Changes in soluble interleukin-2 receptor level in serum and Na^+ -K^+ -exchanging ATPase activity in semen of infertile men caused by antisperm antibody

Aim: To explore the possible mechanisms of male infertility caused by antisperm antibody (AsAb). Methods: Thesoluble interleukin-2 receptor (sIL-2R) level in serum was analyzed by ELISA and Na^+ -K^+ -exchanging ATPase activi-ty in semen by phosphorus (Pi) assay. Results: The slL-2R level in serum was significantly higher and the Na^+ -K^+ -exchanging ATPase activity in semen significantly lower in AsAb positive infertile men when compared with thecontrols. Conclusion: The AsAb titer varies with the slL-2R level in serum. A decrease in Na^+ -K^+ -exchangingATPase activity in semen may play a role in male infertility caused by AsAb.

Effects of Aprotinin on Serum Interleukin-2 and Soluble Interleukin-2 Receptor during Cardiopulmonary Bypass

Interleukin-2 and its receptor are of importance in regulating immunity responses. The changes of interleukin-2 (IL-2) and soluble interleukin-2 receptor (IL-2R) during heart valve (s) replacement operation and effects of aprotinin on them were observed. Twenty patients undergoing heart valve (s) replacement were randomly divided into two groups: control group (n=10) and apro- tinin group (n=10). In aprotinin group, 1 000 000 KIU aprotinin was given by vein injection and then 2 000 000 KIU was given as a bolus in prime. Blood samples were collected before CPB, right after CPB and on the 1st, 3rd and 7th postoperative day (POD) for serum IL-2 and sIL-2R determination. Results showed that after CPB, IL-2 was reduced and slL-2R increased. Meanwhile, serum IL-2R was lower in aprotinin group than that of control. It is concluded that the immunity depression after CPB is associated with low level of IL-2 and high level of sIL-2R and aprotinin can ameliorate the situation.

Increased serum levels of soluble CD146 and vascular endothelial growth factor receptor 2 in patients with exudative age-related macular degeneration

AIM: To investigate serum levels of soluble CD146(s CD146) and vascular endothelial growth factor receptor 2(VEGFR2) in patients with age-related macular degeneration(AMD). METHODS: Eighty-eight patients with exudative AMD and 45 sex-and age-matched healthy controls were enrolled in this study conducted in China. Serum samples was obtained from the patients with exudative AMD and from the controls. Serum sCD146 and VEGFR2 protein levels were measured using an enzyme-linked immunosorbent assay.RESULTS: We found that serum sCD146 and VEGFR2 protein levels were significantly higher in the patients with exudative AMD group than in the controls(t=3.859, P<0.001 and t=3.829, P<0.001, respectively). Serum sCD146 levels were significantly higher in patients with classic choroidal neovascularization(CNV) than in those with occult CNV(t=9.899, P<0.001). There was a significant difference in the trend for exudative AMD in the highest versus lowest quartile of circulating sCD146 levels(χ2=10.29, P=0.001). The receiver operating characteristic curve analysis showed that the area under the curve was 0.696 for s CD146(95%CI: 0.601-0.791) with an optimum diagnostic cut-off value of 157.16 ng/mL, a sensitivity of 55.7%, and a specificity of 82.2%.CONCLUSION: The serum sCD146 level increases and may be a biomarker for exudative AMD.

Study of the Effect of Leeching on Plasma Endothelin and Soluble Interleukin-2 Receptor in Patients with Systemic Lupus Erythematosus

Objective: to explore the mechanism of leeching in treating systemic lupus erythematosus (SLE). Methods: Forty-four patients with SLE were randomly divided into conventional corticosteroid treated group (control group, n =20) and conventional treatment group with leeching intervention added (leeching group, n =24). Before and after treatment the concentration of plasma endothelin (ET) and soluble interleukin-2 receptor (sIL-2R) were determined. Results: Before treatment the level of plasma ET and sIL-2R in the SLE patients were all higher than those in the normal healthy group, ( P <0.01). But after treatment the level of these in both groups were significantly improved than those of before treatment ( P <0.05), and comparison between these two treated groups showed that the difference between them was significant ( P <0.05). Conclusion: Leeching added to conventional treatment of SLE could be more effective in improving the level of plasma ET and sIL-2R, and ameliorating the impairment of renal tissues.

