粪钙卫蛋白在溃疡性结肠炎诊断中的价值

目的:研究粪便钙卫蛋白检测作为一种无创性方法用于诊断溃疡性结肠炎(UC)活动性的价值.方法:UC患者82例,60例经结肠镜检查正常的患者作为对照,留取结肠镜检查1wk内的粪便样本10g,采用ELISA方法进行粪便钙卫蛋白检测.对23例活动期3级患者实施随访,监测粪便钙卫蛋白水平,用于指导临床治疗用药并观察疗效.结果:UC缓解期组粪便钙卫蛋白水平和正常对照组之间差异无统计学意义,活动期粪便钙卫蛋白水平与缓解期和正常对照组比均有统计学意义(603.2μg/g vs 8.2μg/g,6.6μg/g,P<0.01),活动期1级(103.5μg/g)、2级(582.9μg/g)和3级(1340.6μg/g)两两比较差异均有统计学意义(P<0.01).粪便钙卫蛋白水平与UC内镜分级显著相关(r=0.89,P<0.01).UC活动期3级患者23例经治疗后至缓解期,粪便钙卫蛋白水平显著下降,其治疗前后相比差异有统计学意义(1383.5μg/g vs 8.0μg/g,P<0.01).结论:粪便钙卫蛋白能较准确地诊断UC活动期和缓解期,用于指导临床治疗较好.     

粪便钙卫蛋白对儿童溃疡性结肠炎诊断和治疗的指导作用

目的探讨粪便钙卫蛋白对儿童溃疡性结肠炎(UC)诊断及治疗的指导作用。方法选取UC患儿57例(UC组),单纯腹泻患儿30例(腹泻组),健康儿童60例(健康对照组)。留取粪便,采用ELISA法检测钙卫蛋白。UC组采用"升阶梯"方案(美沙拉嗪无效时加用激素,继而加用单克隆抗体)治疗,比较治疗前后粪便钙卫蛋白变化,分析钙卫蛋白诊断UC的效能及其与治疗的关系。结果 UC组、腹泻组、健康对照组中位粪便钙卫蛋白分别为307.93、124.95和19.17μg/g,UC组明显高于腹泻组和健康对照组(P均<0.01),腹泻组与健康对照组比较无统计学差异(P>0.05);UC组活动期、缓解期患儿中位粪便钙卫蛋白分别为333.53、273.50μg/g,P<0.05;ROC曲线分析显示粪便钙卫蛋白升高的临界值为175.53μg/g,对应诊断UC的最佳灵敏度和特异度分别为77.2%和87.9%。UC组治疗后活动期患儿中位粪便钙卫蛋白明显下降;中位粪便钙卫蛋白≥307.93μg/g者激素使用率、用药时间长于<307.93μg/g者(P均<0.05)。结论粪便钙卫蛋白诊断儿童UC准确、无创、安全,有助于临床选择治疗药物及判断治疗效果。     

钙卫蛋白监测在炎症性肠病患者中的意义

目的探讨钙卫蛋白监测在炎症性肠病中的意义。方法选取炎症性肠病患者20例和健康对照者20例,采用ELISA方法测定粪便中钙卫蛋白的含量,与C反应蛋白(CRP)进行比较。结果炎症性肠病活动组粪便钙卫蛋白含量高于正常对照组,差异有统计学意义(P0.05)。炎症性肠病活动组中激素组和非激素组钙卫蛋白含量均高于对照组和缓解组。活动期组中激素组CRP降低与对照组和缓解组比较无明显差异,而活动期组中非激素组CRP继续维持较高水平,高于对照组和缓解期组,差异均有统计学意义(P0.01)。结论粪便中的钙卫蛋白在作为监测炎症性肠病患者的活动性及黏膜损伤的临床指标方面具有重要的意义。     

