艾拉莫德对难治性类风湿关节炎患者骨密度和血清B-ALP、CTX-I的机制分析

摘要 目的：探讨艾拉莫德对难治性类风湿关节炎患者骨密度和血清骨碱性磷酸酶（B-ALP）、I型胶原交联羧基末端肽（CTX-I）的机制。方法：选择2019年1月至2020年12月我院接诊的134例难治性类风湿关节炎患者,通过随机数表法分为观察组和对照组,每组67例。对照组给予甲氨蝶呤联合依那西普治疗,观察组给予艾拉莫德片联合依那西普治疗,均连续治疗12周。比较两组临床缓解率、实验室指标、类风湿关节炎患者病情评价（DAS28评分）、骨密度、血清B-ALP、CTX-I的变化和不良反应。结果：治疗后,观察组临床缓解率为90.00%,明显高于对照组72.50%（P＜0.05）;观察组红细胞沉降率（ESR）、C反应蛋白（CRP）、类风湿因子（RF）、抗环挂氨酸肽抗体（抗-CCP）表达和DAS28评分分别为（23.53±2.77）mm/h、（11.73±2.30）mg/L、（17.45±3.08）U/L、（43.22±7.17）RU/mL、（2.74±0.34）分,均明显低于对照组的（31.27±5.04）mm/h、（19.11±2.12）mg/L、（24.47±2.59）U/L、（55.23±7.44）RU/mL、（3.21±0.50）分,差异有统计学意义（P＜0.05）;观察组骨密度、血清B-ALP分别为（0.83±0.05）g/cm3、（117.02±15.65）U/L,均明显高于对照组（0.77±0.04）g/cm3、（101.19±9.59）U/L,观察组CTX-I为（0.36±0.04）μg/L,明显低于对照组（0.47±0.04）μg/L,差异有统计学意义（P＜0.05）;两组不良反应总发生率分别为4.44%和2.22%,差异无统计学意义（P＞0.05）。结论：艾拉莫德联合依那西普治疗难治性类风湿关节炎效果显著,可明显改善骨密度、血清B-ALP、CTX-I的表达,提高临床缓解率,安全性好,值得应用推广。     

哌拉西林他唑巴坦与头孢哌酮钠舒巴坦治疗COPD合并铜绿假单胞菌感染的疗效和安全性对比

摘要 目的：对比哌拉西林他唑巴坦与头孢哌酮钠舒巴坦治疗慢性阻塞性肺疾病（COPD）合并铜绿假单胞菌感染的疗效和安全性。方法：选择2017年1月至2020年1月我院呼吸科住院治疗的60例COPD合并铜绿假单胞菌感染患者纳入研究,通过抽签法分为A组和B组,各30例。A组在常规治疗基础上给予哌拉西林他唑巴坦,B组在常规治疗基础上给予头孢哌酮钠舒巴坦,均持续治疗7 d。比较A组和B组患者的临床疗效、一般治疗情况、血清实验室指标、血气指标的变化及不良反应。结果：治疗后7 d,A组患者的临床疗效、细菌清除率结果分别为93.33%、83.33%,B组为90.00%、76.67%,差异无统计学意义（P＞0.05）;A组体温正常时间、白细胞计数（WBC）正常时间、肺部炎症病灶消失时间、住院时间分别为（2.68±0.47）d、（5.05±0.53）d、（9.21±1.30）d、（10.02±1.94）d,均明显短于B组的（3.31±0.51）d、（6.52±0.60）d、（10.37±1.88）d、（11.69±1.61）d,差异均有统计学意义（P＜0.05）;治疗后3 d时,A组患者的WBC、C反应蛋白（CRP）、降钙素原（PCT）分别为（10.38±1.75）×109/L、（9.75±1.55）mg/L、（1.94±0.31）μg/L,均明显低于B组的（12.10±2.18）×109/L、（11.18±1.64）mg/L、（2.26±0.29）μg/L,治疗后7 d时,A组患者的WBC、CRP、PCT分别为（6.29±1.40）×109/L、（5.91±0.77）mg/L、（0.86±0.20）μg/L,均明显低于B组的（7.55±1.37）×109/L、（7.04±1.29）mg/L、（1.17±0.34）μg/L,差异均有统计学意义（P＜0.05）;A组患者的动脉血氧饱和度（SaO2）、血氧分压（PaO2）分别为（92.11±3.06）%、（68.37±5.13）mmHg,均明显高于B组的（88.64±3.18）%、（62.84±3.20）mmHg,二氧化碳分压（PaCO2）为（44.12±3.03）mmHg,明显低于B组的（48.49±4.21）mmHg,差异均有统计学意义（P＜0.05）。结论：哌拉西林他唑巴坦与头孢哌酮钠舒巴坦对COPD合并铜绿假单胞菌感染患者均具有较好的抗菌效果及安全性,但哌拉西林他唑巴坦可缩短恢复时间,临床应用价值更高。     

