肾上腺髓质素及尾加压素Ⅱ在先天性心脏病肺动脉高压中作用的研究

目的探讨先天性心脏病(CHD)合并肺动脉高压(PH)患者手术前后血浆肾上腺髓质素(ADM)及尾加压素Ⅱ(UⅡ)变化的临床意义。方法将52例患者按肺动脉收缩压分为3组:无PH组(<30 mm Hg)17例,轻度PH组(30~49 mm Hg)18例,中重度PH组(≥50 mm Hg)17例。测定3组术前、术后即刻及术后7 d ADM及UⅡ含量,并比较手术前后的变化;分析两者及其与肺动脉压(PAP)间的相互关系。结果(1)3组患者肺动脉压(PAP)与血浆ADM浓度呈正相关(术前r=0.8012,P<0.01;术后即刻r=0.6325,P<0.01;术后7 dr=0.7126,P<0.01)。(2)3组患者UⅡ浓度则与PAP无相关性(均P>0.05)。(3)无PH组术前ADM浓度为33 pg/m l±5 pg/m l、术后即刻为29 pg/m l±4 pg/m l、术后7 d为20 pg/m l±3 pg/m l;轻度PH组术前ADM浓度为44 pg/m l±8 pg/m l、术后即刻40 pg/m l±6 pg/m l、术后7 d为34 pg/m l±4 pg/m l;中重度PH组术前ADM浓度为60 pg/m l±10 pg/m l、术后即刻58 pg/m l±8 pg/m l、术后7 d为38 pg/m l±4 pg/m l。各组术后ADM浓度呈下降趋势,但只有术后7 d与术前比较差异有统计学意义(无PH组q=5.41,P<0.01;轻度PH组q=4.76,P<0.01;中重度PH组q=6.32,P<0.01)。(4)无PH组术前UⅡ浓度为2.2 pmol/L±0.5pmol/L、术后即刻为2.2 pmol/L±0.44 pmol/L、术后7 d为2.2 pmol/L±0.6 pmol/L;轻度PH组术前UⅡ浓度为2.7 pmol/L±0.6 pmol/L、术后即刻2.6 pmol/L±0.6 pmol/L、术后7 d为2.6 pmol/L±0.5pmol/L;中重度PH组术前UⅡ浓度为2.9 pmol/L±0.6 pmol/L、术后即刻2.6 pmol/L±0.7 pmol/L、术后7 d为2.8 pmol/L±0.4 pmol/L。3组患者手术前后UⅡ浓度差异无统计学意义(均P>0.05)。结论(1)ADM在PH形成和血管重建中发挥重要的作用。(2)UⅡ与PAP无相关性,但是不能排除UⅡ在PH形成和血管重建中有重要的作用。(3)血浆ADM水平可作为判断PH严重程度的指标之一。     

Changes of plasma adrenomedullin and proadrenomedullin N-terminal 20 peptide concentrations in patients with heart failure.

OBJECTIVE: To study the changes in plasma adrenomedullin (ADM) and proadrenomedullin N-terminal 20 peptide (PAMP) concentrations and their clinical significance in the pathological process of congestive heart failure (CHF). METHODS: Plasma ADM and PAMP concentrations in 45 patients with CHF (according to the functional classification of New York Heart Association, NYHA) and 20 control subjects were measured by specific radioimmunoassay. RESULTS: Plasma ADM concentrations were 51.464+/-.52 pg/ml and 70.39+/-3.22 pg/ml respectively in patients of NYHA class II and class III, which were significantly higher than those in control subjects (24.12+/-1.59 pg/ml, P<0.05 for both comparisons), while significant differences in plasma PAMP concentrations were not identified in the 2 groups of patients (6.24+/-1.71 pg/ml and 7.38+/-1.28 pg/ml, respectively) in comparison with the control level(8.56+/-2.44 pg/ml, P>0.05 for both comparisons). Patients of NYHA class IV, when compared with the 2 groups of patients mentioned above, had significantly decreased plasma ADM and PAMP concentrations (36.33+/-2.17 pg/ml and 2.79+/-0.89 pg/ml respectively, P<0.05 in both cases), but had higher plasma ADM and lower PAMP concentrations when compared with the control subjects, (P<0.05 respectively). CONCLUSION: The changes of plasma ADM and PAMP concentrations at different stages of CHF indicate intramolecular regulation disturbances of vasodilator peptides of proadrenomedullin, and ADM may play a more important role in the development of CHF.     

