细胞因子IL-1、IL-6和IL-8水平与胃窦癌恶病质关系

目的探讨胃窦癌病人血清细胞因子白细胞介素（IL）-1、IL-6和IL-8的水平与恶病质发生的关系。方法125例胃窦癌病人分为恶病质组与非恶病质组,将近6个月体质量下降〉10％者定义为恶病质病人。通过放射免疫学方法对胃窦癌病人及健康对照组进行血清IL-1、IL-6和IL-8含量的检测。结果胃窦癌病人血清中3种细胞因子含量较对照组均显著升高（Z=-8．186～-4．665,P〈0．05）,胃窦癌恶病质病人血清IL-6和IL-8含量较非恶病质病人显著升高（Z=-5．018、-3．134,P〈0．05）。多因素Logistic回归分析显示,IL-6（OR=1．048,95％CI：1．021～1．075）和IL-8（OR=3．150,95％CI：0．988～10．037）为恶病质发生的高风险性因素。结论血清IL-6和IL-8水平与胃窦癌病人恶病质的发生具有相关性。     

Serum levels of leptin and proinflammatory cytokines in patients with gastrointestinal cancer

The aim was to investigate the serum levels of leptin, TNF-alpha, IL-1 beta, IL-6, insulin, and growth hormone in patients with upper gastrointestinal cancer and cachexia. A total of 39 patients with various advanced stage (stage IV) gastrointestinal malignancies were enrolled. These cancer patients were divided into two groups according to the presence or absence of cachexia. Fifteen healthy adults were recruited as the control group. Body mass index (BMI; kg/m2) was calculated. Serum leptin, tumour necrosis factor (TNF)-alpha interleukin (IL)-1 beta, interleukin (IL)-6, growth hormone, insulin, glucose, triglyceride, total protein, albumin, erythrocyte sedimentation rate, and CRP were measured. In both cancer groups (cachectic and non-cachectic) body mass index and serum leptin levels were lower than controls (p < 0.001). Serum IL-1 beta, IL-6, and growth hormone levels were higher in both cachectic and non-cachectic groups than those of controls (p < 0.05). Serum TNF-alpha level in non-cachectic group was also significantly higher than in control group (p < 0.01). There is no significant difference between three groups in terms of insulin resistance as assessed by HOMA index. Our results showed that some proinflammatory cytokine levels were increased and leptin level was decreased due to upper gastrointestinal cancers. Increased cytokine levels may lead to decreased food intake and caused a weight loss.     

A randomized pilot study of atractylenolide I on gastric cancer cachexia patients

We determined the therapeutic efficacy of atractylenolide I (ATR), extracted from largehead atractylodes rhizome, in managing gastric cancer cachexia (GCC), and interpreted its probable pharmacological mechanism via investigating tumor necrosis factor alpha (TNF-alpha), interleukin-1 (IL-1), interleukin-6 (IL-6) and proteolysis-inducing factor (PIF). This was a randomized but not-blinded pilot. The study group (n = 11) received 1.32 g per day of atractylenolide I (ATR) and the control group (n = 11) received 3.6 g per day of fish-oil-enriched nutritional supplementation (FOE) for 7 weeks. Conservative therapy was similar in both groups. Clinical [appetite, body weight, mid-arm muscle circumference (MAMC), Karnofsky performance status (KPS) status], biomarker (TNF-alpha, IL-1, IL-6 and PIF) were evaluated in the basal state, at the third and seventh weeks. To analyze changes of cytokines, an immumohistochemistry technique was adopted. Base line characteristics were similar in both groups. Effects on MAMC and body weight increase, TNF-alpha increase and IL-1 decreases of serum level were significant in both groups (P < 0.05). ATR was significantly more effective than FOE in improving appetite and KPS status, and decreasing PIF positive rate (P < 0.05). Slight nausea (3/11) and dry mouth (1/11) were shown in intervention groups but did not interrupt treatment. These preliminary findings suggest that ATR might be beneficial in alleviating symptoms, in modulating cytokine and in inhibiting PIF proteolysis of gastric cancer cachexia. Further research using a randomized controlled design is necessary to confirm these pilot study findings.     

