急性冠状动脉综合征患者血清类金属蛋白酶-9及C-反应蛋白检测的临床分析

目的观察急性冠状动脉综合征(ACS)患者血清类金属蛋白酶-9(MMp-9)及C反应蛋白(CRP)水平的变化并与稳定型心绞痛患者比较,分析MMp-9及CRP与ACS的关系.方法67例经冠状动脉造影证实为冠心病患者分为稳定型心绞痛及ACS二组,分别测定MMp-9及CRP的血清水平并进行分析.结果ACS患者MMp-9及CRP水平较稳定型心绞痛组明显增高,分别为(329.90±200.10)ng/L、(644.50±251.69)ng/L及(12.83±8.06)mg/L、(37.49±34.60)mg/L,P＜0.001,差异有统计学意义.结论MMp-9及CRP参与了ACS的发生发展过程.     

急性冠状动脉综合征患者血清淀粉样蛋白A的临床价值

目的:研究急性冠状动脉综合征(ACS)患者血清淀粉样蛋白A(SAA)水平的变化,探讨其作为易损斑块的检测指标的可能性。方法:设ACS组29例,慢性稳定型心绞痛(SAP)组28例,对照组31例。酶联免疫吸附测定法(ELISA)测定高敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及SAA的表达比较。结果:ACS组血清hs-CRP、IL-6、TNF-α及SAA水平明显高于SAP组及对照组(P<0.01);SAP组4种炎症标记物与对照组比较差异无统计学意义(P>0.05)。结论:ACS患者SAA水平显著增高,对ACS的预测可能有重要的价值。     

不同类型冠心病患者血清C-反应蛋白与白细胞介素-6比较

目的从临床角度结合冠状动脉造影结果分析不同类型冠心病(CHD)患者血清C-反应蛋白(CRP)和白细胞介素-6(IL-6)浓度差异,探讨炎症反应及冠状动脉狭窄程度在CHD发生发展中的作用以及两者的相互关系.方法检测13例急性心肌梗死(AMI)患者(AMI组)、40例不稳定型心绞痛患者(UAP组)、32例稳定型心绞痛患者(SAP组)以及62例正常者(对照组)血清CRP、IL-6浓度,并结合冠状动脉狭窄程度分析不同类型CHD患者血清CRP和IL-6浓度差异,对血清CRP、IL-6及冠状动脉病变积分进行相关分析.结果CHD组患者血清CRP、IL-6显著高于对照组[(5.08±2.44)∶(2.32±1.23) mg/L、(15.51±3.54)∶(11.56±3.28) ng/L],均P<0.01.AMI组与UAP组间血清CRP、IL-6比较差异均无显著性意义(P>0.05),但均显著高于SAP组(P<0.05),SAP组血清CRP、IL-6均显著高于对照组(P<0.05).血清CRP与IL-6显著性相关(r=0.55,P<0.01).血清CRP、IL-6分别与冠状动脉病变积分显著性相关,相关系数分别为0.57和0.43,均P<0.01.结论不同类型CHD患者炎症反应水平不同,冠状动脉病变越广泛,血清CRP、IL-6水平增高越多,血清CRP、IL-6增高可能是CHD的重要危险因素.     

急性冠脉综合征患者血清基质金属蛋白酶-9、C反应蛋白、白介素-6的变化及临床意义

目的探讨血清基质金属蛋白酶-9(MMP-9)、C反应蛋白(CRP)、白细胞介素-6(IL-6)与急性冠脉综合征(ACS)发生的关系。方法测定30例急性心肌梗死(AMI)患者,28例不稳定心绞痛(UA)患者、30例稳定心绞痛(SA)患者及30例健康人群血清MMP-9、CRP、IL-6水平,比较各组的差异及其在ACS中的相互关系。结果ACS组血清MMP-9、CRP、IL-6水平明显高于SA组及健康对照组(P<0.01);ACS患者中MMP-9与CRP、IL-6呈正相关。结论ACS患者外周血清MMP-9水平明显增高且其与CRP、IL-6相关,表明炎症和细胞外基质降解在不稳定斑块破裂导致ACS发病中的作用,可望作为冠状动脉粥样硬化斑块不稳定性的血清学参考指标。     

