血清淀粉样蛋白A与2型糖尿病及其合并大血管病变的关系

目的探讨血清淀粉样蛋白A（serumamyloid A,SAA）与2型糖尿病及其合并大血管病变患者的关系。方法将65例2型糖尿病患者按一定的纳入标准分成不伴血管病变34例和舍并大血管病变组31例,另抽取30名健康体检者作为健康对照组。在特种蛋白仪上采用比浊法测定血清SAA水平,并进行分析。结果2型糖尿病组SAA水平显著高于健康对照组,差异具有统计学意义P〈0．05）,并发大血管病变患者SAA与不伴大血管病变患者组比较差异也具有统计学意义（P〈0．05）。结论SAA在2型糖尿病及并发大血管病变患者中明显升高,在其发生发展中具有重要的临床意义,可能是2型糖尿病大血管病变的重要的危险因素。     

血清淀粉样蛋白A临床应用探讨

血清淀粉样蛋白A(SAA)属于急性时相反应蛋白,其水平在人体有炎症活动性病变时快速升高。SAA可作为病毒、细菌、真菌感染的诊断依据,可预测心血管事件的危险性,也可作为肿瘤患者疗效和预后的观察指标。在某些疾病中,如病毒感染、心血管疾病、移植排斥反应等,SAA的敏感性高于C-反应蛋白(CRP)。SAA在机体遭受感染后比CRP升高更早,恢复时下降更快,能为临床诊断和判断疾病预后提供更高的参考价值。由于CRP在病毒感染时不升高或升高不明显,SAA与CRP联合检测对鉴别细菌和病毒感染具有重要的意义。     

血清淀粉样蛋白A测定试剂盒质量评价与行业标准验证

目的 评价已上市血清淀粉样蛋白A测定试剂盒质量并对建立的行业标准进行验证。方法 验证试剂盒的空白限、检出限、准确度、线性、重复性性能指标与验证方案的符合性；同时评价国际标准物质在试剂盒之间的互换性。结果 大部分参与验证的血清淀粉样蛋白A测定试剂盒的空白限、检出限、准确度、线性、重复性验证结果满足行业标准要求；但59%的系统组合一致性较差；国际标准物质NIBSC92/680在大约37%的系统组合上有互换性。结论 绝大多数试剂盒的验证结果能满足制定的行业标准的要求；部分试剂盒存在基质干扰，导致测定结果的一致性还有待提高；另外，企业在使用国际标准物质NIBSC92/680溯源前应验证互换性。     

血清淀粉样物质A研究进展

血清淀粉样物质A（serum amyloid A,SAA）是组织淀粉样蛋白A的前体物质,属于急性时相蛋白,在组织损伤和炎症反应时升高.近年来,随着对SAA的基因调控、蛋白结构及生物学功能研究的深入,发现SAA对包括急性心肌梗死、移植后急性排斥反应和病毒感染等疾病的早期诊断作用要优于C-反应蛋白（C-response protein,CRP）.SAA的临床应用研究受到学者们的广泛关注,成为新的研究热点.该文主要就SAA超家族的结构、功能以及SAA在临床疾病应用中的研究进展作一综述.     

血清淀粉样蛋白A在感染性疾病中的诊断价值

血清淀粉样蛋白A(serum amyloid A protein,SAA)是一种急性时相反应蛋白,属于载脂蛋白家族中的异质类蛋白质,相对分子量约为12 000。在急性时相反应中,经白细胞介素1(interleukin-1,IL-1)、IL-6和肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)刺激,肝细胞可迅速合成SAA,浓度在4~6 h内达到峰值,从正常水平的1~5 mg/L升高到     

血清淀粉样蛋白A在肾移植术后排斥反应诊断中的价值

目的探讨血清淀粉样蛋白A(SAA)在肾移植术后排斥反应诊断中的价值。方法应用BNproSpec特定蛋白检测仪检测肾移植患者6例及健康者50例血清SAA、C反应蛋白(CRP)的含量。应用日立7600型全自动生化分析仪检测Bu、Cr的含量。结果健康者血清SAA平均值为2.49mg/L。肾移植患者术前血清SAA均值为11.0mg/L,术后第6-10天血清SAA达到峰值。术后发生排斥反应时,SAA水平明显升高且早于Cr水平的升高。结论肾移植术后血清SAA的异常升高较血清Cr更为敏感,可用于肾移植术后急性排斥反应的预测。     

