检测微小病变型肾病综合征患者腺苷脱氨酶的临床意义

目的：检测微小病变型肾病综合征（MCNS）患者血清及淋巴细胞内腺苷脱氨酶（S-ADA,L-ADA）活性的变化,以评估其细胞免疫状态,并探讨临床意义。方法：选取初发的MCNS患者30例,应用免疫学技术测定不同的病程阶段患者的S-ADA及L-ADA活性,比较ADA活性变化。结果：激素治疗前,激素敏感组（SS）、激素依赖组（SD）和激素抵抗组（SR）两两比较无统计学意义（P〉0.05）,经激素足量治疗4周后,SS组、SD组S-ADA和L-ADA活性均下降,SS组下降最明显（P〈0.01）,而SR组无变化（P〉0.05）;短期缓解期组S-ADA活性降至对照组水平,L-ADA活性也下降,但与对照组相比,其水平仍高（P〈0.05）;长期缓解期组S-ADA及L-ADA活性与对照组相比,无统计学差异（P〉0.05）;S-ADA及L-ADA活性有显著的相关性（r=0.811,P〈0.01）。结论：MCNS患者存在着细胞免疫的紊乱,检测S-ADA及L-ADA活性可作为判断临床治疗效果的指标之一。     

兔输精管吻合术后精子腺苷脱氨酶活性的变化

我们利用日本大耳白兔建立的输精管结扎1年吻合术5个月后的动物模型,分析了精子膜上腺嘌呤核苷脱氨酶(ADA)的活性以及该类精子膜上活性与受精能力之间的关系。实验结果显示吻合术5个月后,不孕组精子膜上ADA活性(186.87+63.73nMols/mgPro/h)明显高于孕组的ADA活性(132.81+49.85nMol/mgPro/h(P<0.01)。同时,两实验组ADA活性又高于对照组ADA活性(81.22+47.63nMol/mgPro/h)(P<0.01)。结果显示输精管结扎吻合后,精子膜上ADA活性明显升高是造成精子受精能力低下的原因之一。同时提示生殖道的病理变化将引致精子膜成分的变化。     

脑脊髓液中腺苷脱氨酶活性对结核性脑膜炎诊断价值的临床研究

目的 探讨脑脊髓液中腺苷脱氨酶（CSF-ADA）活性对结核性脑膜炎的诊断价值及在病程中的动态变化.方法 选择160例患者纳入本研究,76例结核性脑膜炎为病例组;84例非结核性脑膜炎为对照组,其中细菌性脑膜炎36例,病毒性脑膜炎30例,隐球菌性脑膜炎18例.每例患者均于治疗前抽取CSF,采用酶耦联Trinder法测定CSF-ADA活性,结果以（-x）±s表示,组间差异使用Mann-Whitney U检验.47例结核性脑膜炎患者于抗结核治疗后2周和6周时再次检测CSF-ADA,治疗前后差异使用配对t检验.结果 结核性脑膜炎组CSF-ADA活性为（12.9±6.4）U/L,非结核性脑膜炎组为（6.0±4.1）U/L,两组比较差异有统计学意义（U=7.860,P＜0.05）.取CSF-ADA≥9 U/L作为临界值时鉴别结核性脑膜炎与非结核性脑膜炎价值最高,灵敏度为84.21%,特异度为83.33%.随着患者病情好转,CSF-ADA活性逐渐降低.结论 CSF-ADA活性≥9 U/L可作为诊断结核性脑膜炎的一项辅助诊断指标,抗结核治疗后CSF-ADA活性可作为疗效判断的参考指标.     

丙种球蛋白治疗儿童原发性肾病综合征的疗效及免疫功能变化

我们采用静脉滴注丙种球蛋白（IVIG）治疗儿童原发性肾病综合征（PNS），观察其疗效及患儿免疫功能的变化。     

儿童肾病综合征血清C肽和胰岛素样生长因子变化及意义

具有类似于生长激素和胰岛素作用的胰岛素样生长因子 (IGFs) ,其由IGF -Ⅰ、IGF -Ⅱ及其受体、系列结合蛋白组成。C -肽 (CP)由胰腺 β细胞释放的 ,经胰岛素原转化酶分解成 ,近期研究表明 ,这些因子在机体的营养代谢中起重要作用[1,2 ] 。本文探索肾病综合征 (PNS)患儿血清CP、IGF-Ⅰ、IGF -Ⅱ的水平及意义。资料与方法1　一般资料　 1999年 1月～ 2 0 0 1年 6月在本院儿科住院的患儿共 2 8例 ,诊断符合全国小儿肾脏病协作组制定的原发性肾病综合征 (PNS)的诊断标准。初发组 13例 ,男10例 ,女 3例 ;年龄 5岁～ 10岁 ,平均 (6 .6…     

