不同亚型卒中患者血清基质金属蛋白酶-2含量及其意义

Objective To investigate the change of serum matix metalloproteinase-2(MMP-2) level and its significance in patients with acute ischemic stroke of different subtypes. Methods Seventy-seven patients with acute ischemic stroke were classified into large-artery atherosclerosis (LAA) (n =29, 37. 66% ), small artery occlusion (SAO, lacunar infarction) (n =23, 29.87%), cardioembolism (CE) (n = 13,16. 88%), stroke of undemonstrated etiology (SUE) (n = 7, 9.09% ), and stroke of other demonstrated etiology (SOE) (n = 5, 6. 49%) according to the TOAST criteria. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum MMP-2 in patients with acute ischemic stroke at 24 hours and 7 days, and they were compared with 42 controls. Results The serum MMP-2 levels at 24 hours and 7 days of the onset of symptoms in the acute ischemic stroke group according to the TOAST criteria were 189. 55 ±24.79 and 307.46 ±84. 16 ng/ml respectively, and they were all significantly higher than 159.76 ± 10. 32 ng/ml in the control group (all P <0.05). Among all the TOAST subtypes, SOE and SUE were not analyzed because of the small numbers of cases; among other subtypes, the serum MMP-2 levels at 24 hours of the onset of symptoms in the LAA, SAO and CE groups were 218. 60 ± 13.42,175.21 ±9.92, and 167.26 ±9.7 ng/ml respectively, and they were all significantly higher than those in the control group (all P < 0. 05); at day 7 of the onset of symptoms they were 404.75 ± 10. 30, 293.18 ± 10.91, and 211.81 ±11.14 ng/ml respectively, and they were also significantly higher than those in the control group (all P < 0.05). Among those, the LAA group was increased significantly (P < 0. 01). Conclusions The serum MMP-2 levels were increased in patients with acute cerebral infarction. "l'ne changes of the serum MMP-2 levels in each TOAST subtype group were different. The LAA group increased most significantly, which supported the different views of the etiology of cerebral infarction subtypes. The serum MMP-2 plays an important role in the process of cerebral infarction of the LAA type.     

不同亚型卒中患者血清基质金属蛋白酶-2含量及其意义

Objective To investigate the change of serum matix metalloproteinase-2(MMP-2) level and its significance in patients with acute ischemic stroke of different subtypes. Methods Seventy-seven patients with acute ischemic stroke were classified into large-artery atherosclerosis (LAA) (n =29, 37. 66% ), small artery occlusion (SAO, lacunar infarction) (n =23, 29.87%), cardioembolism (CE) (n = 13,16. 88%), stroke of undemonstrated etiology (SUE) (n = 7, 9.09% ), and stroke of other demonstrated etiology (SOE) (n = 5, 6. 49%) according to the TOAST criteria. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum MMP-2 in patients with acute ischemic stroke at 24 hours and 7 days, and they were compared with 42 controls. Results The serum MMP-2 levels at 24 hours and 7 days of the onset of symptoms in the acute ischemic stroke group according to the TOAST criteria were 189. 55 ±24.79 and 307.46 ±84. 16 ng/ml respectively, and they were all significantly higher than 159.76 ± 10. 32 ng/ml in the control group (all P <0.05). Among all the TOAST subtypes, SOE and SUE were not analyzed because of the small numbers of cases; among other subtypes, the serum MMP-2 levels at 24 hours of the onset of symptoms in the LAA, SAO and CE groups were 218. 60 ± 13.42,175.21 ±9.92, and 167.26 ±9.7 ng/ml respectively, and they were all significantly higher than those in the control group (all P < 0. 05); at day 7 of the onset of symptoms they were 404.75 ± 10. 30, 293.18 ± 10.91, and 211.81 ±11.14 ng/ml respectively, and they were also significantly higher than those in the control group (all P < 0.05). Among those, the LAA group was increased significantly (P < 0. 01). Conclusions The serum MMP-2 levels were increased in patients with acute cerebral infarction. "l'ne changes of the serum MMP-2 levels in each TOAST subtype group were different. The LAA group increased most significantly, which supported the different views of the etiology of cerebral infarction subtypes. The serum MMP-2 plays an important role in the process of cerebral infarction of the LAA type.     

不同亚型卒中患者血清基质金属蛋白酶-2含量及其意义

Objective To investigate the change of serum matix metalloproteinase-2(MMP-2) level and its significance in patients with acute ischemic stroke of different subtypes. Methods Seventy-seven patients with acute ischemic stroke were classified into large-artery atherosclerosis (LAA) (n =29, 37. 66% ), small artery occlusion (SAO, lacunar infarction) (n =23, 29.87%), cardioembolism (CE) (n = 13,16. 88%), stroke of undemonstrated etiology (SUE) (n = 7, 9.09% ), and stroke of other demonstrated etiology (SOE) (n = 5, 6. 49%) according to the TOAST criteria. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum MMP-2 in patients with acute ischemic stroke at 24 hours and 7 days, and they were compared with 42 controls. Results The serum MMP-2 levels at 24 hours and 7 days of the onset of symptoms in the acute ischemic stroke group according to the TOAST criteria were 189. 55 ±24.79 and 307.46 ±84. 16 ng/ml respectively, and they were all significantly higher than 159.76 ± 10. 32 ng/ml in the control group (all P <0.05). Among all the TOAST subtypes, SOE and SUE were not analyzed because of the small numbers of cases; among other subtypes, the serum MMP-2 levels at 24 hours of the onset of symptoms in the LAA, SAO and CE groups were 218. 60 ± 13.42,175.21 ±9.92, and 167.26 ±9.7 ng/ml respectively, and they were all significantly higher than those in the control group (all P < 0. 05); at day 7 of the onset of symptoms they were 404.75 ± 10. 30, 293.18 ± 10.91, and 211.81 ±11.14 ng/ml respectively, and they were also significantly higher than those in the control group (all P < 0.05). Among those, the LAA group was increased significantly (P < 0. 01). Conclusions The serum MMP-2 levels were increased in patients with acute cerebral infarction. "l'ne changes of the serum MMP-2 levels in each TOAST subtype group were different. The LAA group increased most significantly, which supported the different views of the etiology of cerebral infarction subtypes. The serum MMP-2 plays an important role in the process of cerebral infarction of the LAA type.     

