慢性再生障碍性贫血患者外周血T淋巴细胞亚群改变与中医分型的关系

用McAb和ABC法测定了38例慢性再生障碍性贫血(CAA)患者外周血T淋巴细胞亚群(简称T亚群)。与健康人相比,CAA的Ts明显增高(P<0.001),Th/T5明显降低(P<0.001)。并发现外周血Hb水平、病程、疗效及中医证型与T亚群相关。按气血两虚肾阳虚、肾阴虚、肾阴阳两虚的顺序,患者Th逐渐降低,Ts逐渐升高,Th/Ts明显降低。后两组比前两组Th/Ts下降更显著(P<0.01),提示阳损及阴时机体免疫机能发生更大的改变,从T亚群水平揭示了中医证型特别是肾阳虚、肾阴虚的内涵。     

小儿营养性贫血原因调查

对326名2岁以下婴幼儿进行了调查分析,认为小儿营养性贫血以6～24个月为高发年龄,母乳喂养儿的患病率明显低于人工喂养儿,提示母乳喂养可降低贫血的患病率,有利于婴儿的生长发育,但12个月以后母乳喂养的贫血患病率有明显上升的趋势,因此认为要在大力提倡母乳喂养的同时应强调无论母乳喂养或人工喂养都应及早添加辅食,防止小儿营养性贫血的发生。     

肾组织移植对慢性肾功能衰竭大鼠促红细胞生成素的调节作用

目的研究鼠婴肾组织移植于肾包膜下对促红细胞生成素的调节作用,为临床应用治疗肾性贫血提供理论依据。方法以Wistar雄性大鼠建立慢性肾功能衰竭动物模型为受体,将鼠婴肾组织块多点植入受体肾包膜下。治疗期间用EPO酶联免疫(ELISA)试剂盒测定血清EPO水平;观察肾组织病理改变,用免疫组化方法检测EPO在移植物中的表达。结果①60d时D组血清促红细胞生成素(1.768±0.140)mu/mL高于B组(1.160±0.324)mu/mL(P<0.01),与C组(2.329±0.125)mu/mL也有差异(P<0.05)。②移植后60d,移植物的体积由1mm3增至3-4mm3大小,表面血管网丰富,光镜下见肾小球、肾小管结构正常;③移植物EPO免疫组化,发现移植物EPO着色颗粒主要分布于肾皮质的肾小管,明显多于病例对照组大鼠肾组织(P<0.05)。结论通过对移植物的形态观察和功能测定,证明肾组织移植是一种有效的治疗手段,有可能为慢性肾性贫血提供一种新的途径。     

Chronic anemia as a complication of parvovirus B19 infection in a pediatric kidney transplant patient

. This is a report of unexplained anemia that persisted for 4 months in an adolescent renal transplant patient receiving immunosuppression that included prednisone, tacrolimus, and mycophenolate mofetil. This patient required monthly blood transfusions for fatigue, palpitations, and hematocrit levels between 15% and 17%. In addition, his posttransplant course was notable for the development of insulin-dependent diabetes mellitus. While receiving low-dose prednisone, he was switched from tacrolimus to cyclosporin and tapered off insulin injections over the next 2 months. At 4.5 months post-transplantation, further diagnostic evaluation was suggestive of parvovirus B19 infection as the cause for our patient’s chronic anemia. After testing negative for serum-specific parvovirus B19 IgM and IgG antibodies, parvovirus B19 infection was detected in blood by the polymerase chain reaction. Treatment with intravenous immunoglobulin (1 g/kg per day × 2 days) resulted in normalization of both his reticulocyte count and hematocrit within 6 weeks. At 4 months after receiving the immunoglobulin infusion, he has maintained a normal hematocrit level and stable renal function without requiring further blood transfusions. Received August 23, 1996; received in revised form and accepted November 20, 1996     

儿宝冲剂对防治缺铁性贫血及缺锌症的疗效观察

目的探讨儿童缺铁、缺锌症的防治措施。方法用研制的药品，让有缺铁、缺锌症临床表现的７～１２岁儿童服用，而后检验其头发、血液中的微量元素Ｆｅ、Ｚｎ和Ｈｂ的含量，所得结果用ｔ检验法进行统计分析。结果服用该药品１ｍｏ后，儿童体内微量元素Ｆｅ、Ｚｎ和Ｈｂ含量显著提高（Ｐ＜０．０１），食欲增加，缺铁、缺锌症状明显改善，服２ｍｏ优于服１ｍｏ的治疗效果。结论该药品对儿童缺铁性贫血及缺锌症具有显著的防治效果。     

腹腔镜脾、胆囊联合切除在治疗先天性溶血性贫血及胆囊结石的临床应用

目的:探讨腹腔镜下脾、胆囊联合切除治疗先天性溶血性贫血及胆囊结石的可行性及其价值。方法:应用腹腔镜对患有溶血性贫血及胆囊结石的12例病人进行脾及胆囊联合切除。结果:12例病人手术顺利成功,平均住院7.5d。术中及术后无并发症发生。结论:腹腔镜下脾、胆囊联合切除治疗先天性溶血性贫血及胆囊结石病切实可行,该手术方法具有病人痛苦少和住院时间短的优点,达到微创的目的。     

自身免疫性溶血性贫血20例临床分析

本文报道温抗体型自身免疫性溶血性贫血20例,其中包括特殊类型“兼有冷抗体和温抗体的自身免疫性溶血性贫血”3例,伴有血小板减少性紫瘢的Fisher—Evans综合征4例。并对本病致病因素、发病年龄、临床表现及特殊类型产生机理进行了讨论。     

Clonality of cold agglutinins in patients with hemolytic anemia: an analysis by high-resolution two-dimensional gel electrophoresis.

High-resolution two-dimensional gel electrophoresis (2-DGE) was used to analyse plasma samples and partially purified cold agglutinins (CA) obtained from two selected patients. Both presented an acute hemolytic anemia with CA of high thermal amplitude, normal immunoglobulin levels, no detectable paraproteinemia, and no clinical evidence of a malignant B-cell disorder. The electrophoretograms of their plasma showed evident alternations of the "normal" protein profile, which were directly related to hemolysis (absence of the spots of haptoglobin and in one case of those of hemopexin), but no monoclonal gammopathy. The electrophoretograms of their purified CA revealed two clearly different spot patterns respectively corresponding to a monoclonal IgM and to polyclonal IgM. These results show that the clonality of CA associated with hemolytic anemia can be easily determined by 2-DGE. This technique may be very useful to discriminate chronic cold agglutinin disease in the early phase from "parainfectious" CA.