肺结核患者血清IL-6和IL-10的动态变化及临床意义

目的探讨肺结核患者血清IL-6和IL-10化疗前后的动态变化及其与肺结核病变活动的关系。方法采用ELISA双抗体夹心方法检测38例初治肺结核患者血清中化疗前及化疗后4周IL-6和IL-10的值,并观察结核病变活动的变化。结果肺结核患者IL-6化疗前显著高于正常对照组,化疗4周后明显下降,但仍高于对照组;IL-10化疗前显著高于正常对照组,化疗4周后降低至正常水平。结论肺结核患者化疗前促炎、抑炎反应增强,经过4周有效的抗结核治疗后,结核病灶吸收,空洞缩小,痰菌转为阴性,促炎反应显著减弱,抑炎反应降至正常水平。     

非酒精性脂肪性肝病患者血清中IL-8、IL-18的水平及其临床意义

随着非酒精性脂肪性肝病(NAFLD)发病率的逐年上升及对健康的危害,被认为可能是发展成终末期肝病的一个重要病因,NAFLD是一组在不饮酒人群中发生的常见的脂肪性肝病(不包括病毒性肝炎、自身免疫性肝病、遗传性肝病等原因而引起的脂肪肝).NAFLD包括3种类型:单纯性脂肪肝、非酒精性脂肪性肝炎(NASH)、脂肪性肝硬化.其发病机制比较复杂,至今尚未阐明,由胰岛素抵抗(IR)、脂肪酸代谢紊乱、氧应激反应、细胞因子异常等而引起.NASH是由单纯性脂肪肝到隐源性肝硬化的代谢性脂肪肝疾病链中的关键点,探讨多种生物效应的IL-8、IL-18在NASH发病中的作用,测定血清中IL-8、IL-18的浓度,能反映肝细胞损害程度,对判断患者病情、预后有一定的临床意义.     

冠心病患者血清IL-6和IL-10水平检测的临床意义

目的探讨血清可溶性白细胞介素-6（IL-6）和白细胞介素-10（IL-10）水平与冠心病（CHD）病情及与冠状动脉病变程度的关系。方法将165例冠心病患者按临床诊断分为3组：急性心肌梗死（AMI）组60例、不稳定性心绞痛（UAP）组50例、稳定性心绞痛（SAP）组55例;健康对照组55例。用酶联免疫吸附试验检测各组血清可溶性IL-6和IL—10的水平,并比较各组间的差异。结果AM／组、UAP组及SAP组的血清可溶性IL-6和IL-10水平比对照组高（P〈0．05）,AMI组、UAP组血清IL-6水平高于SAP组（P〈0．05）;AMI组和UAP组血清IL-10水平低于SAP组（P〈0．05）;AMI组和UAP组血清IL-10的水平相似（P〉0．05）;结论冠心病患者血清可溶性IL-6及IL-10明显升高,且在一定程度上反映了病情、病变的严重程度,可作为CHD危险分层及病变程度评估的参考指标。     

非酒精性脂肪性肝病患者血清TLR4、IL-10、IL-22与肠道菌群的相关性

目的探讨非酒精性脂肪性肝病(NAFLD)患者血清Toll样受体4(TLR4)、白介素-10(IL-10)、白介素-22(IL-22)与肠道菌群的相关性。方法研究对象选自2016年6月至2018年8月期间我院消化内科收治的126例NAFLD患者。选取同期进行体检的健康人90例作为对照组。比较各组间肠道菌群及肠道定植抗能力,血清TLR4、IL-10、IL-22水平,并进行pearson相关性分析和logistic多元回归分析。结果与对照组相比,NAFLD组双歧杆菌、乳酸杆菌、B/E值更低(P0.05),肠杆菌、肠球菌更高(P0.05)。NAFLD组血清TLR4显著高于对照组,IL-10、IL-22低于对照组(P0.05)。经pearson相关性分析,NAFLD患者TLR4与双歧杆菌、乳酸杆菌、B/E值呈负相关(P0.05),与肠杆菌、肠球菌呈正相关(P0.05);IL-10、IL-22与双歧杆菌、乳酸杆菌、B/E值呈正相关(P0.05),与肠杆菌、肠球菌呈正负相关(P0.05)。经logistic回归分析发现,TLR4、IL-10、IL-22是NAFLD患者B/E值的影响因素。结论 TLR4、IL-10、IL-22可能通过影响NAFLD患者的肠道菌群失调,参与疾病的发生、发展。     

