不同类型心房颤动患者血清hs-CRP、IL-6水平及临床意义

目的探讨超敏C反应蛋白（high sensitive C-reactive protein,hs-CRP）、白细胞介素6（Interleukin-6,IL-6）在心房颤动（atrialfibrillation,Af）中的水平及临床意义。方法应用免疫法测定100例Af患者（Af组）血清hs-CRP、IL-6水平,与非Af患者（对照组）20例比较;并对Af按持续时间不同分组,进行统计学分析。结果Af组血清hs-CRP、IL-6水平明显高于对照组;持续性、永久性Af组hs-CRP、IL-6水平无显著性差异,但均高于阵发性Af组。结论血清hs-CRP、IL-6水平增高反映的炎症状态可能促进房颤发生和发展。     

急性胰腺炎患者检测血清PCT和CRP的临床意义

[目的]探讨急性胰腺炎患者检测血清降钙素原（PCT）和C-反应蛋白（CRP）水平的临床意义.[方法]选择86例急性胰腺炎患者,其中轻症急性胰腺炎（MAP）47例,重症急性胰腺炎（SAP） 39例,另选择35例健康体检者作为对照组.分别对急性胰腺炎患者及对照组进行血清PCT和CRP水平测定.[结果]MAP组和SAP组患者血清PCT及CRP水平均高于对照组（均P＜0.05）,SAP组患者同期PCT及CRP水平均高于MAP组（均P＜0.05）.[结论]监测血清PCT和CRP水平对急性胰腺炎患者病情严重程度和预后的评估具有重要的临床意义.     

血清IL-6、CRP、PCT水平对新生儿败血症的诊断价值

目的 探讨IL-6、C反应蛋白(CRP)、降钙素原(PCT)诊断新生儿败血症的价值.方法 选择临床诊断为败血症的患儿67例(观察组),另选同期无感染症状的30例新生儿作为对照组.采用ELISA双抗夹心法测定两组IL-6水平,固相免疫层析法半定量测定PCT水平,定量免疫速率比浊法测定CRP水平;以临床常用标准作为阳性诊断阈值,观察各指标诊断新生儿败血症敏感性、特异性、阳性预测值、阴性预测值及约登指数.以灵敏度为纵坐标,1-特异度为横坐标,分析ROC曲线,从而确定检测的最佳阈值.结果 IL-6的敏感性、特异性、阳性预测值、阴性预测值和约登指数及ROC曲线下的面积值均优于CRP和PCT.而三个指标联合诊断的敏感性优于各指标独立诊断.结论 IL-6对新生儿败血症有很好的临床诊断价值;疑诊新生儿败血症者应考虑多个指标联合应用,以提高诊断准确率.     

血清超敏C反应蛋白诊断急性重型胰腺炎的价值

准确而快速鉴定急性胰腺炎(AP)为轻型还是重型，对临床采取及时且针对性强的治疗措施有着重要指导作用。但AP分型比较困难，目前尚无客观的分型依据。我们收集了40例经临床检查确诊的AP患者，对其急性时相反应中变化最显著、最重要的超敏C反应蛋白(HS—CRP)、C反应蛋白(CRP)及参与触发CRP产生的白细胞介素—6(IL—6)进行了     

ACI患者血清hs-CRP、IL-6、IL-8、TNF-α水平检测及分析

目的 探讨急性脑梗死（ACI）患者血清超敏-C反应蛋白（hs-CRP）、IL-6、IL-8和TN-α水平变化及临床意义。方法 选择ACI患者90例（ACI组）及健康查体者30例,应用免疫比浊法测定血清hs-CRP水平,用ELISA法检测血清IL-6、IL-8和TNF-α水平。结果 ACI组血清hs-CRP、IL-6、IL-8和TNF-α水平均明显高于对照组,且随梗死体积增大及神经功能缺损程度评分增高而逐渐升高（P均〈0．05）。结论 ACI患者血清hs-CRP、IL-6、IL-8和TNF-α水平明显升高,并与脑梗死体积及神经功能缺损程度密切相关;临床可据此指导治疗并判断病情及预后。     

