颈椎病患者的血液流变性分析

颈椎病是中老年人的常见病和多发病，轻者眩晕、颈肩痛、手臂麻木，重者可导致肢体瘫痪、大小便失禁等。近年来多数学者认为其发病与血液流变学改变和微循环障碍有关。为此我们对54例颈椎病患者进行了血液流变学检测及分析，结果报道如下。     

硬皮病患者血液流变性改变

目的探讨硬皮病患者与血液流变性的关系。方法采用R -80自动血液粘度仪 ,测定22例硬皮病患者血液流变学各项指标。结果硬皮病患者 ,全血高切、中切和低切粘度、血浆粘度、红细胞聚集指数、血沉、血沉方程K值和全血低切相对粘度等多项血液流变学指标与正常对照组比较 ,均有显著性或非常显著性差异。结论硬皮病患者有血液流变性的异常改变。这种变化可为硬皮病的发病机制、临床诊断和治疗提供新的实验依据。     

老年冠心病患者血液流变性检测的价值

对１０９例老年冠心病（ＣＨＤ）患者血液流变性变化与１００名健康老年人比较、分析，发现老年ＣＨＤ患者血液流变性改善是明显的，尤以全血低切粘度（ηｂ，２０ｓ－１）最为显著（ｔ检验Ｐ＜０．０１；Ｘ２检验Ｐ＜０．００５）。从临床分型看，冠心病越严重，血液流变性异常率越高，各型之间有显著差异（Ｘ２检验Ｐ＜０．００５）。但是血液流变性异常对ＣＨＤ患者诊断灵敏度仅为３７．６１％，其中隐匿型ＣＨＤ仅为１８．６４％。提示：血液流变学检查不适用于在老年人群中筛选冠心病，亦不适用于冠心病的早期诊断。但可以判断冠心病的严重程度及其预后，对指导治疗和疗效观察有一定的参考价值。     

几种常见肺部疾患血液流变性改变及临床意义

作者对几种常见肺部疾患病人做了血液流变学检查,并与正常组进行对照,发现均有显著差异,其中体外血栓形成试验和血液粘度检测有非常显著性差异。同时结合临床病例进行讨论,并且认为血液流变学指标可作为疾病的预防手段和判断疗效的指标。     

癌症患者的血液流变性改变及其意义

观察２７例癌症患者的血液流变学指标，血浆粘度、红细胞聚集指数、血沉及纤维蛋白原含量升高，与正常对照组相比具显著性差异（ｐ＜０．０１）。探讨了癌症患者血液流变学改变及其意义，为抗凝治疗提供了依据。     

急性脑梗塞患者的血液流变学改变

我们对76例急性脑梗塞患者检测血液流变学指标并与45例正常对照组对照,现将检测结果报告如下:     

肺结核患者血液流变学指标的观察

３１例肺结核病患者的血液流变学指标检测结果显示８７．１％（２７例）的患者同时伴有高粘滞血症，其血液流变性有异常变化，特别是全血粘度、血浆粘度、红细胞聚集性、红细胞变形性和血液屈服应力等结果均有显著改变（Ｐ＜０．０１。提示：在肺结核病的诊疗中，及时检测患者的血液流变性，对该病的诊治、病情观察、验证药效及预后等均有重要意义。     

新生儿缺氧缺血性脑病的血液流变性观察

新生儿缺氧缺血性脑病 (ＨＩＥ) ,是指在围产期因缺氧窒息 ,导致脑的缺氧缺血性损害。为了从不同角度对缺氧及脑损伤的性质、类型和严重程度有一个尽可能深入、全面的了解 ,我们通过血液流变学观察为临床诊断提供依据。资料与方法１对象２４例新生儿缺氧缺血性脑病患者全部具备     

慢性肾小球疾病患者血液流变性改变的观察

<正> 我们通过对78例慢性肾小球疾病患者进行的血液流变学检查,表明慢性肾小球疾病可出现高凝状态,血液粘滞性与正常人有显著性差异,现报告如下: 资料与方法一、临床资料:78例慢性肾小球疾病患者均为我院经临床确诊的病人,男40例,女38例,年龄5～67岁(平均36岁);慢性肾盂肾炎17例,慢性肾炎14例,慢性肾功能衰竭27例,肾病综合征20例。正常对照组为本院健康工作人员及部分门诊体检干部共40例(男21例,女19例),年龄为16～65岁     