冠心病患者血浆尾加压素Ⅱ的临床研究

OBJECTIVE: To investigate the changes in plasma urotensin II(U II) expression levels in patients with coronary heart disease (CHD). METHODS: Plasma U II levels in 50 CHD patients with coronary stenosis indicated by coronary angiography and 20 healthy subjects were determined by radio immunoassay. RESULTS: Venous plasma U II levels were significantly lowered in CHD patients in comparison with the healthy subjects (1.61+/-1.02 pg/ml vs 3.70+/-1.30 pg/ml, P=0.000). In the CHD patient group, significantly differences were noted in the U II levels between patients with stable angina (2.62+/-1.20 pg/ml), unstable angina (1.39+/-0.80 pg/ml) and acute myocardial infarction (AMI, 1.04+/-0.45 pg/ml, P=0.004). CHD patients with coronary artery occlusion and those with only coronary stenosis had comparable venous plasma U II levels (1.29+/-1.02 pg/ml vs 1.76+/-1.00 pg/ml, P=0.131), whereas the patients with restenosis after percutaneous transluminal coronary angioplasty (PTCA) had higher U II levels than the other subjects in the CHD patient group (2.28+/-0.94 pg/ml vs 1.40+/-0.96 pg/ml, P=0.008), and the femoral plasma U II levels were significantly elevated after PTCT, increasing from 1.18+/-1.14 pg/ml to a postoperative level of 2.22+/-1.77 pg/ml (P=0.001). CONCLUSION: U II might play a role in the pathophysiological process of CHD and can be involved in the restenosis after angioplasty.     

Endothelin and acute renal failure: study on their relation and possible mechanisms]

In order to investigate the role of endothelin in the pathogenesis of ARF, we determined the plasma endothelin (pET) level in different clinical ARF patients and experimental ARF rat models. It was found that pET level was significantly higher in hepatic renal syndrome (n = 9, pET 210.1 +/- 32.0 pg/ml), epidemic hemorrhagic fever (n = 18, 113.3 +/- 14.86 pg/ml), septic shock ARF (n = 8, 121.5 +/- 13.5 pg/ml), gentamicin ARF (n = 7, 55.9 +/- 6.23 pg/ml) patients, and in HgCl2 ARF (n = 8, 31.75 +/- 3.07 pg/ml), glycerine ARF (n = 8, 44.75 +/- 9.8 pg/ml) rats, compared with that of normal persons (n = 9, 33.6 +/- 3.08 pg/ml) or of normal rats (n = 10, 11.4 +/- 0.98 pg/ml). Both in the patients and animal groups, there were a linear relationship between the levels of pET and Scr (r = 0.603 4 and 0.844, P less than 0.01, respectively). Intrarenal infusion ET in dosage of 0.16 micrograms.kg-1/h produced a severe reduction of RPF and GFR in the infused kidney, without significant similar changes on the contralateral kidney. Pretreated with captopril ameliorated the renal hemodynamic changes induced by iv ET (0.67 micrograms.kg-1/h), whereas indomethacin potentiated this effect. It is concluded that both circulating or local generated ET during the ARF play an important role in the pathogenesis of ARF. RAS and PG might involve in its mechanisms.     

f3-ENDORPHIN-LIKE IMMUNOREACTIVITY IN CSF OF PATIENTS WITH ACUTE HEAD INJURY A CLINIEAL REPORT OF 36 CASES

β-endorphin-like immunoreactivity(β一ELI) was measured in the cerebrospinal fluid (CSF) of 36 pa- tients with acute head injury and 12 controls. The mean values of β-ELI in CSF of controls and patients with moderate and severe acute head injury were 51.9 ± 5.6 pg / ml, 110.5 pg / ml, and 173.8 ± 20.1 pg / ml respectively, with significant difference between them (p < 0.05). The results showed that β-ELI increased in CSF of acute head injury patients.     