粪便钙卫蛋白对溃疡性结肠炎活动性判断价值的研究

目的评价粪便钙卫蛋白测定作为一种非侵入性方法判断溃疡性结肠炎（UC）活动性的价值，并与目前临床最常用的客观指标红细胞沉降率（ESR）和C-反应蛋白（CRP）进行比较。方法确诊的UC患者76例，在结肠镜检查前1周内留取5g粪便进行粪便钙卫蛋白测定，采用ELISA方法检测；同时检查血红蛋白、白蛋白、ESR和CRP，记录患者1周内的临床表现。疾病活动性根据内镜和组织学标准判断。取结肠镜正常的61例门诊患者粪便样本作为对照。结果活动期UC组粪便钙卫蛋白水平（515μg／g）显著高于缓解期（7．5μg／g，P〈0．01）和正常对照（5．7μg／g，n=61，P〈0．01），后两者之间差异无统计学意义（P〉0．05）；缓解期与活动期各级（Ⅰ、Ⅱ、Ⅲ期）差异有统计学意义（P〈0．01）；粪便钙卫蛋白水平与活动期UC内镜分级显著相关（r=0．876，P〈0．01），CRP和ESR与内镜分级的相关系数分别为r=0．725（P〈0．01）和r=0．302（P〈0．01），低于粪便钙卫蛋白。结论粪便钙卫蛋白与UC内镜分级标准具有较好的相关性，可客观反映UC的炎症活动情况，比血清学指标ESR和CRP更敏感和特异；而且是一种方便无创的检查方法，可以弥补内镜检查痛苦大、价格高、不宜反复检查的不足。具有临床推广价值。     

Chemerin和粪便钙卫蛋白对炎症性肠病活动性的诊断价值

目的探讨新型脂肪因子Chemerin与粪便钙卫蛋白(fecal calpotection,FCP)对炎症性肠病(inflammatorybowel disease,IBD)活动性的诊断价值,以求更简单有效评价IBD患者疾病活动性的方法.方法研究共纳入2015-01/2016-05于同济大学附属东方医院住院,住院前或住院期间行结肠镜检查的IBD患者121例,其中克罗恩病(Crohn's disease,CD)患者72例,溃疡性结肠炎(ulcerative colitis,UC)患者49例.健康对照组68例.对照组和IBD组在肠镜检查前1-2 d随机留取新鲜粪便标本2 g及新鲜血液标本6 m L.CD疾病活动性评价指标采用CD活动指数(Crohn's disease activity index,CDAI),UC病变范围采用蒙特利尔分类,疾病活动性评价则采用改良的Mayo评分.评价Chemerin与FCP对IBD活动性评分的相关性.结果IBD组Chemerin、FCP浓度均显著高于对照组,组间比较差异均有统计学意义(P0.05).活动期CD和UC患者Chemerin、FCP浓度均分别显著高于缓解期CD和UC患者,两者比较差异均有统计学意义(P0.001).CD患者的Chemerin及FCP与CDAI具有一定的相关性(rs分别为0.57和0.59,P0.05).UC患者的Chemerin及FCP与改良的Mayo评分具有较好的相关性(rs分别为0.65和0.72,P0.001).CD和UC患者的Chemerin及FCP相关系数rs分别为0.55和0.72(P0.001).结论Chemerin是一种可靠评价IBD活动性的非侵入性生物标志物,具有与FCP相似的IBD活动性评价准确性,临床上可以通过联合检测Chemerin和FCP来实时评价IBD患者的疾病活动状态.     

钙卫蛋白、乳铁蛋白在溃疡性结肠炎患者中表达的临床研究

背景:溃疡性结肠炎(UC)是慢性反复发作的肠道炎性疾病,评估疾病活动度对其疗效判断非常重要,实验室标记物尤其是粪便标记物可很好地反映疾病活动度。目的:探讨钙卫蛋白(Cal)、乳铁蛋白(Lf)在UC患者结肠黏膜和粪便中表达的临床意义。方法:选取1998年1月～2008年1月安徽医科大学第一附属医院收治的具备完整结肠镜或手术病理检查结果的UC患者120例。以临床活动度指数(CAI)评分进行疾病分期,以免疫组化SP法检测结肠黏膜Cal、Lf表达,以ELISA法检测粪便Cal、Lf含量。结果:活动期UC患者结肠黏膜中均表达Cal、Lf,缓解期无或仅弱表达。活动期UC患者粪便Cal、Lf含量显著高于缓解期(P0.01)。UC患者结肠黏膜Cal和Lf表达以及粪便Cal和Lf含量均与CAI评分呈正相关(P=0.000)。粪便Cal和Lf含量与结肠黏膜Cal和Lf表达亦呈正相关(r=0.588,P=0.000;r=0.519,P=0.000),且判断UC活动性的敏感性和特异性均较高。结论:UC患者结肠黏膜Cal、Lf表达可反映临床严重度,粪便Cal、Lf含量与UC活动性显著相关。     

