阻塞性睡眠呼吸暂停低通气综合征患者手术前后血中CRP、TNF-α、IL-8的变化

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者手术前后血中C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平的变化。方法选取67例经多导睡眠监测仪(PSG)证实的重度OS-AHS患者作为研究组,同时以30例与研究对象相匹配的健康人群做对照。用放射免疫法检测血清中TNF-α及IL-8,用乳胶增强免疫比浊法检测血清中CRP。结果术前OSAHS组血清CRP〔(7.01±0.33)mg/L〕、TNF-α〔(1.82±0.36)μg/L〕、IL-8〔(227.18±88.17)ng/L〕水平明显高于对照组〔(2.87±0.21)mg/L、(0.99±0.31)μg/L、(153.23±62.11)ng/L〕(P均<0.05);术后OSAHS组血清CRP〔(3.27±0.33)mg/L〕、TNF-α〔(1.11±0.27)μg/L〕、IL-8〔(149.73±66.12)ng/L〕水平较术前明显下降(P均<0.05),与对照组水平比较差异无统计学意义(P均>0.05)。结论 OSAHS患者术前血清中CRP、TNF-α、IL-8水平失衡,经过鼻持续正压通气及手术治疗后,3种因子水平可下降至正常水平。CRP、TNF-α及IL-8可做为OSAHS诊治的有效指标。     

血栓素A2、前列环素与阻塞性睡眠呼吸暂停低通气综合征及其合并高血压的相关性研究

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)及其合并高血压患者血浆血栓素B2(TXB2)、6-酮前列腺素F1α(6-Keto-PGF1α)水平的变化.方法检测OSAHS及其合并高血压患者血浆TXB2、6-Keto-PGF1α水平并与正常人进行对照,将检测结果与睡眠呼吸监测指标进行相关性分析.结果 OSAHS患者血浆TXB2及TXB2/ 6-Keto-PGF1α(T/P)比值明显高于正常对照组[(77.37±20.13) ng/L vs (47.97±12.05) ng/L,(5.47±3.83) vs (1.73±0.99)](P<0.01),6-Keto-PGF1α浓度明显低于正常对照组[(20.07±12.11) ng/L vs (31.27±9.41) ng/L](P<0.01),且OSAHS合并高血压组与单纯OSAHS组比较血浆TXB2及T/P比值比较差异有统计学意义[(141.78±21.66) ng/L vs (77.37±20.13) ng/L,(11.06±6.97) vs (5.47±3.83)](P<0.01);血浆TXB2、6-Keto-PGF1α水平与OSAHS的病情严重程度有相关性.结论 OSAHS及其合并高血压患者存在TXA2与PGI2的失衡,这种变化在OSAHS合并高血压患者中更为明显.     

视网膜分支静脉阻塞患者同型半胱氨酸和高敏C反应蛋白水平分析

目的探讨视网膜分支静脉阻塞(branch retinal vein occlusion, BRVO)患者血清同型半胱氨酸(homocysteine, Hcy)和血浆高敏C反应蛋白(high-sensitivity C-reactive protein, hs-CRP)水平及临床意义。方法 BRVO患者124例为观察组,体检健康者124例为对照组。采用散射免疫比浊法检测2组血浆hs-CRP水平,采用速率法检测血清Hcy水平,比较2组高同型半胱氨酸血症和hs-CRP升高发生率,观察合并高血压、高胆固醇血症的BRVO患者血浆hs-CRP和血清Hcy水平变化情况。结果观察组血浆hs-CRP[(3.48±1.54)mg/L]、血清Hcy水平[(32.60±16.94)μmol/L]高于对照组[(0.83±0.40)mg/L、(10.18±1.31)μmol/L](P0.05),高血压(33.06%)、高胆固醇血症(35.48%)、高同型半胱氨酸血症(78.23%)和hs-CRP升高(60.48%)发生率高于对照组(17.74%、16.94%、30.65%、20.97%)(P0.05);观察组合并高血压患者血清Hcy水平[(37.22±21.78)μmol/L]高于未合并高血压患者[(21.73±17.90)μmol/L](P0.05),血浆hs-CRP水平[(3.72±1.92)mg/L]与未合并高血压患者[(3.26±1.69)mg/L]比较差异无统计学意义(P0.05),合并高胆固醇血症患者血浆hs-CRP、血清Hcy水平与未合并高胆固醇血症者比较差异均无统计学意义(P0.05)。结论血浆hs-CRP和血清Hcy升高可能与BRVO发生有关,尤其对合并高血压的患者,尽早筛查有助于预防BRVO的发生和及时干预。     

