重度单纯性肥胖儿童外周血中NPY和胰岛素水平的测定

目的　了解神经肽 Y(NPY)与肥胖的关系。方法　应用放免法测定重度单纯性肥胖儿童和正常体重儿童外周血中 NPY和胰岛素含量。结果　肥胖组血浆 NPY含量 (1 85.97± 35.86pg/ml)较对照组 (1 53.57± 42 .0 5pg/ml)显著升高。肥胖组血胰岛素含量也显著高于对照组。结论　肥胖症的发生可能与高水平的血 NPY有关。     

肥胖儿童血浆中神经肽Y的水平及相关因素的分析

[目的]探讨神经肽Y(NPY)在单纯性肥胖儿童血浆中的水平及影响NPY水平的一些相关因素。[方法]选择120名6~14岁单纯性肥胖儿童(轻度、中度、重度各40人)和40名正常体重儿童,用放免法测定血浆NPY水平,比较肥胖组与对照组之间NPY水平的差异性,同时对肥胖儿童进行相关的问卷调查,对资料进行分类分析。[结果]单纯性肥胖组血浆NPY水平(174.64±38.25)pg/mL明显高于对照组(128.69±32.65)pg/mL,P<0.0001;轻度肥胖组(155.67±31.82)pg/mL明显高于对照组而低于中、重度肥胖组(178.55±38.75)、(189.69±37.27)pg/mL,P<0.001。体重越高血浆NPY越高,高血脂组明显高于非高血脂组,每日频繁进食组显著高于非频繁进食组。[结论]NPY在单纯性肥胖儿童血浆中明显升高,其与年龄无关,男、女组间无差异,但与体重、血脂水平、每日进食频率等因素有关。     

恩替卡韦治疗慢性乙型肝炎纤维化的有效性和安全性观察

目的 分析恩替卡韦治疗慢性乙型肝炎(CHB)对患者细胞因子和肝纤维化的影响,探究恩替卡韦对CHB的治疗价值.方法 选取我院2013年2月至2015年10月诊治的180例CHB患者根据抗病毒治疗方案分为恩替卡韦组(使用恩替卡韦,n=90)和对照组(使用聚乙二醇干扰素,n=90),检测用药前后两组患者血清细胞因子、肝纤维化、病毒动力学以及药物不良反应情况,对比两种药物的治疗价值.结果 ①用药后12周恩替卡韦组IL-4(55.34±8.87)pg/mL、IL-6(30.91±8.03)pg/mL、TNF-α(39.93±5.81)pg/mL、TGF-β(11.42±3.05)pg/mL、hs-CRP(10.76±4.01)pg/mL、HA(142.79±28.64)ng/mL、LN(172.85±30.26)ng/mL、ⅣC(269.67±48.15)ng/mL、PCⅢ(166.77±40.46)ng/mL明显低于对照组,差异均有统计学意义(P<0.05);用药后24周、恩替卡韦组IL-4(41.63±7.19)pg/mL、IL-6(22.57±7.21)pg/mL、TNF-α(36.54±5.63)pg/mL、TGF-β(9.25±2.61)pg/mL、hs-CRP(7.19±3.67)pg/mL、HA(130.16±24.08)ng/mL、LN(144.64±28.72)ng/mL、ⅣC(218.67±34.85)ng/mL、PCⅢ(140.54±31.52)ng/mL明显低于对照组,差异均有统计学意义(P<0.05);用药后48周恩替卡韦组IL-4(35.37±6.24)pg/mL、IL-6(19.63±6.65)pg/mL、TNF-α(29.67±4.85)pg/mL、TGF-β(7.44±2.16)pg/mL、hs-CRP(6.14±3.15)pg/mL、HA(95.37±16.69)ng/mL、LN(130.14±23.26)ng/mL、ⅣC(164.28±32.06)ng/mL、PCⅢ(130.98±26.84)ng/mL明显低于对照组,差异均有统计学意义(P<0.05);②用药后24周,恩替卡韦组病毒学应答率(88.89%)、完全应答率(88.89%)明显高于对照组,差异均有统计学意义(P<0.05),用药后48周,恩替卡韦组病毒学应答率(92.22%)、完全应答率(94.44%)明显高于对照组,差异均有统计学意义(P<0.05);③恩替卡韦组不良反应率(14.44%)显著低于对照组(28.89%),组间差异具有统计学意义(P<0.05).结论 恩替卡韦治疗CHB能够明显降低血清炎性因子表达水平,改善肝纤维化和病毒应答情况,且药物副作用少,建议临床加以重视.     

