论著

电子束对体外培养的细粒棘球蚴及其p38 mRNA表达的影响

Effects of radiation on Echinococcus granulosus in vitro culture and its mRNA expression of p38 mRNA

:14-20
 
目的 观察电子束照射对体外培养的细粒棘球蚴形态结构、死亡率及其p38 mRNA表达的影响。方法 采集自然感染的绵羊肝中的细粒棘球蚴原头蚴,随机分成3组,分别用0 Gy、30 Gy、60 Gy的不同剂量的6 MeV电子束各照射1次,照射后连续培养3 d、14 d,光镜观察虫体的大体变化及死亡率,qRT-PCR法测定p38基因的表达水平。结果 60 Gy组较0 Gy、30 Gy组原头蚴变性坏死数目明显增多,死亡率有差异(P<0.0125),连续培养天数(3 d、14 d)对虫体死亡率无影响。经电子束照射后,30 Gy、60 Gy组原头蚴p38 mRNA表达水平较0 Gy组升高(P<0.05)。结论 体外培养的原头蚴经电子束照射后大体形态结构发生明显变化、死亡率升高,且与电子束的剂量存在量效关系;p38 mRNA的表达量随着电子束的剂量的增加而升高,p38基因可能参与电子束所致体外杀伤棘球蚴的作用机制。
Objective To observe the effect of 6 MeV electron beam on the morphological structure,mortality rate and expression of p38 mRNA and in Echinococcus granulosus.Methods Einococcus granulosus was collected from natural infected sheep liver and divided into 3 groups randomly,then irradiated by 6 MeV electron beam of 0 Gy,30 Gy and 60 Gy,respectively.After culturing for 3 and 14 days,the gross change and mortality of worms were observed by light microscopy and the expression level of p38 gene was determined by qRT-PCR.Results In 60 Gy group,compared with 0 Gy and 30 Gy group,the gross morphology and structure have changed significantly,the mortality rate was significantly different(P <0.0125).Days of culture(3 days,14 days)had no obvious effect on mortality,and the p38 mRNA expression levels in 30 Gy and 60 Gy group were significantly higher than 0 Gy group(P <0.05).Conclusions The gross morphology,structure changes and mortality of Einococcus granulosus increases significantly after electron beam irradiation and has obvious quantitative and effective relationship with the electron beam dose,the p38 gene may be involved in the mechanism of in vitro killing by electron beam.
论著

TIMELESS、RAB2A、ASPM在乳腺癌组织中的表达及与临床特征相关性

Expression of TIMELESS,RAB2A and ASPM in breast cancer and their correlation with clinical features

:80-86
 
目的 分析TIMELESS、鼠肉瘤病毒家族相关蛋白2A(RAB2A)、异常纺锤体样小头畸形相关基因(ASPM)在乳腺癌组织中的表达及与临床特征相关性。方法 选取2019年2月—2021年2月我院乳腺癌组织标本84例作为研究组、正常乳腺组织标本53例作为对照组,采用荧光定量聚合酶测定TIMELESS、ASPM,采用Western blot检测RAB2A蛋白表达情况,分析上述三个指标在乳腺癌中表达及与临床特征相关性。结果 对比对照组,研究组TIMELESS、ASPM表达较高,RAB2A较低(P<0.05)。TIMELESS、RAB2A、ASPM与乳腺癌淋巴结浸润、TNM分期、分化程度相关(P<0.05)。TIMELESS、RAB2A、ASPM为影响乳腺癌发生的危险因素(P<0.05)。TIMELESS、RAB2A负相关(r=-0.383、P=0.001);TIMELESS、ASPM正相关(r=0.397、P=0.001);RAB2A、ASPM负相关(r=-0.257、P=0.018)。对比TIMELESS、RAB2A、ASPM单一检测,三者联合检测对乳腺癌的诊断价值较高(P<0.05)。结论 乳腺癌患者TIMELESS、ASPM呈高表达,RAB2A呈低表达,上述三个指标与乳腺癌高度相关,可作为乳腺癌发生的检测指标。
Objective To analyze the expression of TIMELESS,murine sarcoma virus family related protein 2A(RAB2A)and abnormal spindle like microcephaly related gene(ASPM)in breast cancer tissues and their correlation with clinical features.Methods A total of 84 breast cancer tissue samples from our hospital from February 2019 to February 2021 were selected as the study group and 53 normal breast tissue samples were selected as the control group.Time,ASPM and RAB2A protein expression were determined by fluorescent quantitative polymerase,and RAB2A protein expression was detected by Western blot.The expression of the above three indicators in breast cancer and their correlation with clinical characteristics were analyzed.Results Compared with the control group,the study group had higher TIMELESS and ASPM expression levels and lower RAB2A level(P<0.05).TIMELESS,RAB2A and ASPM expressions were correlated with lymph node infiltration,TNM stage and differentiation of breast cancer(P<0.05).TIMELESS,RAB2A and ASPM were the risk factors of breast cancer(P<0.05).TIMELESS and RAB2A were negatively correlated(r=-0.383,P=0.001);TIMELESS and ASPM were positive correlated(r=0.397、P=0.001);RAB2A and ASPM were negatively correlated(r=-0.257,P=0.018).Compared with the single detection of TIMELESS,RAB2A and ASPM,the combined detection had higher diagnostic value for breast cancer(P<0.05).Conclusions Patients with breast cancer had high expression of TIMELESS and ASPM,and low expression of RAB2A.The above three indicators were highly correlated with breast cancer and can be detection indicators for breast cancer.
论著

