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1.
目的 建立Allo-A Sepharose亲和层析技术分离血清中糖缺失转铁蛋白(CDT)和转铁蛋白(Tf).方法 Allo-A与的偶联反应在0.1mmol/L NaHCO3(含0.5mmol/L NaCl)内进行;Allo-A Sepharose 4B亲和层析技术用于分离血清CDT和Tf;ELISA用于定量CDT和Tf.结果 Allo-A Sepharose 4B亲和层析图谱显示2个洗脱峰,CDT存在于第一洗脱峰,Tf存在于第二洗脱峰.ELISA测定结果显示,在5例正常血清中,CDT水平为4.53~4.76(CV=1.8~9.7%),Tf水平为255.3~524.9(CV=5.1~10.7%);在5例患者血清中,CDT水平为3.04~4.20(CV=0.8~11.6%),Tf水平为6.05~34.73(CV=0.7~11.1%).表明Allo-A Sepharose 4B亲和层析技术在分离CDT和Tf中,具有较理想的可重复性.结论 Allo-A Sepharose 4B亲和层析技术可用于CDT和Tf的分离,如果能够获得CDT参比血清,可进一步评价该技术的灵敏度.  相似文献   

2.
背景:酒精性肝病(ALD)的发病率逐年递增,但缺乏特异性诊断指标,探索ALD各阶段的分子标志物变化趋势对其诊断和治疗具有重要意义。目的:探讨血清白细胞介素(IL)-12、糖缺失性转铁蛋白(CDT)、肝细胞生长因子(HGF)和内毒素在不同阶段ALD中的水平及其诊断价值。方法:选取2017年7月—2018年1月包头医学院第二附属医院收治的19例酒精性肝硬化(AC)、14例酒精性肝炎(AH)、16例酒精性脂肪肝(AFL)、16例亚临床患者,以15名体检正常者作为健康对照。采用ELISA法检测血清IL-12、CDT、HGF水平,鲎试验检测内毒素水平。以ROC曲线分析IL-12、CDT诊断ALD的价值。结果:AC、AH患者血清IL-12、内毒素水平显著高于AFL、亚临床和健康对照组(P 0. 05),AC、AH、AFL和亚临床组血清CDT水平均显著高于健康对照组(P 0. 05),AC患者血清HGF水平显著高于AH、AFL、亚临床和健康对照组(P 0. 05)。ALD患者血清IL-12、CDT、HGF与血清内毒素呈正相关(P 0. 05)。截断值为55. 06 pg/m L时,血清IL-12诊断ALD的敏感性和特异性分别为0. 86和0. 95;截断值为354. 41 pg/m L时,血清CDT诊断ALD的敏感性和特异性分别为0. 67和0. 88。结论:血清IL-12、CDT、HGF和内毒素在ALD不同阶段存在趋势性变化,IL-12、CDT诊断ALD具有较高的敏感性和特异性,可作为ALD早期诊断的标志物。血清HGF和内毒素对评估ALD严重程度具有一定的价值。  相似文献   

3.
缺糖转铁蛋白对酒精性肝病的诊断意义   总被引:2,自引:0,他引:2  
目的 评价缺糖转铁蛋白(CDT)对酒精性肝病的诊断价值。方法 选择76例酒精性肝病,55例嗜酒者,32例非酒精性肝病和27例健康者,分别检测谷氨酰转肽酶(GGT)等肝功能指标和CDT。结果 酒精性肝病组CDT阳性率为93.4%;CDT诊断酒精性肝病的灵敏度为93.4%,特异性为71.9%,诊断价值高于GGT、丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)。结论 CDT是诊断酒精性肝病较理想的指标。  相似文献   