Elevated pancreatic enzymes, IgM, soluble interleukin-2 receptor in anti-GADab(+) type 1 diabetes

Type 1 diabetes can be classified into immune-mediated diabetes (type 1A) and idiopathic diabetes, which lacks immunological evidence for beta cell autoimmunity (type 1B). Type 1A diabetes is characterized by the presence of the anti-glutamic acid decarboxylase antibody (anti-GADab). Fulminant type 1 diabetes is classified as type 1B diabetes, and characterized by the absence of anti-GADab, flu-like symptoms, and elevated serum exocrine pancreatic enzymes. We report a type 1 diabetic patient who showed flu-like symptoms, elevated serum exocrine pancreatic enzymes, and an extremely high-titer of anti-GADab, manifesting the characteristics of both type 1A and fulminant type 1 diabetes.

INTERLEUKIN-2 (IL-2) PRODUCTION AND INTERLEUKIN-2 RECEPTOR EXPRESSION IN PATIENTS WITH APLASTIC ANEMIA

IL-2 production and IL-2 receptor (Tac antigen) of the peripheral blood mononuclear cells in 30 patients with aplastic anemic (AA) were studied. We found that mononuclear cells from patients produce spontaneously IL-2 in the absence of exogenous lee-tin stimulation, the proportion of Tac+ cells in mononuclear cells increased. The release of IL-2 and or Tac antigen expression were elevated in almost every patient with AA. The plasma from patients stimulate mitogen-induced blastogenesis and Tac antigen expression of normal human lymphocytes. Immunological 1 abnormalities of patients with AA possibly might represents secondary response to bone marrow depression.

Soluble Interleukin 2 Receptor-Alpha (sIL-2Rα) in the Peripheral Blood of Dogs—Comparison of Malignant Neoplasia with Other Diseases

Background: Cytokines are mediators of diseases. Expression levels in the blood could be of clinical relevance. Objective: sIL-2Rα is used as a marker for different malignancies in human medicine. The aim of this study was to show if sIL-2Rα is detectable and if there is any correlation to different diseases in dogs. Methods: For this purposes sIL-2Rα concentrations in the blood were measured in healthy dogs, in dogs with different non-neoplastic diseases and benign tumors and in dogs with malignant tumors. Serum levels of sIL-2Rα were measured by using a human specific enzyme linked immunosorbent assay (ELISA). Results: Measurement of sIL-2Rα was successful in most of the samples. Dogs with diseases have significantly increased serum levels of sIL-2Rα compared to healthy controls. sIL-2Rα serum levels are higher in patients with non-neoplastic diseases and benign tumors than in those with malignant neoplasia. There is a strong correlation between sIL-2Rα and leukocyte count. Conclusion: Measurements of sIL-2Rα in serum may be helpful in detecting stages and grades of inflammation in the progression of disease. sIL-2Rα could actually not be used as an indicator for malignant diseases in dogs like in humans. The strong correlation between sIL-2Rα and the leukocyte count indicates the inflammatory response to the disease. This could be helpful in giving a prognosis in some cases, because the inflammatory reaction is of prognostic relevance in different diseases including malignant and non-malignant neoplasia. Although the results of our research studies were very promising, further studies should be performed with a canine ELISA.

DETECTION OF PLASMA SOLUBLE INTERLEUKIN－2 RECEPTOR IN PATIENTS WITH SEVERE AND CHRONIC ACTIVE HEPATITIS B

Plasma levels of soluble interleukin-2 receptor (sIL-2R) in patients with chronic active hepatitis B (CAHB) or severe hepatitis B (SHB) were measured quantitatively by 'sandwich' ELISA with monoclonal antibodies in order to explore the change of sIL-2R levels, its clinical significance,and its relation to liver damage. The results showed that the plasma sIL-2R levels in patients with CAHB and SHB were much higher than those in normal controls (P < 0. 01 ), and the level ofplasma sIL-2R in patients with SHB was greatly higher than that in patients with CAHB. These results suggest that there is close relation between plasma level of sIL-2R, the clinical types of hepatitis B,and the severity of liver damage. In addition, there is no significant difference in plasma levels of sIL-2R between acute severe hepatitis B (ASHB), subacute severe hepatitis B (SASHB), and chronic severe hepatitis B (CSHB). No relation was found between sIL-2R level and hepatitis B virusreplication activity.

