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Direct-acting antiviral agents in the management of chronic hepatitis C virus in China: factors and considerations 直接抗病毒药物在中国慢性丙型肝炎病毒管理中的作用:因素和考虑
Pub Date : 2018-10-15 DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.10.001
Lai Wei
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引用次数: 0
The prevalence and risk factors of metabolic syndrome among hepatitis C patients in Chinese Han population 中国汉族丙型肝炎患者代谢综合征的患病率及危险因素
Pub Date : 2018-10-15 DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.10.005
Ying-hui Gao, H. Rao, Rui‐feng Yang, J. Shang, Hong Chen, Jun Li, Q. Xie, Zhiliang Gao, Lei Wang, Jia Wei, Jianning Jiang, Yongtao Sun, R. Fei, Haiying Zhang, X. Kong, Q. Jin, Jian Wang
Objective To evaluate the prevalence and risk factors of metabolic syndrome among hepatitis C patients in Chinese Han population. Methods This was a multicenter, cross-sectional study. A total of 997 Chinese Han patients with hepatitis C virus (HCV) infection were enrolled. Demographic data, anthropometric data and clinical parameters related to metabolic syndrome were collected. Statistical analysis was performed by t-test (normal distribution) or Mann-Whitney U two-sample test (non-normal distribution) and χ2 test. Binary logistic regression analyses were used to determine the parameters significantly related to metabolic syndrome. Results Among the 997 patients, 170 (17.1%) patients were diagnosed with metabolic syndrome. Binary logistic regression showed that genotype 2 (OR=1.594; 95%CI: 1.045-2.431, P=0.030), older age (OR=1.040; 95%CI: 1.022-1.058, P<0.01), overweight (OR=3.876; 95%CI: 2.593-5.792, P<0.01), fatty liver history (OR=2.106; 95%CI: 1.384-3.204, P=0.001), homeostasis model assessment insulin (HOMA-IR) (OR=1.263; 95%CI: 1.118-1.427, P<0.01), fasting insulin (OR=0.949; 95%CI: 0.915-0.985, P=0.006), lower serum albumin level (OR=0.957; 95%CI: 0.915-1.000, P=0.049) and higher γ-GT level (OR=1.004; 95%CI: 1.000-1.008, P=0.0041) were all significantly associated with the presence of metabolic syndrome. Conclusions Hepatitis C patients with genotype 2, older age, overweight, fatty liver history, higher HOMA-IR, lower fasting insulin level, lower serum albumin level or higher γ-GT level should be screened for metabolic syndrome. Key words: Hepatitis C chronic; Genotype; Metabolic syndrome
目的了解中国汉族丙型肝炎患者代谢综合征的患病率及危险因素。方法这是一项多中心、横断面研究。共有997名中国汉族丙型肝炎病毒(HCV)感染者被纳入研究。收集与代谢综合征相关的人口统计学数据、人体测量数据和临床参数。统计分析采用t检验(正态分布)或Mann-Whitney U双样本检验(非正态分布,χ2检验)。二元逻辑回归分析用于确定与代谢综合征显著相关的参数。结果997例患者中,170例(17.1%)被诊断为代谢综合征。二元逻辑回归显示,基因型2(OR=1.594;95%CI:1.045-2.431,P=0.030)、年龄较大(OR=1.040;95%CI:10.022-1.058,P<0.01)、超重(OR=3.876;95%CI:2.593-5.792,P<0.01),脂肪肝病史(OR=2.106;95%CI:1.384-3.204,P=0.001)、稳态模型评估胰岛素(HOMA-IR)(OR=1.263;95%CI:1.118-1.427,P<0.01),较低的血清白蛋白水平(OR=0.957;95%CI:0.915-1000,P=0.049)和较高的γ-GT水平(OR=1.004;95%CI:1.00-1.008,P=0.0041)均与代谢综合征的存在显著相关。结论2型、年龄较大、超重、有脂肪肝病史、HOMA-IR较高、空腹胰岛素水平较低、血清白蛋白水平较低或γ-GT水平较高的丙型肝炎患者应进行代谢综合征筛查。关键词:丙型肝炎慢性;基因型;代谢综合征
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引用次数: 0
Relationship between liver steatosis and serum virological markers during immune clearance phase of chronic hepatitis B 慢性乙型肝炎免疫清除期肝脂肪变性与血清病毒学标志物的关系
Pub Date : 2018-09-15 DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.09.003
Jiaofeng Huang, Su Lin, Yueyong Zhu
Objective To investigate the relationship between hepatic steatosis and virological markers in patients with chronic hepatitis B (CHB) during immune clearance (IC) phase. Methods Pathology proven CHB patients in IC phase were collected from the Liver Center of the First Affiliated Hospital of Fujian Medical University from January 2009 to October 2016. Patients were divided into non-to mild fatty liver (F0-F1) group and moderate to severe fatty liver (F2-F4) group according to the liver steatosis degree. The relationship between liver steatosis and virological markers in serum was compared. The measurement data were analyzed using independent sample t test, and the count data were analyzed by chi-square test. Results A total of 298 patients were included, including 237 males (79.5%) and 61(20.5%) females, and the average age was (32.4±10.3) years old. The 23.5% (70/298) of these patients had liver steatosis. A total of 273 (91.6%) cases were in F0-F1 group, and the remaining 25 (8.4%) cases were in F2-F4 group. The patients in F2-F4 group had higher body mass index ([25.90±2.70] vs [21.68±2.90] kg/m2), serum triglyceride ([1.52±0.77] vs [1.11±0.55] mmol/L) and cholesterol ([4.88±1.15] vs [4.33±0.92] mmol/L) than F0-F1 group, and the differences were all statistically significant (t=-7.007, -2.667, and -2.751, respectively, all P<0.05). In addition, the serum levels of HBsAg and HBV DNA in F2-F4 