4.
内毒素在酒精性肝病肠损伤中的作用   总被引:1,自引:0,他引:1  
目的探讨内毒素在酒精性肝病肠损伤中的作用。方法选择酒精性肝病患者15例和健康不饮酒者15例。采用ELISA法测定血清内毒素;采用分光光度法测定血清丙二醛。另将20只小鼠随机分为对照组和模型组,每组10只,分别喂饲Lieber-Decarli无酒精和含酒精液体饲料。10周后处死小鼠,检测血清内毒素,并进行肝脏和肠组织形态学观察。结果酒精性肝病组和对照组血清内毒素水平分别为0.52±0.54 Eu/L和0.47±0.34 Eu/L(P〈0.05);酒精性肝病组和对照组血清丙二醛水平分别为5.6±5.0nmol/ml和3.7±3.4nmol/m(lP〉0.05);模型组和对照组小鼠血清内毒素水平分别为0.38±0.05 Eu/L和0.13±0.02 Eu/L(P〈0.01);模型组肝细胞明显脂肪变,结肠组织损伤病理学评分为10.3±1.3分,较对照组明显升高(4.8±1.2分,P=0.01)。结论酒精性肝病伴发了肠粘膜损伤,内毒素可能参与了发病过程。  相似文献   

5.
目的 探讨应用酪酸梭菌活菌片辅助硫普罗宁和美他多辛治疗酒精性肝病(ALD)患者的疗效及对血清糖缺失性转铁蛋白(CDT)和肝细胞生长因子(HGF)水平及肠道菌群分布的影响。方法 2018年6月~2019年12月我院消化内科收治的102例ALD患者,采用随机数字表法分为对照组51例和观察组51例,分别给予硫普罗宁片和美他多辛片口服治疗或在此基础上予以酪酸梭菌活菌片口服治疗,两组均连续治疗观察12 w。采用ELISA法检测血清CDT、HGF、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、核因子-кB水平(NF-кB);使用Celsis R Advance II TM快速微生物检测系统检测粪便双歧杆菌、乳杆菌、大肠埃希菌和粪肠球菌。结果 在治疗12 w末,观察组血清CDT水平为(580.2±74.2)pg/mL,显著低于对照组【(815.2±81.4)pg/mL,P<0.05】,血清HGF水平为(150.7±18.4)pg/mL,显著低于对照组【(390.5±40.2)pg/mL,P<0.05】;观察组粪便双歧杆菌水平为(8.7±2.6)lg CFU/g,显著高于对照组【(7.8±1.9)lg CFU/g,P<0.05】, 乳杆菌水平为(9.1±1.1)lg CFU/g,显著高于对照组【(8.5±1.7)lg CFU/g,P<0.05】,而大肠埃希菌水平为(6.5±1.6)lg CFU/g,显著低于对照组【(7.6±1.8)lg CFU/g,P<0.05】,粪肠球菌水平为(6.8±2.0)lg CFU/g,也显著低于对照组【(7.9±1.5)lg CFU/g,P<0.05】;血清IL-6水平为(0.7±0.1)pg/mL,显著低于对照组【(0.9±0.2)pg/mL,P<0.05】,血清TNF-α水平为(5.2±1.6)ng/L,显著低于对照组【(8.0±1.9)ng/L,P<0.05】,血清NF-кB水平为(1.2±0.3)ng/L,显著低于对照组【(2.7±1.0)ng/L,P<0.05】。结论 应用酸梭菌活菌片辅助硫普罗宁和美他多辛治疗酒精性肝病患者可有效改善肠道菌群分布,抑制炎症反应,可能与降低了血清CDT和HGF水平有关。  相似文献   

6.
曾俊涛  陈静 《山东医药》2013,(48):10-12
目的 观察酒精性肝病患者血清瘦素(Lep)水平及其受体(LEPR)基因Gln223Arg多态性变化,并探讨其意义.方法 选择酒精性肝病患者106例,其中酒精性脂肪性肝炎45例(AH组),酒精性肝硬化61例(AC组),同期健康体检者65例作为对照组.采用ELISA法检测血清Lep,葡萄糖氧化酶—过氧化物酶法检测空腹血糖(FPG),化学发光免疫分析法检测空腹血清胰岛素(FINS),PCR-RFLP法检测LEPR基因Gln223Arg多态性,并计算HOMA-IR.结果 AH组血清Lep、HOMA-IR分别为(8.95±1.81) ng/mL、2.44±0.25,AC组分别为(10.57±2.00) ng/mL、3.21 ±0.17,对照组分别为(4.44±0.81) ng/mL、1.77 ±0.18;AH组、AC组与对照组比较,P均<0.05.AH组、AC组血清Lep与HOMA-IR均呈正相关(r=0.45、0.38,P均<0.01).AH组AA、A/G、GG的例数分别为3、11、31例,AC组分别为0、25、36例,对照组分别为1、12、52例;AC组与对照组比较,P<0.05.结论 酒精性肝病患者血清Lep、HOMA-IR水平升高,AC组患者LEPR基因Gln223 Arg杂合基因频率高于健康人群,可能通过胰岛素—瘦素轴促进胰岛素抵抗,影响体内脂肪代谢,参与酒精性肝病的发病机制.  相似文献   