慢性肾功能衰竭大鼠下丘脑组织和血浆食欲素A及神经肽Y水平的变化及其意义

目的　探讨大鼠慢性肾功能衰竭 (CRF)动物模型的下丘脑组织和血浆食欲素A及神经肽Y(NPY)水平的变化及其意义。方法　将 41只 2 0 0～ 2 50 g雄性Wister大鼠分为 :正常组、假手术组和CRF组。术后 4、 8、 1 2周分批断头处死大鼠 ,取血浆和下丘脑组织标本。用放射免疫法测定血浆和下丘脑组织食欲素A和NPY。用生化自动分析仪测定血清肌酐。结果　CRF大鼠术后4、 8和 1 2周血肌酐水平均高于假手术组。其术后 1 2周的血浆食欲素A水平高于假手术组 (2 64pg/ml± 62pg/mlvs 1 83pg/ml± 56pg/ml,P =0 0 39)。CRF大鼠术后 1 2周的下丘脑食欲素A水平明显低于假手术组 (1 0 5fmol/mg± 2 7fmol/mg湿重vs 1 7 4fmol/mg± 3 9fmol/mg湿重 ,P =0 0 2 3)。CRF大鼠术后 8周 (7 1 pmol/ml± 1 7pmol/mlvs 5 0 pmol/ml± 0 5pmol/ml,P =0 0 1 )和1 2周 (7 9pmol/ml± 1 1pmol/mlvs 4 8pmol/ml± 1 1 pmol/ml,P =0 0 0 0 8)的血浆神经肽Y水平高于假手术组 ,其术后 1 2周的下丘脑神经肽Y水平明显低于假手术组 (70fmol/mg± 2 3fmol/mgvs1 1 3fmol/mg± 31fmol/mg湿重 ,P =0 0 33)。 结论　 (1 )CRF大鼠血浆食欲素A和NPY水平有逐渐增高趋势 ,肾功能减退可能导致食欲素A和NPY排泄障碍。 (2 )CRF时下丘脑组织食欲素     

豚鼠钩体病PDH模型血浆栓素和前列腺环素的测定

Guinea pigs were intravenously injected with icterhemorrhagiae serogroup Lai serovar strain 017 leptospirosis to model the pulmonary diffuse hemorrhage (PDH) in leptospirosis. Thirty-eight hours after the injection, the jugular arteries were catheterized to collect blood sample. The plasma was prepared for radioimmunoassay of TXB2 and 6-keto-PGF1a, the stable metabolites of TXA2 and PGI2 respectively. The plasma level of TXB2 in the experimental group, 107.15 +/- 41.65 pg/ml (n = 7), almost doubled that of the control, 54.05 +/- 12.93 pg/ml (n = 7), with significant difference (P less than 0.01); meanwhile, no significant difference was observed of 6-keto-PGF1a, 67.97 +/- 16.89 pg/ml (n = 6) vs. 98.06 +/- 40.63 pg/ml (n = 9) with P greater than 0.1. The fact that TXA2 causes vasoconstriction and increases vessel permeability suggests that TXA2 elevation should play a role in the mechanism of PDH in leptospirosis.     

Vascular endothelial growth factor expression in serum of patients with hepatocellular carcinoma

