【摘要】 目的 比较不同给养途径在重症急性胰腺炎（SAP）中的临床效果。 方法 选择2008年1月-2009年4月收治的49例SAP患者，随机分为观察组和对照组。观察组25例采用肠内营养，对照组24例采用全胃肠外营养，比较两组的临床效果。 结果 两组的并发症发生率、感染率和病死率差异均无统计学意义（Pgt;0.05）；治疗后两组患者的血清白蛋白水平和前白蛋白水平均升高，以观察组升高更明显，组间差异有统计学意义（Plt;0.05）。 结论 肠内营养应用于SAP患者临床效果满意，值得关注。【Abstract】 Objective To compare the clinical effects of different rations pathway in severe acute pancreatitis. Methods From January 2008 to April 2009, 49 patients of severe acute pancreatitis were selected and randomly divided into two groups, the observation group (25 patiens) adopted by enteral nutrition, the control group (24 patiens) adopted by total parenteral nutrition, the clinical effects of the two groups were compared and analyzed. Results The differences in the incidence of complications, infection rates and case fatality rates were not statistically significant (Pgt;0.05). The serum albumin level and prealbumin level of patients in both groups after treatment were significantly increased. Those in the observation group increased more obviously, and the differences between the two groups were statistically significant (Plt;0.05). Conclusion Enteral nutrition in patients with severe acute pancreatitis has satisfactory clinical effects.
摘要:目的: 探讨血清前白蛋白(prealbumin,PAB)、胆碱脂酶(cholinesterase,ChE)、总胆汁酸(total bile acid,TBA)在肝硬化中的检测价值。 方法 :测定105例肝硬化患者和30例健康人的前白蛋白、胆碱脂酶、总胆汁酸活性及肝功能生化指标,并按ChildPugh分级进行比较。 结果 :肝硬化组前白蛋白含量、胆碱脂酶活性均较对照组显著降低;按ChildPugh分级比较,肝硬化组前白蛋白含量在Child A级与对照组、B级与A级之间、在C级与B级之间差异有显著性(Plt;001);胆碱脂酶活性在Child A级与对照组、B级与A级、C级与B级之间差异有显著性(Plt;001)。总胆汁酸在Child B级与A级,C级与B级间有显著差异性,在A级与对照组间差异无显著性。 结论 :血清前白蛋白、胆碱脂酶在肝硬化早期评估中有很重要的价值,而总胆汁酸在肝硬化预后的判定中有重要价值。 Abstract: Objective: To evaluate the role of prealbumin (PAB), cholinesterase (ChE), and total bile acid (TBA) in evaluating liver reserve function in patients with liver cirrhosis. Methods : One hundred and five serum samples from patients with liver cirrhosis were detected in PAB, ChE, TBA and other biochemical markers. All patients were classified in accordance with ChildPugh scale. Results : For PAB, the differences among ChildPugh A, B, C and healthy group were statistically significant (t=1254, 1887, 2316) (Plt;001). For ChE, the differences among ChildPugh A, B, C and healthy group were statistically significant (t=1288, 0856, 1002) (Plt;001). For TBA, the differences among ChildPugh C group, B group and A group were statistically significant (t=0526, 1081)(Plt;001), the difference among ChildPugh A group and healthy group was not statistically significant (t=5615) (Pgt;005). Conclusion : PAB and ChE reflect liver reserve function earlier in patients with liver cirrhosis. The role of TBA is important in reflecting prognosis in patients with liver cirrhosis.
Objective To study the relation between the pathogenesis of gallstone and blood lipid and protein.Methods Then indexes of blood lipid and protein in 204 cases of gallstone patients were measured and analysed by statistical software SPSS. Results There was a significant difference between the gallstone group and control in the value of proalbumin, total cholesterol, high density lipoprotein and carrier protein B (Ｐ＜0.01), the value of total protein, triglyceride, low density lipoprotein cholesterol, very low density lipoprotein cholesterol and carrier protein A1 were higher than those in the control (Ｐ＜0.05). Conclusion The indexes mentioned above may play an important role in the gallstone formation.