7.
目的: 探讨血清胰岛素样生长因子结合蛋白2(insulin-like growth factor binding protein2, IGF B P2)定量检测对非酒精性脂肪肝(nonalcoholic fatty liver disease, NAFLD)的诊断价值.方法: 采用ELISA定量检测非酒精性脂肪肝患者与慢性肝炎、肝硬化、原发性肝癌以及健康成人血清中IGFBP2水平, 并进行统计学分析.结果: 轻度和中重度脂肪肝组患者血清中IGFBP2水平显著高于健康成人组、慢性肝炎组、肝硬化与原发性肝癌组水平(6.89±2.37μg/L, 4.86±1.97 μg/L vs 1.77±1.56 μg/L, 1.67±1.36 μg/L, 1.76±1.52 μg/L, 1.52±1.43 μg/L,均P<0.05), 且轻度脂肪肝组显著高于中重度脂肪肝组( P<0.05).结论: 监测IGFBP2水平有助于早期诊断非酒精性脂肪肝及了解病变严重程度.  相似文献   

8.
目的:探讨TNF-α、TGF-β1、hs-CRP在非酒精性脂肪性肝病患者中的表达及临床意义.方法:选择武汉市第三医院消化内科单纯性脂肪肝51例,非酒精性脂肪性肝炎48例及健康对照者32例,测定血清hs-CRP水平,采用酶联免疫吸附实验(ELISA)测定血清中TNF-α、TGF-β1水平.结果:TNF-α、TGF-β1及hs-CRP是非酒精性脂肪性肝病的独立危险因素.脂肪性肝炎血清hs-CRP、TNF-α水平显著高于单纯性脂肪肝(3.92±1.41 vs 2.01±0.39,8.13±4.21 vs 3.97±0.94,均P<0.05);而脂肪性肝炎和单纯性脂肪肝两组TGF-β1水平差异无显著性.结论:TNF-α和hs-CRP可作为判断非酒精性脂肪性肝病病程发展的指标.  相似文献   

9.
目的:为了研究肝病患者血清IGF-Ⅰ、IGF-Ⅱ水平的变化及其临床意义.方法:将89位肝病患者分成三组,其中肝炎组10例,肝硬化组66例,肝癌组13例;另设对照组38例.应用放射免疫法测定患者血清IGF-Ⅰ、IGF-Ⅱ的含量.结果:肝硬化患者组血清IGFⅠ、IGFⅡ的测值分别为65±14 mg/L,328±86mg/L;肝癌组为49±14 mg/L,194±61 mg/L;两组测值均显著低于对照组(261±75mg/L,1094±119mg/L).肝硬化Child A级患者的血清IGF-Ⅰ、IGF-Ⅱ水平较ChildB/C级患者均明显增高(P<0.05).血清IGF-Ⅰ、IGF-Ⅱ值在不同病因的肝硬化患者之间亦存在显著差异(P<0.05).结论:与IGF-Ⅰ一样,血清IGF-Ⅱ水平的测定同样可作为评价肝硬化、肝癌患者肝功能状况的一项重要指标.  相似文献   

10.
目的 检测肝癌患者血清中肿瘤M2型丙酮酸激酶(TuM2-PK)和甲胎蛋白(AFP)的表达,探讨TuM2-PK在肝癌诊断中的价值.方法 采用夹心酶联免疫吸附法(ELISA)分别检测40例肝癌患者、40例活动性肝病患者和40例健康对照者血清中TuM2-PK和AFP水平,比较三者的差异,评价联合检测TuM2-PK和AFP对诊断肝癌的价值.结果 肝癌组TuM2-PK和AFP值分别为(18.44±3.02) U/ml、(307.42±116.69) ug/L,活动性肝病组分别为(9.92 ± 2.45) U/ml、(93.33±57.72) μg/L,对照组分别为(5.90±0.56) U/ml、(10.02±0.40) μg/L,肝癌组TuM2-PK和AFP明显高于活动性肝病组和对照组(P<0.05),活动性肝病组和对照组TuM2-PK和AFP比较差异无统计学意义(P>0.05);联合检测的灵敏度为75.0%,特异性为87.5%;阳性预测值为85.7%,阴性预测值为77.8%.结论 肝癌患者血清中TuM2-PK和AFP表达明显增加,两者联合检测对诊断肝癌及判断预后有重要价值,可提高肝癌的早期诊断率.  相似文献   

