母乳性黄疸婴儿免疫功能研究

目的探讨母乳性黄疸婴儿免疫功能水平的变化。方法母乳性黄疸患儿53例,按血清总胆红素(totalbilirubin,TBIL)水平分为重度组(TBIL≥342μmol/L)12例、中度组(256μmol/L0.05);轻度组IgG,IgA,IgM,C3及C4水平与对照组比较差异无统计学意义(P>0.05);重度组治疗后IgG,IgA,IgM,C3及C4水平均高于治疗前,差异有统计学意义(P<0.05)。结论母乳性黄疸患儿TBIL水平≥342μmol/L时,免疫功能低下,早期干预可短期恢复免疫损伤。     

肝脏疾病患者血清免疫球蛋白与补体检测的临床意义

目的探讨肝脏疾病患者血清免疫球蛋白与补体检测的临床意义。方法利用免疫比浊法分别检测143例肝脏疾病组患者与50例正常对照组血清免疫球蛋白(IgG、IgA、IgM)和补体(C3、C4)水平。结果肝脏疾病组患者血清IgG、IgM水平明显高于正常对照组(P<0.01);肝硬化组患者血清IgA水平明显高于急性肝炎组、慢性肝炎组和正常对照组(P<0.05);急性肝炎、慢性肝炎和正常对照组间血清IgA水平比较差异无统计学意义(P>0.05);肝脏疾病组患者血清C3、C4水平明显低于正常对照组(P<0.01)。结论检测血清免疫球蛋白与补体水平对肝脏疾病的诊断有重要意义。     

老年糖尿病患者免疫状况分析

目的探讨老年糖尿病患者自身免疫状况及其临床意义。方法采用放射免疫分析测定31例50岁以上的老年糖尿病患者(糖尿病组)和29例50岁以上的健康老年人(正常对照组)血清中免疫清蛋白(IgG,IgA,IgM)、补体(C3,C4)及B因子的含量。结果糖尿病组血清中IgG水平较正常对照组显著下降(P<0.01),而IgA水平较正常对照组显著升高(P<0.05),补体C4,B因子水平糖尿病组较正常对照组显著升高(P<0.05),IgM,C3水平两组比较差异无显著性意义。结论老年糖尿病患者免疫球蛋白及补体含量变化可能与糖尿病的发生、发展有关。     

类风湿关节炎患者血清14-3-3η蛋白、免疫球蛋白的变化及其意义

目的探讨类风湿关节炎(RA)患者血清免疫球蛋白、14-3-3η蛋白的变化及其意义。方法选取我院2015年2月—2017年12月收治的RA患者110例(RA组)和年龄、性别相匹配的健康对象40例(对照组),检测两组的血清IgA、IgG、IgM、补体C3、C4、14-3-3η蛋白水平,并根据RA患者是否处于疾病活动期和放射学分级进行分层分析。结果 RA组的血清IgG、14-3-3η蛋白水平显著高于对照组(P0.05),血清IgA、IgM、补体C3、C4蛋白水平与对照组比较差异无统计学意义(P0.05);活动期RA患者血清IgG、14-3-3η蛋白水平显著高于非活动期的RA患者(P0.05),血清IgA、IgM、补体C3、C4水平与非活动期的RA患者比较差异无统计学意义(P0.05);放射学分级3级、4级RA患者血清IgG、补体C3、14-3-3η蛋白水平显著高于非活动期组的2级患者(P0.05),血清IgA、IgM、补体C4水平与放射学分级2级RA患者比较差异无统计学意义(P0.05)。结论 RA患者血清IgG、补体C3 14-3-3η蛋白水平较高,血清14-3-3η蛋白、免疫球蛋白水平变化与RA患者病情、活动情况具有一定的相关性。     

