慢性肾小球肾炎患者治疗前后血清CRP和VEGF浓度变化及临床意义

目的:研究慢性肾小球肾炎(CNG)中血清C反应蛋白(CRP)和血管内皮生长因子(VEGF)的浓度变化及其临床意义。方法:采用ELISA法测定35例正常对照组与41例慢性肾小球肾炎患者治疗前后血清IL-6和VEGF的浓度,同时放射免疫分析法测定血清TNF-α浓度,免疫比浊法测定血清CRP与尿Alb浓度。结果:①治疗前后CNG患者血清中IL-6、TNF-α和CRP较正常对照组均显著升高(P<0.05或P<0.01),但治疗后IL-6、TNF-α和CRP水平显著低于治疗前(P<0.01),且血清CRP与IL-6和TNF-α呈正相关(P<0.01)。②治疗后,CNG患者血清VEGF水平与尿Alb含量较治疗前明显降低(P<0.05或P<0.01),仍显著高于正常对照组(P<0.05或P<0.01),且血清VEGF与尿Alb水平呈正相关(P<0.01)。结论:CRP、IL-6和TNF-α参与了CNG患者慢性炎症反应,VEGF则与蛋白尿的产生密切相关,治疗前后血清CRP和VEGF检测对于慢性肾小球肾炎的病情了解及临床疗效评估均具有重要的临床价值。     

子宫内膜异位症患者血清VEGF和CRP水平变化及其相关性

目的：探讨子宫内膜异位症患者血清血管内皮生长因子（VEGF）和C-反应蛋白（CRP）的水平变化及其相关性。方法：采用ELISA的方法测定30例III～Ⅳ期子宫内膜异位症患者（其中增生期13例、分泌期17例）和22例非子宫内膜异位症患者（其中增生期10例、分泌期12例）血清VEGF和CRP的水平,并分析两者相关性。结果：子宫内膜异位症组分泌期血清VEGF水平明显高于对照组（P〈0．05）;子宫内膜异位症组增生期血清CRP水平明显高于对照组（P〈0．05）;子宫内膜异位症组增生期和分泌期血清VEGF与CRP水平存在显著的正相关（F0．52,P〈0．05;r=0．44,P〈0．05）。结论：子宫内膜异位症患者血清VEGF、CRP水平的升高说明了过度血管生成和异常炎症反应是子宫内膜异位症的显著特征。     

血清胱抑素C和尿微量白蛋白在慢性肾小球肾炎早期肾功能损害评估中的意义

目的:探讨血清胱抑素C和尿微量白蛋白在慢性肾小球肾炎早期肾功能损害评估中的意义。方法:选取2010年9月至2013年7月我院收治的86名慢性肾小球肾炎患者,设为观察组。另选取同期在我院体检的年龄、性别等资料与之匹配的66名健康者设为对照组。分别对患者的CysC以及mALB的含量进行测定,并进行统计分析。结果:观察组和对照组的Cys C含量分别为(2.68±1.19)mg/L、(0.83±1.04)mg/L,观察组明显高与对照组;mALB的含量观察组为(38.16±4.25)mg/L,相比于对照组的(6.87±3.93)mg/L明显升高;Cys C及mALB阳性指标的检出率分别为75.58%、76.74%,而Cys C与mALB进行联合检测,检出率为91.86%,相比于单指标的检出率明显提高。差异具有统计学意义(P0.05)。通过对慢性肾小球肾炎患者的两项指标进行相关性分析,发现血清Cys C和尿mALB的含量呈显著的正相关(r=0.941,P0.05)。结论:将CysC与mALB相结合检测用以对慢性肾小球肾炎患者早期肾功能损害进行评估,检出率和敏感性均明显高于单指标检测。     

肾炎康复片对慢性肾小球肾炎患者血清FN、IL-2及胱抑素C 水平的影响

目的:探讨肾炎康复片对慢性肾小球肾炎患者血清粘连蛋白(fibronectin,FN)、白介素-2(interleukin-2,IL-2)及胱抑素C水平影响。方法:收集我院慢性肾小球肾炎患者80例,随机分为实验组和对照组。两组患者均予低盐优质蛋白饮食、控制血压、预防感染等常规治疗。对照组予以贝那普利治疗,实验组在对照组基础上加用肾炎康复片。两组患者分别于治疗前、后各进行一次血清FN、IL-2、胱抑素C水平测定;血压,肾功能血清肌酐(SCr)、尿素氮(BUN),24 h尿蛋白测定。结果:治疗后两组患者血清FN、IL-2水平均上升,胱抑素C水平均下降(P0.05),与对照组比较,实验组三项指标均变化更明显(P0.05);治疗后两组患者血压、血清肌酐、尿素氮、24 h尿蛋白水平均下降(P0.05),与对照组比较,实验组四项指标均较低(P0.05)。结论:肾炎康复片可更显著升高慢性肾小球肾炎患者血清FN、IL-2水平,降低胱抑素C水平,对患者血压控制,肾功能修复及减少尿蛋白有重要作用。     

