血清SF、sTfR、sTfR/SF在诊断难治性贫血与慢性再生障碍性贫血中的价值

目的探讨可溶性转铁蛋白受体(sTfR)、血清中铁蛋白(SF)及它们的比值(sTfR/SF)在鉴别诊断难治性贫血(RA)与慢性再生障碍性贫血(CAA)中的意义.方法分别对34例难治性贫血与37例慢性再生障碍性贫血和30例正常对照组应用免疫比浊法和化学发光法测定sTfR和SF并计算其比值.结果正常人、RA和CAA患者三组之间SF有显著性差异(P《0.05),sTfR有显著性差异(P《0.05).sTfR/SF:三组间及两两比较均有极显著的差异(P《0.001),CAA》正常人》RA.结论同时测定血清SF、sTfR尤其是计算sTfR/SF值在RA与CAA的诊断和鉴别诊断中可提供重要的实验依据.     

sTfR对慢性炎症患者并发缺铁性贫血的诊断价值

目的:探讨血清可溶性转铁蛋白受体(sTfR)水平对慢性炎症患者并发缺铁性贫血与慢性炎症患者并发非缺铁性贫血的鉴别诊断价值.方法:采用散射免疫比浊法定量测定非贫血对照组,单一原因造成的缺铁性贫血(IDA)、慢性炎症并发缺铁性贫血患者、慢性炎症并发非缺铁性贫血患者sTfR浓度.采用t检验和ROC曲线评价sTfR的诊断价值.结果:非贫血对照组与单一原因造成的IDA sTfR浓度有显著性差异(P＜0.05),AUC=0.965,有较高的诊断准确度.慢性炎症并发缺铁性贫血患者与慢性炎症并发非缺铁性贫血患者sTfR浓度有显著性差异(P＜0.05);AUC=0.834,有一定的准确度.结论:sTfR浓度对单一原因造成的IDA和慢性炎症并发缺铁性贫血患者有较高的诊断准确性;并且根据不同的临床资料选用不同的阈值用于诊断.     

可溶性转铁蛋白受体在慢性肾衰伴缺铁贫血诊断及治疗中的应用

本文通过对42例慢性肾衰(CRF)患者、20名健康对照者进行转铁蛋白受体(sTFR)及其它铁参数的检测,以评价sTFR在CRF伴缺铁贫血诊断和治疗中的应用价值。     

可溶性血清转铁蛋白受体和血清铁在诊断妊娠妇女缺铁性贫血中的比较

目的比较可溶性血清转铁蛋白受体(soluble transferrin receptor,sTfR)和血清铁(serum iron,SI)两种检测指标,在诊断妊娠妇女缺铁性贫血中的灵敏度和特异性.方法采用免疫分析法和比色法测定30例贫血妊娠妇女和30例贫血妊娠妇女和30例健康妊娠妇女的sTfR水平的SI水平,并对实验数据进行分析和比较.结果30例贫血妊娠妇女的sTfR平均值是31.3860±6.7990nmol/L,高于临界值28.1mmol/L(P＜0.05),属于贫血范围;SI的平均值是9.53±4.2622nmol/L,与临界值9nmol/L没有差异,属于正常范围.30例正常妊娠妇女的sTfR平均值是25.2080±6.9032nmol/L,小于临界值28.1nmol/L(P＜0.05),属于正常范围;SI的平均值是13.3733±4.8359nmol/L,高于临界值属于正常范围(P＜0.01).贫血妊娠妇女的sTfR水平明显高于正常妊娠妇女的sTfR水平(P＜0.01)、SI水平明显低于正常妊娠妇女(P＜0.01).sTfR、SI测定妊娠妇女缺铁性贫血的灵敏度分别是70%和53.3%、特异性分别是83.3%和80.0%.结论在诊断妊娠妇女缺铁性贫血,两种指标的特异性都比较高,但sTfR测定比SI测定灵敏性高、能更正确地对妊娠妇女是否缺铁做出正确判断.     

血清TfR测定在缺铁性贫血中的诊断价值

为探讨血清中可溶性转铁蛋白受体在缺铁性贫血中的诊断意义 ,采用散射免疫比浊法定量测定正常对照组、缺铁性贫血 (IDA)组、慢性病贫血伴缺铁 (CDID)组、慢性病贫血 (ACD)组血清 Tf R。初步结果显示 IDA、 CDID组血清 Tf R水平显著高于正常对照组 (P<0 .0 0 1)及 ACD组 (P<0 .0 0 1) ;而 ACD组血清 Tf R水平与正常对照组无显著性差异 (P>0 .0 5 )。提示血清 Tf R测定为缺铁性贫血、慢性病贫血伴缺铁的诊断提供了一项实用、可靠的临床指标     

