血清FABP4、Cat S和PON-1在急性非ST段抬高心肌梗死中的临床价值

目的 观察血清脂肪酸结合蛋白-4(FABP4)、组织蛋白酶S(Cat S)和氧磷酶(PON)-1预测急性非ST段抬高心肌梗死(NSTEMI)患者发生主要不良心血管事件(MACE)的临床价值.方法 选择2019年该院收治的119例NSTEMI患者作为NSTEMI组.另选同期于该院就诊的45例ST段抬高心肌梗死(STEMI)和75例不稳定型心绞痛(UAP)患者分别作为STEMI组、UAP组.比较各组血清FABP4、Cat S和PON-1水平的变化,分析NSTEMI患者血清FABP4、Cat S和PON-1水平与MACE发生的危险程度和心功能的关系,评估其对NSTEMI发生MACE的预测效能.结果 STEMI组血清FABP4和Cat S水平高于NSTEMI组和UAP组,NSTEMI组高于UAP组,且随着MACE发生的危险程度和心功能分级升高而升高(P<0.05);而STEMI组血清PON-1水平低于NSTEMI组和UAP组,NSTEMI组低于UAP组,且随着MACE发生的危险程度和心功能分级升高而降低(P<0.05).MACE组血清FABP4和Cat S水平高于非MACE组,而血清PON-1水平低于非MACE组(P<0.05).血清FABP4、Cat S和PON-1对NSTEMI患者发生MACE均有较高的预测效能,3项联合检测的曲线下面积(AUC)为0.983,高于FABP4、Cat S和PON-1的AUC(P<0.05).结论 血清FABP4、Cat S和PON-1在NSTEMI患者中出现异常表达,3项指标联合检测对NSTEMI患者发生MACE具有重要的预测价值.     

血清S100A4水平与急性心肌梗死患者预后相关性分析

目的探讨血清钙卫蛋白A4(S100A4)水平对急性心肌梗死(AMI)患者预后的预测价值。方法选取中铁二局集团中心医院2015年6月至2018年6月诊治的128例AMI患者作为研究组,根据患者住院期间和出院后30d主要心血管不良事件(MACE)发生情况分为非MACE组(37例)和MACE组(91例);同时选取64例体检健康人群作为对照组。检测研究对象血清S100A4、B型脑钠肽(BNP)和心肌肌钙蛋白T(cTnT)水平。采用多因素Logistic回归分析MACE发生的危险因素,同时采用受试者工作特征曲线(ROC曲线)分析血清S100A4、BNP和cTnT对AMI患者发生MACE的预测价值。结果非MACE组血清S100A4、BNP和cTnT水平显著性低于MACE组(P<0.05)。受试者工作特征曲线分析显示:S100A4对AMI患者预后的预测价值优于BNP和cTnT。多因素Logistic回归分析显示:年龄(OR=2.90,95%CI 1.24~6.74)、Killip分级(OR=5.02,95%CI 2.53~9.94)、吸烟史(OR=1.67,95%CI 1.07~2.61)、BNP>389.17pg/mL(OR=1.76,95%CI 1.19~2.61)、cTnT>0.93ng/mL(OR=1.61,95%CI 1.05~2.49)、S100A4>120.56pg/mL(OR=1.88,95%CI 1.16~3.02)是AMI患者发生MACE的危险因素。结论 AMI患者血清S100A4水平显著上升,可作为预测AMI患者MACE发生的标志物。     

急性冠状动脉综合征患者血清可溶性细胞间黏附分子-1水平的变化

目的通过测定不同类型冠心病患者血清可溶性细胞黏附分子-1(sICAM-1)浓度的变化,探讨一种早期识别和预测急性冠状动脉综合证(ACS)预后的炎性指标。方法分三组,急性冠状动脉综合征组65例(其中急性心肌梗死患者36例,不稳定心绞痛患者29例),稳定型心绞痛组50例,健康对照组50例。应用酶联免疫吸附法检测各组血清可溶性细胞间黏附分子-1水平,并测定糖脂代谢指标和血浆血浆纤维蛋白原水平。结果冠状动脉综合征组和稳定型心绞痛组血清可溶性细胞间黏附分子-1水平明显高于对照组(P<0.01)。冠状动脉综合征组血清可溶性细胞间黏附分子-1水平高于稳定型心绞痛组(P<0.01)。在冠状动脉综合征组中,急性心肌梗死亚组血清细胞间黏附分子-1水平明显高于不稳定型心绞痛亚组(P<0.05);急性心肌梗死亚组血清细胞间黏附分子-1水平与血浆纤维蛋白原和白细胞总数呈正相关(r=0.691和r=0.603,P<0.05)。不稳定型心绞痛亚组血清细胞间黏附分子-1水平与血浆纤维蛋白原、白细胞总数亦呈正相关(r=0.412和r=0.561P<0.05)。结论急性冠状动脉综合征患者血清细胞间黏附分子-1水平显著升高,且与斑块稳定和未来心脏事件密切相关。     