超声诊断糖尿病脑血管病变及与Hcy、CysC及vWF相关性研究

摘要 目的：研究超声对糖尿病合并缺血性脑血管疾病的诊断效果,并分析疾病与血清 Hcy、CysC及vWF水平相关性,以期为糖尿病脑血管病的诊断提供一定的临床依据。方法：以糖尿病合并缺血性脑血管病患者为研究组,体检健康者为对照组,分别采用经颅多普勒超声（Transcranial Doppler , TCD）和CT血管造影（CT angiography,CTA）对研究组患者进行检查,分析TCD与CTA检查结果的一致性,并对两组研究对象的血清同型半胱氨酸（Homocysteine,Hcy）、胱抑素（Cystatin,CysC）以及血管性血友病因子（Von Willebrand factor,vWF）水平进行检测,对危险因素进行分析。结果：TCD对血管重度狭窄的灵敏度、阳性预测值和Kappa值最高,阳性似然比为74.52＞10,表明TCD 对于糖尿病合并重度脑血管狭窄的检测与CTA的一致性最好。Hcy、CysC及vWF水平均显著升高（P＜0.05）,其中研究组Hcy水平为24.28±4.01 μmol/L,显著高于对照组的10.31±1.45 μmol/L,研究组CysC水平为1.45±0.21 mg/L,显著高于对照组的0.80±0.16 mg/L,研究组vWF水平为 152.88±15.73 %,显著高于对照组的92.31±16.21 %。多因素回归分析显示,Hcy、CysC及vWF均可作为独立预测指标,与患者疾病程度显著相关,对诊断和预后有一定的预测作用。结论：超声在糖尿病脑血管病的诊断中有较高的灵敏度和特异度,有重要的诊断意义,Hcy、CysC及vWF均可作为糖尿病脑血管病的独立预测指标,与患者疾病程度显著相关。     

针灸、推拿及中药外敷对腰椎间盘突出的临床疗效及血清TXB2、IL-1β、IL-10水平对比

摘要 目的：研究针灸、推拿及中药外敷对腰椎间盘突出的临床疗效及血清血栓素（thromboxane,TXA2）、白细胞介素-1β （Interleukin-1β）、白细胞介素-10 （Interleukin-10 IL-10）水平对比。方法：选取2019年1月至2020年12月的80例腰椎间盘突出患者。按照随机数表法分为观察组（n=41）和对照组（n=39）,对照组采用中药外敷治疗,观察组采用针灸、推拿及中药外敷联合治疗。对比两组治疗效果,治疗前后日本骨科协会评估治疗分数（Japanese Orthopaedic Association Scores JOA）、视觉模拟评分法（visual analogue scale VAS）评分情况变化,血清TXB2、IL-1β、IL-10水平变化,腰椎功能及腰部关节活动度,不良反应发生率。结果：治疗后,观察组总有效率显著高于对照组[95.12%（39/41）vs71.79％（28/39）]（P＜0.05）;JOA显著高于对照组[（23.19±3.21）分vs（17.62±2.65）分]（P<0.05）,VAS评分显著低于对照组[（2.07±0.38）分vs（3.58±0.61）分]（P<0.05）;血清TXB2、IL-1β水平均显著低于对照组[（24.37±3.26）μg/L vs（34.08±4.72）μg/L,（0.12±0.03）ng/L vs（0.27±0.05）ng/L]（P<0.05）;血清IL-10水平显著低于对照组[（85.82±7.03）pg/mL vs（57.28±6.31）pg/mL]（P<0.05）;功能障碍指数（Oswestry disability index）显著低于对照组[（37.81±6.23）％ vs（68.02±8.91）％]（P<0.05）;腰部关节活动度显著高于对照组[（80.36±0.82）° vs（71.27±0.6）°]（P<0.05）;两组不良反应对比无显著差异（P>0.05）。结论：针灸、推拿及中药外敷对腰椎间盘突出的临床疗效显著,可有效改善患者的临床症状,缓解疼痛,抑制炎症因子TXB2、IL-1β表达,促进抗炎因子IL-10水平升高,安全有效。     

