目的:探讨晚期糖基化终末产物受体(receptors for advanced glycation end products,RAGE)、表面活性蛋白D(surfactant protein D,SP-D)、血管生成素2(angiopoietin 2,ANG2)及高迁移率族蛋白B1(high mobility group protein B1,HMGB1)...目的:探讨晚期糖基化终末产物受体(receptors for advanced glycation end products,RAGE)、表面活性蛋白D(surfactant protein D,SP-D)、血管生成素2(angiopoietin 2,ANG2)及高迁移率族蛋白B1(high mobility group protein B1,HMGB1)在社区获得性肺炎(community-acquired pneumonia,CAP)严重程度及预后评估中的价值。方法:连续纳入2022年1月至2023年1月于河南省人民医院呼吸与危重症医学科住院并确诊为CAP的患者,共112例,其中非重症CAP(non-severe community-acquired pneumonia,NSCAP)70例,重症CAP(severe community-acquired pneumonia,SCAP)42例;根据90 d生存情况,分为生存组和死亡组,分别为83例和29例。ELISA法检测血浆RAGE、SP-D、ANG2及HMGB1的浓度,采用二元logistic回归分析评估发展为SCAP及90 d死亡的危险因素,应用受试者工作特征(ROC)曲线分析上述指标单独及联合CURB-65评分预测SCAP、90 d死亡风险的价值。结果:SCAP组RAGE、SP-D、ANG2、HMGB1的浓度中位数(四分位数)分别为2.09(0.90,4.99)ng/ml、3.48(2.22,6.98)ng/ml、3.59(2.50,6.31)ng/ml、47.52(25.99,80.58)ng/ml,均较CAP组[分别为1.21(0.88,2.26)ng/ml、2.45(1.36,3.77)ng/ml、0.90(0.53,1.64)ng/ml、14.09(7.96,25.31)ng/ml]显著升高,差异均有统计学意义(Z=-2.861,P=0.004;Z=-2.951,P=0.003;Z=-7.272,P<0.001;Z=-6.256,P<0.001)。其中,ANG2和HMGB1均是CAP发展为SCAP的独立危险因素(OR=3.889,95%CI:1.775~8.518,P=0.001;OR=1.047,95%CI:1.012~1.082,P=0.008),两者联合预测发展为SCAP取得的AUC值为0.923,敏感度和特异度分别为83.3%和85.7%。死亡组RAGE、SP-D、ANG2、HMGB1浓度中位数(四分位数)分别为2.73(0.82,4.59)ng/ml、3.41(2.49,6.86)ng/ml、4.30(2.98,6.63)ng/ml、64.01(35.32,89.34)ng/ml均明显高于生存组[分别为1.24(0.90,2.37)ng/ml、2.61(1.38,4.32)ng/ml、1.00(0.60,1.98)ng/ml、15.05(9.26,26.44)ng/ml],差异均有统计学意义(Z=-1.989,P=0.047;Z=-2.295,P=0.022;Z=-7.024,P<0.001;Z=-6.446,P<0.001),其中,ANG2、HMGB1、CURB-65评分均是CAP患者90 d死亡的独立危险因素(OR=5.458,95%CI:1.374~21.683,P=0.016;OR=1.089,95%CI:1.030~1.151,P=0.003;OR=2.772,95%CI:1.097~7.003,P=0.031),ANG2、HMGB1联合CURB-65评分可以更准确地预测CAP患者90 d死亡风险,其AUC值为0.970,敏感度和特异度分别为89.7%和92.8%。结论:SCAP组及90 d死亡组RAGE、SP-D、ANG2、HMGB1显著升高,ANG2和HMGB1均是发展为SCAP的独立危险因素,ANG2、HMGB1和CURB-65评分均是CAP患者90 d死亡的独立危险因素,三者联合可提高预测90 d死亡风险的价值。展开更多
Isoflavonoids possess broad activities besides cardiovascular activity.3 phenyl 4(1H)quinolinone derivatives are isosteres of isoflavonoids.They have similar spatial structures.Eight 3 phenyl 4(1H)quinolinone halide d...Isoflavonoids possess broad activities besides cardiovascular activity.3 phenyl 4(1H)quinolinone derivatives are isosteres of isoflavonoids.They have similar spatial structures.Eight 3 phenyl 4(1H)quinolinone halide derivatives were synthesised for studying their biological activities especially cardiovascular activity.Their chemical structures were confirmed by 1 H NMR,MS and IR.The preliminary tests with isolated heart of rabbits indicated that both mixtures,A 1B 1,A 2B 2,had more positive inotropic effect than vesnarinone which appeared on the market in Japanese.The results of the pharmacological tests showed that the two mixtures did not affect the blood pressure and respiration of the dogs.展开更多
文摘Isoflavonoids possess broad activities besides cardiovascular activity.3 phenyl 4(1H)quinolinone derivatives are isosteres of isoflavonoids.They have similar spatial structures.Eight 3 phenyl 4(1H)quinolinone halide derivatives were synthesised for studying their biological activities especially cardiovascular activity.Their chemical structures were confirmed by 1 H NMR,MS and IR.The preliminary tests with isolated heart of rabbits indicated that both mixtures,A 1B 1,A 2B 2,had more positive inotropic effect than vesnarinone which appeared on the market in Japanese.The results of the pharmacological tests showed that the two mixtures did not affect the blood pressure and respiration of the dogs.