老年慢性肺源性心脏病患者胃生长素水平和营养状况关联性的研究

目的:探讨老年慢性肺源性心脏病患者血清胃生长素(Ghrelin)水平和营养状况的关联性。方法:对64例老年慢性肺源性心脏病患者进行营养状态评价,分为营养不良组(38例)和营养正常组(26例),另用30例健康老年人作为正常对照组,同时测定其血清Ghrelin水平,并分析其与各营养指标的关联性。结果:营养不良组的Ghrelin水平〔(1.6±0.1)pg/mL〕低于营养正常组〔(2.4±0.1)pg/mL〕(P<0.05)和正常对照组〔(3.1±0.1)pg/mL〕(P<0.01);各组Ghrelin水平与各营养指标均呈显著关联性。结论:血清Ghrelin水平与老年慢性肺源性心脏病营养不良有关,临床上可以作为诊断老年慢性肺源性心脏病合并营养不良的筛选指标。     

艾拉莫德联合甲氨蝶呤对类风湿性关节炎患者血清M-CSF、IL-6、IL-8及骨代谢的影响

目的：观察艾拉莫德联合甲氨蝶呤对类风湿性关节炎(RA)患者血清巨噬细胞集落刺激因子（M-CSF）、白介素-6(IL-6)、白介素-8(IL-8)及骨代谢的影响。方法选取我院风湿免疫科2013年6月至2015年6月收治的116例RA患者,按随机数字表法分为观察组和对照组,每组58例。对照组给予甲氨蝶呤片治疗,观察组在对照组治疗的基础上联合艾拉莫德治疗,持续治疗24周。比较治疗前后两组患者血清中M-CSF、IL-6和IL-8水平变化和骨代谢相关指标。结果治疗后观察组患者血清中环氧合酶(COX-2)、肿瘤坏死因子(TNF-α)、M-CSF、IL-6和IL-8各指标水平[(12.61±2.49) pg/mL、(5.48±1.36) pg/mL、(894±156) pg/mL、(2.49±0.46) pg/mL、(82.47±16.26) ng/mL]明显低于对照组[(16.88±3.94) pg/mL、(7.46±1.46) pg/mL、(1249±246) pg/mL、(4.76±1.21) pg/mL、(112.36±24.67) ng/mL],差异均具有统计学意义(P<0.05);治疗后观察组患者的N-端骨钙素(N-MID)、总1型胶原氨基端延长肽(T-P1NP)和25羟维生素D[25(OH)D]各指标含量[(19.34±3.98) ng/mL、(44.25±8.54) ng/mL、(18.72±3.86) ng/mL]明显高于对照组[(14.16±3.04) ng/mL、(32.47±7.42) ng/mL、(15.01±2.19) ng/mL],差异均具有统计学意义(P<0.05),而观察组β-胶原降解产物(β-CTX)、血沉、C-反应蛋白、触痛关节数及肿胀关节数和ADS28评分等指标[(0.47±0.11) pg/mL、(21.45±6.14) mm/h、(12.69±4.18) mg/L、(2.48±0.36)个、(1.24±0.26)个、(3.45±0.86)分]均明显低于对照组[(0.76±0.18) pg/mL、(36.42±9.17) mm/h、(19.38±5.12) mg/L、(3.89±0.76)个、(2.06±0.66)个、(5.85±1.69)分],差异均具有统计学意义(P<0.05)。结论艾拉莫德联合甲氨蝶呤治疗类风湿性关节炎患者疗效显著,其能缓解关节疼痛及临床症状,改善患者骨代谢,值得临床推广应用。     

