目的 探讨急性脑梗死(Acute cerebral infarct,ACI)患者静脉溶栓前后核苷酸结合寡聚化结构域样受体蛋白3(Nucleotide-binding oligomerization domain-like receptor protein 3,NLRP3)炎性小体信号通路因子变化,分析NLRP3炎性小体信号...目的 探讨急性脑梗死(Acute cerebral infarct,ACI)患者静脉溶栓前后核苷酸结合寡聚化结构域样受体蛋白3(Nucleotide-binding oligomerization domain-like receptor protein 3,NLRP3)炎性小体信号通路因子变化,分析NLRP3炎性小体信号通路因子与功能结局的关系。方法 选取2022年6月-2023年6月北京市大兴区人民医院收治的180例进行溶栓治疗的ACI患者,检测患者溶栓前后NLRP3炎性小体信号通路因子[NLRP3、半胱氨酰天冬氨酸特异性蛋白酶1(Caspase-1)]水平。根据日常生活能力量表(Activity of daily living scale,ADL)评分将ACI患者分为功能结局良好组(ADL评分>60分)及功能结局不良组(ADL评分≤60分)。收集两组患者一般资料,分析两组ACI患者溶栓前后外周血NLRP3和Caspase-1水平。Logistic回归模型分析ACI功能结局的影响因素,根据受试者工作特征(Receiver operating characteristic curve,ROC)曲线分析NLRP3炎性小体信号通路因子对ACI功能结局的预测价值。结果 与溶栓前比较,溶栓1周后,ACI患者外周血NLRP3[(1.81±0.35)vs(1.26±0.22)]及Caspase-1[(1.89±0.31)vs(1.33±0.19)] mRNA水平均降低(P<0.05);180例ACI患者中45例功能结局不良,功能结局不良发生率为25%(45/180);功能结局不良组溶栓前及溶栓1周后的NLRP3及Caspase-1水平均高于功能结局良好组(P<0.05);功能结局不良组美国国立卫生院卒中量表(National institute of health stroke scale,NIHSS)评分、空腹血糖(Fasting blood glucose,FBG)水平均高于功能结局良好组(P<0.05);多因素Logistic回归分析结果显示,NIHSS评分高、溶栓1周后的NLRP3及Caspase-1 mRNA高水平是影响ACI功能结局的独立危险因素(P<0.05);ROC分析结果显示:溶栓1周后NLRP3、Caspase-1mRNA单独及联合预测ACI功能结局的曲线下面积(Area under curve,AUC)分别为0.738(95%CI:0.667~0.800)、0.684(95%CI:0.684~0.815)、0.893(95%CI:0.838~0.934),溶栓1周后NLRP3、Caspase-1 mRNA联合的预测效能高于单独检测(Z=3.093、2.634,P均<0.05)。结论 ACI患者溶栓后外周血NLRP3、Caspase-1mRNA水平降低,外周血NLRP3、Caspase-1mRNA联合检测用于预测ACI功能结局具有较高的参考价值。展开更多
AIM:To evaluate the safety of adding ketoprofen to pegylated-interferon(PEG-IFN)with or without ribavirin and the effect on viral kinetics,STAT1 activity and expression of 2'-5'-oligoadenylate synthetase (2...AIM:To evaluate the safety of adding ketoprofen to pegylated-interferon(PEG-IFN)with or without ribavirin and the effect on viral kinetics,STAT1 activity and expression of 2'-5'-oligoadenylate synthetase (2'-5'OAS)in genotype 1 chronic hepatitis C in a phaseⅡstudy. METHODS:Forty-five patients were studied:fifteen were randomized to PEG-IFN plus ribavirin(PR),16 to PEGIFN plus ketoprofen and 14 to PR and ketoprofen.Themolecular study of IFN-dependent signal transduction was conducted in 9 patients from each group. RESULTS:The combination of ketoprofen and PEG- IFN with or without ribavirin was safe and well tolerated.An early activation of STAT1 was observed in ke-toprofen-treated patients,but this activation was less sustained over time.Conversely,ketoprofen plus PEG- IFN and ribavirin induced an early and sustained increase of 2'-5'OAS transcription starting 24 h after the first dose until the 36th wk.These data are consistent with the clinical results,showing a better sustained virological response and a lower relapse rate in patients receiving ketoprofen plus PEG-IFN and ribavirin. CONCLUSION:The addition of ketoprofen to the standard therapy of chronic hepatitis C should be explored in larger randomized clinical studies.展开更多
