甲型肝炎患者淋巴细胞mIL－2R的表达及血清sIL－2R释放的动态变化

对５２例甲型肝炎（甲肝）患者血ＴＩＬ－２Ｒ释放水平进行了动态观察，并对患者ＰＢＭＣｍＩＬ－２Ｒ的表达进行了同步监测。发现在甲肝急性期，ｍＩＬ－２Ｒ的表达（２０．５５±１０．５２％）及ｓＩＬ－２Ｒ的释放（６６４．１３±４８８．８４ｕ／ＭＬ）均较正常对照组（７．５５±４．２８％，Ｐ＜０．００１；１８８．９０±１２２．９１ｕ／ｍＬ，Ｐ＜０．００１）显著增强，恢复期（９．３２±６．２０％；２０６．７８±１７６．０７ｕ／ＭＬ）两者均基本降至正常水平。相关分析发现ｍＩＬ－２Ｒ的表达与ｓＩＬ－２Ｒ的释放存在显著的正相关，两者与ＡＬＴ之间亦显著相关。提示ｍＩＬ－２Ｒ的表达及ｓＩＬ－２Ｒ的释放可能与甲肝患者的肝损伤有关。     

可溶性白介素2受体与急性心肌梗塞相关性的研究

本研究采取双抗体夹心ＥＬＩＳＡ法测定３２例急性心肌梗塞患者血清可溶性白介素２受体（ｓＩＬ－２Ｒ）和肌酸激酶（ＣＫ）结果显示：急性心肌梗塞的ｓＩＬ－２Ｒ和ＣＫ明显高于恢复期的患者及正常对照组（ｎ＝４０）（Ｐ＜０．００１，Ｐ＜０．００１），而恢复期与正常对照组无显著差异（Ｐ＞０．０５）；ｓＩＬ－２Ｒ水平与急性心肌梗塞的面积呈正相关（Ｐ＜０．００１，Ｐ＜０．０５）；无并发症的急性心肌梗塞与伴有并发症的急性心肌梗塞的ｓＩＬ－２Ｒ、ＣＫ有显著差异（Ｐ＜０．０５．Ｐ＜０．０１）．提示急性心肌梗塞患者存在免疫调节功能改变，显示ｓＩＬ－２Ｒ做为急性心肌梗塞患者病情监测、判断预后的指标。     

SINGLE DAILY DOSE SHORT TERM CARBIMAZOLE THERAPY FOR HYPERTHYROID GRAVES''DISEASE

Twenty-one patients with hyperthyroid Graves' disease were treated with carbimazole 30 mg daily, given as a single dose. Propranolol was also given for the first 3 weeks. All became clinically euthyroid with normal serum thyroxine (T4) levels, usually within 1-3 months. Patients with large goitres and raised serum alkaline phosphatase concentrations took longer to respond. In 19 patients a positive thyroid stimulating hormone (TSH) response to intravenous thyrotrophin releasing hormone (TRH) developed. Carbimazole was stopped soon after (median time of treatment 18 weeks, range 9-41 weeks) and 18 patients have been followed. Seven of these (39%) have remained in remission from hyperthyroidism for more than one year (median 77 weeks). Carbimazole 30 mg once daily is a convenient and effective treatment for hyperthyroid Graves' disease. Many patients will achieve prolonged remissions if treatment is stopped when serum T3 and T4 levels are in the low-normal range, usually 2-4 months after clinical euthyroidism has been reached.     

CORRELATION OF ORBITAL COMPUTED TOMOGRAPHY AND ANTIBODIES IN PATIENTS WITH HYPERTHYROID Graves''DISEASE

The purpose of this study was to elucidate the incidence of orbital changes in computed tomography, and the relationships of orbital changes with eye-muscle antibody (EMAb), thyrotrophin-binding inhibitor immunoglobulin (TBII), antithyroglobulin antibody (TgAb) and anti-thyroid microsomal antibody (MsAb), in 55 consecutive patients with hyperthyroid Graves' disease. EMAb was demonstrated by an immunoperoxidase technique. The results showed that the prevalence of orbital fat increase, extraocular muscle enlargement, lacrimal gland enlargement and optic nerve swelling were 54.5, 41.8, 21.8 and 16.5% respectively. There were 32.7% of patients without any orbital changes. The patients with extraocular muscle enlargement, lacrimal gland enlargement and optic nerve swelling had higher titres of EMAb than the patients without these orbital changes. The patients with lacrimal gland enlargement had a lower TBII index than those without. There was no difference in TgAb or MsAb between the patients with extraocular muscle enlargement, lacrimal gland enlargement, optic nerve swelling or orbital fat increase and those patients without these orbital changes. The patients with extraocular muscle enlargement, optic nerve swelling and orbital fat increase had a higher degree of exophthalmos than the patients without these orbital changes. EMAb was negatively correlated with TBII. However, there was no correlation between EMAb and TgAb or MsAb. The degree of exophthalmos was positively correlated with EMAb and negatively correlated with age. There was no correlation between exophthalmos and TBII, TgAb or MsAb. In conclusion, although the pathogenesis of orbital changes and hyperthyroidism is different, a close link between these two entities is suggested by the high incidence of orbital changes in hyperthyroid Graves' disease.(ABSTRACT TRUNCATED AT 250 WORDS)     