Objectives To determine the pre-therapeutic serum level of vascular endothelial growth factor (VEGF) in patients with hepatocellular carcinoma (HCC) and to elucidate the relation between the serum level and clinical characteristics and metastasis of HCC. Methods One-hundred and fifteen HCC patients, 40 patients with benign liver lesions, and 30 healthy control subjects were included in this study. The serum VEGF level was measured with the quantitative sandwich enzyme linked immunosorbent assay (ELISA, R&amp;D systems). Results The serum VEGF levels in the HCC group (465.62±336.24 pg/ml) was significantly elevated as compared with those in patients with benign liver lesions (159.54±120.58 pg/ml) and those in normal controls (123.53±51.84 pg/ml). The VEGF levels were not significantly different between the patients with benign liver lesions and the normal controls. The serum VEGF concentration showed a positive rate of 77.4%, 25%, and 3.3% in the HCC patients, benign liver lesion patients and normal controls, respectively. In the 115 HCC patients, the serum VEGF levels in patients with portal vein (PV) emboli (n=26, 582.76±441.89 pg/ml), with metastasis (n=43, 548.29±438.57 pg/ml) or with large HCC lesions (≥5 cm in diameter) (n=69, 554.43±369.99 pg/ml) were significantly higher than those without PV-emboli (n=89, 431.39±292.84 pg/ml), without metastasis (n=72, 416.24±247.27 pg/ml) or with small HCC lesions (n=42, 328.67±227.47 pg/ml). The serum VEGF levels in stage Ⅰ, Ⅱ, Ⅲ, Ⅳa and Ⅳb HCC patients were 340.6 pg/ml, 451.55±307.84 pg/ml, 397.44±257.18 pg/ml, 486.10±397.73 pg/ml and 647.93±344.56 pg/ml, respectively. Conclusion The pre-therapeutic serum VEGF levels in HCC patients appear to reflect the disease’s potential activity of vascular invasion and metastasis.     

SERUM LEVELS OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN PATIENTS WITH ANGINA PECTORIS AND ACUTE MYOCARDIAL INFARCTION

ＩＮＴＲＯＤＵＣＴＩＯＮ　　Ｖａｓｃｕｌａｒｅｎｄｏｔｈｅｌｉａｌｇｒｏｗｔｈｆａｃｔｏｒ (ＶＥＧＦ)ｏｒｖａｓｃｕｌａｒｐｅｒｍｅａｂｉｌｉｔｙｆａｃｔｏｒ (ＶＰＦ)ｃｏｎｓｉｓｔｓｏｆａｆａｍｉｌｙｏｆｐｏｌｙｐｅｐｔｉｄｅｉｓｏｆｏｒｍｓｔｈａｔｓｐｅｃｉｆｉｃａｌｌｙｒｅｇｕｌａｔｅｅｎｄｏｔｈｅｌｉａｌｃｅｌｌｆｕｎｃｔｉｏｎ ,ｉｎｃｌｕｄｉｎｇｅｎｈａｎｃｅｍｅｎｔｏｆａｎｇｉｏｇｅｎｅｓｉｓ( 1) ,ｅｎｈａｎｃｅｍｅｎｔｏｆｍｉｃｒｏｖａｓｃｕｌａｒｐｅｒｍｅａｂｉｌｉｔｙ ( 2 ) ,ａｎ…     

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.     

醛固酮合成酶基因-344T/C多态性与高血压患者血浆醛固酮及血管紧张素Ⅱ水平相关

目的探讨醛固酮合成酶基因（CYP11B2）-344T/C多态性与原发性高血压（EH）患者血浆肾素活性（PRA）以及血管紧张素Ⅱ（AngⅡ）、醛固酮（Aldo）水平的关系.方法用聚合酶链反应–限制性片段长度多态性（PCR-RFLP）法,检测421例EH患者和207例正常人CYP11B2的-344T/C基因型.用放射免疫法测328例EH患者基础PRA、血浆AngⅡ和Aldo浓度,其中279例患者同时测定激发PRA和血浆AngⅡ浓度.结果 EH与正常对照组间-344T/C多态性的基因型（P=0.61）和等位基因频率（P=0.34）差异无统计学意义.调整年龄、性别和体重指数后,328例EH患者中TT基因型者血浆Aldo浓度（213.5 pmol/L）显著高于TC （163.5 pmol/L）和CC（141.5 pmol/L）基因型者（P=0.02）. 而不同基因型间基础PRA（P=0.63）和血浆AngⅡ浓度（P=0.28）差异无统计学意义.激发时279例EH患者中CC基因型血浆AngⅡ浓度（81.9 pmol/L）显著高于TC （52.2 pmol/L）和TT（49.5 pmol/L）基因型（P=0.02）.结论 CYP11B2基因-344T/C多态性与EH患者血浆Aldo水平及激发血浆AngⅡ浓度显著相关.     