Expression of sIL-2R before and after Chemotherapy in Patients with Breast Cancer

Objective： To investigate the difference of peripheral blood sIL-2R before and after chemotherapy in breast cancer patients, and evaluate the clinical value of the sIL-2R in breast cancer＇s diagnosis and therapy. Methods： The peripheral blood sIL-2R levels of the breast cancer patients with or without chemotherapy were detected by ELISA. The healthy persons were made as the control group. Results： The sIL-2R levels of the breast cancer patients were higher than that of the control group（P（0.05）; the sIL-2R＇s levels in I^II stage breast cancer were lower than that in Ill^IV stage breast cancer （P（0.05）; the sIL-2R levels of the patients before chemotherapy were higher than that of the patients undergone chemotherapy（P（0.05）; The level of the patient with chemotherapy was still higher than that of the control group （P（0.05）; the sIL-2R levels of the patients whose chemotherapies were noneffective were higher than that of the patients received effective chemotherapies （P（0.05）. There was no significant difference between the group with ER（＋） or PR（＋） and the group with ER（-） or PR（-）（P〉0.05）. Conclusion： The breast cancer patients have the high sIL-2R levels. There is a close relationship between the cancer incidence and the patients, immune situation. The level of sIL-2R could be a clinical index which can be used for evaluating the cancer degree, because the higher levels of sIL-2R can indicate that the immune ability of patient is worse. There is a significant difference between the sIL-2R levels of the patients before chemotherapy and that of the patients undergone chemotherapy.

血清可溶性生长刺激表达因子2水平与急性ST段抬高型心肌梗死患者冠状动脉病变程度及短期预后的相关性分析

目的探讨血清可溶性生长刺激表达因子2(sST2)与急性ST段抬高型心肌梗死(STEMI)患者冠状动脉病变程度及短期预后的相关性。方法选取2018年12月至2019年10月于中国医科大学附属第一医院心血管内科行急诊经皮冠状动脉介入治疗(PCI)的STEMI患者137例,根据PCI术前SNYTAX评分分为低分组(n=76)和中高分组(n=61)。比较2组临床资料的差异,采用多因素logistic回归模型分析中高分组的独立危险因素,绘制受试者操作特征(ROC)曲线以评估血清sST2对出院后3个月内发生主要心血管不良事件(MACE)的预测效能。结果SYNTAX评分中高分组血清sST2高于低分组(P<0.05)。血清sST2是中高分组的独立危险因素(P<0.05)。STEMI患者PCI术后发生MACE的独立影响因素是血清sST2、肌酸激酶同工酶-MB(CK-MB)、N末端B型脑钠肽前体(NT-proBNP)、室壁瘤形成(均P<0.05)。预测MACE事件的ROC曲线显示,血清sST2联合CK-MB后曲线下面积最大(P<0.05)。结论血清sST2水平越高,冠状动脉病变越严重,STEMI患者出院后3个月内发生MACE的风险越高。联合检测CK-MB对MACE的预测价值更高。