生长抑素对急性胰腺炎免疫异常的双向调节作用

目的　观察急性胰腺炎时炎症性细胞因子和抗炎症性细胞因子的分泌变化 ,并探讨生长抑素(思他宁 )对急性胰腺炎的治疗机理。方法　实验选用 SD大鼠 ,分为正常对照组 (n=6 )、急性胰腺炎组 (采用开腹胰管注射 5 %牛黄胆酸钠 1.0 m l/ kg诱导急性胰腺炎 ,不治疗 )和生长抑素治疗组 (胰腺炎诱导成功后 0 .5小时静脉注射思他宁 2 0μg/ kg)。后两组动物分别在术后 2小时 (n=6 )、6小时 (n=6 )和 2 4小时 (n=8)处死抽血 ,用 Bioassay法检测血中炎症性细胞因子 IL - 1、TNFα和 IL - 6 ;用 EL ISA检测血中抗炎症性细胞因子 IL - 10和 TGF-β;作血清淀粉酶及胰腺湿重测定。结果　对照组血中 IL - 1为 0 .5 6± 0 .0 6 ng/ m l,TNFα为 2 3.5 0± 1.871IU / m l,IL - 6为 6 9.0±6 .40 IU/ m l,IL- 10为 32 .0 5± 14.87pg/ ml,TGF- β为 6 6 .4± 13.2 0 pg/ ml。急性胰腺炎组成模后 2 4小时其血中 IL-1为 1.15± 0 .13ng/ m l,TNFα为 5 5 .33± 12 .79IU/ m l,IL- 6为 12 7.17± 13.91IU/ ml,IL- 10为 6 8.13± 19.90 pg/ml,TGF- β为 10 3.77± 2 8.95 pg/ m l,与正常对照组比较明显升高 (P<0 .0 5 )。生长抑素治疗组在生长抑素治疗后2 4小时 ,其血中 IL- 1为 0 .83± 0 .12 ng/ m l,TNFα为 33.0 0± 7.40 I     

慢性肾炎患者内皮素、降钙素基因相关肽变化的临床意义

为探讨内皮素 (ET)和降钙素基因相关肽 (CGRP)在慢性肾炎肾衰竭失代偿期的病理意义及其与肾小球滤过率 (GFR)的关系 ,采用放射免疫法检测 36例慢性肾炎肾衰竭失代偿期患者血及尿中的ET和CGRP质量浓度 ,同时测定GFR。结果 :慢性肾炎肾衰竭失代偿期患者ET质量浓度血浆为 ( 72 .4 5± 2 0 .6 5)ng/L〔对照组 ( 47.72± 5.95)ng/L〕 ,尿为 ( 2 3.72± 5.18)ng/L〔对照组 ( 18.55± 2 .83)ng/L〕 ;CGRP质量浓度血浆为 ( 90 .0 1± 2 9.77)ng/L〔对照组( 51.73± 15.2 2 )ng/L〕 ,尿为 ( 58.33± 2 2 .53)ng/L〔对照组 ( 2 6 .2 1± 7.2 2 )ng/L〕 ;均明显高于对照组 (P <0 .0 1)。血、尿中ET呈正相关 (r =0 .34 1,P <0 .0 5)。血、尿中CGRP呈显著正相关 (r=0 .516 ,P <0 .0 0 1)。血ET与CGRP呈显著正相关 (r =0 .573,P <0 .0 0 1) ,与GFR呈显著负相关 (r =- 0 .593,P <0 .0 0 1) ;尿ET与GFR呈显著负相关(r=- 0 .330 ,P <0 .0 1)。血、尿CGRP与GFR呈显著正相关 (r分别为 0 .392、0 .4 12 ,P均 <0 .0 1)。提示 :慢性肾炎患者病程发展与血及尿中ET、CGRP的变化有一定的关系     