白细胞介素-17水平升高在急性冠脉综合征患者中的临床意义

目的 探讨白细胞介素-17(IL-17)水平在急性冠脉综合征(ACS)发病中的作用及可能途径.方法 ACS患者50例,包括不稳定型心绞痛(UAP)34例、急性心肌梗死(AMI)16例;稳定型心绞痛(SAP)21例;健康对照者10例.ELISA法检测血清IL-17水平.结果 AMI组和UAP组IL-17水平较SAP组和正常对照组明显增高(P<0.05);根据不同组别的亚组分析发现,不稳定型斑块组IL-17水平较稳定型斑块组明显增高(P<0.05).冠脉病变支数与IL-17水平无关,各组水平比较差异无统计学意义(P>0.05).结论 ACS患者血清IL-17水平增高,IL-17有望作为ACS斑块稳定性的预测因子.     

血清S100A8/A9、MMP-2水平变化与急性冠状动脉综合征的关系

目的:观察急性冠脉综合征(ACS)患者外周静脉血清S100A8/A9、基质金属蛋白酶-2(matrix metalloproteinase-2,MMP-2)水平并评价其临床意义.方法:选取ACS患者84例为ACS组,其中急性心肌梗死(acute mvocardial infarction,AMI)43例,不稳定型心绞痛(unstable angina,UA)41例.正常对照组为健康体检患者,选用23例作为对照.用酶联免疫吸附法(enzyme-linked immunosorbnent assay,ELISA)检测血清S100A8/A9、MMP-2水平.结果:AMI组、UA组血清S100A8/A9、MMP-2水平高于对照组(P<0.01);AMI组和UA组血清S100A8/A9、MMP-2的水平有显著差异(P<0.01).ACS组患者血清S100A8/A9与MMP-2水平无相关性(R=0.151,P>0.05).结论:S100A8/A9、MMP-2在ACS患者的高表达提示可能与动脉粥样斑块的形成有关,联合检测血清S100A8/A9、MMP-2可能成为一种有效的预测急性心血管事件发生的临床指标.     

S100A8/A9与不稳定型心绞痛患者冠状动脉病变及短期预后相关性分析

目的探讨不稳定型心绞痛患者经皮冠状动脉介入术(percutaneous coronary intervention, PCI)前血清S100A8/A9蛋白水平与冠状动脉病变严重程度的相关性以及PCI后S100A8/A9蛋白水平变化与短期预后的相关性。方法行冠状动脉造影检查的不稳定型心绞痛患者99例,其中冠状动脉正常27例(对照组),冠状动脉病变72例(冠状动脉病变组,均行PCI),再根据Gensini评分将冠状动脉病变组分为轻中度病变(Gensini评分1～59分)组43例和重度病变组(Gensini评分≥60分)29例。记录患者临床资料,采用ELISA法检测血清S100A8/A9蛋白水平,采用Spearman相关法分析S100A8/A9蛋白水平与Gensini评分的相关性,采用多因素logistic回归分析冠状动脉病变严重程度的危险因素,应用Cox比例风险回归模型分析患者PCI前、后S100A8/A9蛋白水平变化与短期预后的关系。结果冠状动脉病变组PCI前血清S100A8/A9蛋白水平[628.80(359.90,1 045.00)μg/L]高于对照组[362.30(230.80,558.50)μg/L](P0.05);重度病变组PCI前血清S100A8/A9蛋白水平[813.50(577.10,1 645.00)μg/L]高于轻中度病变组[505.50(300.60,862.10)μg/L](P0.05)。冠状动脉病变组PCI前血清S100A8/A9蛋白水平与冠状动脉Gensini评分呈正相关(r=0.332,P=0.004)。PCI术前血清S100A8/A9蛋白水平升高是冠状动脉重度病变的独立危险因素(OR=1.091,95%CI:1.010～1.178,P=0.027)。冠状动脉病变患者PCI后S100A8/A9蛋白水平较术前每升高100个单位,发生短期主要心血管不良事件的风险提高5.8%(HR=1.058,95%CI:1.021～1.096,P=0.002)。结论不稳定型心绞痛冠状动脉病变患者PCI前S100A8/A9蛋白水平与冠状动脉病变严重程度相关,PCI前、后S100A8/A9蛋白变化水平与患者短期预后相关。     