group were also significantly higher than F0-F1 group (t=-3.291 and -2.831, respectivelt, both P<0.01). According to the grading of inflammation and fibrosis, the differences of HBsAg and HBV DNA levels between F0-F1 group and F2-F4 group were statistically significant only in patients with more severe inflammation (t=-2.738 and -2.135, respectively, both P<0.05) or less severe fibrosis (t=-2.258 and -2.333, respectively, both P<0.05). Conclusion Among CHB patients experiencing immune clearance, serum HBsAg and HBV DNA levels are positively correlated with the severity of hepatic steatosis, and this phenomenon is closely related to the degree of liver inflammation. Key words: Hepatitis B, chronic; Hepatitis B surface antigens; Fatty liver; Immune clearance
目的探讨慢性乙型肝炎(CHB)免疫清除期肝脂肪变性与病毒学标志物的关系。方法收集福建医科大学附属第一医院肝脏中心2009年1月至2016年10月经病理证实的慢性乙型肝炎IC期患者。根据肝脂肪变性程度将患者分为非轻度脂肪肝(F0-F1)组和中度至重度脂肪肝(F2-F4)组。比较了肝脂肪变性与血清病毒学标志物的关系。测量数据采用独立样本t检验进行分析,计数数据采用卡方检验进行分析。结果298例患者,其中男性237例(79.5%),女性61例(20.5%),平均年龄(32.4±10.3)岁。23.5%(70/298)的患者有肝脂肪变性。F0-F1组共273例(91.6%),F2-F4组共25例(8.4%)。F2-F4组患者的体重指数([25.90±2.70]vs[21.68±2.90]kg/m2)、血清甘油三酯([1.52±0.77]vs[1.11±0.55]mmol/L)和胆固醇([4.88±1.15]vs[4.33±0.92]mmol/L)均高于F0-F1组,差异均有统计学意义(t=-7.007、-2.667和-2.751,均P<0.05),F2-F4组血清HBsAg和HBVDNA水平也明显高于F0-F1组(t=-3.291和-2.831,均P<0.01),F0-F1组和F2-F4组HBsAg和HBVDNA水平的差异仅在炎症较重(t=-2.738和-2.135,均P<0.05)或纤维化较轻(t=-2.258和-2.333,均<0.05)的患者中具有统计学意义,血清HBsAg和HBVDNA水平与肝脂肪变性的严重程度呈正相关,这种现象与肝脏炎症程度密切相关。关键词:乙型肝炎,慢性;乙型肝炎表面抗原;脂肪肝;免疫清除
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引用次数: 0
Significance of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 levels in evaluation of severe hand, foot, and mouth disease complicated with neurogenic pulmonary edema 基质金属蛋白酶-9和组织金属蛋白酶-1抑制剂水平在评价重度手足口病合并神经源性肺水肿中的意义
Pub Date : 2018-09-15 DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.09.007
Shu-qin Fu, Chunlan Song, Yajie Cui, Peng Li, Fangzhou Chen, Lin Zhu
Objective To investigate the significance of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in serum and cerebrospinal fluid for evaluation of severe hand, foot, and mouth disease (HFMD) complicated with neurogenic pulmonary edema (NPE). Methods A total of 140 patients diagnosed with HFMD in Henan Children′s Hospital were enrolled and divided into three groups including mild group, severe HFMD group without NPE , severe HFMD group with NPE .These severe HFMD patients were also divided into survival group and death group according to the 28-day prognosis. Meanwhile, 50 age-matched healthy children were selected as controls. Serum MMP-9 and TIMP-1 levels were measured in all enrolled children. At the same time, MMP-9, TIMP-1 and ratio of MMP-9/TIMP-1 in cerebrospinal fluid were measured in the severe HFMD group with and without NPE. Quantitative data were compared using one-way analysis of variance, and means comparisons between samples were conducted using LSD- t test. Results Among 140 children with HFMD, 66 were in mild group, 42 in severe HFMD without NPE group, and 32 in severe HFMD with NPE group. And 50 healthy children were in control group. After 28 days, 14 cases died in severe HFMD groups. MMP-9, TIMP-1 and MMP-9/TIMP-1 in serum of severe HFMD group with NPE increased significantly greater than those in the other three groups (F=269.356, 121.301 and 101.502, respectively, all P <0.05). MMP-9, TIMP-1 and MMP-9/TIMP-1 in cerebrospinal fluid of severe HFMD group with NPE were (57.24±8.92) μg/L, (35.26±8.14) μg/L and (1.66±0.23) μg/L, respectively, while those in cerebrospinal fluid of severe HFMD group without NPE were (30.57±3.89) μg/L, (26.25±0.32) μg/L and (1.17±0.61) μg/L, respectively. The differences between the two groups were all statistically significant (t=62.485, 37.680 and 169.387, respectively, all P<0.01). MMP-9, TIMP-1 and MMP-9/TIMP-1 in serum and cerebrospinal fluid of death group increased significantly greater than those in survival group, the difference were statistically significant (all P<0.01). The maximum area under curve (AUC) was reached when the MMP9/TIMP-1 ratio in cerebrospinal fluid was 0.890 (95% CI: 0.801-0.978). Conclusions MMP-9 and TIMP-1 may be involved in the pathogenesis of HFMD complicated with NPE. The detection of MMP-9 and TIMP-1 levels may be beneficial for the early diagnosis of severe HFMD with NPE. The imbalance of MMP-9/TIMP-1 ratio can be used as one of the predictors of severe HFMD combined with NPE. Key words: Matrix metalloproteinase 9; Hand, foot and mouth disease; Pulmonary edema; TIMP-1