Act1对高糖诱导肾小管上皮细胞炎症反应及细胞外基质表达的调控作用

Regulation effect of Act1 on high glucose induced inflammatory response and extracellular matrix expression in renal tubular epithelial cells

:21-27
 
目的 研究核因子-κB激活剂1(Act1)对高糖诱导肾小管上皮细胞炎症反应及细胞外基质表达的调控作用。方法 培养肾小管上皮细胞MK2,设置对照组和高糖组,处理12 h、24 h、48 h、72 h后检测细胞中Act1的mRNA和蛋白表达水平;设置si-NC组(5.5 mmol/L葡萄糖培养基中转染NC siRNA)、si-NC+高糖组(30 mmol/L葡萄糖培养基中转染NC siRNA)、si-Act1+高糖组(30 mmol/L葡萄糖培养基中转染Act1 siRNA),48 h后检测细胞中Act1、E-钙黏蛋白(E-cadherin)、N-钙黏蛋白(N-cadherin)、I型胶原(Col-I)、III型胶原(Col-III)的mRNA和蛋白表达水平以及培养基中肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)、干扰素-γ(IFN-γ)的含量。结果 高糖组处理12 h、24 h、48 h、72 h时细胞中Act1的mRNA和蛋白表达水平均高于对照组(P<0.05);si-NC+高糖组处理48h时细胞中Act1、N-cadherin、Col-I、Col-III的mRNA和蛋白表达水平以及培养基中TNF-α、IL-1β、IFN-γ的含量均高于si-NC组,细胞中E-cadherin的mRNA和蛋白表达水平均低于si-NC组(P<0.05);si-Act1+高糖组处理48h时细胞中Act1、N-cadherin、Col-I、Col-III的mRNA和蛋白表达水平以及培养基中TNF-α、IL-1β、IFN-γ的含量均低于si-NC+高糖组,细胞中E-cadherin的mRNA和蛋白表达水平均高于si-NC+高糖组(P<0.05)。结论 Act1表达增加对高糖诱导肾小管上皮细胞炎症反应激活和细胞外基质增多具有促进作用。
Objective To study the regulation effect of nuclear factors-κB activator 1(NF-κB activator 1,Act1)on high glucose induced inflammatory response and extracellular matrix expression in renal tubular epithelial cells.Methods Renal tubular epithelial cells MK2 were cultured and control group and high glucose group were set.The mRNA and protein expression of Act1 were detected after treatment for 12,24,48 and 72 hours.MK2 were divided into si-NC group(transfected with NC siRNA in 5.5 mmol/L glucose medium),si-NC+high glucose group(transfected with NC siRNA in 30 mmol/L glucose medium)and si-Act1+high glucose group(transfected with Act1 siRNA in 30 mmol/L glucose medium).The mRNA and protein expression of Act1,E-cadherin,N-cadherin,type I collagen(Col-I),and type III collagen(Col-III)and the contents of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interferon-γ(IFN-γ)in culture medium were detected.Results The mRNA and protein expression levels of Act1 in cells of high glucose group were higher than those of control group at 12 h,24 h,48 h and 72 h(P<0.05).The mRNA and protein expression levels of Act1,N-cadherin,CoL-I,Col-III in cells and the contents of TNF-α,IL-1β,IFN-γ in culture medium of si-NC+high glucose group were higher than those of si-NC group,the mRNA and protein expression levels of E-cadherin in cells were lower than those of si-NC group at 48 h(P<0.05).The mRNA and protein expression levels of Act1,N-cadherin,CoL-I,Col-III in cells and the contents of TNF-α,IL-1β,IFN-γ in culture medium of si-Act1+high glucose group were lower than those of si-NC+high glucose group,the mRNA and protein expression levels of E-cadherin in cells were higher than those of si-NC+high glucose group at 48 h(P<0.05).Conclusions The increased expression of Act1 promotes the activation of inflammatory response and the increase of extracellular matrix in renal tubular epithelial cells induced by high glucose.
论著

