细胞因子及特异性抗体的检测在肾综合征出血热诊断中的意义

探讨检测血清细胞因子及肾综合征出血热(HFRS) 病毒特异性抗体IgM和IgG的含量在HFRS发病机制及诊断中的意义.选择24例HFRS患者及30例健康人血清标本,采用生物素-亲和素-酶免疫技术检测IL-2、IL-6和TNF-α,ELISA方法检测血清HFRS病毒特异性抗体IgM和IgG,并对其进行统计学分析. 结果显示, ELISA法检测HFRS患者抗HFRS病毒IgM和IgG的阳性率分别为75.00 % 和50.00 %,健康对照组的抗体阳性率为零;HFRS患者血清IL-2、IL-6、TNF-α的含量分别为10.88±2.31pg/mL、256.46±102.51pg/mL和45.63±5.32pg/mL,高于健康对照组0.59±0.24pg/mL(P＜0.01)、53.8±19.21 pg/mL(P＜0.01)和5.81±3.58 pg/mL(P＜0.01). 结论 :HFRS患者血清IL-2、IL-6和TNF-α及血清特异性抗体IgM和IgG的含量较健康人明显升高,检测这些指标对该病发病机理、诊断及预后评价有一定意义.     

单克隆抗体ELISA间接夹心法检测家鼠型HFRS疫区人和动物血清中特异性抗体

用McAb-ELISA间接夹心法和IFAT或酶标SPA染色法平行检测山西地区(家鼠型HFRS疫区)的人及动物血清中HFRS病毒特异性IgM和/或IgG抗体。结果ELISA检测174份HFRS病人血清的阳性率及抗体滴度均明显高于IFAT。检测295份无明确HFRS病史的健康人血清,ELISA的阳性率也高于IFAT。检测215份鼠类血清,102份兔血清及108份猪血清,ELISA的阳性检出率与IFAT或酶标SPA染色法基本相同。用阻断试验等证明本ELISA检出的确是HFRS病毒特异性抗体。对ELISA的某些试验条件作了讨论,并认为,McAb-ELISA在帮助临床早期诊断及血清流行病学调查等方面均有实用价值。     

强直性脊柱炎患者血清白细胞介素18检测的意义

目的探讨白细胞介素18(IL-18)在强直性脊柱炎(AS)发病中的作用及其血清水平检测的临床意义。方法采用酶联免疫吸附试验法(ELISA)检测53例活动期AS患者与40例健康对照组血清IL-18及肿瘤坏死因子α(TNF-α)的水平,并动态观察治疗前后IL-18及TNF-α的变化及其与病情活动指标之间的关系。结果AS患者治疗前血清IL-18水平明显高于健康对照组[(415.7±30.4)ng/L比(45.7±10.4)ng/L,P<0.05)],并与TNF-α、Bath强直性脊柱炎病情活动性指数(BASDAI)、晨僵时间、Bath强直性脊柱炎功能指数(BASFI)和Bath强直性脊柱炎脊柱活动测量指数(BASMI)呈正相关(r分别为0.52、0.63、0.48、0.58和0.48,P均<0.01)。治疗12周、24周后AS患者血清IL-18水平分别为(323.6±85.8)和(220.1±15.1)ng/L,均较治疗前明显下降,且治疗24周后下降更明显。结论IL-18可能参与AS发病机制,血清IL-18的检测可作为反映AS病情活动的指标之一。     

烟台地区肾综合征出血热患者血清抗体检测和汉坦病毒序列测定

目的 了解烟台地区肾综合征出血热(HFRS)患者血清中IgG、IgM抗体水平，确定引起该地区HFRS流行的汉坦病毒的型别分布。方法 收集临床HFRS急性期和恢复期患者血清；用EMSA检测IgG、IgM抗体；用交叉空斑减少中和试验检测中和抗体；采用Trizol法提取患者血清中HFRS病毒RNA，用套式PCR产物做TA试验，测定核苷酸序列。结果 HFRS患者血清IgM阳性率为82．2％(88／107)，IgG阳性率为85．7％(66／77)。该地区两城市38份HFRS患者血清中，有32份属家鼠型病毒(SE0)感染，另6份未能定型；另一城市16份HFRS患者血清中，有15份属姬鼠型病毒感染，1份未定型。该地区HFRS病毒与SE0的同源性达90％以上。结论 引起烟台地区HFRS流行的汉坦病毒，属于以SE0为主的混合型病毒。     