11.
We meesured serum levels of carbohydrate deficient transferrin (CDT) in 420 subjects: 100 healthy blood donors, 82 healthy employses, 70 abstaining patients with different chronic nonalcoholic liver disease, 16 abstaining patients with alcoholic fatty liver, 50 abstaining patients with alcohotic liver cirrhosls, 25 abusing patients with alcoholic fatty liver, 41 abusing patients with alcoholic liver cirrhosis, and 36 patients with alcohol dependence syndrome with a daily ethanol consumption of 173 ± 120 g the last 4 weeks before blood was drawn. In controls the serum level of CDT was significantly higher in females compared with males (17.7 ± 5.1 and 13.7 ± 3.8 units/liter, respectively), and the upper normal limit was defined as 27 and 20 units/liter. Sixty-two of 102 (60.8%) abusing patients with alcoholic liver disease had increased levels of CDT compared with 1 of 66 abstaining (1.5%) patients with alcoholic liver disease, and 10 of 70 (14.3%) abstaining patients with nonalcoholic liver disease among them 3 with primary biliary cirrhosis and 2 with chronic autoimmune hepatitis. No correlation was found between serum CDT and γ-glutamyltranspeptidase (GGT), AST, ALT, and mean red cell volume (MCV). The sensitivity and specificity for serum CDT was 61 and 92%, respectively, compared with 85 and 18% for GGT and 70 and 66% for MCV. No advantage was gained by using the CDT/transferrin ratio. Our study confirms that CDT is a specific marker for chronic alcohol abuse, except in few patients with other chronic liver diseases. Serum CDT seems to be a better indicator of abstention than GGT; AST and MCV in patients with alcoholic liver disease. However, in our hands CDT is not so sensitive for alcohol abuse in patients with liver disease as reported earlier in unselected alcoholics  相似文献   

12.
Many studies have shown carbohydrate-deficient transferrin (CDT) to be a sensitive and specific marker of chronic alcohol abuse. We present the case of a 23-year-old, healthy professional soccer player who caused a car accident due to alcohol consumption. Several CDT test results were elevated above the laboratory reference range and were considered to be caused by alcohol intake at a level commensurate with misuse and thus license reapplication was refused. In addition, assuming chronic alcohol abuse, the young man suffered from increasing social isolation. He was finally referred to our out-patient clinic for further evaluation on the assumption of a liver disease. Since chronic alcohol consumption was denied, and there was no evidence of liver disease, a qualitative characterization of the transferrin isoforms was performed. Isoelectric focusing of serum transferrin revealed a pattern atypical for chronic alcohol intake but detected a genetically determined transferrin (Tf)-D-variant. The changed amino acid sequence caused an overlapping of transferrin isoforms with different degrees of sialylation, thus revealing false-positive serum CDT values. Determination of this Tf-D-variant heterozygosity resulted in his social rehabilitation and license reinstatement. Thus, where the evidence for alcohol dependency is either uncertain or uncorroborated, qualitative isoelectric focusing of transferrin is a useful method for analyzing unexplained CDT elevations, thus increasing the value of CDT as a marker for chronic alcoholic abuse.  相似文献   

