西格列汀对2型糖尿病患者血清对氧磷酶及氧化应激水平影响研究

目的探讨西格列汀对2型糖尿病(T2DM)患者血清对氧磷酶及氧化应激水平的影响。方法纳入80例T2DM患者,随机分为西格列汀组(n=40)和二甲双胍组(n=40)。另选取40例非糖尿病健康人作为对照组。比较两组患者入组时和治疗后1个月血清总氧化态(TOS)、总抗氧化态(TAS)、氧化应激指数(OSI)及对氧磷酶(PON1)等指标检测。结果治疗前两组T2DM患者TAS和PON1水平明显低于对照组(P0.05),而TOS和OSI水平明显高于对照组(P0.05)。治疗后西格列汀组TAS和PON1水平较治疗前明显升高(P0.05),而TOS和OSI水平较治疗前明显降低(P0.05)。结论西格列汀可以有效减少T2DM患者慢性氧化应激损伤。     

肥胖哮喘患儿血清脂肪因子chemerin水平改变及其临床意义研究

目的探讨肥胖哮喘患儿血清脂肪因子chemerin水平改变及其临床意义。方法纳入100例哮喘急性发作期的肥胖患儿和60例健康肥胖患儿。分别于患儿入院当天和出院当天检测血清总氧化态(TOS)、总抗氧化态(TAS)、氧化应激指数(OSI)和chemierin水平。结果哮喘组患儿TAS明显低于对照组,差异有统计学意义(P0.05);而TOS和OSI明显高于对照组,差异有统计学意义(P0.05)。哮喘组出院时TOS和OSI水平低于入院时,差异有统计学意义(P0.05)。入院时哮喘组chemerin水平明显高于对照组,差异有统计学意义(P0.05),出院时哮喘组chemerin水平低于入院时,差异有统计学意义(P0.05)。危重度亚组患儿入院时和出院时TOS、OSI和chemerin水平均明显高于轻度亚组患儿,差异均有统计学意义(P0.05)。入院时chemerin水平诊断哮喘急性发作的受试者工作特征曲线下面积(AUC)为0.820。相关性分析提示chemerin与哮喘急性发作(r=0.658,P0.05)和严重分级(r=0.608,P0.05)呈正相关。Logistic回归分析提示OSI(OR=1.24,P0.05)和chemerin(OR=1.54,P0.05)是哮喘急性发作发生的独立危险因素。结论新型脂肪因子chemerin通过调控体内氧化应激水平参与到肥胖患儿哮喘急性发作的病理生理学机制,chemerin水平可以作为肥胖患儿哮喘急性发作潜在标记物。     

哮喘肥胖患儿血清脂联素水平变化及其临床意义研究

目的探讨哮喘肥胖患儿血清脂联素水平的变化及其临床意义。方法 2014年1月至2015年12月,以120例确诊的哮喘急性发作期肥胖患儿为研究对象(哮喘组),并根据病情将患儿分为轻度亚组、中度亚组和危重度亚组。于患儿入院当天和出院当天检测血清脂联素、总氧化态(TOS)、总抗氧化态(TAS)和氧化应激指数(OSI)水平。以非哮喘肥胖儿童为对照组。结果哮喘组患儿出院时TOS、OSI水平较入院时明显下降(P0.05)。哮喘组患儿入院时脂联素水平低于对照组(P0.05),出院时脂联素水平较入院时明显上升(P0.05)。危重度亚组患儿TOS水平明显高于轻度亚组患儿(P0.05),脂联素水平则明显低于轻度亚组患儿(P0.05)。以患儿入院时血清脂联素水平2.3mg/L作为cut-off值,则脂联素诊断肥胖患儿哮喘急性发作期的受试者工作特征曲线下面积为0.799(95%置信区间:0.699~0.878),灵敏度为85.6%,特异度为80.4%。脂联素与哮喘急性发作和严重程度分级呈负相关,与TOS、OSI亦呈负相关(P0.05)。OSI16.1U和脂联素水平2.3mg/L是哮喘急性发作的独立危险因素(P0.05)。结论脂联素通过调控氧化应激水平参与肥胖患儿哮喘急性发作的病理学发病机制。脂联素可作为肥胖患儿哮喘急性发作的潜在标记物。     