血清可溶性髓样细胞触发受体2与脑小血管病的相关性研究

目的:探讨血清可溶性髓样细胞触发受体2(sTREM2)与脑小血管病(CSVD)影像学总负荷及其认知功能的相关性。方法:选取CSVD病人86例为观察组,同期具有脑血管病危险因素、头颅MRI结果阴性的门诊就诊病人70例为对照组。ELISA检测2组间sTREM2及白细胞介素6(IL-6)水平。观察组根据CSVD影像学总负荷评分分为轻度组(0~1分)、中度组(2分)和重度组(3~4分)3个亚组,简易精神状态检查量表(MMSE)评估观察组的认知功能水平。比较sTREM2与IL-6水平、CSVD影像学总负荷及MMSE评分的相关性。结果:观察组sTREM2和IL-6水平较对照组升高,MMSE评分较对照组降低(P<0.01)。观察组中度组和重度组sTREM2和IL-6水平高于轻度组,重度组高于中度组(P<0.01),观察组中度组和重度组MMSE评分低于轻度组,重度组低于中度组(P<0.01)。观察组sTREM2水平与IL-6水平呈正相关关系,与MMSE评分均呈负相关关系(r=0.842,-0.526,P<0.01)。以CSVD为因变量,以sTREM2、IL-6、年龄、高血压、糖尿病、低密度脂蛋白等为自变量进行logistic多因素回归分析,结果显示sTREM2、年龄及高血压是CSVD的危险因素。结论:sTREM2在CSVD病人外周血中表达增高,且与其认知功能损害呈正相关关系。sTREM2、年龄及高血压病是CSVD的危险因素。

高分辨率CT评分联合血清sTREM-1、HBD-2对老年肺结核患者的预后价值

目的探讨高分辨率CT(HRCT)评分与血清可溶性髓系细胞触发受体-1(sTREM-1)、β-防御素2(HBD-2)联合检测对老年肺结核患者预后的预测价值。方法纳入该院2021年5月至2023年5月收治的132例老年肺结核患者作为研究组,根据预后分为预后良好组96例和预后不良组36例。选取同期行HRCT检查的130例体检健康者作为对照组。采用酶联免疫吸附试验检测血清sTREM-1、HBD-2水平,采用受试者工作特征(ROC)曲线分析HRCT评分及血清sTREM-1、HBD-2水平对老年肺结核患者预后不良的预测价值,采用多因素Logistic回归分析老年肺结核患者预后不良的影响因素。结果研究组HRCT评分及血清sTREM-1、HBD-2水平均高于对照组(P<0.05)。治疗前及治疗后2、6个月,预后良好组HRCT评分及血清sTREM-1、HBD-2水平呈下降趋势(P<0.05),即存在时间效应。治疗后2、6个月,预后不良组HRCT评分及血清sTREM-1、HBD-2水平高于预后良好组(P<0.05),时间和分组因素存在交互效应。HRCT评分及血清sTREM-1、HBD-2水平单独及联合预测老年肺结核患者预后不良的曲线下面积(AUC)分别为0.847、0.743、0.810、0.954。HRCT评分、sTREM-1、HBD-2是老年肺结核患者预后不良的影响因素(P<0.05)。结论HRCT评分联合血清sTREM-1、HBD-2有望作为预测老年肺结核患者预后不良的标志物。

急性缺血性脑卒中患者血清sTREM2和DKK-1水平检测对抑郁发生的预测价值研究

目的 研究急性缺血性脑卒中(acute ischemic stroke,AIS)患者血清可溶性髓细胞表达触发受体2(soluble triggering receptor expressed on myeloid cells 2,s TREM2)及Wnt信号通路抑制因子1(DKK-1)水平对抑郁发生的预测价值。方法 选取2019年1月~2021年1月于武汉市汉口医院住院治疗的AIS患者251例为研究对象。根据卒中后6个月汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分,将AIS患者分为非卒中后抑郁(NPSD)组(<7分,n=183)和卒中后抑郁(PSD)组(≥7分,n=68)。比较两组一般临床资料、神经功能评分及实验室检查指标的差异。相关性分析采用Pearson相关分析。多因素Logistic回归分析影响AIS患者PSD发生的影响因素。受试者工作曲线分析血清sTREM2,DKK-1及联合检测对AIS患者PSD的预测价值。结果 PSD组患者血清sTREM2(312.79±51.24 ng/L),DKK-1(4.47±0.62μg/L),美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分均高于NPSD组(172.96±32.55 ng/L,3.01±0.57μg/L),日常生活活动能力量表(ADL)评分明显低于NPSD组,差异均有统计学意义(t=25.585,17.607,5.937,47.288,2.990,均P<0.05)。PSD组血清sTREM2,DKK-1水平与NIHSS评分、mRS评分均呈显著正相关(r=0.657,0.669;0.620,0.614,均P<0.05),与ADL评分呈显著负相关(r=-0.712,-0.701,均P<0.05)。sTREM2(OR=1.219,95%CI=1.040~1.429)升高,DKK-1(OR=1.363,95%CI=1.076~1.728)升高是影响AIS患者PSD发生的独立危险因素(P <0.05)。血清sTREM2,DKK-1两者联合对AIS患者PSD的预测曲线下面积(95%CI)为0.914(0.843~0.967),高于血清sTREM2,DKK-1单一指标检测[0.823(0.760~0.869),0.801(0.743~0.851)],差异具有统计学意义(Z=3.864,4.072,均P<0.05)。结论 血清sTREM2和DKK-1水平升高是AIS患者PSD的独立影响因素,对AIS发生6个月内抑郁的发生有预测作用。