Soluble forms of P-, E- and L-selectin in children with Kawasaki disease

Kawasaki disease (KD) is an acute, self-limiting systemic vasculitis syndrome of unknown origin, that mainly affects small and medium-sized arteries, particularly the coronary artery, which affects primarily infants and young children. Cell adhesion molecules play important roles in the inflammatory process. The aims of this study were to investigate the pathophysiological role of cell adhesion molecules in KD, and to look for the evidence of direct relationship between the plasma levels of soluble cell adhesion molecules and the incidence of coronary artery lesion (CAL). The 52 patients with KD, Group A patients who were clinical responders of initial intravenous immunoglobulin (IVIG) treatment (n = 30), Group B patients who did not respond to the initial IVIG treatment (n = 22), were studied. The circulating E-selectin (105.6 +/- 12.6 ng/ml) in the acute phase of KD, while the peak plasma P-selectin level (238.4 +/- 26.8 ng/ml) occurred in the subacute phase of illness (p < 0.05, respectively). Plasma L-selectin levels (1557.3 +/- 44.3 ng/ml) during the convalescent phase tend to higher than in the acute and in the convalescent phases (p = NS). The analysis of paired samples in Group A patients before (E-selectin: 131.2 +/- 9.8 ng/ml, P-selectin: 216.6 +/- 13.4 ng/ml) and 48 hour after (E-selectin: 98.9 +/- 9.2 ng/ml, P-selectin: 153.9 +/- 34.1 ng/ml) IVIG administration revealed significantly lower values of E- and P-selectins, however, no significant differences in those in Group B patients. There were also no significant differences in the values of L-selectins between the 2 groups. Before IVIG treatment, the plasma levels of E- (225.1 +/- 46.1 ng/ml) and P-selectin (259.4 +/- 76.2 ng/ml) of patients with CAL (n = 11) were significantly higher than those of patients (n = 41) without CAL (p < 0.05, respectively). Plasma L-selectin levels (1596.9 +/- 385.0 ng/ml) in patients with CAL tended to be lower than those in patients without CAL (p = NS). E- and P-selectin may have potential as predictors of CAL in patients with KD.     

T-cell sensitisation to hepatitis B virus surface antigens

The present study was conducted to explore the immunity to hepatitis B surface antigens (HBsAg) of ad and ay subtypes at the cellular level among adult individuals. Peripheral blood mononuclear cells (PBMCs) obtained from acute hepatitis B virus (HBV) infected patients, chronic HBV infected patients, recovered subjects from HBV infection and uninfected vaccinated controls were stimulated with HBsAg ad and HBsAg ay subtypes in vitro. Stimulated PBMCs were incubated in CO(2) for production of interferon-gamma (IFN-gamma), which was measured from the supernatant of cultured PBMCs by an in-house ELISA technique. The mean +/- SE of IFN-gamma levels produced by PBMCs in response to HBsAg ad among the acute, chronic, recovered and control groups were 282.5+/-134.51 pg/ml, 307.45+/-94.84 pg/ml, 915.62+/-170.80 pg/ml and 511.67+/-161.22 pg/ml respectively, while on stimulation by HBsAg ay, the levels were 246.25+/-103.50 pg/ml, 374.70+/-104.02 pg/ml, 1040 +/-140.76 pg/ml and 465.83+/-166.26 pg/ml respectively among the above mentioned groups. The results of this study showed that PBMCs were non-responsive to stimulation by both HBsAg ad and HBsAg ay subtypes in acute and chronic patients with HBV infection. The recovered group responded significantly to both subtypes of HBsAg and the control group did not. The study indicates that although the patients with acute and chronic HBV infection showed weak or no IFN-gamma response to the HBsAg, subjects showed strong IFN-gamma response to the surface antigens on recovery from HBV infection.     