CircRNA-0003340在2型糖尿病大鼠肝脏组织中的表达及意义

CircRNA-0003340 expression and significance in the liver of T2DM rats

:7-13
 
目的 观察2型糖尿病大鼠肝脏组织中circRNA-0003340的表达,并探讨与糖尿病的关系。方法 选取健康雄性SD大鼠30只,随机分为2组,正常对照组(NC组,n=10)与2型糖尿病组(T2DM组,n=20),检测FPG、FINs、HbA1c、TC、TG、HDL-C、LDL-C、AST、ALT;行腹腔注射糖耐量实验和胰岛素耐量实验,计算胰岛素抵抗指数(HOMA-IR);HE染色观察胰岛细胞形态;RT-PCR检测大鼠肝脏组织circRNA-000334的表达量。结果 与NC组比较,T2DM组的AST、ALT、FPG、HAb1c、FINs、HOMA-IR、TG、TC、LDL-C均升高(P<0.05),HDL-C降低(P<0.05)。circRNA-0003340在T2DM组肝脏组织中的表达较NC组肝脏组织中的表达是下调的,差异有统计学意义(P<0.05)。Sperman相关分析示大鼠肝脏组织中circRNA-0003340表达水平与FPG、TG及TC呈负相关(P<0.05)。结论 circRNA-003340的表达水平可能与T2DM大鼠的糖脂代谢密切相关,circRNA-003340在肝脏组织中的表达水平下调可能参与T2DM的发生发展。
Objective To observe the expression of circRNA-0003340 in the liver tissue of type 2 diabetes mellitus (T2DM)rats and to explore its relationship with diabetes.Methods A total of 30 healthy male SD rats were randomly divided into two groups,normal control group(NC group,n=10)and T2DM group(n=20),and fasting plasma glucose(FPG),fasting insulins(FINS),glycated hemoglobin(HbA1c),total cholesterol(TC),triglyceride (TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),aspartate aminotransferase(AST),alanine aminotransferase(ALT)levels were detected.Intraperitoneal glucose tolerance test and insulin tolerance test were performed to calculate the insulin resistance index(HOMA-IR),HE staining was used to observe islet cell morphology,the expression of circRNA-000334 in rat liver tissue was detected by RT-PCR.Results Compared with the NC group,the T2DM group had increased AST,ALT,FPG,HAb1c,FINs,HOMA-IR,TG,TC,LDL-C(P<0.05)and decreased HDL-C(P<0.05).The expression of circRNA-0003340 in liver tissue in T2DM group was down-regulated compared with that in NC group,with statistically significant difference(P<0.05).Sperman correlation analysis showed that the expression level of circ-0003340 in rat liver tissue was negatively correlated with FPG,TG and TC(P<0.05).Conclusions The expression level of circRNA-003340 may be closely related to the glycolipid metabolism of T2DM rats,and the downward regulation of the circRNA-003340 expression level in liver tissues may be involved in the occurrence and development of T2DM.
论著

