低钾右旋糖酐液与低钾右旋糖酐—组氨酸液对供体肺保护的实验研究

目的 :在兔肺离体再灌注模型上 ,对比研究低钾右旋糖酐 (LPD)液与低钾右旋糖酐 组氨酸(LPDH)液的肺保护效果。方法 :实验分为 3组 (n =6 ) ,A组为未经灌洗和保存的正常对照组。B组为用LPD液灌洗和保护组。C组为用LPDH液灌洗和保护组。B、C 2组供体心肺均在 10℃下保存 18h后 ,离体灌注供体左肺 30min。结果 :C组流出血氧分压PO2 均值 (112 4 0± 4 4 3mmHg)显著高于B组 (78 4 3±5 4 1mmHg) ,P <0 0 0 1。C组流出血二氧化碳分压均值 (2 6 76± 0 79mmHg)显著低于A组 (32 4 6± 1 2 3mmHg)和B组 (31 6 6± 1 0 8mmHg) ,P <0 0 0 1。C组再灌注后供体肺的湿 干比率 (5 4 8± 0 16 )显著低于B组 (6 32± 0 39)。结论 :供体兔肺采用LPDH液低温保护 18h后的效果 ,显著优于LPD液。     

低温保存供体兔肺离体再灌注模型的建立

目的：用离体兔肺连续温血再灌注模型评价低温保存后供体肺功能。方法：将未经灌洗和保存的对照组（ｎ＝６）供体左肺，与低温１０℃下保存１８小时后的实验组（ｎ＝６）供体左肺，分别在离体状态下，连续通气和温静脉血灌注３０分钟，将离体左肺引流出的动脉血，泵入另一兔体内，通过交叉循环使之静脉化后连续再灌注。结果：对照组氧分压显著优于实验组，两组间的肺动脉平均压、呼吸道峰压及再灌注后离体肺的湿／干重量比率结果无显著性差异。结论：该方法的建立为供体肺保存的研究提供了较理想的动物模型。     

2型糖尿病患者细胞外液、细胞内液体积比值与尿白蛋白肌酐比值相关性的研究

目的 探讨T2DM患者细胞外液、细胞内液体积比值（ECW/ICW）与UACR的相关性。方法 选取2021年5月至2022年4月于空军军医大学唐都医院内分泌科住院治疗的T2DM患者322例,根据UACR分为<30 mg/g的蛋白尿正常组（Con,n=175）、30≤UACR≤300 mg/g的微量蛋白尿组（Mic,n=78）和>300 mg/g的大量蛋白尿组（Mac,n=69）。比较各组一般资料及生化指标,Spearman相关分析T2DM患者ECW/ICW与UACR的相关性,二元Logistic回归分析T2DM患者UACR的影响因素。结果 Mac组DM病程、SBP、DBP、TC、LDL-C、BUN、血肌酐、血尿酸、ECW/ICW、内脏脂肪面积（VFA）高于Con、Mic组（P<0.05或P<0.01）,eGFR低于Con、Mic组（P<0.05）。Spearman相关分析显示,ECW/ICW与UACR呈正相关（r=0.157,P=0.005）。二元Logistic回归分析显示,ECW/ICW是T2DM患者UACR的影响因素。结论 ECW/ICW是T2DM患者...     