急性冠脉综合征感染及炎性指标结果分析

目的:探讨急性冠脉综合征(ACS)患者血清中各项炎性指标的变化以及发病前感染的发生情况。方法:选取ACS患者83例为研究组,稳定型心绞痛患者或造影阴性的冠心病患者71例为对照组。分析患者临床资料,并比较其血清C-反应蛋白(CRP)、白介素-6(IL-6)以及可溶性P-选择素(Sp-sel)水平。结果:1研究组与对照组发病前感染率分别为41.0%和25.4%,研究组高于对照组(χ2=4.170,P0.05);且年龄70岁的患者发病前感染的概率明显高于年龄≤70岁的患者(χ2=3.645,P0.05)。2研究组患者血清中CRP、IL-6和Spsel水平分别为(7.52±1.62)mg/L、(247.55±62.17)ng/L和(90.14±23.71)mg/L,均显著高于对照组,差异有统计学意义(t=21.556、18.391、14.091,P0.05)。结论:ACS与发病前急性感染可能存在相关性,且ACS患者血清中的炎性指标明显升高,提示临床可以通过对患者炎性指标的检测对ACS进行预测。     

102例冠心病病人C反应蛋白水平与病变程度关系探讨

目的探讨血浆C反应蛋白(CRP)水平与冠心病(CHD)严重程度之间的关系.方法测定102例冠心病病人血浆CRP浓度,并与正常对照组104例血浆CRP浓度进行比较,分析两组之间以及冠心病组中急性心肌梗死、不稳定型心绞痛、稳定型心绞痛与相应CRP浓度的关系.结果 CRP浓度在正常对照组、稳定型心绞痛组、不稳定型心绞痛组、急性心肌梗死组依次增高,分别为(2.2±0.2)mg/L、(5.8±0.4)mg/L、(12.7±1.1)mg/L和(18.6±1.1)mg/L.结论 CRP浓度与冠心病病变程度呈正相关.     

超敏C-反应蛋白、血清淀粉样蛋白与冠心病的关系探讨

目的 检测超敏C-反应蛋白(hs - CRP)与血清淀粉样蛋白(SAA)的水平,并分析与冠心病(CHD)的关系.方法 采用免疫比浊法和酶联免疫吸附试验(ELISA)对72例冠心病病人及80例正常人进行血清hs - CRP与SAA含量检测,并进行统计学分析.结果 冠心病病人血清hs - CRP(2.85 mg/L±1.35 mg/L),SAA(9.58 mg/L±4.28 mg/L),均明显高于正常对照组(0.65mg/L±0.21mg/L与1.56mg/L±1.23mg/L,P＜0.05).结论 hs - CRP与SAA水平与冠心病的发生呈正相关,hs - CRP与SAA可作为预测冠心病发生的敏感指标.     

急性冠状动脉综合征患者白细胞介素-10及白细胞介素-6表达

目的:通过与C反应蛋白(CRP)检测对比,探讨抗炎因子白细胞介素(IL)-10、促炎因子IL-6与急性冠状动脉综合征(ACS)的关系。方法:冠心病患者78例,其中ACS患者40例(ACS组),稳定型心绞痛(SAP组)患者38例,33例胸痛综合征(CPS组)患者作为对照。所有患者均行冠状动脉造影检查。采用ELISA法检测血浆IL-6、IL-10水平,采用免疫比浊法测定CRP值。结果:与SAP组及CPS组相比,ACS组血浆IL-10水平明显降低,IL-6、CRP水平明显升高,差异有统计学意义;SAP组IL-10水平低于CPS组,IL-6、CRP水平高于CPS组,差异无统计学意义;血浆IL-10水平与IL-6及CRP水平呈负相关,IL-6水平与CRP水平正相关。结论:血浆IL-10水平降低和IL-6、CRP值升高对患者ACS的发生有预测价值。抗炎因子和促炎因子水平的失衡是导致斑块不稳定、急性冠状动脉事件发生的重要因素。     