急性冠状动脉综合征患者血浆神经肽Y神经降压素水平变化的临床意义

目的研究急性冠状动脉综合征(ACS)患者发病不同阶段血浆神经肽Y(NPY),神经降压素(NT)水平的变化,探讨其在ACS发生发展中的临床意义.方法采用放射免疫方法(RIA)测定急性冠状动脉综合征患者80例血浆中NPY、NT的浓度变化,并选择60例健康者作对照组.结果ACS患者急性心肌缺血或胸痛发作期血浆NPY(279±69pg/ml)、NT(148±37pg/ml)水平明显高于对照组107±17pg/ml、62±19pg/ml,P＜0.01,ACS患者急性心肌缺血或胸痛发作期治疗前血浆NPY275±72pg/ml、NT 152±41pg/ml,明显高于治疗后NPY113±15pg/ml、NT65±17pg/ml水平,P＜0.01.结论ACS患者急性心肌缺血或胸痛发作期血浆NPY、NT水平明显升高,提示NPY、NP参与了ACS的发病过程,在ACS的发生发展中发挥重要作用.     

心房颤动患者血栓形成与血浆组织因子和组织因子途径抑制物的关系

目的检测心房颤动(AF)患者血浆组织因子(TF)和组织因子途径抑制物(TFPI)抗原的变化,探讨组织因子凝血途径在心房血栓形成机制中的作用。方法选择心房颤动患者64例,采用酶联免疫吸附(ELISA)方法测定血浆TF和TFPI抗原水平,并与对照组进行比较。结果①与正常对照组比较,AF组血浆TF抗原水平显著增高[(1060.0±669.8)pg/mLvs(423.6±245.1)pg/mL,P=0.000],总TFPI和游离TFPI抗原水平降低[(38.2±8.9)ng/mLvs(70.1±24.0)ng/mL,P=0.000;(26.3±8.0)ng/mLvs(41.2±16.7)ng/mL,P=0.000]。②伴左房血栓心房颤动组与无左房血栓心房颤动组比较,伴左房血栓心房颤动组TF抗原水平显著增高[(1431.4±564.5)pg/mLvs(904.6±660.3)pg/mL,P=0.004],总TFPI和游离TFPI抗原水平降低[(33.1±9.6)ng/mLvs(40.0±7.8)ng/mL,P=0.01;(22.9±8.2)ng/mLvs(22.7±7.4)ng/mL,P=0.048]。结论心房颤动患者血浆组织因子途径改变表现为凝血活性增高和抗凝活性减低,组织因子凝血途径参与了心房颤动患者心房血栓形成机制。     

氯化钠对高血压大鼠循环及组织血管紧张素Ⅱ的影响

观察了氯化钠对自发性高血压大鼠 (spontaneouslyhypertensiverats,SHR)循环及组织血管紧张素Ⅱ (an giotensinⅡ ,AngⅡ )的影响。 2 0只雄性 8周龄SHR配对分为高氯化钠组和对照组 (均n =1 0 ) ,分别给予 2 %氯化钠和清水喂养 6周 ,用放射免疫法测定血浆肾素活性 ( plasmareninactivity,PRA)、血浆和组织血管紧张素Ⅱ。结果 :高氯化钠组PRA为 ( 1 .1 3± 0 .72 )ng/(mL·h) ,较对照组〔( 1 .94± 0 .96 )ng/(mL·h)〕明显下降 (P <0 .0 5 ) ,血浆AngⅡ为 ( 89.4± 1 .4 )ng/L ,较对照组〔( 1 1 1 .6± 1 .3)ng/L〕略有下降 ,但无统计学意义 (P >0 .0 5 ) ,高氯化钠组的心脏、血管AngⅡ水平较对照组升高 ,分别为 ( 2 2 7.1± 1 .1 )pg/g比 ( 1 5 1 .4± 1 .1 ) pg/g,P <0 .0 1 ,( 5 7.1± 1 .5 ) pg/g比 ( 30 .7±2 .0 )pg/g ,P <0 .0 5 ;肾脏AngⅡ水平 2组间无差异 (P >0 .0 5 )。提示氯化钠负荷对循环及组织AngⅡ的影响是不同的。     

Circulating leptin and osteoprotegerin levels affect insulin resistance in healthy premenopausal obese women