The changes of plasma 8-iso-prostaglandin F2αand serum C-reactive protein levels in patients with obstructive sleep apnea-hypopnea syndrome

Objective To investigate the plasma 8-iso-prostaglandin F2α(8-iso-PGF2α and the serum C-re-active protein(CRP) levels in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) with and without hypertension(OSAHS + HT),and to explore the changes of pathophysiology in patients with OSAHS and the patho-genesis of OSAHS + HT. Methods All observed subjects were divided into 3 groups: control group (n=20),OS-AHS group(n=19),OSAHS + HT group (n=21). Plasma 8-iso-PGF2αand serum CRP concentrations levels were measured by ELISA and were compared. Results The plasma 8-iso-PGF2αand serum CRP levels,were higher in OSAHS patients than those in control subjects [(11.08±3.26)μg/L vs (7.49±2.10)μg/L,P<0.01;(1.75±0.82) mg/L vs (0.52±0.26 ) mg/L,P<0.01],and were higher in OSAHS + HT group than those in control group [14.84±3.43)μG/L vs(11.08±3.26)μg/L,P<0.01 ;(3.13±1.06)mg/L vs(1.75±0.82)mg/L,P<0.01]. Conclusions Oxidative stress and inflammation in OSAHS patients are increased,which are involved in the devel-opment of OSAHS associated hypertension.     

The changes of plasma 8-iso-prostaglandin F2αand serum C-reactive protein levels in patients with obstructive sleep apnea-hypopnea syndrome

Objective To investigate the plasma 8-iso-prostaglandin F2α(8-iso-PGF2α and the serum C-re-active protein(CRP) levels in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) with and without hypertension(OSAHS + HT),and to explore the changes of pathophysiology in patients with OSAHS and the patho-genesis of OSAHS + HT. Methods All observed subjects were divided into 3 groups: control group (n=20),OS-AHS group(n=19),OSAHS + HT group (n=21). Plasma 8-iso-PGF2αand serum CRP concentrations levels were measured by ELISA and were compared. Results The plasma 8-iso-PGF2αand serum CRP levels,were higher in OSAHS patients than those in control subjects [(11.08±3.26)μg/L vs (7.49±2.10)μg/L,P<0.01;(1.75±0.82) mg/L vs (0.52±0.26 ) mg/L,P<0.01],and were higher in OSAHS + HT group than those in control group [14.84±3.43)μG/L vs(11.08±3.26)μg/L,P<0.01 ;(3.13±1.06)mg/L vs(1.75±0.82)mg/L,P<0.01]. Conclusions Oxidative stress and inflammation in OSAHS patients are increased,which are involved in the devel-opment of OSAHS associated hypertension.     

The changes of plasma 8-iso-prostaglandin F2αand serum C-reactive protein levels in patients with obstructive sleep apnea-hypopnea syndrome

Objective To investigate the plasma 8-iso-prostaglandin F2α(8-iso-PGF2α and the serum C-re-active protein(CRP) levels in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) with and without hypertension(OSAHS + HT),and to explore the changes of pathophysiology in patients with OSAHS and the patho-genesis of OSAHS + HT. Methods All observed subjects were divided into 3 groups: control group (n=20),OS-AHS group(n=19),OSAHS + HT group (n=21). Plasma 8-iso-PGF2αand serum CRP concentrations levels were measured by ELISA and were compared. Results The plasma 8-iso-PGF2αand serum CRP levels,were higher in OSAHS patients than those in control subjects [(11.08±3.26)μg/L vs (7.49±2.10)μg/L,P<0.01;(1.75±0.82) mg/L vs (0.52±0.26 ) mg/L,P<0.01],and were higher in OSAHS + HT group than those in control group [14.84±3.43)μG/L vs(11.08±3.26)μg/L,P<0.01 ;(3.13±1.06)mg/L vs(1.75±0.82)mg/L,P<0.01]. Conclusions Oxidative stress and inflammation in OSAHS patients are increased,which are involved in the devel-opment of OSAHS associated hypertension.     