血清淀粉样蛋白A 与肿瘤诊断、分期和预后相关性研究进展

目前用于肿瘤诊断和肿瘤分期的方法多具有侵袭性,且部分肿瘤标志物敏感性较低,已不能满足临床需求。已有大量的研究表明:血清淀粉样蛋白A(serum amyloid A, SAA) 与多种肿瘤的发生、发展密切相关,有较高的敏感度和特异度,无侵袭性、操作简单和成本低等优点。SAA 联合其他肿瘤标志物及肿瘤检测方法在肿瘤诊断、病理分期和预后判定中发挥临床价值。该文就近年来SAA 在多种肿瘤中的研究进展进行综述,为肿瘤患者个体化精准治疗、提升治疗效果、提高生存质量、提供理论支持。     

血清淀粉样蛋白A与2型糖尿病肾病的相关性

目的探讨血清淀粉样蛋白A（serum amyloid A,SAA）水平在2型糖尿病（T2DM）伴发糖尿病肾病（DN）中的意义。方法根据尿白蛋白排泄率（UAER）将102例2型糖尿病（T2DM）患者分为单纯糖尿病组（SDM组）、早期糖尿病肾病组（EDN组）和临床糖尿病肾病组（CDN组）,30名本院健康体检者作为对照组,应用免疫透射比浊法测定血清SAA,将组间的SAA进行统计学比较,并进行相关分析。结果各糖尿病组血清SAA水平与对照组比较均具有统计学差异（P〈0．05）,EDN、CDN组显著高于SDM组（P〈0．05）,CDN组与EDN组相比亦明显升高（P〈0．05）。相关分析显示SAA与UAER呈显著正相关（r=0．536,P〈0．01）。结论SAA水平在T2DM组和并发DN组中随着UAER的增加而升高,两者之间关系密切,提示炎症反应可能在DN的发病机制中起着重要的作用。     

血清淀粉样蛋白A在肾移植排异反应诊断中的作用

目的：探讨血清淀粉样蛋白A（SAA）在肾移植排异反应诊断中的作用。方法：用BNproSpec特定蛋白检测仪测定SAA、C反应蛋白（CRP）；用Olympus AU1000全自动生化仪测定肌酐（Cr).结果：60例正常人血清SAA浓度平均值为2.33mg/L，中位粒（测定范围）为1．56（0．72－17．7）mg/L,95%上限≤7.7mg/L，7例肾移植患者术前血清SAA浓度平均值为7.5mg/L，中位数（测定范围）为1．82（0．82－27．0）mg/L，移植后第1至第2天升高至中位数（测定范围）289（58.9-535)mg/L，而CRP水平与移植前相比差异无显著（P＞0．05）。移植后第1天至第15天，SAA水平下降的相对值显著高于血清Cr（P＜0．01）。结论：SAA浓度的测定对于肾移植急性排异反应的诊断比血清Cr更为敏感，在排除感染的情况下，SAA的异常的升高对肾移植急性排异反应具有很大的诊断价值。     

血清淀粉样蛋白A在疾病中的作用机制及应用研究进展

血清淀粉样蛋白A(SAA)属于急性时相反应蛋白,在感染急性期、炎症反应、组织损伤时迅速升高,在恢复期迅速下降.SAA与细菌或病毒感染、动脉粥样硬化、肿瘤、移植排斥反应、类风湿性关节炎、淀粉样病变等密切相关.文章主要就淀粉样蛋白(AA)超家族的结构、功能、检测方法及SAA在各种疾病中的作用机制及应用进展作一综述.     

