关键词： 维持性血液透析   尿毒清颗粒   炎症因子   甲状旁腺激素  

摘要： 目的:探讨维持性血液透析(MHD)患者应用尿毒清颗粒的临床疗效。方法:选取2011年1月~2015年6月在湖北医药学院附属襄阳市第一人民医院进行治疗的200例MHD患者采用随机数字表法分为观察组和对照组各100例,两组患者均进行常规血液透析治疗(2~3次/周),观察组同时给予尿毒清颗粒进行辅助治疗,用药6个月后,对比两组患者透析治疗后的炎症因子指标、甲状旁腺激素(PTH)水平及瘙痒评分。结果:治疗前两组患者血清hs-CRP、IL-6、IL-8、TNF-α、Ca^(2+)、P、PTH水平及瘙痒评分差异无统计学意义(P>0.05);治疗后观察组血清hsCRP、IL-6、IL-8、TNF-α、P、PTH水平及瘙痒评分显著低于对照组(P<0.05)。结论:MHD患者应用尿毒清颗粒可显著改善炎症状态、降低PTH水平,缓解瘙痒程度。

关键词： 维持性血液透析   终末期肾病   高通量血液透析   低通量血液透析   微炎症状态  

摘要： 目的探讨高通量血液透析(high flux hemodialysis,HFHD)对维持性血液透析(maintenancehemodialysis,MHD)患者微炎症状态及并发症的影响。方法本研究采用随机对照的方式设计临床研究方案,研究选择2014年1月至2014年12月间于本院血液净化中心接受血液透析治疗的终末期慢性肾脏病患者76例进行研究,随机将患者分为高通组和低通组各38例,分别采用HFHD和低通量血液透析治疗。观察研究开始时和治疗12个月后患者的高敏C反应蛋白(hypersensitive C-reactive protein,hsCRP)、全段甲状旁腺激素(intactparathyroidhor mone,i PTH)、β_2-微球蛋白(β_2-microglobulin,β_2-MG)、瘙痒评分和高血压、心律失常、心肌缺血等心血管疾病的发生率。结果低通量组患者有3例死亡,1例转院,1例伴随严重感染,最终纳入统计者33例;高通量组2例死亡,1例接受肾移植,2例转院,1例伴随严重感染,最终纳入统计者32例。研究开始时两组的hs-CRP、β_2-MG、i PTH等差异均无显著性(P>0.05);治疗12个月后高通量组患者hs-CRP、β_2-MG和i PTH均较治疗前降低(P<0.05)。治疗12个月后两组hs-CRP、β_2-MG和i PTH差异有显著性(P<0.05)。研究开始时两组瘙痒视觉模拟评分法(visual analogue score,VAS)评分差异无显著性(P>0.05),治疗12个月后高通量组VAS评分低于低通量组(P<0.05)。研究开始时两组高血压、心律失常和心肌缺血发生率差异无显著性(P>0.05);治疗12个月后高通量组高血压和心肌缺血发生率低于低通量组(P<0.05),心律失常发生率差异无显著性(P>0.05)。结论 MHD患者采用HFHD可改善患者体内的微炎症状态,降低并发症的发生率,从而增加MHD的治疗效果,有利于改善预后。

关键词： 沙美特罗   喘可治注射液   COPD   全身炎症反应   降钙素原   γ干扰素  

摘要： 目的探讨沙美特罗联合喘可治注射液对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)伴全身炎症反应患者血清降钙素原与γ干扰素水平的影响。方法选择我院呼吸内科自2015年4月~2016年11月符合条件的COPD伴全身炎症反应患者94例,随机分为对照组47例和治疗组47例,对照组予抗炎、化痰、舒张平滑肌治疗;治疗组在此基础上予沙美特罗联合喘可治注射液治疗,两组共治疗1周为1个疗程,治疗前后采血测定血清白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、γ-干扰素(Interferon-γ,IFN-γ)、降钙素原(procalcitonin,PCT)以及免疫功能,测定肺功能指标,同时对比临床疗效和不良反应状况。结果与治疗前比较,两组治疗后FEV_1、FVC、FEV_1%pre、FEV_1/FVC升高,血清IL-6、TNF-α、IFN-γ、PCT含量降低,血清CD3^+、CD4^+、CD4^+/CD8^+升高,CD8^+降低(P<0.05);与对照组比较,治疗组治疗后FEV_1、FVC、FEV_1%pre、FEV_1/FVC较高,血清IL-6、TNF-α、IFN-γ、PCT含量较低,血清CD3^+、CD4^+、CD4^+/CD8^+较高,CD8^+较低(P<0.05);对照组有效率为74.47%(35/47),治疗组有效率为91.49%(43/47),治疗组高于对照组(P<0.05);两组间不良反应发生率比较,差异无统计学意义(P>0.05)。结论沙美特罗联合喘可治注射液对COPD伴全身炎症反应患者疗效确切,降低炎症指标,提高免疫功能,值得临床广泛推广。