The changes of plasma 8-iso-prostaglandin F2αand serum C-reactive protein levels in patients with obstructive sleep apnea-hypopnea syndrome

Objective To investigate the plasma 8-iso-prostaglandin F2α(8-iso-PGF2α and the serum C-re-active protein(CRP) levels in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) with and without hypertension(OSAHS + HT),and to explore the changes of pathophysiology in patients with OSAHS and the patho-genesis of OSAHS + HT. Methods All observed subjects were divided into 3 groups: control group (n=20),OS-AHS group(n=19),OSAHS + HT group (n=21). Plasma 8-iso-PGF2αand serum CRP concentrations levels were measured by ELISA and were compared. Results The plasma 8-iso-PGF2αand serum CRP levels,were higher in OSAHS patients than those in control subjects [(11.08±3.26)μg/L vs (7.49±2.10)μg/L,P<0.01;(1.75±0.82) mg/L vs (0.52±0.26 ) mg/L,P<0.01],and were higher in OSAHS + HT group than those in control group [14.84±3.43)μG/L vs(11.08±3.26)μg/L,P<0.01 ;(3.13±1.06)mg/L vs(1.75±0.82)mg/L,P<0.01]. Conclusions Oxidative stress and inflammation in OSAHS patients are increased,which are involved in the devel-opment of OSAHS associated hypertension.     

The changes of plasma 8-iso-prostaglandin F2αand serum C-reactive protein levels in patients with obstructive sleep apnea-hypopnea syndrome

Objective To investigate the plasma 8-iso-prostaglandin F2α(8-iso-PGF2α and the serum C-re-active protein(CRP) levels in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) with and without hypertension(OSAHS + HT),and to explore the changes of pathophysiology in patients with OSAHS and the patho-genesis of OSAHS + HT. Methods All observed subjects were divided into 3 groups: control group (n=20),OS-AHS group(n=19),OSAHS + HT group (n=21). Plasma 8-iso-PGF2αand serum CRP concentrations levels were measured by ELISA and were compared. Results The plasma 8-iso-PGF2αand serum CRP levels,were higher in OSAHS patients than those in control subjects [(11.08±3.26)μg/L vs (7.49±2.10)μg/L,P<0.01;(1.75±0.82) mg/L vs (0.52±0.26 ) mg/L,P<0.01],and were higher in OSAHS + HT group than those in control group [14.84±3.43)μG/L vs(11.08±3.26)μg/L,P<0.01 ;(3.13±1.06)mg/L vs(1.75±0.82)mg/L,P<0.01]. Conclusions Oxidative stress and inflammation in OSAHS patients are increased,which are involved in the devel-opment of OSAHS associated hypertension.     

The changes of plasma 8-iso-prostaglandin F2αand serum C-reactive protein levels in patients with obstructive sleep apnea-hypopnea syndrome

Objective To investigate the plasma 8-iso-prostaglandin F2α(8-iso-PGF2α and the serum C-re-active protein(CRP) levels in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) with and without hypertension(OSAHS + HT),and to explore the changes of pathophysiology in patients with OSAHS and the patho-genesis of OSAHS + HT. Methods All observed subjects were divided into 3 groups: control group (n=20),OS-AHS group(n=19),OSAHS + HT group (n=21). Plasma 8-iso-PGF2αand serum CRP concentrations levels were measured by ELISA and were compared. Results The plasma 8-iso-PGF2αand serum CRP levels,were higher in OSAHS patients than those in control subjects [(11.08±3.26)μg/L vs (7.49±2.10)μg/L,P<0.01;(1.75±0.82) mg/L vs (0.52±0.26 ) mg/L,P<0.01],and were higher in OSAHS + HT group than those in control group [14.84±3.43)μG/L vs(11.08±3.26)μg/L,P<0.01 ;(3.13±1.06)mg/L vs(1.75±0.82)mg/L,P<0.01]. Conclusions Oxidative stress and inflammation in OSAHS patients are increased,which are involved in the devel-opment of OSAHS associated hypertension.     