肺结核患者血清可溶性白细胞介素－2受体检测的临床意义

应用夹心法ＥＬＩＳＡ测定肺部疾病患者血清可溶性白细胞介素２－受体（ｓＩＬ－２Ｒ），结果表明，进展期肺结核及急性肺炎患者血清ｓＩＬ－２Ｒ较正常对照组的明显升高，进展期肺结核及好转期肺结核患者血清ｓＩＬ－２Ｒ，较稳定期肺结核患者的增高（Ｐ＜０．０１）。进展期肺结核患者血清ｓＩＬ－２Ｒ的高低与肺部病灶大小有关。经抗结核化疗后，进展期肺结核患者血清ｓＩＬ－２Ｒ降低或无改变。与Ｘ线胸片和／或痰菌改变一致，提示测定肺结核患者血清ｓＩＬ－２Ｒ，有助于对进展期肺结核患者疾病活动性的判断。     

降钙素原检测诊断肺结核合并肺部细菌感染的价值

目的 分析肺结核合并肺部细菌感染患者检测降钙素原（PCT）在临床诊断中的重要价值。方法 回顾分析2018年4月~2019年4月在我院诊治的112例肺结核患者临床资料,将未合并肺部感染69例设为未合并组,将合并肺部感染43例设为合并组。合并组给予抗菌治疗,依据抗菌效果分为控制组和未控制组,比较合并组与未合并组、控制组和未控制组治疗前后血清PCT水平。结果 合并组血清PCT高于未合并组,差异有统计学意义（P＜0.05）;控制组和未控制组治疗前血清PCT比较,差异无统计学意义（P＞0.05）;治疗后控制组血清PCT低于治疗前,且控制组低于未控制组,差异有统计学意义（P＜0.05）;合并组43例患者,肺部细菌感染的ROC曲线下面积为0.941,95%CI:0.896~0.983,临界值为0.674 μg/L,PCT检测敏感度为86.04%（37/43）,特异度94.87%（37/39）。结论 肺结核合并肺部细菌感染患者血清PCT监测,有助于判断患者是否合并肺部感染及抗菌药物治疗效果,为临床诊断和指导抗菌药提供一定的参考。     

Prevalence and Its Predictors of Extrapulmonary Involvement in Patients with Pulmonary Tuberculosis

Extrapulmonary organ involvement in human immunodefiaency virus (HIV)-infected patients with pulmonary tuberculosis (TB) is reported to be 26%, however, the clinical predictors of extrapulmonary involvement in pulmonary TB patients has not been reported yet. We tried to determine the clinical predictors of presence of extrapulmonary involvement in patients with pulmonary TB. Cross-sectional study was performed including all adult patients with culture-proven pulmonary TB diagnosed between January 1, 2004 and July 30, 2006, at a tertiary referral hospital in South Korea. The presence of extra-pulmonary TB involvement was diagnosed based on bacteriological, pathological, or clinical evidence. Among 320 patients with a culture-proven pulmonary TB, 40 had extrapulmonary involvement. Patients with bilateral lung involvement were more likely to have extrapulmonary involvement, with an adjusted odds ratio (OR) of 4.21 (95% confidence interval [CI], 1.82-9.72), while patients older than 60 yr (adjusted OR, 0.27; 95% CI, 0.08-0.89), patients with cavitary lesions (adjusted OR, 0.37; 95% CI, 0.16-0.84), and with higher levels of serum albumin (adjusted OR, 0.45; 95% CI, 0.25-0.78) had less frequent involvement. Clinicians should be aware of the possibility of extrapulmonary involvement in TB patients with bilateral lung involvement without cavity formation or lower levels of serum albumin.     

支气管肺泡灌洗液诊断肺结核的诊断的价值应用

目的评价纤维支气管镜防污染支气管肺泡灌洗液技术对肺结核分支杆菌快速培养和痰菌阴的不典型肺结核的诊断价值应用。方法对98例肺结核患者采用支气管镜进行检查,并对病变部位灌洗标本液,并且培养出结核杆菌。结果98例结核分支杆菌检出率为66.3%、84.8%,其中30例活检,20例确诊为结核内芽肿,检出率为66.7%。结论纤支镜下进行BALF快培对不典型肺结核具有良好的诊断及时,阳性率较高,通过支气管镜下不同的取材方法能够有效的提高诊断率。     

肺结核抗体检测联合CRP检测判断HIV合并肺结核杆菌感染的效果研究

目的 分析肺结核抗体检测联合C反应蛋白(CRP)检测判断HIV合并肺结核杆菌感染的应用价值.方法 采用试剂盒对46例HIV合并肺结核杆菌感染患者和40例HIV感染患者进行结合分枝杆菌抗体检测,并绘制受试者工作特征曲线(ROC),依据ROC曲线确定CRP诊断界点.结果 单纯肺结核抗体检测灵敏度为52.2％ (24/46),特异性为57.5％(23/40).CRP临界点为4.91 mg/L,灵敏度为78.3％(36/46),特异性为57.5％ (23/40).串联检测灵敏度和特异性分别为43.5％ (20/46)和70.0％ (28/40),并联检测灵敏度和特异性分别为87.0％ (40/46)和67.5％ (27/40).结论 肺结核抗体检测串联CRP检测判断HIV合并肺结核杆菌感染的效果更优,具有临床应用价值.     