可溶性转铁蛋白受体与血清铁蛋白在慢性炎症性疾病合并缺铁性贫血诊断中的价值比较

目的：探讨可溶性转铁蛋白受体（Soluble tranferrin receptor,sTfR）与血清铁蛋白（Serum ferritin,SFer）在慢性炎症性疾病合并缺铁性贫血（Iron deficiency anemia,IDA）诊断中的价值。方法：随机选取我院2009年8月至2011年6月收治的29例患有慢性炎症性疾病伴IDA患者,31例慢性炎症性疾病无贫血患者,以及28例健康人,进行SFer,sTfR检测。结果：sTfR在慢性炎症性疾病合并IDA组明显升高,与慢性炎症性疾病无贫血组比较有显著性差异（P〈0.01）;SFer在慢性炎症性疾病合并IDA组有降低,与慢性炎症性疾病无贫血组比较无显著性差异（P〉0.05）。结论：血清sTfR的测定较SFer更能准确反映体内铁贮存情况,对慢性炎症性疾病合并IDA的诊断具有指导意义。     

转铁蛋白、乳酸脱氢酶、胃蛋白酶原Ⅰ和胃泌素在恶性贫血诊断中的价值

目的探讨转铁蛋白(transferrin,TRF)、乳酸脱氢酶(lactate dehydrogenase,LDH)、胃蛋白酶原I(pepsinogen,PGI)和胃泌素(Gastrin)在恶性贫血诊断中的价值。方法选取恶性贫血患者、缺铁性贫血患者、非恶性贫血的巨幼红细胞性贫血患者和健康体检者各30例分别为恶性贫血组、缺铁贫血组、巨幼贫血组和对照组,检测4组研究对象转铁蛋白、乳酸脱氢酶、胃蛋白酶原Ⅰ和胃泌素的血清水平。用ROC曲线下面积分析转铁蛋白、乳酸脱氢酶、胃蛋白酶原Ⅰ和胃泌素在恶性贫血诊断中的价值。结果恶性贫血患者血清中的乳酸脱氢酶、胃泌素和转铁蛋白的表达量均明显高于非恶性贫血的巨幼细胞贫血患者、缺铁性贫血和健康体检者(P <0. 05),而胃蛋白酶原Ⅰ的表达量明显低于巨幼细胞贫血患者、缺铁性贫血和健康体检者(P <0.05)。LDH,PGI,Gastrin和TRF在恶性贫血组与缺铁贫血组的诊断灵敏度分别为83%、67%、80%、80%,特异性分别为73%、83%、77%、70%;PGI和transferrin在恶性贫血组与巨幼贫血组的诊断灵敏度分别为80%、56%;特异性分别为73%、93%。结论转铁蛋白,乳酸脱氢酶,胃蛋白酶原Ⅰ和胃泌素可作为诊断恶性贫血的潜在标志物。     

缺铁合并感染儿童铁剂治疗前后血清可溶性转铁蛋白受体及转铁蛋白的变化

目的探讨血清可溶性转铁蛋白受体(sTfR)、转铁蛋白(Tf)在缺铁合并急性感染儿童(IDAI)口服铁剂治疗前后的变化规律.方法将病例分成IDAI组、单纯缺铁性贫血(IDA)组及IDAI治疗组.IDAI组给口服铁剂3w.采用速率散射免疫比浊法,测定初诊时及治疗3w后患儿血清sTfR、Tf、铁蛋白(SF)水平.部分病例采用常规铁染色观察骨髓储存铁.结果 IDAI组和IDA组患儿sTfR、Tf均显著高于对照组(P<0.01),这两组间无显著差异(P>0.05),IDAI患儿经治疗后血色素(Hb)升高但尚未正常时,sTfR、Tf已降至对照组水平,治疗前后差异显著(P<0.01).结论 sTfR、TF对诊断早期铁缺乏特异,敏感,测定结果不受感染因素干扰,是临床诊断早期缺铁合并感染儿童,指导铁剂治疗及疗效监测的可靠指标.     