HBV感染患者氧化应激状态与病毒基因型和耐药突变的相关性

目的探讨慢性乙型肝炎患者氧化应激(OxS)状态和疾病严重程度与乙型肝炎病毒(HBV)基因型和耐药突变的相关性。方法 2014年2月至2016年4月该院确诊的乙型肝炎病毒感染患者296例,其中慢性乙型肝炎(CHB)145例,肝硬化(HBC)101例,CHB相关原发性肝癌(HCC)50例。采用PCR-反向点杂交法检测3种HBV基因型(B、C、D型)和8种耐药突变基因(t180L、rt204M、rt207V、rt236N、rt250M、rt181A、rt184T、rt202S);同时,检测总氧化态(TOS)和总抗氧化态(TAS),并计算OxS指数(OSI)。比较不同肝病、不同基因型及有无耐药突变患者之间TOS、TAS、OSI的差异,并分析HBV基因型、耐药突变、患者OxS与肝病严重程度的相关性。结果 CHB、HBC和HCC患者血清TOS和OSI,以及C型比值和耐药突变率依次增高(均P0.05);血清TAS则依次降低,但CHB患者和HBC患者之间差异无统计学意义(P0.05)。除HBC患者TAS水平外,耐药突变患者的TOS和OSI水平升高,而TAS水平降低,与无突变患者比较,差异有统计学意义(P0.05),且耐药突变发生与血清TOS(r=0.476,P0.01)和OSI(r=0.441,P0.01)水平呈正相关,与TAS(r=―0.249,P0.01)水平呈负相关;突变位点数与HBV感染后病情严重程度呈正相关(r=0.614,P0.01)。结论 HBV感染患者存在不同程度的氧化损伤,其程度随病毒基因型和耐药突变不同而有所差异。因此,OxS参数可能是反映HBV感染患者疾病进展的有用指标。     

高同型半胱氨酸血症患者氧化应激指标的研究

目的观察高同型半胱氨酸血症(HHcy)患者氧化应激指标的水平,并对其临床价值做初步评价。方法检测108例HHcy患者、106名健康体检者(正常对照组)循环谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)、对氧磷酯酶1(PON1)、一氧化氮合酶(NOS)活性及同型半胱氨酸(Hcy)、一氧化氮(NO)和丙二醛(MDA)水平。分析Hcy与GSH-Px、SOD、PON1、NOS、NO、MDA之间的相关性。结果 HHcy患者血浆MDA水平[(6.23±1.55)μmol/L]明显高于正常对照组[(4.14±1.13)μmol/L](P0.01),而GSH-Px[(189.3±25.1)U/L]、SOD[(77.3±20.5)NU/mL]、PON1[(133.6±23.9)kU/L]、NOS活性[(25.3±2.9)U/mL]及NO[(68.3±10.1)μmol/L]水平低于正常对照组[(240.3±78.1)U/L、(89.2±24.8)NU/mL、(168.2±26.0)kU/L、(30.0±3.3)U/mL、(92.1±12.1)μmol/L](P均0.01)。HHcy患者血浆Hcy与MDA呈正相关(r=0.72,P0.01),与GSH-Px、SOD、PON1、NOS、NO呈明显负相关(r值分别为-0.60、-0.49、-0.51、-0.43、-0.50,P均0.01)。结论 HHcy患者氧化应激增强可能与Hcy氧化过程中产生过多的过氧化物及活性氧、Hcy损伤NO/L-精氨酸系统及直接抵制抗氧化酶活性有关。Hcy可能通过增加氧化应激和降低抗氧化能力在动脉粥样硬化发生、发展中起重要的作用。     