慢性肾小球肾炎患者血清UA、Cys C、TAFI联合检测的临床意义

目的:探讨血清尿酸(UA)、胱抑素C(Cys C)和凝血酶激活纤溶抑制物(TAFI)联合检测在慢性肾小球肾炎(CGN)早期诊断中的应用价值。方法:选取2016年10月-2018年10月青海省人民医院肾内科收治的CGN患者80例作为研究组,同时间段于我院行体检的健康志愿者70例作为对照组,比较两组间UA、Cys C、TAFI和肾小球滤过率(GFR)的水平变化,采用Pearson相关性分析CGN患者GFR与UA、Cys C、TAFI的相关性,采用受试者工作特征(ROC)曲线比较各指标及联合检测对CGN的诊断价值。结果:与对照组相比,研究组血清UA、Cys C、TAFI水平均升高,GFR降低,差异有统计学意义(P<0.05);Pearson相关性分析显示,CGN患者GFR与UA、Cys C、TAFI呈显著负相关(P<0.05);联合检测血清UA、Cys C、TAFI水平,诊断CGN的敏感度为86.3%,特异性为80.0%,均明显高于UA、Cys C、TAFI的单独应用。结论:CGN患者血清UA、Cys C、TAFI水平升高,三者联合检测有助于临床早期诊断CGN。     

慢性肾小球肾炎患者血清HGF、Cys-C、TAFI水平变化及其临床诊断价值

目的:分析慢性肾小球肾炎患者血清肝细胞生长因子(HGF)、胱抑素C(Cys-C)、凝血酶激活的纤溶抑制物(TAFI)水平的变化及其临床诊断价值。方法:选择我院2017年1月～2018年5月收治的71例慢性肾小球肾炎患者作为慢性肾小球肾炎组及同期于本院进行健康体检的83例作为健康对照组。检测进而比较两组血清HGF、Cys-C、TAFI水平,分析以上指标和患者肾功能的相关性及对慢性肾小球肾炎的诊断价值。结果:慢性肾小球肾炎组血清HGF、Cys-C、TAFI水平均显著高于对照组(P0.05)。慢性肾小球肾炎患者治疗后血清HGF、Cys-C、TAFI水平均显著低于治疗前(P0.05)。慢性肾小球肾炎患者血清HGF、Cys-C、TAFI水平和肾功能指标(肌酐(Scr)、尿素氮(BUN)、尿酸(UA))均呈显著正相关(P均0.05)。血清HGF水平诊断慢性肾小球肾炎的曲线下面积为0.826,敏感度和特异度分别为0.747和0.746;血清Cys-C水平诊断慢性肾小球肾炎的曲线下面积为0.821,敏感度和特异度分别为0.687和0.859;血清TAFI水平诊断慢性肾小球肾炎的曲线下面积为0.816,敏感度和特异度分别为0.855和0.647;血清HGF、Cys-C、TAFI水平联合检测诊断慢性肾小球肾炎的曲线下面积为0.951,敏感度和特异度分别为0.831和0.757。结论:慢性肾小球肾炎患者血清HGF、Cys-C及TAFI水平均明显升高,联合检测血清HGF、Cys-C及TAFI可能作为慢性肾小球肾炎诊断及预评估参考指标。     

原发性高血压肾病患者血清CRP、胱抑素C和尿微量白蛋白检测的临床意义

目的:探讨原发性高血压肾病患者血清C反应蛋白(CRP)、胱抑素C和尿微量白蛋白(mALB)水平的改变及其临床意义.方法:采用常规生化法肌酐(Cr)、尿酸(UA)、肌酐清除率(Ccr)、24尿蛋白(U-pro)分别采用免疫比浊法和速率散射比浊法对45例原发性高血压肾病患者治疗前后血清CRP,血清胱抑素C和尿微量蛋白含量变化进行检测,同时选取35例健康正常人作为对照.结果:①经治疗后,原发性高血压肾病患者Cr、UA和U-pro水平均较治疗前明显降低(P<0.05或0.01),Ccr水平显著升高(P<0.01),但Cr、UA和U-pro水平仍显著高于正常对照组,Ccr水平则低于对照组(P<0.01).②患者治疗前后血清CRP,胱抑素C和mALB水平均明显高于对照组(P<0.01),但患者治疗后CRP,胱抑素C和mALB水平明显低于治疗前(P<0.01).③患者血清CRP与胱抑素C和mALB呈明显正相关(P<0.01).结论:检测患者血清CRP、胱抑素C和mALB水平的变化对于监测原发性高血压肾病病程发展,指导临床治疗用药具有重要意义.     