SARS患者和普通肺炎患者体液免疫调查

目的 :调查SARS患者和普通肺炎患者体液免疫的差别。方法 :采用速率散射免疫比浊法检测 5 2例SARS患者 (抗SARS病毒抗体阳性 3 4例 ,阴性 18例 )和 2 6例普通肺炎患者血清免疫球蛋白IgG、IgM、IgA ,补体C3、C4和C反应蛋白 (CRP)的含量。结果 :SARS患者的血清免疫球蛋白IgG、IgM、IgA、补体C3、C4和CRP的含量都高于普通肺炎患者 ,P >0 0 5。抗SARS病毒抗体阳性组的血清免疫球蛋白IgG、IgM含量显著高于普通肺炎患者(P <0 0 1) ;IgA、补体C4和CRP含量也显著高于普通肺炎患者 (P <0 0 5 ) ;C3含量略高于普通肺炎患者 (P >0 0 5 )。抗SARS病毒抗体阴性组血清免疫球蛋白IgG、IgM、IgA、补体C3、C4和CRP含量与普通肺炎患者组差异无显著性。结论 :抗SARS病毒抗体阳性患者组与普通肺炎患者组非特异性体液免疫反应存在显著差别     

老年糖尿病患者免疫状况分析

目的 探讨老年糖尿病患者自身免疫状况及其临床意义。方法 采用放射免疫分析测定31例50岁以上的老年糖尿病患者(糖尿病组)和29例50岁以上的健康老年人(正常对照组)血清中免疫清蛋白(IgG，IgA，IgM)、补体(C3，C4)及B因子的含量。结果糖尿病组血清中IgG水平较正常对照组显著下降(P&;lt;0．01)，而IgA水平较正常对照组显著升高(P&;lt;0．05)，补体C4，B因子水平糖尿病组较正常对照组显著升高(P&;lt;0．05)，IgM，C3水平两组比较差异无显著性意义。结论老年糖尿病患者免疫球蛋白及补体含量变化可能与糖尿病的发生、发展有关。     

血清补体及免疫球蛋白检测在系统性红斑狼疮中的应用

目的探讨血清补体(C3c、C4、CH50)及免疫球蛋白(IgC、IgA、IgM)检测在系统性红斑狼疮(SLE)中的应用价值。方法选取2015年2月～2018年2月在我院治疗的76例系统性红斑狼疮患者设为SLE组,并选择同期我院收治的64例其他免疫性疾病患者设为病例对照组,同期30例健康体检者设为健康对照组。采用速率散射比浊法对所有人员血清中的血清补体及免疫球蛋白水平进行检测,利用受试人员的工作特性曲线(ROC)分析各指标对SLE患者的诊断性能,并对其进行比较和评价。结果 SLE组患者血清中的血清补体(C3c、C4、CH50)水平低于其他两组,差异有统计学意义(P<0.01),各组之间的免疫球蛋白(IgC、IgA、IgM)水平比较,无显著性差异(P>0.05);C3c、C4与CH50在诊断SLE的特异性与灵敏度方面比较,无显著性差异(P>0.05)。结论 SLE组患者的血清补体(C3c、C4、CH50)水平比较低,而免疫球蛋白水平没有明显的特异性变化。尤其血清补体中的C3c、C4、CH50水平对早期筛查和诊断SLE有较高的临床价值,可作为诊断SLE的重要辅助指标。     

血清免疫球蛋白及补体C3、C4水平变化与白癜风患者疾病分期的关联性分析

目的 分析血清免疫球蛋白及补体C3、C4水平变化与白癜风患者疾病分期的关联性。方法 选取我院198例白癜风患者为观察组(2017年4月～2019年3月),按照疾病分期分为进展期者(n=94)与稳定期者(n=104),并选取同期健康体检者82例为健康对照组。均检查2组血清免疫球蛋白[免疫球蛋白G(IgG)、免疫球蛋白M(IgM)及免疫球蛋白A(IgA)]及补体C3、C4水平,并分析其与白癜风疾病分期关联性。结果 观察组血清IgG、IgM、IgA及补体C3、C4水平较健康对照组低(P＜0.05);进展期者血清IgG、IgM、IgA及补体C3、C4水平较稳定期者低(P＜0.05);经Spearman相关性分析,血清IgG、IgM、IgA、补体C3、C4水平与白癜风疾病分期呈正相关(P＜0.05)。结论 血清IgG、IgM、IgA、补体C3、C4水平与白癜风疾病分期呈正相关,故检测白癜风体液免疫指标,可为临床判定病情程度、对症治疗、评估预后效果提供科学合理的理论依据。     