水通道蛋白-4和神经元特异性烯醇化酶在手足口病中表达及临床意义

目的探讨手足口病(hand,foot and mouth disease,HFMD)患儿血清水通道蛋白-4(aquaporin-4,AQP-4)和神经元特异性烯醇化酶(neuron-specific enolase,NSE)表达水平及其临床意义。方法 28例危重型HFMD患儿为危重型HFMD组,25例重症HFMD患儿为重症HFMD组,25例普通型HFMD患儿为普通HFMD组,同期25例体检健康儿童为对照组,采用ELISA法检测对照组及HFMD患儿治疗前和治疗7d后血清AQP-4和NSE水平,采用Pearson相关分析AQP-4和NSE水平的相关性。结果危重型HFMD组血清AQP-4[(54.42±19.86)μg/L]和NSE[(24.28±5.37)μg/L]水平明显高于重症HFMD组[(22.04±8.14)μg/L、(15.76±2.88)μg/L]、普通型HFMD组[(8.02±1.59)μg/L、(8.06±3.77)μg/L]和对照组[(8.03±1.65)μg/L、(8.07±3.73)μg/L](P0.01),重症HFMD组明显高于普通型HFMD组和对照组(P0.01),普通型HFMD组与对照组比较差异无统计学意义(P0.05);危重型HFMD组和重症HFMD组患儿治疗7d后血清AQP-4[(36.27±15.37)μg/L、(16.76±6.22)μg/L]和NSE[(19.40±5.77)μg/L、(12.24±2.90)μg/L]水平明显低于治疗前(P0.05);重症HFMD组和危重型HFMD组血清AQP-4与NSE水平均呈正相关(r=0.879,P0.001;r=0.875,P0.001)。结论血清AQP-4和NSE水平变化有助于判断HFMD病情严重程度及预后。     

2型糖尿病患者血清晚期氧化蛋白产物水平与心血管危险因素的关系

目的 探讨2型糖尿病患者血清晚期氧化蛋白产物(AOPP)水平与心血管危险因素的关系.方法 选择2006年1月至2007年12月我院内分泌科就诊2型糖尿病患者90例,健康体检者60名.采用分光光度法测定血清AOPP水平,全自动生化分析仪检测空腹血浆血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇以及高密度脂蛋白胆固醇水平,微柱亲和层析法测定糖化血红蛋白水平,化学发光法测定空腹胰岛素水平,高分辨超声测定大动脉内膜-中层厚度.根据检测结果将2型糖尿病组分成不同亚组,比较各亚组间血清AOPP水平及各相关指标的变化.结果 血清AOPP水平在2型糖尿病组[(80.32±12.65)μmol/L]显著高于对照组[(41.80±17.09)μmoL/L,P<0.01];血糖控制不良组[(91.30±15.52)μmol/L]显著高于血糖良好控制组[(73.16±13.45)μmoL/L,P<0.05];胰岛素抵抗组[(89.07±11.24)μmol/L]显著高于非胰岛素抵抗组[(74.94±12.15)μmol/L,P<0.05];有大血管并发症组[(89.69±12.58)μmol/L]显著高于无大血管并发症组[(75.10±13.09)μmol/L,P<0.01].相关分析显示血清AOPP水平与空腹血浆血糖、糖化血红蛋白、甘油三酯、体重指数以及胰岛素抵抗指数正相关(r=0.286,P=0.03;r=0.310,P=0.01;r=0.461,P=0.001;r=0.257,P=0.04;r=0.461,P=0.001).Logistic回归分析显示年龄、平均动脉压、AOPP是2型糖尿病患者大血管并发症发生的独立危险因素(β=0.508,P<0.001;β=0.326,P<0.001;β=0.339,P<0.001).结论 2型糖尿病患者蛋白氧化应激增强,血清AOPP水平与2型糖尿病患者多种心血管危险因素相关,是2型糖尿病患者大血管并发症发生的独立危险因素.     