We investigated the relationship between circulating leptin and osteoprotegerin (OPG) levels and insulin resistance assessed by HOMA-IR in premenopausal obese and normal weight women. Thirty four obese women (age 31 +/- 8 years) (BMI 35 +/- 4 kg/m(2)) with 19 healthy controls (age 31 +/- 7 years) (BMI <25 kg/m(2)) (BMI 21 +/- 2 kg/m(2)) were included in the study. Women were healthy and had no osteoporosis. Circulating leptin levels were significantly higher in obese women (17.11 +/- 2.05 ng/mL vs. 8.38 +/- 4.71 ng/mL, p <0.0001) and decreased OPG levels were found (14.7 +/- 7.15 pg/mL vs. 19.17 +/- 6.37 pg/mL, p = 0.03). Leptin showed a positive correlation with BMI (r = 0.851, p <0.0001), waist-to-hip ratio (r = 0.692, p <0.0001), fasting insulin (r = 0.441, p <0.001), HOMA-IR (r = 0.412, p = 0.002), fibrinogen (r = 0.387, p = 0.004), uric acid (r = 0.293, p = 0.033), hematocrit (r = 0.394, p = 0.003), systolic (r = 0.504, p <0.0001), and diastolic blood pressure (r = 0.363, p = 0.008). OPG showed a negative correlation with insulin (r = -0.341, p = 0.013) and HOMA-IR (r = -0.324, p = 0.018). In obese women group, the regression equation of HOMA-IR was (HOMA-IR = [0.095 x leptin]-[0.051 x OPG] + 1.71). However, there was no relation between leptin and OPG levels. In conclusion, circulating leptin and OPG levels were related to insulin resistance in premenopausal obese women. However, leptin had no interference in OPG in premenopausal women.     

Serum leptin levels and adiposity in adult Chinese: a preliminary observation

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The role of serum leptin and tumor necrosis factor-α in malnutrition of male chronic obstructive pulmonary disease patients

Background Leptin is a protein mainly secreted by adipocytes, and the major function of leptin was its role in body weight regulation. It is suggested that increased levels of circulating leptin may contribute to anorexia in pathologic conditions including chronic obstructive pulmonary disease (COPD). Recent studies have provided evidence for a link between leptin and proinflammatory cytokines such as tumor necrosis factor-α (TNF-α). This study aimed to explore the role of serum leptin in the malnutrition of COPD patients, and to observe the changes of serum leptin levels during acute exacerbation, also to investigate relationship between leptin and TNF-α. Methods Seventy-two COPD patients and 34 control subjects participated in this study. Seventy-two COPD patients were divided into 3 groups: group COPD IA (patients without malnutrition during acute exacerbation, n=25), group COPD IB (patients without malnutrition during stable disease, n=29), group COPD II (patients with malnutrition during stable disease, n=18). To eliminate the effect of sex differences, all patients and controls were male. Body mass index (BMI), percent ideal body weight (IBW％), triceps skin-fold thickness (TSF), mid-upper arm circumference (MAC), mid-upper arm muscle circumference (MAMC), serum leptin and TNF-α levels, serum prealbumin (PA), serum transferrin (TF), serum albumin (Alb), total lymphocytes count (TLC), forced expiratory volume in one second (FEV(1)), maximal inspiration pressure (MIP) and maximal expiration pressure (MEP) were measured in all participants. Leptin levels were measured by radioimmunoassay. TNF-α levels were measured by ELISA. The between group difference and correlation of these parameters were analyzed. Results Serum leptin levels were significantly lower in group COPD II [(4.07±3.42) ng/ml] than in group COPD IB [(9.72±6.67) ng/ml] and controls [(8.21±5.41) ng/ml] (P&lt;0.05). There was no statistically significant difference in serum leptin levels between group COPD IA [(10.82±6.40) ng/ml], group COPD IB [(9.72±6.67) ng/ml] and controls [(8.21±5.41) ng/ml]. There was no statistically significant difference in serum TNF-α levels between group COPD II [(8.03±3.37) pg/ml], group COPD IA [(8.90±1.60) pg/ml], and group COPD IB [(7.25±2.08) pg/ml]. There was no significant correlation between leptin and TNF-α in any group. Conclusions Leptin was not involved in anorexia and weight loss of COPD patients. There was no statistically significant difference in serum leptin levels between COPD patients during stable stage and acute exacerbation, and there was no significant correlation between TNF-α and leptin during the regulation of the energy balance in COPD patients.     