用酶标Ig交叉反应性单抗作间接ELISA检测肾综合征出血热(HFRS)病毒抗体

<正> 自Tkachenko等和Gavrilovskaya等应用酶联免疫吸附试验(ELISA)检测了HFRS病毒抗体以来,ELISA在HFRS的诊断与血清流行病学调查上的应用得到不断的发展。1986年,柴瑞珍等建立了ELISA抗IgM固相法检测人血清中的IgM抗体,但若用于不同种属血清的检测则需选用不同的固相包被抗体。本文在制备了Ig交叉反应性单抗(McAb)的基础上,制备了可用于人、猪、兔血清IgG检测的酶标McAb,建立了检测人、猪、兔血清中HFRS病毒抗体的ELISA间接法。     

系统性红斑狼疮患者血清IL-10的水平及临床意义

目的观察系统性红斑狼疮(systemic lupus erythematosus,SLE)患者血清IL-10的表达与疾病活动的关系。方法选取22例SLE患者及24名健康人作为对照,根据狼疮疾病活动指数(SLE disease activity index,SLEDAI)将SLE患者分为活动期组和非活动期组,检测血清抗dsDNA抗体,血清总补体溶血活性(CH50)及C反应蛋白(C reactive protein,CRP),酶联免疫吸附法(ELISA)检测血清IL-10表达。结果与对照组[(18.11±6.97)ng/L]相比,IL-10在SLE活动期组[(78.54±5.62)ng/L,P<0.01]及非活动期组[(30.36±10.98)ng/L,P<0.05]均有所增高,活动期组增高更为明显(与非活动期组相比,P<0.05)。IL-10水平与SLEDAI呈正相关(SLE活动期,r=0.77,P<0.01;SLE非活动期,r=0.84,P<0.01),IL-10的水平与抗dsDNA抗体(r=0.71,P<0.01)、CRP(r=0.63,P<0.01)和CH50(r=-0.56,P<0.05)均相关。结论IL-10在SLE患者血清中表达升高,在疾病活动时更为明显,IL-10能反应疾病活动的程度,可以做为临床观察SLE疾病活动的指标之一。     

自身免疫病患者血液中穿通支原体分离培养及其血清IL-6与TNF-α的检测

目的:探讨自身免疫病AID患者血液中穿通支原体(Mpe)的分离检出以及Mpe感染患者血清中IL-6与TNF-α的浓度水平.方法:采用分离培养共计从44例AID患者血液标本, 16例ASO或RF阳性体检人员及28例正常对照相应标本中进行支原体分离检测, 对培养阳性菌株采用穿通及发酵支原体套式PCR予以证实, 并用RIA对相应血清进行IL-6及TNF-α浓度检测.结果:于17例(38.6%)AID患者血液中分离到Mpe, 2例(12.5%)ASO或RF阳性体检人员中分离到Mpe, 而正常对照组中则无1例阳性, 组间支原体检出率有统计学意义(P<0.01).支原体阳性AID组血液IL-6浓度(3.30±1.49) μg/L与支原体阴性AID组(2.43±0.95) μg/L及正常对照组(1.14±0.32) μg/L之间差异有统计学意义(P<0.01);支原体阳性AID组血液TNF-α浓度(293.3±179.9) ng/L与支原体阴性AID组(173.9±73.9) ng/L及正常对照组(108.8±33.8) ng/L组之间也有统计学意义(P<0.01).结论:Mpe感染与AID的发生密切相关, Mpe感染患者血清中IL-6与TNF-α较非感染对照人群明显升高.     