快通道麻醉对行手术治疗先天性心脏病患儿心肌氧化应激损伤及血清miR-1的影响

目的探讨行手术治疗先天性心脏病患儿采用快通道麻醉(fast-track anesthesia,FTA)对心肌氧化应激损伤及血清miR-1的影响。方法行手术治疗先天性心脏病患儿120例,随机分为观察组和对照组各60例,对照组采用常规麻醉,观察组采用FTA,比较2组动脉阻断前(T0)及动脉开放后15min(T1)、30min(T2)、60min(T3)、180min(T4)血清心肌肌钙蛋白I(cardiac troponin I,cTnI)、miR-1水平,丙二醛(malonaldehyde,MDA)含量和超氧化物歧化酶(superoxide dismutase,SOD)活性;Pearson相关法分析观察组血清miR-1水平与血清cTnI、MDA水平及SOD活性的相关性。结果 2组手术时间、体外循环时间、主动脉阻断时间比较差异均无统计学意义(P0.05);观察组T0时血清cTnI[(0.25±0.02)μg/L]、MDA[(4.09±0.87)μmol/L]、SOD活性[(43.28±9.68)u/mL]及miR-1(0.36±0.05)与对照组[(0.24±0.03)μg/L、(4.15±0.74)μmol/L、(42.76±8.54)u/mL、0.35±0.06]比较差异均无统计学意义(P0.05);观察组T1、T2、T3、T4时血清cTnI[(1.89±0.28)、(2.67±0.36)、(3.62±0.48)、(2.76±0.32)μg/L]、MDA[(5.21±0.78)、(6.47±0.95)、(8.23±1.15)、(6.09±0.91)μmol/L]、SOD活性[(52.45±9.36)、(64.73±11.36)、(75.75±11.57)、(59.57±8.74)u/mL]及miR-1水平(2.03±0.13、3.28±0.15、4.03±0.16、3.18±0.13)均低于对照组[cTnI:(2.85±0.30)、(3.35±0.40)、(5.51±0.62)、(4.12±0.55)μg/L;MDA:(6.63±1.06)、(7.94±1.21)、(9.82±1.28)、(7.26±0.98)μmol/L;SOD:(65.21±10.26)、(73.74±9.85)、(84.36±14.79)、(68.64±12.62)u/mL;miR-1:2.95±0.11、4.73±0.14、6.37±0.18、4.63±0.15](P0.05),且均高于T0时(P0.05);Pearson相关分析结果显示,观察组血清miR-1表达与血清cTnI、MDA含量及SOD活性均呈正相关(r=0.543,P0.001;r=0.723,P0.001;r=0.639,P0.001)。结论 miR-1可作为评估先天性心脏病患儿手术中主动脉阻断和开放后心肌损伤和氧化应激程度的血清学标志物;FTA可显著减轻行手术治疗先天性心脏病患儿心肌损伤、氧化应激程度及血清miR-1水平,具有明显的心肌保护作用。     

血清S100蛋白及神经元烯醇化酶在新生儿胆红素脑病中表达及意义

目的探讨胆红素脑病新生儿血清S100蛋白、神经元烯醇化酶(neuron-specific enolase,NSE)的表达及临床意义。方法重度高胆红素血症新生儿129例,其中胆红素脑病患儿45例为观察组,非胆红素脑病患儿84例为对照组。采用ELISA法检测2组血清S100蛋白、总胆红素(total bilirubin,TBIL)及间接胆红素(indirect bilirubin,IBIL)水平,电化学发光免疫法检测血清NSE水平;Pearson相关分析血清NSE、S100蛋白与TBIL、IBIL的相关性。结果观察组血清NSE[(79.65±27.86)μg/L]、S100蛋白[(1.35±0.13)μg/L]水平高于对照组[(33.01±12.37)、(0.37±0.15)μg/L](P0.05),血清TBIL[(447.53±103.45)μmol/L]、IBIL[(416.18±97.37)μmol/L]与对照组[(451.37±98.38)、(407.18±108.37)μmol/L]比较差异无统计学意义(P0.05);Pearson相关分析结果显示,观察组、对照组血清S100蛋白与TBIL(r=0.172,P=0.133;r=0.163,P=0.274)、IBIL(r=0.131,P=0.261;r=0.153,P=0.194)均无线性相关,观察组、对照组血清NSE与TBIL(r=0.241,P=0.133;r=0.114,P=0.241)、IBIL均无线性相关(r=0.147,P=0.264;r=0.203,P=0.237)。结论血清S100蛋白、NSE水平可作为评估胆红素脑病新生儿脑损伤的参考指标。     

对氧磷酯酶1与氧化应激指标检测在非酒精性脂肪性肝炎中的临床意义

目的 探讨对氧磷酯酶1(PON1)与氧化应激指标检测在非酒精性脂肪性肝炎中的变化及临床意义.方法 检测68例非酒精性脂肪性肝炎患者血浆PON1,超氧化物歧化酶(SOD) 和丙二醛(MDA)的水平并与46例健康对照组比较,进行相关性分析.结果 非酒精性脂肪性肝炎患者血浆PON1活性和SOD水平分别为(134.5±60.2)kU/L和(81.3±11.2) U/ml,均较对照组(165.1±68.0)kU/L和(93.5±9.8)U/ml降低,P<0.05;而MDA含量较对照组显著升高[(13.5 ±5.0)μmol/L vs(9.5 ±3.0)μmol/L,P<0.01].PON1与SOD水平呈正相关(r=0.402,P<0.05),与MDA水平呈负相关(r=-0.518,P<0.01).结论 非酒精性脂肪性肝炎中血浆PON1降低可能与脂质过氧化增加互为因果关系.PON1降低与脂质过氧化增加可能在非酒精性脂肪性肝炎病理过程中发挥作用.     

