纳洛酮对外伤性脑损伤患者血浆ET-1和CGRP影响的临床研究

探讨外伤性脑损伤患者血浆ET-1和CGRP变化以及纳洛酮治疗对血浆ET-1和CGRP的影响。90例外伤性脑损伤患者随机分为纳洛酮治疗组与常规治疗组,另取30名健康人作为对照组。用放射免疫分析法测定患者治疗前后血浆ET-1、CGRP含量。纳洛酮治疗组和常规治疗组治疗前血浆ET-1显著升高,治疗后明显下降,常规治疗组下降幅度明显小于纳洛酮治疗组（P〈0.01）;纳洛酮治疗组和常规治疗组治疗后血浆CGRP明显升高,纳洛酮治疗组升高幅度明显大于常规治疗组（P〈0.01）。外伤性脑损伤患者血浆ET-1水平显著升高,CGRP水平显著降低;早期应用纳洛酮可显著降低ET-1和提高CGRP水平。初步研究显示,纳洛酮具有脑保护作用,伤后早期应用纳洛酮可改善病人预后。     

依达拉奉对外伤性脑内出血患者血浆ET-1和CGRP影响的临床探讨

目的：探讨外伤性脑内出血患者血浆ET-1和CGRP变化以及依达拉奉治疗对血浆ET-1和CGRP的影响。方法：80例外伤性脑内出血患者随机分为依达拉奉组与常规治疗组,另取30例健康人作为对照组。用放射免疫分析测定外伤性脑内出血患者依达拉奉治疗前后血浆ET-1、CGRP含量。结果：依达拉奉组和常规治疗组治疗前血浆ET-1显著增高,治疗后明显下降,治疗后血浆ET-1降低常规治疗组明显少于依达拉奉组（P〈0.01）;依达拉奉组和常规治疗组治疗前血浆CGRP显著降低,治疗后明显升高,治疗后血浆CGRP增加,依达拉奉组明显高于常规治疗组（P〈0.01）。结论：外伤性脑内出血患者血浆ET-1水平显著升高,CGRP水平显著降低;早期应用依达拉奉可显著降低ET-1和提高CGRP水平,初步研究显示,依达拉奉具有脑保护作用。伤后早期应用依达拉奉可改善病人预后。     

超短波治疗慢性肺源性心脏病患者的初步探讨

目的:探讨超短波对慢性肺心病CCP患者的临床应用价值。方法:急性发作期CCP患者87例分为超短波治疗组45例和对照组42例,治疗组在常规治疗的基础上给予超短波治疗,对照组行常规治疗。治疗前后分别测定两组患者血浆中血管内皮生长因子VEGF、内皮素(ET-1)含量,动脉血氧分压(PaO2)和平均肺动脉压(mPAP)水平。结果:与对照组比较治疗组治疗后PaO2显著升高(P<0.01),VEGF、ET-1、mPAP明显降低(P<0.01)。VEGF、ET-1与PaO2呈负相关(P<0.01)、与mPAP呈正相关(P<0.01)。结论:超短波可以通过降低肺动脉高压对CCP患者起治疗作用。     

颅脑外伤患者血浆ET-1与CGRP测定的临床意义

目的:探讨不同程度颅脑外伤患者血浆内皮素-1(ET-1)与降钙素基因相关肽(CGRP)水平测定的临床意义.方法:107例患者根据GCS评分法分成三组:轻度(13～15分)25例;中度(9～12分)33例;重度(3～8分)49例,其中20例死亡.分别测定各组患者及30例正常对照组血浆ET-1与CGRP水平.结果:①轻、中、重三组患者血浆ET-1水平均明显高于正常对照组,病情越重升高越显著.②轻、中度患者血浆CGRP含量较正常对照组显著升高,而重度患者组则与对照组比较无统计学意义.③病情越重CGRP/ET-1值越低.结论:不同程度颅脑外伤患者血浆ET-1水平及CGRP与ET-1比值变化与其病情的严重程度有关,对患者预后的判定具有一定的临床参考价值.     