不同亚型卒中患者血清基质金属蛋白酶-2含量及其意义

Objective To investigate the change of serum matix metalloproteinase-2(MMP-2) level and its significance in patients with acute ischemic stroke of different subtypes. Methods Seventy-seven patients with acute ischemic stroke were classified into large-artery atherosclerosis (LAA) (n =29, 37. 66% ), small artery occlusion (SAO, lacunar infarction) (n =23, 29.87%), cardioembolism (CE) (n = 13,16. 88%), stroke of undemonstrated etiology (SUE) (n = 7, 9.09% ), and stroke of other demonstrated etiology (SOE) (n = 5, 6. 49%) according to the TOAST criteria. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum MMP-2 in patients with acute ischemic stroke at 24 hours and 7 days, and they were compared with 42 controls. Results The serum MMP-2 levels at 24 hours and 7 days of the onset of symptoms in the acute ischemic stroke group according to the TOAST criteria were 189. 55 ±24.79 and 307.46 ±84. 16 ng/ml respectively, and they were all significantly higher than 159.76 ± 10. 32 ng/ml in the control group (all P <0.05). Among all the TOAST subtypes, SOE and SUE were not analyzed because of the small numbers of cases; among other subtypes, the serum MMP-2 levels at 24 hours of the onset of symptoms in the LAA, SAO and CE groups were 218. 60 ± 13.42,175.21 ±9.92, and 167.26 ±9.7 ng/ml respectively, and they were all significantly higher than those in the control group (all P < 0. 05); at day 7 of the onset of symptoms they were 404.75 ± 10. 30, 293.18 ± 10.91, and 211.81 ±11.14 ng/ml respectively, and they were also significantly higher than those in the control group (all P < 0.05). Among those, the LAA group was increased significantly (P < 0. 01). Conclusions The serum MMP-2 levels were increased in patients with acute cerebral infarction. "l'ne changes of the serum MMP-2 levels in each TOAST subtype group were different. The LAA group increased most significantly, which supported the different views of the etiology of cerebral infarction subtypes. The serum MMP-2 plays an important role in the process of cerebral infarction of the LAA type.     

不同亚型卒中患者血清基质金属蛋白酶-2含量及其意义

Objective To investigate the change of serum matix metalloproteinase-2(MMP-2) level and its significance in patients with acute ischemic stroke of different subtypes. Methods Seventy-seven patients with acute ischemic stroke were classified into large-artery atherosclerosis (LAA) (n =29, 37. 66% ), small artery occlusion (SAO, lacunar infarction) (n =23, 29.87%), cardioembolism (CE) (n = 13,16. 88%), stroke of undemonstrated etiology (SUE) (n = 7, 9.09% ), and stroke of other demonstrated etiology (SOE) (n = 5, 6. 49%) according to the TOAST criteria. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum MMP-2 in patients with acute ischemic stroke at 24 hours and 7 days, and they were compared with 42 controls. Results The serum MMP-2 levels at 24 hours and 7 days of the onset of symptoms in the acute ischemic stroke group according to the TOAST criteria were 189. 55 ±24.79 and 307.46 ±84. 16 ng/ml respectively, and they were all significantly higher than 159.76 ± 10. 32 ng/ml in the control group (all P <0.05). Among all the TOAST subtypes, SOE and SUE were not analyzed because of the small numbers of cases; among other subtypes, the serum MMP-2 levels at 24 hours of the onset of symptoms in the LAA, SAO and CE groups were 218. 60 ± 13.42,175.21 ±9.92, and 167.26 ±9.7 ng/ml respectively, and they were all significantly higher than those in the control group (all P < 0. 05); at day 7 of the onset of symptoms they were 404.75 ± 10. 30, 293.18 ± 10.91, and 211.81 ±11.14 ng/ml respectively, and they were also significantly higher than those in the control group (all P < 0.05). Among those, the LAA group was increased significantly (P < 0. 01). Conclusions The serum MMP-2 levels were increased in patients with acute cerebral infarction. "l'ne changes of the serum MMP-2 levels in each TOAST subtype group were different. The LAA group increased most significantly, which supported the different views of the etiology of cerebral infarction subtypes. The serum MMP-2 plays an important role in the process of cerebral infarction of the LAA type.     

不同亚型卒中患者血清基质金属蛋白酶-2含量及其意义

Objective To investigate the change of serum matix metalloproteinase-2(MMP-2) level and its significance in patients with acute ischemic stroke of different subtypes. Methods Seventy-seven patients with acute ischemic stroke were classified into large-artery atherosclerosis (LAA) (n =29, 37. 66% ), small artery occlusion (SAO, lacunar infarction) (n =23, 29.87%), cardioembolism (CE) (n = 13,16. 88%), stroke of undemonstrated etiology (SUE) (n = 7, 9.09% ), and stroke of other demonstrated etiology (SOE) (n = 5, 6. 49%) according to the TOAST criteria. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum MMP-2 in patients with acute ischemic stroke at 24 hours and 7 days, and they were compared with 42 controls. Results The serum MMP-2 levels at 24 hours and 7 days of the onset of symptoms in the acute ischemic stroke group according to the TOAST criteria were 189. 55 ±24.79 and 307.46 ±84. 16 ng/ml respectively, and they were all significantly higher than 159.76 ± 10. 32 ng/ml in the control group (all P <0.05). Among all the TOAST subtypes, SOE and SUE were not analyzed because of the small numbers of cases; among other subtypes, the serum MMP-2 levels at 24 hours of the onset of symptoms in the LAA, SAO and CE groups were 218. 60 ± 13.42,175.21 ±9.92, and 167.26 ±9.7 ng/ml respectively, and they were all significantly higher than those in the control group (all P < 0. 05); at day 7 of the onset of symptoms they were 404.75 ± 10. 30, 293.18 ± 10.91, and 211.81 ±11.14 ng/ml respectively, and they were also significantly higher than those in the control group (all P < 0.05). Among those, the LAA group was increased significantly (P < 0. 01). Conclusions The serum MMP-2 levels were increased in patients with acute cerebral infarction. "l'ne changes of the serum MMP-2 levels in each TOAST subtype group were different. The LAA group increased most significantly, which supported the different views of the etiology of cerebral infarction subtypes. The serum MMP-2 plays an important role in the process of cerebral infarction of the LAA type.     