酒精性肝硬变患者血清干扰素和可溶性干扰素受体的检测及意义

酒精性肝硬变(AC)常伴有体液免疫和细胞免疫系统功能改变,干扰素(IFN)和可溶性干扰素受体(sIFNR)是免疫细胞的重要调理素。为了进一步弄清IFN和sIFNR与AC之间的关系,我们用ELISA法检测了32例AC患者和10例正常人血清IFN和sIFNR水平。结果发现AC组α-IFN,γ-IFN和sIFNR的血清浓度明显高于正常人(P值分别<0.01,<0.05和<0.05),但其变化与疾病的严重程度无相关性。这些结果提示AC患者存在血清α-IFN、γ-IFN和sIFNR的改变。     

THE EFFECT OF ATENOLOL ON SERUM THYROID HORMONES IN HYPERTHYROID PATIENTS

SUMMARY. The effect of the 4bT-1 -adrenoceptor blocking agent, atenolol, on serum levels of thyroxine (T4), triiodothronine (T3) and reverse triiodothyronine (rT3) was studied in twelve hyperthyroid patients. While all patients improved symptomatically after treatment with atenolol 100 mg twice daily for 2 weeks, there were no significant changes in the serum T3 or rT3 concentrations. The serum T4 level showed a small but statistically significant fall. These data do not support the hypothesis that the beneficial clinical effects of β-adrenoceptor blocking drugs in thyrotoxicosis are mediated by an action on the peripheral metabolism of thyroid hormones.     

血液透析患者sIL－2R、IL－6变化与淫羊藿的免疫调节作用

用ＥＬＩＳＡ方法和白细胞介素６（ＩＬ－６）依赖细胞株ＭＴＴ掺入法对血液透析患者循环可溶性ＩＬ－２受体（ｓＩＬ－２Ｒ）和ＩＬ－６水平进行了检测，并同时观察了用中药淫羊藿治疗同一血透患者３个月前、后上述指标的变化。结果证实血液透析患者ｓＩＬ－２Ｒ水平明显增高（Ｐ＜０．０１），ＩＬ－６水平明显降低（Ｐ＜０．０１），用淫羊藿治疗后ｓＩＬ－２Ｒ及ＩＬ－６水平可调整至正常水平。由此说明血液透析患者存在免疫功能的降低，中药淫羊藿的调节作用是有效的。     

肾病综合征患者可溶性白介素2受体变化及意义

为了探讨肾病综合征（ＮＳ）患者可溶性白介素２受体（ＳＩＬ－２Ｒ）变化的临床意义，我们检测３６例ＮＳ血清及尿液ＳＩＬ－２Ｒ。结果表明：ＮＳ发作组血清及尿液ＳＩＬ－２Ｒ浓度明显高于ＮＳ缓解组（Ｐ＜０．０１）及健康对照组（Ｐ＜０．０１），而ＮＳ缓解组血清及尿液ＳＩＬ－２Ｒ浓度和健康对照组无显著性差异（Ｐ＜０．０５）。血ＳＩＬ－２Ｒ和血肌酐呈正相关（ｒ＝０．４４，Ｐ＜０．０１），尿　ＳＩＬ－２Ｒ和尿蛋白排泄量呈正相关（ｒ＝０．４８，Ｐ＜０．０１）。研究提示ＳＩＬ－２Ｒ浓度升高可作为ＮＳ活动及（或）肾功能恶化的指标。     

肾移植术后可溶性白介素－2受体的动态观察

多年来人们一直在寻找一种非创伤性检查方法来诊断肾移植急性排斥反应。我们采用双抗体夹心ＥＬＩＳＡ分别于术前、术后第３、７天及以后每周１次，连续２个月动态监测２４例肾移植患者１１４例次血清可溶性白介素－２受体（ｓＩＬ－２Ｒ），以探讨其对移植肾急性排斥反应诊断和鉴别诊断的临床意义。结果表明ｓｌＬ－２Ｒ水平移植前高于正常对照组，移植后随着移植肾功能的恢复而明显降低（Ｐ＜０．０１），当发生急性排斥反应时则显著升高，而环孢素肾中毒、急性肾小管坏死时则变化不明显。特别强调了动态检测ｓＩＬ－２Ｒ变化百分率对急性排斥反应的预测、诊断和鉴别诊断具有更重要意义。     