肾病综合征患者血小板参数的变化及临床意义

肾病综合征由于高脂血症、低蛋白血症、高黏质血症等容易形成血栓.近年来国内外研究表明,在血栓性疾病血小板参数有明显变化.为探讨血小板参数在肾病综合征中的变化及其临床意义,我们对62例肾病综合征患者血小板计数(PLT)、血小板体积(MPV)、血小板分布宽度(PDW)、血小板压积(PCT)4项指标进行了回顾性分析,并与正常对照组进行比较.     

原发性肾病综合征患儿内皮素和一氧化氮的变化及意义

关于内皮素 (ＥＴ)和一氧化氮 (ＮＯ)在肾脏疾病中的作用文献已有报道〔1,2〕,但均是分别探讨它们各自的变化 ,将二者结合起来研究在肾脏疾病中的作用 ,尚未见文献报道。因此 ,本文同时检测了原发性肾病综合征 (ＰＮＳ)患儿血、尿ＥＴ和ＮＯ的变化 ,并探讨了二者之间的关系。现将结果报告如下。资料与方法1　对象　我科 2 0 0 0年 3月～ 2 0 0 0年 11月收治的ＰＮＳ患儿 2 4例 ,男 13例 ,女 11例 ;年龄 1.5岁～ 4岁 ,均为初治病例 ,其中单纯性肾病综合征 19例 ,肾炎性肾病综合征 5例 ,均符合全国小儿肾脏病诊断标准〔3〕。对照组 17例 ,为同…     

Lymphocyte adenosine deaminase activity in children with idiopathic nephrotic syndrome

Adenosine deaminase (ADA) activity, as a marker of cell-mediated immunity, was evaluated in the serum (S-ADA) and lymphocytes (L-ADA) of 47 children with idiopathic nephrotic syndrome, and 23 healthy controls. The mean S-ADA and L-ADA levels were significantly raised in active nephrotic syndrome (ANS) and in its sub-groups in comparison with controls. The ADA activity was significantly more elevated in relapsers than for the first attack of nephrotic patients, and the frequent relapsers had the highest enzymatic levels both in serum as well as lymphocytes. A significant positive correlation was found between serum and lymphocyte ADA levels (r =0.736, p <0.01). In remission, the S-ADA showed a significant fall in comparison with their corresponding ANS value (p <0.001) and reached the level of controls. The mean L-ADA also showed reduction but the difference was statistically insignificant and the value was significantly raised, when compared with controls. The enzyme activity in serum and lymphocytes normalized in the long-term remission group. Thus, ADA activity was abnormal in ANS cases, and L-ADA demonstrated change both in active as well as remission stage of the disease.     

微小病变型肾病综合征患者腺苷脱氨酶检测的意义

本研究中,我们检测微小病变型肾病综合征(MCNS)患者腺苷脱氨酶(ADA)活性,并分析ADA活性与病程和疗效的关系.     

Aldolase and adenosine deaminase activity in lymphocytes of patients with glomerulonephritis

Studies on the adenosine deaminase (ADA) and aldolase activities in lymphocytes were performed in 67 patients with glomerulonephritis (gn) and in 20 healthy individuals from the control group to get an insight into the lymphocyte metabolism. Statistically significant decrease of ADA activity was found in the groups of patients with chronic proliferative gn, membranoproliferative gn, membranous gn and lupus nephritis in comparison with the healthy individuals from the control group. As far as decrease of aldolase activity is concerned it has reached statistical significance in patients with mesangial gn, membranoproliferative gn, membranous gn and lupus nephritis. The lymphocyte metabolism did not show any abnormalities in the enzymatic indicators only in patients with acute proliferative gn and submicroscopic gn. The activity comparison between both enzymes in the lymphocytes, contrasted on the basis of high and low clinical dynamics of gn, revealed a tendency to lower ADA and aldolase activities in patients with high clinical dynamics. However, this difference was at the limit of statistical significance (p less than or equal to 0.10).     