不同亚型卒中患者血清基质金属蛋白酶-2含量及其意义

Objective To investigate the change of serum matix metalloproteinase-2(MMP-2) level and its significance in patients with acute ischemic stroke of different subtypes. Methods Seventy-seven patients with acute ischemic stroke were classified into large-artery atherosclerosis (LAA) (n =29, 37. 66% ), small artery occlusion (SAO, lacunar infarction) (n =23, 29.87%), cardioembolism (CE) (n = 13,16. 88%), stroke of undemonstrated etiology (SUE) (n = 7, 9.09% ), and stroke of other demonstrated etiology (SOE) (n = 5, 6. 49%) according to the TOAST criteria. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum MMP-2 in patients with acute ischemic stroke at 24 hours and 7 days, and they were compared with 42 controls. Results The serum MMP-2 levels at 24 hours and 7 days of the onset of symptoms in the acute ischemic stroke group according to the TOAST criteria were 189. 55 ±24.79 and 307.46 ±84. 16 ng/ml respectively, and they were all significantly higher than 159.76 ± 10. 32 ng/ml in the control group (all P <0.05). Among all the TOAST subtypes, SOE and SUE were not analyzed because of the small numbers of cases; among other subtypes, the serum MMP-2 levels at 24 hours of the onset of symptoms in the LAA, SAO and CE groups were 218. 60 ± 13.42,175.21 ±9.92, and 167.26 ±9.7 ng/ml respectively, and they were all significantly higher than those in the control group (all P < 0. 05); at day 7 of the onset of symptoms they were 404.75 ± 10. 30, 293.18 ± 10.91, and 211.81 ±11.14 ng/ml respectively, and they were also significantly higher than those in the control group (all P < 0.05). Among those, the LAA group was increased significantly (P < 0. 01). Conclusions The serum MMP-2 levels were increased in patients with acute cerebral infarction. "l'ne changes of the serum MMP-2 levels in each TOAST subtype group were different. The LAA group increased most significantly, which supported the different views of the etiology of cerebral infarction subtypes. The serum MMP-2 plays an important role in the process of cerebral infarction of the LAA type.     

不同亚型卒中患者血清基质金属蛋白酶-2含量及其意义

Objective To investigate the change of serum matix metalloproteinase-2(MMP-2) level and its significance in patients with acute ischemic stroke of different subtypes. Methods Seventy-seven patients with acute ischemic stroke were classified into large-artery atherosclerosis (LAA) (n =29, 37. 66% ), small artery occlusion (SAO, lacunar infarction) (n =23, 29.87%), cardioembolism (CE) (n = 13,16. 88%), stroke of undemonstrated etiology (SUE) (n = 7, 9.09% ), and stroke of other demonstrated etiology (SOE) (n = 5, 6. 49%) according to the TOAST criteria. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum MMP-2 in patients with acute ischemic stroke at 24 hours and 7 days, and they were compared with 42 controls. Results The serum MMP-2 levels at 24 hours and 7 days of the onset of symptoms in the acute ischemic stroke group according to the TOAST criteria were 189. 55 ±24.79 and 307.46 ±84. 16 ng/ml respectively, and they were all significantly higher than 159.76 ± 10. 32 ng/ml in the control group (all P <0.05). Among all the TOAST subtypes, SOE and SUE were not analyzed because of the small numbers of cases; among other subtypes, the serum MMP-2 levels at 24 hours of the onset of symptoms in the LAA, SAO and CE groups were 218. 60 ± 13.42,175.21 ±9.92, and 167.26 ±9.7 ng/ml respectively, and they were all significantly higher than those in the control group (all P < 0. 05); at day 7 of the onset of symptoms they were 404.75 ± 10. 30, 293.18 ± 10.91, and 211.81 ±11.14 ng/ml respectively, and they were also significantly higher than those in the control group (all P < 0.05). Among those, the LAA group was increased significantly (P < 0. 01). Conclusions The serum MMP-2 levels were increased in patients with acute cerebral infarction. "l'ne changes of the serum MMP-2 levels in each TOAST subtype group were different. The LAA group increased most significantly, which supported the different views of the etiology of cerebral infarction subtypes. The serum MMP-2 plays an important role in the process of cerebral infarction of the LAA type.     

