白细胞介素8基因多态性与新疆汉族迟发型阿尔茨海默病关系的研究

目的探讨白细胞介素8(IL-8)基因-251A/T多态性与新疆汉族人群迟发性阿尔茨海默病(LOAD)遗传易感性的关系。方法选择老年患者80例为LOAD组,同期体检者80例为对照组。采用PCR-RFLP检测IL-8基因-251A/T多态性分布。结果 2组AA基因型分布及A等位基因频率比较,差异有统计学意义(16.3%vs 7.5%,P=0.035;41.3%vs 27.5%,P=0.010)。进一步分析显示,LOAD组A等位基因频率可能是LOAD的危险因素(OR=1.851,95%CI:1.159².957,P=0.010);AA基因型患LOAD的危险性是TT基因型的3.370倍(OR=3.370,95%CI:1.1432.957,P=0.010);AA基因型患LOAD的危险性是TT基因型的3.370倍(OR=3.370,95%CI:1.143⁹.939,P=0.023);AT基因型与LOAD发病风险不相关(OR=1.944,95%CI:0.9949.939,P=0.023);AT基因型与LOAD发病风险不相关(OR=1.944,95%CI:0.994³.803,P=0.051)。结论 IL-8基因-251A/T多态性与LOAD发病风险有一定关系。     

降钙素原在监测高龄患者体外循环心脏术后早期并发症的应用研究

目的通过测定高龄患者体外循环心脏术后的降钙素原(procalcitonin,PCT),了解PCT的变化规律及其和其他炎性因子的相关性,评价PCT对提示高龄患者体外循环心脏术后早期并发症的应用价值。方法选取32例60岁以上体外循环下手术患者为研究对象。分别测定术前、转流前、手术结束、术后4 h、术后24 h、术后48 h和术后72 h七个不同时间点的白细胞计数、C反应蛋白、白细胞介素(interleukin,IL)-6、IL-8、肿瘤坏死因子-α和PCT数值。结果 PCT于体外循环结束开始升高,术后48 h可达到峰值,术后72 h逐渐下降。PCT与其他炎性因子的相关性分析结果显示,PCT与白细胞计数(r=0.938,P=0.002)、肿瘤坏死因子-α(r=0.950,P=0.001)和IL-8(r=0.930,P=0.003)相关性最高,其次为IL-6(r=0.883,P=0.012),与CRP(r=0.673,P=0.113)相关性最小。术后早期发生并发症患者术后24 h、48 h、72 h的PCT浓度高于术后无并发症患者,差异有统计学意义[(3.25±1.05)ng/mL vs.(1.88±0.87)ng/mL,P<0.05;(4.87±1.54)ng/mL vs.(2.13±0.90)ng/mL,P<0.05;(8.25±1.70)ng/mL vs.(1.10±0.38)ng/mL,P<0.01]。结论PCT是一种早期的、敏感性和特异性极佳的高危监测指标;测定PCT有助于临床鉴别心脏术后高危患者。     

白细胞介素-8基因多态性与艰难梭菌感染之间关系的研究

背景:艰难梭菌是院内感染的常见原因,在炎症性肠病(IBD)中的感染率较高,而白细胞介素-8(IL-8)在艰难梭菌的炎症反应中起有重要作用。目的:探讨IL-8-251位点A/T基因多态性与艰难梭菌感染之间的关系。方法:选取2011年12月—2013年1月武汉大学中南医院就诊的173例IBD患者、76例肠易激综合征患者,以90名正常人群作为对照组。以聚合酶链反应(PCR)法检测粪便中艰难梭菌感染情况,Sanger测序法测定IL-8-251位点A/T基因多态性,并分析艰难梭菌感染与IL-8-251位点A/T基因多态性的关系。结果:共检出艰难梭菌阳性者31例(9.1%)。艰难梭菌阳性患者IL-8-251位点AA基因型比例显著高于艰难梭菌阴性患者(χ~2=96.6718,P0.0001)。结论:IL-8-251位点AA基因型可能是艰难梭菌感染的危险因素,可增加感染艰难梭菌的机会。     