磁共振成像检查联合血清HE4、TK1、CA199检测在卵巢癌诊断中的应用价值

摘要 目的：研究磁共振成像（MRI）检查联合血清人附睾蛋白4（HE4）、细胞质胸苷激酶（TK1）、糖类抗原199（CA199）检测在卵巢癌诊断中的应用价值。方法：将2017年4月～2019年12月我院收治的卵巢癌患者54例作为卵巢癌组,卵巢良性肿瘤患者49例作为卵巢良性肿瘤组,所有受试者均进行MRI检测,并采集受试者血清检测HE4、TK1、CA199水平,以受试者工作特征（ROC）曲线分析MRI检查联合血清HE4、TK1、CA199检测诊断卵巢癌的效能。结果：卵巢癌MRI特点包括以下几点：①囊实性肿块;②形态不规则;③呈长T2/T1等信号;④病灶边界模糊;⑤增强扫描结果呈病灶显著强化;⑥腹膜转移者存在显著腹腔积液以及散在分布的结节状种植病灶。卵巢良性肿瘤MRI特点包括以下几点：①囊壁光滑;②呈长T1以及长T2信;③病灶边界清晰;④增强扫描结果提示病灶无强化/稍有强化。卵巢癌组血清HE4、TK1、CA199水平分别为（87.13±15.32）pmol/L、（2.15±0.13）pmol/L、（95.39±15.25）U/mL,明显高于卵巢良性肿瘤组的（66.42±10.19）pmol/L、（0.85±0.20）pmol/L、（37.94±1.05）U/mL（均P＜0.05）。经ROC曲线分析可得：MRI检查联合血清HE4、TK1、CA199检测诊断卵巢癌的灵敏度、特异度以及曲线下面积均高于上述各项单独诊断。结论：卵巢癌患者血清HE4、TK1、CA199水平较高,MRI检查联合血清HE4、TK1、CA199检测诊断卵巢癌的价值较高,具有一定的临床应用价值。     

限制性液体复苏对多发性骨折合并创伤失血性休克患者凝血功能、心肌损害指标及预后的影响

摘要 目的：研究限制性液体复苏对多发性骨折合并创伤失血性休克患者凝血功能、心肌损害指标及预后的影响。方法：选择2020年6月至2022年5月的90例多发性骨折合并创伤失血性休克患者进行本次研究，按照随机数表法分为研究组（n=47）和对照组（n=43），对照组采用常规液体复苏治疗，研究组采用限制性液体复苏治疗。对比两组输液量、失血量、输血量，复苏前及复苏后1 h凝血功能指标（PT、APTT、TT）水平，心肌损害指标（CK、CK-MB、CTnT）水平，并发症发生率。结果：研究组输液量、失血量、输血量均显著低于对照组[（2106.87±135.62）mL vs（2950.39±139.57）mL，（1049.31±160.07）mL vs（1390.18±135.89）mL，（1465.02±191.78）mL vs（1860.23±198.59）mL]（P＜0.05）；研究组PT、 APTT、 TT水平均显著高于对照组[（19.06±1.80）s vs（15.82±1.26）s，（42.03±3.85）s vs（37.02±3.19）s，（21.03±3.86）s vs（15.80±3.27）s]（P＜0.05）；研究组CK、CK-MB、CTnT水平均显著低于对照组[（20.85±2.72）U/L vs（32.97±3.69）U/L，（23.06±3.28）U/L vs（35.97±3.70）U/L，（2.07±0.36）ng/mL vs（2.90±0.38）ng/mL]（P＜0.05）；研究组并发症发生率显著低于对照组[10.64%（5/47）vs27.91％（12/43）]（P＜0.05）。结论：多发性骨折合并创伤失血性休克患者采用限制性液体复苏可有效改善的其凝血功能，保护心肌细胞，提高患者预后。     