小儿紫绀型先天性心脏病血浆MDA和血液流变学变化

测定３５例青紫型先天性心脏病患儿红细胞、血浆丙二醛（ＭＤＡ）含量、红细胞膜微粘度及血液流变学指标。结果患儿红细胞、血浆ＭＤＡ、膜微粘度、全血粘度、经细胞比积、红细胞聚集指数、刚性指数均显著高于正常组；ＭＤＡ含量，膜微粘度、红细胞刚性指数、聚集指数及全血粘度之间均存在正相关关系。提示患儿红细胞脂质过氧化反应增强，导致膜流动性降低、红细胞变形性差，聚集性增加，可能是血液粘度增加较为主要的原因。     

川芎嗪注射液对老年肺心病加重期患者血液流变性的影响

目的观察川芎嗪注射液对老年肺心病患者血液流变性的影响。方法将32例老年肺心病患者随机分为两组,常规治疗组采用抗感染、祛痰、平喘、吸氧等综合治疗,川芎嗪治疗组在上述治疗基础上加用川芎嗪注射液,160mg静脉滴注,1次/天。观察两组治疗有效率及治疗前后血流变学指标变化。结果川芎嗪治疗组总有效率93.75%,常规治疗组总有效率81.25%,差异有显著性(P<0.05)。川芎嗪治疗组全血粘度、血浆粘度、红细胞压积、红细胞聚集指数、红细胞电泳时间及纤维蛋白原等指标较治疗后明显下降(P均<0.05)。结论老年人肺心病加重期血液粘滞性增高。川芎嗪注射液能有效降低肺心病患者的血液粘稠度,改善微循环,降低肺循环阻力,从而提高治疗有效率。     

Acceptability of Sputum Specimens for Diagnosing Pulmonary Tuberculosis

The evaluation of the quality of a sputum specimen prior to bacterial culture has been an accepted practice. However, optimal sputum criteria for pulmonary tuberculosis (TB) are not well established. We investigated indicators for sputum acceptability in tuberculosis cultures and acid-fast bacilli (AFB) smear. A post-hoc analysis of a randomized trial with 228 sputum specimens from 77 patients was conducted. In the trial, pulmonary TB suspects were requested for collecting three sputum specimens. We performed both TB study (AFB smear and M. tuberculosis culture) and Gram staining in each specimen. By using generalized estimating equations, the association between sputum characteristics and positive TB testings were analyzed. Although acceptable specimens for bacterial pneumonia showed higher TB-culture positive rates than unacceptable specimens (adjusted odds ratio [aOR]=1.66; 95% confidence interval [CI]=1.11-2.49), a specimen with ≥25 white blood cells/low-power field was the better predictor for positive M. tuberculosis cultures (aOR=2.30; 95% CI=1.48-3.58) and acid-fast bacilli smears (aOR=1.85; 95% CI=1.05-3.25). Sputum leukocytosis could be an indicator of sputum acceptability for diagnosing pulmonary tuberculosis.

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Multidrug-resistant Pulmonary Tuberculosis Among Young Korean Soldiers in a Communal Setting

The goal of this study was to evaluate the prevalence of first-line anti-tuberculosis drug resistance and risk factors associated with multidrug-resistant tuberculosis (MDR TB) among young soldiers in the Korean military, which has a strict tuberculosis control program. All patients with culture-confirmed pulmonary tuberculosis during their service at the Armed Forces Capital Hospital from January 2001 to December 2006 were enrolled in the study. Drug resistant Mycobacterium tuberculosis was isolated from 18 patients (12.2%) and multidrug-resistant M. tuberculosis was isolated from 12 patients (8.1%). Previous treatment of tuberculosis and the presence of a cavity on the patient''s chest computed tomography scan were associated with MDR TB; military rank, smoking habits, and positive acid-fast bacilli smears were not associated with MDR TB. In a multiple logistic regression analysis, previous treatment of tuberculosis was a significant independent risk factor for MDR TB (odds ratio 6.12, 95% confidence interval 1.53-24.46). The prevalence of drug resistant tuberculosis among young soldiers in the Korean military was moderately high and the majority of resistant cases were found in patients who had undergone previous treatment of tuberculosis. Based on our results, we suggest that relapsed tuberculosis cases within communal settings should be cautiously managed until the drug susceptibility tests report is completed, even if previous treatment results were satisfactory.