右美托咪啶联合乌司他丁调控促炎/抗炎系统改善老年结直肠癌患者术后认知功能障碍的效果

目的:探讨右美托咪啶联合乌司他丁对调节体内促炎/抗炎系统改善老年结直肠癌患者术后认知功能障碍(postoperative cognitive dysfunction,POCD)的研究.方法:连续性纳入浙江省丽水市中心医院住院治疗的164例行腹腔镜下结直肠癌手术的老年患者,随机平均分为4组(A组右美托咪啶组,B组乌司他丁组,C组联合治疗组以及D组对照组).监测统计术后第1天和第3天POCD的发生率,血清促炎因子[肿瘤坏死因子-α(tumor necrosis factorα,TNF-α)和白介素(interleukin,IL)-6]和抗炎因子[转化生长因子β(transforming growth factor-β,TGF-β)和IL-4]水平.结果:诱导麻醉前使用右美托咪啶后可以明显减低丙泊酚的使用量(P0.05).D组患者术后第1天和第3天的POCD发生率明显高于其他三组(P0.05).D组患者术后1 d和术后3 d促炎因子(TNF-α和IL-6)水平明显高于其他3组.ABC三组患者术后1 d和3 d TGF-β水平均明显高于D组(P0.05).右美托咪定(r=-0.445,P0.05),乌司他丁(r=-0.426,P0.05)联合治疗(r=-0.721,P0.05)干预与POCD呈负相关.结论:乌司他丁联合右美托咪啶可以通过调节促炎/抗炎系统平衡,有效减少老年结直肠癌患者POCD的发生率,是临床预防POCD的有效途径之一.     

陕西人群中IL-8、IL-10单核苷酸基因多态性与结直肠癌的易感性

目的:探讨陕西人群中白介素-8(interleukin-8,IL-8)-251A/T、IL-10-1082A/G单核苷酸基因多态性(single nucleotide polymorphism,SNP)与结直肠癌的遗传易感性.方法:采用病例对照研究的方法,应用等位特异性聚合酶链式反应(allele specific polymerase chain reaction,AS-PCR),分别检测102例结直肠癌患者和105例健康对照人群中IL-8-251A/T、IL-10-1082A/G的基因分布,运用χ2检验的方法比较2个多态性位点中不同基因型与结直肠癌的易感性.结果:在陕西人群中,结直肠癌组和健康对照组中IL-8-251A/T位点的3种基因型分布差异有统计学意义(χ2=8.278,P=0.016),A等位基因在结直肠癌组中的频率高于对照组(χ2=5.083,P=0.024),携带AA基因型的个体更易患结直肠癌(OR=3.84,95%CI:1.44-10.23);分层分析显示:携带A等位基因年龄55岁或吸烟的个体,相对于年龄≥55岁或非吸烟者更易罹患结直肠癌(P=0.003).两组间IL-10-1082A/G位点的3种基因型分布差异无统计学意义(χ2=1.808,P=0.405).结论:相同环境条件下,陕西人群中携带IL-8-251A等位基因者增加结直肠癌发生的危险性,尤其是在年龄55岁及吸烟的个体中,考虑IL-8-251位点的SNP可能是结直肠癌的易感基因;IL-10-1082A/G与结直肠癌的发病无明显相关性.     

经纤维支气管镜支气管肺泡灌洗术治疗老年肺癌患者的临床效果

目的分析经纤维支气管镜支气管肺泡灌洗术治疗老年肺癌患者的临床效果。方法选取2016—2017年承德市中心医院心胸外科收治的老年肺癌患者96例,根据治疗方法分为对照组和观察组,各48例。对照组患者采用肺叶切除术+纵隔淋巴结清扫术治疗,观察组患者在对照组基础上对患侧肺进行经纤维支气管镜支气管肺泡灌洗术治疗。比较两组患者术后临床症状改善时间(包括体温及白细胞计数恢复正常时间、咳痰消失时间、拔管时间、特级护理改二级护理时间)、术后脱离呼吸机24 h动脉血气分析指标[包括pH值、动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)]、术前及术后3 d血清炎性因子[包括C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白介素8(IL-8)、降钙素原(PCT)]水平,并观察两组患者术后并发症发生情况。结果 (1)观察组患者体温及白细胞计数恢复正常时间、咳痰消失时间、拔管时间及特级护理改二级护理时间短于对照组(P0.05)。(2)观察组患者术后脱离呼吸机24 h pH值、PaO_2高于对照组,PaCO_2低于对照组(P0.05)。(3)两组患者术前血清CRP、TNF-α、IL-8、PCT水平比较,差异无统计学意义(P0.05);观察组患者术后3 d血清CRP、TNF-α、IL-8、PCT水平低于对照组(P0.05)。(4)两组患者术后并发症发生率比较,差异无统计学意义(P0.05)。结论经纤维支气管镜支气管肺泡灌洗术可有效缩短老年肺癌患者术后临床症状改善时间,改善术后动脉血气分析指标,减轻术后炎性反应,且安全性较高。     