尼莫地平对脑出血患者血浆ET-1和CGRP影响的临床探讨

目的：探讨脑出血患者血浆ET-1和CGRP变化以及尼莫地平治疗对血浆ET-1和CGRP的影响。方法：60例脑出血患者随机分为尼莫地平组与常规治疗组,在治疗前后进行血浆ET-1、CGRP水平测定。结果：尼莫地平组和常规治疗组治疗前血浆ET-1和CGRP均显著增高,治疗后明显下降,治疗后血浆ET-1和CGRP降低值尼莫地平组明显高于常规治疗组（P〈0．01）。尼莫地平组与常规治疗组治疗前血肿体积与血浆ET-1和CGRP水平呈显著性正相关,治疗后也呈显著性正相关。结论：脑出血患者血浆ET-1及CGRP水平显著升高,尼莫地平组治疗后明显下降。     

婴儿重症肺炎合并心力衰竭时血浆TNF—α与CGRP水平变化的研究

目的　探讨肿瘤坏死因子 -α(TNF -α)与降钙素基因相关肽 (CGRP)在婴儿重症肺炎并急性充血性心力衰竭时的动态变化及其临床意义 .方法　对 2 2例肺炎并心衰、16例轻型肺炎患儿及 16例正常同龄儿童的血浆TNF -α与CGRP水平进行同期动态观察 .结果　心衰急性期血浆TNF -α较缓解期显著增高 (p <0 .0 1) ,并明显高于轻型肺炎组与对照组 (p <0 .0 1) .急性期血浆CGRP水平较缓解期及对照组均显著降低 (p <0 .0 1) ;心衰缓解期与轻型肺炎组和对照组间血浆TNF -α、CGRP水平变化无差异 (p >0 .0 5 ) .急性期血浆TNF -α含量变化与CGRP水平呈显著负相关 (t=0 .4 7,p <0 .0 5 ) .结论　TNF -α与CGRP在肺炎合并心衰的发生中起重要作用 ,TNF -α参与了肺水肿及心肌功能减退的病理过程 ,CGRP可能对肺血管及心肌有保护作用 ;动态监测血浆TNF -α及CGRP水平变化对判断病情及预后有重要临床意义     

脑出血患者血浆ET-1、CGRP和NSE变化及临床应用

目的:观察脑出血患者急性发作期、恢复期血浆内皮素(ET-1)、降钙素基因相关肽(CGRP)和神经元特异性烯醇化酶(NSE)的含量变化,探讨它们在脑出血不同时期的临床意义.方法:脑出血组60例,健康对照组60例.脑出血组分别于入院次日、第7d、第21d空腹静脉采集血液标本.用放射免疫分析ET-1、CGRP、NSE含量.结果:脑出血组各时间的ET-1、CGRP和NSE均高于健康对照组,与对照组比较,差异有统计学意义(P＜0.01).ET-1、CGRP发病次日与第7d含量比较,差异无统计学意义(P＞0.05),与第21d含量比较,差异有统计学意义(P＜0.01);NSE发病次日含量与第7d、21d比较,差异有统计学意义(P＜0.01),第7d与第21d含量比较,无统计学意义(P＞0.05).结论:脑出血患者血浆ET-1、CGRP和NSE水平发病次日显著升高.恢复期ET-1、CGRP、NSE含量较发病次日逐渐下降 .测定血浆ET-1、CGRP和NSE含量有助于脑出血患者的早期诊断和预后判断,具有重要的临床价值.     