13.
BACKGROUND: Carbohydrate deficient transferrin (CDT), a biochemical marker of chronic alcohol consumption, is used by researchers and clinicians alike in a variety of populations. Levels of CDT may be affected by certain types of medical illnesses and conditions. Thus the interpretation of CDT results may need to be carefully examined in these populations. Because CDT is synthesized, glycosylated, and secreted by the liver, the use of CDT values in patients with liver disease has been an area of focused interest. METHODS: We evaluated the CDT values of 79 abstaining patients with end-stage liver disease. These patients were recruited from a liver transplant clinic while they were listed and waiting for transplantation. Patients were determined to be abstaining both by interview and by random blood alcohol levels in those with a diagnosis of alcoholic liver disease. The severity of the liver disease was categorized by the Child-Pugh score. Correlations were determined between CDT values and liver enzymes, and Child-Pugh scores and liver diagnosis. RESULTS: Nearly 50% of the patients had a CDT value of 2.6% or above, indicating a clinically positive value. There were strong correlations between CDT and a number of biochemical and physical variables, most importantly the Child-Pugh score (r = 0.52, p = 0.000). Specific liver diseases were not associated with absolute CDT values. However, patients with hepatitis C (HCV) had a significantly higher chance of having a clinically positive CDT compared with patients with other types of liver diseases. CONCLUSIONS: These results suggest that an elevated CDT value may not accurately represent alcohol consumption in patients with advanced liver disease. In fact, in such patients, the CDT may become a marker for the degree of liver impairment in alcoholic and nonalcoholic liver disease. CDT values should be viewed with caution in any patient with liver disease especially when the degree of cirrhosis reaches a Child-Pugh score of C (total score of 10 or above).  相似文献   

14.
OBJECTIVE: The congenital disorders of glycosylation (CDGs) are progressive multisystemic disorders characterized by a heterogeneous deficiency of the carbohydrate moieties in various structural and circulating glycoproteins, representing a natural model for glycoprotein hormone studies. Here, we studied the carbohydrate moiety of circulating glycoprotein hormones in four patients with a clinical suspicion of CDGs. METHODS: The diagnosis of CDG-I was confirmed in two out of the four cases by transferrin isoelectrofocusing (IEF) and/or carbohydrate-deficient transferrin (CDT) test. The carbohydrate moiety of serum endocrine-related glycoproteins was investigated by means of Ricin (immunopurified thyrotropin (TSH)) and Concanavalin A (Con-A) (TSH, follicle-stimulating hormone, alpha-subunit and thyroglobulin) lectin affinity chromatography measurement. RESULTS: CDT concentrations were very high in the two patients with CDG-I and moderately enhanced in the remaining two. In the two CDG-I patients, Ricin analysis of immunopurified TSH showed a severe impairment of lectin binding, both before and after neuroaminidase treatment, indicating a nearly complete lack of terminal sialic acid and galactose residues. In these two cases, Con-A analysis showed a significant prevalence of firmly bound isoforms with poorly processed carbohydrate chains. In the remaining two cases with unknown CDG classification, TSH binding pattern to Ricin was modestly affected and Con-A analysis showed the prevalence of weakly bound glycoprotein isoforms. CONCLUSIONS: The results of Ricin analyses in all four patients were consistent with the CDT test and/or serum transferrin IEF. The severe alteration of TSH binding pattern to Ricin seems to be characteristic of CDG-I. Nevertheless, TSH biological properties are not severely altered, as normal thyroid function was found in both cases.  相似文献   

15.
Carbohydrate-deficient transferrin (CDT) in serum was analyzed by isocratic microanion exchange chromatography at pH 5.65 followed by a transferrin radioimmunoassay in 102 patients with biopsy-verified liver diseases. CDT values were normal in all of the 87 nonalcohol-abusing patients irrespective of type or degree of liver disease. Thirteen of the 15 alcoholic patients (87%) with current abuse showed elevated CDT values while in abstaining alcoholics with remaining liver disease the values were normal. No correlations were found between CDT level and volume density of liver fibrosis or steatosis or values of a number of clinicochemical liver tests. The only significant correlation demonstrated was between CDT concentration and the level of present daily alcohol consumption in the alcoholic patients. These results indicate that CDT can be used as a marker of present but not previous alcohol abuse, even in patients with various liver diseases.  相似文献   