Serum Paraoxonase 1 Activity and Oxidative Stress in Pediatric Patients with Pulmonary Tuberculosis

Objectives

The aim of this study was to determine the oxidative stress and paraoxonase 1 (PON1) levels in children with pulmonary tuberculosis (TB) compared to healthy controls, and to examine the association of demographical with oxidative stress.

Subjects and Methods

Forty children diagnosed with pulmonary TB and 40 age- and gender-matched healthy controls were enrolled in the study. Serum total antioxidant status (TAS), total oxidant status (TOS) and PON1 levels were measured. The oxidative stress index (OSI) was calculated to indicate the degree of oxidative stress.

Results

The TAS levels were lower (1.73 ± 0.5 vs. 2.54 ± 1.2 μmol Trolox Eq/l) while TOS levels were significantly higher (26.9 ± 14.4 vs. 13.4 ± 7.7 μmol H₂O₂ Eq/l) in the TB group than in the controls (p < 0.001). The OSI was significantly higher in the TB group than in the controls (21.2 ± 5.1 vs. 6.5 ± 4.9 units, p = 0.006). Serum PON1 levels were significantly lower in the TB group than in the controls (14.2 ± 13.2 vs. 28.4 ± 17.3 U/l, p < 0.001). The lower PON1 levels correlated with TAS and OSI levels but not with anthropometric parameters (r = 0.264, p = 0.018 and r = −0.255, p = 0.023, respectively).

Conclusion

The TOS and OSI levels were higher and the TAS and PON1 levels were lower in pediatric patients with pulmonary TB when compared to healthy controls. This indicates greater oxidative stress in the patients.Key Words: Total oxidant status, Paraoxonase 1, Tuberculosis, Oxidative stress     

The correlation of the total antioxidant status (TAS), total oxidant status (TOS) and paraoxonase activity (PON1) with smoking

Objective

In this study, we aimed to assess the total antioxidant status (TAS), total oxidant status (TOS) and paraoxonase activity (PON1) in smokers and nonsmokers.

Design and methods

This cross-sectional analytical study was conducted on 100 smokers and 100 nonsmokers. Low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), total cholesterol (TC), triglyceride (TG), fasting blood glucose (FBG), TAS, TOS and PON1 levels of the participants were determined in the blood samples. TAS and TOS were determined by using the automated measurement method. Paraoxon was used as a substrate for measuring PON1 activity.

Results

A statistically significant difference could not be found between smokers and nonsmokers in terms of mean FBG, LDL-c, HDL-c, TC, TG, TAS, TOS, PON1, oxidative stress index (OSI) and body mass index (BMI). Mean TAS and TOS levels were higher in men than women (p = 0.001). As age (p = 0.022) and age to start smoking (p = 0.023) increased, TOS level decreased. As the age to start smoking (p = 0.001) increased, TAS level decreased whereas as BMI (p = 0.001) increased, TAS level also increased. A statistically significant relationship could not be established between age, age to start smoking, duration and amount of smoking, dependence score and BMI and PON1 (p > 0.05).

Conclusions

In our study, although no significant correlation could be established between smokers and nonsmokers in terms of mean TAS, TOS and PON1, it is a fact that TAS, TOS and PON1 in the organism are affected by many factors and therefore there is a need for more extensive studies in this regard.     