老年COPD患者痰IL-4、IL-10、INF-γ水平及临床意义

目的探讨COPD患者痰白细胞介素4(interleukin,IL-4)、IL-10、干扰素-γ(interferon,INF-γ)水平及临床意义。方法老年COPD患者共60例(重度20例,中度20例,轻度20例),正常对照20例。采用双抗体夹心酶联免疫吸附实验,检测诱导痰IL-4、IL-10、INF-γ水平。结果①急性期重、中度COPD组痰IL-4水平低于轻度组(P<0.05)。②急性期重度组痰IL-10水平均高于轻度组。治疗后重度、中度组痰IL-10水平均比治疗前显著升高(P均<0.01)。③重、中度组急性期痰IFN-γ值显著高于治疗后缓解期(P均<0.01),且重、中度组急性期痰IFN-γ值均高于轻度组。④老年COPD患者痰中IL-4与IL-10;IL-10与IFN-γ存在相关,IL-4与IFN-γ不存在相关。结论 COPD时Th1类细胞因子(IFN-γ)呈优势状态;前炎症因子水平增高。     

肺结核患者外周血sIL-2R、IL-6、IL-8、IL-10及TNF-α的检测意义

目的分析未抗痨治疗的结核患者及已经有效治疗的患者s IL-2R、IL-6、IL-8、IL-10及TNF-α表达的差异,以探讨上述指标的变化及意义。方法采用免疫化学发光法检测未抗结核治疗患者(A组)、抗结核治疗有效患者(B组)及健康组(C组)上述指标的表达水平,并比较各组差异。结果 A组C组相比较,均明显升高(P0.01)。B组s IL-2R和IL-6的含量较A组明显下降,分别为(509.41±96.52)U/ml vs(1207.09±105.33)U/ml和(8.91±3.22)pg/ml vs(37.84±15.46)pg/ml(P0.01);IL-8和TNF-α在B组中的含量较A组明显下降,分别为(12.78±3.69)pg/ml vs(23.82±5.67)pg/ml和(14.33±6.82)pg/ml vs(32.41±11.66)pg/ml(P0.05);而IL-10水平未发生明显变化。结论肺结核病患者s IL-2R、IL-6、IL-8、TNF-α水平明显增加,抗结核治疗后上述因子水平明显降低,初步提示s IL-2R、IL-6、IL-8、TNF-α表达水平与结核活动程度相关,有望进一步作为评价肺结核活动程度的指标。     

热性惊厥患儿血清IL-6、IL-10水平与呼吸道病毒感染的关系

目的检测热性惊厥患儿血清白介素-6(IL-6)、白介素-10(IL-10)表达水平,并探讨其与呼吸道病毒感染的关系。方法选取2016年4月～2018年4月来西安医学院第二附属医院就诊的136例热性惊厥患儿为研究对象,同期选择88例健康儿童作为对照组,采用酶联免疫吸附法检测血清IL-6、IL-10表达水平,采用免疫荧光法对受试者鼻咽部脱落细胞进行病毒抗原检测,分析不同类型病毒感染热性惊厥患儿血清中IL-6、IL-10水平及患儿临床特征,探讨对非典型热性惊厥(复杂性热性惊厥,CFS)患儿临床特征的危险因素。结果复杂性热性惊厥组患儿血清IL-6水平显著高于单纯性热性惊厥(SFS)组和对照组(P0.05),SFS组患儿血清IL-6水平显著高于对照组(P0.05),CFS组患儿血清中IL-10表达水平显著低于SFS组和对照组(P0.05),SFS组患儿血清中IL-10水平显著低于对照组(P0.05);流感病毒A(FluA)组热性惊厥患儿血清中IL-6水平显著高于副流感病毒(PIV)组、腺病毒(ADV)组、呼吸道合胞病毒(RSV)组(P0.05),FluA组热性惊厥患儿血清中IL-10水平显著低于PIV组、ADV组、RSV组(P0.05);FluA、PIV、ADV、RSV四组之间年龄、热峰、热程、同一热程多次惊厥发作、发作后长程意识水平下降(PPIC)比较差异具有统计学意义(P0.05);非典型热性惊厥患儿临床特征的危险因素分析结果显示年龄与部分性发作有关(P0.05),同一热程中多次惊厥发作与年龄、FluA病毒有关(P0.05)。PPIC与热程、同一热程中多次惊厥发作、ADV感染有关(P0.05)。结论 FS患儿血清IL-6表达水平上调,IL-10水平下调,不同病毒类型感染的热性惊厥患儿临床表现不同,年龄、同一热程中多次惊厥发作、FluA、PPIC等可能是FS发作的重要因素,其中FIuA可能是FS发病的高危因素。     