大骨节病患者血清促炎症细胞因子水平的检测

目的探讨前炎症细胞因子TNF、IL-1β和IL-6在大骨节病(KBD)发病机制中的作用。方法采集62例KBD患者和60例健康对照的血清标本,采用双抗体夹心ELISA法测定血清前炎症细胞因子TNF、IL-1β和IL-6的水平。结果KBD患者血清IL-1β和IL-6的水平分别为(238.4±698.5)ng/L和(164.4±661.4)ng/L,健康人分别为(74.5±130.0)ng/L和(52.2±154.6)ng/L,但它们之间差异均不显著(P>0.05)。然而,KBD患者血清TNF的水平[(109.2±145.3)ng/L]高于健康对照[(40.9±89.7)ng/L],差异非常显著(P<0.01)。患者血清TNF与IL-1β的水平及血清TNF与IL-6水平的相关性均不显著(r值分别为0.0387和0.2135,P>0.05)。血清IL-1β与IL-6的水平呈显著的正相关(r=0.3460,P<0.01)。结论血清前炎症细胞因子水平的升高,可能与大骨节病的发病有关。     

强直性脊柱炎患者血清白细胞介素18检测的意义

目的 探讨白细胞介素18(IL-18)在强直性脊柱炎(AS)发病中的作用及其血清水平检测的临床意义.方法 采用酶联免疫吸附试验法(ELISA)检测53例活动期AS患者与40例健康对照组血清IL-18及肿瘤坏死因子α(TNF-α)的水平,并动态观察治疗前后IL-18及TNF-α的变化及其与病情活动指标之间的关系.结果 AS患者治疗前血清IL-18水平明显高于健康对照组[(415.7±30.4)ng/L比(45.7±10.4)ng/L,P＜0.05)],并与TNF-α、Bath强直性脊柱炎病情活动性指数(BASDAI)、晨僵时间、Bath强直性脊柱炎功能指数(BASFI)和Bath强直性脊柱炎脊柱活动测量指数(BASMI)呈正相关(r分别为0.52、0.63、0.48、0.58和0.48,P均＜0.01).治疗12周、24周后AS患者血清IL-18水平分别为(323.6±85.8)和(220.1±15.1)ng/L,均较治疗前明显下降,且治疗24周后下降更明显.结论 IL-18可能参与AS发病机制,血清IL-18的检测可作为反映AS病情活动的指标之一.     

老年抑郁症患者治疗前后血清细胞因子水平的研究

目的观测老年抑郁症患者使用盐酸帕罗西汀治疗前后血清细胞因子水平的变化。方法采用酶联免疫吸附法(ELISA)检测30例首发老年抑郁症患者(研究组)治疗前后的血清IL-6、IL-1β、TNF-α的水平并和30例健康老年人(对照组)比较,结合汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)总分及各因子分进行相关分析。结果研究组治疗前血清IL-6(63.24±15.67ng/1)、IL-1β(33.24±17.27ng/1)、TNF-α(29.24±15.67ng/1)水平显著高于对照组IL-6(31.41±11.51ng/l)、IL-1β(18.36±8.17ng/l)、TNF-α(18.24±10.56ng/l);P0.05。帕罗西汀治疗后血清IL-6、IL-1β、TNF-α水平较治疗前显著下降(P0.05)。结论血清IL-6、IL-1β、TNF-α水平升高可能是老年抑郁症的免疫学标志之一;帕罗西汀抗抑郁的同时降低血清IL-6、IL-1β、TNF-α水平。     