关键词： 术后慢性疼痛   炎症反应   免疫调节  

摘要： 术后慢性疼痛具有发病率高、持续时间长、发病机制复杂等特点,严重影响病人的生活质量。手术所致神经病理性损伤是术后慢性疼痛发生的重要机制。与此同时,手术损伤所致神经系统的过度炎症反应和免疫调节机制亦加快术后慢性疼痛的形成。在术后慢性疼痛的发生发展过程中,神经损伤、坏死组织炎症反应和/或感染均可导致外周神经、DRG及脊髓背角中多种免疫细胞及胶质细胞活化,产生多种促炎症细胞因子和趋化因子,导致组织微环境中促炎症细胞因子和抗炎症细胞因子的比例失衡,外周和中枢神经元兴奋阈值下降,神经元兴奋性提高,发生痛觉敏化。本文主要综述术后神经系统炎症反应与免疫调节所致术后慢性疼痛的相关机制。

关键词： COPD急性加重期   CRP   PCT   全身炎症反应  

摘要： 目的:探讨COPD急性加重期患者血清CRP和PCT含量与全身炎症反应程度的相关性。方法:收集2012年8月~2016年2月本院收治的COPD急性加重期患者68例作为观察组,另取同期在本院进行健康体检的正常人50例作为正常对照组。采用放射免疫法检测血清CRP、PCT含量;进一步根据CRP、PCT含量中位数对观察组进行分组,检测高含量组、低含量组患者的血清促炎因子、抗炎因子、应激激素含量。结果:观察组患者血清中CRP、PCT的含量显著高于正常对照组;观察组中CRP、PCT高含量组患者的血清促炎因子IL-1β、IL-6、IL-8含量高于CRP、PCT低含量组,抗炎因子IL-4、IL-13含量低于CRP、PCT低含量组患者,应激激素AngⅡ、ALD、Cor含量高于CRP、PCT低含量组患者。结论:COPD急性加重期患者血清CRP和PCT含量与机体炎症反应程度呈正相关关系,可以作为疾病早期诊断、治疗效果评估及预后判断的辅助手段。

关键词： 天然免疫应答   组蛋白修饰   炎症反应   调控作用   类风湿性关节炎   表观遗传修饰   多发性硬化症   免疫系统  

摘要： 在机体中,天然免疫应答和炎症反应均受到精准的调控,最终使免疫系统保持稳态。组蛋白修饰是一种表观遗传修饰,它通过调控基因的表达在众多生理过程中起着重要的作用。组蛋白修饰异常与多种疾病如类风湿性关节炎、多发性硬化症和肿瘤等的发病密切相关,并逐渐成为疾病诊断治疗研究的新靶点,然而关于组蛋白修饰在天然免疫应答中发挥的作用目前不是非常清楚。因此,需要进一步探索组蛋白修饰与天然免疫应答及炎症反应之间的关系。

关键词： 胃癌   快速康复   炎症   免疫  

摘要： 目的探讨快速康复外科理念对腹腔镜胃癌根治术患者术后炎症反应及免疫功能的影响。方法回顾性分析2015年5月—2016年5月该院收治的116例纳入标准的腹腔镜胃癌根治术患者资料。其中行快速康复路径的患者60例(观察组),行常规治疗56例(对照组)。比较和分析两组患者术前及术后第1、4、7天C反应蛋白(C reactive protein,CRP)、降钙素原(PCT)、CD4+/CD8+。结果两组患者CRP及PCT均较术前有所增高,对照组增高更明显(P<0.05)。术后第1天观察组CRP:(17.24±10.16)mg/L,对照组CRP:(25.31±18.20)mg/L;术后第4天观察组CRP:(13.72±4.07)mg/L,对照组:(19.82±7.78)mg/L。术后第1天观察组PCT:(1.57±1.31)ng/m L,对照组PCT:(2.27±1.19)ng/m L;术后第4天观察组PCT:(1.43±1.13)ng/m L,对照组PCT:(1.85±0.96)ng/m L。CD4+/CD8+均较术前有所下降,对照组下降更明显(P<0.05)。术后第4天观察组CD4+/CD8+:(1.20±0.22),对照组CD4+/CD8+:(1.10±0.16);术后第7天观察组CD4+/CD8+:(1.24±0.19),对照组CD4+/CD8+:(1.13±0.17)。结论快速康复外科理念有助于促进腹腔镜胃癌根治术患者术后的康复,减轻炎症反应,改善免疫功能。