目的探讨血清和脑脊液中基质金属蛋白酶-9 (MMP-9)和金属蛋白酶-1组织抑制剂(TIMP-1)水平对重度手足口病(HFMD)合并神经源性肺水肿(NPE)的评价意义。方法选取河南省儿童医院确诊的140例手足口病患者,将其分为轻度组、无NPE的重度组、有NPE的重度组,并根据28 d预后分为生存组和死亡组。同时选取50名年龄相匹配的健康儿童作为对照。测定所有入组儿童血清MMP-9和TIMP-1水平。同时测定重度手足口病伴及不伴NPE组脑脊液中MMP-9、TIMP-1及MMP-9/TIMP-1比值。定量资料比较采用单因素方差分析,样本间均数比较采用LSD- t检验。结果140例手足口病患儿中,轻症组66例,重度手足口病无NPE组42例,重度手足口病伴NPE组32例。50名健康儿童作为对照组。28天后,重度手足口病组有14例死亡。重度手足口病合并NPE组血清MMP-9、TIMP-1及MMP-9/TIMP-1的升高均显著高于其他3组(F分别为269.356、121.301、101.502,P均<0.05)。重度手足口病合并NPE组脑脊液中MMP-9、TIMP-1和MMP-9/TIMP-1含量分别为(57.24±8.92)、(35.26±8.14)和(1.66±0.23)μg/L,非NPE组脑脊液中MMP-9、TIMP-1含量分别为(30.57±3.89)、(26.25±0.32)和(1.17±0.61)μg/L。两组间差异均有统计学意义(t分别为62.485、37.680、169.387,P均<0.01)。死亡组血清和脑脊液中MMP-9、TIMP-1及MMP-9/TIMP-1升高均显著大于生存组,差异均有统计学意义(P<0.01)。当脑脊液MMP9/TIMP-1比值为0.890时,曲线下面积(AUC)最大(95% CI: 0.801 ~ 0.978)。结论MMP-9和TIMP-1可能参与手足口病合并NPE的发病过程。检测MMP-9和TIMP-1水平可能有助于严重手足口病合并NPE的早期诊断。MMP-9/TIMP-1比值失衡可作为重度手足口病合并NPE的预测指标之一。关键词:基质金属蛋白酶9;手足口病;肺水肿;TIMP-1
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引用次数: 0
Expression and clinical significance of serum microRNA-122 in liver fibrosis of patients with chronic hepatitis B 慢性乙型肝炎肝纤维化患者血清microRNA-122的表达及临床意义
Pub Date : 2018-09-15 DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.09.004
Yan Wang, Xiangyu Chen, Ya Li, Yu Wang
Objective To evaluate the expression of serum microRNA (miRNA)-122 in patients with chronic hepatitis B (CHB) with different stages of liver fibrosis, and to investigate its relevance with the clinical parameters. Methods Totally 138 CHB patients and 30 healthy controls were enrolled. Real-time polymerase chain reaction was used to measure the relative expression of miRNA-122 in serum. Serum levels of ALT, AST, γ-glutamyl-transferase (γ-GT), alkaline phosphatase (ALP), total bilirubin (TBil), albumin, prothrombin time (PT) and HBV DNA were measured, and their correlations with serum miRNA-122 were analyzed. Receiver operating characteristic (ROC)curev analysis was performed for miRNA-122 to compare healthy controls and CHB patients with fibrosis. Non-parametric t-test was used for comparison between groups. Results The relative expressions of serum miRNA-122 in patients with CHB and healthy controls were 4.41±1.32 and 1.47±0.58, respectively, with significantly statistical difference (t=3.16, P 0.05). The area under curve (AUC) value for miRNA-122 in the differentiation between CHB patients and control group was 0.92, and the AUC for predicting significant fibrosis and cirrhosis were 0.78 and 0.81, respectively. Conclusion Serum miRNA-122 is closely related to the replication of HBV, liver damage and liver fibrosis stage. It may play a suppressive role on the HBV replication and the development of liver fibrosis. Key words: Liver cirrhosis; Hepatitis B virus; microRNA-122
目的评价慢性乙型肝炎(CHB)不同阶段肝纤维化患者血清miRNA -122的表达水平,并探讨其与临床参数的相关性。方法138例慢性乙型肝炎患者和30例健康对照。实时聚合酶链反应测定血清中miRNA-122的相对表达量。测定血清ALT、AST、γ-谷氨酰基转移酶(γ-GT)、碱性磷酸酶(ALP)、总胆红素(TBil)、白蛋白、凝血酶原时间(PT)、HBV DNA水平,并分析其与血清miRNA-122的相关性。对miRNA-122进行受试者工作特征(ROC)曲线分析,比较健康对照组和CHB纤维化患者。组间比较采用非参数t检验。结果慢性乙型肝炎患者与健康对照组血清miRNA-122相对表达量分别为4.41±1.32、1.47±0.58,差异有统计学意义(t=3.16, P < 0.05)。miRNA-122在CHB患者与对照组鉴别中的曲线下面积(AUC)值为0.92,预测显著纤维化和肝硬化的AUC值分别为0.78和0.81。结论血清miRNA-122与HBV复制、肝损伤及肝纤维化分期密切相关。它可能对HBV的复制和肝纤维化的发生有抑制作用。关键词:肝硬化;乙型肝炎病毒;微rna - 122
{"title":"Expression and clinical significance of serum microRNA-122 in liver fibrosis of patients with chronic hepatitis B","authors":"Yan Wang, Xiangyu Chen, Ya Li, Yu Wang","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.09.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.09.004","url":null,"abstract":"Objective \u0000To evaluate the expression of serum microRNA (miRNA)-122 in patients with chronic hepatitis B (CHB) with different stages of liver fibrosis, and to investigate its relevance with the clinical parameters. \u0000 \u0000 \u0000Methods \u0000Totally 138 CHB patients and 30 healthy controls were enrolled. Real-time polymerase chain reaction was used to measure the relative expression of miRNA-122 in serum. Serum levels of ALT, AST, γ-glutamyl-transferase (γ-GT), alkaline phosphatase (ALP), total bilirubin (TBil), albumin, prothrombin time (PT) and HBV DNA were measured, and their correlations with serum miRNA-122 were analyzed. Receiver operating characteristic (ROC)curev analysis was performed for miRNA-122 to compare healthy controls and CHB patients with fibrosis. Non-parametric t-test was used for comparison between groups. \u0000 \u0000 \u0000Results \u0000The relative expressions of serum miRNA-122 in patients with CHB and healthy controls were 4.41±1.32 and 1.47±0.58, respectively, with significantly statistical difference (t=3.16, P 0.05). The area under curve (AUC) value for miRNA-122 in the differentiation between CHB patients and control group was 0.92, and the AUC for predicting significant fibrosis and cirrhosis were 0.78 and 0.81, respectively. \u0000 \u0000 \u0000Conclusion \u0000Serum miRNA-122 is closely related to the replication of HBV, liver damage and liver fibrosis stage. It may play a suppressive role on the HBV replication and the development of liver fibrosis. \u0000 \u0000 \u0000Key words: \u0000Liver cirrhosis; Hepatitis B virus; microRNA-122","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43165598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Screening of differential microRNA and prediction of target genes between human immunodeficiency virus-Burkitt lymphoma and diffuse large B cell lymphoma 人免疫缺陷病毒-伯基特淋巴瘤与弥漫性大B细胞淋巴瘤差异microRNA筛选及靶基因预测