母婴血清胆红素对免疫球蛋白及补体的影响

目的 探讨母婴血清胆红素对免疫球蛋白及补体的影响。方法 同时检测118组临产母亲、脐血、新生儿和42例对照组成人血清免疫球蛋白(IgG、IgA、IgM)、补体(C_3、C_4)和总胆红素(Bil-T)、结合胆红素(Bil-D)含量,并作相关分析。结果 (1)新生儿的血清 Bil-T、Bil-D 含量>脐血>母亲、对照纽。(2)母亲和新生儿的血清 IgG、IgA、IgM、C_3、C_4均不受母亲 Bil-T、Bil-D的影响。(3)新生儿的血清 IgG 和 C_3含量均不受脐血和自身 Bil-T、Bil-D 的影响;IgA、IgM 含量受脐血和自身 Bil-T、Bil-D 的影响,C_4含量仅受自身 Bil-T、Bil-D 的影响。结论 胆红素对免疫反应的影响与胆红素水平的高低有关,临床母亲血中胆红素含量正常,不影响 IgG、IgA、IgM、C_3、C_4的产生;新生儿出生以后,血中胆红素在生理范围内逐渐升高,对 IgA、IgM、C_4的产生可能有促进作用,但不影响 IgG 和 C_3。     

血清糖类抗原199在阻塞性黄疸中升高的分析

目的探讨血清糖类抗原199(CA199)水平升高在不同性质的阻塞性黄疸患者中的应用。方法选取血清CA199水平高于参考值的21例良性阻塞性黄疸患者(良性组)和24例恶性阻塞性黄疸患者(恶性组)为研究对象,动态监测治疗前后患者血清CA199与直接胆红素(DBIL)变化及相关性。结果良性阻塞性黄疸患者与恶性阻塞性黄疸患者中治疗前血清CA199及DBIL水平差异无统计学意义(P0.05),治疗后良性阻塞性黄疸患者血清CA199及DBIL水平明显下降,较治疗前差异有统计学意义(P0.05),而恶性组患者治疗前后血清CA199及DBIL水平比较,差异无统计学意义(P0.05)。结论血清CA199不是肿瘤特异度非常高的标志物,不能作为判断良恶性疾病的唯一标志,动态监测治疗前后血清CA199变化及与DBIL的相关性有助于良恶性肿瘤的鉴别。     

Mechanism of Liver Injury during Obstructive Jaundice: Role of Nitric Oxide, Splenic Cytokines, and Intestinal Flora

To elucidate the roles of enteric bacteria and immunological interactions among liver, spleen and intestine in the pathogenesis of liver injury during obstructive jaundice, we studied the effects of antibiotics and splenectomy on bile-duct-ligated C57BL mice. When animals were subjected to bile-duct-ligation (BDL), plasma levels of bilirubin, alanine aminotransferase and aspartate aminotransferase increased markedly. However, the increases in plasma transaminases were significantly lower in splenectomized or antibiotics-treated groups than in the control BDL group. Histological examination revealed that liver injury was also low in the two groups. BDL markedly increased plasma level of interferon-gamma (IFN-gamma) and the expression of inducible nitric oxide synthase (iNOS) in liver and spleen. These changes were suppressed either by splenectomy or administration of antibiotics. Kinetic analysis revealed that BDL-induced liver injury and the increase of interleukin-10 (IL-10) and INF-gamma were lower in iNOS(-/-) than in wild type animals. BDL markedly increased the expression of IgA in colonic mucosa. These observations suggest that enteric bacteria, nitric oxide and cytokines including IFN-gamma and IL-10 derived from spleen and intestines form a critical network that determines the extent of liver injury during obstructive jaundice.     