Evidence for the involvement of interleukin 6 in experimental cancer cachexia.

In this report we describe an experimental model of cachexia that fulfills the criteria of an early effect with a small tumor mass not related to the growth rate of the tumor, and progressive wasting of muscle and fat without a detectable loss of appetite. C-26.IVX is a cell line derived from murine colon-26 adenocarcinoma which retains the transplantability of the original tumor and induces true cachexia in syngeneic hosts. Evidence is presented to support a role for interleukin (IL-6) as a cachectic factor in the development of cancer cachexia in this model system. Thus, increasing levels of IL-6 in C-26.IVX-bearing mice correlate with the development of cachexia. If the primary tumors were resected, mice gained weight and the levels of IL-6 in the serum were reduced significantly. Moreover, monoclonal antibody to murine IL-6 (but not anti-tumor necrosis factor antibody) was able to significantly suppress the development of key parameters of cachexia in tumor bearing mice.     

Effects of Viscum album extract therapy in patients with cancer: relation with interleukin-6, soluble interleukin-6 receptor, and soluble gp130

OBJECTIVES: The aim of this investigation was to determine the effects of Viscum album (VA) extract therapy on interleukin (IL)-12, IL-16, IL-6, soluble interleukin-6 receptor (sIL-6R), and soluble gp130 (sgp130) in patients with cancer. VA extract as immunomodulator is used as treatment either following or in combination with chemo/radiotherapy. Previously we showed that serum levels of IL-12 and IL-16 were significantly elevated during tumor progression in 72 patients. The serum values of IL-6 were not significantly altered, however sIL-6R and sgp130 also increased significantly. DESIGN: In this study the serum levels of the five parameters were measured during VA extract therapy in 46 of these 72 tumor patients and compared to the values before VA extract treatment. The levels of the serum parameters IL-12, IL-16, IL-6, sIL-6R, sgp130 were determined by enzyme-linked immunosorbent assay (ELISA). SETTING: Private cancer hospital in Arlesheim, Switzerland. RESULTS: Eighty percent (80%) of the tumor patients survived longer than 1 year (11 patients in stage I + II without, 8 patients after chemotherapy/radiotherapy, 10 patients in stage III + IV without, 8 patients after chemotherapy). Clinically and with laboratory investigations there was no progression in these patients. VA extract therapy did not affect serum values of IL-12 or IL-16. However both the number of patients with increased levels of IL-6, sIL-6R, and sgp130 and also the serum values decreased significantly during the treatment, (between p < 0.05 and p < 0.001). In 20% of the patients with cancer with rapid progression who died within 3 months, the serum values of IL-6 increased significantly (p < 0.05), whereas the other investigated parameters did not change. CONCLUSION: The results show that measurements of IL-6, sIL-6R, and sgp130 could be important for establishing the clinical condition and evaluating treatment in tumor patients.     

血清IL-10水平及其基因-1082A/G位点单核苷酸多态性与胃窦癌恶病质的关系

目的探讨胃窦癌病人血清细胞因子白细胞介素10（IL-10）水平及-1082A/G位点单核苷酸多态性与恶病质发生的关系。方法采用放射免疫学方法检测150例胃窦癌病人及135例健康人（对照组）血清IL-10水平。用聚合酶链反应-限制性片段长度多态性（PCR-RFLP）方法检测胃窦癌病人IL-10基因-1082A/G位点单核苷酸多态性。结果胃窦癌病人血清IL-10水平较对照组显著升高（Z=-11.862,P〈0.001）,胃窦癌Ⅲ、Ⅳ期病人血清IL-10水平较Ⅰ、Ⅱ期显著升高（Z=-10.028,P〈0.001）。胃窦癌恶病质病人血清IL-10水平较非恶病质病人显著升高（Z=-10.369,P〈0.001）。Logistic回归分析显示,IL-10为恶病质发生的高风险性因素（OR=1.559,95%CI=1.299-1.870,P〈0.001）。单核苷酸多态性分析显示,胃窦癌恶病质病人IL-10基因-1082G等位基因频率较非恶病质病人显著升高（χ2=3.953,P〈0.05）。胃窦癌恶病质病人IL-10基因-1082AG基因型频率较非恶病质病人显著升高（χ2=4.511,P〈0.05）。Logistic回归分析显示,校正肿瘤分期后,IL-10基因-1082AG基因型为胃窦癌恶病质的高风险性因素（OR=2.295,95%CI=1.029-5.117,P〈0.05）。结论血清IL-10水平高及IL-10基因-1082AG基因型与胃窦癌病人恶病质的发生具有相关性。     

