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find Keyword "炎性反应" 28 results
  • 全身性炎性反应综合征的基础与临床

    多年来,对脓毒症(sepsis)的病理生理变化研究虽有显著的进展,但其名词与概念上有很多混淆之处。长期以来,临床上都把发热、白细胞增高、神志改变、血流动力学及内环境紊乱,进而发生器官功能障碍者作为全身性感染即脓毒症的特征性临床表现。但各家描述所含的症状、诊断标准及名称均不一致,也不能反映该病的本质。临床发现,脓毒症虽大部分是由微生物引起,但仍有30%具有该症状群而未能发现感染病灶。这种症状群也可由非细菌感染因素引起,如创伤、急性胰腺炎、免疫反应和药物反应等。由于以上原因,为了使脓毒症有更清晰的层次概念,1991年美国急诊医学会(ACCP)和胸科医学会一致提出全身性炎性反应综合征(systimic inflammational respones syndrome, SIRS)一词,并对SIRS、sepsis以及与sepsis有关的临床情况作了一定的解释。按照新的概念,SIRS是指非感染性侵害引起的全身性炎性反应,并具有两个以上SIRS所应有的临床特征,而sepsis则是来自有感染的全身性炎性反应。SIRS的诊断标准: ①体温gt;38 ℃或lt;36 ℃; ②心率gt;90次/分; ③呼吸gt;20次/分或PaCO2lt;4.26 kPa(32 mm Hg); ④白细胞计数gt;12×109/L或lt;4×109/L,或中性幼稚粒细胞gt;10%。凡符合上述两项以上指标者可诊断为SIRS。但在诊断时要注意它是急性的临床表现,应排除其它因素引起的上述症状,如化学治疗所致的白细胞减少。

    Release date:2016-08-28 04:49 Export PDF Favorites Scan
  • RESEARCH ON THE KINETIC EFFECT OF INFLAMMATORY CYTOKINES PRODUCTION IN THE MONOCYTES OF MULTIPLE SYSTEM ORGAN FAILURE PATIENTS

    The synthesis and secretion of inflammatory cytokines in the monocytes of 68 cases of multiple system organ failure (MSOF) patients was investigated by the method of MTT stained in cytokines dependent defferential cell strain. The data showed that the serum levels of tumor necrosis factor, interleukine 1 and interleukine 6 were increased (P<0.01) in the monocytes of MSOF patients. The synthesis and secretion of these inflammatory cytokines gradually increased in the monocytes after onset of MSOF. After 5 days of treatment with antibiotics and electrolytes intravenous infusion, the secretion of TNF, IL-1 and IL-6 were decreased respectively. These results suggested that the TNF, IL-1 and IL-6 are integrated into system inflammatory responese and caused the injury to the tissues and organs. The production levels of these cytokines can be regarded as the index of MSOF and its severity.

    Release date:2016-08-29 03:18 Export PDF Favorites Scan
  • 常温体外循环对肺损伤的影响

    目的 探讨常温体外循环对全身炎性反应和肺损伤的影响. 方法 将30例心瓣膜手术患者随机分为低温组和常温组,每组15例.测定两组补体、白细胞计数、多形核白细胞跨肺差值、血浆中脂质过氧化物(LPO)和髓过氧化物酶(MPO)水平.对9例患者进行了肺组织学检查. 结果 在体外循环中、结束后,两组补体明显减少,但组间比较差别无显著性意义.主动脉开放后两组多形核白细胞跨肺差值增大,但组间比较差别无显著性意义.主动脉开放后两组LPO和MPO明显增高,但组间比较差别无显著性意义.肺组织形态学检查,低温组线粒体出现肿胀,常温组线粒体变形,内质网断裂. 结论 在低温和常温体外循环中,炎性反应相似,但肺组织形态学表明常温组肺损伤明显,提示常温体外循环可能不利于肺保护.

    Release date:2016-08-30 06:32 Export PDF Favorites Scan
  • 术中自体血液回收对体外循环术后全身性炎性反应的影响

    目的 探讨在体外循环手术中使用洗涤式自体血液回收机(ATS)对术后全身性炎性反应的影响.方法 将择期体外循环冠状动脉旁路移植术(CABG)的12例患者随机分为两组(每组6例),实验组:将手术野渗血和停机后机血混合经ATS处理后回输;对照组:将停机后机血直接回输.于围手术期测定两组补体终末复合物(sC5b-9)、白细胞介素-6(IL-6)等炎性因子指标.实验组分别测定ATS处理前后炎性因子指标. 结果 实验组回收血经ATS处理后红细胞压积(HCT)明显升高(Plt;0.01),sC5b-9、肿瘤坏死因子-α(TNF-α)和IL-6水平显著降低(Plt;0.05).停机6小时、24小时和48小时,实验组sC5b-9变化率均低于对照组(Plt;0.05),停机48小时,实验组IL-6变化率低于对照组(Plt;0.05),术后两组TNF-α水平以及变化率差别无显著性意义;停机48小时,实验组中性粒细胞(PMN)显著低于对照组(Plt;0.01). 结论 在体外循环手术中使用ATS回收术野渗血和停机后机血可以去除绝大部分炎性介质,回输后可以降低术后部分炎性介质的水平,减轻体外循环术后的炎性反应.