不同类型冠心病患者血浆游离脂肪酸水平变化及其与病变程度的关系

目的探讨血浆游离脂肪酸(NEFA)水平变化与冠心病(CAD)病变程度的相关性。方法选取疑为CAD患者84例,分别行生化检验和冠状动脉造影检查;根据冠状动脉造影结果将其分为4组,分别为不稳定型心绞痛组(n=46)、稳定型心绞痛组(n=9)、急性心肌梗死组(n=20)、阴性对照组(n=9),对比组间血脂指标与NEFA是否存在差异分析,CAD患者发生急性心肌梗死风险与造影特点。结果 CAD组NEFA水平均高于阴性对照组,差异有统计学意义(P0.05);急性心肌梗死组NEFA水平高于稳定型心绞痛组和不稳定型心绞痛组,差异有统计学意义(P0.05);Logistic回归分析显示,校正后NEFA≥0.415mmol/L组出现急性心肌梗死的风险是NEFA0.415mmol/L组的2.61倍,95%CI:1.33~5.02,P0.05;不同水平的NEFA患者GENSINI积分、狭窄冠状动脉支数与3支冠状动脉病变数量差异无统计学意义(P0.05)。结论 CAD患者血浆NEFA出现升高,急性心肌梗死患者升高明显,但其与病变程度相关性未明确。     

心理应激与急性心肌梗死的相关性

目的:分析心理应激与急性心肌梗死的相关性.方法:经冠状动脉造影检查及临床确诊为急性心肌梗死和稳定型心绞痛患者60例分为急性心肌梗死组和稳定型心绞痛组,进行社会心理应激调查,检测其血清白细胞介素-6、可溶性细胞间黏附分子-1及C-反应蛋白水平,并进行比较.结果;(1)急性心肌梗死组有心理应激者明显高于稳定型心绞痛组.分别为88.5%和32.4%(P<0.01);心理应激组急性心肌梗死、稳定型心绞痛患者分别为67.6%.32.4%(P<0.01).(2)心理应激组血清C-反应蛋白、白细胞介素-6及可溶性细胞间黏附分子-1水平高于非心理应激组(P<0.01);急性心肌梗死组血清C-反应蛋白、白细胞介素-6及可溶性细胞间黏附分子-1水平高于稳定型心绞痛组(P<0.01).结论:心理应激因素与急性心肌梗死发生、发展关系密切.心理应激使体内炎症因子分泌增高,致使动脉粥样硬化斑块由稳定变为不稳定,从而诱发急性心肌梗死发生.     

4 ℃高渗盐对心搏骤停大鼠S100蛋白的影响

目的 探讨4℃高渗盐(HTS)对心搏骤停(SCA)大鼠血清及脑海马组织S100蛋白的影响.方法 30只大鼠随机分为假手术(A)组、生理盐水(NS)(B)组、4℃生理盐水(NS)(C)组、HTS(D)组、4℃HIS(E)组.每组6只,除A组外,其余各组均于复苏即刻给药.制作窄息致大鼠SCA模型,自主循环恢复(ROSC)后24 h采静脉血检测各组血清S100蛋白浓度,处死大鼠取脑组织检测脑海马S100蛋白的表达.数据以均数±标准差(χ±s)表示,统计采用方差分析和q检验,以P<0.05为差异具有统计学意义.结果 血清S100蛋白浓度B,c,D,E组较A组均明显升高(P<0.01),C,D.E组较B组明显降低(P<0.01),D,E组较C组明显降低(P<0.01),E组较D组降低(P<0.05).脑组织S100表达B,C,D组较A组均明显升高(P<0.01),E组较A组亦升高(P<0.05);C组较B组低(P<0.05),D,E较B组降低更明显(P<0.01);D、E组较C组下降显著(P<0.01);E组较D组低(P<0.05).结论 SCA后给予4℃HTS能降低血清S100蛋白的浓度、抑制脑海马组织S100蛋白的表达,保护脑组织.     

血清S100B蛋白测定对儿童自身免疫性脑炎早期识别的临床意义

目的 探讨血清S100B蛋白测定对儿童自身免疫性脑炎（AE）早期识别的临床意义。方法 选取30例AE患儿为AE组、30例病毒性脑炎患儿为病毒性脑炎组、30名健康儿童为健康对照组，分别检测3组的血清S100B蛋白、神经元特异性烯醇化酶（NSE）、基质金属蛋白酶（MMP）水平，使用受试者操作特征（ROC）曲线分析血清S100B蛋白、NSE、MMP水平对儿童AE早期识别的预测价值。比较不同分期、不同病情程度和不同预后AE患儿的血清S100B蛋白水平。结果 AE组的血清S100B蛋白、NSE、MMP水平高于病毒性脑炎组、健康对照组，且病毒性脑炎组的血清S100B蛋白、NSE、MMP水平高于健康对照组（P <0.05）。血清S100B蛋白、NSE、MMP水平预测AE时，血清S100B蛋白的AUC最高，为0.881，明显高于NSE(Z=2.142,P=0.032)和MMP(Z=2.360,P=0.018)。急性发作期、重症、预后不良的AE患儿血清S100B蛋白水平分别高于恢复期、轻症、预后良好的AE患儿（P <0.05）。结论 血清S100B蛋白测定对儿童AE的早期诊断有较高价值，且S...     