肾炎康复片与贝那普利联合应用治疗慢性肾小球肾炎152例临床疗效观察

目的:探讨肾炎康复片与贝那普利联合应用治疗慢性肾小球肾炎152例临床患者的疗效.方法:本实验选取了304例在2009年8月份到2011年10月份在我科室进行治疗的慢性肾小球肾炎患者为对象进行研究,把所有患者打乱分为152例治疗组(肾炎康复片联合贝那普利组)和152例对照组(单纯贝那普利组),后进行统计及比较各组患者的治疗效果以及血压、尿蛋白和血肌酐情况.结果:治疗组患者的治疗效果以及血压、尿蛋白和血肌酐情况明显优于对照组,P＜0.05,有显著性差异.结论:应用肾炎康复片联合贝那普利的方法治疗慢性肾小球肾炎患者疗效显著,建议在此类患者中广泛使用.     

肾炎康复片联合阿魏酸哌嗪对慢性肾小球肾炎患者肾功能、炎症因子和氧化应激的影响

目的：探讨肾炎康复片联合阿魏酸哌嗪对慢性肾小球肾炎患者肾功能、炎症因子和氧化应激的影响。方法：按随机数字表法将2021年4月-2022年12月西安交通大学第一附属医院收治的110例慢性肾小球肾炎患者分为对照组（n=55,阿魏酸哌嗪治疗）与观察组（n=55,对照组的基础上接受肾炎康复片治疗）。对比两组疗效、肾功能指标[尿素氮（BUN）、血肌酐（Scr）、24 h尿蛋白定量（24hUPR）、尿红细胞（RBC）]、炎症因子指标[白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、白介素-17(IL-17)]、氧化应激指标[谷胱甘肽过氧化物酶（GSH-PX）、超氧化物歧化酶（SOD）、丙二醛（MDA）]和不良反应发生情况。结果：观察组的临床总有效率高于对照组（P<0.05）。观察组治疗2个疗程后BUN、Scr、24hUPR、尿RBC低于对照组（P<0.05）。观察组治疗2个疗程后MDA低于对照组,GSH-PX、SOD高于对照组（P<0.05）。观察组治疗2个疗程后IL-1β、TNF-α、IL-17低于对照组（P<0.05）。两组均未见明显的不良反应发生（P>...     

冠心病患者血清CRP的变化及其临床意义

目的:探讨冠心病(CAD)患者血清C-反应蛋白(CRP)的变化及其临床意义.方法:运用全自动生化分析仪检测97例CAD患者和28例对照组人群的血清CRP,将CAD患者进一步分为稳定性心绞痛组(SAP)、不稳定心绞痛(UAP)、心肌梗死组(AMI)三组.另外,将97例CAD惠者分为1支病变组、2支病变组和3支病变组.所有研究对象均行选择性冠状动脉造影检查.结果:(1)与对照组比较,CAD患者血清CRP显著升高(P<0.05);(2)与对照组比较,SAP组、UAP组和AMI组患者血清CRP均显著升高(P<0.05);与SAP组比较,UAP组和AMI组患者血清CRP亦显著升高(P<0.05);(3)与对照组比较,1支病变组、2支病变组和3支病变组患者血清CRP均显著升高(P<0.05);与1支病变组比较,2支病变组和3支病变组患者血清CRP亦显著升高(P<0.05);与2支病变组比较,3支病变组患者血清CRP亦显著升高(P<0.05).结论:(1)CRP可能与CAD有关;(2)CRP异常升高可能反映冠状动脉斑块的不稳定和CAD的严重程度.     