白细胞介素-8基因251 A/T位点的多态性与亚洲人群胃癌易感性的Meta分析

[目的]用Meta分析的方法评价IL-8基因251 A/T位点的多态性与亚洲人群胃癌易感性的关系。[方法]检索Web of science、PubMed、EMBASE、万方数据库、中国生物医学文献数据库、中文科技期刊数据库、中国期刊全文数据库,日期均从各数据库开始建库至2018年1月。全面检索IL-8基因251 A/T位点的多态性与胃癌易感性的病例对照研究文献,采用STATA统计软件进行Meta分析。[结果]最终纳入15篇病例对照研究进行Meta分析,共计3738例胃癌患者、4497例健康对照者。分析结果显示,IL-8基因251 A/T位点在等位基因模型(A vs T:OR=1.12;95%CI为1.04~1.21;P=0.002)、共显性模型(AA vs AT:OR=1.15;95%CI为1.00~1.32;P=0.050)、相加模型(AA vs TT:OR=1.36;95%CI为1.18~1.57;P=0.000)、相加模型(AT vs TT:OR=1.23;95%CI为1.11~1.36;P=0.000)、显性模型(AA vs AT+TT:OR=1.23;95%CI为1.08~1.40;P=0.002)、隐性模型(TT vs AA+AT:OR=1.26;95%CI为1.15~1.39)下均与亚洲人群胃癌易感性有关。[结论]IL-8基因251 A/T位点多态性与亚洲人群胃癌的易感性相关。     

解毒活血法对急性冠脉综合征患者PCI术后CD40L及IL-8表达的影响

目的：观察解毒活血中药对急性冠脉综合征（ACS）患者经皮冠状动脉介入（PCI）术后CD40L及白细胞介素（IL）-8表达的影响。方法：PCI术后的50例ACS患者被随机分为常规治疗组（25例,予常规西药治疗）,中药治疗组（25例,在常规西药治疗基础上加用活血解毒中药治疗）,检测治疗前后血清中CD40L及IL-8的表达水平。结果：治疗后,与常规治疗组比较,中药治疗组CD40L[（1.60±0.62）ng/ml比（1.35±0.49）ng/ml]及IL-8[（6.03±0.69）ng/ml比（5.33±0.62）ng/ml]表达水平均显著降低（P均〈0.05）;中药治疗组临床疗效优于常规治疗组（总有效率：92%比72%,P〈0.05）。结论：解毒活血中药能明显降低急性冠脉综合征患者PCI术后血清CD40-L及IL-8的表达水平,能抑制PCI术后炎性反应,对于急性冠脉综合征有一定疗效。     

单核苷酸多态性与慢性HBV感染结局相关性分析

目的:探讨分析血清白细胞介素(IL)-8水平及IL-8基因启动子区-251A/T、-738T/A、-845T/C单核苷酸多态性与慢性HBV感染结局的相关性。方法:选取2014年2月至2017年2月接受治疗的HBV感染者203例,其中慢性HBV感染者102例为试验组,急性自限HBV感染者101例作为对照组,收集并提取患者外周静脉血DNA,采用聚合酶链反应技术检测IL-8基因启动子区-251A/T、-738T/A、-845T/C基因分布及等位基因频率,并采用酶联免疫吸附试验检测两组患者血清中IL-8的水平。结果:IL-8 251A/T单核苷酸形态多样性有AA、AT、TT基因型,试验组和对照组患者3种基因型频率和等位基因频率对比差异有统计学意义(P0.05),携带A等位基因相比T基因患慢性HBV感染风险更高;IL-8-738T/A和IL-8-845T/C单核苷酸多态性均只发现TT基因型;试验组血清中IL-8水平高于对照组,且其感染程度越高,血清IL-8水平越高;AA基因型的慢性HBV感染者血清IL-8水平更高。结论:IL-8基因启动子区-251A/T单核苷酸多态性与慢性HBV感染者发病存在相关性,但与疾病严重程度无明显关系。A等位基因容易诱发慢性HBV感染,血清中IL-8水平与病情程度有关。IL-8-738T/A和IL-8-845T/C单核苷酸多态性与慢性HBV感染者是否发病没有相关性。     