胱抑素C、白细胞介素-6联合检测在糖尿病肾病诊断中的临床意义

目的：探讨胱抑素C、白细胞介素6检测在糖尿病肾病早期诊断和治疗中的临床意义。方法：选取临床确诊的2型糖尿病患者70例,分为糖尿病无肾病组（DM组）和糖尿病肾病组（DN组）,30例健康对照组,分别测定其血清中的白细胞介素6（IL-6）、胱抑素C（CysC）含量和糖化血红蛋白水平。结果：DN组血清CysC显著高于DM组与对照组（P＆lt;0．05）,DM组与对照组之间血清cysc相比差异无统计学意义（P〉0．05）,DN组血清IL-6显著高于DM组与对照组（P＆lt;0．05）,DM组血清IL-6显著高于对照组（P＆lt;0．05）。糖尿病患者血清IL-6含量与糖化血红蛋白水平呈显著正相关。结论：血清CysC、IL-6的含量与DN 的发生、发展密切相关,联合检测可提高DN诊断的灵敏度。     

血清HGF、IL-6水平对血液透析患者蛋白质-能量消耗的诊断价值

目的 探讨血清肝细胞生长因子(HGF)、白细胞介素6(IL-6)水平对血液透析患者蛋白质-能量消耗的诊断价值.方法 选取2014年1月至2017年12月在该院接受血液透析治疗的122例终末期肾病患者为研究对象,分为蛋白质-能量消耗组和非蛋白质-能量消耗组.观察患者临床指标及血清HGF、IL-6水平差异,分析血液透析患者...     

黄芪注射液对放疗作用下食管癌大鼠抗肿瘤功能的影响及其机制研究

目的 探讨黄芪注射液(AI)对放疗作用下食管癌大鼠抗肿瘤功能的影响及其机制。方法 采用甲基苄基亚硝胺构建食管癌放射治疗模型,将64只Wistar大鼠按照随机数字表法分为4组:对照组、阳性对照组(EM+RT组)、放射治疗组(RT组)和治疗组(AI+RT组),每组各16只。其中对照组不接受任何治疗,RT组仅进行放射治疗,EM+RT组放射后给予不锈钢喂食针食管内灌注111.7 g/m L的食道混合物治疗,AI+RT组放射治疗后给予不锈钢喂食针食管内灌注大鼠100 g/m L AI。在放射后7、14、21和28 d,测定各组大鼠体重,并取食管组织进行组织病理学和免疫组织化学染色,进一步采用酶联免疫吸附试验(ELISA)法测定血清白细胞介素(IL)-6、IL-10和肿瘤坏死因子-α(TNF-α)。结果 放射后14、21、28 d,与对照组相比,RT组、EM+RT组和AI+RT组大鼠体重显著降低,差异均有统计学意义(P <0.05);放射后14、21、28 d,与RT组比较,EM+RT组、AI+RT组体重显著降低,差异均有统计学意义(P<0.05)。放射后28 d,RT组大鼠黏膜上皮严...     