血清NSE在金双歧、茵栀黄及蓝光照射治疗高胆红素血症新生儿脑损伤前后的临床意义

目的 分析血清神经元特异性烯醇化酶（NSE）含量在金双歧、茵栀黄及蓝光照射治疗前后高胆红素血症新生儿脑损伤的关系。方法 对130例高胆红素血症新生儿在治疗前及治疗后分别采用酶联免疫法测定血清NSE,同时行新生儿神经行为测定（NBNA）评分及急性胆红素脑病（ABE）的胆红素致神经功能障碍（BIND）评分,按血清总胆红素（TBIL）严重程度分为试验组和对照组,试验组包括：轻度升高组（A组）：205.2 μmol/L＜TBIL≤256.5 μmol/L;中度升高组（B组）：256.5 μmol/L＜TBIL≤342.0 μmol/L;重度升高组（C组）：TBIL＞342.0 μmol/L。对照组：金双歧、茵栀黄及蓝光照射治疗后的患儿TBIL＜91.9~171.0 μmol/L。比较各组高胆红素血症新生儿治疗前后血清NSE、NBNA评分及BIND评分,并对血清NSE与NBNA评分及BIND评分进行相关性分析。结果 各组高胆红素血症新生儿血清NSE、NBNA评分及BIND评分治疗前后差异均具有统计学意义（Ps<0.05）。血清NSE与NBNA评分呈负相关（r=-0.869,P<0.01）;血清NSE与BIND评分呈正相关（r=0.577,P<0.01）。结论 血清NSE水平变化可作为高胆红素血症新生儿脑损伤的检测指标。     

Clinical improvement after treatment with VEGF165 in patients with severe chronic lower limb ischaemia

The present study focuses on the application of a therapeutic strategy in patients with chronic severe lower limb ischaemia using a plasmid vector encoding the vascular endothelial growth factor (phVEGF₁₆₅). It has been shown that VEGF promotes neo-vascularization and blood vessel network formation and thus might have the ability to improve blood-flow at the level of the affected limbs. However, little information is available regarding the necessary level of expression of VEGF and its possible related adverse effects. We have subcloned VEGF ₁₆₅ isoform into pCMV-Script expression vector (Stratagene) under the control of the CMV promoter. Three patients with chronic ischaemia of the lower limb, considered as not suitable for surgical re-vascularization, received intramuscular injection with 0.5 ml saline solution containing 10¹¹ copies of VEGF ₁₆₅ plasmid. The clinical evolution has been monitored by angiography and estimated by walking time on the rolling carpet (Gardner protocol). Two months after therapy, all three patients showed complete relief of rest pain, improvement of ischaemic ulcer lesions and increased walking distance on the rolling carpet most probably due to appearance of newly formed collateral vessels.     

Clinical significance of serum gastrin levels in patients with colorectal cancer

AIMS: An association between elevated serum gastrin levels and the presence of human colorectal cancer has been reported, and gastrin has been shown to stimulate the growth of experimentally induced colon neoplasia. The aim of this study was to determine the preoperative and postoperative concentrations of serum gastrin in 53 patients with colorectal cancer and to assess the correlation between gastrin levels and tumor characteristics and prognosis. MATERIALS AND METHODS: A prospective study was performed over a six-year period during which 53 patients received potentially curative surgery for colorectal cancer. The prognostic variables used for the analysis included age, sex, tumor site, stage and degree of differentiation, preoperative and postoperative serum values of carcinoembryonic antigen (CEA) and gastrin, cancer-related mortality, and survival. CEA and gastrin serum values were determined using radioimmunological methods. Follow-up was carried out with clinical and radiological tests. RESULTS: The mean preoperative gastrin concentration was 51.2+/-27.4 pg/mL (range 12-146). Significantly increased serum gastrin concentrations, which returned to normal after surgery, were detected only in patients with well-differentiated cancer (74.2+/-28.3 pg/mL; moderately differentiated, 52.1+/-23.8; poorly differentiated, 29.9+/-12.3, p=0.02). The prognosis was unrelated to serum gastrin level; instead, tumor stage, preoperative CEA value, and degree of differentiation affected patient survival. CONCLUSIONS: This study showed that the serum gastrin concentration is not an appropriate clinical oncogenic factor. Although occurring only in well-differentiated tumors, serum gastrin is unrelated to the prognosis of patients with colorectal cancer.     

胃肠道穿孔感染性休克患者肠道菌群及其与血清C反应蛋白和降钙素原的相关性

目的探究胃肠道穿孔感染性休克患者肠道菌群及其与血清C反应蛋白(CRP)、降钙素原(PCT)的相关性。方法选取2017年1月到2019年6月辽宁省人民医院收治的110例胃肠道穿孔致感染性休克患者,按照APACHEII评分分为A组(APACHEII评分<20分,n=67)和B组(APACHEII评分≥20分,n=43)。另选52例同期体检正常的健康者作为正常组。检测各组对象血中免疫细胞数、肠道微生物及血清CRP、PCT水平,并分析患者肠道菌群与血清CRP、PCT水平的相关性。结果各组对象血液中白细胞、中性粒细胞、CD4^+细胞、CD4^+/CD8^+水平均为B组>A组>正常组,差异均有统计学意义(均P<0.05)。各组对象肠道肠杆菌数量为B组>A组>正常组,双歧杆菌数量及B/E值均为B组A组>正常组,差异均具有统计学意义(均P<0.05)。Pearson相关性分析显示,双歧杆菌数量、B/E值与血清CRP、PCT分别呈负相关(r=-0.624,-0.746;-0.638,-0.757,均P<0.05)。结论胃肠道穿孔感染性休克患者存在以双歧杆菌减少和肠杆菌增加为主要特点的肠道菌群失衡,且双歧杆菌数量和B/E值与血清CRP、PCT水平具有一定相关性,推测肠道菌群可能参与了疾病的发生和发展过程。     