慢性阻塞性肺疾病急性加重期患者呼气冷凝液中肺部活化调节趋化因子、Clara细胞蛋白16、细胞间黏附分子1水平变化及其与患者短期预后的关系研究

背景目前,关于血清肺部活化调节趋化因子(CCL18)、Clara细胞蛋白16(CC16)、细胞间黏附分子1(ICAM-1)与慢性阻塞性肺疾病(COPD)关系的研究较多,但关于其在慢性阻塞性肺疾病急性加重期(AECOPD)患者呼气冷凝液(EBC)中的变化研究报道较少。目的分析AECOPD患者EBC中CCL18、CC16、ICAM-1水平变化及其与患者短期预后的关系。方法选取2017年6月-2019年6月海口市人民医院收治的COPD患者159例,其中急性加重期99例(A组),缓解期60例(B组);另选取本院同期体检健康者60例作为C组。根据短期预后将99例AECOPD患者分为预后良好亚组24例和预后不良亚组75例。比较A、B、C组受试者EBC中CCL18、CC16、ICAM-1水平;比较预后良好亚组、预后不良亚组患者临床资料,AECOPD患者短期预后的影响因素分析采用多因素Logistics回归分析;绘制受试者工作特征曲线(ROC)以评价EBC中CCL18、CC16、ICAM-1水平对AEPOCD患者短期预后的预测价值。结果A组受试者EBC中CCL18、CC16、ICAM-1水平高于B、C组,B组受试者EBC中CCL18、CC16、ICAM-1水平高于C组(P<0.05)。预后不良亚组患者合并症数量≥2个者所占比例,血清C反应蛋白(CRP)、降钙素原(PCT)水平及EBC中CCL18、CC16、ICAM-1水平高于预后良好亚组(P<0.05);两组患者男性比例、年龄、病程、体质指数(BMI)、吸烟率、饮酒率、激素使用时间、机械通气时间、意识障碍发生率、白细胞计数(WBC)、中性粒细胞与淋巴细胞比值(NLR)、动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)、第1秒用力呼气容积占预计值百分比(FEV1%)、第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,合并症数量≥2个〔OR=2.252,95%CI(1.744,3.760)〕,血清CRP〔OR=2.210,95%CI(1.737,3.580)〕、PCT〔OR=2.049,95%CI(1.687,3.325)〕水平及EBC中CCL18〔OR=2.773,95%CI(1.857,4.336)〕、CC16〔OR=2.678,95%CI(1.801,3.985)〕、ICAM-1〔OR=1.923,95%CI(1.589,3.012)〕水平是AECOPD患者短期预后的独立影响因素(P<0.05)。ROC曲线分析显示,EBC中CCL18、CC16、ICAM-1水平预测AECOPD患者短期预后的曲线下面积(AUC)分别为0.856〔95%CI(0.435,0.902)〕、0.820〔95%CI(0.401,0.842)〕、0.705〔95%CI(0.380,0.758)〕,灵敏度分别为89.90%、82.83%、76.77%,特异度分别为78.79%、70.71%、63.64%。结论COPD患者EBC中CCL18、CC16、ICAM-1水平明显升高,且急性加重期患者高于稳定期患者;EBC中CCL18、CC16、ICAM-1水平是AECOPD患者短期预后的独立影响因素,对AECOPD短期预后具有一定预测价值。     

前列腺素E对氧化和糖基化低密度脂蛋白影响的比较研究

应用生物化学，组织化学和形态计量学等技术对低密度脂蛋白的氧化和糖基化损伤进行了比较研究，同时观察了前列腺素Ｅ类药物的影响。结果显示：与对照组相比，氧化低密度脂蛋白组的抗氧化酶活性明显低落，过氧化脂质含量显著升高，但前列腺素Ｅ类药物却明显提高抗氧化酶活性，抑制过氧化脂质生成。巨噬细胞含脂的形态计量学分析表明前列腺素Ｅ，尤以前列腺素Ｅ２明显抑制泡沫细胞形成。糖基化修饰低密度脂蛋白机理较为复杂，其两酶活     

灯盏花素联合前列腺素E1治疗下肢动脉硬化闭塞症的疗效观察

目的观察灯盏花素联合前列腺素E1对下肢动脉硬化闭塞症的治疗效果。方法回顾性分析2007年—2009年我院收治的下肢动脉硬化闭塞症患者156例的临床资料,评价灯盏花素联合前列腺素E1的治疗效果。结果治疗后总有效率为94.23%,血浆纤维蛋白原水平治疗前后比较差异有统计学意义(P0.05)。结论灯盏花素和前列腺素E1联合用药可扩张血管、抑制血小板聚集、改善微循环作用,从而改善临床症状及体征。     