TAK1与TCF-4在非小细胞肺癌中表达及其相关性的初步研究

Preliminary study on the expression and correlation of TAK1 and TCF-4 in non-small cell lung cancer

:17-22
 
目的 探讨非小细胞肺癌(NSCLC)组织中转化生长因子β激活激酶1(TAK-1)与T细胞因子-4(TCF-4)在 mRNA以及蛋白水平的表达情况及其相关性,并分析两者与NSCLC患者临床病理因素的关系。方法 收集NSCLC手术标本51例,每例均包含肺癌组织及配对癌旁组织,所有患者的术后诊断均经病理结果证实,通过RT-PCR以及Western blot法检测TAK1、TCF-4在癌组织及配对癌旁组织中的表达情况,并通过SPSS进一步分析两者的相关性及其与临床病理因素的关系。结果 TAK1与TCF-4 mRNA以及蛋白水平在NSCLC患者癌组织中均高表达,其中TAK1蛋白的表达与NSCLC的TNM分期(P=0.022)、淋巴结转移(P=0.014)相关,TCF-4蛋白的表达与NSCLC的TNM分期相关(P=0.045)。TAK1在NSCLC组织中的表达与TCF-4呈正相关(r=0.427,P=0.002)。结论 TAK1 mRNA及蛋白水平在NSCLC组织中均高表达,并与TCF-4呈正相关,TAK1有可能成为NSCLC诊断及预后的一个潜在靶标,并且TAK1与TCF-4的联合应用有可能成为一种更为理想的NSCLC辅助诊断及临床治疗方法。
Objective To investigate the mRNA and protein expressions of transforming growth factor β-activated kinase 1(TAK1)and T cell factor-4(TCF-4)in non-small cell lung cancer(NSCLC)tissues and their correlation,and to analyze the relationship between TAK1/TCF-4 and clinicopathological factors in NSCLC patients.Methods Cancer tissues and matched adjacent tissues of 51 NSCLC patients in our hospital were collected.The postoperative diagnosis of all patients was confirmed by pathological results.The expression of TAK1 and TCF-4 in cancer tissues and paired adjacent tissues were detected by RT-PCR and Western blot,then SPSS was used to further analyze the correlation between TAK1 and TCF-4 and clinicopathological factors.Results TAK1 and TCF-4 mRNA and protein were highly expressed in NSCLC tissues,and TAK1 protein expression was significantly correlated with TNM stage of NSCLC(P=0.022)and lymph node metastasis(P=0.014);TCF-4 protein expression was significantly correlated with TNM stage of NSCLC(P=0.045).TAK1 expression in NSCLC tissues was positively correlated with TCF-4(r=0.427,P=0.002).Conclusions TAK1 mRNA and protein were highly expressed in NSCLC tissues and positively correlated with TCF-4.TAK1 may become a potential target for the diagnosis and prognosis of NSCLC,and the combined application of TAK1 and TCF-4 may become a more ideal method for the auxiliary diagnosis and clinical treatment of NSCLC.
临床诊疗

血清外泌体中GP1BA的表达水平与动脉粥样硬化的相关性分析

:95-100
 
目的 探讨血清外泌体中糖蛋白 Ib 血小板亚基α(GP1BA)的表达水平与动脉粥样硬化的相关性。方法 选取福州市第二医院2022年1月—2023年1月收治的30例心电图提示ST-T改变及冠状动脉造影显示有AS斑块的患者为动脉粥样硬化组;30名健康志愿者为对照组。实时荧光定量(RT-qPCR)法和蛋白质印迹(WB)检测受试人员血清外泌体中GP1BA的表达量,ELISA法检测血清中肿瘤坏死因子α(TNF-α)、白细胞介素-1β(IL-1β)、干扰素-γ(IFN-γ)、高敏心肌肌钙蛋白(hs-cTnT)、血管性血友病因子(vWF)含量。采用Pearson相关系数分析血清外泌体中GP1BA的表达水平与TNF-α、IL-1β、IFN-γ、hs-cTnT、vWF的相关性。结果 动脉粥样硬化组血清外泌体中GP1BA的表达水平高于对照组,血清中TNF-α、IL-1β、IFN-γ、hs-cTnT、vWF含量升高(均P<0.05)。相关性分析发现GP1BA的表达水平与TNF-α、IL-1β、IFN-γ、hs-cTnT、vWF含量均呈较强正相关关系(均P<0.05)。结论 血清外泌体中GP1BA的表达水平与AS存在相关性,并可作为AS的潜在标志物。
论著