慢性阻塞性肺疾病患者血清淀粉样蛋白A水平变化及其与C-反应蛋白和白细胞介素-6的相关性

目的观察慢性阻塞性肺疾病(COPD)患者急性加重期及缓解期血清淀粉样蛋白A(SAA)的变化及其与炎症标志物C反应蛋白(CRP)和白细胞介素(IL)-6的相关性。方法选择COPD急性加重期患者86例,健康对照组72例,分别测定COPD患者急性加重期、缓解期及健康对照者血清SAA、CRP、IL-6水平。结果 COPD组急性加重期及缓解期血清SAA、CRP、IL-6水平均明显高于健康对照组(P均0.01);COPD组急性加重期血清SAA、CRP、IL-6水平均明显高于缓解期(P均0.01);AECOPD合并呼吸衰竭组血清SAA、CRP、IL-6水平均明显高于单一AECOPD组(P均0.01);COPD组急性加重期血清SAA分别与CRP、IL-6呈正相关(r=0.317、0.406,P均0.01)。结论血清SAA可以作为一种炎症标志物用于AECOPD患者的早期诊断,对患者病情的严重程度有一定的评估作用;血清SAA与CRP、IL-6联合测定对预测AECOPD的严重性和观察疗效有一定的价值。     

血清高敏C反应蛋白与急性冠脉综合征的相关性

目的研究血清高敏C反应蛋白（hsCRP）与急性冠脉综合征（ACS）的相关性及其相关因素。方法用速率散射光比浊法检测了56例冠心病患者（13例稳定型心绞痛,17例不稳定型心绞痛,26例急性心肌梗死）不同类型冠心病患者血清hsCRP水平。结果ACS组（含不稳定型心绞痛和急性心肌梗死）血清hsCRP水平（7.1±8.1）mg/L显著高于稳定型心绞痛组（1.5±1.1）mg/L（P<0.01）;ACS危险因子多因素Logistic回归分析显示,hsCRP与ACS呈正相关（P<0.05）。结论ACS患者血清hsCRP水平显著增高。hsCRP水平与ACS呈正相关。     

Erythropoiesis, serum erythropoietin, and serum IGF-I in rats during accelerated growth

In this study we have examined the correlation between activity of erythropoiesis and serum concentrations of erythropoietin and insulin-like growth factor I in male and female rats during accelerated growth (day 30-90). We found that fractional incorporation of iron into newly formed red blood cells was linearily correlated with body weight gain. Total iron incorporation into newly formed red blood cells reflecting total daily red cell formation increased almost linearily between day 25 and 80 after birth in both sexes. While serum erythropoietin concentrations decreased in the time interval investigated (25-120 days), serum IGF-I levels increased in both sexes between day 25 and 55. In this period, individual values of total iron incorporation into red blood cells and serum IGF-I concentrations were linearily correlated. Our observations support the concept that IGF-I rather than erythropoietin modulates erythropoiesis during accelerated growth and thus manages a proportional increase in body mass and oxygen transport capacity.     

Day-to-day variations in serum iron,serum iron binding capacity,serum ferritin and erythrocyte protoporphyrin concentrations in anaemic subjects

Day-to-day variations in serum iron, serum iron binding capacity, serum ferritin and erythrocyte protoporphyrin were determined on 2 successive days in 48 patients with anaemia. The correlation coefficients between the paired determinations were 0.86, 0.89, 0.95 and 0.95, and the day-to-day coefficients of variation (in per cent) were 33, 11, 12 and 13 for serum iron, serum iron binding capacity, erythrocyte protoporphyrin and serum ferritin, respectively. Thus, in patients with anaemia, day-to-day variations in serum iron, serum iron binding capacity, erythrocyte protoporphyrin and serum ferritin are at least as high as in healthy controls. The results indicate important limitations in the use, particularly, of serum iron in the clinical investigation of anaemia.     