瘦素、胰岛素样生长因子-1与多囊卵巢综合征高胰岛素血症的关系

目的了解瘦素、胰岛素样生长因子-1(IGF-1)与多囊卵巢综合征(PCOS)高胰岛素血症间的关系,探讨相关发病机制。方法采用病例-对照的方法,实验分为PCOS组(92例)和对照组(92例),其中PCOS组又分为PCOS-高胰岛素血症组(46例)和PCOS-非高胰岛素血症组(46例)。通过放免法检测血清瘦素、胰岛素样生长因子-1、睾酮、双氢睾酮、脱氢表雄酮、硫酸脱氢表雄酮等的水平,葡萄糖氧化酶法检测血糖水平。结果PCOS组瘦素(16.8±9.8ng/mL)、IGF-1水平(214.8±131.6ng/mL)明显高于对照组(分别为11.6±6.8ng/mL、118.0±82.9ng/mL)(P<0.05)。PCOS患者中高胰岛素组瘦素水平(19.2±10.2ng/mL)明显高于正常胰岛素组(12.5±7.6ng/mL)(P<0.05),IGF-1及空腹血糖在两组间差异无统计学意义。多元逻辑回归结果显示,在调整了体重指数、睾酮、黄体生成素/卵泡刺激素比值、双氢睾酮、脱氢表雄酮、硫酸脱氢表雄酮等因素后,瘦素、IGF-1均是PCOS的危险因素,但均不是高胰岛素血症的危险因素。结论瘦素、IGF-1可能与PCOS的发病机制有关,但与高胰岛素血症的关系有待进一步探讨。     

Sympathetic activity and response to ACE inhibitor (enalapril) in normotensive obese and non-obese subjects

BACKGROUND: Angiotensinogen has been proposed as a possible link between obesity and hypertension because the adipocyte produces angiotensinogen and contains the enzymes required for its conversion. Moreover, sympathetic overactivity has been reported in obese subjects. The aim of this study was to compare heart sympathetic activation and serum angiotensinogen levels in obese and non-obese normotensive subjects, their relationship, and the effect of a drug that modifies the renin-angiotensin system. METHODS: Serum angiotensinogen, leptin, lipids, glucose, and insulin levels were measured and 24-h electrocardiograph monitoring was carried out in 41 (20 non-obese and 21 obese) volunteers before and after administration of 5 mg enalapril twice/day for 7 days. RESULTS: Obese subjects had higher values than non-obese subjects for % body fat (35.1+/-4.6 vs. 30.5+/-5.2; p=0.005), triglycerides (1.93+/-0.9 vs. 1.25+/-0.7 g/L, p=0.002), insulin (114.8+/-82.5 vs. 45.9+/-22.2 pmol/L), leptin (31.4+/-20.4 vs. 14.1+/-11.2 ng/mL, p=0.002), and LF/HFn index (4.3+/-2.9 vs. 2.2+/-1.3, p<0.005). Enalapril increased angiotensinogen levels only in the non-obese group (4.2+/-3.9 vs. 9.7+/-5.4 ng/mL, p=0.001) and diminished the LF/HFn index (4.3+/-2.9 vs. 3.0+/-1.4, p=0.007) in the group of obese subjects. There was no association between angiotensinogen levels and sympathetic activity. CONCLUSIONS: Higher level of sympathetic activity was found in normotensive obese as compared with non-obese subjects. Enalapril treatment reduced heart sympathetic activity in obese subjects but did not change angiotensinogen levels.     