替格瑞洛对老年冠状动脉介入治疗患者血清炎性因子的影响

目的观察新型P2Y12受体拮抗剂替格瑞洛对老年PCI患者血清炎性因子的影响。方法将146例因不稳定性心绞痛入院择期行PCI的老年患者随机分为氯吡格雷组、替格瑞洛组,各73例,分别测定患者PCI术前、术后12h、1、6个月和1年时外周血循环内皮细胞(CEC)、CD40配体(CD40L)、白细胞介素6(IL-6)水平。结果 2组术前及术后12hCEC、CD40L、IL-6水平比较,差异无统计学意义(P0.05);2组PCI术后12h较术前明显增高(P0.05);2组术后1、6个月和1年各炎性因子水平较术后12h明显下降(P0.05),且替格瑞洛组术后1个月[CEC(2.87±0.33)个/μl vs(3.88±0.36)个/μl,CD40L(256.87±20.78)ng/L vs(349.23±19.21)ng/L,IL-6(2.51±0.81)ng/L vs(3.49±0.85)ng/L,P0.05]、6个月[CEC(2.60±0.30)个/μl vs(3.81±0.43)个/μl,CD40L(233.09±20.75)ng/L vs(342.25±18.04)ng/L,IL-6(2.23±0.74)ng/L vs(3.27±0.96)ng/L,P0.05]和1年[CEC(2.27±0.27)个/μl vs(3.43±0.46)个/μl,CD40L(204.04±12.65)ng/L vs(308.32±17.48)ng/L,IL-6(2.03±0.80)ng/L vs(3.01±0.86)ng/L,P0.05]较氯吡格雷组下降更为明显。结论新型P2Y12受体拮抗剂替格瑞洛较氯吡格雷具有更强的抗炎及血管保护作用。     

Risk modification of colorectal cancer susceptibility by interleukin-8 -251T>A polymorphism in Malaysians

AIM: To investigate the allele and genotype frequencies and associated risk of interleukin (IL)-8 -251T>A polymorphism on colorectal cancer (CRC) susceptibility risk.METHODS: Peripheral blood samples of 255 normal controls and 255 clinically and histopathologically confirmed CRC patients were genotyped for IL-8 -251T>A polymorphism employing allele-specific polymerase chain reaction. The relative association of variant allele and genotypes with CRC susceptibility risk was determined by calculating the odds ratios (ORs). Corresponding χ² tests on the CRC patients and controls were carried out and 95% confidence intervals (CIs) were determined using Fisher’s exact test. The allele frequencies and its risk association were calculated using FAMHAP, haplotype association analysis software.RESULTS: On comparing the frequencies of genotypes of patients and controls, the homozygous variant AA was significantly higher in CRC patients (P = 0.002) compared to controls. Investigation on the association of the polymorphic genotypes with CRC susceptibility risk, showed that the homozygous variant IL-8 -251AA had a significantly increased risk with OR 3.600 (95% CI: 1.550-8.481, P = 0.001). In the case of allele frequencies, variant allele A of IL-8 -251 showed a significantly increased risk of CRC predisposition with OR 1.32 (95% CI: 1.03-1.69, P = 0.003).CONCLUSION: Variant allele and genotype of IL-8 (-251T>A) was significantly associated with CRC susceptibility risk and could be considered as a high-risk variant for CRC predisposition.     

