CD40L(sCD40L)水平,并探讨其在疾病发生过程中的临床意义.方法:收集12例克罗恩病、42例溃疡性结肠炎和34例健康者的外周血,离心分离血清,使用ELISA检测sCD40L水平.患者经有效治疗,待症状控制后,检测外周血sCD40L水平变化,分析sCD40L与疾病发展的关系.结果:CD和UC患者外周血清中sCD40L水平明显高于健康对照组(2456.5±264.3 ng/L,2105.4±238.1 ng/L vs 564.8±188.6 ng/L,均P＜0.005).患者经过有效治疗,发现外周血sCD40L水平明显降低(P＜0.005).进一步分析发现,sCD40L水平与患者的其他生化指标如CRP、肝肾功能指标等之间无相关关系.结论:sCD40L在IBD患者外周血中明显升高,可能作为早期诊断,判断疗效和预后的指标.     

冠心病患者血浆血栓调节蛋白水平的测定及其临床意义

目的　测定冠心病患者血浆血栓调节蛋白 ( throm bom odulin,TM)水平并探讨其临床意义。方法　急性心肌梗死、不稳定型心绞痛、稳定型心绞痛三组患者及正常对照组 ,抽取血浆并用酶联免疫吸附试验测量其血浆 TM水平。结果　急性心肌梗死组、不稳定型心绞痛组、稳定型心绞痛组血浆 TM水平均高于正常对照组 ( P<0 .0 5 ) ;急性心肌梗死组与不稳定型心绞痛组间患者血浆 TM水平没有显著性差异 ( P>0 .0 5 ) ,但均高于稳定型心绞痛组和正常对照组 ( P<0 .0 5 )。结论　血浆可溶性 TM水平是反映冠心病患者内皮细胞损伤程度和范围的良好标志 ,对急性心肌梗死、不稳定型心绞痛、稳定型心绞痛的鉴别有一定的临床指导意义