缺氧对男性肺心病患者急性发作期下丘脑-垂体-性腺轴功能变化的影响

本文应用放免法检测了50例急性发作期男性肺心病患者及26名正常健康男性之血浆睾酮(T)、雌二醇(E_2)、血清黄体生成激素(LH)、卵泡刺激素(FSH)水平及对黄体生成激素释放激素(LRH)刺激的反应性。结果表明,急性发作期血浆T值明显降低(P<0.01),E_2/T比值显著升高(P<0.01);缓解期二者均恢复至对照水平。急性发作期患者对LRH刺激之反应亦有所减退。血浆E_2、血清LH和FSH水平均无明显变化。患者血浆T值与PaO_2呈明显正相关,E_2/T比值与PaO_2,呈明显负相关,T值、E_2/T比值与PaCO_2均无相关关系。作者提出:缺氧是导致男性肺心病患者急性发作期下丘脑-垂体-性腺轴功能改变的重要影响因素。     

婴儿重症肺炎合并心力衰竭时血浆TNF-α与CGRP水平变化的研究

目的探讨肿瘤坏死因子-α(TNF-α)与降钙素基因相关肽(CGRP)在婴儿重症肺炎并急性充血性心力衰竭时的动态变化及其临床意义.方法对22例肺炎并心衰、16例轻型肺炎患儿及16例正常同龄儿童的血浆TNF- α与CGRP水平进行同期动态观察.结果心衰急性期血浆TNF-α较缓解期显著增高(p<0.01),并明显高于轻型肺炎组与对照组(p<0.01).急性期血浆CGRP水平较缓解期及对照组均显著降低(p<0.01);心衰缓解期与轻型肺炎组和对照组间血浆TNF-α、CGRP水平变化无差异(p>0.0 5).急性期血浆TNF-α含量变化与CGRP水平呈显著负相关(t=0.47,p<0.05 ).结论 TNF- α与CGRP在肺炎合并心衰的发生中起重要作用,TNF-α参与了肺水肿及心肌功能减退的病理过程,CGRP可能对肺血管及心肌有保护作用;动态监测血浆TNF-α及CGRP水平变化对判断病情及预后有重要临床意义.     

脑出血患者血浆ET-1、CGRP和NSE变化及临床应用b

目的：观察脑出血患者急性发作期、恢复期血浆内皮素（ET-1）、降钙素基因相关肽（CGRP）和神经元特异性烯醇化酶（NSE）的含量变化,探讨它们在脑出血不同时期的临床意义。方法：脑出血组60例,健康对照组60例。脑出血组分别于入院次日、第7d、第21d空腹静脉采集血液标本。用放射免疫分析ET-1、CGRP、NSE含量。结果：脑出血组各时间的ET-1、CGRP和NSE均高于健康对照组,与对照组比较,差异有统计学意义（P〈0.01）。ET-1、CGRP发病次日与第7d含量比较,差异无统计学意义（P〉0.05）,与第21d含量比较,差异有统计学意义（P〈0.01）;NSE发病次日含量与第7d、21d比较,差异有统计学意义（P〈0.01）,第7d与第21d含量比较,无统计学意义（P〉0.05）。结论：脑出血患者血浆ET-1、CGRP和NSE水平发病次日显著升高。恢复期ET-1、CGRP、NSE含量较发病次日逐渐下降。测定血浆ET-1、CGRP和NSE含量有助于脑出血患者的早期诊断和预后判断,具有重要的临床价值。     

缺氧大鼠出、入肺血、肺组织及心室肌降钙素基因相关肽和内皮素-1含量的变化

目的和方法:采用放免法观察常压间断缺氧大鼠出、入肺血和肺及心室肌组织匀浆中降钙素基因相关肽(CGRP)和内皮素-1(ET-1)的含量变化,并分析其与缺氧性肺动脉高压(HPH)和右心肥大间的相关关系。结果:正常大鼠入肺血CGRP含量显著高于出肺血,而ET-1含量和ET-1/CGRP比值则显著低于出肺血(P<0.01);随缺氧时间的延长,缺氧大鼠出肺血CGRP含量显著升高(P<0.05),与其肺动脉平均压(mPAP)呈正相关,而ET-1/CGRP比值则明显降低(P<0.05),与其mPAP呈负相关(r=-0.896,P<0.05);与对照组比较,缺氧大鼠入肺血及肺组织匀浆中CGRP和ET-1的含量及ET-1/CGRP比值均呈现先升高后降低趋势,至缺氧21d时入肺血的3项指标均接近正常水平;缺氧21d大鼠出肺血CGRP含量显著高于其入肺血(P<0.05)。结论:结果提示肺内CGRP和ET水平的失调在慢性HPH和右心肥大发生机制中起重要的作用。     