Evaluation of adenosine deaminase activity in patients with head and neck cancer

ADA is a key enzyme in the mammalian purine salvage pathway. The lack of ADA activity has been linked to a lack of cellular immunity in various immune and myeloproliferative disorders. Data on its role in patients with solid tumors are scant and inconclusive. In this report, we have evaluated the activity of this enzyme in the peripheral lymphocytes of patients with head and neck squamous cell cancer (HNC). The mean ADA activity in Stage IV patients (0.57 +/- 0.08 SEM, n = 12) was significantly lower than that of controls (1.55 +/- 0.25 SEM, P less than 0.05, n = 14) and also significantly lower that the mean ADA activity in patients with Stages I, II, and III (1.14 +/- 0.10 SEM, P less than 0.05, n = 17). Fourteen out of 19 controls, Stage I, II, and III patients had positive skin tests compared to 7 out of 10 Stage IV patients. These differences were not statistically significant. There was also no correlation between ADA activity and the absolute lymphocyte counts. Our results indicate that ADA activity in lymphocytes of patients with advanced HNC is lower than that of controls or patients with earlier stages of the disease. ADA may be a more sensitive indicator of suppressed cellular immunity than delayed cutaneous hypersensitivity reactions, or monitoring absolute lymphocyte counts.     

Soluble IL-2 receptor in patients with primary nephrotic syndrome

The soluble interleukin-2 receptor (SIL-2R) levels in 46 patients with primary nephrotic syndrome were examined. The values in the nephrotic patients exceeded those in healthy controls (p less than 0.05), and were the same at the nephrotic and non-nephrotic stages. The serum interleukin-2 (IL-2) levels in the nephrotic patients were low and did not correlate with the serum SIL-2R levels. Only at the nephrotic stage were the latter closely correlated with the serum IgG (p less than 0.001) but not with the serum IgA or IgM. The SIL-2R production by phytohemagglutinin stimulated peripheral blood lymphocytes (PBL) in the nephrotic patients was less at the nephrotic and non-nephrotic stages than that in the healthy controls. The IgG production by pokeweed mitogen stimulated PBL was low at the nephrotic stage but not at the non-nephrotic stage. Based on these findings, it is suggested that SIL-2R determinations should prove useful in clarifying the relationship between cellular and humoral immunological disorders in nephrotic syndrome.     

原发性IgA肾病106例临床与病理分析

本研究回顾性总结106例IgA肾病（IgAN）资料，重点探讨IgAN肾小管间质损害与临床的关系，旨在早期识别肾小管间质损害的临床指标。     

Lymphocyte ectoenzymes in childhood idiopathic nephrotic syndrome

Lymphocyte ectoenzymes with immunomodulatory function were investigated in 11 children with minimal change disease (MCD), 9 with primary focal segmental glomerulosclerosis (FSGS), and 17 age- and sex-matched healthy children. Basal, concanavalin A (Con A)-, and pokeweed mitogen (PWM)-stimulated lymphocyte ecto-5′-nucleotidase (5′-Nu), dipeptidyl peptidase IV (DPP IV), and alkaline phosphodiesterase I (APD) activities were determined. In MCD relapse ecto-APD activity of unstimulated lymphocytes was higher than controls. Ecto-APD of Con A-stimulated lymphocytes was below controls (23.0, range 7.2– 48.7 nmol/min per 10⁶ lymphocytes) in all active MCD (18.7, range 7.6–32.6), during corticosteroid treatment (14.6, range 4.5–54), and in remission (13.1, range 6.1–19.6), but was significant only in remission. Con A-stimulated DPP IV was significantly lower from controls (53.8, range 19.3–85.7 nmol/min per 10⁶ lymphocytes) in all active MCD (38.1, range 10.8–82.1), during treatment (37.5, range 20.2–58.7), and in remission (39.4, range 24.3–69.6). In FSGS, unstimulated lymphocyte ecto-APD activity was greater than controls. However, Con A-stimulated lymphocyte ecto-APD and DPP IV activities were not significantly different from controls. Con A stimulation of lymphocyte ecto-APD and DPP IV activity was significantly reduced in MCD relapse and in remission, but not in FSGS. Basal, Con A-, and PWM-stimulated ecto-5′-Nu in MCD and FSGS were not different from controls. These results suggest a role for abnormal T cell function in MCD but not in FSGS. The difference in mitogen-stimulated expression of these ectoenzymes suggests a different pathogenesis of childhood MCD and primary FSGS. Received June 30, 1997; received in revised form May 13, 1998; accepted May 27, 1998     

Serum adenosine deaminase activity in brain tumours

Summary Adenosine deaminase (ADA) activity in serum was estimated in 86 patients with intracranial tumours and 40 healthy volunteers. Although high ADA concentrations in biological fluids and tumour tissues were observed in several neoplastic conditions, there was no significant difference in the ADA in sera of brain tumour patients when compared to the control values. Therefore, cell-mediated immunity probably does not play a significant role in brain tumours.