急性脑梗死患者血清IL-18、IL-6水平的变化及临床意义

目的观察急性脑梗死患者血清白细胞介素-18(interleukin-18,IL-18)、白细胞介素-6(interleukin-6,IL-6)水平变化,探讨炎症因子在脑梗死发病机制中的作用。方法采用ELISA法检测急性脑梗死患者(实验组)的血清IL-18和IL-6水平,并与32例健康对照组比较。结果急性脑梗死患者血清IL-18和IL-6水平为(168.30±27.42)pg/mL与(0.33±0.43)mg/mL,显著高于对照组(P<0.05)。结论急性脑梗死患者血清IL-18和IL-6水平明显升高,提示炎症反应参与了缺血性脑梗死的病理生理过程,早期炎症干预治疗可能有助于减轻脑组织缺血性损害,提高临床疗效。     

有机磷中毒患者血清hs-CRP、IL-6和TNF-α的变化及其临床意义

目的探讨急性有机磷中毒（AOPP）患者血清hs-CRP、IL-6和TNF-α水平变化及临床意义。方法选择AOPP患者80例,其中轻度中毒23例,中度中毒31例,重度中毒26例。采用免疫比浊法测定血清hs-CRP,利用酶联免疫吸附法测定血清IL-6 TNF-α水平,并以30例健康体检者作对照组。结果 AOPP组血清hs-CRP、IL-6、TNF-α水平明显高于对照组（P均〈0.05）,并且随着患者中毒程度的加重,血清hs-CRP、IL-6、TNF-α水平逐渐升高（P均〈0.05）。结论 AOPP患者存在过度的炎症反应,检测血清中hs-CRP、IL-6、TNF-α水平对评估AOPP患者的病情及其预后有重要作用。     

急性胰腺炎合并急性肺损伤与血清中IL-6变化的关联性研究

目的：探讨白细胞介素－6（IL－6）在急性胰腺炎合并急性肺损伤发生发展中的临床意义。方法入选患者96例,分为急性胰腺炎组62例及急性胰腺炎合并急性肺损伤组34例,以健康成人30名为对照组。采用放射免疫法测定血清中IL－6含量变化,进行统计学分析。结果急性胰腺炎组和急性胰腺炎合并急性肺损伤组IL－6值均高于对照组,急性胰腺炎合并急性肺损伤组高于急性胰腺炎组,差异均有统计学意义（ P＜0．05）。结论 IL－6作为炎症启动因子,参与急性胰腺炎合并肺损伤的病理生理过程。     

急性胰腺炎患者血清TNF-α、IL-6及IL-8水平测定及分析

目的 观察TNF-α、IL-6及IL-8在急性胰腺炎（AP）发病中的作用。方法 对60例AP患者（AP组）分别于入院时及治疗7d后抽取空腹肘静脉血,采用放射性免疫法检测血清及TNF-α、IL-6及IL-8水平,同时选择20例健康体检者作为对照组。结果 AP组入院时血清TNF-α、IL-6及IL-8水平均显著高于对照组,其中重症（SAP）者显著高于轻症（MAP）者（P均〈0．05）;治疗7d后AP组上述指标均明显低于入院时,其中SAP患者仍显著高于对照组（P均〈0．05）。结论TNF-α、IL-6及IL-8均与AP发生、发展密切相关;检测其血清水平有助于AP早期诊断、病情判断和疗效观察。     

高敏C-反应蛋白与白介素-6在急性冠状动脉综合征意义

目的 探讨急性冠状动脉综合征(acute coronary symptom,ACS)病人血清高敏C反应蛋白(high sensitivity-C reactive protein,hs-CRP)和白介素-6(interleukin-6,IL-6)浓度的变化及临床意义.方法 ACS组ACS病人60例,稳定型心绞痛(stable angina pectoris,SAP)组病人40例,对照组为40名健康人,检测血清IL-6、hs-CRP水平.结果 ACS组血清IL-6、hs-CRP水平明显高于SAP组和对照组(P＜0.01);ACS组中,急性心肌梗死病人又高于不稳定型心绞痛病人(P＜0.05);SAP组与对照组差异无统计学意义(P＜0.05);血清IL-6和hs-CRP水平呈正相关(r=0.5942,P＜0.01).结论 ACS病人血清IL-6和hs-CRP升高,其水平变化反映ACS的严重程度.     