Oxidative status and serum PON1 activity in beta-thalassemia minor

OBJECTIVES: Paraoxonase-1 (PON1) deficiency is related to increased susceptibility to low density lipoprotein oxidation and development of atherosclerosis. The aim of this study was to investigate paraoxonase and arylesterase activities along with oxidative status parameters, and to find out if there is any increased susceptibility to atherogenesis, which might be reflected with increased oxidative stress and decreased serum PON1 activity in beta-thalassemia minor (BTM) subjects. DESIGN AND METHODS: Thirty-two subjects with BTM and 28 healthy subjects as control were enrolled in the study. Serum paraoxonase and arylesterase activities, lipid hydroperoxide (LOOH) levels, total antioxidant capacity (TAC), total oxidant status (TOS) and oxidative stress index (OSI) were determined. RESULTS: Serum TAC, paraoxonase and arylesterase activities were significantly lower in BTM subjects than controls (for all p<0.001), while TOS, LOOH levels and OSI were significantly higher (p<0.001, p<0.05 and p<0.001; respectively). In BTM subjects, OSI, TOS, LOOH levels and TAC were significantly correlated with serum paraoxonase (r=-0.245, p<0.05; r=-0.231, p<0.05; r=-0.264, p<0.05 and, r=0.342, p<0.05, respectively) and arylesterase activities (r=-0.332, p<0.05, r=-0.308, p<0.05; r=-0.320, p<0.05 and r=0.443, p<0.05). Additionally, hemoglobin level was also correlated with serum paraoxonase (r=0.501, p<0.001) and arylesterase activities (r=0.501, p<0.001), TAC (r=0.402, p<0.05), TOS (r=-0.274, p<0.05) and OSI (r=-0.352, p<0.05). CONCLUSIONS: Oxidative stress is increased, while serum PON1 activity is decreased in BTM subjects. Decrease in PON1 activity seems to be associated with both the degree of oxidative stress and anemia. BTM subjects may be more prone to development of atherogenesis due to low serum PON1 activity.     

Paraoxonase-1 activity and oxidative status in patients with knee osteoarthritis and their relationship with radiological and clinical parameters

Abstract Background. The aim of this study was to investigate serum paraoxonase-1 (PON1) activity and oxidative/anti-oxidative status in knee osteoarthritis (OA), and evaluate their relationship using radiological and clinical parameters. Materials and methods. The study population comprised 127 patients with knee OA and 107 healthy volunteers. Patients with knee OA were divided into four subgroups according to the Kellgren-Lawrence (K&L) grading scale. In addition, each patient was clinically evaluated by the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). Serum PON1 activity was measured spectrophotometrically. Oxidative status was assessed by measuring serum lipid hydroperoxide (LOOH) and total oxidant status (TOS). Anti-oxidative status was assessed by measuring serum free sulfydryl groups (-SH = total thiol) and total antioxidant capacity (TAC). Oxidative stress index (OSI) was calculated. Lipid parameters were determined by routine laboratory methods. Results. Serum PON1 activity was significantly lower in the knee OA group compared to the control group (p ?0.05). The lowest and highest mean serum PON1 activities were detected in patients with grades 4 and 1, respectively (ANOVA p 相似文献   

不同容量肺灌洗术对合并COPD的尘肺病患者血清炎性因子和肺功能的影响

目的比较大容量肺灌洗术与小容量肺灌洗术治疗对尘肺病合并慢性阻塞性肺疾病(COPD)患者血清炎性因子及肺功能的改善效果。方法回顾性选取2017年8月至2019年7月首都医科大学附属北京世纪坛医院收治的90例尘肺合并COPD患者,根据不同容量肺灌洗治疗方案分为2组,每组各45例,对照组采用小容量肺灌洗术治疗,观察组采用大容量肺灌洗术。比较2组患者治疗前和治疗后30 d血清炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、转化生长因子β1(TGF-β1)]、肺功能[第1秒用力呼气量(FEV1)、第1秒用力呼气量占用力肺活量比值(FEV1/FVC)、最大呼气流量(PEF)]以及随访6个月运动耐量及生活质量变化,记录2组患者术后不良反应发生情况。结果治疗前,2组患者血清IL-6、TNF-α、TGF-β1水平、FEV1、FEV1/FVC、PEF、6 min步行距离(6MWD)、圣乔治呼吸问卷(SGRQ)评分比较,差异无统计学意义(P> 0.05)。观察组患者治疗后30 d的血清IL-6、TNF-α、TGF-β1含量分别为(0.35±0.08)μg/m L、(150.35±25.63) ng/L、(41.25±5.32) ng/L,均明显低于对照组[(0.43±0.09)μg/m L、(182.76±24.17) ng/L,(50.37±5.17) ng/L],差异有统计学意义(P <0.05)。观察组患者治疗后30 d的FEV1、FEV1/FVC、PEF分别为(1.72±0.13) L、(69.59±5.23)%、(371.59±10.58) L/min,均明显高于对照组[(1.46±0.12) L、(61.03±5.17)%、(347.02±9.27) L/min],差异有统计学意义(P <0.05)。随访6个月,观察组患者SGRQ评分为(41.39±3.02)分,明显低于对照组[(49.27±3.08)分],6MWD为(381.75±18.31) m,明显远于对照组[(307.51±17.59) m],差异均有统计学意义(P <0.05)。2组患者不良反应发生率比较(35.6%vs. 31.1%),差异无统计学意义(P> 0.05)。结论与小容量肺灌洗方案相比,采用大容量肺灌洗术治疗尘肺合并COPD可进一步抑制血清炎性因子表达,有助于增强肺通气功能,并有利于改善运动耐量及生活质量,且其治疗安全性与小容量肺灌洗方案相当。     