Comparative efficacy of oral and intravenous calcitriol treatment in haemodialysis patients: effects on serum biochemistry and cytokine levels

This study compared the effects of oral and intravenous calcitriol on serum biochemistry parameters and levels of bone-resorptive cytokines in haemodialysis patients. Patients were randomized to receive oral (n = 18) or intravenous (n = 16) calcitriol treatment for 6 months. Serum levels of total calcium, ionized calcium, intact parathyroid hormone (iPTH), magnesium, alkaline phosphatase, tumour necrosis factor-alpha (TNF-alpha), interleukin (IL)-1 and IL-6 were measured at baseline and after 3 and 6 months of treatment. After treatment, serum levels of iPTH, total calcium, ionized calcium, TNF-alpha, IL-1 and IL-6 were not significantly different from baseline. The intravenous calcitriol treatment group showed significant decreases in levels of iPTH, TNF-alpha, IL-1 and IL-6 and a significant increase in total calcium level after 3 and 6 months. There was no significant change in serum ionized calcium levels. Significantly decreased serum alkaline phosphatase and magnesium levels were found in both treatment groups after 3 and 6 months. In conclusion, intravenous calcitriol treatment has a significant depressive effect on iPTH and bone-resorptive cytokines in patients undergoing haemodialysis.     

Acute-phase response proteins are related to cachexia and accelerated angiogenesis in gastroesophageal cancers.

BACKGROUND: Accurate outcome prediction in gastroesophageal malignancies is challenging. Acute-phase response proteins (APRPs) have been claimed to be independent prognosticators, although the basis for their association with prognosis remains unexplained. We hypothesized that, similarly to pancreatic and lung cancers, changes in APRPs in gastroesophageal malignancies are associated with cachexia and accelerated angiogenesis. METHODS: C-reactive protein (CRP), albumin and transferrin serum levels were evaluated and the Glasgow Prognostic Score (GPS) calculated. These data were compared with concentrations of circulating interleukin (IL)-1, IL-6 and IL-8, tumor necrosis factor-alpha (TNF-alpha), vascular endothelial growth factor (VEGF)-A, VEGF-C and midkine in 96 gastroesophageal cancer patients (49 with cachexia) and 42 healthy subjects. Results: Albumin and CRP levels were altered in the cancer patients, with further CRP elevation in those with cachexia. Transferrin was decreased only in the cachectic patients. The interrelationships between the APRPs were strengthened in cachexia and only then were APRPs correlated with the cytokines elevated in gastroesophageal cancer-related cachexia: IL-6, IL-8, VEGF-A and midkine. GPS corresponded well to transferrin, IL-1, IL-6, IL-8, TNF-alpha, VEGF-A and midkine concentrations. CONCLUSIONS: Cachexia in gastroesophageal cancers is associated with changes in APRP concentrations. This, together with a direct relationship of APRPs with accelerated angiogenesis, may constitute a foundation for the association of APRPs and GPS with outcome in these malignancies.     

Amelioration of cancer cachexia with preemptive administration of tumor necrosis factor-α blocker

Cancer cachexia is syndrome accompanying weight reduction, fat loss, muscle atrophy in patients with advanced cancer. Since tumor necrosis factor-α (TNF-α) played pivotal role in cancer cachexia, we hypothesized preemptive administration of TNF-α antibody might mitigate cancer cachexia. Detailed molecular mechanisms targeting muscle atrophy, cachexic inflammation, and catabolic catastrophe were explored whether TNF-α antibody can antagonize these cachexic mechanisms. Stimulated with preliminary finding human antibody, infliximab or adalimumab, significantly inhibited TNF-α as well as their signals relevant to cachexia in mice, preemptive administration of 1.5 mg/kg adalimumab was done in C-26-induced cancer cachexia. Adalimumab significantly mitigated cancer cachexia manifested with significantly lesser weight loss, leg muscle preservation, and higher survival compared to cachexia control (p<0.05). Significant ameliorating action of muscle atrophy were accompanied significant decreases of muscle-specific UPS like atrogin-1/MuRF-1, Pax-7, PCG-1α, and Mfn-2 after adalimumab (p<0.01) and significantly attenuated lipolysis with inhibition of ATGL HSL, and MMPs. Cachexic factors including IL-6 expression, serum IL-6, gp130, IL-6R, JAK2, and STAT3 were significantly inhibited with adalimumab (p<0.01). Genes implicated in cachexic inflammation like NF-κB, c-Jun/c-Fos, and MAPKs were significantly repressed, while mTOR/AKT was significantly increased adalimumab (p<0.05). Conclusively, preemptive administration of adalimumab can be tried in high risk to cancer cachexia.     