白细胞介素8－251A/T单核苷酸多态性及其血浆水平与冠心病易感性的关系

目的研究白细胞介素8-251A/T单核苷酸多态性及其血浆水平与冠心病易感性的关系。方法应用聚合酶链反应限制片长多态性检测冠心病组与对照组白细胞介素8-251A/T单核苷酸多态性,酶联免疫吸附法测定白细胞介素8血浆水平。结果白细胞介素8血浆水平在冠心病组显著高于对照组(P<0.05),-251A/T基因型频率、等位基因A和T频率在两组间差异无统计学意义(P>0.05)。但是与其他冠心病患者相比,急性冠状动脉综合征患者AA基因型明显减少(OR=0.43,95%CI为0.2～0.97,P<0.05)。结论白细胞介素8血浆水平与冠状动脉粥样硬化病变有相关性。-251A/T位点单核苷酸多态性与冠心病无相关性,但可影响冠心病的临床表现。AA基因型或许能降低急性冠状动脉综合征的发病风险。     

Comparison of troponin T versus creatine kinase-MB in suspected acute coronary syndromes

Limitations of creatine kinase-MB (CK-MB) have led to alternative biochemical markers, including troponin T (TnT), to detect myocardial necrosis. Limited data are available regarding the predictive value of this new marker in patients with chest pain of uncertain etiology. Therefore, we prospectively compared CK-MB and TnT in a broad population with suspected acute coronary syndromes, including those admitted to a short-stay chest pain unit. CK-MB, quantitative TnT levels, and a rapid bedside assay were performed at 0, 4, 8, and 16 hours. Adverse events, including infarction, recurrent ischemia, coronary surgery, need for catheterization and/or intervention, stroke, congestive heart failure, or death, were identified by chart review and by follow-up phone call at 6 months. Of 707 patients, 104 were excluded for creatinine >2 mg/dl or incomplete data, leaving a total cohort of 603 patients. Coronary Care Unit admissions were 18%, intermediate care admissions were 14%, telemetry admissions is 21%, and admissions to 24-hour short-stay area were 47%. TnT (at 0.1 ng/ml) and CK-MB were positive in a similar proportion of patients (20.4% and 19.7%, respectively); however, the patients identified by TnT and CK-MB were not identical. In-hospital adverse events occurred in 37.1% with no differences in positive predictive value for the markers (p = NS). If CK-MB and TnT were negative, the early adverse event rate was 27%. No cardiac marker was positive by 16 hours in 54.9% of patients with an adverse event. Six-month follow-up was obtained in 576 of the 603 patients (95.5%). One hundred fifty-five late adverse events occurred in 134 patients (23.3%) at an average of 3.3+/-2.5 months after discharge. If both markers were negative, the late event rate was 20.2% and did not increase in patients with positive CK-MB or TnT >0.2 ng/ml. However, the late event rate was substantially higher (52.9%) in those with intermediate TnT levels of 0.1 to 0.2 ng/ml (p = 0.002). Thus, TnT is a suitable alternative to CK-MB in patients with suspected acute coronary syndromes. The rapid bedside assay is comparable to quantitative TnT and may enable early diagnosis and triage. A negative cardiac marker value (TnT or CK-MB) does not necessarily confer a low risk of complication in patients presenting with acute chest pain to an emergency department.     

Genetic polymorphism of MCP-1-2518, IL-8-251and susceptibility to acute pancreatitis： A pilot study in population of Suzhou, China

AIM： To study the relationship between MCP-1-2518A/ G, IL-8-251A/T polymorphism and acute pancreatitis （AP） in the Han population of Suzhou, China.
METHODS： A case-control study was conducted to compare the distribution of genotype and genetic frequency of MCP-1-2518A/G, IL-8-251A/T gene polymorphism among AP （n = 101）, including mild AP （n = 78） and severe AP （n = 23） and control healthy individuals （n = 120） with polymerase chain reaction- restriction fragment length polymorphism （PCR-RFLP） and DNA sequencing, and analyze the relationship between the MCP-1-2518A/G, IL-8-251A/T gene polymorphism and the susceptibility to AP.
RESULTS： Significant differences were found in the distribution of genotype of MCP-1-2518A/G between the healthy control group and mild AP group （χ^2 = 32.015, P 〈 0.001）, the same was evident between the healthy control group and severe AP group （χ^2 = 12.932, P 〈 0.05） in Suzhou. However, no difference of genotypic distribution was noted between MAP and SAP （Z2 = 0.006, P = 0.997）. The genetic frequencies of G allele in mild AP were 72.4% （113/156） and 76.1% （35/46） in severe AP, both were higher than the controls, 47.1% （113/240） （χ^2 = 24.804; P 〈 0.001, and 4,2 = 13：005; P 〈 0.001）, but no difference was found between severe AP and mild AP （χ^2 = 0.242, P = 0.623）. No difference was found in the distribution of genotype of IL-8-251A/T between the healthy control group and AP group neither in the frequency of A and T allele.
CONCLUSION： The MCP-1-2518 AA genotype of the population in Suzhou may be a protective genotype of AP, while one with higher frequency of G allele is more likely to suffer from pancreatitis. But the genotype of AA and the frequency of G allele could not predict the risk of severe AP. No correlation is found between the IL-8-251 polymorphism and the liability of AP.     

