应用抗DNA酶B诊断风湿热的临床评价

目的 观察测定风湿热[RF]患者的血清DNA酶抗体滴度帮助诊断风湿热.方法 应用抗DNA酶B微量测定法分别测定急性风湿热[ARF]组和复发风湿热[rRF]组.与风心病[RHD]对照组和正常对照组的血清抗DNA酶B[ADNaseB]和抗链球菌溶血素O[ASO]进行对照研究.结果 ARF组ADNaseB阳性率为68.5%与ASO阳性率65.6%无可比性(P＞0.05);rAF组ADNaseB阳性率为85.7%与ASO阳性率47.6%有显著性差异(P＜0.05);ADNaseB和ASO联合测定在ARF组和rRF组阳性率阳性率均达90%,大大高于对照组.结论 抗DNA酶B在风湿热诊断中有重要价值,对复发风湿热优于ASO.     

联合检测DNA-酶B和ASO对临床诊断链球菌感染的意义

目的探讨联合检测DNA-酶B和ASO对临床诊断链球菌感染的意义。方法选取临床疑有链球菌感染的住院及门诊病人患者93例,空腹抽静脉血,采用联合检测DNA-酶B和ASO,观察检测结果。结果 93例疑似风湿热病人患者中24例ASO升高,69例阴性,阳性率26%,DNA酶B阳性41例,阴性51例,阳性率44%,明显高于ASO的阳性率。结论联合检测血清中的ASO和DNA酶B可使链球菌感染的阳性率提高,大大减少因为方法学造成的假阴性结果。     

多发性抽动症患儿血清抗DNA酶B抗体、抗链球菌溶血素O和C反应蛋白的测定及其临床意义

目的探讨A族溶血链球菌（GAS）感染和多发性抽动症（TS）的关系。方法采用抗DNA酶B微量法及免疫比浊法分别测定39例TS患儿和40例非感染性疾病患儿抗DNA酶B抗体、抗链球菌溶血素O（ASO）和C反应蛋白（CRP）以确定链球菌感染。结果 TS患儿抗DNA酶B抗体的阳性率（51%,22/39）高于非感染性疾病对照组（30%,11/40）（P〈0.05）;ASO阳性率（41%,16/39）高于对照组（20%,8/40）（P〈0.05）;CRP的阳性率（31%,12/39）也高于对照组（3%,1/40）（P〈0.01）。结论 GAS感染可能和TS有关。     

抗DNA酶B和ASO联合检测对急性肾小球肾炎诊断的临床价值

目的:探讨抗DNA酶B和ASO联合检测对A组溶血性链球菌(GSA)感染所致的急性肾小球肾炎(AGN)诊断的临床价值。方法:用微量中和法和散射速率法分别测定68例AGN病例的抗DNA酶B和ASO。结果:AGN组抗DNA酶B和ASO的阳性分别为77.9％和69.1％,二者联合检测的阳性率可提高至86.8％,AGN亚组中,抗DNA酶B和ASO的阳性率上感组为73.5％和69.4％,二者联合为83.7％,皮损组为89.5％和52.6％,二者联合为94.7％。结论:抗DNA酶B和ASO联合检测可提高GAS感染所致的AGN的病原学诊断阳性率,具有重要的临床价值。     

A组溶血性链球菌抗DNA酶B抗体检测的临床应用价值探讨

应用微量法检测抗DNA酶B ,以探索其在A组溶血性链球菌感染所致疾病中的临床应用价值 ,同时用乳胶凝集法检测抗链球菌溶血素O (ASO)。结果显示 :风心组、急性肾小球肾炎组抗DNA酶B阳性率分别为 86 .5 %和 90 .7% ,显著高于ASO阳性率 5 1.9%、5 5 .8% (P <0 .0 5 )。而两者联合检测阳性率在 90 %以上。风湿热组、咽炎扁桃体炎组抗DNA酶B阳性率分别为 73 .5 %和 2 8.8% ,虽和ASO (6 7.6 % ,38.5 % )差异无显著性 (P >0 .0 5 ) ,但两者联合检测阳性率可达88.2 %和 5 7.7%。提示抗DNA酶B对急性肾小球肾炎、风湿热、风心病的诊断有重要的临床价值。ASO联合抗DNA酶B检测可提高A组溶血性链球菌的检出率 ,两者有重要的互补作用     

抗DNA酶B与ASO联合测定对小儿链球菌感染的诊断价值

目的:探讨抗DNA酶B与抗链球菌溶血素"O"(ASO)联合测定对小儿链球菌感染的诊断价值.方法:分别测定126例小儿链球菌感染患者(分成4组)和50例健康人群抗DNA酶B和ASO水平,计算各组别的阳性率,并进行分析.结果:急性不典型风湿热组、肾炎上感组、急性咽炎组等组别,抗DNA酶B与ASO联合测定阳性率差异无显著性(P>0.05).而肾炎皮损组、肾炎恢复期组差异有极显著性(P<0.01).结论:抗DNA酶B与ASO联合检测可以提高小儿链球菌感染的检出率.     