静注人免疫球蛋白联合万古霉素治疗小儿败血症的疗效及外周血NLR、PCT变化观察

摘要 目的：观察静注人免疫球蛋白联合万古霉素治疗小儿败血症的疗效及外周血中性粒细胞/淋巴细胞比值（NLR）、降钙素原(PCT)变化。方法：选取2011年1月~2020年1月我院收治的败血症患儿80例为研究对象,按数字随机表法分为对照组和观察组各40例,对照组给予万古霉素治疗,观察组在对照组基础上给予静注人免疫球蛋白治疗,比较两组临床疗效、症状改善时间和住院时间、NLR、PCT、超敏C反应蛋白(hs-CRP)、白细胞计数（WBC）、免疫功能及不良反应发生率。结果：观察组治疗有效率高于对照组（87.50%vs65.00%）（P<0.05）。观察组神经系统症状改善时间、体温改善时间、拒奶改善时间和住院时间为（6.22±1.05）d、（3.88±0.25）d、（5.10±0.86）d、（8.71±2.05）d,均短于对照组的（8.76±1.53）d、（6.22±0.64）d、（7.53±1.46）d和（11.24±3.36）d,比较差异有统计学意义（P<0.05）。治疗后观察组外周血NLR、PCT、hs-CRP、WBC水平为（1.35±0.20）、（0.80±0.34）mg/mL、（3.56±0.62）g/L、（9.12±1.80）×10⁹/L,均显著低于对照组的（1.83±0.32）、（2.19±0.73）mg/mL、（9.78±2.64）g/L和（12.26±2.59）×10⁹/L,比较差异有统计学意义（P<0.05）。治疗后观察组CD4⁺、CD3⁺、CD4/CD8为（42.77±11.36）％、（41.27±11.26）％、（1.70±0.33）,均显著高于对照组的（35.80±9.32）％、（35.66±9.40）％和（1.29±0.25）,比较差异有统计学意义（P<0.05）。两组不良反应发生率比较无差异（10.00%vs7.50%）（P>0.05）。结论：静注人免疫球蛋白联合万古霉素治疗小儿败血症的疗效显著,可降低炎症因子,提高免疫功能,且安全性较高。     

黄葵胶囊联合阿魏酸哌嗪片对慢性肾小球肾炎患者肾功能、氧化应激和血清MMP-9、TIMP-1的影响

摘要 目的：观察黄葵胶囊联合阿魏酸哌嗪片治疗慢性肾小球肾炎患者的应用价值。方法：选择2019年4月~2021年1月期间我院收治的慢性肾小球肾炎患者131例,以双色球随机分组法将患者分为对照组65例（阿魏酸哌嗪片治疗）、实验组66例（黄葵胶囊联合阿魏酸哌嗪片治疗）。对比两组疗效、肾功能[血肌酐（Scr）、尿素氮（BUN）、24 h 尿蛋白定量（24 h-Upr）]、氧化应激[超氧化物歧化酶（SOD）、丙二醛（MDA）]和血清基质金属蛋白酶-9（MMP-9）、基质金属蛋白酶组织抑制因子-1（TIMP-1）水平,记录两组不良反应发生率。结果：与对照组比较,实验组的临床总有效率明显更高（P<0.05）。与对照组相比,实验组治疗3个月后Scr、BUN、24 h-Upr更低（P<0.05）。与对照组相比,实验组治疗3个月后TIMP-1更低,MMP-9更高（P<0.05）。与对照组相比,实验组治疗3个月后MDA更低,SOD更高（P<0.05）。两组不良反应发生率组间对比无差异（P>0.05）。结论：黄葵胶囊联合阿魏酸哌嗪片治疗慢性肾小球肾炎,可减轻机体氧化应激,调节血清MMP-9、TIMP-1水平,促进肾功能改善,安全可靠。     

