目的 观察免疫球蛋白联合甲泼尼龙疗法对自身免疫性脑炎患者T淋巴细胞亚群、免疫球蛋白、白介素-6(IL-6)和CXC趋化因子13(CXC13)水平影响。方法 选取2017年1月—2020年3月本院收治的60例自身免疫性脑炎患者,采用随机数字表法分为观察组30例与对照组30例。对照组给予甲泼尼龙疗法,观察组在对照组结合免疫球蛋白治疗。两组均以4周后评价。比较两组疗效,治疗前后T淋巴细胞亚群、免疫球蛋白、IL-6、CXC13及简易智能精神状态检查量表(MMSE)变化。结果 观察组总有效率(83.33%)高于对照组(60.00%)(P<0.05)。观察组治疗后CD⁺₃、CD⁺₄和CD⁺₄/CD⁺₈高于对照组(P<0.05)。观察组治疗后血清IgA、IgG和IgM水平低于对照组(P<0.05)。观察组治疗后血清IL-6和CXC13水平低于对照组(P<0.05)。观察组治疗后MMSE评分高于对照组(P<0.05)。结论 免疫球蛋白联合甲泼尼龙疗法对自身免疫性脑炎患者疗效良好,且可增强机体细胞和体液免疫功能,降低IL-6和CXC13水平。

Objective To observe the effect of immunoglobulin combined with methylprednisolone on T lymphocyte subsets, immunoglobulin, interleukin-6 (IL-6) and CXC chemokine 13 (CXC13) in patients with autoimmune encephalitis. Methods 60 patients with autoimmune encephalitis admitted to our hospital from January 2017 to March 2020 were divided into 30 cases of observation group and 30 cases of control group. The control group was treated with methylprednisolone, and observation group was treated with immunoglobulin compared with the control group. The course of treatment in both groups was 4 weeks. The effects of the two groups were compared. The changes of T lymphocyte subsets, immunoglobulin, IL-6, CXC13 and MMSE before and after treatment were compared. Results Total effective rate (83.33%) of the observation group was higher than that of control group (60.00%) (P<0.05). After treatment, in the observation group, CD⁺₃, CD⁺₄ and CD⁺₄/CD⁺₈ were higher than that of control group (P<0.05); levels of serum IgA, IgG and IgM were lower than that of control group (P<0.05); serum levels of IL-6 and CXC13 were lower than that of control group (P<0.05); MMSE score was higher than that of control group (P<0.05). Conclusion Immunoglobulin combined with methylprednisolone is effective in the treatment of autoimmune encephalitis. It may enhance the cellular and humoral immune function, and reduce the levels of IL-6 and CXC13.

目的 探讨前列地尔联合依帕司他对糖尿病足患者创面肉芽组织肿瘤坏死因子(tumor necrosis factor-α,TNF-α)、白介素-6 (interleukin-6,IL-6)及血管内皮生长因子(vascular endothelial growth factor,VEGF)表达的影响。方法 将90例糖尿病足患者随机分为研究组和对照组,每组45例,对照组予常规治疗,研究组在常规治疗基础上给予前列地尔+依帕司他联合治疗。监测两组患者创面愈合率,患肢足背血流动力学及腓总神经传导速度,创面肉芽组织TNF-α、IL-6、VEGF含量及基因表达变化。结果 治疗后第2、4周研究组较对照组创面愈合率升高,差异有统计学意义(P<0.05);治疗后两组患者足背动脉血流动力学及腓总神经传导速度均有改善,而研究组疗效更明显(P<0.05);治疗后研究组患者创面肉芽组织TNF-α、IL-6含量及基因表达较对照组降低,VEGF含量及基因表达则升高(P<0.05)。结论 前列地尔联合依帕司他联合治疗可改善糖尿病足患者足背动脉血流动力学,促进受损神经功能恢复;降低糖尿病足患者创面肉芽组织TNF-α、IL-6表达,减轻免疫损伤;增加VEGF基因表达,促进血管生成,加速创伤愈合。

Objective To investigate the effects of alprostadil combined with epalrestat on the expression of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) in granulation tissue in patients with diabetic foot patients.Methods Totally 90 cases with diabetic foot were randomly divided into study group (45 cases)and control group(45 cases). The control group received conventional treatment for 4 weeks and the study group additionally received combination of alprostadil and epalatone for 4 weeks. The curative rate of wound healing, limb dorsal hemodynamics, peroneal nerve conduction velocity and the levels of TNF-α, IL-6 and VEGF in the granulation tissue of the wound were monitored in the two groups.Results The wound healing rate of the study group was significantly higher than that of the control group at the 2nd and 4th week after treatment (P<0.05). After treatment, the hemodynamics and peroneal nerve conduction velocity were improved (P<0.05). The contents and expressions of TNF-α and IL-6 in the granulation tissue of the treatment group were significantly lower than that of the control group, and the content of VEGF and gene expression were significantly increased in the study group (P<0.05).Conclusion The combination therapy of alprostadil and epalrestat may improve the hemodynamics of dorsalis pedis artery in patients with diabetic foot and promote the recovery of damaged nerve function.Also it may reduce the expression of TNF-α and IL-6 in the granulation tissue of diabetic patients and reduce the immune injury. It promotes angiogenesis and accelerates wound healing by increasing VEGF gene expression.

目的 探讨慢性阻塞性肺疾病急性期加重期(AECOPD)患者血清降钙素原(PCT)、白介素6(IL-6)、超敏C反应蛋白(hs-CRP)水平变化及与肺功能的相关性。方法 选择121例COPD急性加重期患者为实验组研究对象,选取同期体检的80例稳定期COPD患者为对照组,比较两组患者血清PCT、IL-6、hs-CRP的差别,并对三者与COPD患者肺功能的相关性进行探讨。结果 实验组患者IL-6、hs-CRP水平显著高于对照组(P＜0.05)。实验组FEV1值、FEV1%显著低于对照组(P＜0.05)。Pearson分析显示,实验组hs-CRP与肺功能指标FEV1%呈负相关关系(r=-1.51,P=0.048)。结论 AECOPD患者的血清炎症因子水平明显高于COPD稳定期患者,血清炎症因子与慢阻肺患者肺功能损伤密切相关。