    Release date:2016-08-30 06:32 Export PDF Favorites Scan
  • 参附注射液对体外循环中炎性反应的影响

    摘 要 目的 观察参附注射液对体外循环(CPB)中肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)的影响。方法 将20例人工心脏瓣膜置换术患者随机分成参附组和对照组(每组10例)。参附组分别于麻醉诱导前、CPB前及主动脉开放10分钟内分别静脉滴注参附注射液20ml、40ml和40ml,于CPB前、主动脉阻断前、主动脉阻断30分钟,主动脉开放15分钟和60分钟时采用放射免疫法测定两组血心中TNF-α和IL-6的含量。结果 主动脉阻断前、主动脉阻断30分钟、主动脉开放后15分钟和60分钟,对照组TNF-α值均明显高于参附组(P<0.05),各时点IL-6组间比较差别无显著性意义(P>0.05)。结论 参附注射液可降低主动脉开放后血浆TNF-α的含量,具有对抗CPB所致的炎性反应的作用,而对CPB中IL-6作用不明显。

    Release date:2016-08-30 06:32 Export PDF Favorites Scan
  • 体外循环术中小剂量抑肽酶对急性炎性反应的作用

    目的 探讨体外循环(ECC)术中小剂量抑肽酶是否能减轻ECC所致的急性炎性反应。 方法 将28例首次心瓣膜置换术患者随机分为抑肽酶组和对照组,各14例。于麻醉诱导前、ECC前、ECC后1小时和24小时测定血浆中白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)和白细胞计数。 结果 两组IL-10 ECC后1小时比麻醉诱导前明显升高(P<0.01),且抑肽酶组明显高于对照组(P<0.01);对照组TNF-α和白细胞计数在ECC后1小时和24小时较麻醉诱导前明显升高,且高于抑肽酶组(P<0.05)。 结论 小剂量抑肽酶可抑制ECC所致的炎性反应。

    Release date:2016-08-30 06:33 Export PDF Favorites Scan
  • COMPARISON OF TRAUMATIC RELATED INDEX IN SERUM BETWEEN MINIMALLY INVASIVE AND OPEN TRANSFORAMINAL LUMBAR INTERBODY FUSION FOR TISSUE INJURY

    Objective To compare the difference of traumatic related index in serum and its significance between minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and open TLIF. Methods Sixty patients were enrolled by the entry criteria between May and November 2012, and were divided into MIS-TLIF group (n=30) and open TLIF group (n=30). There was no significant difference in gender, age, type of lesions, disease segment, and disease duration between 2 groups (P gt; 0.05). The operation time, intraoperative blood loss, and postoperative hospitalization time were recorded, and the pain severity of incision was evaluated by visual analog scale (VAS). The serum levels of C-reactive protein (CRP) and creatine kinase (CK) were measured at preoperation and at 24 hours postoperatively. The levels of interleukin 6 (IL-6), IL-10, and tumor necrosis factor α (TNF-α) in serum were measured at preoperation and at 2, 4, 8, and 24 hours after operation. Results The operation time, intraoperative blood loss, and postoperative hospitalization time of MIS-TLIF group were significantly smaller than those of open TLIF group (P lt; 0.05), and the VAS score for incision pain in MIS-TLIF group was significantly lower than that of open TLIF group at 1, 2, and 3 days after operation (P lt; 0.05). The levels of CRP, CK, IL-6, and IL-10 in MIS-TLIF group were significantly lower than those in open TLIF group at 24 hours after operation (P lt; 0.05), but there was no significant difference between 2 groups before operation (P gt; 0.05). No significant difference was found in TNF-α level between 2 groups at pre- and post-operation (P gt; 0.05). Conclusion Compared with the open-TLIF, MIS-TLIF may significantly reduce tissue injury and systemic inflammatory reactions during the early postoperative period.

    Release date:2016-08-31 04:08 Export PDF Favorites Scan
  • RESEARCH PROGRESS OF BONE MARROW MESENCHYMAL STEM CELLS IN ACUTE LUNG INJURY

    Objective To review the basic research, the cl inical progress, and the mechanism of bone marrow mesenchymal stem cells (BMSCs) in acute lung injury (ALI). Methods The l iterature concerning the basic and cl inical researches of BMSCs in ALI was reviewed. Results BMSCs can take the initiative to “homing” the site of lung injury and take partici pate in repair by means of differentiation, meanwhile BMSCs could regulate and balance local and systematic inflammatory response and immune disorders in ALI. Currently, the mechanism of BMSCs on anti-inflammation and immune regulation in ALI is not clear. Conclusion BMSCs have comprehensive biological effect on ALI, providing a potential cl inical treatment and also laying the foundation for gene therapy and stem cell therapy of ALI in the future.