过敏性紫癜与链球菌感染关系探讨

目的：探讨过敏性紫癜与链球菌感染的关系。　方法：对2006年1月至2007年12月本科收治的42例过敏性紫癜患儿（观察组）和40例体检儿童（对照组）进行血抗溶血素Ｏ检测。　　结果：观察组中血ASO检测阳性22例，占52.4%；正常对照组儿童40例，血ASO检测阳性2例，占5%，二者对比差异有显著意义（χ2=22.22, p<0.01）；腹型紫癜患儿23例，血ASO检测阳性17例，占73.9%；非腹型紫癜患儿19例，血ASO检测阳性5例，占26.3%，二者对比差异有显著意义（χ2=9.45, p<0.01）；反复发作的紫癜患儿14例，血ASO检测阳性12例，占85.7%；无反复发作的紫癜患儿28例，血ASO检测阳性10例，占35.7%，二者对比差异有显著意义（χ2=9.35, p<0.01）。　　结论： （１）小儿过敏性紫癜与链球菌感染关系是密切的。（2）腹型紫癜以及紫癜的复发和链球菌感染有关。     

ASO联合抗DNA酶B检测在风湿热风心病上的应用

对 38例急性风湿热 (ARF)和 5 6例活动期风湿性心脏病 (风心病 )人体血清中脱氧核糖酸酶B(DNA酶B)的抗体及抗链球菌溶血素“O”(ASO)测定 ,结果显示 :ARF抗DNA酶B阳性率 73 .7%与ASO阳性率 76 .5 %比较 ,差异无显著性(P >0 .0 5 ) ,但风心病抗DNA酶B阳性率 85 .7%与ASO阳性率 5 1.8%比较 ,差异有显著性 (P <0 .0 5 ) ,ASO联合抗DNA酶B检测ARF为 89.5 % ,风心病为 92 .8% ,认为提高A族溶血性链球菌的检出率 ,ASO联合抗DNA酶B检测有必要性。     

过敏性紫癜与链球菌感染的关系分析

目的探讨过敏性紫癜(HSP)与链球菌感染的关系。方法选取2014年6月至2015年12月贵州省人民医院儿科收治的78例HSP患儿作为观察组,另选取56例门诊体检正常儿童作为对照组。对两组患儿进行抗链球菌溶血素O(ASO)检测。结果观察组78例中29例(37.18%)ASO阳性,对照组56例中7例(12.50%)ASO阳性;观察组ASO阳性率高于对照组,差异有统计学意义(χ2=10.11,P<0.05)。29例ASO阳性HSP患儿中,16例给予敏感抗生素抗感染治疗,1个月内复发5例(31.25%);13例未予抗生素抗感染治疗,1个月内复发9例(69.23%)。抗感染治疗者HSP复发率较非抗感染治疗者低,差异有统计学意义(χ2=4.14,P<0.05)。结论链球菌感染是儿童过敏性紫癜的诱发因素之一,抗链球菌感染治疗可减少过敏性紫癜复发。     

链球菌感染与儿童过敏性紫癜肾损害关系的临床研究

[摘要] 目的 探讨小儿溶血链球菌感染与过敏性紫癜、紫癜性肾炎发生的关系。方法 对118例过敏性紫癜患儿（HSP组,其中57例紫癜性肾炎患儿设为HSPN组）和30例体检正常的儿童（对照组）进行咽部分泌物A组β型溶血链球菌抗原和血抗溶血素O（ASO）检测,同时对HSPN组患儿进行临床相关检查和统计学分析。结果 HSP组和HSPN组溶血链球菌抗原和ASO阳性率分别与对照组比较,HSPN组与HSP组比较,差异均有显著性（P <0.05）;HSPN组临床检查发现,感染链球菌HSPN组（S-HSPN组）患儿尿蛋白定量（g/24 h）、血BUN（mmol/L）、Scr（umol/L）、C3（g/L）和IgG（g/L）的平均水平与未感染链球菌HSPN组(NS-HSPN组) 对比,差异有显著性（P <0.05）。结论 A组β溶血链球菌感染可能是诱发儿童过敏性紫癜并导致紫癜性肾炎的重要因素之一,链球菌感染的监测对该病临床诊断和判断预后有重要的参考价值。     

Is there any relationship between streptococcal infection and multiple sclerosis?