血清AIb、PA、NLR水平在直肠癌术后发生吻合口瘘评估中的应用

摘要 目的：探讨血清白蛋白（AIb）、前白蛋白（PA）、中性粒细胞与淋巴细胞比值（NLR）水平在直肠癌术后发生吻合口瘘评估中的应用。方法：选择2018年6月至2019年12月于我院进行直肠癌手术患者90例患者进行研究,其中38例发生术后吻合口瘘,设为研究组, 52例未发生吻合口瘘作为对照组。分析患者术后血清AIb、PA、NLR水平变化情况,采用受试者工作特征曲线分析血清AIb、PA、NLR对术后发生吻合口瘘的评估作用。结果：研究组血清AIb、PA水平显著低于对照组,NLR水平显著高于对照组,差异显著（P＜0.05）;造口组术后血清AIb、PA水平显著高于未造口组,NLR水平显著低于未造口组,差异显著（P＜0.05）;ROC结果显示,血清AIb预测术后吻合口瘘的AUC为0.967,灵敏度为81.25%,特异度为90.14%,截断值为33.06 g/L;血清PA预测术后吻合口瘘的AUC为0.772,灵敏度为80.36%,特异度为89.56%,截断值为119.04 mg/L;血清NLR预测术后吻合口瘘的AUC为0.991,灵敏度为85.62%,特异度为93.23%,截断值为6.86。结论：监测血清AIb、PA、NLR水平有助早期发现直肠癌患者术后吻合口瘘。     

替格瑞洛对行PCI术后患者心肌酶影响及一年随访事件相关性分析

摘要 目的：研究替格瑞洛对行PCI术后患者心肌酶影响及一年随访事件相关性分析。方法：选取2019年5月至2019年12月的133例急性心肌梗死患者。按照随机数表法分为观察组（n=68）和对照组（n=65）,两组均采用PCI术治疗,术后对照组采用氯吡格雷治疗,观察组采用替格瑞洛治疗。对比两组治疗效果,心肌血流灌注指标,心肌酶变化,不良反应发生率。结果：治疗后,观察组总有效率显著高于对照组[95.58%（65/68）vs75.38％（49/65）]（P＜0.05）;TIMI3级、TMPG3级及无复流/满血流均显著低于对照组[17.64%（12/68）vs40.00%（26/65）,26.47%（18/68）vs46.15%（30/65）,7.35%（5/68）vs27.69%（18/65）]（P<0.05）; LDH、CK、CK-MB均显著低于对照组[（207.38±21.90）U/L vs（253.75±26.37）U/L,（166.38±19.32）U/L vs（389.75±52.03）U/L,（121.58±15.86）U/L vs（162.60±18.75）U/L]（P<0.05）;一年随访事件发生率显著低于对照组［11.76％（8/68）vs36.92％（24/65）］（P<0.05）。结论：替格瑞洛对可有效改善行PCI术后患者血流灌注,保护心肌细胞,改善心肌功能,提高治疗疗效。     

血清C反应蛋白、正五聚蛋白-3对小儿肺动脉高压的诊断价值

目的:研究血清C反应蛋白(CRP)和正五聚蛋白-3(PTX-3)在小儿肺动脉高压(PAH)诊断中的临床价值。方法:选择32例PAH患儿及32例健康小儿,检测和比较其血清CRP、PTX-3水平,分析血清CRP、PTX-3水平的相关性,通过绘制ROC曲线评价其对于PAH的诊断价值。结果:PAH组血清CRP水平(29.63±15.82 mg/L)、PTX-3水平(1.20±1.03 ng/m L)与对照组[CRP水平(3.38±1.74 mg/L)、PTX-3水平(0.64±0.43 ng/m L)]相比均显著升高(P0.01)。血清CRP与PTX-3的相关系数r为0.356(P0.05)。血清CRP诊断PAH的ROC曲线AUC为0.983,临界点为6.6 mg/L;PTX-3诊断PAH的ROC曲线AUC为0.669,临界点为0.95ng/m L;两者联合诊断的AUC为0.986,临界点为1.01。结论:PAH患儿血清PTX-3和CRP水平均显著升高,CRP大于PTX对PAH的诊断价值,两者联合诊断的价值更大。     