The changes of plasma 8-iso-prostaglandin F2αand serum C-reactive protein levels in patients with obstructive sleep apnea-hypopnea syndrome

Objective To investigate the plasma 8-iso-prostaglandin F2α(8-iso-PGF2α and the serum C-re-active protein(CRP) levels in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) with and without hypertension(OSAHS + HT),and to explore the changes of pathophysiology in patients with OSAHS and the patho-genesis of OSAHS + HT. Methods All observed subjects were divided into 3 groups: control group (n=20),OS-AHS group(n=19),OSAHS + HT group (n=21). Plasma 8-iso-PGF2αand serum CRP concentrations levels were measured by ELISA and were compared. Results The plasma 8-iso-PGF2αand serum CRP levels,were higher in OSAHS patients than those in control subjects [(11.08±3.26)μg/L vs (7.49±2.10)μg/L,P<0.01;(1.75±0.82) mg/L vs (0.52±0.26 ) mg/L,P<0.01],and were higher in OSAHS + HT group than those in control group [14.84±3.43)μG/L vs(11.08±3.26)μg/L,P<0.01 ;(3.13±1.06)mg/L vs(1.75±0.82)mg/L,P<0.01]. Conclusions Oxidative stress and inflammation in OSAHS patients are increased,which are involved in the devel-opment of OSAHS associated hypertension.     

The changes of plasma 8-iso-prostaglandin F2αand serum C-reactive protein levels in patients with obstructive sleep apnea-hypopnea syndrome

Objective To investigate the plasma 8-iso-prostaglandin F2α(8-iso-PGF2α and the serum C-re-active protein(CRP) levels in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) with and without hypertension(OSAHS + HT),and to explore the changes of pathophysiology in patients with OSAHS and the patho-genesis of OSAHS + HT. Methods All observed subjects were divided into 3 groups: control group (n=20),OS-AHS group(n=19),OSAHS + HT group (n=21). Plasma 8-iso-PGF2αand serum CRP concentrations levels were measured by ELISA and were compared. Results The plasma 8-iso-PGF2αand serum CRP levels,were higher in OSAHS patients than those in control subjects [(11.08±3.26)μg/L vs (7.49±2.10)μg/L,P<0.01;(1.75±0.82) mg/L vs (0.52±0.26 ) mg/L,P<0.01],and were higher in OSAHS + HT group than those in control group [14.84±3.43)μG/L vs(11.08±3.26)μg/L,P<0.01 ;(3.13±1.06)mg/L vs(1.75±0.82)mg/L,P<0.01]. Conclusions Oxidative stress and inflammation in OSAHS patients are increased,which are involved in the devel-opment of OSAHS associated hypertension.     

The changes of plasma 8-iso-prostaglandin F2αand serum C-reactive protein levels in patients with obstructive sleep apnea-hypopnea syndrome

Objective To investigate the plasma 8-iso-prostaglandin F2α(8-iso-PGF2α and the serum C-re-active protein(CRP) levels in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) with and without hypertension(OSAHS + HT),and to explore the changes of pathophysiology in patients with OSAHS and the patho-genesis of OSAHS + HT. Methods All observed subjects were divided into 3 groups: control group (n=20),OS-AHS group(n=19),OSAHS + HT group (n=21). Plasma 8-iso-PGF2αand serum CRP concentrations levels were measured by ELISA and were compared. Results The plasma 8-iso-PGF2αand serum CRP levels,were higher in OSAHS patients than those in control subjects [(11.08±3.26)μg/L vs (7.49±2.10)μg/L,P<0.01;(1.75±0.82) mg/L vs (0.52±0.26 ) mg/L,P<0.01],and were higher in OSAHS + HT group than those in control group [14.84±3.43)μG/L vs(11.08±3.26)μg/L,P<0.01 ;(3.13±1.06)mg/L vs(1.75±0.82)mg/L,P<0.01]. Conclusions Oxidative stress and inflammation in OSAHS patients are increased,which are involved in the devel-opment of OSAHS associated hypertension.     