不同亚型卒中患者血清基质金属蛋白酶-2含量及其意义

Objective To investigate the change of serum matix metalloproteinase-2(MMP-2) level and its significance in patients with acute ischemic stroke of different subtypes. Methods Seventy-seven patients with acute ischemic stroke were classified into large-artery atherosclerosis (LAA) (n =29, 37. 66% ), small artery occlusion (SAO, lacunar infarction) (n =23, 29.87%), cardioembolism (CE) (n = 13,16. 88%), stroke of undemonstrated etiology (SUE) (n = 7, 9.09% ), and stroke of other demonstrated etiology (SOE) (n = 5, 6. 49%) according to the TOAST criteria. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum MMP-2 in patients with acute ischemic stroke at 24 hours and 7 days, and they were compared with 42 controls. Results The serum MMP-2 levels at 24 hours and 7 days of the onset of symptoms in the acute ischemic stroke group according to the TOAST criteria were 189. 55 ±24.79 and 307.46 ±84. 16 ng/ml respectively, and they were all significantly higher than 159.76 ± 10. 32 ng/ml in the control group (all P <0.05). Among all the TOAST subtypes, SOE and SUE were not analyzed because of the small numbers of cases; among other subtypes, the serum MMP-2 levels at 24 hours of the onset of symptoms in the LAA, SAO and CE groups were 218. 60 ± 13.42,175.21 ±9.92, and 167.26 ±9.7 ng/ml respectively, and they were all significantly higher than those in the control group (all P < 0. 05); at day 7 of the onset of symptoms they were 404.75 ± 10. 30, 293.18 ± 10.91, and 211.81 ±11.14 ng/ml respectively, and they were also significantly higher than those in the control group (all P < 0.05). Among those, the LAA group was increased significantly (P < 0. 01). Conclusions The serum MMP-2 levels were increased in patients with acute cerebral infarction. "l'ne changes of the serum MMP-2 levels in each TOAST subtype group were different. The LAA group increased most significantly, which supported the different views of the etiology of cerebral infarction subtypes. The serum MMP-2 plays an important role in the process of cerebral infarction of the LAA type.     

Effect of early administration of exogenous basic fibroblast growth factor on acute edematous pancreatitis in rats

AIM: To observe the therapeutic effect of early administration of exogenous Basic fibroblast growth factor (bFGF) on acute edematous pancreatitis (AEP) in rats. METHODS: Thirty male Sprague-Dawley rats were randomly divided into three (n = 10): normal control group (groupⅠ), AEP group (groupⅡ) and AEP with bFGF treatment group (groupⅢ). AEP was induced by subcutaneous injection of cerulein (5.5μg/kg and 7.5μg/kg) at 1 h interval into rats of groupsⅡandⅢ. Three hours after induction of AEP, 100μg/kg bFGF was administrated intraperitoneally for 1h to groupⅢrats. For test of DNA synthesis in acinar cells, 5-bromo-2'-deoxyuridine (BrdU) labeling solution was intraperitoneally injected into the rats of groupsⅡandⅢ24 h after bFGF treatment. The changes in serum amylase, lipase, pancreatic tissue wet/dry ratio were detected. RESULTS: In bFGF treatment group, there was a significant decrease in the volume of serum amylase, lipase and the pancreatic wet/dry weight ratio(1383.0±94.6 U/L, 194.0±43.6 U/L, 4.32±0.32) compared to AEP group (3464±223.7 U/L, 456±68.7 U/L, 6.89±0.47) (P < 0.01), and no significant difference was found between bFGF treatment and control group (1289±94.0 U/L, 171±23.4 U/L, 4.12±0.26, P > 0.05). The inflammatory changes such as interstitial edema, polymorphonuclear neutrophils (PMNs) and vacuolization were significantly ameliorated compared to AEP group (P < 0.01). A small number of BrdU-labeled nuclei were observed in acinar cells of AEP rats (1.8±0.3 nuclei/microscopic field, n = 10) while diffuse BrdU-labeled nuclei were found in bFGF-treated rats (18.9±1.4 nuclei/microscopic field, n = 10) {P < 0.01). Immunohistochemical study showed increased DNA synthesis in pancreatic acinar cells. CONCLUSION: Early administration of exogenous bFGF has significant therapeutic effect on cerulein-induced acute edematous pancreatitis in rats. Its mechanism is related to the amelioration of inflammation and facilitation of pancreatic regeneration.     

不同亚型卒中患者血清基质金属蛋白酶-2含量及其意义

目的 探讨不同亚型急性缺血性卒中患者血清基质金属蛋白酶-2(matrixmetaUoproteinase-2,MMP-2)含量的变化及其意义.方法 77例急性缺血性卒中患者按照TOAST标准进行病因学分型,大动脉粥样硬化性卒中(large-artery atherosclerosis,LAA)29例(37.66%),小动脉闭塞性卒中(small artery occlusion,sAO)23例(29.87%),心源性脑栓塞(cardioembolism,CE)13例(16.88%),原因不明的缺血性卒中(stroke ofundemomtrated etiology,SUE)7例(9.09%),其他确定原因引发的缺血性卒中(stroke ofother demonstrated etiology,SOE)5例(6.49%).用酶联免疫吸附试验(enzyme-1inked immtmosorbent assay,ELISA)检测急性缺血性卒中患者发病后24 h和7 d时血清MMP-2含量,并与42例对照者进行比较.结果 TOAST病因分型急性缺血性卒中组患者发病后24 h和7d血清MMP-2水平分别为(189.55±24.79)和(307.46±84.16)ng/ml,均显著高于对照组的(159.76 ±10.32)ng/ml(P均<0.05).在TOAST各亚型中,SOE和SUE因例数过少未做分析;在其他各型中,LAA、SAO和CE组发病后24 h血清MMP-2水平分别为(218.60±13.42)、(175.21 ±9.92)和(167.26±9.7)ng/ml,均显著高于对照组(P均<0.05);发病7d时分别为(404.75±10.30)、(293.18 ±10.91)和(211.81±11.14)ng/ml,也均显著高于对照组(P均<0.05).其中,以LAA组增高显著(P<0.01).结论 急性脑梗死患者血清MMP-2水平增高,TOAST各亚型患者组MMP-2水平变化不同,LAA组升高最显著,支持脑梗死亚型的病因不同的论点,血清MMP-2在LAA型脑梗死发病过程中起着重要作用.     