Effect of Kang’ai Injection (康艾注射液) on Serum Level of Soluble Interleukin-2 Receptor and Vascular Endothelial Growth Factor in Patients with Esophageal Carcinoma during Radiotherapy

Objective： To observe the effect of Kang＇ai Injection （康艾注射液, KAI） on serum level of soluble interleukin-2 receptor （sIL-2R） and vascular endothelial growth factor （VEGF） in patients with esophageal carcinoma （EC） during radiotherapy （RT）, and to investigate its synergistic effect with RT and its influence on immunological function of the body. Methods： One hundred and seventy patients with EC, who had missed the chance of surgical operational therapy, were assigned to the treated group （90 cases） and the RT group （80 cases）, and at the same time a control group consisting of 80 inpatients without tumors was set up. Patients in the RT group were treated with RT alone but KAI was given additionally to those in the treated group, with 50 ml given once per day via intravenous dripping, 15 days as one course, and 2 courses administered in total. The immediate therapeutic efficacy and changes of serum slL-2R and VEGF levels were observed, and the effect of KAI on patients＇ quality of life （QOF） was evaluated by Karnofsky scoring. Results： In 16 patients of the treated group it was completely remission （OR）, in 54 partially remission （PR）, in 18 it was stabilized disease （SD） and in 2 progressive disease （PD）, with the total effective rate （CR ＋ PR） as 77.8%, while in those of the control group it was 12, 46, 18, 4 and 72.5%, respectively, the immediate therapeutic efficacy in the treated group was somewhat better than that in the RT group, but showed no statistical significance （P〉0.05）. Serum levels of slL-2R and VEGF in all the patients before treatment were higher than those in the control group, which were decreased after treatment in both groups （P〈0.05）, but the improvement in the treated group was better than that in the RT group, showing significant difference （P〈0.05）, and patients＇ QOF improved more significantly in the former as well （62.2 % vs 40.0%, P〈 0.05）. Conclusion： KAI in combination with RT in treating patients with EC could enhance the immunological function of patients, improve their QOF and enhance their sensitivity to RT.

CLINICAL SIGNIFICANCE OF ELEVATED SERUM SOLUBLE INTERLEUKIN-2 RECEPTOR IN GASTRIC CANCER

This is China’s pilot stndy in the assessment of the diagnostic value of serum soluble IL-2 receptor (sIL-2R) in gastric cancer.We measured its level by ELISA method in 45 patients with gastric cancer (without metastasis:32;with metastasis:5;recurrence:8)27 gastric ulcer,

小胶质细胞髓样细胞触发受体2及其可溶形式在肌萎缩侧索硬化症中的研究进展

髓样细胞触发受体2(triggering receptor expressed on myeloid cells 2,TREM2)是一种表达在髓系细胞上的跨膜受体,在中枢神经系统(central nervous system,CNS)内,仅表达在小胶质细胞表面[1],参与小胶质细胞的一系列活动,包括扩增、迁移、存活、激活、吞噬[2~8],具有抑制炎症反应、促进小胶质细胞吞噬病理性蛋白、凋亡神经元[9~14]等作用。