S100 proteins as cancer biomarkers with focus on S100B in malignant melanoma

Although histochemical staining of the S100 protein family has been used for many years in the diagnosis of malignant melanoma, recent studies suggest one of the proteins comprising the S100 family, S100B, has particular utility in many aspects of the clinical management of malignant melanoma. This protein has been shown to be of use in staging malignant melanoma, in establishing prognosis, in evaluating treatment success and in predicting relapse. S100B is an independent prognostic factor and pretreatment circulating S100B concentrations predict duration of survival in melanoma patients. Survival is significantly longer in melanoma patients with normal S100B levels compared to those with elevated levels. Circulating S100B levels very sensitively detect metastatic growth of malignant melanoma, particularly in stage IV disease where S100B is certainly superior to other laboratory parameters. S100B concentrations reflect tumor mass. Serum S100B levels predict efficacy of treatment. Decreasing S100B concentrations reflect response to therapy while increasing S100B concentrations indicate tumor progression. Circulating S100B has a role to play in the decision to switch treatment regimens.     

Significance of S100A8, S100A9 and calprotectin levels in bladder cancer

Objectives: Members of the S100 protein family, S100A8, S100A9 and their heterodimer complex known as calprotectin are thought to be involved not only in inflammatory pathways but also in tumorigenesis and cancer progression. Therefore, they have been widely studied in various types of cancer; however, there is limited knowledge about their role in bladder cancer. In this study, our aim was to determine the levels of S100A8 and S100A9 in the sera, and calprotectin levels in the sera and urines of bladder cancer patients and compare it to urinary BTA, a tumor marker that can be used in the diagnosis of bladder cancer.

Materials and methods: The study was comprised of two major groups: 52 healthy controls and 82 patients with bladder cancer. The patient group was also divided into subgroups according to tumor stage and grade. Urine BTA levels, serum S100A8 and S100A9 levels, and serum and urine calprotectin levels in healthy controls and patients were determined using commercially available ELISA kits.

Results: While serum S100A8 and S100A9 levels did not differ between the controls and patients significantly, serum and urine calprotectin levels and urine BTA levels were significantly elevated in patients compared to controls. Serum calprotectin or urine BTA levels did not differ significantly among the patient subgroups. However, urine calprotectin levels were significantly elevated in muscle-invasive tumors (T2–4) compared to lower stages (Ta and T1).

Conclusions: Urine calprotectin levels can be used in the diagnosis and staging of bladder cancer as a marker for muscle invasion.     

S100B testing in pregnancy

Follow-up studies have shown that the vast majority of neurological abnormalities present during childhood can have a prenatal or perinatal origin. It is relevant, therefore, to investigate the timing of adverse insults in the search for measures of prevention. However, such knowledge is still incomplete and subject to debate. Until recently, clinical-laboratory assessment was based essentially on biochemical aspecific parameters, ultrasound and Doppler patterns, and the determination of blood pH and gases. However, the measurement of brain constituents may offer a direct indicator of cell damage in the nervous system. The S100B protein, a calcium-binding protein highly concentrated in the nervous system, appears to meet the criteria required of such a marker in prenatal and perinatal medicine for its reproducible, simple and sensible measurements. Results in high-risk pregnancies demonstrated that S100B concentration increased in amniotic fluid and in cord blood of fetuses with brain damage. In addition, S100B protein has been also usefully employed to monitor the effects of maternal-antenatal therapy, such as NO and glucocorticoid administration. It appears also to be relevant that a neurotrophic role has been hypothesized for the protein, which in fact exhibits in amniotic fluid, in cord blood and in placenta patterns of concentration related to the gestational age.     

ELISA法测定血清S100B蛋白

目的建立ELISA测定血清S100B蛋白的方法。方法制备S100B单克隆和多克隆抗体,以双抗体夹心法测定血清S100B蛋白。结果方法的平均回收率为93.7%-104%,批内及批间平均变异分别为3.7%和5.9%,方法的线性为0-12.5μg/l,参考值范围为0.14-0.38μg/l。结论该法简便、快速、特异、敏感,适于临床常规应用。