Genetic susceptibility to enteroaggregative Escherichia coli diarrhea: polymorphism in the interleukin-8 promotor region

Enteroaggregative Escherichia coli (EAEC) infection can be identified in 26% of travelers with diarrhea and is associated with fecal interleukin (IL)-8 production. We hypothesized that single-nucleotide polymorphisms (SNPs) in the IL-8 gene are associated with EAEC-related symptoms. Fecal IL-8 production and IL-8 SNPs at 5 loci were identified in 69 US students who remained in Mexico for 5 weeks; 23 subjects had EAEC-associated diarrhea, 7 were asymptomatic EAEC carriers, 22 had nonspecific diarrhea, and 17 were asymptomatic without an enteropathogen. The chances of having EAEC-associated diarrhea were significantly increased among those with the AA genotype at the -251 position (odds ratio [OR], 208.51; 95% confidence interval [CI], 28.5-1525.36) and among those with AT genotype (OR, 14.3; 95% CI, 1.98-105.74), compared with those with the TT genotype at the -251 position. Among subjects with EAEC-associated diarrhea, the AA genotype at the -251 position produced greater concentrations of fecal IL-8 than those with the AT or TT genotype (P=.0053). In the present study, the AA genotype at the -251 position was associated with the occurrence of EAEC-associated diarrhea and increased levels of fecal IL-8.     

Association of interleukin-8 (IL-8 or CXCL8) -251T/A and CXCR2 +1208C/T gene polymorphisms with breast cancer

A case-control study involving 257 breast cancer patients with invasive ductal carcinoma and 233 healthy women was carried out to explore if the IL-8 -251T/A polymorphism and the CXCR2 +1208 C/T polymorphism have a role in breast cancer susceptibility. Genotypic analysis showed an increased frequency of high producer IL-8 -251AA genotype (p=0.016) in the patient group as compared to controls while CXCR2 +1208 C/T polymorphism did not show any differences between studied groups. However, in contrast to IL-8 -251 polymorphism, the percentage of CXCR2 +1208 TT genotype was significantly lower in patients with NPI3.4 (2% and 12%, respectively; p=0.03). Also, ER- tumors showed an approximately significant higher CXCR2 +1208 TT genotype compared to ER+ tumors (18.6% and 7.1%, respectively; p=0.07). In conclusion, IL-8 -251T/A polymorphism is associated with development of invasive ductal carcinoma type of breast cancer while CXCR2 +1208C/T polymorphism may affect the disease progression.     

Peak cardiac troponin-T level, scintigraphic myocardial infarct size and one-year prognosis in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction

Current guidelines recommend troponin T (TnT) as the biomarker of choice in the diagnosis of myocardial infarction. In patients with ST-elevation myocardial infarction (STEMI) however, its role in providing a measurement of infarct size and its association with survival is less well established. We sought to assess the correlation of TnT and creatine kinase-MB (CK-MB) with scintigraphically determined infarct size and to assess the predictive value of all 3 parameters on 12-month mortality. Patients presenting with STEMI managed with primary percutaneous intervention underwent serial TnT and CK-MB measurements at admission and for ≥72 hours after presentation. Before hospital discharge patients underwent assessment of infarct size by technetium-99m sestamibi single-photon emission computed tomographic (SPECT) scan. Clinical follow-up was performed up to 1 year. Data were available for 1,237 patients. Mean age was 62.9 ± 12.9 years. Infarct location was anterior in 509 patients (41%); 75 (6.1%) had cardiogenic shock. Median admission and peak TnT were 0.74 μg/L (0.10 to 2.70) and 3.70 μg/L (1.69 to 6.99), respectively. Corresponding values for CK-MB were 44.1 U/L (21.0 to 108.8) and 160.0 U/L (69.0 to 301.0), respectively. Median infarct size on SPECT scan was 12.0% (3.0 to 25.0) of the left ventricle. Peak TnT and CK-MB demonstrated similar moderate correlation with final infarct size (r = 0.45, p <0.001, and r = 0.41, p <0.001 respectively). This correlation was not affected by Thrombolysis In Myocardial Infarction flow grade after intervention. At 1 year, 47 patients (3.8%) had died. Final infarct size at SPECT scanning better predicted mortality than peak TnT or CK-MB. In conclusion, this study is the largest investigation on the value of cardiac troponin for assessment of infarct size in acute STEMI. Compared to peak CK-MB, peak TnT shows similar correlation with scintigraphic infarct size, although scintigraphic infarct size remains a better correlate of 1-year mortality than either biomarker.     