急性冠脉综合征患者血清COMP、sST2及sLRP-1变化及与冠脉病变的相关性分析

目的探讨急性冠脉综合征患者血清软骨寡聚基质蛋白(COMP)、可溶性生长刺激表达基因2(sST2)、可溶性低密度脂蛋白受体相关蛋白1(sLRP-1)变化及与冠状动脉(冠脉)病变的相关性。方法选择2020年1月至2022年1月于青岛市市立医院治疗的120例急性冠脉综合征患者作为病例组,并选择我院同期体检的健康人群100例作为对照组,分析两组COMP、sST2及sLRP-1水平变化及与冠脉病变程度的相关性。结果病例组患者血清COMP、sST2及sLRP-1显著高于对照组,差异有统计学意义(P<0.05);轻度组(Gensini评分<50分)COMP、sST2及sLRP-1显著低于中度组(Gensini评分50~90分)和重度组(Gensini评分>90分),且中度组血清COMP、sST2及sLRP-1显著低于重度组,差异有统计学意义(P<0.05);预后不良组血清COMP、sST2及sLRP-1较预后良好组更高,差异有统计学意义(P<0.05);相关性分析显示,血清COMP、sST2及sLRP-1均与冠脉病变程度之间呈正相关(P<0.05)。结论血清COMP、sST2及sLRP-1在急性冠脉综合征患者中均呈高表达,且与冠脉病变程度关系密切,对于控制病情具有重要意义。

呼吸道念珠菌定植与儿童细菌性VAP及SIL-2R、IL-18、sTREM-1水平的关系

目的 分析呼吸道念珠菌定植与儿童细菌性呼吸机相关性肺炎(VAP)及可溶性白细胞介素-2受体(SIL-2R)、白细胞介素-18(IL-18)、可溶性髓系细胞触发受体-1(sTREM-1)水平的关系。方法 选择保定市竞秀区妇幼保健院2020年6月至2022年6月期间80例VAP患儿作为研究对象,根据有无呼吸道念珠菌定植分为定植组、未定植组,比较两组患儿血清β-葡聚糖水平、肺部感染程度(CPIS)评分,常规实验室指标及血清SIL-2R、IL-18、sTREM-1水平,采用Pearson相关性分析血清β-葡聚糖水平与CPIS评分常规实验室指标及血清SIL-2R、IL-18、sTREM-1的相关性。结果 植组血清β-葡聚糖水平、CPIS评分及血清SIL-2R、IL-18、sTREM-1水平分别为(78.63±7.17)ng/L、(7.01±1.65)分、(476.79±73.42)kU/L、(327.43±50.85)pg/mL、(146.79±31.72)ng/mL,高于未定植组的(61.09±4.22)ng/L、(4.85±1.24)分、(331.06±66.15)k U/L、(262.19±48.27)pg/mL、(102.64±27.68)ng/L,定植组白蛋白水平(25.75±3.28)g/L,低于未定植组的(28.92±2.73),差异有统计学意义(P<0.05);Pearson相关性分析显示,血清β-葡聚糖与CPIS、血肌酐、白细胞计数及血清SIL-2R、IL-18、sTREM-1水平均呈正相关(r=0.630、0.759、0.707、0.748、0.730、0.702,P均<0.05)。结论 呼吸道念珠菌定植可加重儿童细菌性VAP病情,且与血清SIL-2R、IL-18、sTREM-1表达上调有关。