类风湿关节炎患者血清DKK-1，CCL21水平与体液免疫指标的相关性研究

目的　探讨类风湿关节炎（ rheumatoid arthritis ,RA）患者血清 Dickkopf-1（DKK-1）,趋化因子（ chemokine, CCL）21水平与体液免疫指标的相关性。方法　选择 2018年 3月～ 2020年 6月邯郸市中心医院免疫科收治的 120例 RA患者（ RA组）和 117例体检志愿者（对照组）,根据 28个关节疾病活动度（ disease activity score 28,DAS28）评分将 RA组分为低度组（ 2.6～ 3.2分,38例）、中度组（ 3.3～ 5.1分,50例）和重度组（＞ 5.1分,32例）。检测血清 DKK-1,CCL21,免疫球蛋白 A（immunoglobulin A, IgA）、免疫球蛋白 G（IgG）、免疫球蛋白 M（IgM）、免疫球蛋白 E（IgE）、补体 C3和补体 C4水平。分析 DKK-1,CCL21与 IgG,IgA,IgM,IgE,补体 C3,补体 C4之间相关性。结果　RA组血清 DKK-1（72.14±15.26 pg/ml）,CCL21（285.16±32.16 pg/ml）,IgG（16.35±4.56 g/L）,IgA（3.65±0.52 g/L）和 IgM（1.95±0.42 g/L）水平高于对照组（ 43.26±7.46 pg/ml,170.06±20.41pg/ml,10.35±1.65g/L,2.02±0.24g/ L,1.42±0.39g/L）,差异均有统计学意义（ t=10.061～ 32.803,均 P＜ 0.05）,补体 C3（1.05±0.16 g/L）和补体 C4（0.15±0.07 g/L）水平低于对照组（ 1.39±0.25g/L,0.36±0.11g/L）,差异均有统计学意义（ t=12.502,17.579,均 P＜ 0.05）。重度组血清 DKK-19（83.26±3.09 pg/ml）,CCL21（310.06±6.45 pg/ml）,IgG(19.84±0.68 g/L）,IgA（4.14±0.03 g/ L）和 IgM（2.28±0.06 g/L）水平高于中度组（ 74.90±6.59 pg/ml,289.75±12.54 pg/ml,17.40±2.11 g/L,3.71±0.26 g/ L,2.03±0.16 g/L）和轻度组（59.15±2.34 pg/ml, 258.15±4.06 pg/ml, 12.03±0.21 g/L, 3.16±0.02 g/L, 1.57±0.03 g/L）,差异均有统计学意义（ t=6.322～ 162.999, 均 P＜ 0.05）;补体 C3和补体 C4水平低于中度组 (1.18±0.02 g/L vs 1.07±0.05 g/L,0.20±0.01 g/L vs 0.16±0.04 g/L)和轻度组 (0.91±0.02 g/L,0.09±0.01 g/L), 差异均有统计学意义（t= 5.536～ 45.847,均 P＜ 0.05）。中度组血清 DKK-1,CCL21,IgG,IgA和 IgM水平高于轻度组（ t=12.993～ 17.468,均 P＜ 0.05）;补体 C3和补体 C4水平低于轻度组（ t=18.607,10.527,均 P＜ 0.05）,差异均有统计学意义。 RA患者血清 DKK-1和 CCL21水平与 IgG,IgA和 IgM呈正相关（ r=0.742～ 0.805,均 P＜ 0.05）,与补体 C3和补体 C4水平呈负相关（ r= -0.736～ -0.744,均 P＜ 0.05）,各组之间的 IgE差异均无统计学意义 (F=0.869,P＞ 0.05),DKK-1和 CCL21与 IgE也无相关性 (r=0.168,0.203,均 P＞ 0.05)。结论　RA患者血清 DKK-1和 CCL21水平升高与 RA疾病活动程度以及 IgG,IgA和 IgM增高与补体 C3和 C4消耗有关。     

Immunoglobulins and complement in migraine

In 54 patients with migraine and 70 persons comprising the control group, the total complement level (CH50) was evaluated together with its C3 and C4 fraction level and the level of IgG, IgA and IgM immunoglobulins. It was found that the average C3 fraction level was significantly decreased, while the C4 fraction level and total complement activity remained in the normal range. The immunoglobulin level did not show any statistically significant alterations except for the IgA level, which was lowered in migraine patients. On this basis, i.e. lowering of the C3 fraction level with normal C4 fraction level and total complement activity and lack of elevation of IgA, it is felt that the alternative pathway of complement system may be activated in migraine.     