血清和腹腔液中IL-6、TNF-α及CA125与子宫内膜异位症关系探讨

目的探讨IL-6、TNF-α及CA125在子宫内膜异位症患者血清和腹腔液中水平及其关系,寻找可以对疾病的发展进行监测较为准确而快捷的途径和方法．方法分别采用放射免疫法及免疫放射法测定内异症患者（内异症组）和对照组的血清及腹腔液中IL-6、TNF-α、CA125的浓度,并把内异症患者按r-AFS分期法分为Ⅰ-Ⅳ期,其中Ⅰ、Ⅱ期纳为1组,Ⅲ、Ⅳ期纳为2组．结果（1）内异症组血清中IL-6（207．91±40．24）pg／mL、TNF—α（1．28±0．55）ng／mL及CA125（65．56±49．32）U／mL的浓度分别明显高于对照组血清中IL-6（178．62±69．79）pg／mL、TNF-α（0．92±0．16）ng／mL及CA125（39．82±22．64）U／mL的浓度,各组比较均有统计学差异（P〈0．05）．（2）内异症组腹腔液中IL-6（208．87±44．87）pg／mL、TNF-α[（1．32±0．17）ng／mL的浓度分别明显高于对照组腹腔液中IL-6（164．12±41．33）pg／mL、TNF—α（1．08±0．16）ng／mL的浓度,各组比较均差异有统计学意义（P〈0．05）,而内异症组腹腔液中CA125的浓度（243．43±161．04）U／mL与对照组的浓度（166．18±65．72）U／mL比较差异无统计学意义（P〉0．05）．（3）内异症组中1组血清IL-6（202．90±45．63）pg／mL、TNF—α（1．30±0．18）ng／mL及CA125（61．54±39．32）u／mL的浓度分别与2组血清IL-6（210．60±37．66）pg／mL、TNF-α（1．35±0．13）ng／mL及CA125（71．60±62．36）U/mL的浓度比较均差异无统计学意义（P〉0．05）．（4）内异症组中1组腹腔液IL-6（204．58±33．65）pg／mL、TNF—α（1．18±0．11）ng／mL及CA125（148．30±40．22）U/mL的浓度分别与2组腹腔液IL-6（210．22±48．60）pg／mL、TNF-α[（1．47±0．93）ng／mL及CA125（173．73±77．12）U/mL的浓度比较差异均无统计学意义（P〉0．05）．结论内异症患者血清或腹腔液中TNF—α、IL-6及CA125与内异症的发生、发展     

沙美特罗替卡松粉吸入剂联合孟鲁司特对支气管哮喘患儿细胞免疫及血清瘦素、嗜酸性粒细胞趋化因子、ECP、LPO的影响

目的探讨沙美特罗替卡松粉吸人剂联合孟鲁司特对支气管哮喘患儿细胞免疫及血清瘦素、嗜酸性粒细胞趋化因子、嗜酸性粒细胞阳离子蛋白（ECP）和脂质过氧化物（LPO）的影响。方法将榆林市儿童医院2011年10月-2012年12月收治的90例支气管哮喘患儿根据治疗方法分为研究组和对照组,每组各45例,研究组给予沙美特罗替卡松粉吸入剂联合盂鲁司特治疗,对照组给予沙美特罗替卡松粉吸入剂治疗。比较两组患儿治疗前后细胞免疫及血清瘦素、嗜酸性粒细胞趋化因子、ECP、LPO的变化情况。结果治疗前两组患儿的CD3＋、CD4＋、CD8’及CD4／CD8水平,差异无统计学意义（均P〉0．05）。治疗6：12周时研究组患儿的CD3＋、CD4＋、CD4／CD8f（64．35±7．55）％,（36．42±4．22）％,（1．69±0．15）;（68．56±8．11）％,（39．01±4．77）％,（1．85±0．17）]明显高于对照组[（60．02±6．04）％,（32．96±3．23）％,（1．25±0．14）;（63．31±6．87）％,（34．82±3．88）％,（1．42±0．16）],差异有统计学意义（均P〈0．05）;而研究组CD8±[（28．66±2．45）％]明显低于对照组[（25．21±5．43）％],差异有统计学意义（P〈0．05）。治疗前两组患儿的血清瘦素、嗜酸性粒细胞趋化因子、ECP、LPO比较,差异无统计学意义（均P〉0．05）。治疗6、12周后研究组患儿的血清瘦素、嗜酸性粒细胞趋化因子、ECP、LPO水平[（7．05±0．48）μg／L,（16．35±1．94）ng／L,（11．03±1．35）pg／L,（9．46±0．10）nmol／L;（6．52±0．47）μg／L,（6．48±O．90）ng／L,（6．05±0．79）pg/L,（7．03：t0．55）nmol／L]均低于对照组[（8．73±0．72）μg／L,（25．24±3．15）ng／L,（16．25±1．76）pg/L,（12．83±1．50）nmol／L;（7．95±0．55）μg/L,（9．25±1．03）ng／L,（10．09±1．24）pg／L,（10．22±1．09）nmol／L],差异有统计学意义（P〈0．05）。结论沙美特罗替卡松粉吸人剂联合孟鲁司特对支气管哮喘患儿细胞免疫及血清瘦素、嗜酸性粒细胞趋化因子、ECP、LPO水平的改善有重要作用。     