急性脑梗死患者血清CTRP-3、D-二聚体、sTREM2水平及相关临床特征与溶栓后出血性转化的关系

目的 探讨急性脑梗死患者血清补体C1q/肿瘤坏死因子相关蛋白3(CTRP-3)、D-二聚体、可溶性髓样细胞触发受体2(sTREM2)水平及相关临床特征与溶栓后出血性转化(HT)的关系。方法 回顾性分析2018年9月—2022年9月在青海省人民医院接受溶栓治疗的120例急性脑梗死患者的临床资料,根据患者溶栓后是否发生HT分为HT组(30例)、非HT组(90例)。比较两组患者的临床资料及血清CTRP-3、D-二聚体、sTREM2水平。采用多因素逐步Logistic回归分析急性脑梗死患者溶栓后发生HT的危险因素;绘制受试者工作特征(ROC)曲线,分析急性脑梗死患者溶栓后HT预测模型预测HT发生的价值。结果 HT组心房颤动(以下简称房颤)、大面积脑梗死、入院NIHSS评分≥15分占比高于非HT组(P <0.05),血清CTRP-3水平低于非HT组(P <0.05),D-二聚体、sTREM2水平高于非HT组(P <0.05)。血清CTRP-3、D-二聚体、sTREM2水平预测急性脑梗死患者溶栓后发生HT的敏感性分别为66.7%(95%CI:0.598,0.756)、70.0%(95%CI:0.607,0.812)、80.0%(95%CI:0.714,0.889),特异性分别为73.3%(95%CI:0.636,0.821)、86.7%(95%CI:0.778,0.923)、86.7%(95%CI:0.747,0.942)。多因素Logistic逐步回归分析结果显示,房颤[OR=1.237(95%CI:1.103,1.387)]、大面积脑梗死[OR=2.338(95%CI:1.292,4.231)]、入院NIHSS评分≥15分[OR=2.087(95%CI:1.231,3.538)]、CTRP-3≤269.265μg/L [OR=3.006(95%CI:1.508,5.992)]、D-二聚体≥2.625 mg/L [OR=2.649(95%CI:1.374,5.107)]、sTREM2≥314.675 ng/L [OR=2.328(95%CI:1.411,3.841)]是急性脑梗死患者溶栓后发生HT的危险因素(P <0.05)。根据多因素Logistic逐步回归分析结果建立急性脑梗死患者溶栓后HT预测模型,Logit(P)=-33.887+0.213×房颤+0.849×大面积脑梗死+0.736×入院NIHSS评分+1.101×CTRP-3+0.974×D-二聚体+0.845×sTREM2;ROC曲线分析结果表明,预测模型预测HT发生的敏感性为93.3%(95%CI:0.841,0.991),特异性为87.8%(95%CI:0.808,0.976)。结论 血清CTRP-3、D-二聚体、sTREM2水平与急性脑梗死患者溶栓后HT有关,预测价值较高,且急性脑梗死患者溶栓后HT预测模型预测HT优于各项指标单独预测。

Predicting value of serum soluble ST2 and interleukin-33 for risk stratification and prognosis in patients with acute myocardial infarction

Background Acute myocardial infarction （AMI） is a common cardiac emergency with high mortality.Serum soluble ST2 （sST2） is a new emerging biomarker of cardiac diseases.The present study is to investigate the predictive value of sST2 and interleukin-33 （IL-33） for risk stratification and prognosis in patients with AMI.Methods Fifty-nine patients with AMI,whose chief complaint was chest pain or dyspnea,were selected for our study.Physical examination,chest radiograph,electrocardiograph （ECG）,biomarkers of myocardial infarction,NT-proBNP,echocardiography and other relevant examinations were performed to confirm the diagnosis of AMI.Thirty-six healthy people were chosen as the control group.Serum samples from these subjects （patients within 24 hours after acute attack） were collected and the levels of sST2 and IL-33 were assayed by enzyme-linked immuno-sorbent assay （ELISA） kit.The follow-up was performed on the 7th day,28th day,3rd month and 6th month after acute attack.According to the follow-up results we defined the end of observation as recurrence of AMI or any causes of death.Results Median sST2 level of the control group was 9.38ng/ml and that of AMI patients was 29.06ng/ml.Compared with the control group,sST2 expression in the AMI group was significantly different （P〈0.001）.In contrast,the IL-33 level showed no significant difference between the two groups.Serum sST2 was a predictive factor independent of other variables and may provide complementary information to NT-proBNP or GRACE risk score.IL-33 had no relationship to recurrence of AMI.Both sST2 and the IL-33/sST2 ratio were correlated with the 6-month prognosis; areas under the ROC curve were 0.938 and 0.920 respectively.Conclusions Early in the course （〈24 hours） of AMI,sST2 usually increases markedly.The increase of sST2 has an independent predictive value for the prognosis in AMI patients and provides complementary information to NT-proBNP or GRACE risk score.The IL-33/sST2 ratio correlates with the 6-month prognosis of AMI patients.However,there is no significant relationship between IL-33 and the prognosis of AMI patients.