动脉粥样硬化相关血清生物化学及分子生物学检测指标的最新研究进展

动脉粥样硬化是一种在人群中发病率较高的疾病,可以累及全身各处动脉引起相应的并发症,严重危害群体健康。传统的动脉粥样硬化的血清学检测指标仅有助于危险因素的检出,特异度较差。随着研究的进展,新发现许多血清学指标与动脉粥样硬化的发生发展相关,有可能为之后的诊断及后续的靶点治疗提供新的思路和方法,该文就新发现的与动脉粥样硬化相关的血清生物化学及分子生物学检测指标包括S100 钙结合蛋白A8 和A9,小分子RNA, 金属基质蛋白酶MMP-9, 微粒MPs 及白细胞介素33 进行综述。     

Changes in Human Serum Amyloid A and C-Reactive Protein after Etiocholanolone-Induced Inflammation

Secondary amyloidosis is a complication of diseases characterized by recurrent acute inflammation. In this study, a standardized stimulus which induced fever and inflammation was given to six normal subjects (19-24 yr old) to follow the fluctuation in concentration of serum amyloid A (SAA), the precursor of the secondary amyloid fibril protein. After a single intramuscular injection of etiocholanolone (0.3 mg/kg), blood samples were drawn twice a day for 12 days for determination of SAA by solid phase radioimmunoassay. From a base line of <100 μg/ml, the SAA concentration began rising within 12 h to a maximum value at about 48 h of 1,350-1,800 μg/ml in three males and 380-900 μg/ml in three females and returned to base line by 4-5 days. The SAA response showed a similar time response to C-reactive protein (CRP), a well-documented acute phase protein which was assayed semiquantitatively by capillary tube precipitin reaction. CRP, but not SAA, showed a quantitative correlation with the amount of fever induced by etiocholanolone. One subject exhibited a second rise in SAA and CRP concentrations after acute over-indulgence with alcohol, suggesting that acute liver damage may have caused an acute phase reaction. Thus, a controlled episode of fever and inflammation produced a prompt and prolonged elevation of SAA and CRP concentrations. Unlike SAA, CRP has not been implicated in the pathogenesis of amyloidosis, although its relationship to the P component of amyloid has recently been established.     

老年人群血清淀粉样蛋白A的分布水平

目的:研究广州市城乡结合部—石牌村老年人群血清淀粉样蛋白A(SAA)水平。方法:从该村原居民老年人群血清标本(共950份)随机抽取151份,应用酶联免疫吸附法(ELISA)测量SAA水平。结果:本研究人群SAA总体水平为(1104±986)ng/mL,且不同年龄组及不同性别组人群间SAA水平均无显著性差异。结论:目前SAA测量方法的标化及正常值范围的制定对SAA测定的广泛开展非常必要和迫切。     

Serum Amyloid A: EVIDENCE FOR ITS ORIGIN IN POLYMORPHONUCLEAR LEUKOCYTES

In this study the presence of an amyloid A, antigenically related material was determined in four subpopulations of human leukocytes. Monocytes, granulocytes, thymus-derived lymphocytes, and bone marrow-derived and null lymphocytes were isolated from the peripheral blood of five apparently normal subjects, two patients with secondary amyloidosis, three patients with acute infections, and seven patients with metastatic cancer. Mononuclear leukocytes, isolated from the interface of a Ficoll-Hypaque gradient, were separated into monocytes, thymus-derived lymphocytes, and bone marrow-derived plus null lymphocytes by glass adherence and depletion of sheep erythrocyte rosette-forming lymphocytes. Granulocytes were isolated by sedimentation in 2% methyl cellulose from the erythrocyte-rich pellet formed at the bottom of the Ficoll-Hypaque gradient. The four isolated leukocyte subpopulations were cultured and, at varying intervals, the amyloid A content of the culture medium and of sonicated, 2 x 10(6) cells was determined by radioimmunoassay. Our results indicated a 2-14 times greater amount of amyloid A-related material in the sonicated granulocytes compared with the individuals' serum amyloid A levels. The mononuclear subpopulations showed a low or negligible amyloid A content. The amount of amyloid A antigenic material was further found to increase in cultured granulocytes, reaching a peak value between the 16th and 30th h of culture. The granulocytes of only two out of eight individuals tested released amyloid A antigenically related material into the culture medium. This release was found to be blocked by the presence of colchicine, vincristine, puromycin, or cycloheximide in the culture medium. In contrast, only the presence of puromycin or cycloheximide was shown to significantly inhibit the intracellular increase of amyloid A in the cultured granulocytes. Thus, it appears that among the circulating blood cells, the granulocytes produce amyloid A antigenically related material and could release it under conditions that remain to be further defined.     