Plasma C-reactive protein and endothelin-1 level in patients with chronic obstructive pulmonary disease and pulmonary hypertension

Pulmonary hypertension is a frequent complication of chronic obstructive pulmonary disease (COPD) and associated with a worse survival and increased risk of hospitalization for exacerbation of COPD. However, little information exists regarding the potential role of systemic inflammation in pulmonary hypertension of COPD. The purpose of the present study was to investigate the degree of C-reactive protein (CRP) and endothelin-1 (ET-1) levels in COPD patient with and without pulmonary hypertension. The levels of CRP and ET-1 were investigated in 58 COPD patient with pulmonary hypertension and 50 patients without pulmonary hypertension. Pulmonary hypertension was defined as a systolic pulmonary artery pressure (Ppa) ≥35 mmHg assessed by Doppler echocardiography. Plasma CRP and ET-1 levels were significantly higher in patients with pulmonary hypertension than in patients without hypertension. There were significant positive correlations between the plasma ET-1 level and CRP level in the whole study groups. For COPD patients, systolic Ppa correlated significantly with plasma CRP levels and plasma ET-1 levels. These findings support a possibility that CRP and ET-1 correlate to pulmonary hypertension in COPD patients.     

老年男性代谢综合征患者血浆ET-1和CGRP检测及意义

目的:探讨血浆内皮素(ET-1)和降钙素基因相关肽(CGRP)在老年男性代谢综合征患者中的变化特征及意义。方法:采用放射免疫分析对65例临床诊断为高血压、糖尿病和35例代谢综合征的老年男性患者进行血浆ET-1和CGRP的含量检测,同步检测血脂和血糖水平,以35例健康老年男性作为对照。结果:老年男性单纯高血压和糖尿病患者血浆ET-1水平明显增高,代谢综合征组ET-1水平亦明显增高,与对照组比较有显著性差异(P<0.01,P<0.05,P<0.01),高血压组ET-1水平明显高于糖尿病组(P<0.05)。高血压组与代谢综合征组CGRP水平均明显低于对照组,有显著性差异(P<0.05,P<0.05)。两组血浆ET-1水平增高与CGRP水平下降呈显著负相关(r=-0.75,P<0.01,r=-0.53,P<0.01)。结论:老年男性代谢综合征患者血浆中ET-1和CGRP表达异常及其关联在其发病过程中具有重要临床意义,其缩、舒血管作用失调参与了高血压和糖尿病发病的病理过程。     