依达拉奉对急性脑梗死患者自由基清除的临床研究

目的 探讨依达拉奉清除自由基治疗急性脑梗死的临床疗效.方法 脑梗死患者60例,随机分为治疗组和对照组,两组均常规脱水、降颅压、控制血压等,治疗组用生理盐水250 ml+依达拉奉30 mg静脉滴注,2次/d,连续使用14 d;对照组用生理盐水250 ml,静脉滴注,2次/d,连续使用14d.两组分别于治疗前和治疗后第14 d进行神经功能缺失程度和日常生活活动能力评分(ADL),测定血清超氧化物歧化酶(SOD).结果 治疗组与对照组比较,治疗第14天患者的神经功能缺失程度[(7.5±5.4)分与(15.9±7.9)分,P＜0.05]、ADL得分[(58.32±11.57)分与(43.73±12.48)分,P＜0.05]和血清SOD[(157.25±21.81)mmol/L与(127.08±13.14)mmol/L,P＜0.05]都得到改善,差异均有统计学意义.结论 依达拉奉治疗急性脑梗死可以提高机体清除自由基能力,促进神经功能恢复.     

简易腹腔灌洗联合早期血液滤过治疗重症急性胰腺炎

目的 探讨简易腹腔灌洗联合早期血液滤过治疗重症急性胰腺炎(SAP)的临床效果.方法 以腹腔穿刺针穿刺入腹腔,连接三通管,滴入生理盐水1000 ml,然后排出,如此反复3次.之后滴入利多卡因、地塞米松及抗生素,每日一次,直至灌洗液由血性变清亮.同时行床旁血液滤过.结果 按随机数字表法将61例SAP患者分为腹腔灌洗+血液滤过组(治疗组,31例)和对照组(30例).治疗组腹痛缓解、腹胀缓解、恶心呕吐消失及腹膜刺激征消失天数分别为(1.5±0.3)d、(2.7±0.3)d、(1.9±0.3)d、(1.5±0.2)d,住院天数为(11.0±2.0)d,显著短于对照组的(3.9±0.3)d、(4.5±0.6)d、(3.7±0.2)d、(5.3±0.4)d、(18.0±2.5)d(P值均＜0.05).治疗组治疗后1 d起,血ALT及AST浓度较对照组显著下降;3 d起血、尿淀粉酶及TNF-α、IL-6、IL-8含量较对照组显著下降,血HCO3-、IL-10含量显著增高(P＜0.05或＜0.01);5 d起血尿素氮、肌酐含量较对照组显著下降(P＜0.05).结论 腹腔灌洗联合早期血液滤过能及时清除炎性因子,对于SAP的治疗更合理、有效.     

人白介素-10基因转染对大鼠脑缺血再灌注损伤半影区炎性因子基因和蛋白表达的影响

目的 观察人白介素(IL)-10基因转染对大鼠局灶脑缺血再灌注损伤半影区肿瘤坏死因子-α(TNF-α)和白介素-1β(IL-1β)基因和蛋白表达的影响. 方法 建立大脑中动脉栓塞(MCAO)模型,采用立体定向脑室内注射的方式进行转染,逆转录-聚合酶链式反应(RT-PCR)和酶联免疫吸附实验(ELISA)检测其转染效果,氯化三苯四氮唑(TTC)染色测定脑梗死体积,荧光实时定量PCR检测半影区TNF-α和IL-1β基因表达情况,ELISA法检测半影区TNF-α和IL-1β蛋白的含量.结果 正常对照组、缺血对照组、空质粒组和IL-10基因转染组半影区TNF-α蛋白含量分别为(0.66±0.04)、(1.16±0.26)、(1.15±0.26)ng/g和(0.84±0.05)ng/g,IL-1β蛋白含量分别为(0.37±0.05)、(1.25±0.39)、(1.21±0.58)ng/g和(0.62±0.05)ng/g.与正常对照组比较,其余各组TNF-α和IL-1β蛋白含量明显升高(P＜0.01),而IL-10基因转染组TNF-α和IL一1β含量则较缺血对照组和空质粒组显著降低(P＜0.01);正常对照组,缺血对照组、空质粒组和IL-10基因转染组半影区TNF-αmRNA的表达量分别为1.00±0.53、9.42±1.83、9.69±1.96和3.53±1.09;IL-1βmRNA的表达量分别为1.00±0.51、27.81±4.84、23.96±4.90和13.55±4.45.与正常对照组比较,其余各组TNF-α和IL-1βmRNA表达量明显升高(P＜0.01),而IL-10基因转染组TNF-α和IL-1βmRNA表达量则较缺血对照组和空质粒组显著降低(P＜0.01). 结论 人IL-10基因转染后能抑制大鼠局灶脑缺血再灌注损伤半影区TNF-α和IL-1β基因和蛋白的表达,可能是其发挥缺血脑保护作用的机制之一.     

腺相关病毒介导的血管内皮生长因子基因与骨髓间充质干细胞联合治疗大鼠肢体缺血的研究

目的 探讨腺相关病毒(rAAV)介导的人血管内皮生长因子(VEGF)165基因转染大鼠骨髓间充质干细胞(MSC)移植对血管新生的影响.比较单纯干细胞移植与联合基因治疗的疗效.方法 全骨髓培养法提取培养MSC;rAAV-VEGF165转染MSC中,酶联免疫吸附试验(ELISA)及反转录-聚合酶链反应(RT-PCR)检测VEGF的表达;以近交系大鼠建立骨骼肌缺血模型,40只大鼠随机分为4组,每组10只.对照组注射磷酸盐缓冲液(PBS);干细胞组移植等量MSC,转染术后7 d组和转染术后10 d组分别于结扎7 d和10 d后的缺血区移植转染VEGF基因的MSC,移植6周后做Ⅷ因子染色检测血管新生情况.结果成功培养出MSC,免疫组化CD44阳性表达,CD34阴性表达;流式细胞术CD90阳性表达.在转染rAAV-VEGF165后转染组1、3、5、7、9 d上清液中VEGF165分泌水平分别为(131.98±6.00)、(263.96±4.58)、(540.85±5.97)、(208.98±5.06)、(174.45±5.00)ng/L,明显高于未转染组的(68.72±1.99)、(76.47±4.98)、(89.86±1.99)、(84.93±8.97)、(68.71±5.98)ng/L[t值分别为14.14、51.16、79.28、27.56、26.07,(均P＜0.05)],且5 d时达到高峰,此后表达开始下降.琼脂糖凝胶电泳可见在579 bp处见到高亮度条带,证明rAAV-VEGF165成功转染进MSC细胞中.转染后的生长曲线及细胞形态较未转染组无明显变化.Ⅷ因子染色示转染术后10 d组动物缺血区毛细血管密度[(9.35±2.72)条/视野]明显高于对照组[(1.05±0.50)条/视野]和干细胞组[(3.10±1.43)条/视野](均P＜0.01),较转染术后7 d组[(6.95±1.69)条/视野]亦有一定程度的升高(P＜0.05).结论 MSC有利于VEGF基因的稳定表达,可作为VEGF基因的良好细胞载体,且联合应用效果高于单独移植MSC,移植最佳时间为术后10 d.     