The changes of plasma 8-iso-prostaglandin F2αand serum C-reactive protein levels in patients with obstructive sleep apnea-hypopnea syndrome

Objective To investigate the plasma 8-iso-prostaglandin F2α(8-iso-PGF2α and the serum C-re-active protein(CRP) levels in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) with and without hypertension(OSAHS + HT),and to explore the changes of pathophysiology in patients with OSAHS and the patho-genesis of OSAHS + HT. Methods All observed subjects were divided into 3 groups: control group (n=20),OS-AHS group(n=19),OSAHS + HT group (n=21). Plasma 8-iso-PGF2αand serum CRP concentrations levels were measured by ELISA and were compared. Results The plasma 8-iso-PGF2αand serum CRP levels,were higher in OSAHS patients than those in control subjects [(11.08±3.26)μg/L vs (7.49±2.10)μg/L,P<0.01;(1.75±0.82) mg/L vs (0.52±0.26 ) mg/L,P<0.01],and were higher in OSAHS + HT group than those in control group [14.84±3.43)μG/L vs(11.08±3.26)μg/L,P<0.01 ;(3.13±1.06)mg/L vs(1.75±0.82)mg/L,P<0.01]. Conclusions Oxidative stress and inflammation in OSAHS patients are increased,which are involved in the devel-opment of OSAHS associated hypertension.     

C反应蛋白检测在2型糖尿病血管内皮损伤中的临床价值

目的探索C反应蛋白(CRP)检测在2型糖尿病患者血管损伤中的价值。方法实验分为健康对照组、无并发症的2型糖尿病组和合并冠心病的2型糖尿病组,采集血液标本并分别检测CRP、血栓调节蛋白(TM)水平。结果无并发症的2型糖尿病组CRP水平[(6.3±2.2)mg/L]和TM水平[(41±17)μg/L]明显高于健康对照组[(3.4±1.6)mg/L和(28±12)μg/L],但明显低于合并冠心病的2型糖尿病组[(8.7±2.6)mg/L和(58±19)μg/L],差异有统计学意义(P<0.05)。结论 CRP水平可反映2型糖尿病患者血管内皮损伤程度,可作为监测糖尿病患者血管损伤的指标。     

急性脑梗死合并高尿酸血症患者血清几丁质酶-3样蛋白-1和高敏C反应蛋白水平变化及临床意义

目的探讨急性脑梗死合并高尿酸血症(hyperuricemia,HUA)患者血清几丁质酶-3样蛋白-1(chtinase-3-like-1protein,YKL-40)、高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)水平变化及临床意义。方法急性脑梗死患者120例,根据血尿酸水平分为脑梗死合并HUA组62例和单纯脑梗死组58例;同期体检健康者50例为对照组。采用ELISA法测定3组血清YKL-40水平,采用免疫散射比浊法测定血清hs-CRP水平,并进行组间比较;分析急性脑梗死合并HUA组血尿酸水平与血清YKL-40、hs-CRP水平的相关性。结果单纯脑梗死组和脑梗死合并HUA组血清YKL-40[(182.13±40.42)、(273.60±55.88)μg/L]、hs-CRP水平[(9.88±2.37)、(15.89±3.40)mg/L]水平高于对照组[(98.65±29.11)μg/L、(3.02±0.64)mg/L](P0.01),脑梗死合并HUA组高于单纯脑梗死组(P0.01);脑梗死合并HUA组患者血尿酸水平[(488.25±62.77)μmol/L]高于单纯脑梗死组[(368.80±61.22)μmol/L]和对照组[(350.62±52.73)μmol/L](P0.05),单纯脑梗死组与对照组比较差异无统计学意义(P0.05);脑梗死合并HUA组血尿酸水平与血清YKL-40、hs-CRP水平均呈正相关(r=0.522,P0.001;r=0.483,P0.001)。结论YKL-40及hs-CRP可能参与了急性脑梗死的发生、发展,且血尿酸水平升高可加重急性脑梗死患者机体炎性反应。     

降钙素原与C反应蛋白联合检测在慢性阻塞性肺疾病急性加重期的临床价值

目的评估慢性阻塞性肺疾病(COPD)急性加重期患者血清降钙素原(PCT)与C反应蛋白(CRP)联合检测的临床意义。方法选择COPD急性加重期患者155例,于治疗前后分别采用免疫发光法检测血清PCT,用免疫浊度法检测CRP,并根据临床特征、影像学检查、痰液细菌学培养等实验室结果,将COPD急性加重期患者分成细菌感染组及非细菌感染组,比较两组患者治疗前后血清PCT及CRP的变化。结果细菌感染组血清PCT[(1.79±0.33)μg/L]及[CRP(83.51±13.98)mg/L]水平在急性加重期显著高于非细菌感染组[PCT(0.22±0.19)μg/L,CRP(27.88±4.97)mg/L,P0.01];而疾病稳定期两组患者血清PCT[(0.14±0.11)、(0.11±0.08)μg/L]及CRP[(19.59±6.21)、(18.49±4.30)mg/L]比较,差异无统计学意义(P0.05)。结论血清PCT及CRP联合检测有助于COPD急性加重期患者感染状况判断及指导抗菌药物使用。     