柏榆灌肠方治疗轻中度远端大肠湿热证溃疡性结肠炎的回顾性队列分析

目的:回顾性分析柏榆灌肠方治疗轻中度远端大肠湿热证溃疡性结肠炎(UC)的临床疗效。方法:采用回顾性研究的方法，将2016年1月—2020年12月就诊的213例轻中度远端大肠湿热证UC患者根据治疗方式分为观察组(清肠化湿加减口服+柏榆灌肠方灌肠，100例)、对照组(清肠化湿加减口服+美沙拉秦栓组，113例),比较两组患者的临床缓解率、中医证候疗效、单项症状积分和炎症指标水平。结果:观察组患者的临床缓解率高于对照组(85.00%vs 78.76%),两组间比较差异有统计学意义(P<0.05);观察组患者的中医证候临床总有效率高于对照组(88.00%vs 76.99%),两组间比较差异有统计学意义(P<0.05);黏液脓血便和腹痛评分两组比较差异有统计学意义(P<0.05);部分Mayo评分较治疗前降低，观察组患者低于对照组，两组间比较差异有统计学意义(P<0.05);两组患者的粪便钙卫蛋白、C-反应蛋白、血沉水平均较治疗前降低，两组间比较差异无统计学意义(P>0.05)。治疗过程中未发现明显治疗相关的肝肾损害等不良反应。结论:柏榆灌肠方灌肠可提高轻中度远端大肠...     

粪便钙卫蛋白、降钙素原在溃疡性结肠炎及腹泻型肠易激综合征诊断中的临床意义

目的本研究通过检测UC及IBS-D患者粪便中FC及血液中PCT的水平,探索FC、PCT诊断UC、IBS-D的临床意义。方法 2016年12月至2017年12月内蒙古医科大学附属医院收治的UC患者(缓解期UC 20例;活动期UC全结肠型20例;活动期UC部分结肠、直肠型20例) 60例,IBS-D患者30例,体检健康者(对照组) 30例。留取受检者粪便5～10 g,进行ELISA检验。空腹8 h后于次晨取静脉血5 mL,用罗氏701生化分析仪测定PCT。结果 UC组FC水平显著高于IBS-D组和对照组,差异均有统计学意义(P 0.05);IBS-D组FC水平与对照组比较,差异无统计学意义(P0. 05)。FC与UC内镜下分期高度正相关(rs=0. 806)、与累及范围正相关(rs=0. 593)。UC组PCT水平显著高于IBS-D组和对照组,差异均有统计学意义(P 0. 05); IBS-D组PCT水平与对照组比较,差异无统计学意义(P 0. 05)。PCT与UC内镜下分期呈正相关关系(rs=0. 720)、与内镜下累及范围无显著相关性(P 0. 05)。结论 FC在UC与IBSD的鉴别诊断中具有较高的敏感性,其可作为一种临床上诊断和鉴别UC、IBS-D的辅助指标; FC可作为监测患者治疗期间UC活动、缓解情况的辅助指标;可作为评估活动性UC累及范围的参考指标。PCT在UC与IBS-D的鉴别诊断中具有临床意义,但对于活动性UC、累及范围无显著相关。     

粪便标志物在炎症性肠病中的应用进展

炎症性肠病(inflammatory bowel disease,IBD)包括溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(Crohn's disease,CD),目前主要依靠内镜检查联合病理活检进行诊断及评价炎症活动性.粪便标志物具有非侵入性、简便、快捷、短期内可重复检测等优点,在判断炎症活动程度、监测病情变化、鉴别器质性与功能性疾病、评估治疗效果等方面都有作用.本文对粪便钙卫蛋白、乳铁蛋白、M2型丙酮酸激酶、S100A12、髓过氧化物酶等多种IBD粪便标志物作一综述.     