血清sFlt-1、LDH及hs-CRP联合检测对重型急性胰腺炎的早期诊断价值

目的分析研究血清中可溶性Fms样酪氨酸激酶-1 (sFlt-1)、乳酸脱氢酶(LHD)和超敏反应蛋白(hs-CRP)联合检测对重型急性胰腺炎(AP)的早期诊断价值。方法选择我院于2015年1月至2017年12月收治的因急性腹痛来院治疗的AP患者93例,并根据诊断结果分为轻度组(MAP)和重度组(SAP)。同时按照病例对照设计原则选取等额的受试者作为健康对照组。收集所有研究对象的基本资料,如年龄、性别等,并采用常规检测其血清LHD和hs-CRP水平,酶联免疫吸附法(ELISA)检测血清sFlt-1水平,通过SPSS20.0统计软件对研究对象的基本资料以及各检测指标进行描述和统计分析,并计算各指标的诊断灵敏度及其对重型AP患者的诊断价值。结果三组受试者在年龄、性别上差异无统计学意义,其基本资料具有可比性;此外,三组受试者的血清sFlt-1、LHD和hs-CRP水平差异均有统计学意义(均有P <0.001);除SAP组sFlt-1水平与健康对照组差异没有统计学意义外,MAP组和SAP组均与健康对照组水平差异存在统计学意义(均有P <0.05)。另外血清sFlt-1对SAP患者的单独检测的灵敏度为80.4%,特异性为76.5%,LHD的灵敏度为86.3%,特异性为89.4%,hs-CRP检测的灵敏度为68.8%,特异性为83.7%,且三者联合检测的灵敏度为91.6%,特异性为93.5%,即血清sFlt-1、LHD和hs-CRP联合检测对重型急性胰腺的早期诊断优于其中任何方法的单一检测。结论血清sFlt-1、LHD和hs-CRP联合检测对重型急性胰腺炎的早期诊断具有一定的诊断价值,且优于其中任何单一检测,对急性胰腺炎的发生和病情发展具有重要的临床意义。     

联合检测血清铁蛋白、叶酸、维生素B12、乳酸脱氢酶在 鉴别诊断巨幼细胞性贫血中的意义

目的 探讨联合检测血清铁蛋白,叶酸,维生素B12,乳酸脱氢酶在鉴别诊断巨幼细胞性贫血中的意义。方法 2015年1月~2017年2月经萍乡市人民医院骨髓细胞学形态和临床确诊的,分组为巨幼细胞性贫血组34例,缺铁性贫血组53例,再生障碍性贫血组25例,骨髓异常增生综合症组36例,另随机选取60例体检健康者为正常对照组,回顾性分析不同组别患者的血清铁蛋白,叶酸,维生素B12,乳酸脱氢酶水平变化。结果 巨幼细胞性贫血患者铁蛋白轻度升高,与正常对照组及MDS组差异不明显（P>0.05）,与IDA组及AA组相比较,差异具有统计学意义（P<0.05）;MA组叶酸,维生素B12水平降低幅度明显,与正常对照组及其他类型贫血组水平相比,差异明显（P<0.05）;MA组乳酸脱氢酶水平明显增高,与正常对照组及其他类型贫血组变化水平相比较具有明显差异（P<0.05）。结论 联合检测血清铁蛋白,叶酸,维生素B12,乳酸脱氢酶可为鉴别诊断MA提供有效的依据,对减少误诊率,减轻患者身心及经济负担方面具有积极的意义。     

触珠蛋白对溶血性贫血的鉴别诊断价值及其影响因素分析

目的 探讨触珠蛋白(HP)对溶血性贫血患者的鉴别诊断价值,研究影响HP诊断准确性的因素.方法 分别测定溶血性贫血组、其它类型贫血组、肝硬化组和急性时相反应组患者血清HP浓度,并应用受试者工作特征曲线(ROC曲线)评价HP对溶血性贫血的诊断价值.结果 溶血性贫血组HP中位数水平显著低于其它各组(P＜0.01),HP的ROC曲线下面积(AUC)等于0.927 (95％ CI:0.863 ～ 0.967),HP诊断溶血性贫血的临床准确性较高,二分类Logistic回归分析发现,血清HP和间接胆红素(IBIL)是溶血性贫血诊断的重要指标,溶血部位及伴发急性时相反应都不会影响HP对溶血性贫血的诊断.结论 HP是诊断溶血性贫血的一个敏感的诊断指标,仅肝硬化等肝脏严重损伤疾病影响HP的诊断.     

Association between Primary Cytomegalovirus Infection and Severe Hemolytic Anemia in an Immunocompetent Adult

 Hemolysis is a rare complication of cytomegalovirus infection in the immunocompetent adult, and the mechanisms responsible for it remain obscure. Guidelines for treatment have yet to be established, and the effectiveness of antiviral therapy has not been proven. In this report, an unusual case of primary cytomegalovirus infection manifested by severe hemolysis in an immunocompetent adult is presented. Treatment with ganciclovir (5 mg/kg b.i.d.) for 10 days and prednisolone (2 mg/kg/day) for more than 3 months suggests that both virological and immunological mechanisms are probably responsible for the hemolysis.     