Pub Date : 2018-09-15 DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.09.005
Di Wang, Dong Zeng, Ye Zheng, Peng Zhang, Yan-ling Feng
Objective To screen the differential microRNA (miRNA) in human immunodeficiency virus (HIV) related Burkitt lymphoma (BL) and diffuse large B cell lymphoma (DLBCL). Methods Five freshly frozen tissue samples of BL and 3 freshly frozen tissu samples of DLBCL, 19 paraffin specimens of BL and 15 paraffin specimens of DLBCL were collected from Shanghai Public Health Clinical Center. Agilent human miRNA microarrays were employed to detect the miRNA expressions in fresh frozen BL tissues and fresh frozen DLBCL tissues, and to find out differential miRNA. SmartRNAplex™ miRNA was employed to verify the expressions of crucial miRNA in BL formalin fixed and paraffin-embedded tissues and DLBCL FFPET. Bioinformatics methods were used to predict the target genes of the crucial miRNA. Results Compared with DLBCL group, 42 differential miRNA were detected in BL group. Among them, 28 miRNA were up-regulated and 14 miRNA were down-regulated in BL group. According to positive control in eukaryote and high-expression molecular contributing to the emergence of tumor, 5 crucial miRNA were selected from 28 up-regulated miRNA in BL group for validation. The result was consistent with that of Agilent human miRNA microarrays. Compared with the DLBCL group, 5 crucial miRNA were all up-regulated in BL, which were miRNA-16-2-3p, miRNA-20a-3p, miRNA-130b-3p, miRNA-185-5p and miRNA-423-5p (t=2.7151, 2.539, 2.750, 4.004, and 3.625, respectively, all P<0.05). The corresponding target genes of miRNA-16-2-3p might be CTNND2 and RAD21.The target genes of miRNA-20a-3p might mainly be DYRK1A and GPAM. The target genes of miRNA-130b-3p might mainly be IRF1, DICER1 and PTEN. The target genes of miRNA-185-5p might mainly be VEGFA, NFATC3 and SEC24C.The target genes of miRNA-423-5p might mainly be PA2G4 and PNKD. Conclusions There are significantly differentially expressed miRNA between BL and DLBCL tissues. These miRNA are expected to provide new molecular markers for diagnosis and differential diagnosis of BL and DLBCL. Potential target genes of crucial miRNA are related with cell survival, proliferation, differentiation, apoptosis and carcinogenesis, etc, which may play important roles in the origination and progress of BL. Key words: Human immunodeficiency virus; Burkitt lymphoma; Lymphoma, large B-cell, diffuse; MicroRNA; Clinical pathology
目的筛选人类免疫缺陷病毒(HIV)相关的伯基特淋巴瘤(BL)和弥漫性大B细胞淋巴瘤(DLBCL)的差异性微小RNA(miRNA)。方法从上海市公共卫生临床中心采集5份BL新鲜冷冻组织标本和3份DLBCL新鲜冷冻组织样本,19份BL石蜡标本和15份DLBCL石蜡标本。采用安捷伦人miRNA微阵列检测新鲜冷冻BL组织和新鲜冷冻DLBCL组织中miRNA的表达,并找出差异miRNA。SmartRNAplex™ miRNA用于验证关键miRNA在BL福尔马林固定和石蜡包埋组织以及DLBCL-FFPET中的表达。生物信息学方法用于预测关键miRNA的靶基因。结果BL组与DLBCL组相比,共检测到42个不同的miRNA。其中BL组有28个miRNA上调,14个miRNA下调。根据真核生物中的阳性对照和对肿瘤发生有贡献的高表达分子,从BL组的28个上调的miRNA中选出5个关键miRNA进行验证。该结果与安捷伦人类miRNA微阵列的结果一致。与DLBCL组相比,BL中有5个关键的miRNA均上调,分别是miRNA-16-2-3p、miRNA-20a-3p、iRNA-130b-3p、miRNA-185-5p和miRNA-423-5p(t=2.7151、2.539、2.750、4.004和3.625,均P<0.05)。miRNA-16-2-3p的相应靶基因可能是CTNND2和RAD21。miRNA-20a-1p的靶基因可能主要是DYRK1A和GPAM。miRNA-130b-3p的靶基因可能主要是IRF1、DICER1和PTEN。miRNA-185-5p的靶基因可能主要是VEGFA、NFATC3和SEC24C。miRNA-423-5p的靶蛋白可能主要是PA2G4和PNKD。结论BL和DLBCL组织中存在显著差异表达的miRNA。这些miRNA有望为BL和DLBCL的诊断和鉴别诊断提供新的分子标记。关键miRNA的潜在靶基因与细胞存活、增殖、分化、凋亡和致癌等有关,可能在BL的起源和发展中发挥重要作用。关键词:人类免疫缺陷病毒;伯基特淋巴瘤;淋巴瘤,大B细胞,弥漫性;微小核糖核酸;临床病理学
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引用次数: 0
The changes and significance of the soluble B cell-activating factor in the peripheral blood of patients with chronic human immunodeficiency virus infection 慢性人类免疫缺陷病毒感染患者外周血可溶性B细胞活化因子的变化及意义
Pub Date : 2018-09-15 DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.09.006
Xingzhong Hu, W. Kong, Guiqing He, Jichan Shi, Xiaoya Cui