联合检测粪便癌胚抗原和钙卫蛋白诊断大肠癌的临床价值

目的联合检测粪便中癌胚抗原（CEA）及钙卫蛋白,探讨其诊断大肠癌的临床应用价值。方法收集北京军区总医院消化内镜中心接受肠镜检查病人的新鲜粪便标本共177例,其中大肠癌48例,结直肠息肉51例,功能性肠病78例。采用ELISA法半定量检测粪便中钙卫蛋白及癌胚抗原浓度,比较其在不同组中的差异;应用ROC曲线确定最佳临界值,并对两个检测指标进行综合评价。结果大肠癌组粪便钙卫蛋白及CEA含量的中位数分别为470（0．9—1380．61）μg,／g,19．42（0．46～109．78）μg／g,高于其余组,差异有统计学意义（P〈0．05）;肿瘤发生部位不同的患者粪便钙卫蛋白及CEA的水平无明显差异（P〉0．05）;ROC曲线分析提示：以12．09μg／g为临界点,CEA诊断大肠癌的灵敏度为73％,特异度为56％;以104．2μg／g为临界点,钙卫蛋白诊断大肠恶性肿瘤的灵敏度为90．1％,特异度为54．2％;钙卫蛋白联合CEA诊断大肠癌的灵敏度为97．3％,特异度为30．35％。结论粪便钙卫蛋白及CEA检测大肠癌有较高的敏感性,且不受肿瘤部位的影响,可以作为门诊筛查大肠癌的标志物。     

Clinical value of fecal calprotectin in determining disease activity of ulcerative colitis

AIM： To investigate possibility and clinical application of fecal calprotectin in determining disease activity of ulcerative colitis （UC）. METHODS： The enzyme-linked immunosorbent assay （ELISA） was used to measure the concentrations of calprotectin in feces obtained from 66 patients with UC and 20 controls. C-reactive protein （CRP）, erythrocyte sedimentation rate （ESR）, acid glycoprotein （AGP） were also measured and were compared with calprotectin in determining disease activity of UC. The disease activity of UC was also determined by the Sutherland criteria. RESULTS： The fecal calprotectin concentration in the patients with active UC was significantly higher than that in the inactive UC and in the controls （402.16 ± 48.0 μg/g vs 35.93 ± 3.39 μg/g, 11.5 ± 3.42 μg/g, P 〈 0.01）. The fecal calprotectin concentration in the inactive UC group was significantly higher than that in the control group （P 〈 0.05）. A significant difference was also found in the patients with active UC of mild, moderate and severe degrees. The area under the curve of the receiver operating characteristics （AUCR~c） was 0.975, 0.740, 0.692 and 0.737 for fecal calprotectin, CRP, ESR and AGP, respectively. There was a strong correlation between the fecal calprotectin concentration and the endoscopic gradings for UC （r = 0.866, P 〈 0.001）. CONCLUSION： Calprotectin in the patient＇s feces can reflect the disease activity of UC and can be used as a rational fecal marker for intestinal inflammation in clinical practice. This kind of marker is relatively precise, simple and noninvasive when compared with other commonlyused markers such as CRP, ESR and AGP.     

粪钙卫蛋白、乳铁蛋白水平与克罗恩病肠黏膜病变的关系

目的 研究粪钙卫蛋白、乳铁蛋白水平与克罗恩病肠黏膜病变的关系.方法 选取88例经确诊的克罗恩病(CD)患者为研究对象,35例肠易激综合征(IBS)患者为对照.CD患者于肠镜检查前1周内、IBS患者于门诊就诊时分别留取粪便标本.其中CD患者同时计算CD活动指数(CDAI),并在其后的内镜检查中计算CD内镜指数(CDEI).通过酶联免疫吸附法检测粪钙卫蛋白和乳铁蛋白水平.结果 CD患者粪钙卫蛋白、乳铁蛋白水平[中位值(四分位数间距)]分别为277.16 (96.85~693.57) mg/kg和59.68(10.75～100.58) mg/kg,明显高于IBS患者[7.6(5.54～32.3) mg/kg和0.65(0.23～4.34) mg/kg],差异均有统计学意义(Z值分别=-8.301和-7.986,P值均=0.000).存在结肠病变的CD患者粪钙卫蛋白、乳铁蛋白水平与无结肠病变的CD患者比较差异均无统计学意义(Z值分别=-0.424和-0.699,P值分别=0.672和0.485).CD缓解期者粪钙卫蛋白、乳铁蛋白水平与CD活动期者比较,差异均无统计学意义(Z值分别=-1.491和-1.075,P值分别=0.136和0.283).内镜中重度活动期者粪钙卫蛋白、乳铁蛋白水平分别为663.11(263.45～2015.63) mg/kg、105.64(56.52～187.44) mg/kg,轻度活动期者分别为344.54(132.03～722.67) mg/kg、86.68(21.07～100.55) mg/kg,静止期者分别为133.94(60.54～583.33) mg/kg、45.31(7.59～48.31) mg/kg,各活动期患者粪钙卫蛋白和乳铁蛋白水平高于静止期(χ2分别=10.63和8.18,P值分别=0.005和0.017).结论 粪钙卫蛋白、乳铁蛋白水平可反映肠道黏膜病变及其严重程度.