原发性肾小球疾病和高血压肾病患者血清Ald水平比较

目的：比较原发性肾小球疾病和高血压肾病所致慢性肾脏疾病（CKD）患者随疾病进展血清醛固酮（Ald）水平变化的异同。方法：此两种病因导致不同程度慢性肾功能不全而未开始肾替代治疗的CKD患者共95例，依据病因分成两组，比较这两组患者的血浆肾素活性（PRA）、血管紧张素Ⅱ（AngⅡ）和血清Ald浓度以及电解质水平；PRA、AngⅡ和Ald的检测采用放射免疫分析。结果：高血压肾病所致CKD患者血清Ald水平显著高于原发性肾小球疾病所致CKD患者（P〈0．01），经肌酐清除率（Ccr）修正后高血压肾病所致CKD患者血清Ald水平仍显著高于原发性肾小球疾病所致CKD患者（P〈0．05）。结论：在肾功能可比较的情况下，高血压肾病所致CKD患者较原发性肾小球疾病所致CKD患者血清Ald水平更容易升高。     

Treatment of asthma in pre-school children with inhalation of terbutaline in Turbuhaler compared with Nebuhaler

The aim of this study was to evaluate the efficacy, safety and preference of pre-school children with regard to two different devices for treatment of bronchial asthma with terbutaline. Turbuhaler, a powder inhaler preloaded with pure terbutaline for inhalation, was compared with a pressurized metered dose inhaler, attached to a Nebuhaler. The study had an open, cross-over randomized design. Each treatment period consisted of 2 weeks. Diary cards were filled in every morning and evening by the parents regarding PEF, asthma symptoms, extra inhalations of terbutaline, and side effects. Twenty-one children (mean age 3.9 years) were included in the study. A highly significant (P less than 0.001) increase in peak expiratory flow (PEF) was obtained after inhalation with both devices. The PEF values in the mornings after inhalation of terbutaline with Turbuhaler were significantly higher (P = 0.046) than those with Nebuhaler. Further, the PEF baseline values in the evenings before inhalation were also significantly higher (P = 0.03) with Turbuhaler. No difference was found in asthma symptoms and extra medication between the two devices. Side effects were mild and few with both devices. The parents found Turbuhaler easier to handle and 19 of 21 preferred this device for future use.     

Correlation of in situ hybridization with histology and viral culture in patients with acquired immunodeficiency syndrome with cytomegalovirus colitis

Endoscopic colonic biopsy specimens from 34 patients with acquired immunodeficiency syndrome and six patients without acquired immunodeficiency syndrome (3 were human immunodeficiency virus-seropositive and 3 were human immunodeficiency virus-seronegative) were examined by in situ hybridization for evidence of cytomegalovirus colitis and the results were compared with histologic examinations and viral cultures. In situ hybridization was positive in 22 of 25 patients with acquired immunodeficiency syndrome with histologic evidence of cytomegalovirus colitis. By our interpretation, 15 patients without cytomegalovirus colitis histologically all had negative hybridization studies. No correlation was found between in situ hybridization and viral culture results. In situ hybridization is a useful confirmatory test when the histologic changes are suspicious for cytomegalovirus but not considered diagnostic; it will only rarely demonstrate staining in a case considered negative histologically.     

Associations of paternal involvement in disease management with maternal and family outcomes in families with children with chronic illness

OBJECTIVE: The role of fathers in pediatric disease management and its associations with family functioning have rarely been the focus of empirical study. In this study, we used the Dads Active Disease Support scale (DADS), a measure of the amount and helpfulness of paternal involvement in pediatric disease management, to explore the association between father involvement and other aspects of family functioning. METHOD: A sample of 190 heterosexual couples completed the DADS and measures of maternal, marital, and family functioning. RESULTS: Maternal report of higher ratings on DADS Helpfulness scale was associated with fewer self-reported maternal psychiatric symptoms and less perceived impact of the disease on family functioning. Both mothers' and fathers' reports indicated that more paternal involvement was related to more favorable outcomes in marital satisfaction and family functioning. CONCLUSIONS: More paternal involvement in disease management was associated with healthier maternal, marital, and family functioning. Longitudinal studies are needed to determine whether paternal involvement is likely to be a fruitful target for psychological intervention.