慢性阻塞性肺疾病患者血清PCT、IL-6及CRP与BODE指数的相关性研究

目的探讨慢性阻塞性肺疾病患者血清中降钙素原(PTC)、白介素-6(IL-6)及C-反应蛋白(CRP)水平与BODE指数的相关性,为慢阻肺病情的判断和治疗提供参考。方法选择2014年12月-2015年10月在我院呼吸内科治疗的30例慢阻肺急性加重期病人作为A组,30例门诊随访的慢阻肺稳定期病人作为B组,另选30例健康者作为对照C组,收集三组研究对象的血液标本,比较血清PCT、IL-6和CRP的水平,分析其与BODE指数的相关性。结果健康对照组、慢阻肺稳定期组和慢阻肺急性加重期组的血清PCT和CRP水平两两组间比较差异显著,具有统计学意义(P0.05);B组和A组患者的血清IL-6分别与C组相比,差异显著,具有统计学意义(P0.05),B组和A组组间差异不显著,无统计学意义(P0.05);慢阻肺稳定期组和慢阻肺急性加重期组血清中PCT与相应的BODE指数显著正相关性(r=0.756,P=0.006和r=0.916,P=0.000),血清IL-6与BODE指数具有显著相关性(r=0.744,P=0.007和r=0.891,P=0.001),血清CRP与BODE指数具有显著相关性(r=0.681,P=0.009和r=0.712,P=0.008)。结论慢阻肺患者血清PTC、IL-6及CRP水平与BODE指数具有相关性,可以为病情分析提供参考价值,是评估慢阻肺病情及预后的敏感指标。     

Changes in serum interleukin-6 and high-sensitivity C-reactive protein levels in patients with acute coronary syndrome and their responses to simvastatin

The role of inflammation in acute coronary syndrome (ACS) and the mechanism by which statin treats ACS is explored. Serum high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) levels were measured in 50 patients with ACS [including 30 cases with unstable angina (UA) and 20 patients with acute myocardial infarction (AMI)], 34 patients with stable angina (SA), and 30 controls. Patients in the ACS group were randomly assigned to a simvastatin group (including a simvastatin AMI subgroup, n = 11 and a simvastatin UA subgroup, n = 14) and a routine group (including a routine AMI subgroup, n = 9 and a routine UA subgroup, n = 16). The simvastatin group was given simvastatin 20mg/day and the routine group a placebo. After a 3-week follow-up, serum hs-CRP, IL-6 levels, and serum lipid concentrations were measured again. Both serum IL-6 and hs-CRP levels were significantly higher in the ACS group (including the UA and AMI subgroups) than in the SA and control groups (P < 0.001). After 3 weeks of treatment with simvastatin, the serum IL-6, hs-CRP, total cholesterol, and low-density lipoprotein cholesterol levels were decreased significantly in the simvastatin group (P < 0.001), but no significant changes were observed in the routine group. No relationship was observed between the rate of decrease of serum IL-6 or hs-CRP and serum lipids levels. The hs-CRP level showed a significant correlation with IL-6 by Spearmans rank correlation analysis (P < 0.01). Inflammation plays an important role in the initiation of ACS. Simvastatin possesses an anti-inflammatory effect, independent of its lipid-lowering action, which may play an important role in the early treatment of ACS.     

急性胰腺炎血清sTNF-R、IFN-γ、IL-6、IL-8、NO、NOS水平与其严重程度的研究

目的　探讨急性胰腺炎 (AP)血清可溶性肿瘤坏死因子受体 (sTNF R)、γ 干扰素 (IFN γ)、白细胞介素 6(IL 6)、白细胞介素 8(IL 8)、一氧化氮 (NO)和一氧化氮合成酶 (NOS)的临床意义。方法　分为三组 ,轻症AP(MAP)组 ,重症AP(SAP)组和对照组。在发病 3天内取外周静脉血检测 ,同期测定对照组。结果　MAP组sTNF R、IFN γ、IL 6及IL 8水平明显高于对照组 (P <0 0 5 ) ,NO及NOS水平均略高于对照组 (P >0 0 5 ) ,SAP组所有因子均高于MAP组 (P <0 0 1,P <0 0 5 )。结论上述血清因子有助于判断AP严重程度和预后 ,具有积极的临床意义     