Impact of weight loss on circulating IL-1, IL-6, IL-8, TNF-alpha, VEGF-A, VEGF-C and midkine in gastroesophageal cancer patients

OBJECTIVE: Proinflammatory cytokines are involved in cancer-related weight loss, but the involvement of VEGF-A, VEGF-C, IL-8 and midkine in gastroesophageal cancer patients remains unknown. DESIGN AND METHODS: Serum IL-1, IL-6, IL-8, TNF-alpha, VEGF-A, VEGF-C, and midkine were evaluated in 96 cancer patients and 42 controls using ELISAs and were related to the occurrence of weight loss, patient's age, gender and BMI, cancer TNM status and blood cell counts. RESULTS: All cytokines were elevated in cancer patients with further up-regulation of IL-6, IL-8, midkine and VEGF-A in cachexia. Underweight, midkine and VEGF-A were found independent indicators of weight loss. Primary tumor seems to be a major source of pro-cachectic cytokines, yet neutrophils and platelets also contribute to cytokine elevation. CONCLUSIONS: IL-6 and IL-8, and probably midkine and VEGF-A, appear to participate in the development of cancer-related cachexia in gastroesophageal malignancies, although a detailed mechanism underlying cytokine involvement needs to be elucidated.     

Use of complementary and alternative medicine therapies to control symptoms in women living with lung cancer

Complementary and alternative medicine (CAM) use by cancer patients, especially women, is increasing. However, CAM use among patients with lung cancer, who have been reported to have the highest symptom burden, is poorly documented. This study describes types and frequencies of specific CAM therapies used by women with lung cancer to manage symptoms, and examines differences in demographic and clinical characteristics between CAM users and non-CAM users. Participants included 189 women with non-small cell lung cancer and > or =1 of 8 symptoms. Six CAM therapies, used to control symptoms, were assessed, including herbs, tea, acupuncture, massage, meditation, and prayer. Forty-four percent (84 women) used CAM therapies, including prayer (34.9%), meditation (11.6%), tea (11.6%), herbs (9.0%), massage (6.9%), and acupuncture (2.6%). Complementary and alternative medicine use was greatest for difficulty breathing and pain (54.8% each), with prayer the most commonly used CAM for all symptoms. Significant differences (P < .05) were found for age (t = 2.24), symptom frequency (t = -3.02), and geographic location (chi = 7.51). Women who were younger, experienced more symptoms, and lived on the West Coast or South (vs Northeast) were more likely to use CAM. We found that CAM use is variable by symptom and may be an indicator of symptom burden. Our results provide important initial data regarding CAM use for managing symptoms by women with lung cancer.     

Indomethacin and ibuprofen preserve gastrocnemius muscle mass in mice bearing the colon-26 adenocarcinoma

Skeletal muscle wasting is a prominent feature of cancer cachexia and involves decreased muscle protein synthesis and increased activity of the ubiquitin-proteasome pathway of protein degradation. We report that both indomethacin and ibuprofen improved body weight and weight of the gastrocnemius muscle in tumor-bearing mice. Ibuprofen increased the soluble protein content of the muscle without affecting muscle levels of phosphorylated p70 S6 kinase, a ribosomal kinase involved in protein synthesis. Paradoxically, indomethacin increased levels of ubiquitin-conjugated proteins. Further study is needed to understand the mechanism of action by which indomethacin and ibuprofen preserve body weight and muscle mass in the tumor-bearing mice. The data suggest that ibuprofen may have beneficial effects in the treatment of cancer cachexia.     