16.
Background: It had previously been suggested that individuals with cirrhosis may have a pattern of transferrin glycosylation that interferes with the interpretation of carbohydrate‐deficient transferrin (CDT) testing for heavy alcohol use. The goal of this case series was to evaluate the prevalence of liver disease among individuals with poor resolution of transferrin glycoforms by high performance liquid chromatography. Methods: We reviewed the electronic medical records of 35 consecutive patients with poor chromatographic resolution of disialotransferrin from trisialotransferrin and recorded information on diagnosed liver disease, liver function testing, and other factors. Results: Thirty of the 35 subjects with poor chromatographic resolution of the transferrin glycoforms had sufficient data in the medical record for some estimation of liver function. Of these 30 subjects, 25 had previously diagnosed liver pathology. Of the remaining 5 subjects, 2 had liver imaging results suggestive of benign tumor; the remaining 3 had mildly elevated bilirubin and aminotransferase activity, and low albumin. Conclusions: Liver abnormalities, but not necessarily cirrhosis, are common in individuals with poor chromatographic separation of transferrin glycoforms, which might lead to false‐positive results on CDT testing. However, the chromatographic‐based assay can detect this issue, minimizing the reporting of false positives, but not necessarily assisting in valid detection of heavy drinking.  相似文献   

17.
It has been known for some years that a partial deglycosylation of transferrin occurs in the sera of alcohol abusers. Different methods have been proposed in order to evaluate this carbohydrate-deficient fraction of serum transferrin. Chromatofocusing or isoelectric focusing followed by direct immunofixation have been used until now. Recently, a new method called the carbohydrate-deficient transferrin (CDT) test based on ion-exchange chromatography has been developed by Stibler et al. (Alcohol Clin Exp Res 10:535-544, 1986). Here we compare this new method with results obtained using our Tf index determination method. The upper limit of normal values was set to the 90th percentile of the values observed in a reference population. The population under investigation consisted of 50 healthy volunteers and 160 alcohol abusers whose ethanol consumption was evaluated through a questionnaire. Sensitivity and specificity of the CDT test have been found higher than 0.76 and 0.90, respectively. The correlation between both methods was 0.794, a satisfactory result considering that the CDT test and the Tf index do not exactly measure the same part of the carbohydrate-deficient transferrin. In a population of 23 patients with liver diseases not related to alcohol abuse, no abnormal CDT value was observed. We can conclude from these results that the CDT test now seems to be the best test to detect alcohol abusers.  相似文献   

18.
This study has investigated the serum levels of carbohydrate‐deficient isoforms of transferrin (CDT) and sialic acid (SA) in iron‐deficiency anemia (IDA). Blood samples were collected from 60 women with IDA and from 20 healthy controls. CDT was estimated by anion‐exchange chromatography on minicolumns followed by photometric detection of transferrin and was expressed as a percentage of total transferrin (%CDT). SA was measured by an enzymatic method. There was no difference in the mean level of %CDT between patients with IDA (2.26%) and control patients (2.05%). SA increased significantly from control level 0.61 to 0.69 g/l in anemic patients. We concluded that elevated concentration of total transferrin in IDA did not change the relative value of low sialylated isoforms (%CDT) and the increase of total SA level in the sera of anemic patients is not related to the increase of total transferrin.  相似文献   

19.
AIM: To demonstrate if carbohydrates deficient transferrin (CDT) is the best marker to detect an excessive alcohol consumption as a cause of acute pancreatitis. MATERIAL AND METHODS: Prospective study of 60 patients consecutively admitted in our hospital. Acute pancreatitis were classified according to their different etiologies, alcoholic (11), probably alcoholic (4), biliary (25) and others (20). In all cases, we have compared CDT with classical quemical markers of alcohol abuse such as mean corpuscular volumen (MCV), gamma-glutamyltransferase (GGT) and aspartateaminotransferase (AST). Statistic correlations were done between the quantity of alcohol consumed and CDT, GGT, AST and MCV variables. RESULTS: Correlation between CDT and MCV with the excessive alcohol consumption was statistically significant. The acute pancreatitis caused by alcohol and the suspicious alcoholic group had a average CDT higher than the rest of the groups (p < 0.05). Taking a cut point with a CDT value of 20, the diagnosis capacity of the test to detect the alcoholic etiology was 82 and 92% of specificity. Taking a cut point with a MCV value higher than 95, sensibility was 67% and specificity was 82%. CONCLUSION: In our experience, the most efficient marker of the alcoholic etiology in acute pancreatitis was CDT.  相似文献   

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