文摘目的 探讨急性脑梗死(Acute cerebral infarct,ACI)患者静脉溶栓前后核苷酸结合寡聚化结构域样受体蛋白3(Nucleotide-binding oligomerization domain-like receptor protein 3,NLRP3)炎性小体信号通路因子变化,分析NLRP3炎性小体信号通路因子与功能结局的关系。方法 选取2022年6月-2023年6月北京市大兴区人民医院收治的180例进行溶栓治疗的ACI患者,检测患者溶栓前后NLRP3炎性小体信号通路因子[NLRP3、半胱氨酰天冬氨酸特异性蛋白酶1(Caspase-1)]水平。根据日常生活能力量表(Activity of daily living scale,ADL)评分将ACI患者分为功能结局良好组(ADL评分>60分)及功能结局不良组(ADL评分≤60分)。收集两组患者一般资料,分析两组ACI患者溶栓前后外周血NLRP3和Caspase-1水平。Logistic回归模型分析ACI功能结局的影响因素,根据受试者工作特征(Receiver operating characteristic curve,ROC)曲线分析NLRP3炎性小体信号通路因子对ACI功能结局的预测价值。结果 与溶栓前比较,溶栓1周后,ACI患者外周血NLRP3[(1.81±0.35)vs(1.26±0.22)]及Caspase-1[(1.89±0.31)vs(1.33±0.19)] mRNA水平均降低(P<0.05);180例ACI患者中45例功能结局不良,功能结局不良发生率为25%(45/180);功能结局不良组溶栓前及溶栓1周后的NLRP3及Caspase-1水平均高于功能结局良好组(P<0.05);功能结局不良组美国国立卫生院卒中量表(National institute of health stroke scale,NIHSS)评分、空腹血糖(Fasting blood glucose,FBG)水平均高于功能结局良好组(P<0.05);多因素Logistic回归分析结果显示,NIHSS评分高、溶栓1周后的NLRP3及Caspase-1 mRNA高水平是影响ACI功能结局的独立危险因素(P<0.05);ROC分析结果显示:溶栓1周后NLRP3、Caspase-1mRNA单独及联合预测ACI功能结局的曲线下面积(Area under curve,AUC)分别为0.738(95%CI:0.667~0.800)、0.684(95%CI:0.684~0.815)、0.893(95%CI:0.838~0.934),溶栓1周后NLRP3、Caspase-1 mRNA联合的预测效能高于单独检测(Z=3.093、2.634,P均<0.05)。结论 ACI患者溶栓后外周血NLRP3、Caspase-1mRNA水平降低,外周血NLRP3、Caspase-1mRNA联合检测用于预测ACI功能结局具有较高的参考价值。
文摘AIM:To evaluate the safety of adding ketoprofen to pegylated-interferon(PEG-IFN)with or without ribavirin and the effect on viral kinetics,STAT1 activity and expression of 2'-5'-oligoadenylate synthetase (2'-5'OAS)in genotype 1 chronic hepatitis C in a phaseⅡstudy. METHODS:Forty-five patients were studied:fifteen were randomized to PEG-IFN plus ribavirin(PR),16 to PEGIFN plus ketoprofen and 14 to PR and ketoprofen.Themolecular study of IFN-dependent signal transduction was conducted in 9 patients from each group. RESULTS:The combination of ketoprofen and PEG- IFN with or without ribavirin was safe and well tolerated.An early activation of STAT1 was observed in ke-toprofen-treated patients,but this activation was less sustained over time.Conversely,ketoprofen plus PEG- IFN and ribavirin induced an early and sustained increase of 2'-5'OAS transcription starting 24 h after the first dose until the 36th wk.These data are consistent with the clinical results,showing a better sustained virological response and a lower relapse rate in patients receiving ketoprofen plus PEG-IFN and ribavirin. CONCLUSION:The addition of ketoprofen to the standard therapy of chronic hepatitis C should be explored in larger randomized clinical studies.