82例子宫内膜癌错配修复蛋白表达与临床病理特征的关系

The structure and clinicopathological features of endometrial carcinoma in 82 cases

:44-48
 
目的 探讨子宫内膜癌构成及临床病理特征。方法 以南平市第一医院2020年1月—2022年6月期间收治的82例子宫内膜癌患者为研究对象,收集其临床资料,通过免疫组织化学染色法检测4种错配修复蛋白表达,并分析错配修复蛋白表达与临床病理特征的关系。结果 82例患者中,70例(85.37%)为子宫内膜样癌,病理组织学类型以G1级30例(42.86%)为主,其他类型较为少见。错配修复蛋白表达总缺失率为35.71%,其中MUTL同源物1(MLH1)单独缺失率为2.86%,错配修复蛋白2抗体(MSH2)为4.29%,错配修复蛋白6抗体(MSH6)为14.29%,肿瘤错配修复基因PMS2抗体(PMS2)为14.29%;错配修复表达缺失(dMMR)组患者年龄50岁以上、伴脉管侵犯和淋巴结转移、组织学G3级和FIGO分期Ⅲ期占比高于错配修复表达正常(pMMR)组患者(P<0.05);MSH6蛋白表达缺失易发生在年龄50岁以上、有家族相关疾病史的患者(P<0.05);PMS2蛋白表达缺失易发生在组织学G2级、FIGO分期Ⅲ期、妊娠1次及以上、脉管内癌栓和淋巴结转移的患者(P<0.05)。结论 子宫内膜癌错配修复蛋白表达与其部分临床病理特征存在密切关联,可为患者后续治疗提供有价值的指导。
Objective To investigate the composition and clinicopathological features of endometrial carcinoma.Methods A total of 82 cases of endometrial carcinoma patients admitted to the First Hospital of Nanping City from January 2020 to June 2022 were studied.Epidemiological data were collected,and the expression of 4 mismatch repair proteins were detected by immunohistochemical staining,and their relationship with clinicopathological features was analyzed.Results Among 82 patients,70 cases(85.37%)were endometrioid carcinoma,and 30 cases(42.86%)were mainly G1 grade,other types were rare.The total deletion rate of mismatch repair proteins expression was 35.71%,in which MLH1 alone was 2.86%,MSH2 was 4.29%,MSH6 was14.29% and PMS2 was14.29%.The proportions of dMMR patients over 50 years old,with vascular invasion and lymph node metastasis,G3 grade histology and FIGO stage Ⅲ were significantly higher than those of the pMMR group(P<0.05).The loss of MSH6 protein expression was more likely to occur in patients over 50 years old with a family history of related diseases(P<0.05).The deletion of PMS2 protein expression was more likely to occur in patients with histological G2 grade,FIGO stage III,pregnancy of once or more and intravascular cancer thrombin and lymph node metastasis(P<0.05).Conclusions The expression of mismatch repair proteins in endometrial carcinoma is closely related to some clinicopathological features,which provides valuable guidance for follow-up treatment.
临床诊疗