血清淀粉样蛋白A 与降钙素原水平检测在儿童感染性疾病中的诊断价值

目的　探讨血清淀粉样蛋白A（SAA）及降钙素原水平（PCT）在儿童感染性疾病中的诊断价值。方法　回顾性分析2019 年3~8 月于广州中医药大学第一附属医院就诊的150 例感染性疾病患儿的临床资料。其中,80 例细菌感染患儿纳入细菌感染组,70 例病毒感染患儿纳入病毒感染组,另随机选取50 例同期于该院体检健康儿童纳入对照组。采集三组血液样本,检测三组样本血清SAA 及PCT 水平,并分析其临床诊断价值。结果　三组血清SAA 及PCT 水平比较,差异均有统计学意义（F =17.383,11.169,均P ﹤ 0.05）;细菌感染组和病毒感染组血清SAA 水平与对照组比较,差异均有统计学意义（t =13.795,10.247,均P ﹤ 0.05）;细菌感染组血清PCT 水平与病毒感染组及对照组比较,差异均有统计学意义（t =15.005,18.146,均P ﹤ 0.05）;三组血清SAA 及PCT 阳性率比较,差异均有统计学意义（χ2=9.706,26.092,均P<0.05）。细菌感染组和病毒感染组SAA 阳性率均高于对照组（χ2=8.273,6.318,均P< 0.05）。细菌感染组PCT 阳性率高于病毒感染组及对照组（χ2=14.268,19.042,均P 值﹤ 0.05）。由ROC 曲线图可知,细菌感染组SAA及PCT 曲线下面积分别为0.785 及0.824,病毒感染组SAA 及PCT 曲线下面积分别为0.813 及0.551。SAA 对病毒感染的诊断特异度较高,PCT 对细菌感染的诊断特异度较高,SAA 与PCT 联合诊断细菌感染的敏感度为92.18%,特异度为88.03%;SAA 与PCT 联合诊断病毒感染的敏感度为80.14%,特异度为86.52%。结论　SAA 诊断病毒感染的敏感度较高,PCT 诊断细菌感染的敏感度较高,SAA 与PCT 联合检测可有效诊断儿童感染性疾病。     

Recent Advances in Percutaneous Cardioscopy

Percutaneous cardioscopy, using high-resolution fiberoptic imaging, enables direct visualization of the cardiac interior, thereby enabling macroscopic pathological diagnosis. Percutaneous cardioscopy has demonstrated that the endocardial surface exhibits various colors characteristic of different heart diseases. This imaging modality can now be used for evaluation of the severity of myocardial ischemia, and staging of myocarditis. Myocardial blood flow recovery induced by vasodilating agents or percutaneous coronary interventions can be clearly visualized. Morphological and functional changes in the cardiac valves can also be evaluated. Cardioscope-guided endomyocardial biopsy enables pin-point biopsy of the diseased myocardium. Recently, dye-image cardioscopy and fluorescence cardioscopy were developed for evaluation of the subendocardial microcirculation. Cardioscope-guided intracardiac therapies such as myotomy, myectomy, valvulotomy, and transendocardial angiogenic and myogenic therapy have been trialed using animal models in anticipation of future clinical applications. Percutaneous cardioscopy has the potential to contribute to our understanding of heart disease, and to assist in guidance for intracardiac therapies.     

高血压病治疗的若干近展

高血压病治疗的若干近展郑兴，章同华（第二军医大学附属长海医院上海２００４３３）ＲｅｃｅｎｔＡｄｖａｎｃｅｓｉｎＡｎｔｉｈｙｐｅｒｔｅｎｓｉｖｅＴｈｅｒａｐｙＺｋｅｎｇＸｉｎｇ，ＺｈａｎｇＴｏｎｇｈｕａ（ＣｈａｎｇｈａｉＨｏｓｐｉｔａｌ，ｔｈｅＳｅｃｏ...