ObjectiveTo explore the relationship between the levels of transferrin (TRF), prealbumin (PAB) and total bile acids (TBA) in serum and the loss of the hepatic reserve function in primary liver cancer (PHC) patients and the importance of the former factors for diagnosis of PHC. MethodsA total of 154 patients with PHC collected between March 2010 and February 2013 were included in our study. Based on the information of hepatic reserve function and the Child-Pugh classification standard, the patients were divided into Child-Pugh-A, B, and C groups with 67, 55 and 42 patients respectively. Another 58 healthy subjects were selected as the control group. Serum TRF, PAB and TBA levels were measured by automated chemiluminescence immunoassay, immune turbidimetric assay and enzymatic cycling respectively, and they were compared among the groups. ResultsTRF level of patients in the control group and Child-Pugh-A, B, and C groups was respectively (2.574±0.214), (1.618±0.135), (0.988±0.121), and (0.314±0.107) g/L, with significant differences among the groups (P<0.05). PAB level of patients in four groups was respectively (269.32±37.29), (165.22±21.01), (123.24±31.15), and (83.66±19.74) mg/L, with significant differences among the groups (P<0.05). TBA level in the above four groups was respectively (9.16±2.48), (65.13±4.25), (133.62±8.44), and (250.73±21.59) μmol/L, and there was also significant differences among the groups. A positive correlation between serum TRF and PAB was found (r=0.927, P<0.001), and negative correlations between serum TBA level and serum TRF and between TBA and PAB were found (r=-0.454, P<0.001; r=-0.432, P<0.001, respectively). ConclusionSerum TRF, PAB and TBA levels are closely related to the hepatic reserve function in PHC patients, and they can be used as an important indicator for PHC diagnosis.
ObjectiveTo explore the effects of transthyretin (TTR) on biological behavior of retinal microvascular epithelial cell (RMVEC). MethodsRMVEC was cultured in medium with 0 μmol/L and 4 μmol/L TTR. The proliferation, migration and healing abilities (0, 24, 48 hours) of RMVEC with different concentrations of TTR were measured by methyl thiazol tetrazolium (MTT) assay, transwell assay and scarification test. ResultsMTT assay shows that RMVEC with the concentrations of 4 μmol/L TTR [absorbance (A) value=0.17±0.02] glows faster than with the concentrations of 0 μmol/L TTR (A value=0.40±0.03), the difference was statistically significant (t=15.47, P=0.000 1). The transwell assay shows RMVEC with the concentration of 4 μmol/L TTR [(140±7) cells] migrants faster than RMVEC with the concentration of 0 μmol/L TTR [(227±14) cells], the difference was statistically significant (t=5.44, P=0.000 6). The scarification test shows that the RMVEC with the concentration of 4 μmol/L TTR [(134.4±45.4) μm] heals faster than the RMVEC with the concentration of 0 μmol/L TTR [(330.0±23.1) μm], the difference was statistically significant (t=8.25, P<0.01). The cells in 48 hours and 4 μmol/L group were healed completely, but not healed in 0 μmol/L group. ConclusionTTR can promote the proliferation, migration and healing abilities of RMVEC.
Objective To explore transthyretin (TTR) effect on retinal vascular endothelial cells (hREC) under high glucose and hypoxia environment. Methods hREC and human retinal pigment epithelial cell (hRPEC) were cultured at low-glucose (LG), high glucose (HG) and hypoxia. The glucose concentration was increased from 5.5 mmol/L up to 25 mmol/L, and hypoxia was induced by 200 μmol/L CoCl2. The cells were divided into LG group, LG-hypoxia group, HG group, HG-hypoxia group according to the different cell culture environment. The growth index was detected at 0, 4, 8, 16, 24, 36, 48, 60, 72 hours after cultured. Furthermore, hREC and hRPEC were also cultured with additional TTR (4 μmol/L), respectively. Then transwell co-culture system was employed to reveal the effects of hRPEC on the growth of hREC. Results At 72 hours after cultured, the growth index of hREC and hRPEC in LG group were increased as compared with LG-hypoxia group and HG group (hREC: F=17.098, 22.970; P < 0.05. hRPEC: F=45.442, 9.011; P < 0.05); the growth index of hREC and hRPEC were decreased in HG group and HG-hypoxia group (hREC: F=146.184, P < 0.05；hRPEC: F=27.907, P < 0.05). Additionally, hREC could be significantly repressed by added TTR during culture with high concentration of glucose (F=161.430, 24.106; P < 0.05). hREC could be significantly increased by added TTR during culture with low concentration of glucose (F=200.486, 48.662; P < 0.05). In co-culture process, hRPEC revealed inhibition activity against hREC under both natural and abnormal environment (LG group: F=15.711, P < 0.05; LG-hypoxia group: F=45.659, P < 0.05; HG group: F=7.857, P < 0.05; HG-hypoxia group: F=6.348, P < 0.05). Conclusion Under high glucose and hypoxia environment, the growth of hREC from neovascular could be inhibited by TTR.