血浆内源性洋地黄样物质在围体外循环期的动态变化

目的探讨围体外循环(CPB)期患者血浆内源性洋地黄样物质(EDLS)浓度的变化及对心功能的影响。方法29例心功能分级(纽约心脏学会分级)为~级的先天性或后天性成年心脏病患者纳入研究。分别于CPB前、停机、术后2 h、6 h、1 d和3 d取静脉血,放免法测定血浆EDLS浓度。结果级心功患者术前血浆内EDLS浓度〔(403±27)pg/mL〕显著高于级〔(221±98)pg/mL,P<0.01〕和级患者〔(296±71)pg/mL,P<0.01〕。CPB能够引起EDLS的浓度升高,至术后2 h〔(683±371)pg/mL〕和6 h〔(577±274)pg/mL〕达峰值,显著高于术前〔(324±79)pg/mL,P<0.01〕,术后24 h恢复至术前水平。然而,无论在手术后2 h或6 h,高浓度EDLS(>1000 pg/mL)患者血压和正性肌力药物的使用与中等浓度(401~999 pg/mL)和低浓度EDLS(<400 pg/mL)患者差异无统计学意义,但术后高浓度EDLS组级心功患者比例(术后2 h:50%;术后6 h:63%)显著高于低浓度组(术后2 h:0%;术后6 h:8%)和中等浓度组(术后2 h:11%;术后6 h:30%)。相关性分析显示,手术后2 h和6 h血浆EDLS浓度与升主动脉阻断时间无关(r分别为0.0748和0.0393)。结论心力衰竭和CPB手术均能够引起EDLS的释放。手术后2~6 h血浆EDLS的浓度迅速升高。高浓度的EDLS与心脏缺血损伤的严重程度无关,但可能增强心功能。     

儿童复发性口疮血清微量元素与免疫功能检测结果分析

目的分析儿童复发性口疮患者发病期间血清微量元素变化与免疫功能状态。方法随机抽取65例患儿作为试验组,选取同期的50例健康体检学生作为对照组,检测两组血清中锌、铁含量、铜/锌比值、T淋巴细胞亚群及免疫球蛋白的含量,并对两组进行对比分析。结果试验组中Fe含量[男（1.10±0.55）μg/mL、女（0.95±0.45）μg/mL]和Zn含量[男（0.55±0.11）μg/mL、女（0.58±0.11）μg/mL]及Cu/Zn比值[男（1.94±0.20）、女（1.83±0.22）]与对照组中Fe含量[男（1.60±0.71）μg/mL、女（1.55±0.62）μg/mL]和Zn含量[男（0.93±0.18）μg/mL、女（0.99±0.18）μg/mL]及Cu/Zn比值[男（1.14±0.22）、女（1.08±0.25）]比较,差异均有高度统计学意义（均P〈0.01）。试验组中CD3（48.50±5.60）%、CD4（29.04±5.80）%、CD4/CD8（0.95±0.45）与对照组中CD3（66.50±6.20）%、CD4（46.20±5.60）%、CD4/CD8（1.70±0.72）比较,差异均有高度统计学意义（均P〈0.01）,IgG含量明显高于对照组（P〈0.01）。结论儿童复发性口疮患者在发病期间存在血清微量元素改变、免疫功能紊乱的情况。