创伤患者血清免疫球蛋白、补体和C-反应蛋白的变化

目的：探讨创伤患者免疫功能的变化及临床意义。方法：３０例创伤术后患者分为创伤组及创伤并发症组,分别在术后第１,７及１４日测定外周血清免疫球蛋白ＩｇＧ,ＩｇＡ,ＩｇＭ,补体Ｃ３,Ｃ４及Ｃ－反应蛋白（ＣＲＰ）,并与正常对照组进行对比分析。结果：创伤组及创伤并发症组的免疫球蛋白,补体均在术后第１日明显降低,而ＣＲＰ明显升高。     

Complement and immunoglobulin levels in serum and ascitic fluid of patients with spontaneous bacterial peritonitis,malignant ascites,and tuberculous peritonitis

BACKGROUND: We determined complement and immunoglobulin levels in ascitic fluid and serum of 47 patients with spontaneous bacterial peritonitis, malignant ascites, or tuberculous ascites. METHODS: Paracentesis was done to confirm the underlying cause of ascites. Biochemical, hematologic, and microbiologic investigations were also done. RESULTS: The highest serum and ascitic fluid C3 and C4 levels and ascitic fluid IgM, IgA, and IgG levels were found in patients with tuberculosis. Ascitic fluid C3 level was found to be higher in the tuberculous group than in the patients with spontaneous bacterial peritonitis or malignant ascites. Ascitic fluid C4 levels were higher in patients with tuberculosis than in those with spontaneous bacterial peritonitis. CONCLUSION: We believe that further studies of the in vivo kinetics of immunoglobulins and complement in ascitic fluid of various causes are necessary for a better understanding of the host defense mechanisms of these fluids.     

血清免疫球蛋白及补体C3、C4水平与高血压性脑出血患者预后的关系

目的 探究高血压性脑出血(HICH)患者血清免疫球蛋白、补体C3、补体C4的变化及预后的关系。方法 选取我院收治的150例HICH患者作为研究对象,根据发病1个月后改良Rankin量表评分(mRS)划分为预后良好组和预后不良组,另择同期体检正常的健康人作为对照组;收集格拉斯哥昏迷量表(GCS)评分、神经缺损程度的量表(NIHSS)评分及血肿量,采用免疫透射比浊法测定IgG、IgA、IgM及补体C3、C4。 结果 预后不良组第1 d GCS评分低于预后良好组(P<0.05),NIHSS评分、血肿量及WBC高于预后良好组(P<0.05)。预后不良组、预后良好组及对照组第1 d体液免疫IgG、IgM及补体C3、C4水平比较差异有统计学意义(P<0.05),预后不良组、预后良好组IgG、IgM及补体C3、C4水平均低于对照组(P<0.05),预后不良组IgG、IgA、IgM及补体C3、C4水平均低于预后良好组(P<0.05)。2组患者均第3 d血清IgG、IgM水平下降至最低;组间、同时点比较,预后不良组第1 d、3 d血清IgG、IgM、C3、C4均低于预后良好组(P<0.05),预后不良组第11 d血清补体C3、C4均高于预后良好组(P<0.05)。2组IgG、C3、C4的组间、不同时点及组间和不同时点的交互作用均有统计学意义(P<0.05),不同时间、组别的IgM比较差异有统计学意义(P<0.05)。IgG、IgM、C3、C4水平与GCS评分均呈正相关(P<0.05);IgG、IgM、C3、C4水平与NIHSS评分、血肿量及WBC呈负相关(P<0.05)。结论 HICH患者体内存在体液免疫抑制,血清免疫球蛋白及补体C3、C4水平均低于正常人水平,且HICH不良预后患者体液免疫抑制或激活程度高于预后良好患者。     

Immunologic studies in pneumococcal disease.

Many patients die from pneumococcal disease despite the availability of effective antimicrobial agents. Immunologic studies including detection, typing, and quantitation of serum pneumococcal capsular polysaccharide (PCP) antigen by counterimmunoelectrophoresis (CIE), quantitation of PCP antibody by radioimmunoassay (RIA), and quantitation of serum complement components C3, C4, and C3PA and serum immunoglobulins IgG, IgM, and IgA by the radial immunodiffusion technique of Mancini were performed with the sera of 18 patients. Five patients died (group I), and 13 survived (group II) pneumococcal infection. Both groups were comparable in age, underlying disease, and leukopenia on admission. All patients of group I and 10 of 13 (77%) of group II patients were bacteremic. Two patients in each group had an extrapulmonary focus infection. PCP antigen was detected in the sera of all group I and nine of 13 group II patients. PCP antigen levels were larger than or equal to 15 microng/ml in four of five group I and two of 13 group II patients (p = 0.022). Levels of antibody to PCP exceeded 100 ng/ml of antibody nitrogen (AbN) in 10 of 12 group II and one of five group I patients (p = 0.027) during the course of illness. All group I patients and three of 12 group II patients had decreased levels of one or more complement components on admission (p less than 0.01). One or more complement components remained decreased until death in four group I patients but returned to normal or elevated levels in all group II patients. No difference in serum immunoglobulin concentrations were found.     