急性冠状动脉综合征患者白细胞介素-10及白细胞介素-6表达

目的:通过与C反应蛋白(CRP)检测对比,探讨抗炎因子白细胞介素(IL)-10、促炎因子IL-6与急性冠状动脉综合征(ACS)的关系。方法:冠心病患者78例,其中ACS患者40例(ACS组),稳定型心绞痛(SAP组)患者38例,33例胸痛综合征(CPS组)患者作为对照。所有患者均行冠状动脉造影检查。采用ELISA法检测血浆IL-6、IL-10水平,采用免疫比浊法测定CRP值。结果:与SAP组及CPS组相比,ACS组血浆IL-10水平明显降低,IL-6、CRP水平明显升高,差异有统计学意义;SAP组IL-10水平低于CPS组,IL-6、CRP水平高于CPS组,差异无统计学意义;血浆IL-10水平与IL-6及CRP水平呈负相关,IL-6水平与CRP水平正相关。结论:血浆IL-10水平降低和IL-6、CRP值升高对患者ACS的发生有预测价值。抗炎因子和促炎因子水平的失衡是导致斑块不稳定、急性冠状动脉事件发生的重要因素。     

Use of antibiotics in acute pancreatitis: ten major concerns

Abstract

Acute pancreatitis is one of the most common gastrointestinal causes for hospitalization. In 15–20% it evolves into severe necrotizing pancreatitis. Recent studies have shown no association between the initiation of antibiotic therapy in acute pancreatitis and severe outcomes such as organ failure, infection of pancreatic necrosis, extrapancreatic infections or mortality. Specific subgroups with predicted severe acute pancreatitis or both extensive sterile necrosis and persistent organ failure may benefit from prophylactic antibiotics. Local infection develops in 30% of patients with pancreatic necrosis and results in morbidity and mortality. Contrast enhanced computed tomography should be performed in all patients with acute pancreatitis who develop sepsis, organ failure or fail to improve. C-reactive protein is an independent predictor of severe acute pancreatitis. Procalcitonin is the most sensitive laboratory test for detection of pancreatic infection. Antibiotics do however play a large role in patients with suspected or confirmed infected pancreatic necrosis and extrapancreatic infections. In clinical practice most clinicians prescribe antibiotics in the first 3?days of acute pancreatitis which in turns lead to excessive, unjustified use of antibiotics. Deep knowledge of the recent guidelines combined with an individualized management based on right clinical judgment is a rationale approach of patients with acute pancreatitis.     

Relationship between somatostatin and interleukin-6: A cross-sectional study in patients with acute pancreatitis

Objectives

The aim of the analysis is to determine dynamic changes in somatostatin (SS) and interleukin-6 (IL-6) concentrations during in acute pancreatitis (AP).

心痛泰通过降低Lp-PLA2、IL-6、hs-CRP、LOX-1水平减轻兔动脉粥样硬化炎症反应

目的研究心痛泰对动脉粥样硬化兔血清脂蛋白相关磷脂酶A2(Lp-PLA2)、白细胞介素6(IL-6)以及主动脉组织高敏C反应蛋白(hs-CRP)和血凝素样氧化型低密度脂蛋白受体1(LOX-1)的影响。方法 120只日本大耳白兔随机分为空白组、模型组、心痛泰低剂量组、中剂量组、高剂量组和瑞舒伐他汀组。采用前瞻性研究,造模的同时予以相应药物灌胃。60天后采血,测定血清Lp-PLA2和IL-6水平;免疫组织化学法检测胸主动脉hs-CRP和LOX-1含量。结果心痛泰低剂量组、中剂量组和高剂量组血清Lp-PLA2和IL-6水平比模型组低(P0.01);与心痛泰低剂量组比较,心痛泰中剂量组和高剂量组、瑞舒伐他汀组血清Lp-PLA2和IL-6水平降低(P0.01或P0.05)。心痛泰中剂量组和高剂量组的hs-CRP和LOX-1表达水平比模型组低(P0.01);与心痛泰低剂量组比较,心痛泰中剂量组和高剂量组、瑞舒伐他汀组的hs-CRP和LOX-1表达水平降低(P0.05)。免疫组织化学染色显示,模型组主动脉内膜hs-CRP和LOX-1大量表达;与模型组比较,心痛泰低剂量组、中剂量组、高剂量组和瑞舒伐他汀组主动脉内膜hs-CRP和LOX-1表达减轻。结论心痛泰能降低动脉粥样硬化兔Lp-PLA2、IL-6、hs-CRP、LOX-1的水平,从而达到抗动脉粥样硬化炎症反应的作用。