BACKGROUND: Multiple sclerosis (MS) is an immune-mediated inflammatory demyelinating disease of uncertain etiology. Although the mechanisms of inducting autoimmunity by some of the infectious agents have been investigated, there is not yet enough research on streptococcal infections. MATERIAL/METHODS: To understand the effect of past group A streptococcal infection on MS, antistreptolysin O (ASO) and antideoxyribonuclease B (ADNase B) were measured in 21 patients with relapsing-remitting MS and 21 healthy blood donors by nephelometric assay. RESULTS: ADNase B levels in the patients with MS were found to be significantly higher than in the controls (p<0.001); however, ASO levels were similar in both groups. CONCLUSIONS: These findings indicate that a relationship between multiple sclerosis and streptococcal infections may exist, but to acquire a better understanding of the role of group A streptococci in the pathogenesis of multiple sclerosis, more studies with animal models are necessary.     

链球菌感染及家庭因素与小儿抽动障碍的关系

目的 探讨小儿抽动障碍与链球菌感染、家庭因素的关系.方法 选取小儿抽动障碍患儿共60例为观察组、100例健康儿童作为对照组.检测并比较两组链球菌感染情况、血清抗DNA酶B和肿瘤坏死因子-α(TNF-α)水平,同时对两组进行相关家庭因素的问卷调查;采用logistic回归模型分析影响小儿抽动障碍发生的危险因素.结果 观察组链球菌感染率为41.67%,高于对照组的18.00%(P<0.05).观察组抗DNA酶B滴度、TNF-α水平均高于对照组(P<0.05).对照组存在打骂体罚、孕期营养不良、任性发脾气、注意力分散、压力大、近期有感染症状者的比例高于观察组(P<0.05).Logistic回归分析结果显示打骂体罚、孕期营养不良、高抗DNA酶B滴度、压力大和任性发脾气是小儿抽动障碍的独立危险因素(P<0.05).结论 抽动障碍与链球菌感染相关,而父母打骂、母亲孕期营养不良以及家庭环境和个性也是小儿抽动障碍发生的危险因素,在临床上应该高度重视.     

急性肾小球肾炎非典型表现81例分析

目的：探讨急性链球菌感染后肾小球肾炎（APSGN）的非典型表现。方法：通过对81例APSGN非典型病例进行分析。结果：大量蛋白尿型44例（54．3％）,肾外症状型23例（28．4％）,亚临床型7例（8．7％）,急进。肾炎型3例（3．7％）,尿路感染型4例（4．9％）。误诊为肾炎型肾病17例,误诊为急性中毒、颅内出血、颅内感染、重症心肌炎共8例,误诊率30．9％;漏诊7例,漏诊率8．8％。结论：APSGN非典型病例有多种表现形式,且有增多趋势,容易误诊和漏诊。     

急性肾炎血清游离唾液酸含量变化及其意义

为了探讨致肾炎株链球菌分泌的神经氨酸酶(NM)在急性链球菌感染后肾炎(APSGN)发病中的作用,采用硫代巴比妥酸法对81例APSGN患儿血中NM的水解产物——血清游离唾液酸(FSA)含量进行了测定。结果APSGN患儿血清FSA急性期明显高于恢复期和正常对照组。进一步分析发现血清FSA值的变化与病情和病程密切相关,提示NM在APSGN发病中可能起重要作用。     

急性肾小球肾炎肾病型26例临床分析

目的: 分析和评价急性链球菌感染后肾小球肾炎肾病型的临床特征及预后。方法: 对我院1993~2001年住院患者中符合标准者进行观察和门诊随访的资料进行分析。结果: 水肿5~35天消失,蛋白尿2周~3个月消失,血压7~28天恢复正常,血尿8天~19个月消失。所有患儿均治愈,无死亡病例。结论: 急性链球菌感染后肾小球肾炎肾病型的临床表现较重,肉眼血尿和蛋白尿持续时间较长。经长期随访观察,绝大多数预后良好。     

Acute polyarthritis associated with active Epstein-Barr virus infection

Nine patients with an initial onset of symptoms of acute arthritis within the preceding four weeks were enrolled in a prospective serological study with clinical follow-up for six months to two years. Four adults with chronic rheumatoid arthritis and ten healthy adults were similarly studied. Serial titers measured included antibodies to Epstein-Barr virus (EBV) antigens, group B coxsackieviruses, rubella virus, cytomegalovirus, and herpes simplex virus. Serological evidence of active EBV infection was found in four of the patients with acute arthritis, none of the patients with chronic arthritis, and one of the ten healthy adults. There was no similar correlation between acute disease and presence of antibodies to the other viruses tested. We suggest that EBV may cause acute rheumatic illnesses more commonly than is currently appreciated but is probably not involved in the etiology of typical chronic rheumatoid arthritis.     