白介素-1受体拮抗剂对缺血再灌注心肌的保护作用及其机制探讨

目的　探讨急性心肌梗死 (AMI)再灌注过程中白介素 - 1β(IL 1β)的变化及重组人白介素 - 1受体拮抗剂 (rhIL 1ra)对缺血再灌注心肌的保护作用及其机制。方法　 (1)用ELISA法测定了 8名健康人和 2 2例接受急诊经皮冠脉介入治疗 (PCI)并且梗死相关血管 (IRA)血流达心肌梗死溶栓 (TIMI) 3级的AMI患者血浆IL 1β水平的动态变化。 (2 )在兔心肌缺血 5 0min再灌注 4h的模型上 ,观察不同剂量rhIL 1ra(A组 :rhIL 1ra 10mg/kg ;B组 :rhIL 1ra 2 0mg/kg ;C组 :rhIL 1ra 4 0mg/kg)对心肌梗死面积、心肌髓过氧化物酶 (MPO)活性、心肌细胞凋亡程度 (TUNEL、AnnexinⅤ和DNA 梯形图法 )及凋亡相关基因Bcl 2 /Bax的表达。结果　 (1) 2 2例AMI患者再灌注前血浆IL 1β(2 8pg/ml±9pg/ml)已明显高于健康对照组 (2 0 pg/ml± 11pg/ml,P <0 0 5 ) ,IRA再通后 12h血浆IL 1β水平达高峰 (86 pg/ml± 14pg/ml) ,至术后 2 4hIL 1β血浆水平 (5 6 pg/ml± 15 pg/ml)仍明显高于再灌注前 (2 8pg/ml± 9pg/ml,P <0 0 1)。 (2 )兔AMI对照组与rhIL 1ra各组之间心肌缺血面积差异均无显著意义 ,但各rhIL 1ra组梗死心肌面积均小于对照组 ,组间差异呈剂量依赖性 (47%±7% ,34%± 8% ,31%± 6 %比 6 1%± 11% ,分别P <0     

An animal and clinical study on the change of neuropeptide Y release evoked by electrical stimulation and myocardial ischemia

ＯｂｊｅｃｔｉｖｅＴｏｉｎｖｅｓｔｉｇａｔｅｔｈｅｃｈａｎｇｅｃｈａｒａｃｔｅｒｉｓｔｉｃｓｏｆｎｅｕｒｏｐｅｐｔｉｄｅＹ（ＮＰＹ）ｒｅｌｅａｓｅｄｕｒｉｎｇａｃｕｔｅｍｙｏｃａｒｄｉａｌｉｓｃｈｅｍｉａｐｅｒｉｏｄ．ＭｅｔｈｏｄｓＴｈｅａｎｉｍａｌ...     

Plasma beta-phenylethylamine in Parkinson's disease

Plasma beta-phenylethylamine (PEA) levels were determined in 27 patients with Parkinson's disease (PD) in order to evaluate its relation with the severity or clinical course of PD. The plasma PEA concentrations in PD patients were significantly lower (mean +/- SD, 862 +/- 554 pg/ml) than those in the control group (1765 +/- 790 pg/ml) (p < 0.0001). The concentrations of PEA in plasma did not correlate with Hoen and Yahr stage. However, in serial measurements of the PEA of 5 patients in the progressive group of the clinical course of PD, the plasma PEA levels revealed a downward trend after one or two years. On the other hand, in 3 patients of non-progressive group, the plasma PEA remained at the same level. This study suggests that plasma PEA level might reflect nigrostriatal degeneration in patients with PD.     

内皮素含量变化在诊断脑血管病发生发展中的价值

目的 :通过内皮素 ( ET)含量变化观察 ET在脑血管病 ( CVD)发生、发展中的作用。方法 :用放免测定方法动态观察 1 0 4例 CVD患者不同时期血浆中内皮素含量。结果 :脑出血 ( CH)和脑梗死 ( CI)患者急性期血浆 ET水平分别为 1 39.9± 60 .5 pg/ml和1 2 3.5± 5 0 .9pg/ml,与对照组 ( 83.0± 37.2 pg/ml)比较有显著升高 ( P<0 .0 0 1 ) ;CH病人30 d后血浆中 ET含量与对照组比较 ,仍然是升高的 ( P<0 .0 5 ) ,但 CI患者 30 d后血浆中ET含量与对照组比较已无显著性差异 ( P>0 .0 5 )。结论 :ET在 CVD的发生发展中可能具有重要作用 ,动态观察血浆中 ET含量的变化对于判断 CVD的变化可能有一定的帮助     