前列腺素E1对肝硬化门静脉高压影响的临床研究

３０例肝硬化门静脉高压患者以前列腺素Ｅ１１００μｇ／ｄ静滴共，１０日，用彩色多普苗观察治疗前后血液动力学变化，另以３０例口服心得安作对照，ＰＧＥ１可使门脉高压患者的门静脉，脾静脉口径缩小、肝血流量减少，有一定降门静脉压的效果，与心得安对比有显著性。     

Effects of prostaglandin E1 on oxygen delivery and consumption in patients with the adult respiratory distress syndrome. Results from the prostaglandin E1 multicenter trial. The Prostaglandin E1 Study Group

We wanted to determine the long-term effects of a continuous infusion of PGE1 on DO2 and VO2 in patients with ARDS. Data were obtained from a randomized double-blind multicenter trial, which evaluated the effects of PGE1 on survival in patients with ARDS. Patients were stratified according to treatment and outcome: placebo-died (n = 8); PGE1-died (n = 12); placebo-survived (n = 9); and PGE1-survived (n = 8). In the placebo-died group, elevations occurred in VO2, which were associated with increases in O2ext and a constant DO2. In contrast, in the PGE1-died group, elevations in VO2 were associated with increases in DO2 and an unchanged O2ext. In the placebo-survived group, VO2 and DO2 decreased, whereas in the PGE1-survived group, VO2 and DO2 increased; however, O2ext decreased in both of these groups. Since impaired O2ext occurs in ARDS, PGE1-induced elevations in DO2, rather than compensatory increases in O2ext, may achieve better tissue oxygenation. We conclude that although the recently completed multicenter trial failed to show an enhancing effect of PGE1 on survival in patients with advanced ARDS, PGE1 may have important effects on oxygen transport and, therefore, may still have a role in the treatment of early manifestations of ARDS, either alone or in combination with other agents.     

Effect of Growth Factors and Prostaglandin E2 on Restitution and Proliferation of Rabbit Esophageal Epithelial Cells

Factors and mechanisms involved in esophagealmucosal injury and repair are not well known. The aim ofthis study was to assess the effects of growth factorsand prostaglandins on esophageal mucosal cell repair activities. Rabbit esophageal cells wereisolated, cultured, and exposed to different growthfactors and prostaglandin E₂. Subconfluentcell cultures were used to study proliferative responsesdetermined by [³H]thymidine incorporation intoDNA. Restitution was studied in confluent monolayerswounded by mechanical denudation. Restitution was themain mechanism involved in wound repair within the first24 hr. HGF, IGF-I, and EGF dose-dependentlystimulated cell proliferation but did not affectrestitution. TGF-₁ inhibited bothproliferation and restitution while PDGF-BB andprostaglandin E₂ had no effect. Esophageal epithelial cell restitution andproliferation are affected by growth factors. HGF,IGF-I, EGF (stimulation), and TGF-₁(inhibition) are major growth factors affecting in vitroesophageal wound repair activities, which, unlike those ofother areas of the digestive tract, are not affected byprostaglandins.     

尿激酶和前列腺素E1联合溶解深静脉血栓的临床研究

目的：观察静脉内联用尿激酶（ＵＫ）和前列腺素Ｅ１（ＰＧＥ１）对下肢深静脉血栓（ＤＶＴ）患者的溶栓效果。方法：将８９例经静脉造影确诊为ＤＶＴ患者分为联合溶栓组［ＵＫ＋ＰＧＥ１ｎ＝５１，第１组（病程＜２周）：先静脉注射ＵＫ１０万ＩＵ，接着静脉滴注ＵＫ（３万ＩＵ／ｈ）及ＰＧＥ１（１００μｇ／ｄ）持续２～３天，之后持续静脉滴注肝素钠５～７天，再服用华法林（使凝血酶原时间为基础对照的１．５～２．０倍）３～６个月；第２组（病程＞２周）：静脉注射ＵＫ１０万ＩＵ后，静脉滴注ＵＫ２０万ＩＵ及ＰＧＥ１１００μｇ，每日１次，连用７～１０天，再服华法林３～６个月］和常规治疗组（肝素，ｎ＝３８，剂量同上）。以血管造影为标准判断溶栓效果。结果：联合溶栓组的疗效明显优于常规治疗组（Ｐ＜０．０１）；其疗效与病程长短关系密切，病程小于２个月者疗效显著（显效率７５％，总有效率９６．５％）；无严重并发症发生。结论：静脉内联用ＵＫ和ＰＧＥ１治疗ＤＶＴ是一种安全、有效的治疗方法。     