Evidence suggesting the occurrence of C3-independent intravascular immune hemolysis. Reactive hemolysis in vivo

The authors present circumstantial evidence for the involvement of reactive hemolysis, i.e., C3-independent binding of the cytolytic C5b-9 complement complex to bystander red cells (RBC), in a case of intravascular immune hemolysis. Fresh serum obtained from a 6-year-old patient during the hemolytic episode, but not obtained thereafter, induced C5b-9-dependent hemolysis of human RBCs but the indirect C3 antiglobulin test remained negative. Particles (presumably RBC ghosts) isolated from the patient's plasma anticoagulated with EDTA at the peak of hemolysis were coated with C5b-9 complexes, whereas the direct antiglobulin test was strongly positive for IgA, only weakly positive for IgG, and negative for C3. Moreover, neither the autoantibodies isolated by elution (IgG plus IgA), nor free serum autoantibodies (IgA alone) activated complement in vitro. Additionally, serum samples collected later during the 12-month period of observation contained normal levels of C3, C4, C8, and C9, but markedly reduced levels of C7. These serums all produced strong reactive lysis in agarose plates, but not in test tubes. These results appear compatible with the working hypothesis that the intravascular hemolytic episode in this patient might have arisen through a local initiation of complement activation with subsequent C3-independent binding of C5b-9 to and hemolysis of bystander RBCs.     

急性心肌梗死合并多器官功能障碍综合征患者血清免疫球蛋白、补体和C-反应蛋白的变化

目的:探讨急性心肌梗死(AMI)合并多器官功能障碍综合征(MODS)患者免疫功能的变化及临床意义。方法:81例AMI患者分为AMI(A)组及AMI合并MODS(B)组,分别在病后第1、7及14 d测定免疫球蛋白IgG、IgA、IgM,补体C3、C4及C-反应蛋白(CRP),并与正常对照组进行对比分析。再根据溶栓情况将81例AMI患者分为常规治疗组、溶栓未通组、溶栓再通组,溶栓后2 h再测定上述指标。结果:两组免疫球蛋白、补体均在病后第1 d明显降低,而CRP明显升高(P<0.05)。A组在病后第7 d免疫球蛋白、补体及CRP均基本恢复正常(P>0.05);而B组在病后第7 d IgG、IgA仍明显低于正常,而CRP更为升高(P<0.01),A组在病后第14 d免疫球蛋白及补体均明显高于正常(P<0.01),而B组免疫球蛋白稍高于正常;CRP下降至接近正常。溶栓再通组免疫球蛋白、补体均明显高于溶栓未通组和常规治疗组:溶栓再通组CRP明显低于溶栓未通组和常规治疗组。结论:AMI后早期免疫功能处于抑制状态,动态观察免疫球蛋白、补体及CRP在血清中的变化可作为AMI患者病情观察的客观指标。     

抗核抗体荧光模式及滴度与免疫球蛋白及补体的关系分析

目的探讨抗核抗体荧光模式及滴度与免疫球蛋白及补体的关系。方法采用透射比浊法对768例抗核抗体阳性患者血清进行免疫球蛋白及补体检测,另选取200名健康体检者作为对照组。根据抗核抗体荧光模式及滴度进行分组,分别研究各组免疫球蛋白及补体水平。结果①抗核抗体滴度≥1∶100时,血清IgG、IgA明显升高(P<0.01),但升高的幅度与抗核抗体滴度无明显相关;IgM和C3、C4只有在抗核抗体滴度≥1∶1 000时才分别显著升高和下降(P<0.01)。②各种单荧光模式型患者血清IgG、IgA、IgM、C3、C4浓度无显著差异;与各单荧光模式患者比较,二联及二联以上荧光模式型患者血清IgG、IgA、IgM显著升高、补体C3、C4水平显著下降(P<0.01)。结论抗核抗体、免疫球蛋白及补体虽然与自身免疫性疾病高度相关,但并不与病情成平行关系,三项联合检测才能对疾病的诊断与病情发展作出正确判断。