非酒精性脂肪性肝病患者内毒素、瘦素、IL-6及IL-8水平测定

目的探讨非酒精性脂肪性肝病（NAFLD）患者内毒素（ET）、瘦素、IL-6、IL-8水平在NASH发生发展中的变化情况,以及它们与脂肪肝严重程度的关系。方法90例NAFLD患者根据脂肪肝严重程度分为轻度者30例,中度者30例,重度者30例。测定患者及30例健康对照者的体重指数（BM I）、内毒素（ET）、瘦素、IL-6、IL-8的水平。结果与健康对照者比较,NAFLD患者ET升高,伴随ET水平的升高,瘦素及IL-6、IL-8也升高,中度及重度更加明显（P〈0.05）。重度与中度相比差异无统计学意义（P〉0.05）。结论NAFLD患者存在肠源性内毒素血症（IETM）、瘦素、IL-6、IL-8等细胞因子在非酒精性脂肪性肝病发病中具有重要致病作用,其升高程度与脂肪肝严重程度一致。     

应用美洛昔康对手术病人IL-6和IL-10的不同影响

目的 观察口服美洛昔康对手术病人IL-6和IL-10的不同影响。方法 择期腹部外科手术病人40例，随机分为安慰剂组(Ⅰ组20例)，美洛昔康组(Ⅱ组20例)。术前和切皮后30min、2h、4h、6h、12h和24h检测血中IL-6，IL-10和皮质醇浓度。术前和切皮后24h测量体温，白细胞计数和C-反应蛋白浓度。结果 IL-6和IL-10浓度升高，两者分别在12h和6h达到高峰。在12h时，IL-6浓度在Ⅱ组明显低于工组的病人(P=0．03)；相比之下，在6h时，IL-10浓度在Ⅱ组明显高于Ⅰ组的病人(P=0．008)；同时在Ⅱ组病人中有更低的发热(P=0．03)，更少的白细胞计数(P=0．0002)和更低的C-反应蛋白浓度(P=0．0034)，血清皮质醇浓度更低。结论 应用美洛昔康后IL-6浓度下降，IL-10浓度升高，白细胞计数降低，C-反应蛋白浓度和体温下降。美洛昔康对手术病人有抗炎作用。     

非酒精性脂肪性肝病患者肝损伤程度与IL-18、IL-8含量的相关性

目的 探讨非酒精性脂肪性肝病(NAFLD)患者肝损伤程度与白介素(IL)-18、IL-8水平的相关性.方法 分别用酶联免疫吸附分析(ELISA)法及放射免疫分析(RIA)法检测60例NAFLD患者(NAFLD组)[其中非酒精性脂肪肝患者30例(NAFL组),非酒精性脂肪性肝炎患者30例(NASH组)]和30例正常对照组血清IL-18、IL-8的水平;常规方法检测ALT、AST、TG的水平.结果 NAFL组、NASH组与对照组比较血清IL-18、IL-8、TNF-a、ALT、AST、TG水平差异具有非常显著性(P<0.01),NAFL组与对照组及NASH组与NAFL组比较,上述指标差异均具有显著性(P<0.05).结论 IL-18、IL-8水平随肝细胞受损程度加重而增加,并与ALT、TG水平呈正相关.IL-18是T细胞介导肝损伤的必须媒介,IL-8是介导炎症反应中起重要作用的因子,可能在肝损伤起重要作用.血清IL-18、IL-8浓度的高低可用于判断NAFLD患者肝损伤的严重程度及监测疾病变化.     