Abstract：

Objective To study the correlation of fecal calprotectin and lactoferrin with intestinal mucosa lesions in Crohn′s disease (CD). Methods Eighty-eight cases of diagnosed CD patients were selected as study group and 35 irritable bowel syndrome (IBS) patients were as controls. Fecal samples of CD patients were collected in one week before colonoscopy examination and of IBS patients were collected of CD patients, CD activity index (CDAI) was calculated at same visit, and CD endoscopic index (CDEI) was calculated in the subsequent endoscopic examination. The level of fecal calprotectin and lactoferrin were tested by ELISA method. Results The median levels of facal calprotectin and lactoferrin in CD patients were 277.16 mg/kg (from 96.85 to 693.57 mg/kg) and 59.68 mg/kg (from 10.75 to 100.58 mg/kg) respectively, which were significantly higher than those of IBS patients (7.6mg/kg, from 5.54 to 32.3 mg/kg and 0.65 mg/kg from 0.23 to 4.34 mg/kg), (Z=-8.301 and -7.986, respectively both P =0.000). There were no significant difference of calprotectin and lactoferrin level between CD patients with colon pathological changes and without colon pathological changes (Z=-0.424 and -0.699,P=0.672 and 0.485, respectively). There was no significant difference of calprotectin and lacoferrin level between remission and active periods in CD patients (Z=-1.491 and -1.075, P=0.136 and 0.283, respectively). The median values of calprotectin and lactoferrin of patients in moderate and severe active period judged under endoscopy were 663.11 mg/kg (from 263.45 to 2015.63 mg/kg) and 105.64 mg/kg (from 56.52 to 187.44) mg/kg respectively, in mild active period were 344.54 mg/kg (from 132.03 to 722.67 mg/kg) and 86.68 mg/kg (from 21.07 to 100.55 mg/kg) accordingly, and in remission period were 133.94 mg/kg (from 60.54 to 583.33 mg/kg) and 45.31 mg/kg (from 7.59 to 48.31 mg/kg, respectively). Both calprotectin and lactoferrin levels were significantly higher in active period than in remission period (χ2=10.63 and 8.18, while, P=0.005 and 0.017, respectively). Conclusions The level of fecal calprotectin and lactoferrin can reflect the pathological changes and severity of the intestinal mucosa.     

肠内营养对溃疡性结肠炎的临床疗效观察

目的探讨肠内营养对活动期溃疡性结肠炎(ulcerative colitis,UC)的临床疗效及肠黏膜的作用。方法将符合UC标准的45例患者随机分为两组,对照组采用传统抗炎治疗,治疗组采用传统抗炎治疗和肠内营养支持治疗,观察两组患者临床疗效及内镜下肠黏膜的变化。结果治疗组临床疗效总有效率明显优于对照组,差异有统计学意义(P0.05)。治疗组中、重度UC患者临床疗效优于对照组中、重度UC患者临床疗效,差异有统计学意义(P0.05);治疗组轻、中度UC患者临床疗效与对照组轻、中度UC患者临床疗效比较,差异无统计学意义(P0.05)。结论肠内营养作为对活动期UC患者的辅助治疗,其疗效显著,值得临床推广。     

Fecal calprotectin and lactoferrin as predictors of relapse in patients with quiescent ulcerative colitis during maintenance therapy

Purpose

This prospective study was to evaluate the significance of fecal calprotectin and lactoferrin for the prediction of ulcerative colitis (UC) relapse.

Methods

Eighty UC patients in remission for ≥3 months on mesalamine as maintenance therapy were included. At entry, stool samples were collected for the measurement of calprotectin and lactoferrin. All patients were followed up for the following 12 months. To identify predictive factors for relapse, time-dependent analyses using the Kaplan-Meier graphs and Cox's proportional hazard model were applied.

Results

During the 12 months, 21 patients relapsed. Mean calprotectin and lactoferrin levels were significantly higher in patients with relapse than those in remission (calprotectin—173.7 vs 135.5 μg/g, P?=?0.02; lactoferrin—165.1 vs 130.7 μg/g, P?=?0.03). A cutoff value of 170 μg/g for calprotectin had a sensitivity of 76 % and a specificity of 76 % to predict relapse, while a cutoff value of 140 μg/g for lactoferrin had a sensitivity of 67 % and a specificity of 68 %. In a multivariate analysis, calprotectin (≥170 μg/g) was a predictor of relapse (hazard ratio, 7.23; P?=?0.002). None of the following parameters were significantly associated with relapse: age, gender, duration of UC, number of UC episode, severity of the previous episode, extent of UC, extraintestinal manifestation, and lactoferrin level.