AA genotype of IL‐8 −251A/T is associated with low PaO2/FiO2 in critically ill patients and with increased IL‐8 expression

Background and Objective: Interleukin‐8 (IL‐8) is a central chemokine in acute respiratory distress syndrome (ARDS), and the IL‐8 gene contains a functional single nucleotide polymorphism (SNP) ?251A/T in its promoter region. We hypothesized that IL‐8 ?251A/T SNP is associated with PaO₂/FiO₂ in critically ill patients. Methods: We conducted genetic‐association studies in intensive care units at academic teaching centres using a derivation septic shock cohort (vasopressin and septic shock trial (VASST), n = 467) and a validation post‐cardiopulmonary bypass surgery cohort (CPB, n = 739) of Caucasian patients. Patients in both cohorts were genotyped for IL‐8 ?251A/T. The primary outcome variable in both cohorts was the fraction of patients who had a PaO₂/FiO₂ < 200. IL‐8 mRNA expression was measured in genotyped lymphoblastoid cells in vitro. Results: The frequency of the patients with PaO₂/FiO₂ <200 was significantly greater in patients who had the AA genotype of ?251A/T than in patients who had the AT or TT genotypes in both VASST (AA = 60.8% vs AT and TT = 53.8% and 48.0%, P = 0.038) and the CPB cohort (AA = 37.0% vs AT and TT = 27.0% and 26.0%, P = 0.039). Patients having the AA genotype had a higher probability to remain on mechanical ventilation (P = 0.047) in the first 14 days. Lymphoblastoid cells having the AA genotype had significantly higher IL‐8 mRNA expression than cells having the AT or TT genotype (P = 0.022). Conclusions: Critically ill Caucasian patients who had the AA genotype of IL‐8 ?251A/T had an increased risk of PaO₂/FiO₂ <200. The AA genotype was associated with greater IL‐8 mRNA expression than the AT or TT genotypes.     

Plasma and urinary levels of heart fatty acid-binding protein in patients undergoing cardiac surgery

To evaluate the clinical significance of the plasma and urinary levels of heart fatty acid-binding protein (H-FABP) in patients undergoing cardiac surgery, a prospective study was conducted. Ten patients undergoing coronary artery bypass grafting were enrolled. Blood samples for determination of plasma H-FABP (pH-FABP), the MB isoenzyme of creatine kinase (CK-MB) and troponin-T (TnT), and urine samples for determination of urinary H-FABP (uH-FABP) were collected serially. None of the patients had perioperative myocardial infarction. The time to reach the peak level after aortic declamping was significantly (p<0.05) shorter for pH-FABP (1.4+/-0.5 h) than for CK-MB (2.5+/-0.5 h), TnT (6.6+/-1.3 h) or uH-FABP (3.0+/-0.6 h). Peak levels of pH-FABP correlated with those of CK-MB (r = 0.51, p = 0.04), TnT (r = 0.60, p = 0.03) and uH-FABP (r = 0.61, p = 0.03), and peak levels of uH-FABP correlated with CK-MB (r = 0.57, p = 0.04). Postoperative uH-FABP levels correlated inversely with the left ventricular stroke work index (r = -0.63, p = 0.04). This study demonstrated that H-FABP appears rapidly in plasma after reperfusion and reaches its peak earlier than other available biochemical markers; it appears also in urine and the levels correlated with cardiac function. Plasma and urinary H-FABP may be an early and sensitive biochemical marker for the diagnosis of myocardial injury in patients undergoing cardiac surgery.