Serum Resistin Levels in Adult Patients with Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis

Background and AimsPrevious studies reported that serum resistin levels were remarkably changed in patients with nonalcoholic fatty liver disease (NAFLD) but the conclusions were inconsistent. The aim of this study was to investigate accurate serum resistin levels in adult patients with NAFLD.MethodsA complete literature research was conducted in the PubMed, Embase, and Cochrane Library databases, and all the available studies up to 7 May 2020 were reviewed. The pooled standardized mean difference (SMD) values were calculated to investigate the serum resistin levels in patients with NAFLD and healthy controls.ResultsA total of 28 studies were included to investigate the serum resistin levels in patients with NAFLD. Patients with NAFLD had higher serum resistin levels than controls (SMD=0.522, 95% confidence interval [CI]: 0.004–1.040, I²=95.9%). Patients with nonalcoholic steatohepatitis (NASH) had lower serum resistin levels than the healthy controls (SMD=−0.44, 95% CI: −0.83–0.55, I²=74.5%). In addition, no significant difference of serum resistin levels was observed between patients with NAFL and healthy controls (SMD=−0.34, 95% CI: −0.91–0.23, I²=79.6%) and between patients with NAFL and NASH (SMD=0.15, 95% CI: −0.06–0.36, I²=0.00%). Furthermore, subgroup and sensitivity analyses suggested that heterogeneity did not affect the results of meta-analysis.ConclusionsThis meta-analysis investigated the serum resistin levels in adult patients with NAFLD comprehensively. Patients with NAFLD had higher serum resistin levels and patients with NASH had lower serum resistin levels than healthy controls. Serum resistin could serve as a potential biomarker to predict the development risk of NAFLD.     

非酒精性脂肪肝患者血清抵抗素与胰岛素抵抗关系的研究

目的 探讨非酒精性脂肪肝患者血清抵抗素水平及其与肥胖、胰岛素抵抗、血糖、血脂的关系.方法 选择非酒精性脂肪肝患者100例,正常对照30例,采用ELISA方法测定空腹血清抵抗素,同时检测其身高、体重、腰围、臀嗣、血糖、血脂、肝功能及胰岛素水平,并计算体重指数、腰臀比和胰岛索敏感指数.结果 非酒精性脂肪肝患者血清抵抗素水平为17.68±5.2 ng.ml,高于正常对照组的12.85±4.4 ng.ml,P<0.01.相关分析显示,血清抵抗素与体重指数、甘油三酯呈正相关关系(分别为r=0.376、0.426,P<0.05),与胰岛素敏感指数呈负相关关系,(r=-0.584,P<0.01),而与腰臀比、总胆固醇、低密度酯蛋白胆固醇、高密度脂蛋白胆固醇、血糖无相关性,(P>0.05).结论 在非酒精性脂肪肝的发病过程中,抵抗素可能参与了胰岛素抵抗.     

Serum Lipid Abnormalities and Nonalcoholic Fatty Liver Disease in Adult Males

Background

Dyslipidemia is a risk factor for nonalcoholic fatty liver disease (NAFLD). The aim of our study was to determine the associations of serum lipid indexes with NAFLD in adult males.

Gallstone Disease Does Not Predict Liver Histology in Nonalcoholic Fatty Liver Disease

Background/Aims

We sought to examine whether the presence of gallstone disease (GD) in patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD) is associated with liver fibrosis and histological nonalcoholic steatohepatitis (NASH) score.

Methods

We included 441 Turkish patients with biopsy-proven NAFLD. GD was diagnosed in the presence of sonographic evidence of gallstones, echogenic material within the gallbladder with constant shadowing and little or no visualization of the gallbladder or absence of gallbladder at ultrasonography, coupled with a history of cholecystectomy.

Results

Fifty-four patients (12.2%) had GD (GD+ subjects). Compared with the GD- subjects, GD+ patients were older, had a higher body mass index and were more likely to be female and have metabolic syndrome. However, GD+ patients did not have a higher risk of advanced fibrosis or definite NASH on histology. After adjustment for potential confounding variables, the prevalence of GD in NAFLD patients was not associated with significant fibrosis (≥2) (odds ratio [OR], 1.06; 95% confidence interval [CI], 0.53 to 2.21; p=0.68) or definite NASH (OR, 1.03; 95% CI, 0.495 to 2.12; p=0.84).

Conclusions

The presence of GD is not independently associated with advanced fibrosis and definite NASH in adult Turkish patients with biopsy-proven NAFLD.