血清脂滴蛋白-5表达水平与STEMI老年患者冠状动脉病变及近远期预后的相关性

:92-94
 
目的 探究血清脂滴蛋白-5表达水平与ST段抬高型心肌梗死(STEMI)老年患者冠状动脉病变和预后的相关性。方法 对2016年1月—2018年1月的100例STEMI老年患者进行研究,所有患者于入院次日晨起空腹状态下检测血清脂滴蛋白-5表达水平,根据中位值分成高表达组(对照组)和低表达组(观察组)各50例,比较不同表达水平患者的冠状动脉病变支数、死亡率和不良事件发生率,分析血清脂滴蛋白-5表达水平与冠状动脉病变血管支数和预后的相关性。结果 2组冠状动脉血管单支、双支病变概率对比无差异(P>0.05);观察组3支病变概率为48.00%,高于对照组的24.00%,数据有差异(P<0.05);观察组治疗1个月、半年和3年后的死亡率分别为18.00%、28.00%和36.00%,高于对照组的2.00%、6.00%和12.00%,存在数据差异(P<0.05);观察组治疗1个月、半年和3年后的主要心血管不良事件发生率分别为30.00%、40.00%和48.00%,数据对比有差异(P<0.05);血清脂滴蛋白-5表达水平与病变支数为负相关关系,与近远期预后为正相关关系(r=-0.754,P=0.008;r=0.816,P=0.005)。结论 血清脂滴蛋白-5表达水平与STEMI老年患者冠脉病变严重性和近远期预后密切相关:表达水平低,病情越严重,预后越差。
论著

阴道灌洗液中炎性因子表达水平与高危型HPV持续感染的相关性

Correlation between expressions of inflammatory factors in vaginal lavage fluid and persistent infection of high risk HPV

:46-48
 
目的 分析阴道灌洗液中炎性因子表达水平与高危型人乳头瘤病毒(HPV)持续感染的相关性。方法 选择本院2019年3月—2021年3月接诊的80例高危型HPV持续感染患者作为试验组,以病理组织检查结果分组,将19例宫颈癌患者作为试验组1、将30例宫颈上皮不典型增生(CIN)I级患者作为试验组2,将31例CIN II、III级患者作为试验组3,选取同期门诊体检的30例健康女性作为对照组,均进行TGF-β、IFN-γ、IL-17、IL-6表达水平检测,比较4组TGF-β、IFN-γ、IL-17、IL-6水平、高危型HPV负荷量,Pearson分析TGF-β、IFN-γ、IL-17、IL-6水平与高危型HPV负荷量的相关性。结果 阴道灌洗液炎症因子水平、高危型HPV负荷量4组相比较,差异均有统计学意义(P<0.05)。TGF-β、IL-17、IL-6水平与高危型HPV负荷量呈正相关性,与IFN-γ水平呈负相关性,P<0.05。结论 高危型HPV持续感染患者机体阴道灌洗液中炎性因子水平与高危型HPV负荷量存在一定的相关性,高危型HPV负荷量与IFN-γ水平呈负相关性,与TGF-β、IL-17、IL-6水平呈正相关性,通过检测阴道灌洗液中炎性因子水平,可评估HPV感染程度。
Objective To analyze the correlation between the expressions of inflammatory factors in vaginal lavage fluid and persistent infection of high-risk human papillomavirus(HR-HPV). Methods A total of 80 patients with HR-HPV persistent infection in our hospital from March 2019 to March 2021 were selected as the experimental group. According to the pathological examination results, 19 patients with cervical cancer were selected as the experimental group 1, 30 patients with CIN grade I were selected as the experimental group 2, and 31 patients with CIN grade II and III were selected as the experimental group 3. Thirty healthy women in the same period were selected as the control group. HR-HPV load, TGF- β, IFN-γ, IL-17 and IL-6 levels were detected and were compared among the four groups. Pearson analysis of correlation between TGF- β, IFN-γ, IL-17, IL-6 levels and HR-HPV load was carried out. Results There were significant differences in the levels of inflammatory factors in vaginal lavage fluid and HR-HPV load among the four groups (P<0.05). TGF- β、IL-17 and IL-6 levels were positively correlated with HR-HPV load and negatively correlated with IFN-γ (P<0.05). Conclusions There is a certain correlation between inflammatory factors in vaginal lavage fluid and HR-HPV load in patients with HR-HPV persistent infection. HR-HPV load is negatively correlated with IFN-γ, and positively correlated with TGF-β, IL-17 and IL-6. The degree of HPV infection could be evaluated by detecting the inflammatory factors in vaginal lavage fluid.
论著

超低频经颅磁刺激联合艾司唑仑对失眠症患者睡眠脑电图参数及血清神经营养因子表达的作用

Effects of infra-low frequency transcranial magnetic stimulation combined with estazolam on sleep EEG parameters and serum neurotrophic factors expression in patients with insomnia