白细胞介素-1β和10的全身水平与冠状动脉粥样硬化病变局部水平的关系及其临床意义

目的 观察冠心病患者促炎因子白细胞介素(IL)-1β和抑炎因子IL-10的全身水平与病变局部水平的关系.方法 入选慢性稳定性心绞痛(SA)、不稳定性心绞痛/非ST段抬高型心肌梗死(UA/NSTEMI)、ST段抬高型心肌梗死(STEMI)和拟诊冠心病但冠状动脉造影正常者(对照组)各30例.在所有患者(n=120)的主动脉根部(代表全身水平)、冠状动脉疾病患者(n=90)的冠状动脉病变以远和14例STEMI患者的冠状静脉窦取血,采用ELISA法检测IL-1β和II-10水平,并比较IL-1 β和IL-10全身水平和病变局部水平.结果 对照组、SA、UA/NSTEMI和STEMI组全身IL-1 β水平分别为lg-1(0.97±0.42)、lg-1(0.98±0.43)、lg-11.21±0.42)和lg-1(1.30±0.43)ng/L,UA/NSTEMI和STEMI组均明显高于对照组(P＜0.05,P＜0.01);IL-10水平分别为lg-1(0.77±0.29)、lg-1(0.73±0.45)、lg-1(0.75±0.35)和lg-1(1.14±0.36)ng/L,STEMI组IL-10水平高于对照组(P＜0.01).SA组粥样硬化病变以远IL-1β和IL-10水平分别为lg-1(0.98±0.41)和lg-1(0.67±0.47)ng/L,与全身水平比较差异无统计学意义;UA/NSTEMI组粥样硬化病变以远IL-1 β和IL-10水平分别为lg-1(1.22±0.48)和lg-1(0.89±0.46)ng/L,IL-10血浆浓度高于全身水平(P=0.024),IL-1β水平差异无统计学意义;STEMI组罪犯病变以远IL-1β和IL-10水平分别为lg-1(1.45±0.45)和lg-1(1.35±0.31)ng/L,均高于全身水平(P均＜0.01).左冠状动脉急性闭塞的STEMI患者的全身、冠状动脉内病变以远和冠状静脉窦的IL-1β水平分别为lg-1(1.47±0.37)、lg-1(1.65±0.34)和lg-1(1.53±0.35)ng/L,IL-10水平分别为lg-1(1.06±0.48)、lg-1(1.34±0.39)和lg-1(1.34±0.23)ng/L.冠状静脉窦IL-1β水平显著低于罪犯病变以远水平(P＜0.05),而IL-10水平差异无统计学意义.结论 促炎因子IL-1β和抑炎因子IL-10的全身水平可能不能完全真实反映动脉粥样硬化病变局部的炎症活动程度.

Abstract：

Objective To compare the systemic and local near atherosclerosis lesion levels of proinflammatory factor interleukin-1β (IL-1β) and anti-inflammatory factor IL-10 in patients with coronary artery disease (CAD). Methods Plasma samples were collected from 30 individuals without angiographical coronary artery stenosis (control group), 90 patients with CAD (stable angina pectoris, SA, n = 30,unstable angina pectoris/non-ST-segment elevation myocardial infarction, UA/NSTEMI, n = 30 and ST-segment elevation myocardial infarction, STEMI, n = 30). During diagnostic coronary angiography or interventional procedures, systemic samples were obtained from aorta root in all patients (n = 120), local samples from distal of the coronary lesion in patients with CAD (n = 90), and samples from coronary sinus of 14 patients with STEMI. IL-1β and IL-10 were determined by ELISA method. Results The result showed systemic levels of IL-1β were lg-1 (0. 97 ±0. 42), lg-1 (0. 98 ±0. 43), lg-1 ( 1.21 ±0. 42), lg-1 ( 1.30 ±0. 43)ng/L in the control, SA,UA/NSTEMI and STEMI groups, were significantly higher in UA/NSTEMI and STEMI groups compared with the control group (P ＜ 0. 05, P ＜0. 01 ); systemic IL-10 levels were lg-1 (0. 77 ± 0. 29), lg - 1 (0. 73 ± 0. 45 ), lg- 1 (0. 75 ± 0. 35 ), lg- 1 ( 1.14 ± 0. 36) ng/L in the four groups and was significantly higher in STEMI group than the control group ( P ＜ 0. 01 ). The local concentration of IL-1β and IL-10 were similar as the systemic levels in SA group [lg-1 (0.98 ±0.41 ), lg-1 (0.67 ±0.47)ng/L], local IL-1β [lg-1 ( 1.22 ±0. 48) ng/L] was similar while local IL-10 [lg-1 (0. 89 ±0. 46) ng/L]was significantly higher than the systemic levels in UA/NSTEMI group. The local levels of IL-1β and IL-10 [lg-1 ( 1.45 ±0. 45), lg-1 ( 1.35 ±0. 31 ) ng/L] were both significantly higher than the systemic levels in STEMI group ( all P ＜ 0. 01 ). The IL-1β levels of systemic, local and coronary sinus in STEMI patients with acute totally occluded left coronary artery [lg-1 ( 1.47 ± 0. 37 ), lg- 1 ( 1.65 ± 0. 34), lg- 1 ( 1.53 ± 0. 35 )ng/L] and the IL-10 levels [lg-1 ( 1.06 ± 0. 48 ), lg- 1 ( 1.34 ± 0. 39 ), lg-1 ( 1.34 ± 0. 23 ) ng/L] were similar. The level of IL-1β in coronary sinus was significantly lower than in culprit lesion (P＜0. 05) while IL-10 levels were similar at these two sites ( P ＞ 0. 05 ). Conclusion The systemic level of pro-inflammatory marker IL-I β and anti-inflammatory marker IL-10 could not rehably reflect the local inflammatory status near the atherosclerosis plaque locations.     