围手术期血浆ET-1/CGRP比值的变化

本文研究围手术期血浆内皮素－１和降钙素基因相关肽水平的动态变化及其意义。选择胃癌和结直肠癌患者,分别取术前、术中和术后第１、７天外周静脉血。     

Endothelin infusion reduces hypoxic pulmonary hypertension in pigs in vivo

Previous work has shown that the plasma levels of the potent vasoactive peptide endothelin (ET) are increased in pathophysiological conditions with increased pulmonary vascular resistance and it has been speculated that ET may play some part in hypoxic pulmonary hypertension. We have therefore evaluated the effects of ET-infusion in the porcine pulmonary circulation after hypoxia-induced hypertension. Pigs under general anaesthesia were artificially ventilated through an endotracheal tube and hypoxia was induced by decreasing the fraction inhaled 0₂ from 0.21 to 0.10. Haemodynamic parameters were continuously recorded using a Swan-Ganz catheter in combination with thermodilution for cardiac output measurements. ET-1 or ET-3 was given as an i.v. infusion through the Swan-Ganz catheter in the right ventricle. Hypoxia induced a reproducible increase in pulmonary vascular resistance (PVR), mean pulmonary artery pressure (MPAP) and right ventricular stroke work (RVSW) while the systemic vascular resistance (SVR) slightly decreased. Cumulative infusion of ET-1 (10, 25 and 50 ng kg^-1 min^-1) dose-dependently decreased MPAP and PVR; at a higher dose (100 ng kg^-1min^-1), the PVR returned to the level observed at hypoxia. ET-infusions at 50 and 100 ng kg^-1 min^-1 evoked an increase in SVR and a decrease in cardiac output (CO) and stroke volume (SV). RVSW also gradually decreased during ET-1 infusion. Infusion of ET-3 evoked effects similar to those of ET-1 infusions, although the response to ET-3 was not that rapid in onset. In a second series of animals, repeated 15 min periods of hypoxia evoked a stable, reproducible response with a consistent increase in PVR, MPAP and RVSW which returned to baseline values during normoxia. Infusion of ET-1 (25 ng kg^-1 min^-1) evoked a rapidly developing decrease in PVR and MPAP which was quickly normalized upon cessation of the ET-infusion. ET-1 infusion at this concentration did not per se influence the haemodynamic parameters during normoxia. It is concluded that in the pig, short-term ET-infusion reduces the pulmonary hypertension associated with acute hypoxia.     

Expression of endothelin-1 in rats developing hypobaric hypoxia-induced pulmonary hypertension

Experimental pulmonary hypertension induced in a hypobaric hypoxic environment (HHE) is characterized by structural remodeling of the heart and pulmonary arteries. Endothelin-1 (ET-1), a 21-amino acid peptide, is a novel and long-lasting vasoconstrictor that increases pulmonary arterial pressure in both in vivo and in vitro experiments. To study the effects of HHE on ET-1 activity in the lungs, 59 male rats were subjected to the equivalent of an altitude of 5500 m for 1 to 4 weeks. In rats exposed to HHE, the mean pulmonary arterial pressure increased significantly from 15.2+/-0.3 (ground level) to 30.6+/-1.5 mm Hg (5500-m level) at 4 weeks, whereas their mean systemic arterial pressure remained normal. The levels of ET-1 mRNA and protein, measured respectively by Northern blot analysis and enzyme immunoassay, increased rapidly in the lungs on exposure to HHE. By in situ hybridization and immunohistochemistry, respectively, ET-1 mRNA and protein were detected in control rats in nonciliated bronchiolar epithelial cells and alveolar epithelial cells, as well as in the endothelial cells of pulmonary arteries, but minimally in the smooth muscle cells of pulmonary arteries. ET-1 mRNA- and protein-reactive smooth muscle cells in pulmonary arteries and ET-1 mRNA-reactive airway epithelial cells were significantly more abundant in rats exposed to HHE than in ground level controls. These results suggest the possibility that in smooth muscle cells in pulmonary arteries and airway epithelial cells, ET-1 may play an autocrine or paracrine role in the remodeling of blood vessels during the development of the pulmonary hypertension that is induced by HHE.     

强直性脊柱炎和类风湿关节炎患者内皮素-1、降钙素基因相关肽水平的临床观察

目的：探讨内皮素-1（ET-1）、降钙素基因相关肽（CGRP）在强直性脊柱炎（AS）和类风湿关节炎（RA）病理生理过程中的作用。方法：用放射免疫法检测AS和RA患者血浆及关节液中ET-1、CGRP含量,并与健康志愿（HC）组进行比较。结果：AS、RA组血浆ET-1水平均明显高于HC组（P<0.01）;AS组和RA组血浆CGRP水平均与HC组无显著差异（P>0.05）;关节滑液中CGRP水平明显高于血浆（P<0.01）,ET-1水平明显低于血浆（P<0.01）。结论：ET-1、CGRP参与了AS、RA病理生理过程,但在AS、RA疾病过程中作用机制不同。