白细胞介素-18在特发性血小板减少性紫癜中作用的研究

目的 探讨白细胞介素-18(IL-18)与特发性血小板减少性紫癜(ITP)发病的关系,研究其在ITP发病中的作用及临床意义.方法 酶联免疫吸附测定(ELISA)测定血浆IL-18,对36例ITP患者和正常对照组血浆IL-18的水平进行分析.结果 ITP组血浆IL-18含量为(538.31±111.33)pg/ml,正常对照组血浆IL-18含量为(489.44±49.07)pg/ml.IL-18含量与血小板数量呈显著性负相关(r=-0.395,P＜0.05).结论 ITP发病时患者血浆中的IL-18水平比正常对照组明显升高,IL-18与ITP发病密切相关.     

Sequential occurrence of IgA nephropathy and Henoch-Schönlein purpura: support for common pathogenesis

We report a patient who developed Henoch-Schönlein purpura (HSP) 13 years after he presented with IgA nephropathy (IgAN). In both HSP and IgAN renal biopsy most commonly reveals focal proliferative glomerulonephritis on light microscopy and immunofluorescence displays mesangial IgA deposits. In addition, patients with HSP or IgAN have elevated serum IgA levels, circulating IgA immune complexes, IgA-bearing lymphocytes, immunoglobulin-producing cells, and binding of IgG to glomerular components of similar molecular weight. The occurrence of both diseases in the same patient or the same families and the presence of immune abnormalities compatible with HSP or IgAN in relatives of patients with these diseases suggest a common pathogenesis.     

Protein C concentrate prevents peripartum thrombosis.

A protein C deficient woman, with a past history of recurrent thrombosis and purpura fulminans, was successfully treated with protein C concentrate in the peripartum period. © 1992 Wiley-Liss, Inc.     

过敏性紫癜的心肌损害

目的观察儿童过敏性紫癜并心肌损害的发生率及临床特点。方法回顾性分析93例过敏性紫癜患儿并心肌损害的临床资料，对其发生率、临床表现及其他系统损害的关系和预后进行分析。结果497例过敏性紫癜患者中有93例（18．71％）有心肌受损，主要表现为心肌酶学异常和（或）心电图异常。所有病例应用肾上腺皮质激素治疗后均治愈。结论过敏性紫癜合并心肌损害是临床较常见的表现，早期识别并及时应用激素治疗及对症处理可避免严重并发症的发生，提高治疗效果。     

从热、虚、瘀辨证论治小儿过敏性紫癜

从热、虚、瘀三个方面论述了小儿过敏性紫癜的病因病机特点，抓住病因病机的核心，确定了热伤血络、阴虚火旺、气不摄血三个本证证型和风热、热毒、湿热、血瘀四个标证证型。采用本证和标证相结合的方法对小儿过敏性紫癜进行辨证论治，并从理论上探讨了该方法的科学性和实用性。     

免疫性血小板减少性紫癜辨证分型与血小板表面相关抗体及T淋巴细胞亚群的关系

为探讨免疫性血小板减少性紫癜（ITP）中医辨证分型与免疫机理的关系,将ITP患者中医辨证分型结合血小板相关抗体（PAIg）及T淋巴细胞亚群进行分析。发现作为本病主要抗体的PAIgG脾肾阴亏型明显高于脾虚失统型（P<0.01）;OKT₈⁺值亦显著高于脾虚失统型（P<0.05）,OKT₄⁺/OKT₈⁺比值则明显低于脾虚失统型（P<0.05）。提示脾肾阴亏型的免疫损伤程度较脾虚失统型严重。     

Subacute (acute,persistent) thrombotic microangiopathy

Six patients with prolonged acute courses of thrombotic microangiopathy are reviewed. These patients had in common courses of acute disease requiring plasma support for more than 3 months, with subsequent complete remission. Plasma support requirements may be prodigious, and the acute course may require more than 100 plasma exchanges before a stable remission is achieved. These patients appear to represent a subset of thrombotic microangiopathy distinct from the more common acute T.T.P. course, which resolves in 3–6 weeks, and the chronic relapsing pattern, which may have a short or prolonged acute course. © 1992 Wiley-Liss, Inc.     

发色三肽底物测定血浆蛋白C活性及临床应用

建立了血浆蛋白Ｃ活性水平测定的发色三肽底物法，并对临床５６例病例进行了检测。以正常人血浆蛋白Ｃ活性平均值为１００％作对照，３０例肝硬化病人血浆蛋白Ｃ活性平均为（６１．４±２７．３）％；７例慢性肾功能不全病人血浆蛋白Ｃ活性平均为（５１．２±２５．７）％，１８例正常晚期妊娠妇女血浆蛋白Ｃ活性平均为（１３８．０±２３．５）％。与正常对照组比较，结果差异均有显著性。在的１例血栓性血小板减少性紫癜（ＴＴＰ）     

特发性血小板减少性紫癜患者感染的危险因素及预防措施

目的　探讨ITP患者感染的危险因素 ,提出预防感染的相关措施。方法　对 6 7例ITP住院患者进行回顾性调查 ,对患者感染部位、性别、年龄、合并糖尿病情况、住院天数、使用激素及丙种球蛋白情况进行评估及统计学处理。结果　感染以呼吸系统最多 ,其次为泌尿道感染 ;年龄大、合并糖尿病、住院天数长 (>4周 )、应用激素量大与感染发生呈正相关 ,并进行Logistic多元回归分析 (P值分别 >0 .0 5、<0 .0 5、<0 .0 5、<0 .0 5 ) ,OR值分别约 1.385、9.16 9、8.90 0、18.6 6 7。结论　应用激素量大、合并糖尿病、住院天数长 (>4周 )是ITP患者感染的主要危险因素 ,其中应用激素量大最为重要 ,合并糖尿病次之 ;必须控制易患因素 ,有效地预防感染。