Association of secreted frizzled-related protein 4 (SFRP4) with type 2 diabetes in patients with stable coronary artery disease

Background

The interplay between the novel adipokine retinol-binding protein-4 (RBP4) and coronary artery disease (CAD) is still obscure. We investigated the relationship between RBP4 levels and the presence and severity of angiographically proven CAD and determined its possible role in acute myocardial infarction (AMI).

Methods

305 individuals with angiographically proven CAD (CAD-patients), were classified into 2 subgroups: 1) acute myocardial infarction (AMI, n = 141), and 2) stable angina (SA, n = 164). Ninety-one age- and sex-matched individuals without CAD, but with at least 2 classical cardiovascular risk factors, served as controls (non-CAD group). RBP4 serum levels were measured at hospital admission and were analyzed in relation to the coronary severity stenosis, assessed by the Gensini-score and the number of coronary narrowed vessels. Other clinical parameters, including insulin levels, HOMA-IR, hsCRP, glycaemic and lipid profile, and left-ventricular ejection fraction were also assessed.

Results

Serum RBP4 levels were significantly elevated in patients with CAD compared to non-CAD patients (39.29  ± 11.72 mg/L vs. 24.83  ± 11.27 mg/L, p < 0.001). We did not observe a significant difference in RBP4 levels between AMI and SA subgroups (p = 0.734). Logistic regression analysis revealed an independent association of CAD presence with serum RBP4 (β = 0.163, p = 0.006), and hsCRP (β = 0.122, p = 0.022) levels, in the whole study group. Among variables, hsCRP (β = 0.220), HDL (β = β0.150), and RBP4 (β = 0.297), correlated in both univariate and multivariate analysis with CAD severity (R² = 0.422, p < 0.001). Similarly, RBP4 concentrations increased with the number of coronary narrowed vessels (p < 0.05).

Conclusion

Patients with CAD, both SA and AMI, showed elevated RBP4 serum levels. Notably, increased RBP4 concentration seemed to independently correlate with CAD severity, but no with AMI.

Trial registration

The ClinicalTrials.gov Identifier is: NCT00636766

     

Serum RBP4 positively correlates with triglyceride level but not with BMI,fat mass and insulin resistance in healthy obese and non-obese individuals

Abstract

Purpose: Retinol binding protein 4 (RBP4) has recently been identified as an adipokine possibly involved in the development of impaired glucose metabolism. We aimed to test serum RBP4 in healthy non-obese individuals and in patients with well-characterized phenotype: obesity without confounding effects of diabetes, metabolic syndrome or dyslipidaemia. Additionally, we examined whether serum RBP4 is associated with anthropometric parameters, insulin resistance and blood lipid parameters.

Patients and methods: Twenty-eight patients with obesity and no co-morbidities and twenty-five age-matched lean controls were recruited. Anthropometric parameters, body composition, fasting blood lipid profile, RBP4, glucose and insulin were assessed and HOMA-IR was calculated.

Results: Mean concentration of RBP4 did not differ between studied groups (in obese patients was 33.93?±?4.46?µg/ml and 32.53?±?2.53?µg/ml in non-obese controls). RBP4 positively correlated with serum triglycerides in obese and non-obese individuals (r?=?0.74, p?=?0.03 and r?=?0.62, p?=?0.02, respectively) and did not show any significant associations with HOMA-IR, anthropometric and body composition parameters.