Clinical improvement after treatment with VEGF(165) in patients with severe chronic lower limb ischaemia

The present study focuses on the application of a therapeutic strategy in patients with chronic severe lower limb ischaemia using a plasmid vector encoding the vascular endothelial growth factor (phVEGF₁₆₅). It has been shown that VEGF promotes neo-vascularization and blood vessel network formation and thus might have the ability to improve blood-flow at the level of the affected limbs. However, little information is available regarding the necessary level of expression of VEGF and its possible related adverse effects. We have subcloned VEGF ₁₆₅ isoform into pCMV-Script expression vector (Stratagene) under the control of the CMV promoter. Three patients with chronic ischaemia of the lower limb, considered as not suitable for surgical re-vascularization, received intramuscular injection with 0.5 ml saline solution containing 10¹¹ copies of VEGF ₁₆₅ plasmid. The clinical evolution has been monitored by angiography and estimated by walking time on the rolling carpet (Gardner protocol). Two months after therapy, all three patients showed complete relief of rest pain, improvement of ischaemic ulcer lesions and increased walking distance on the rolling carpet most probably due to appearance of newly formed collateral vessels.     

慢性腹痛患儿C~(13)-尿素呼气试验与胃镜检查的临床意义

目的了解慢性腹痛患儿幽门螺杆菌(H.pylori)的感染状态及幽门螺杆菌感染患儿内镜下表现的特点。方法应用C13尿素呼气试验,对905例以慢性腹痛为主要症状的患儿进行检测,对C13呼气试验阳性者进行电子胃镜检查。结果905例慢性腹痛患儿中H.pylori呈阳性185例(20.44%),随年龄增长,其H.pylori阳性率升高,学年组已达高峰。对H.pylori阳性者进行胃镜检查结果显示十二指肠隆起病变47例占25.40%,结节性胃炎41例占22.1%,慢性浅表性`胃炎38例占20.5%,结节性胃炎伴十二指肠隆起病变23例占12.43%,十二指肠球部溃疡23例占12.4%。胃溃疡7例,占3.7%(其中包括1例复合性溃疡),结节性胃炎伴十二指肠炎6例,占3.2%。结论H.pylori感染为小儿慢性腹痛的主要原因之一,也是导致慢性胃炎及消化性溃疡的主要原因之一。C13尿素呼气试验方便,快速,无痛苦,无放射性,是一较好的H.pylori检测方法;对既有消化道症状同时C13呼气试验阳性者进行胃镜检查能够协助临床诊断及治疗。     

Associations of serum CRP levels with demographics,health behaviors,and risk of cancer among the Mexican American Mano A Mano Cohort

C-Reactive protein (CRP) is a well-known inflammatory marker, and elevated CRP levels has been reported to be associated with the risk of various cancers. To date, no study has investigated the association between elevated CRP and incidents of cancer among Mexican Americans. In the current prospective cohort study, we measured pre-diagnostic CRP levels in serum samples and evaluated their relationships with demographic characteristics and health behaviors associated with cancer risk among 2753 Mexican Americans selected from the Mano-A-Mano Mexican American Cohort Study. At baseline, median levels of serum CRP significantly differed by demographics (sex, age category, marital status, and education levels) and health behaviors (cigarette smoking status, alcohol drinking status, BMI category, and physical activity levels). In the multivariable analysis, the study participants who were women, older, never drinking alcohol, overweight or obese, and physically inactive had increased likelihood of having high CRP levels (≥ median levels among all study participants) compared to their counterparts. A total of 177 cancer cases were identified during the follow-up with a median follow-up time of 127 months. In the quartile analysis, study participants in the 4^th quartile with highest CRP levels had significantly 1.88 fold increased risk of cancer (hazard ratio (HR) = 1.88, 95%CI: 1.12, 3.13) compared to those in the 1^st quartile with lowest CRP levels. The association was further confirmed in analyses using clinical CRP levels. In summary, our findings suggested that serum CRP levels have potential to serve as a predictive marker of cancer risk in Mexican Americans.