关键词： Acute appendicitis   CO2 pneumoperitoneum   Immune response   Inflammatory reaction   应激反应   急性阑尾炎   炎症反应   Acute appendicitis   CO2 pneumoperitoneum   CO2气腹   CO2气腹   Immune response   Inflammatory reaction   Language of Keywords: English   Chinese  

摘要： To study the effect of CO2 pneumoperitoneum on postoperative inflammatory reaction and immune response of elderly patients with acute appendicitis, and to provide basis for clinical treatment. Methods: 130 elderly patients with acute appendicitis who were treated in our hospital from January 2015 to March 2016 were selected, according to the random number table method,they were divided into study group and control group,with 65 patients in each group. The patients in control group were treated with conventional open appendectomy, while the patients in study group were treated with CO2 pneumoperitoneum laparoscopic appendectomy. The white blood cell count, neutrophil count, interleukin -10 (IL-10) and tumor necrosis factor - α(TNF-α) level were compared between the two groups before and after operation 1 d, 3 d and 5 d. The white blood cell count, neutrophil count, levels of IL-10 and TNF-α in the two groups were significantly increased at 1 d after operation, the differences were statistically significant(P<0.05). Results: The white blood cell count and neutrophil count were compared with the control group at 1 d after operation, the differences were not statistically significant (P>0.05). The levels of TNF-α and IL-10 in the study group were significantly lower than that in the control group at 1 d after operation, the differences were statistically significant (P<0.05); 3 d, 5 d after operation compared with 1 d, the white blood cell count, neutrophil count, levels of IL-10 and TNF-α levels in the two groups were significantly reduced, there was no significant difference between the 3 d after operation and before operation (P>0.05), the difference between the 5 d after operation and before operation was statistically significant(P<0.05). The white blood cell count, neutrophil count, IL-10 and TNF-α in the study group were significantly lower than those in the control group at 3 d and 5 d after operation, the differences were statistically significant(P<0.05). Conc

关键词： Chronic disease   Inflammation   Kidney diseases   Leukocyte count   Renal dialysis   慢性病   炎症   白细胞计数   肾疾病   肾透析   Chronic disease   Inflammation   Kidney diseases   Leukocyte count   Renal dialysis   Language of Keywords: English   Chinese  

摘要： Objective To investigate the Relationship between the blood neutrophil-to- lymphocyte ratio and the inflani mation in chronic kidney disease. Methods 116 CKD patients(at stage 3-4)before dialysis(pre-HD group) and 108 GKD patients on maintenance hemodialysis(MHD group) with stable clinical conditions treated in Hainan Hospital Affiliated to Nantong University were recruited for this study. Fifty-four healthy individuals were used as the controls. We measured the whole blood cell count, leukocyte classification and the blood neutmphil-to- lymphocyte ratio(NLR). The blood hs-CRP and Al-B were measured as well as other laboratoiy parameters. rrhe relationship between NLR and other parameters was assessed using Spearman correlation. Results rrhe NLJ{ as well as hs-CRF were significantly higher in MHI) group and pre-HD group as compaid lo the control group, and the two parameters were higher in MHI) group than the pre-HD group(P<0.01 r.Q5). Compared to the control group, the ALB was lower in MHD group and pre-HD group, while the ALB was lower in MHD group compared to the pre-HD group (P<0.01 or P<0.05). In MHD patients v correlation analysis showed the coiTeladon coefficients of NUi to hs-CRP and ALB were r=0.324, P<0.01 ,r=-0.296,p<0.01 ,respectively. Bui there was no coiTeladon between NLR and hs-CRPor Al-B in pre-HD padents(p<.05). Conclusion NLR may be used as a marker of inflammation in MHD patients. [ABSTRACT FROM AUTHOR]