Preceding infection as an important risk factor for ischaemic brain infarction in young and middle aged patients

The role of preceding infection as a risk factor for ischaemic stroke was investigated in a case-control study of 54 consecutive patients under 50 years of age with brain infarction and 54 randomly selected controls from the community matched for sex and age. Information about previous illnesses, smoking, consumption of alcohol, and use of drugs was taken. A blood sample was analysed for standard biochemical variables and serum cholesterol, high density lipoprotein cholesterol, triglyceride, and fasting blood glucose concentrations determined. Titres of antimicrobial antibodies against various bacteria, including Staphylococcus, Streptococcus, Yersinia, and Salmonella and several viruses were determined. Febrile infection was found in patients during the month before the brain infarction significantly more often than in controls one month before their examination (19 patients v three controls; estimated relative risk 9.0 (95% confidence interval 2.2 to 80.0)). The most common preceding febrile infection was respiratory infection (80%). Infections preceding brain infarction were mostly of bacterial origin based on cultural, serological, and clinical data. In conditional logistic regression analysis for matched pairs the effect of preceding febrile infection remained significant (estimated relative risk 14.5 (95% confidence interval 1.9 to 112.3)) when tested with triglyceride concentration, hypertension, smoking, and preceding intoxication with alcohol. Although causality cannot be inferred from these data and plausible underlying mechanisms remain undetermined, preceding febrile infection may play an important part in the development of brain infarction in young and middle aged patients.     

Guillain-Barré syndrome and Campylobacter jejuni: a serological study

The association between Campylobacter jejuni infection and Guillain-Barré syndrome was investigated serologically in a retrospective study of 56 patients admitted to this hospital over four years. Evidence of preceding C jejuni infection was found in 21 (38%) of these patients, indicating that C jejuni was the most common single identifiable pathogen precipitating the disease. Among those patients who had presented with preceding diarrhoea the serum antibody response was similar to that in uncomplicated C jejuni enteritis. Patients with serological evidence of preceding C jejuni infection manifested a significantly more severe form of the disease. In cerebrospinal fluid the predominant specific antibody class was IgG, and this was closely related to the serum titres of specific IgG. IgA and IgM specific antibodies were found only in the cerebrospinal fluid of patients with recent C jejuni infection. These findings support the possibility that humoral immune factors are responsible for the neural damage and demyelination seen in Guillain-Barré syndrome.     

慢性乙型肝炎血液透析患者动脉粥样硬化与血清肝细胞生长因子表达的研究

目的评价慢性乙型肝炎血液透析患者(hemodialysis patient with chronic hepatitisB,CHB-HD)动脉粥样硬化的情况及血清肝细胞生长因子(hepatocyte growth factor,HGF)的水平,分析二者的相关性。方法以43例CHB-HD患者为观察对象,以46例普通血液透析(HD)患者作为对照,采用超声测定颈动脉内-中膜厚度(IMT)、粥样硬化斑块,检测生化指标、全段甲状旁腺激素(iPTH)、超敏C反应蛋白(hs-CRP)、血红蛋白(Hb)、血清HGF水平。比较CHB-HD与HD患者动脉粥样硬化、血清HGF及其他生化指标的差异,并分析CHB-HD患者动脉粥样硬化可能的危险因素。结果 CHB-HD与HD患者相比,动脉粥样硬化发生率明显增加(41.89%vs.21.74%,P0.05),血清HGF水平明显升高[(1040.98±259.45)pg/mlvs.(893.98±259.48)pg/ml,P0.05]。在CHB-HD患者中,动脉粥样硬化患者的血清HGF水平明显高于无动脉粥样硬化患者[(1167.76±246.57)pg/mlvs.(924.35±189.20)pg/ml,P0.05]。CHB-HD患者的Hb、白蛋白(ALB)、前白蛋白(PALB)、总胆固醇(TC)明显低于HD患者。Logistic回归显示CHB-HD患者血清HGF水平是其动脉粥样硬化的独立危险因素(OR=1.007,P=0.044)。结论 CHB-HD患者动脉粥样硬化更为显著,血清HGF亦明显升高,HGF可能参与其动脉粥样硬化的发生、发展。     

山东省血友病患者乙型肝炎、丙型肝炎和人类免疫缺陷病毒感染情况调查分析

目的了解山东省血友病患者乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）和人类免疫缺陷病毒（HIV）的感染情况。方法对2005～2011年山东省血友病诊疗中心确诊或治疗的628例血友病患者进行HBsAg、抗-HCV和抗-HIV检测,并根据年龄段进行分组。结果 628例血友病患者HBsAg、抗-HCV和抗-HIV阳性率分别为3.3%（21/628）、9.6%（60/628）和0.6%（4/628）,总感染率为13.5%,不同年龄段患者HBsAg和抗-HCV阳性率有明显差异。结论山东省血友病患者乙型肝炎感染率低于一般人群,而丙型肝炎感染率高于一般人群,艾滋病感染有上升趋势,乙型肝炎和丙型肝炎感染与年龄密切相关。