Relation of serum ascorbic acid to serum vitamin B12, serum ferritin, and kidney stones in US adults

BACKGROUND: Concern has been raised that high levels of ascorbic acid consumption may lead to potential adverse effects, such as vitamin B12 deficiency, iron overload, and kidney stones. OBJECTIVE: To examine the relation of serum ascorbic acid level, which reflects intake, to serum vitamin B12 level, serum ferritin level, and kidney stones. METHODS: We analyzed data collected on a random sample of the US population enrolled in the Second National Health and Nutrition Examination Survey, 1976-1980. We analyzed data using linear and logistic regression models. Serum ascorbic acid, serum vitamin B12, hemoglobin, red blood cell mean corpuscular volume (MCV), and serum ferritin levels were measured using standardized protocols. History of kidney stones was determined by self-report. RESULTS: After multivariate adjustment, serum ascorbic acid level was associated with higher serum vitamin B12 levels among women in regression models that assumed a linear relationship; each 57-pmol/L (1.0-mg/dL) increase in serum ascorbic acid level (range, 6-153 micromol/L [0.1 to 2.7 mg/dL]) was independently associated with a serum vitamin B12 level increase of 60 pmol/L (81 pg/ mL) (P<.001). Among men, serum ascorbic acid level was marginally associated with higher serum vitamin B12 levels: each 57-micromol/L (1.0-mg/dL) increase in serum ascorbic acid level was associated with a serum vitamin B12 level increase of 27 pmol/L (36 pg/mL) (P = .10). In addition, serum ascorbic acid level was not associated with correlates of vitamin B12 deficiency, such as higher MCV levels, macrocytosis (MCV >100), or lower hemoglobin concentrations. Serum ascorbic acid level was not independently associated with serum ferritin levels. However, among women only, serum ascorbic acid levels were associated in a nonlinear fashion with prevalence of elevated serum ferritin levels (P = .02). We found no association between serum ascorbic acid level and prevalence of kidney stones in women or men (both P>.05). CONCLUSIONS: Serum ascorbic acid levels were not associated with decreased serum vitamin B12 levels (or indicators of vitamin B12 deficiency), prevalence of kidney stones, serum ferritin levels, or-among men-prevalence of elevated serum ferritin levels. Serum ascorbic acid levels were associated with prevalence of elevated serum ferritin levels among women. Although the clinical relevance of these findings is uncertain, it seems prudent to suggest that women with a genetic susceptibility to iron overload should consider moderating their intake of ascorbic acid.     

血清维生素A、C、E水平与尿酸水平的相关性

目的 探讨血清维生素A、C、E水平与尿酸水平的关系.方法 采用高效液相法检测100例高尿酸血症患者和100例正常对照组的血清维生素A、C、E水平,利用SPSS16.0统计软件分析尿酸与血清维生素A、C、E水平的关系.结果 高尿酸血症患者血清维生素A水平高于对照组,但维生素C、E水平低于对照组.高尿酸血症患者维生素C、E缺乏高于对照组(P＜0.05).结论 高尿酸血症患者的血清维生素C、E水平降低,可能参与了高尿酸血症的的发生.     

血清肌酐、胱抑素C及肾小球滤过率与支架内再狭窄的相关性

目的探讨血清肌酐、血清胱抑素C(Cys C)及肾小球滤过率(GFR)与冠状动脉内置入药物洗脱支架后发生支架内再狭窄的相关性。方法回顾性分析624例患者,均于冠状动脉内植入药物洗脱支架且于中国医科大学附属盛京医院复查冠状动脉造影,按复查造影结果分为再狭窄组(147例)及非再狭窄组(477例),统计并分析所有患者的临床资料、生化指标、介入靶血管、再狭窄等数据。结果无论是PCI术前、术后以及复查造影时,再狭窄组患者的血清肌酐、血清Cys C水平均高于非再狭窄组(P0.05);GFR均低于非再狭窄组(P0.05);通过多因素Cox回归分析示,血清肌酐及血清Cys C水平升高、GFR下降是预测药物洗脱支架内再狭窄的独立危险因子。结论肾功能水平与支架内再狭窄的发生密切相关,血清肌酐及Cys C升高、GFR下降是冠状动脉内药物洗脱支架术后发生再狭窄的独立危险因素。     