前列腺素E_1在先天性心脏病合并肺动脉高压的术前诊治作用

目的：本文目的是了解先天性心脏病（先心病）合并肺动脉高压患者，术前应用前列腺素Ｅ１（ＰＧＥ１）治疗后对其心肺功能的改善作用，为该病的诊治提供依据。方法：对２２例先心病合并严重肺动脉高压患者术前应用ＰＧＥ１治疗（ＰＧＥ１１００～２００ｎｇ·ｋｇ－１／ｍｉｎ，静脉滴注４～５ｈ／ｄ）４～７天。结果：对于肺低阻力组（平均全肺阻力７８．７０±２９．１６ｋＰａ·ｓ／Ｌ，用药后心前区杂音较前明显，动脉氧饱和度增加（Ｐ＜０．０５），肺血流受阻程度改善，右心射血分数增加（Ｐ＜０．０５）；对于肺高阻力组（平均全肺阻力２６５．３３±７６．９７ｋＰａ·ｓ／Ｌ，用药后除右心射血分数明显增加（Ｐ＜０．０５）外，其余各项指标改善不明显。结论：对于先心病合并肺动脉高压的患儿，应用ＰＧＥ１治疗，不但可判断肺血管病变性质，为手术适应证的选择提供参考；同时还可以改善患者的心肺功能，为手术做好准备。     

Effects of Prostaglandin E1 Infusion on Limb Hemodynamics and Vasodilatory Response in Patients with Arteriosclerosis Obliterans

It is well known that prostaglandin E1 (PGE1>) increases peripheral blood flow. The aim of this study was to investigate the effects of PGE1 infusion on the hemodynamics and vasodilatory response of the leg affected by intermittent claudication in patients with arteriosclerosis obliterans (ASO). Fourteen legs of 8 male patients with ASO were infused intravenously with PGE1 (120 µg/day) for 7 consecutive days. Before the infusion and 5 days after cessation of the infusion, resting skin and skeletal muscle blood flow in the calf and occlusion-induced reactive hyperemic flow were measured using plethysmography and a laser Doppler flowmeter. Clinical symptoms in the legs were assessed by treadmill exercise testing. Resting calf blood flow was found to have increased significantly (skin, from 2.6 ± 0.1 ml/min/100 g tissue to 2.9 ± 0.1 ml/min/100 g tissue, p > 0.02; skeletal muscle, from 3.1 ± 0.2 ml/min/dl tissue to 4.0 ± 0.5 ml/min/dl tissue, p > 0.02). There was also a significant reduction in the peripheral vascular resistance (–17.8 ± 7.2%, p > 0.05) 5 days after the cessation of infusion. The time to the half-maximum post peak of hyperemia was significantly elongated (from 34.6 ± 5.7 sec to 58.6 ± 9.2 sec, p > 0.01). Borg's score of the legs on exercise testing was markedly reduced, and symptom-free walking distance was increased by an average of 70.9 ± 15.6%. In conclusion, PGE1 infusion has vascular effects on not only resting calf blood flow but also hyperemic flow responses. These retentive effects may be due to alteration in vascular functions and/or rheological state as a result of PGE1-induced regular enhancement of blood flow, rather than the direct vasodilatory effect of the agent.