乙肝患者血清高尔基蛋白73水平改变及其临床意义

目的探讨乙肝患者血清高尔基蛋白(GP)73水平改变及其临床意义。方法连续性纳入2013年1月至2015年6月于镇江市中西医结合医院就诊的300例慢性乙肝病毒感染患者,根据病情分为乙肝病毒携带(HBV-C)组共50例,慢性乙肝(CHB)组共120例,乙肝相关肝硬化(LC)组共60例,乙肝相关肝细胞癌(HCC)组70例。比较各组之间血清GP73水平差异,并通过相关性分析和受试者工作特征曲线(ROC曲线)分析比较GP73对不同乙肝患者病变程度的诊断学价值。结果 CHB组、HCC组和LC组患者GP73水平分别为(117.3±12.8)、(181.5±21.7)、(263.2±33.4)ng/mL,均明显高于HBV-C组患者的(39.2±3.5)ng/mL,差异均有统计学意义(P0.05)。HCC组和LC组患者GP73水平又明显高于CHB组,差异有统计学意义(P0.05)。代偿LC亚组GP73水平[(245.6±29.3)ng/mL]明显低于失代偿LC亚组[(279.5±39.6)ng/mL],差异有统计学意义(P0.05)。血清GP73水平与天门冬氨酸氨基转移酶(r=0.554,P0.05)、丙氨酸氨基转移酶(r=0.409,P0.05)、清蛋白(r=0.445,P0.05)、Child-pugh分级(r=0.609,P0.05)和失代偿LC(r=0.722,P0.05)呈正相关。GP73对于CHB的ROC曲线下面积(AUC)为0.741,95%CI为0.519~0.813,cut off值为176.3ng/mL,敏感性为77.8%,特异性为77.2%;GP73对于HCC的AUC为0.749,95%CI为0.676~0.834,cut off值为232.0ng/mL,敏感性为78.0%,特异性为82.5%;GP73对于LC的AUC为0.738,95%CI为0.636~0.841,cut off值为292.2ng/mL,敏感性为74.4%,特异性为80.9%;GP73对于失代偿性LC的AUC为0.802,95%CI为0.699~0.932,cut off值为319.3ng/mL,敏感性为84.2%,特异性为90.3%。结论 GP73可以作为一种较为敏感且特异性较高的肝脏标记物,不但有助于早期诊断HCC和LC,还有助于辅助判断LC患者肝功能代偿状态。     

血清降钙素原与超敏C反应蛋白联合检测在真菌性感染诊断中的应用

目的：观察细菌性及真菌性感染患者血清降钙素原（PCT）、超敏C反应蛋白（hs‐CRP）检测水平。方法选取56例感染患者,其中细菌性感染33例（细菌组）、真菌性感染23例（真菌组）,另选择30例体检中心健康体检者作为对照组。采集静脉血检测3组血清PCT及hs‐CRP水平。结果细菌组、真菌组、对照组血清hs‐CRP分别为（38．1±10．5）、（36．5±9．8）、（7．2±3．6）mg／L ,细菌组、真菌组与对照组比较差异有统计学意义（P＜0．05）;细菌组与真菌组比较差异无统计学意义（P＞0．05）。细菌组、真菌组、对照组血清PCT分别为（7．35±2．12）、（3．15±1．03）、（0．42 ± 0．16）ng／mL ,细菌组、真菌组与对照组比较差异有统计学意义（P＜0．05）;细菌组与真菌组比较差异有统计学意义（P＜0．05）。结论真菌性感染患者血清hs‐CRP、PCT水平均升高,但较细菌性感染患者血清PCT水平升高不明显,故联合检测血清PCT、hs‐CRP有助于早期诊断真菌性感染。