充血性心力衰竭患者血浆尾加压素Ⅱ变化的临床研究

OBJECTIVE: To investigate the changes of plasma urotensinII (UII) levels in patients with congestive heart failure (CHF) of different severities and their clinical implications. METHODS: Plasma UII was determined by radioimmunoassay in 45 patients with CHF and 20 healthies control subjects. In all the subjects, the left ventricular fraction (LVEF) and the ratio of E/A were measured by echocardiography. RESULTS: The plasma UII level was significantly lowered in CHF patients in comparison with that in control subjects (1.41+/-1.09 pg/ml vs 4.35+/-1.22 pg/ml, P=0.000). A significant correlation of plasma UII level with LVEF (r=0.540, P=0.000) and the E/A ratio was observed (r=0.539, P=0.000), and the severity of CHF was shown to be inversely correlated with plasma UII levels in the patients (r=-0.656, P=0.000), which was elevated after treatment. CONCLUSION: UII might play a role in the pathophysiological process of CHF, and its plasma level may serve as an indicator of the severity of CHF.     

心肌缺血大鼠血浆8-异前列腺素F2α水平及N-乙酰半胱氨酸干预作用

OBJECTIVE: To examine the correlation between 8-iso-prostaglandin F2alpha (8-iso-PGF2alpha) levels in the plasma and myocardial tissue of rats with myocardial ischemia and observe the intervention effect of N-acetylcysteine (NAC), for the purpose of assessing the value of 8-iso-PGF2alpha in estimating the extent of free radical damage and implementing possible interventions. METHODS: Forty-five Wistar rats were divided into ischemia, ischemia+NAC and control groups, and in the former 2 groups, acute myocardial ischemia models were produced by pituitrin. Elevated ST segment in ECG served as the indicator for myocardial ischemia. Rats in ischemia+NAC group were pre-treated with NAC (0.1 g/kg x d) for three weeks before the ischemia 8-iso-PGF2alpha levels in the plasma and myocardial tissue were determined by enzyme-linked immunosorbent assay (ELISA). RESULTS: In ischemia group, the 8-iso-PGF2alpha levels in the plasma and myocardial tissue were 187.4+/-45.8 pg/ml and 259.3+/-47.5 pg/g, respectively, higher than those in the control group (60.4+/-13.7 pg/ml and 88.6+/-16.9 pg/g, respectively, P<0.01) and those in ischemia+NAC group (88.2+/-16.4 pg/ml and 109.4+/-24.7 pg/g, respectively, P<0.01). A positive correlation was noted between the 8-iso-PGF2alpha levels in the plasma and myocardial tissue (r=0.865, P<0.01). In comparison with the control group, elevation of the ST segment of ECG in rats with myocardial ischemia was obvious, and the peak elevation occurred 45 min after ischemia (0.34+/-0.05 mV, P<0.01). Pre-treatment with NAC proved to help alleviate the subsequent ischemia, with ST segment elevation of only 0.18+/-0.05 mV. CONCLUSION: In condition of acute myocardial ischemia in rats, 8-iso-PGF2alpha levels tend to increase, which can be indicative of the degree of myocardial ischemia. NAC pre-treatment can alleviate the ischemic condition by offsetting the damage caused by the free radicals.     

脑钠肽水平变化对急性肺栓塞预后评估的价值

为探讨脑钠肽在不同急性肺栓塞患者中的变化及意义,回顾性分析济宁市第一人民医院确诊的47例急性肺栓塞患者的血脑钠肽浓度,大面积或次大面积肺栓塞患者脑钠肽浓度均显著高于非大面积肺栓塞患者（P=0．001、0．048）。死亡患者脑钠肽浓度显著高于非死亡患者（P=0．027）。脑钠肽〉400pg／ml患者大面积肺栓塞（包括次大面积）发生率显著高于≤400pg／ml患者（100％与75％,P=0．023）。提示血脑钠肽浓度有助于判断患者的预后。