    Release date:2016-08-31 05:42 Export PDF Favorites Scan
  • A STUDY ON BLOCKING EFFECT OF POLYLACTIC ACID PATCH ON INTRA-DISCAL INFLAMMATION AFTER ANNULUS PUNCTURE

    Objective Polylactic acid (PLA) patch has proper steric configuration, sufficient mechanic strength, and flexibil ity, to investigate the blocking effect on the intra-discal inflammation after annulus puncture sticked by medical glue so as to seal the pinhole left after annulus puncture. Methods Twenty healthy New Zealand white rabbits (weighing 2.0-2.5 kg) were randomly divided into 4 groups (n=5): groups A, B, C, and D. In group A, the rabbits underwent exposure of intervertebral disc and transverse process at L2-7 as a control; in group B, the rabbits received annulus puncture at L2-7 with an 18-gauge needle; and in groups C and D, the pinholes were sealed respectively with a PLA patch sticked with medical gel and medical gel alone after annulus puncture at L2-7. General condition of rabbits was observed after operation. The intervertebral disc tissue was harvested 1 week after operation. The tissue structure was observed by HE and Masson staining. And the expressions of inflammatory factors l ike interleukin 1β (IL-1β), tumor necrosis factor α (TNF-α), and inducible nitric oxide synthase (iNOs) were detected with immunohistochemistry and ELISA. Results All the animals survived till the end of the experiment. In group A at 1 week, the nucleus pulposus tissue had normal structure. In group B at 1 week, leak of nucleus pulposus from the pinhole and sl ight adhesion to the adjacent tissue could be seen, and the nucleus pulposus tissue had significant degenerative change by histological observation. In groups C and D, clots of coagulated medical gel and extensive adhesion to the adjacent tissue could be seen; histological observation suggested that the nucleus pulposus tissue of group C had similar histology manifestation to that of group A; while group D had similar histology manifestation to group B with obviously-decreased cells and disorder of matrix. ELISA test showed remarkably elevated expression level of inflammatory factors including IL-1β, TNF-α, and iNOs in groups B and D when compared with groups A and C, showing significant differences (P lt; 0.05), and similar expression level were observed in groups A and C, groups B and D (P gt; 0.05). Conclusion The PLA patch sticked with medical gel is effective in blocking the intra-discal inflammation 1 week after annulus puncture.

    Release date:2016-09-01 09:03 Export PDF Favorites Scan
  • CHANGES OF SERAL TNF-α, IL-6 AND IL-10 LEVEL AFTER IMPLANTATION OF VALVED BOVINE JUGULAR VEIN CONDUIT IN COMPLEX CONGENITAL HEART DISEASES

    Objective To study the inflammation response and the biocompatibil ity of valved bovine jugular vein conduit (BJVC) and valved bovine jugular vein patch (VBJV-P) in treating complex congenital heart disease (CHD). Methods From December 2007 to March 2008, 16 patients with complex CHD were treated. Of 16 patients, 6 underwent conjunction right ventricular to pulmonary artery with BJVC and broaden right ventricular outflow tract (RVOT) with VBJV-P (BJVC group), and 10 underwent broaden RVOT with self pericardial patch (control group). In BJVC group, there were 3 males and 3 females, aging (5.6 ± 3.6) years, and including 1 case of type I truncus arteriosus, 1 case of type I truncus arteriosus with ventricular septal defect and patent foramen ovale, 1 case of congenital pulmonary atresia with ventricular septal defect and patent arterial duct, and 3 cases of Fallot’s tetrad. In control group, there were 5 males and 5 females, aging(4.3 ± 3.1) years, all being Fallot’s tetrad. The periphery vein blood of the two groups was collected during operation and after operation, and the levels of cytokine were detected with ELISA method. Meanwhile the cl inical data of the two groups were collected. Results There were no significant differences at levels of TNF-α and IL-6 between BJVC group and control group 1 week after operation (P gt; 0.05), and there was significant difference at level of IL-10 [(25.7 ± 5.0) pg/mL vs (19.5 ± 4.7) pg/ mL, P lt; 0.05]. There were no significant differences at levels of IL-6 and IL-10 within groups both in control group and in BJVC group (P gt; 0.05) between 1 week after operation and the anesthesia inducing period. And there was significant difference at level of TNF-α in BJVC group [(77.0 ± 1.6) pg/mL vs (82.9 ± 1.3) pg/mL, P lt; 0.05] and in control group [(78.6 ± 3.4) pg/mL vs (83.1 ± 1.9) pg/mL, P lt; 0.05] between 1 week after operation and the anesthesia inducing period. There were no statistically significant differences (P gt; 0.05) in leukocyte count and body temperature between BJVC group and control group. The X-ray films showed no abnormal ity in BJVC group and control group before operation and after operation. No hepatic and renal dysfunction occurred in control group; and 2 patients had hepatic dysfunction, which may be caused by antibiotics. Conclusion BJVC has a good biocompatibil ity in treating complexty CHD.

    Release date:2016-09-01 09:07 Export PDF Favorites Scan
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