重组人脑利钠肽和硝普钠治疗老年人慢性充血性心力衰竭急性期的疗效对照研究

目的 比较重组人脑利钠肽(rhBNP)和硝普钠治疗老年人慢性充血性心力衰竭(CHF)急性期的临床疗效,对心功能、血清脑利钠肽(BNP)、去甲肾上腺素(NE)、内皮素-1(ET-1)及抗利尿激素(ADH)水平的影响.方法 89例年龄65～85岁的CHF急性期患者随机分为rhBNP组(47例)和硝普钠组(42例),观察两组患者治疗前、后的临床疗效、心功能的变化和血清BNP、NE、ET-1及ADH水平的变化.结果 rhBNP组显效率51.1%(24例),总有效率95.7%(45例),均高于硝普钠组,分别为26.2%(11例)及66.7%(28例),差异有统计学意义(P＜0.05和P＜0.01);无效率4.3%(2例),低于硝普钠组33.3%(14例),差异有统计学意义(P＜0.01);rhBNP组死亡1例,硝普钠组死亡3例;rhBNP组治疗后2周左心室射血分数值较治疗前升高,分别为(46.2±9.5)%与(38.1±6.0)%,差异有统计学意义(P＜0.05);rhBNP组治疗后2周血清BNP水平较硝普钠组下降(P＜0.05);rhBNP组治疗后24 h及治疗后2周血清BNP、NE均较基线值下降(P＜0.01),治疗后2周较治疗后24 h进一步降低(P＜0.01);rhBNP组治疗后2周血清ET-1水平较硝普钠组下降(P＜0.05),rhBNP组治疗后24 h血清ET-1与基线值比较差异无统计学意义(P＞0.05),但治疗后2周较基线值及治疗后24 h下降(均P＜0.01);两组治疗前、治疗后24 h及治疗后2周血清ADH水平比较差异均无统计学意义(P＞0.05),rhBNP组发生头痛2例(4.3%),低血压7例(14.9%),均低于硝普钠组[分别为8例(19.0%)及10例(23.8%)],差异有统计学意义(P＜0.05).结论 rhBNP能明显改善CHF急性期患者心室收缩功能,拮抗神经-内分泌激素的过度激活,可安全、有效用于老年CHF患者急性期的治疗.

Abstract：

Objective To compare the curative effects between recombinant human brain natriuretic peptide (rhBNP) and sodium nitroprusside in treatment of the acute attack of elderly patients with chronic heart failure (CHF), and probe the impacts of rhBNP on the heart function,serum B-type natriuretic peptide (BNP), norepinephrine (NE), endothelin 1 (ET-1) and antidiuretic hormone (ADH) levels. Methods The 89 patients aged 65-85 years at acute attack stage of CHF were randomized into two therapy groups: rhBNP group (n= 47) and sodium nitroprusside group (n=42). The clinical effects, heart function, serum BNP, NE, ET-1 and ADH changes were observed before and after the treatment. Results After 24 hours of treatment, the efficacy rate and total effective rate were higher in rhBNP group than in sodium nitroprusside group (51.1% vs. 26.2 %,95.7% vs. 66. 7%, respectively, P＜0. 05 and P＜0. 01), and non-efficacy rate in rhBNP group was lower (4.3% vs. 33. 3%, P＜0. 01). There was one death case in rhBNP group and three in sodium nitroprusside group. In rhBNP group, left ventricular ejection fraction values increased after 2 weeks of treatment [(46.2± 9.5)% vs. (38.1 ±6.0)%], P＜0.05. Serum BNP level significantly decreased in rhlBNP group than in sodium nitroprusside group after 2 weeks of treatment (P＜0.05).In rhBNP group, serum BNP and NE levels decreased 24 hours and 2 weeks after treatment (P＜0. 01) and the levels furtherly reduced after 2 weeks (P＜0.01). Serum ET-1 level decreased in rhBNP group than in sodium nitroprusside group 2 weeks after treatment (P＜0.05). In rhBNP group, there was no significant difference in serum ET-1 level between baseline and 24 hours after treatment (P＞ 0. 05), but the ET-1 level decreased 2 weeks after treatment as compared with 24 hours after treatment (P＜0.01). There were no significant differences between the two groups before and after treatment (P＞0.05). Incidences of headache and hypotension were lower in rhBNP group than in sodium nitroprusside group (4.3% vs. 19.0%, 14.9% vs. 23.8%, both P＜0.05),Conclusions RhBNP can be safely and effectively used for acute attack of CHF.     