Objective To measure the concentration of serum transthyretin (TTR) of patients with different stages of diabetic retinopathy (DR). Methods A total of 176 patients with diabetes mellitus were included in this study. There were 104 males and 72 females. The patients aged from 21 to 74 years, with the mean age of (56±11) years. The diabetes duration raged from 1 to 30 years, with the mean diabetes duration of (10±7) years. The HbA1C was 5.2%−14.1%, with the mean HbA1C of (8.6±2.0)%. According to the fundus examination, 58 patients had DR (33.0%), but the other 118 patients not (67.0%). For these DR patients, 10 patients were in stage Ⅰ (5.7%), 26 patients in stage Ⅱ (14.8%), 8 patients in stage Ⅲ (4.5%), and 14 patients in stage Ⅳ (8.0%). The concentration of serum TTR was measured by enzyme-linked immunosorbentassay kit. The differences in the concentration of serum TTR between different DR stages were compared.Bivariate analysis was used to analyze the influencing factors of TTR. Results The concentrations of serum TTR of the patients without DR or with DR of stage Ⅰ to Ⅳ were (224.96±65.47), (383.68±102.99), (247.44±63.21), (228.2±45.89), (189.34±70.12) mg/L, respectively. The difference between different DR stages was statistically significant (F=14.690,P＜0.001).Bivariate analysis showed that the concentration of TTR was correlation to DR (r=0.179,P=0.017). There was no correlation between the concentration of TTR and diabetes duration (r=−0.027,P=0.727), hypertension (r=0.018,P=0.810), hyperlipoidemia (r=0.101,P=0.182), and the use of insulin (r=−0.032,P=0.675). Conclusion The concentration of serum TTR was increased in early DR patients, and gradually decreased with the progression of DR. The concentration of TTR is correlated to DR.
ObjectiveTo explore the changes of plasma prealbumin (PA), homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) levels before and after treatment in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and analyze the correlation of PA and Hcy with hs-CRP and body mass index (BMI).MethodsA total of 132 hospitalized AECOPD patients with GOLD lung function as grade III-IV were recruited as an experimental group and 45 healthy subjects as a control group. The levels of plasma PA, Hcy and hs-CRP were measured by automatic biochemical analyzer, and the main indexes of pulmonary function were determined in all subjects.ResultsCompared with the control group, the level of plasma PA before and after treatment in the experimental group decreased significantly [(146.49±36.53) mg/L and (219.60±41.29) mg/L vs. (269.48±42.63) mg/L], the level of plasma Hcy before and after treatment increased significantly [(16.44±5.21) μmol/L and (12.61±4.56) μmol /L vs. (10.13±3.25) μmol/L], and the levels of plasma hs-CRP before and after treatment increased significantly [(45.24±29.94) mg/L and (7.71±3.41) mg/L vs. (5.01±1.52) mg/L] (all P<0.05). The levels of plasma PA, Hcy and hs-CRP after treatment were significantly better than before treatment in the experimental group (allP<0.01). The plasma PA values before and after treatment were negatively correlated with the level of hs-CRP before and after treatment, and positively correlated with BMI (bothP<0.05).ConclusionsThe levels of plasma PA, Hcy and hs-CRP are significantly different before and after the treatment in AECOPD patients and the healthy controls. PA is negatively correlated with hs-CRP and positively correlated with BMI. The detection of plasma PA and Hcy can help to determine the condition and efficacy of patients with COPD, and PA can reflect the level of inflammation and nutritional status to a certain extent.