Objective To elaborate the changes of the soluble B cell-activating factor of the tumor necrosis factor family (BAFF) in the peripheral blood of chronic human immunodeficiency virus (HIV)-infected patients, and to study the correlation between the soluble BAFF in HIV-infected patients and the progressions of acquired immune deficiency syndrome (AIDS). Methods Fifty untreated HIV outpatients and 30 healthy controls were recruited. According to the counts of CD4+ T lymphocytes, HIV-infected patients were divided into three groups, 350 cells/μL group. B cell counts and the BAFF levels were compared among the three groups and the healthy controls. The correlation analysis was conducted for the levels of BAFF, the counts of CD4+ T lymphocytes and B cells, and viral load in HIV-infected patients. The value of BAFF in staging of HIV disease was identified by receiver operating characteristic (ROC) curve. Results The B cell counts were (90.3±43.1) cells/μL in 350 cells/μL group and (307.1±97.0) cells/μL in healthy controls, which was significantly different among the four groups (F=47.92, P<0.05). The concentrations of BAFF in the four groups were (1 737.5±719.7), (962.8±341.1), (859.8±270.4), and (456.9±163.7) ng/L, with significant difference among the groups (F=36.72, P<0.05). The level of BAFF was negatively correlated with both B cell counts and CD4+ T lymphocyte counts (r=-0.722 and -0.568, respectively; both P<0.05), and positively correlated with viral load (r=0.607, P<0.05). The area under the ROC curve was 0.881. If the level of BAFF was 1 281.5 ng/L, the sensitivity and specificity to predict the period of AIDS were 74.1% and 87.0%, respectively. Conclusion The levels of soluble BAFF in HIV-infected patients are significantly increased and related with the reduction of B cell counts and disease progression. Key words: HIV-1; B-lymphocytes; BAFF
目的探讨慢性免疫缺陷病毒(HIV)感染者外周血中肿瘤坏死因子家族可溶性B细胞活化因子(BAFF)的变化,探讨HIV感染者可溶性B细胞激活因子与获得性免疫缺陷综合征(AIDS)进展的相关性。方法选择50例未经治疗的HIV门诊患者和30例健康对照者。根据CD4+T淋巴细胞计数,将HIV感染者分为三组,350细胞/μL组。比较三组和健康对照组之间的B细胞计数和BAFF水平。对HIV感染患者的BAFF水平、CD4+T淋巴细胞和B细胞计数以及病毒载量进行相关性分析。BAFF在HIV疾病分期中的价值通过受试者操作特征(ROC)曲线来确定。结果350细胞/μL组的B细胞计数为(90.3±43.1)个细胞/μL,健康对照组为(307.1±97.0)个细胞-μL,四组间差异有统计学意义(F=47.92,P<0.05)。四组BAFF浓度分别为(737.5±719.7)、(962.8±341.1)、(859.8±270.4)和(456.9±163.7)ng/L,BAFF水平与B细胞计数和CD4+T淋巴细胞计数均呈负相关(r=-0.722和-0.568,均P<0.05),与病毒载量呈正相关(r=0.607,P<0.05),ROC曲线下面积为0.881。如果BAFF水平为1 281.5 ng/L,则预测艾滋病病程的敏感性和特异性分别为74.1%和87.0%。结论HIV感染者可溶性BAFF水平显著升高,与B细胞计数减少和疾病进展有关。关键词:HIV-1;B淋巴细胞;BAFF
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引用次数: 0
Study on the construction and virulence observation of Rv2346c gene knockout strains of Mycobacterium tuberculosis mediated by bacteriophage 噬菌体介导结核分枝杆菌Rv2346c基因敲除菌株的构建及毒力观察
Pub Date : 2018-08-15 DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.08.007
Xiaolin Chen, Sixia Chen, Jing Yao, Lei Shu, Kaili Deng
Objective To investigate the Rv2346c gene function through constructing Rv2346c gene knockout strains of Mycobacterium tuberculosis (M. tuberculosis) mediated by bacteriophage and observing its virulence after infecting mice lung tissue in vivo. Methods The affinal exchange sites (AES) of the target gene was built, and then integrated into the phage genomes of M. tuberculosis for harvesting the phagemids. The phagemids was imparted into Mycobacterium smegmatis to get recombinant phages with the same AES. A high titer of the recombinant phages was harvested through amplification in vitro. The M. tuberculosis was transfected and coated on solid medium with hygromycin resistance and cultured for 4 weeks at 37℃. Single clone was picked out and gene knock-out was confirmed by PCR. Then C57BL/6J mice were infected with either wild type strain (WT) or knockout strain (KO) of M. tuberculosis. Mice mortality, lung tissue inflammation and colony-forming units (CFU) counts in vitro were observed 6 to 8weeks post infection with different strains. Paired-samples t test was used for comparison between groups, chi-square test was used for comparison of rates. Results The products of PCR and inserted fragment sizes were consisted with the expectation and confirmed to be the target gene. The target fragment of Rv2346c was removed successfully and the mice were infected for 6-8 weeks. The mice infected with Rv2346c KO strain had reduced mortality (53% vs 20%, χ2=6.1112, P<0.05), lung tissue inflammation (1 040±89 vs 1 960±56, t=7.101 6, P<0.05) and CFU count in vitro (15.0±0.8 vs 90.0±1.5, t=23.036 1, P<0.05) compared with WT strain 6-8 weeks post infection. Conclusion Rv2346c gene knockout strains of M. tuberculosis mediated by bacteriophageis are successfully constructed, which establishes the foundation for the future gene function study of Rv2346c. Key words: Bacteriophages; Mycobacterium tuberculosis; Gene knockout strains; Rv2346c gene
目的通过噬菌体介导构建结核分枝杆菌Rv2346c基因敲除株,并在体内观察其感染小鼠肺组织后的毒力,探讨其基因功能。方法构建靶基因的亲和交换位点(AES),并将其整合到结核分枝杆菌噬菌体基因组中以获得噬菌体。将噬菌体导入耻垢分枝杆菌中,得到具有相同AES的重组噬菌体。通过体外扩增获得了高滴度的重组噬菌体。将结核分枝杆菌转染并包被在具有潮霉素抗性的固体培养基上,在37℃下培养4周。筛选出单个克隆,并通过PCR确认基因敲除。然后用结核分枝杆菌的野生型菌株(WT)或敲除菌株(KO)感染C57BL/6J小鼠。在不同菌株感染后6至8周,观察小鼠死亡率、肺组织炎症和体外集落形成单位(CFU)计数。配对样本t检验用于组间比较,卡方检验用于比率比较。结果PCR产物和插入片段大小符合预期,确定为目标基因。Rv2346c的靶片段被成功去除,并且小鼠被感染6-8周。感染Rv2346c-KO株的小鼠在感染后6-8周的死亡率(53%vs 20%,χ2=6.1112,P<0.05)、肺组织炎症(1040±89 vs 1960±56,t=7.1016,P<0.05)和体外CFU计数(15.0±0.8 vs 90.0±1.5,t=23.036 1,P<0.05)均低于WT株。结论成功构建了噬菌体介导的结核分枝杆菌Rv2346c基因敲除菌株,为进一步研究Rv2346c基因功能奠定了基础。关键词:噬菌体;结核分枝杆菌;基因敲除菌株;Rv2346c基因