血清总胆红素水平与急性缺血性卒中患者梗死灶体积、严重程度和病因学分型的相关性

目的 探讨血清总胆红素水平与急性缺血性卒中患者梗死灶体积、卒中严重程度和病因学分型的相关性.方法 以2012年1月至2014年1月期间收治的急性缺血性卒中患者作为研究对象,收集其临床和影像学资料,并检测血清总胆红素水平,分析血清总胆红素水平与缺血性卒中患者梗死灶体积、卒中严重程度和病因学分型的相关性.结果 共纳入290例急性缺血性卒中患者.根据脑梗死体积中位数将患者分为大梗死组(≥1.8 cm3;n=145)和小梗死组(＜1.8 cm3;n=145).大梗死组总胆红素水平显著高于小梗死组[(16.896±7.761) μmol/L对(13.039±4.477) μmol/L;=5.185,P＜0.001],多变量logistic回归分析显示,总胆红素最高四分位数组(＞17.893 μmol/L)为大梗死的独立危险因素[优势比(odds ratio,OR)2.754,95％可信区间(confidence interval,CI)1.028～7.375;P =0.044].根据美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分将患者分为轻度卒中组(NIHSS评分＜8分;n=210)和中重度卒中组(NIHSS评分≥8分;n=80),中重度卒中组的总胆红素水平显著高于轻度卒中组[(16.861±7.689) μmol/L对(14.246±6.019)μmol/L;=3.052,P=0.002],多变量logistic回归分析显示,总胆红素水平并非中重度卒中的独立危险因素.将小动脉闭塞性卒中、大动脉粥样硬化性卒中和其他明确病因的卒中合并为非心源性脑栓塞组(n =244),心源性脑栓塞组(n=46)总胆红素水平显著高于非心源性脑栓塞组[(19.639±8.409) μmol/L对(14.087±5.831) μmol/L;t =5.479,P＜0.001],多变量logistic回归分析显示,总胆红素最高四分位数组(＞ 17.893 μmol/L)为心源性脑栓塞的独立危险因素(OR 8.405,95％ CI 1.719 ～41.106;P=0.009).结论 血清总胆红素水平升高是大梗死卒中和心源性脑栓塞的独立危险因素.急性期血清总胆红素作为一种氧化应激指标,可为早期判断缺血性卒中患者的梗死灶体积和病因学亚型提供帮助.     

血清和肽素水平与急性缺血性卒中患者转归的相关性

目的 探讨血清和肽素水平与急性缺血性卒中患者转归的关系.方法 纳入发病24 h内的首次缺血性卒中患者,应用酶联免疫吸附法检测血清和肽素水平,应用美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评估基线卒中严重程度.在发病后90 d时应用改良Rankin量表(modified Rankin Scale,mRS)评分评价转归,0～2分定义为转归良好.年龄和性别相匹配的健康体检者作为对照者.结果 共纳入连续86例发病24 h内首次缺血性卒中患者和50名年龄和性别相匹配的健康体检者作为对照者.急性缺血性卒中患者发病24 h、7d和14 d血清和肽素水平分别为(7.81±0.66) pmol/L、(4.78±1.76) pmol/L和(2.82±1.42) pmol/L,均显著高于对照组[(1.67±0.56) pmol/L;P均＜0.05].86例患者中,74例(86.05％)转归良好,12例(13.95％)转归不良.转归不良组年龄[(67.64 ±9.62)岁对(61.12±7.31)岁;t=-3.420,P=0.020]、NIHSS评分[(14.16±4.22)分对(6.96±2.04)分;t=-8.26 3,P＜ 0.001]、基线收缩压[(166.06±13.42)mmHg对(154.12±11.69)mmHg;t=5.216,P=0.037;1mmHg=0.133 kPa]、空腹血糖[(8.79±2.98) mmol/L对(6.92±2.24) mmol/L;t=2.076,P=0.041]、C反应蛋白[(7.02±1.72) mg/L对(4.07±1.58) mg/L;t=-1.724,P=0.019]、24 h时和肽素水平[(9.67±2.28)p mol/L对(6.88±2.82)pmol/L;t=13.962,P＜ 0.001]、7d时和肽素水平[(8.22±2.14) pmol/L对(2.97±2.04)pmol/L;t=20.564,P＜0.001]、14 d时和肽素水平[(4.77±1.86)p mol/L对(2.02±0.76) pmol/L;t=8.428,P=0.032]以及心房颤动(33.33％对8.11％;x2=4.986,P=0.036)、大动脉粥样硬化性卒中(41.67％对21.62％;x2 =6.729,P=0.038)、心源性栓塞(33.33％对8.11％;x2=4.986,P=0.036)的患者构成比均显著高于转归良好组,小动脉闭塞性卒中的患者构成比显著低于转归良好组(16.67％对70.27％;x2=16.972,P=0.041).多变量logistic回归分析显示,血清24 h(优势比2.424,95％可信区间1.920 ～ 3.562;P＜0.001)和7d(优势比2.326,95％可信区间1.768 ～3.482;P＜0.001)时和肽素水平以及基线NIHSS评分(优势比2.146,95％可信区间1.616～3.268;P＜0.001)是转归不良的独立危险因素.结论 基线血清和肽素水平增高是急性缺血性卒中患者90 d时转归不良的独立预测因素.     

尿激酶溶栓对大脑中动脉血栓栓塞模型大鼠MMP-9、血脑屏障通透性和脑出血的影响

目的 观察栓塞性脑缺血后及应用尿激酶(urokinase,UK)溶栓后基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)的表达及对脑出血量和血脑屏障通透性的影响,探讨MMP-9与血脑屏障通透性和溶栓后脑出血之间的关系.方法 通过颈动脉内注射自体血制作大鼠血栓栓塞性大脑中动脉闭摩模型,缺血6h后静脉应用UK,24 h后分别采用免疫组化法检测脑组织MMP-9表达、伊文思蓝渗出法检测血脑屏障通透性、TTC染色法检测脑梗死体积、分光光度法检测脑出血量.结果 脑缺血组MMP-9表达显著高于假手术组(P＜0.01),UK溶栓组显著高于脑缺血组(P＜0.01).脑缺血组伊文思蓝含量为(5774.00±1659.70)ng/g,显著高于假手术组的(643.33±151.34)ng/g(P＜0.01),UK溶柃组为(6283.83±1099.28)ng/g,有高于脑缺血组的趋势.UK溶柃组和脑缺血组脑出血量分别为(3.16±8.84)μl(中位数±四分位数)和(0.00±1.48)μl,脑出血发生率分别为25.00%和4.17%.结论 UK溶栓可能上调 MMP-9表达,MMP-9表达与BBB通透性增加与溶栓后脑出血有关.