Activity and Latent Activity of Lactate Dehydrogenase Isoenzymes from Patients with Disadaptation

Spontaneous proliferation and structural and functional properties of the cell membranes were studied by measuring activity and latent activity of lactate dehydrogenase isoenzymes in peripheral blood leukocytes from patients with disadaptation at admission to the hospital and during therapy. The spectrum of lactate dehydrogenase isoenzymes in patients with disadaptation at admission did not differ from the corresponding values in the control group. Therapy was accompanied by a shift in isoenzyme spectrum of lactate dehydrogenase toward the prevalence of one isoform, which probably reflected metabolic changes in immunocytes under conditions of adaptive immune response to psychoemotional stress. Latent activity of lactate dehydrogenase isoenzymes in patients at admission was below the control. Latent enzyme activity returned to normal during therapy. The observed changes in latent enzyme activity were probably associated with recovery of structural and functional properties of leukocyte membranes.__________Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 139, No. 6, pp. 707–710, June, 2005     

Effect of Hyperoxia on the Ultrastructural Pathology of Alveolar Epithelium in Relation to Glutathione Peroxidase,Lactate Dehydrogenase Activities,and Free Radical Production in Rats,Rattus norvigicus

Hyperoxia (HP) exposure inducts reactive oxygen species (ROS) in the lungs that may result in lung injury, including alveolar epithelial and endothelial cells. Lactate dehydrogenase (LDH) activity relates to glycolysis, whereas glutathione peroxidase (Gpx) activity relies on the pentose phosphate pathway (PPP). The purpose of this study was to examine early ROS-induced alveolar pathological changes in relation to the activity of glutathione peroxidase (GPx) and lactate dehydrogenase (LDH) activity. Twenty adult male rats, matched with age and body weight, were randomly assigned to two groups, control and experimental. The experimental group was exposed to hyperoxia for 24?h. Ultrastructure examination showed degenerated pneumocyte type I, containing swollen mitochondria associated with dilated rough endoplasmic reticulum, and was projecting into the alveolar lumen. Pneumocyte II showed mitochondria swelling and hyperplasia and was desquamated in structure, depleted in surfactant, and falling into the alveolar lumen. Pulmonary capillary showed distention without observed damage in the endothelial layer. Following HP, the average (±) free radical (FR) production increased significantly (p<.05) from the baseline control of 181.20±30.06 to 260.30±68.10 (Carr U) and average (±SD) GPx activity also increased significantly (p<.05) from the baseline control of 8178.30±2402.62 to 19,589.50±2392.44 (U/L), whereas average (±SD) LDH activity decreased significantly (p<.05) from baseline control of 194.11±75.52 to 42.68±11.41 (U/L), which demonstrated slowing down of glycolysis. Based on these results it can be concluded that exposure to high inspired oxygen inducted the buildup of mitochondria-driven ROS that was related to early injury in the alveolar epithelium without obvious endothelium injury.     

Regulatory Role of Supramolecular Alcohol Dehydrogenase and Lactate Dehydrogenase Complex in Cell Mitochondria

The existence of a supramolecular alcohol dehydrogenase–lactate dehydrogenase complex was demonstrated. Enzyme activities were evaluated in a preparation of mitochondrial membranes from mouse liver. The role of the enzyme complex (alcohol dehydrogenase–lactate dehydrogenase) in the regulation of pyruvate and acetaldehyde metabolism in the cell was studied.     

成人下颌下腺内瘦素和瘦素受体的表达及意义

目的 观察成人下颌下腺内瘦素和瘦素受体的表达和分布。方法 HE染色法和免疫组织化学SABC法。结果 成人下颌下腺内闰管、纹状管和部分小叶间导管上皮细胞呈瘦素及瘦素受体免疫阳性反应，免疫反应产物分布于导管上皮细胞胞质内，细胞核呈阴性反应。结论 成人下颌下腺内有瘦素和瘦素受体表达，可能参与调节胃肠功能及下颌下腺自身的分泌活动。     

Dendritic Cells in Bone Marrow at Diagnosis and after Chemotherapy in Adult Patients with Acute Myeloid Leukaemia

Dendritic cells (DCs) develop in the bone marrow from haematopoietic progenitor cells. Two subsets, plasmacytoid DCs (pDCs) and myeloid DCs (mDCs), have been identified. Little is known regarding DC levels in bone marrow of patients with acute myeloid leukaemia (AML) before and after chemotherapy. We investigated relative pDC and mDC levels in bone marrow from 37 hospital controls and 60 patients with AML [at diagnosis, complete remission (CR) and follow‐up] using four‐colour flow cytometry. The pDC immunophenotype was characterized as lin‐/HLA‐DR+/CD123 +  and mDC as lin‐/HLA‐DR+/CD11c+. In 69% of patients with AML, no DCs were detected at diagnosis. At CR, mDC levels were the same in patients with AML and hospital controls while pDC levels were slightly lower. There was no association between minimal residual disease or survival rates and DC levels. Patients with low mDC levels at CR were more likely to suffer from complicated infections, although the difference was not statistically significant. Altogether, there was a profound decrease in DC levels in patients with AML at diagnosis. DC levels increased at CR and were higher than in hospital controls after post‐remission therapy, suggesting that DCs recover after repeated chemotherapy. There may be an association between mDC levels and infectious complications.