术前肠内营养对胃底贲门癌病人术后康复的影响

目的研究术前肠内营养对胃底贲门癌病人术后康复的影响。方法回顾性研究2008年1月至2010年12月井冈山大学附属医院62例胃底贲门癌病人的临床资料,将62例胃底贲门癌病人随机分为两组,其中对照组31例,术后早期行肠内营养;治疗组31例,术前开始口服能全力,术后治疗同对照组。所有病人均于术前第1天及术后第7天测量体质量,静脉采血检测血清白蛋白和血红蛋白含量,并观察切口愈合情况。结果两组病人术后均有免疫功能降低,对照组2例出现切口液化感染,治疗组无切口液化感染,体质量减轻比率治疗组小于对照组,血清白蛋白和血红蛋白含量治疗组明显优于对照组。结论术前肠内营养能明显改善胃底贲门癌病人术后的营养状况,有利于病人术后康复。     

恩格列净、利拉鲁肽与二甲双胍治疗新发2型糖尿病合并非酒精性脂肪肝的临床疗效及对血清炎性因子、D-二聚体及肝功能的影响

目的比较恩格列净、利拉鲁肽和二甲双胍治疗新发2型糖尿病合并非酒精性脂肪肝(NAFLD)的临床疗效及对血清炎性因子、D-二聚体及肝功能的影响。方法前瞻性选取2018年2月至2019年8月长江大学附属仙桃市第一人民医院收治的126例新发2型糖尿病合并NAFLD患者,按照随机数字表法分为利拉鲁肽组、利格列汀组及二甲双胍组,各42例。利拉鲁肽组:皮下注射0.6 mg,1次/d(第1周),第2周开始及以后皮下注射1.2 mg,1次/d;恩格列净组:早上口服10 mg片剂,1次/d;二甲双胍组:口服0.5 g,进食或餐后服用,1次/d,疗程12周。比较治疗前、治疗12周后3组患者体重、体重指数(BMI)、血糖[空腹血糖(FPG),餐后2 h血糖(2 hPG)]、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(GGT)],血脂指标[胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)]及血清D-二聚体和炎性因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平;记录3组患者用药期间不良反应发生情况。结果治疗12周后,3组患者的体重、BMI、ALT、AST、GGT、FINS、HOMA-IR、FPG、2 hBG、TG、HbAlc、血清D-二聚体、CRP、IL-6及TNF-α水平均较治疗前明显降低,差异均有统计学意义(P<0.05),二甲双胍组、利拉鲁肽组的LDL-C和TC水平较治疗前均显著降低,差异均有统计学意义(P<0.05),而恩格列奈组治疗前后的LDL-C和TC水平比较,差异无统计学意义(P>0.05)。治疗12周后,3组间体重比较,差异无统计学意义(P>0.05),而恩格列净组、利拉鲁肽组的BMI、ALT、AST、GGT、FINS、HOMA-IR、FPG、2 hBG、TG、HbAlc、血清D-二聚体、CRP、IL-6及TNF-α均较二甲双胍组低,差异均有统计学意义(P<0.05);治疗12周后,利拉鲁肽组的TC和LDL水平低于恩格列奈组与二甲双胍组,差异有统计学意义(P<0.05);3组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论利拉鲁肽和恩格列净在控制新发2型糖尿病合并NAFLD患者血糖、降低体重和胰岛素抵抗、降低炎性因子水平、改善肝功能、预防血栓效果相当,均优于二甲双胍,但是恩格列净在改善血脂方面不如利拉鲁肽。     