慢性阻塞性肺疾病患者血清HIF-1α、OPN水平与继发肺动脉高压的关系

目的探讨慢性阻塞性肺疾病(COPD)患者血清低氧诱导因子1α(HIF-1α)、骨桥素(OPN)水平与继发肺动脉高压(PH)的关系。方法回顾性选取2016年6月至2018年6月北京市海淀医院收治的COPD继发PH患者100例,依据肺动脉收缩压(PASP)分为轻度组(PASP为31~40 mmHg,n=48)、中度组(PASP为41~70 mmHg,n=32)、重度组(PASP>70 mmHg,n=20),同期选取单纯COPD(无继发PH)患者50例。检测所有患者的血清HIF-1α、OPN水平和肺通气功能[动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)]。结果COPD继发PH患者PASP [(56.24±6.82)mmHg]、PaCO2 [(54.18±6.72) mmHg]和血清HIF-1α[(265.42±30.21) pg/ml]、OPN [(160.95±19.71)μg/L]水平明显高于单纯COPD患者[(20.46±2.49) mmHg、(45.04±4.88) mmHg、(182.12±25.12) pg/ml、OPN(102.12±15.42)μg/L]但PaO2 [(62.45±7.82) mmHg]明显低于单纯COPD患者[(75.04±7.86)mmHg],差异均具有统计学意义(P<0.05);重度组患者PASP[(81.42±8.59) mmHg]、PaCO2 [(64.01±6.82) mmHg]和血清HIF-1α[(319.41±33.42)pg/ml]、OPN [(200.52±23.04)μg/L]水平明显高于中度组[(55.79±5.62) mmHg、(54.99±5.72) mmHg、(264.27±27.62) pg/ml、OPN(159.72±17.97)μg/L]但PaO2 [(51.04±5.67) mmHg]明显低于中度组[(61.05±6.32) mmHg];中度组患者PASP、PaCO2和血清HIF-1α、OPN水平明显高于轻度组[(36.24±3.81) mmHg、(50.02±5.12) mmHg、(230.11±25.72) pg/ml、OPN(135.42±15.27)μg/L],但PaO2明显低于轻度组[(67.52±6.91) mmHg],差异均具有统计学意义(P<0.05);Pearson相关性分析结果显示血清HIF-1α、OPN水平与PASP呈明显正相关(r=0.812 <0.001;r=0.803,P<0.001)。结论COPD患者血清HIF-1α、OPN水平与继发PH有关血清HIF-1α、OPN水平可作为评估COPD继发PH及其病情的重要指标。     

牙周基础治疗对慢性肾脏病伴牙周炎患者牙周指数及龈沟液炎性因子和肾功能指标的影响

目的探讨慢性肾脏病伴牙周炎患者规律血液透析治疗同时行牙周基础治疗对牙周袋探诊深度(probing depth,PD)、牙龈探诊出血(bleeding on probing,BOP)、牙周临床附着丧失(clinical attachment loss,CAL),龈沟液白细胞介素(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α),血清肌酐、三酰甘油、C反应蛋白(C-reactive protein,CRP)的影响。方法慢性肾脏病伴牙周炎患者98例,随机分为观察组52例和对照组46例,对照组仅给予规律血液透析治疗,观察组在规律血液透析治疗的同时行牙周基础治疗。分别于治疗前及治疗6周后测量PD、BOP、CAL,检测龈沟液IL-6、TNF-α,血清肌酐、CRP及24h尿蛋白定量,并进行比较。结果观察组治疗6周后PD[(1.46±0.24)mm]、BOP[(23.17±10.72)%]低于治疗前[(3.12±0.77)mm、(42.47±11.20)%](P0.05),CAL[(4.37±0.72)mm]与治疗前[(5.17±0.89)mm]比较差异无统计学意义(P0.05);对照组治疗6周后龈沟液IL-6[(22.78±5.38)ng/L]和TNF-α[(17.23±6.08)ng/L],血清CRP[(7.11±0.32)mg/L]和肌酐[(179.67±32.48)μmol/L]及24h尿蛋白定量[(1.23±0.73)g]与治疗前[(34.12±5.29)ng/L、(20.65±4.37)ng/L、(8.12±0.37)mg/L、(210.67±33.65)μmol/L、(1.64±0.35)g]比较差异均无统计学意义(P0.05);治疗6周后,观察组龈沟液IL-6[(19.23±3.34)ng/L]及TNF-α[(9.89±4.08)ng/L],血清CRP[(5.89±0.48)mg/L]、24h尿蛋白定量[(0.97±0.43)g]均低于治疗前[(32.31±4.34)ng/L、(16.42±3.24)ng/L、(7.37±0.67)mg/L、(1.78±0.65)g](P0.05),血肌酐[(189.67±27.88)μmol/L]与治疗前[(223.43±33.70)μmol/L]比较差异无统计学意义(P0.05);治疗6周后,观察组龈沟液IL-6及TNF-α,血清CRP及24h尿蛋白定量均低于对照组(P0.05)。结论慢性肾脏病伴牙周炎患者规律透析治疗同时行牙周基础治疗,可改善微炎症状态,有助于减轻肾功能损害。     