Conclusions: Excessive adiposity without co-morbidities is not associated with higher levels of circulating RBP4. Serum RBP4 cannot be considered as a direct predictive marker for impaired glucose metabolism. RBP4 possibly contributes to lipid metabolism.     

Retinol binding protein 4 levels relate to the presence and severity of coronary artery disease

BackgroundThe previous studies have showed that serum retinol binding protein 4 (RBP4) levels increase in metabolic disorders which are closely associated with cardiovascular diseases (CVD). However, the human studies investigating the role of RBP4 in CVD are conflicted. Therefore, we aimed to evaluate the relationship between RBP4 with the presence and severity of coronary artery disease (CAD) in this study.Methods55 patients with presenting acute coronary syndrome (ACS) and 43 control subjects who had various cardiovascular risk factors with normal coronary artery on coronary angiography were included in this study. The serum RBP4 concentrations were measured using ELISA method, clinically and anatomically score models were used to assess the severity of coronary lesion.ResultsSerum RBP4 levels were significantly higher in patients with ACS compared to the without ACS (68.40 ± 47.94 mg/L vs. 49.46 ± 13.64 mg/L; p = 0.014). RBP4 was correlated with GENSINI and SYNTAX I score (r = 0.286 p = 0.034; r = 0.403 p = 0.002 respectively). However, there was no relationship between RBP4 and GRACE score.ConclusionsThe serum RBP4 levels increase in patients with CAD and its increased levels may be correlated with CAD severity.     

Concentraciones séricas de colesterol y triglicéridos en pacientes diabéticos con hipotiroidismo subclínico

ObjectiveTo assess whether subclinical hypothyroidism is associated to elevations in serum cholesterol and triglyceride levels in patients with type 2 diabetes.Patients and methodsFrom a total population of 1,112 patients with type 2 diabetes screened for thyroid dysfunction (thyrotropin measurement), a group of 325 patients with normal thyroid function and another group of 29 patients with subclinical hypothyroidism were selected. No patient had known dyslipidemia or was taking lipid lowering medication.ResultsPatients with subclinical hypothyroidism had serum levels of total cholesterol (4.88 ± 0.74 mmol/L), HDL cholesterol (1.37 ± 0.34 mmol/L), LDL cholesterol (2.94 ± 0.58 mmol/L), and triglycerides (1.05 [0.88-1.41] mmol/L) that did not significantly differ from those found in euthyroid patients (4.79 ± 0.83, 1.33 ± 0.36, 2.87 ± 0.76, and 1.11 [0.81-1.43] mmol/L, respectively). Multiple regression analysis showed no association between TSH and serum lipid levels.ConclusionThese results suggest that, in our population, there are no significant differences in serum cholesterol and triglyceride levels between diabetic patients with normal and reduced thyroid function.     

精酮合剂对小鼠的抗疲劳作用

通过观察小鼠负重力竭游泳时间探讨精氨酸-酮戊二酸盐(精酮合剂,AAKG)对小鼠的抗疲劳作用,分别测定小鼠游泳前后血清尿素含量、肝糖原含量、全血乳酸含量等指标以探讨AAKG抗疲劳机制。结果表明,经AAKG处理过的小鼠负重游泳时间(4.71±1.36min)比对照组小鼠(3.01±0.46min)明显延长(P<0.05),AAKG组小鼠血清尿素氮含量(177.94±17.7mg/L)明显低于对照组(202.38±8.95mg/L)(P<0.05),AAKG组小鼠乳酸曲线下面积(85.88±9.74mmol/L)也显著低于对照组(112.82±17.10mmol/L)(P<0.05),而AAKG组小鼠肝糖原含量(11.95±0.35mg/g)显著性高于对照组小鼠(8.42±0.97mg/g)(P<0.05)。本实验结果表明AAKG具有较好的抗疲劳作用,推测与其能够提高小鼠代谢能力和增强应激能力有关。     