缺血性心肌病患者血红蛋白水平、细胞因子、神经内分泌激素及左室功能的相关性研究

目的探讨缺血性心肌病（ICM）患者血红蛋白水平、细胞因子、神经内分泌激素及心功能变化的相关性。方法测定入选121例慢性充血性心力衰竭（CHF）患者的血红蛋白（Hb）水平、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和血管紧张素Ⅱ（AngⅡ）的变化;超声心动图测量左室射血分数（LVEF）,评价心功能;按Hb水平分为ICM贫血组和非贫血组,同时选择27例正常人作为对照组。结果ICM贫血组TNF-α、IL-6和AngⅡ水平明显高于非贫血组,而LVEF显著低于非贫血组（P〈0.01）;随着TNF-α、IL-6和AngⅡ水平升高,Hb和LVEF明显降低（P〈0.01）;ICM患者Hb水平和LVEF与TNF-α、IL-6和AngⅡ水平呈负相关,Hb水平与LVEF呈正相关（P〈0.01）。结论ICM患者神经内分泌激素和细胞因子激活影响并促进贫血与心力衰竭的病理生理过程。     

血液灌流联合连续性血液滤过治疗脓毒血症并急性肾损伤

目的评价采用中性树脂的血液灌流联合连续性血液滤过治疗脓毒血症合并急性肾损伤(AKI)的临床疗效及安全性。方法回顾性分析广州市第一人民医院2008年至2010年脓毒症合并AKI患者78例,其中联合治疗组(L组)32例,单纯血液滤过组(S组)46例。L组先行血液灌流治疗,再行血液滤过治疗,S组仅接受血液滤过治疗。2组患者分别于治疗前及治疗第24、48、72h监测APACHEⅡ评分、氧合指数(OI)、平均动脉压(MAP)、多巴胺用量(DA)、血肌酐水平(Scr)、C反应蛋白水平(CRP)、血清白介素-6(IL-6)和白介素-10(IL-10)水平、血红蛋白浓度(Hb)和血小板计数(Plt)。观察2组以上指标的变化。结果 L组患者均能耐受血液灌流治疗,无不良并发症发生。与治疗前比较,2组在治疗第24、48、72h时,其APACHEⅡ评分、DA、Scr、CRP及血清IL-6水平均显著下降(P<0.05),OI、MAP均明显上升(P<0.05)。在治疗第24、48、72h时,L组的APACHEⅡ评分、DA、Scr、CRP及血清IL-6水平均低于S组(P<0.05),而OI和MAP均高于S组(P<0.05),但2组间IL-10水平、血红蛋白浓度及血小板计数比较均无差异(P>0.05)。结论采用中性树脂的血液灌流联合连续性血液滤过可降低脓毒症患者APACHEⅡ评分、多巴胺用量、CRP及IL-6水平,提高OI及MAP,缩短患者ICU停留时间,而对30d生存率、IL-10水平、Hb浓度及Plt计数无影响。     

炎症因子与乳腺癌患者辅助放射治疗期间癌性疲劳的相关性

目的探讨炎症因子与乳腺癌患者辅助放射治疗期间癌性疲劳的相关性。方法选取术后辅助放射治疗的乳腺癌患者,按埃德蒙顿症状评估系统的疲劳评分将其分为疲劳组及观察组,比较2组血清炎症因子CRP、IL-6及可溶性肿瘤坏死因子受体2(sTNFR2)的差异;检测每位患者的疲劳相关炎症因子编码基因启动子的单核苷酸多态性,分析炎症因子相关基因分型与放射治疗结束时疲劳评分的相关性。结果共61例患者入组,其中疲劳组37例。观察组24例,癌性疲劳的发生率为60.6%。疲劳组伴有恶心、焦虑及厌食者较观察组多(P均<0.05)。疲劳组放射治疗后血清IL-6水平较治疗前高(P <0.001),观察组放射治疗前、后IL-6水平比较差异无统计学意义(P> 0.05)。IL-6水平与疲劳的发生呈正相关(r_s=0.51,P <0.001)。2组治疗前后CRP及sTNFR2水平比较差异均无统计学意义(P均> 0.05)。IL-6启动子编码基因IL6-174 GG基因分型的乳腺癌患者放射治疗结束时的疲劳评分高于CC基因分型患者(P=0.001)。结论血清IL-6水平及IL6-1...