可溶性白介素2受体在慢性乙型肝炎中的意义及其升高机制初探

用夹心酶联免疫吸附法检测了３９例慢性乙型肝炎病人血清可溶性白介素２受体（ｓＩＬ－２Ｒ）水平以及病人外周血淋巴细胞（ＰＢＬ）在体外经植物血凝素（ＰＨＡ）刺激后ｓＩＬ－２Ｒ的分泌能力。结果示慢性乙型肝炎病人血清ｓＩＬ－２Ｒ明显高于对照组，并且其升高与病人血清谷丙转氨酶（ＡＬＴ）及肝内单个核细胞浸润和肝细胞坏死相关。而病人ＰＢＬ经ＰＨＡ刺激分泌ｓＩＬ－２Ｒ的能力与正常人无明显差异。     

慢性重型乙型肝炎患者血清可溶性肿瘤坏死因子受体的变化

应用酶联免疫吸附试验法测定了32例慢性重型乙型肝炎患者血清可溶性肿瘤坏死因子受体(sTNFR)水平。结果 慢性重型肝炎患者sTNFR水平显著升高,升高程度与总胆红素呈正相关,与凝血酶原活动度呈负相关。伴有感染或肝肾综合征时,sTNFR水平显著高于无感染或无肝肾综合征患者,最终死亡者其水平也显著高于存活者。提示测定慢性重型肝炎患者血清sTNFR水平对判断病情及预测转归有一定的价值。     

晚期日本血吸虫病患者血清可溶性白细胞介素-2受体的研究

采用双抗体夹心ELISA法,检测47例晚期日本血吸虫病患者血清可溶性白细胞介素-2受体(sIL-2R),同时用间接免疫荧光法测定其外周血单个核细胞(PBMCs)膜IL-2受体(mIl-2R)的表达水平。结果表明晚血患者血清sIL-2R较正常人明显增高,而mIl-2R表达明显低下(P<0.01),其sIL-2R水平与mIl-2R表达呈负相关(r=-0`62,P<0.01).血清sIL-2R高低与COPT阳性与否无关,说明患者血清sIL-2R高低与病原体本身无直接关系,而与患者是否伴腹水有关,提示sIL-2R水平与疾病进展程度有关。观察患者血清sIL-2R的高低可作为疾病病程的监测指标。     

老年病毒性肝炎和肝细胞癌患者外周血可溶性白细胞介素2受体的检测及意义

应用单克隆抗体夹心酶联免疫吸附试验(ELISA)对75例老年病毒性肝炎和肝细胞癌患者血清的可溶性白细胞介素2受体(sIL-2R)进行检测,并与健康老年人作对照比较。结果显示,急性肝炎黄疸期、慢性肝炎(中度)、重型肝炎组血清sIL-2R分别为129.36±37.15/ml、174.44±91.90u/ml、245.00±77.67u/ml,明显高于正常对照组的72.67±43.46/ml(P<0.01)。而慢性肝炎(轻度)、急性肝炎恢复期、肝癌组分别为82.67±30.86u/ml、73.61±20.28u/ml、70.12±30.36u/ml,与正常对照组比较无显著差异(P>0.05)。sIL-2R水平与感染的肝炎病毒类型无关(P>0.05)。老年肝癌组经免疫增强型治疗后血清sIL-2R水平升高至207.14±88.45u/ml(P<0.05)。血清sIL-2R含量的消长与疾病严重程度似呈正相关,提示临床检测sIL-2R水平对判定病情变化和预后及评估机体免疫状态有一定的意义。老年人免疫力低下可能是肝癌的重要致病因素之一。     

EFFECT OF ACUTE AND CHRONIC NEUROLEPTIC THERAPY ON SERUM PROLACTIN LEVELS IN MEN AND WOMEN OF DIFFERENT AGE GROUPS

A single fasting level of serum prolactin was measured in each of sixty control subjects and eighty-three psychiatric patients of both sexes who had been on neuroleptic therapy for 2-4 weeks (acute treatment) or at least 5 years (chronic treatment) and who were aged either 17-45 or 48-85 years. All groups of patients had significantly higher mean prolactin levels than controls. Gender, age group of women, and exposure to acute or chronic treatment were significant variables determining the magnitude of neuroleptic-induced elevation of prolactin. In some of the groups, dose, duration of chronic therapy, and concomitant administration of anticholinergic drugs also influenced prolactin levels. Whereas all acutely treated women had prolactin values above the control range, one out of twelve (8.3%) of the women aged 17-45 years and six out of fourteen (42.9%) of the women aged 48-85 years who were under chronic treatment had normal values. Normal prolactin levels were also found in five out of sixteen (31.2%) of the acutely treated and nine out of twenty-four (37.5%) of the chronically treated men aged 17-85 years.     