{"title":"Study on the construction and virulence observation of Rv2346c gene knockout strains of Mycobacterium tuberculosis mediated by bacteriophage","authors":"Xiaolin Chen, Sixia Chen, Jing Yao, Lei Shu, Kaili Deng","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.08.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.08.007","url":null,"abstract":"Objective \u0000To investigate the Rv2346c gene function through constructing Rv2346c gene knockout strains of Mycobacterium tuberculosis (M. tuberculosis) mediated by bacteriophage and observing its virulence after infecting mice lung tissue in vivo. \u0000 \u0000 \u0000Methods \u0000The affinal exchange sites (AES) of the target gene was built, and then integrated into the phage genomes of M. tuberculosis for harvesting the phagemids. The phagemids was imparted into Mycobacterium smegmatis to get recombinant phages with the same AES. A high titer of the recombinant phages was harvested through amplification in vitro. The M. tuberculosis was transfected and coated on solid medium with hygromycin resistance and cultured for 4 weeks at 37℃. Single clone was picked out and gene knock-out was confirmed by PCR. Then C57BL/6J mice were infected with either wild type strain (WT) or knockout strain (KO) of M. tuberculosis. Mice mortality, lung tissue inflammation and colony-forming units (CFU) counts in vitro were observed 6 to 8weeks post infection with different strains. Paired-samples t test was used for comparison between groups, chi-square test was used for comparison of rates. \u0000 \u0000 \u0000Results \u0000The products of PCR and inserted fragment sizes were consisted with the expectation and confirmed to be the target gene. The target fragment of Rv2346c was removed successfully and the mice were infected for 6-8 weeks. The mice infected with Rv2346c KO strain had reduced mortality (53% vs 20%, χ2=6.1112, P<0.05), lung tissue inflammation (1 040±89 vs 1 960±56, t=7.101 6, P<0.05) and CFU count in vitro (15.0±0.8 vs 90.0±1.5, t=23.036 1, P<0.05) compared with WT strain 6-8 weeks post infection. \u0000 \u0000 \u0000Conclusion \u0000Rv2346c gene knockout strains of M. tuberculosis mediated by bacteriophageis are successfully constructed, which establishes the foundation for the future gene function study of Rv2346c. \u0000 \u0000 \u0000Key words: \u0000Bacteriophages; Mycobacterium tuberculosis; Gene knockout strains; Rv2346c gene","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43987439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Screening for cryptococcal antigenemia and analyzsis of the related cryptococcal lesions in hospitalized human immunodeficiency virus infected patients 人类免疫缺陷病毒感染住院患者隐球菌抗原血症筛查及相关隐球菌病变分析
Pub Date : 2018-08-15 DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.08.005
Zhiliang Hu, Wei Chen, Yaling Chen, Yuan Liu, Yun Chi, Cong Cheng, Yongfeng Yang
Objective To evaluate the prevalence of cryptococcal antigenemia and explore the related cryptococcal lesions in hospitalized human immunodeficiency virus (HIV)-infected patients. Methods Medical records of 517 HIV-infected patients, including patients' age, sex, clinical features, previous medical history, laboratory tests, chest CT, treatment and the response to treatment, in the Second Hospital of the Nanjing between January 2016 and February 2018 were retrospectively analyzed. The serum cryptococcal antigen (sCrAg) was detected by lateral flow immunoassay. The χ2 test or Fisher exact test was used to perform the statistical analysis. Results Among 517 HIV-infected cases, 51 were sCrAg positive, of whom 96.1% (49 cases) were men. The cases with CD4+ T lymphocyte count <100×106 cells/L accounted for 66.2% (342 cases), while 90.2% (46 cases) in sCrAg-positive patients showed CD4+ T lymphocyte count <100×106 cells/L with statistical significance (χ2=14.6, P<0.01). Multivariable analysis revealed that CD4+ T lymphocyte count <100 ×106 cells/L was independent risk factor for cryptococcal antigenemia (OR=4.7; 95%CI: 1.8-12.5, P<0.01). Clinical cryptococcal diseases were found in 76.4% (39/51) of patients with cryptococcal antigenemia, and cryptococcal meningitis (CM), pulmonary cyptococcosis (PC) and cryptococcal septicemia were found in 56% (28/50), 52.9% (27/51) and 44.4% (16/36) of the patients, respectively. Cryptoccal disease was not identified in 21.6% (11/51) of the patients with cryptococcal antigenemia (isolated cryptococcal antigenemia). The median (range) sCrAg titers of the patients with and without CM were 1∶1 280 (1∶10-1∶2 560) and 1: 15 (1∶2-1∶2 560), respectively (P<0.01). The proportion of CM in patients with sCrAg titers ≤1∶5, 1∶10-1∶320 and ≥1∶640 were 0 (0/10), 50% (10/20) and 90% (18/20), respectively. When cryptococcal infection was restricted to the lung, 87.5% (7/8) of the patients had sCrAg titers ≤1∶20. 