笼养丹顶鹤成体与亚成体血液生理生化指标比较

为了揭示丹顶鹤(Grus japonensis)不同年龄和性别个体之间血液生理生化指标的差异性,对沈阳动物园42只笼养丹顶鹤(成体24只,亚成体18只)的15项血液生化指标和13项血液生理指标进行了比较。所测得的血液生理生化指标在不同性别之间不存在显著差异(P0.05)。血清肌酐成体(37.05±17.03)mmol/L、亚成体(22.57±11.68)mmol/L,血清尿酸成体(878.22±514.41)mmol/L、亚成体(426.17±207.74)mmol/L,血清甘油三酯成体(7.73±4.75)mmol/L、亚成体(3.51±4.07)mmol/L,这3项指标均为成体高于亚成体,差异性显著(P0.05)。这几项指标的变化表明,丹顶鹤在成体和亚成体时期采取了相同或不同的生态适应策略。     

The impact of obesity to antioxidant defense parameters in adolescents with increased cardiovascular risk

BackgroundThe goal of this study was to assess the oxidative stress status through the values of antioxidant defense parameters: superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR) and total antioxidant status (TAS), as well as cardiovascular risk factors (total cholesterol, LDL-cholesterol, VLDL-cholesterol, non-HDL-cholesterol and triglycerides), anthropometric parameters (Body mass index-BMI, waist circumference-WC, hipp circumferemce-HC, waist-to-hipp ratio-WHR and inflammatory markers (high sensitive C-reactive protein) in a group of obese adolescents.MethodsA total of 238 students of both sexes, age of 22.32 ± 1.85 yr. were included in the study. According to the values of BMI lower and higher than 25 kg/m2 and WC higher and lower than 94 cm (males)/80 cm (females) the tested group of students was divided into 2 subgroups: Group 1 (increased risk for CVD) and Group 2 (lower risk for CVD).ResultsSignificantly reduced SOD and GPx with increased GR, TAS, inflammatory and lipoprotein parameters were obtained in Group 1 compared to Group 2. Significant positive association of hsCRP (OR:1.41; 95%CI 1.08-1.83; P=0.007), TAS (OR:827.2; 95%CI 19.27-35498; P=0.007) and GR (OR:1.13; 95%CI 1.05-1.21; P=0.002) and negative association of GPx (OR:0.97; 95%CI 0.94-1.003; P=0.043) and HDL-cholesterol (OR:0.41; 95%CI 0.176-0.963; P=0.0014) with cardiovascular risk factors were found in obese students. According to the ROC analysis GR>44.8 U/L, TAS>1.35 mmol/L, hsCRP>1.71 mg/L and HDL-cholesterol <1.13 mmol/L have sufficient predictive ability for cardiovascular disease in obese students.ConclusionsSignificant association of antioxidant defense parameters with anthropometric, lipid and inflammatory markers in obese students with increased cardiovascular risk suggest that screening of these parameters is necessary and highly recommended.     

缺血性脑卒中患者血清超敏C反应蛋白、糖化血红蛋白水平及其与神经功能缺损的关系

目的:探讨缺血性脑卒中患者血清超敏C反应蛋白(hs-CRP)、糖化血红蛋白(HbA1c)水平及其与神经功能缺损的关系。方法:选择2016年10月~2017年9月我院接诊的123例缺血性脑卒中患者作为观察组及同期于我院进行体检的健康人群123例作为对照组,检测和比较两组血清hs-CRP、HbA1c水平的差异,并分析缺血性脑卒中患者血清hs-CRP、HbA1c水平与其美国国立卫生研究院卒中量表(NIHSS)评分的关系。结果:观察组患者血清hs-CRP、Hb A1c水平显著高于对照组[(6.23±1.97)mg/L、(7.96±0.65)%vs.(2.54±0.85)mg/L、(5.21±0.30)%],NIHSS评分明显高于对照组[(4.08±3.12)分vs. 8.62±3.25)分],差异具有统计学意义(P0.05);缺血性脑卒中患者血清hs-CRP、Hb A1c水平与NIHSS评分呈显著正相关(r=-0.465,-0.564,P0.05)。结论:缺血性脑卒中患者血清hs-CRP和HbA1c水平均明显上调,二者可以在一定程度上反映缺血性脑卒中患者神经功能缺损的严重程度。