DIETARY INTAKE IN THYROTOXICOSIS BEFORE AND AFTER ADEQUATE CARBIMAZOLE THERAPY; THE IMPACT OF DIETARY ADVICE

Dietary intake, including actual nutrient and energy intake, was assessed in 21 successive thyrotoxic patients before and after adequate carbimazole therapy. Group A (10 subjects) received regular formal dietary advice whereas Group B (11 subjects) did not. An age and sex matched control group, comprising 23 normal individuals, was also studied. The mean energy intake of all the thyrotoxic subjects was significantly greater than that of the normal control group (P less than 0.0025). There was a greater overall reduction in the energy intake of Group A as compared with Group B (P less than 0.01) and the former gained less weight, when expressed as a percentage of pretreatment weight. The mean final weight of all the thyrotoxic subjects exceeded the mean ideal weight for the group, reflecting a degree of true obesity at this stage. The simple measure of incorporating dietary advice into the treatment programme of thyrotoxic patients will usually result in some reduction of energy intake, and thus weight gain, en route to euthyroidism.     

Graves''DISEASE IN PREGNANCY: TSH RECEPTOR BINDING INHIBITING IMMUNOGLOBULINS AND MATERNAL AND NEONATAL THYROID FUNCTION

We studied interrelationships between maternal and neonatal thyroid function, TSH receptor binding inhibiting immunoglobulins (TBII), and dose of thionamide antithyroid drugs in 44 women with active Graves' disease presenting during 46 pregnancies, and their 48 infants. The women were treated with propylthiouracil (PTU) or carbimazole (CBZ). In 30 pregnancies (30 infants) treatment was withdrawn from 3 to 18 weeks before delivery (Group A). Drug treatment (PTU, n = 10, dose 50-400 mg/day or CBZ, n = 6, dose 5-45 mg/day) was continued throughout pregnancy and delivery in 16 pregnancies producing 18 infants (Group B). The maternal TBII at delivery was well correlated with maternal free thyroxine index (FTI) averaged over the third trimester (r = 0.603, P less than 0.001) and umbilical venous serum TBII (r = 0.940, P less than 0.001). Neonatal FTI was independently related to umbilical vein TBII (t = 2.29, P = 0.03) and maternal dose of antithyroid drug (t = -2.21, P = 0.03). Neonatal thyrotoxicosis was seen in all four infants (8% of births) of women whose TBII levels at delivery exceeded 70%. No child was born with a subnormal FTI but 7/18 infants in group B had raised TSH at birth. This was more likely to occur (P = 0.05) if maternal TBII was less than 30% (6/10) than if maternal TBII was greater than 30% (1/8). Four Group B women with FTI in the lower half of the reference range delivered infants with raised TSH compared with 3/14 (21%) women whose FTI was in the upper half of the reference range or above (P = 0.05). In pregnant women with active Graves' disease TBII levels reflect stimulatory TSH receptor antibody activity. TBII measurements are of use in the prediction of neonatal thyrotoxicosis and impaired neonatal thyroid function in infants of women treated with antithyroid drugs.     

血清可溶性白细胞介素2受体测定在病毒性肝炎中的意义

为探讨急慢性病毒性肝炎血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）的改变，及其在诊断、病情演变和预后判定中的意义。本文作者采用夹心酶联免疫吸附法测定１０１例急慢性病毒性肝炎血清ｓＩＬ－２Ｒ水平（包括急性病毒性肝炎８０例、慢性乙型肝炎２１例），急性和慢性病毒性肝炎患者血清ｓＩＬ－２Ｒ分别为９０７．９±２５４．０ｕ／ｍｌ和７９５．７±１９８．２ｕ／ｍｌ，均明显高于对照组（Ｐ＜０．０１），急性肝炎组明显高于慢性肝炎组（Ｐ＜０．０１）；其中急性病毒性肝炎黄疸期血清ｓＩＬ－２Ｒ明显高于恢复期（Ｐ＜０．０１），各型急性病毒性肝炎之间血清ｓＩＬ－２Ｒ差异无显著性（Ｐ＞０．０５）。结果提示：急性和慢性病毒性肝炎患者血清ｓＩＬ－２Ｒ水平均明显增高，其水平的高低在一定程度上反映了机体免疫功能状态、肝细胞损伤及炎症程度。