:32-37
 
目的 探讨超低频经颅磁刺激(ILF-TMS)联合艾司唑仑对失眠症患者睡眠脑电图参数及血清神经营养因子表达的影响。方法 选取2018年8月—2020年4月我院失眠症患者114例,随机数字表法分为研究组(n=57)、对照组(n=57)。对照组予以艾司唑仑联合ILF-TMS假性刺激,研究组予以艾司唑仑联合ILF-TMS真性刺激,均治疗1个月。对比2组疗效与治疗前、治疗1个月后睡眠进程参数(总睡眠时间、入睡时间、睡眠效率、觉醒时间)、睡眠结构(非快速眼动睡眠期、快速动眼睡眠期)、匹兹堡睡眠质量量表(PSQI)评分、失眠严重程度指数量表(ISI)评分、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、血清神经营养因子[胶质细胞源性神经营养因子(GDNF)、脑源性神经营养因子(BDNF)]水平。结果 (1)疗效:研究组治疗1个月后总有效率高于对照组(P<0.05);(2)睡眠进程参数:治疗1个月后研究组总睡眠时间、睡眠效率高于对照组,入睡时间、觉醒时间短于对照组(P<0.05);(3)睡眠结构:治疗1个月后研究组Ⅲ期、Ⅱ期、非快速眼动睡眠期高于对照组,Ⅰ期睡眠期低于对照组(P<0.05);(4)PSQI、ISI评分:治疗1个月后研究组PSQI、ISI评分低于对照组(P<0.05);(5)SAS、SDS评分:治疗1个月后研究组SAS、SDS评分低于对照组(P<0.05);(6)血清神经营养因子:治疗1个月后研究组血清GDNF、BDNF水平高于对照组(P<0.05)。结论 ILF-TMS联合艾司唑仑治疗失眠症效果确切,可上调血清神经营养因子表达,改善睡眠脑电图参数,提高睡眠质量,控制焦虑、抑郁症状。
Objective To investigate the effects of infra-low frequency transcranial magnetic stimulation (ILF-TMS) combined with estazolam on sleep EEG parameters and serum neurotrophic factors expression in patients with insomnia. Methods One hundred and fourteen patients with insomnia in our hospital from August 2018 to April 2020 were divided into study group (n=57) and control group (n=57) by random number table method. The control group was treated with estazolam combined with pseudo ILF-TMS stimulation, and the study group was treated with estazolam combined with real ILF-TMS stimulation, all of which were treated for 1 month. Comparing curative effect of two groups before and 1 month after treatment, and sleep process parameters (total sleep time, falling asleep time, sleep efficiency, waking time), the structure of the sleep stages (stage Ⅲ, Ⅱ, Ⅰ, rapid eye movement sleep), Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI), self-rating anxiety scale (SAS) score, self-rating depression scale (SDS) score, serum neurotrophic factors (GDNF, BDNF) levels. Results (1) Efficacy: the total effective rate of the study group was higher than that of the control group after 1 month of treatment (P<0.05). (2) Sleep process parameters: after 1 month of treatment, the total sleep time and sleep efficiency in the study group were higher than those in the control group, and the falling asleep time and waking time were shorter than those in the control group (P<0.05). (3) Sleep structure: after 1 month of treatment, compared to the control group, the study group had more in stageⅢ, Ⅱ, rapid eye movement sleep, and less in stage Ⅰsleep(P<0.05). (4) PSQI and ISI scores: after 1 month of treatment, PSQI and ISI scores of the study group were lower than those of the control group (P<0.05). (5) SAS and SDS scores: after 1 month of treatment, SAS and SDS scores in the study group were lower than those in the control group (P<0.05). (6) Serum neurotrophic factors: after 1 month of treatment, serum GDNF and BDNF levels in the study group were higher than those in the control group (P<0.05). Conclusions ILF-TMS combined with estazolam is an effective treatment of insomnia. It can up-regulate the expression of serum neurotrophic factors, improve the parameters of sleep EEG, improve sleep quality, and control the symptoms of anxiety and depression.
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