30% (3/10) of the patients with sCrAg titers ≤1∶5 had PC. The median (range) sCrAg titers of the patients with cryptococcal septicemia and with isolated cryptococcal antigenemia were 1∶1 280 (1∶10-1∶2 560) and 1∶5 (1∶2-1∶320), respectively. Conclusions The prevalence of cryptococcal antigenmia is high in hospitalized HIV-infected patients. Most patients with cryptococcal antigenemia have developed cryptococcal diseases. The sCrAg titer in HIV patients may, in some extend, predicts the condition of cryptococcal infection. sCrAg titers ≥1∶640 are strongly suggestive of CM. Patients with sCrAg titers ≤1∶5 seems unlikely to have CM or cryptococcal septicemia, however, clinician should still be alarmed of possible PC. Key words: HIV; Meningitis, cryptococcal; Cryptococcal antigenemia; Pulmonary cryptococcosis; Cryptococcal septicemia
目的了解人类免疫缺陷病毒(HIV)感染住院患者隐球菌抗原血症的流行情况,探讨相关隐球菌病变情况。方法回顾性分析2016年1月至2018年2月南京市第二医院517例hiv感染者的病历,包括患者的年龄、性别、临床特征、既往病史、实验室检查、胸部CT、治疗情况和治疗反应。采用侧流免疫法检测血清隐球菌抗原(sCrAg)。采用χ2检验或Fisher精确检验进行统计分析。结果517例hiv感染者中,sCrAg阳性51例,其中男性49例,占96.1%。CD4+ T淋巴细胞计数<100×106 cells/L占66.2%(342例),scrag阳性患者中CD4+ T淋巴细胞计数<100×106 cells/L占90.2%(46例),差异有统计学意义(χ2=14.6, P<0.01)。多变量分析显示CD4+ T淋巴细胞计数<100 ×106 cells/L是隐球菌抗原血症的独立危险因素(OR=4.7;95%ci: 1.8 ~ 12.5, p <0.01)。隐球菌抗原血症患者临床隐球菌病发生率为76.4%(39/51),隐球菌性脑膜炎(CM)、肺隐球菌病(PC)和隐球菌败血症分别为56%(28/50)、52.9%(27/51)和44.4%(16/36)。21.6%(11/51)隐球菌抗原血症(分离性隐球菌抗原血症)患者未发现隐球菌病。有无CM患者sCrAg滴度中位(范围)分别为1∶1 280(1∶10 ~ 1∶2 560)、1∶15(1∶2 ~ 1∶2 560),差异有统计学意义(P<0.01)。sCrAg滴度≤1∶5、1∶10-1∶320、≥1∶640患者中CM的比例分别为0(0/10)、50%(10/20)、90%(18/20)。当隐球菌感染局限于肺部时,87.5%(7/8)的患者sCrAg滴度≤1∶20。sCrAg滴度≤1∶5的患者中有30%(3/10)发生PC。隐球菌败血症和分离性隐球菌抗原血症患者sCrAg滴度中位(范围)分别为1∶1 280(1∶10 ~ 1∶2 560)和1∶5(1∶2 ~ 1∶320)。结论住院hiv感染者隐球菌抗原血症发生率较高。大多数隐球菌抗原血症患者发生隐球菌疾病。HIV患者的sCrAg滴度在一定程度上可以预测隐球菌感染的情况。sCrAg滴度≥1∶640强烈提示CM。sCrAg滴度≤1∶5的患者不太可能发生CM或隐球菌败血症,但仍应警惕PC的可能。关键词:HIV;隐球菌脑膜炎;隐球菌antigenemia;肺隐球菌病;隐球菌败血症
{"title":"Screening for cryptococcal antigenemia and analyzsis of the related cryptococcal lesions in hospitalized human immunodeficiency virus infected patients","authors":"Zhiliang Hu, Wei Chen, Yaling Chen, Yuan Liu, Yun Chi, Cong Cheng, Yongfeng Yang","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.08.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.08.005","url":null,"abstract":"Objective \u0000To evaluate the prevalence of cryptococcal antigenemia and explore the related cryptococcal lesions in hospitalized human immunodeficiency virus (HIV)-infected patients. \u0000 \u0000 \u0000Methods \u0000Medical records of 517 HIV-infected patients, including patients' age, sex, clinical features, previous medical history, laboratory tests, chest CT, treatment and the response to treatment, in the Second Hospital of the Nanjing between January 2016 and February 2018 were retrospectively analyzed. The serum cryptococcal antigen (sCrAg) was detected by lateral flow immunoassay. The χ2 test or Fisher exact test was used to perform the statistical analysis. \u0000 \u0000 \u0000Results \u0000Among 517 HIV-infected cases, 51 were sCrAg positive, of whom 96.1% (49 cases) were men. The cases with CD4+ T lymphocyte count <100×106 cells/L accounted for 66.2% (342 cases), while 90.2% (46 cases) in sCrAg-positive patients showed CD4+ T lymphocyte count <100×106 cells/L with statistical significance (χ2=14.6, P<0.01). Multivariable analysis revealed that CD4+ T lymphocyte count <100 ×106 cells/L was independent risk factor for cryptococcal antigenemia (OR=4.7; 95%CI: 1.8-12.5, P<0.01). Clinical cryptococcal diseases were found in 76.4% (39/51) of patients with cryptococcal antigenemia, and cryptococcal meningitis (CM), pulmonary cyptococcosis (PC) and cryptococcal septicemia were found in 56% (28/50), 52.9% (27/51) and 44.4% (16/36) of the patients, respectively. Cryptoccal disease was not identified in 21.6% (11/51) of the patients with cryptococcal antigenemia (isolated cryptococcal antigenemia). The median (range) sCrAg titers of the patients with and without CM were 1∶1 280 (1∶10-1∶2 560) and 1: 15 (1∶2-1∶2 560), respectively (P<0.01). The proportion of CM in patients with sCrAg titers ≤1∶5, 1∶10-1∶320 and ≥1∶640 were 0 (0/10), 50% (10/20) and 90% (18/20), respectively. When cryptococcal infection was restricted to the lung, 87.5% (7/8) of the patients had sCrAg titers ≤1∶20. 