Conclusions

Fecal calprotectin showed a higher sensitivity and specificity than fecal lactoferrin for predicting UC relapse. Fecal calprotectin level appeared to be a significant predictor of relapse in patients with quiescent UC on mesalamine as maintenance therapy.     

Relationship between fecal lactoferrin and inflammatory bowel disease

OBJECTIVE: Lactoferrin as a glucoprotein that can reflect the activity of neutrophil leukocytes is a specific and sensitive indicator in the evaluation of intestinal inflammation. The aim of this study was to evaluate the relationship between fecal lactoferrin and intestinal inflammation by quantitative analysis and the effect of fecal lactoferrin in measuring the activity of inflammatory bowel disease (IBD) including ulcerative colitis (UC) and Crohn's disease (CD). MATERIAL AND METHODS: A total of 177 fresh stool samples were collected from 42 active UC, 17 inactive UC, 13 active CD, 5 inactive CD, 41 infectious bowel disease, 25 irritable bowel syndrome (IBS) and 34 healthy volunteers. IBD-SCAN was used quantitatively to measure the level of fecal lactoferrin. A modified Harvey-Bradshaw Active Index was used to evaluate the activity of IBD. RESULTS: Fecal lactoferrin was 3.15+/-1.60 microg/g in healthy volunteers, 2.54+/-1.49 microg/g in IBS, 83.3+/-29.9 microg/g in infectious bowel disease, 1126.29+/-431.21 microg/g in active UC, 1035.25+/-456.59 microg/g in active CD, 96.58+/-82.46 microg/g in inactive UC and 133.52+/-88.89 microg/g in inactive CD. Fecal lactoferrin was significantly higher in active IBD than in inactive IBD, IBS and infectious bowel disease. The sensitivity and specificity of fecal lactoferrin were 92% and 88%, respectively, for UC, and 92% and 80%, respectively, for CD. CCONCLUSIONS: Fecal lactoferrin is a sensitive and specific marker in measuring the activity of IBD. It provides us with a valid method in discriminating between inflammatory and non-inflammatory bowel disease. In addition, an elevated fecal lactoferrin level can lead us to exclude IBS in clinical practice.     

Relationship and significance between anti-β2-glycoprotein I antibodies and platelet activation state in patients with ulcerative colitis

AIM:To study the relationship between anti-β2-glycoproteinⅠ(aβ2GPⅠ) antibodies and platelet activation state in patients with ulcerative colitis (UC)and its significance.METHODS:Peripheral blood samples were collected from 56 UC patients (34 males and 22 females,aged 43.5 years,range 21-66 years),including 36 at active stage and 20 at remission stage,and 25 sex-and age-matched controls.The level of aβ2GPⅠwas measured by ELISA.The platelet activation markers,platelet activation complex-I (PAC- I) and P-selectin (CD62P) were detected by flow cytometry.RESULTS:The A value for IgG aβzGPⅠin the active UC group was 0.61±0.13,significantly higher than that in the remittent UC and control groups (0.50±0.13 and 0.22±0.14,P＜0.01).There was a significant difference between the two groups (P＜0.01).The A value for IgM aβ2GPⅠin the active and remittent UC groups was 0.43±0.13 and 0.38±0.12,significantly higher than that in the control group (0.20±0.12,P＜0.01).However,there was no significant difference between the two groups (P＞0.05).The PAC-I positive rate for the active and remittent UC groups was 30.6%±7.6% and 19.6%±7.8% respectively,significantly higher than that for the control group (6.3%±1.7%,P＜0.01).There was a significant difference between the two groups (P＜0.01).The CD62P positive rate for the active and remittent UC groups was 45.0%±8.8% and 31.9%±7.8% respectively,significantly higher than that for the control group (9.2%±2.7%,P＜0.01).There was a significant difference between the two groups (P＜0.01).In the active UC group,the more severe the state of illness was,the higher the A value for IgG aβ2GPⅠwas,and the positive rate for PAC-I and CD62P was positively correlated with the state of illness (Faβ2GPⅠ= 3.679,P＜0.05;FPAC-I (%) = 5.346,P＜0.01;and FCD62P (%) = 5.418,P＜0.01).Meanwhile,in the same state of illness,the A value for IgG aβ2GPⅠwas positively correlated to the positive rates for PAC-I and CD62P.CONCLUSION:aβ2GPⅠlevel,platelet activation state and their relationship of them are closely correlated with the pathogenesis and development of UC.     