老年急性呼吸窘迫综合征患者血清可溶性血栓调节蛋白水平变化及临床意义

目的探讨老年急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)患者血清可溶性血栓调节蛋白(soluble thrombomodulin, sTM)水平变化及临床意义。方法 138例老年ARDS患者(观察组),根据氧合指数分为轻度组37例,中度组50例,重度组51例,并根据28 d生存状况分为生存组68例和死亡组70例;选择同期体检健康者69例为对照组。检测入选者血清sTM、降钙素原(procalcitonin, PCT)和肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)水平。绘制ROC曲线,分析sTM、PCT和TNF-α对老年ARDS患者预后的预测价值。结果观察组血清sTM[(116.00±41.53)μg/L]、PCT[(1.38±0.51)μg/L]和TNF-α[(47.59±17.39)ng/L]水平均高于对照组[(20.34±7.62)μg/L、(0.22±0.08)μg/L、(22.63±4.31)ng/L](P0.05);轻度、中度、重度组患者血清sTM[(74.98±17.91)、(119.33±38.81)、(142.49±32.35)μg/L]、PCT[(0.74±0.37)、(1.44±0.32)、(1.78±0.23)μg/L]、TNF-α[(26.11±7.19)、(47.74±10.35)、(63.02±10.12)ng/L]水平依次增高(P0.05),生存组患者血清sTM[(89.60±26.84)μg/L]、PCT[(1.16±0.52)μg/L]、TNF-α[(41.97±16.60)ng/L]水平均低于死亡组[(141.65±37.02)μg/L、(1.59±0.40)μg/L、(53.05±16.49)ng/L](P0.05);当血清sTM、PCT和TNF-α最佳截断值分别为97.18μg/L、1.31μg/L、53.01 ng/L时,预测老年ARDS患者预后的AUC分别为0.871、0.739、0.698,灵敏度分别为0.886、0.829、0.557,特异度分别为0.706、0.674、0.779。结论老年ARDS患者血清sTM、PCT和TNF-α水平明显升高,sTM可作为预测老年ARDS患者预后的标志物。     

恶性肿瘤并细菌感染患者降钙素原与C反应蛋白水平变化及意义

目的观察恶性肿瘤并细菌感染患者血清降钙素原(procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)水平变化,探讨PCT与CRP早期诊断恶性肿瘤患者发生细菌感染的价值。方法恶性肿瘤化疗后发生细菌感染患者78例,其中重症感染组37例、局部感染组41例,同期体检健康者48例为对照组,检测3组血清PCT、CRP水平并进行比较。结果重症感染组血清PCT[(30.86±8.53)μg/L]、CRP[(78.32±7.14)mg/L]水平高于局部感染组[PCT(6.13±1.82)μg/L、CRP(46.75±4.32)mg/L]、对照组[PCT(0.08±0.03)μg/L、CRP(4.96±1.35)mg/L](P0.05),重症感染组高于局部感染组(P0.05)。结论恶性肿瘤化疗后发生细菌感染者血清PCT与CRP水平明显增高,且增高程度与感染严重程度有关,血清PCT与CRP可用于恶性肿瘤患者并发细菌感染的早期诊断。