30% (3/10) of the patients with sCrAg titers ≤1∶5 had PC. The median (range) sCrAg titers of the patients with cryptococcal septicemia and with isolated cryptococcal antigenemia were 1∶1 280 (1∶10-1∶2 560) and 1∶5 (1∶2-1∶320), respectively. \u0000 \u0000 \u0000Conclusions \u0000The prevalence of cryptococcal antigenmia is high in hospitalized HIV-infected patients. Most patients with cryptococcal antigenemia have developed cryptococcal diseases. The sCrAg titer in HIV patients may, in some extend, predicts the condition of cryptococcal infection. sCrAg titers ≥1∶640 are strongly suggestive of CM. Patients with sCrAg titers ≤1∶5 seems unlikely to have CM or cryptococcal septicemia, however, clinician should still be alarmed of possible PC. \u0000 \u0000 \u0000Key words: \u0000HIV; Meningitis, cryptococcal; Cryptococcal antigenemia; Pulmonary cryptococcosis; Cryptococcal septicemia","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69753508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The dynamics of serum vascular endothelial cadherin levels and its relationship with prognosis in patients with acute respiratory distress syndrome induced by sepsis 败血症并发急性呼吸窘迫综合征患者血清血管内皮钙粘蛋白水平动态变化及其与预后的关系
Pub Date : 2018-08-15 DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.08.002
Zhenyu Li, Wei Li, Xiaolong Zong, Huiqing Hu
Objective To investigate the prognostic significance of serum vascular endothelial cadherine (VE-Cad) in patients with acute respiratory distress syndrome (ARDS) induced by sepsis. Methods A prospective observational study was performed between June 2015 and Dec 2017, and 48 ARDS patients induced by sepsis from intensive care unit (ICU) were enrolled. And 30 healthy volunteers were enrolled as control. ARDS group was divided into mild group (n=17), moderate group (n=18) and severe group (n=13). The dynamic levels of serum VE-Cad, tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were monitored at day 1, 3 and 7 of admission. Clinical data including extravascular lung water index (EVLWI), pulmonary vascular permeability index (PVPI), lung injury score (LIS), APACHEⅡand SOFA were also collected. The t-test or chi square test were used in the comparison between the two groups. One-way ANOVA was used for comparison among multiple groups. Results The serum VE-Cad level of septic group was higher than control group at day 1 of admission ([5.67±0.29] vs [0.28±0.03] g/L, t=101.2, P<0.01). The serum VE-Cad levels in the mild group, moderate group and severe group were (1.52±0.59), (3.45±0.68), and (4.68±0.53) g/L, respectively (F=15.45, P<0.01). There were positive correlation between VE-Cad levels and EVLWI, PVPI, LIS, TNF-α and IL-6 (r=0.640, 0.601, 0.507, 0.584, and 0.456, respectively, all P<0.01). The PaO2/FiO2and serum albumin level in death group (n=17) were lower than survival group (n=31) ([146.74±16.45] vs [245.42±12.13] mmHg [1 mmHg=0.133 kPa], t=23.72, P<0.01; [23.18±3.24] vs [29.16±3.45] g/L, t=5.865, P<0.01, respectively), and EVLWI , PVPI, LIS, serum lactate, mechanical ventilation time, 7 d fluid balance, APACHEⅡand SOFA in death group were all higher than survival group. The serum VE-Cad levels at day 1, 3 and 7 in death group were all higher than survival group ([4.72±0.96] vs [3.36±0.47] g/L, t=8.801; [3.87±0.28] vs [1.95±0.42] g/L, t=16.86; [3.92±0.53] vs [0.96±0.28] g/L, t=25.42, respectively, all P<0.01). The area under curve (AUC) of VE-Cad for ARDS outcome prediction was 0.878 with sensitivity of 100.00% and specificity of 58.06% with a cutoff of 3.035 g/L. Conclusion Serum VE-Cad level increases in patients with ARDS induced by sepsis, and positively correlates with disease severity, which could be a potential predictor for prognosis. Key words: Sepsis; Acute respiratory distress syndrome; VE-cadherin; Tumor necrosis factor-alpha; Prognosis
目的探讨血清血管内皮钙素(VE-Cad)在脓毒症致急性呼吸窘迫综合征(ARDS)患者中的预后意义。方法2015年6月至2017年12月进行前瞻性观察研究,纳入重症监护病房(ICU) 48例脓毒症致ARDS患者。30名健康志愿者作为对照。ARDS组分为轻度组(n=17)、中度组(n=18)和重度组(n=13)。于入院第1、3、7天监测血清VE-Cad、肿瘤坏死因子-α (TNF-α)、白细胞介素-6 (IL-6)的动态水平。收集肺血管外水指数(EVLWI)、肺血管通透性指数(PVPI)、肺损伤评分(LIS)、APACHEⅡ、SOFA等临床数据。两组间比较采用t检验或卡方检验。多组间比较采用单因素方差分析。结果脓毒症组患者入院第1天血清VE-Cad水平高于对照组([5.67±0.29]vs[0.28±0.03]g/L, t=101.2, P<0.01)。轻度组、中度组、重度组血清VE-Cad水平分别为(1.52±0.59)、(3.45±0.68)、(4.68±0.53)g/L (F=15.45, P<0.01)。VE-Cad水平与EVLWI、PVPI、LIS、TNF-α、IL-6呈正相关(r分别为0.640、0.601、0.507、0.584、0.456,P均<0.01)。死亡组(n=17) PaO2/ fio2、血清白蛋白水平低于生存组(n=31)([146.74±16.45]vs[245.42±12.13]mmHg [1 mmHg=0.133 kPa], t=23.72, P<0.01;[23.18±3.24]vs[29.16±3.45]g/L, t=5.865, P均<0.01),死亡组EVLWI、PVPI、LIS、血清乳酸、机械通气时间、7 d体液平衡、APACHEⅡ、SOFA均高于生存组。死亡组患者第1、3、7天血清VE-Cad水平均高于生存组([4.72±0.96]vs[3.36±0.47]g/L, t=8.801;[3.87±0.28]vs[1.95±0.42]g/L, t=16.86;[3.92±0.53]vs[0.96±0.28]g/L, t=25.42, P均<0.01)。VE-Cad预测ARDS预后的曲线下面积(AUC)为0.878,敏感性为100.00%,特异性为58.06%,临界值为3.035 g/L。结论败血症致ARDS患者血清VE-Cad水平升高,且与病情严重程度呈正相关,可作为预测预后的潜在指标。关键词:脓毒症;急性呼吸窘迫综合征;VE-cadherin;肿瘤坏死因子;预后
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