溃肠宁对TNBS模型大鼠肠形态、血清及结肠组织IL-6和IL-10影响的观察

[目的]观察中药溃肠宁对三硝基苯磺酸（TNBS）致溃疡性结肠炎（UC）大鼠模型肠黏膜形态、大鼠血清及结肠黏膜组织中白介素-6（IL-6）、白介素-10（IL-10）表达的影响,探讨溃肠宁抗UC的相关作用机制以及疗效.[方法]采用TNBS复合50％乙醇法复制UC大鼠模型,分别采用中药溃肠宁和柳氮磺胺毗啶（SASP）作为阳性对照组进行治疗,对比模型组和空白对照组采用ELISA法对各组大鼠肠血清以及肠黏膜中IL-6、IL-10进行检测,并对其检测结果进行分析.[结果]模型组大鼠结肠和血清中的IL-6含量明显高于正常组（P＜0.01）,IL-10的含量则明显低于正常组（P＜0.01）;SASP组结肠及血清中IL-6、IL-10含量与模型组比较差异有统计学意义（P＜0.01）;中药组和模型组相比,结肠和血清中IL-6含量明显低于模型组（P＜0.01）,IL-10的含量则明显高于模型组（P＜0.01）;中药组与西药SASP组比较,中药组结肠和血清中IL-6含量低于西药组,IL-10的含量高于西药组,可见2组之间差异有统计学意义（P＜0.01）.[结论]溃肠宁对TNBS复合50％乙醇法UC大鼠疗效显著,其作用机制可能与调节机体的免疫有关.     

慢性间歇低氧诱导小鼠学习记忆障碍的实验研究

目的 探讨慢性间歇低氧（CIH）诱导小鼠空间学习记忆能力的变化及CIH对认知功能损伤的可能机制.方法 60只ICR雄性幼鼠随机分为常氧对照组（UC组）和间歇低氧组（CIH组）,每组30只;CIH组小鼠置于低氧舱内,通过吹入氮气及压缩空气,每60s做一次缺氧/再氧合循环,使氧浓度波动在6％～8％和20％～ 21％之间,每天8h.CIH组根据低氧造模时间分为3d（A组）、1周（B组）、2周（C组）、4周（E组）、6周（F组）,以及造模结束后常氧饲养1月的10周组（G组）,共6组,每组5只小鼠,同期设6组对照,每组5只小鼠.在慢性间歇低氧3d、1周、2周及6周终点,采用Morris水迷宫的方法测定CIH组和UC组空间学习记忆功能的变化;Western blot法分别测各组海马N-甲基-D-天冬氨酸受体（NMDAR）亚单位1（NR1）蛋白表达的变化;采用免疫荧光标记测定海马Caspase-3表达情况.结果 ①CIH组小鼠在间歇低氧3d时,水迷宫逃避潜伏期较对照组有所延长,但无统计学差异（P＞0.05）;随着间歇低氧时间的延长,逃避潜伏期较对照组逐渐延长（P＜0.05）;低氧6周后,CIH组逃避潜伏期[（68.64±26.52）s]较对照组[（21.36±14.14）s]明显延长（P＜0.01）.低氧6周后,CIH组穿越平台次数[（4.58±2.58）次]较对照组[（8.06±2.74）次]明显减少（P＜0.01）;②与对照组比较,CIH组B、C、E、F及G组小鼠海马神经元NR1蛋白表达均降低（P＜0.叭）,C、E组降至最低水平（P＜0.01）;复氧1月后的G组NR1蛋白与F组相仿,仍较对照组降低（P＜0.01）.CIH各组海马Caspase-3表达均明显升高,并成时间-效应关系,除A组外,其余各组与对照组相比,差异均有统计学意义（P均＜0.01）,CIH组组内指标比较无显著差异（P＞0.05）.结论 慢性间歇低氧诱导小鼠空间学习记忆障碍,且随低氧暴露时间延长学习记忆功能损害加重,这可能与海马神经元NR1蛋白表达下调以及与Caspase-3介导的海?