The effect of graded doses of secretin on serum trypsin, serum pancreatic amylase, serum insulin, plasma somatostatin, and plasma pancreatic polypeptide in man

Six healthy men were studied with intravenous infusions of 0.3, 1.0, and 3.0 CU/kg-h of pure porcine secretin on separate days. The secretin elimination followed a first-order kinetics. Low pharmacological doses of secretin had no significant effects on blood levels of trypsin, pancreatic amylase, insulin, somatostatin, or pancreatic polypeptide (PP), whereas high pharmacological doses significantly elevated the blood levels of trypsin, pancreatic amylase, insulin, and somatostatin but were without effect on PP.     

急性脑血管病患者应激性高血糖、血清钾、钠、氯的变化及其与中风类型、病情轻重、预后关系

目的探讨急性脑血管病患者应激性高血糖、血清钾、钠、氯的变化及其与中风类型、病情轻重、预后关系。方法本文对我院神经内科2004年6月～2005年6月住院急性脑血管病患者248例进行研究，其中出血性中风89例，缺血性中风159例，于入院次日晨检测空腹血糖、血清钾、钠、氯，观察血糖、血钠、血氯、血钾值的变化及其与脑卒中类型、病情轻重、预后关系。结果（1）急性脑血管病患者易出现应激性高血糖、低钠血症、低氯血症、低钾血症；（2）出血性中风血糖明显高于缺血性中风；高血糖组死亡率明显高于非高血糖组；死亡组的血糖均值亦显著高于存活组；统计学上差异有显著性。（3）出血性中风低血钠、低血氯的发生率明显高于缺血性中风，统计学上差异有显著性；低血钠、低血氯组中的中、重度患者显著多于正常血钠、血氯组；与正常血钠、血氯组相比，高血钠、高血氯组患者在中风类型、病情轻重及预后方面差异均无显著性，但血钠、血氯显著升高时，死亡率明显增加。与正常血钾组相比，低血钾组中患者在中风类型、病情及预后方面差异无显著性，但血钾明显降低时，病死率增加。高血钾组患者在中风类型、病情轻重和正常血钾组相比差异无显著性，但病死率则明显高于正常血钾组。结论急性脑血管病患者存在应激反应，急性脑血管病患者应激性高血糖、低钠血症、低氯血症可以作为判断急性脑血管病病情、预后评估的指标之一。高钠血症、高氯血症、高钾血症、低钾血症与中风类型、病情及预后方面差异无显著性，但当出现严重的高钠血症、高氯血症、高钾血症、低钾血症时，病死率明显增加。     

Effects of exercise on haematologic parameters, serum iron, serum ferritin, red cell 2,3-diphosphoglycerate and creatine contents, and serum erythropoietin in long-distance runners during basal training

We studied 18 well-trained male long-distance runners during the basal training. Haematologic parameters, serum iron and ferritin, red cell 2,3-diphosphoglycerate (2,3-DPG) and creatine contents, serum erythropoietin were investigated before and after the daily training and were compared with a group of healthy untrained controls. Red blood cell parameters did not change with the training, even though they were significantly lower than in controls. However, a true anaemic state cannot be suggested because the haemoglobin values fell into the lower limit of the normal range, even before the exercise. A slight but significant increase of neutrophils was found after the exercise, while no alteration of platelet count was observed. Serum iron and ferritin ranged normally. No increase of red cell 2,3-DPG was observed after the exercise, but it was significantly higher than in controls. After the exercise red creatinine was slightly increased. The athletes' erythropoietin was higher than that of controls, and showed a further increase after the training.