2型糖尿病合并感染老年患者机体免疫功能变化

目的探讨2型糖尿病合并感染患者机体免疫功能变化。方法 2型糖尿病患者150例、非糖尿病感染患者75例和体检中心健康者75例分为A组(糖尿病合并感染78例)、B组(糖尿病未合并感染72例)、C组(非糖尿病感染)和D组(健康对照)。观察各组血C3、C4、Ig M、Ig A、Ig G水平和血CD8+、CD4+、CD3+、自然杀伤(NK)细胞和B细胞水平。结果与D组比较,A组、B组和C组C3和C4水平均显著升高(P0.05);与B组和C组比较,A组C3和C4水平均显著升高(P0.05)。与D组比较,A组、B组和C组Ig A水平均显著升高(P0.05);与B组和C组比较,A组Ig A水平显著升高(P0.05);与C组和D组比较,A组、B组Ig G水平显著降低(P0.05)。与D组比较,A组、B组和C组CD4+、CD3+和CD4+/CD8+均显著下降(P0.05);与B组和C组比较,A组CD4+和CD4+/CD8+均显著下降(P0.05)。与D组比较,A组、B组和C组NK细胞和B细胞水平均显著下降(P0.05);与B组和C组比较,A组NK细胞和B细胞水平均显著下降(P0.05)。结论 2型糖尿病患者体内存在体液免疫和细胞免疫异常,其中2型糖尿病合并感染者体内体液免疫和细胞免疫异常更加严重。     

复脉抗衰注射液对缺血性心肌病免疫功能的影响

目的 :研究复脉抗衰注射液对缺血性心肌病患者体液免疫 (Ig G、Ig A、Ig M)、细胞免疫 (T细胞亚群 )及可溶性白细胞介素 - 2受体 (s IL- 2 R)的影响。方法 :49例患者随机分为常规组和复脉抗衰治疗组 (治疗组 )。常规组采用常规治疗 ,治疗组在常规治疗的基础上加用复脉抗衰注射液。两组治疗前后均采肘静脉血测定 T细胞亚群、Ig M、Ig A、Ig G、s IL- 2 R,同时进行临床疗效评价。结果 :治疗前 49例患者的血清 Ig G、Ig A、Ig M均高于正常组 (P<0 .0 5 ) ,两组患者的 CD3、CD4、CD4/CD8比值均低于正常组 (P <0 .0 5 )。 s IL - 2 R高于正常组。用药后 ,治疗组的CD4和 CD4/CD8比值上升 (P <0 .0 5 ) ,s IL - 2 R明显下降 (P <0 .0 5 )。血清 Ig G、Ig A、Ig M均有所下降但无统计学意义 ,而常规组治疗后各项指标均无明显变化 (P >0 .0 5 )。结论 :复脉抗衰注射液具有改善患者免疫功能的作用。     

阿魏酸钠对溃疡性结肠炎模型小鼠炎性因子及免疫功能的影响

目的探讨阿魏酸钠对溃疡性结肠炎(ulcerative colitis,UC)模型小鼠炎性因子及免疫功能的影响。方法选择32只实验小鼠,随机分为空白对照组、模型组、阿魏酸钠低剂量组、阿魏酸钠高剂量组,每组8只,模型组、阿魏酸钠组采用5%葡聚糖硫酸钠制作UC小鼠模型,建模成功后,阿魏酸钠低剂量组经胃管灌胃50 mg/kg阿魏酸钠,阿魏酸钠高剂量组灌灌胃10 mg/kg阿魏酸钠。比较4组血清炎性因子、免疫功能。结果模型组血清白介素1β(IL-1β)、肿瘤坏死因子(TNF-α)明显高于对照组,白介素4(IL-4)明显低于对照组(P0.05),阿魏酸钠干预组血清IL-1β、TNF-α明显低于模型组,IL-4明显高于模型组(P0.05),阿魏酸钠高剂量组血清IL-1β、TNF-α明显低于阿魏酸钠低剂量组,IL-4明显高于阿魏酸钠低剂量组(P0.05);模型组血清免疫球蛋白Ig A、Ig G、Ig M明显高于对照组,补体C3明显低于对照组(P0.05);阿魏酸钠干预组血清Ig A、Ig G、Ig M明显低于模型组,补体C3明显高于模型组(P0.05);阿魏酸钠高剂量组血清Ig A、Ig G、Ig M明显低于阿魏酸钠低剂量组,补体C3明显高于阿魏酸钠低剂量组(P0.05)。结论阿魏酸钠可能通过降低炎性反应、调节体液免疫达到治疗UC的目的,且大剂量阿魏酸钠干预效果更好。     

血清补体C3在IgA肾病中的作用

目的探讨血清补体C3在Ig A肾病(Ig AN)发病中的作用。方法检测并收集59例Ig AN患者的血清补体C3、临床资料及肾脏病理资料并进行统计学分析。结果根据肾小球滤过率(e GFR)和血尿素氮(BUN)将Ig AN患者分组,e GFR降低组血清C3水平较e GFR正常组明显下降(P<0.05);BUN升高组较BUN正常组明显下降(P<0.05);血清补体C3与e GFR、Ig G、Ig A、C4呈显著正相关(P<0.05或P<0.01),与BUN呈负相关(P<0.05),与Katafuchi(K)积分呈显著负相关(P<0.05)。结论 Ig AN患者血清补体C3水平与疾病活动相关,血清补体C3水平能够提示Ig AN患者肾脏病理损害程度以及肾功能水平。     

联合检测心肌酶谱、免疫球蛋白、NSE在病毒性脑炎病情评估中的意义

目的探讨病毒性脑炎(VE)患者血清心肌酶谱、免疫球蛋白以及神经特异性烯醇化酶(NSE)的检测对VE患儿病情评估及预后的意义。方法将118例VE患者分为轻症组和重症组,各59例,另选择30例同时期的健康体检儿童作为对照组,比较各组血清和脑脊液心肌酶谱、免疫球蛋白和NSE水平的变化。结果重症组、轻症组和对照组比较,重症组血清和脑脊液肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、谷草转氨酶(AST)和乳酸盐脱氢酶(LDH)水平较轻症组和对照组显著升高,轻症组略高于对照组,差异均具有统计学意义(F=4. 35～522. 87,P 0. 05)。重症组、轻症组和对照组比较,重症组血清和脑脊液免疫球蛋白G(Ig G)、免疫球蛋白A(Ig A)、免疫球蛋白M(Ig M)和NSE水平较轻症组和对照组明显升高,比较差异有统计学意义(F=4. 39～518. 09,P 0. 05);轻症组Ig A、Ig M和NSE水平均较对照组明显升高,比较差异有统计学意义(P 0. 05),但血清和脑脊液Ig G水平略低于对照组,差异无统计学意义(χ2=72. 00～122. 00,P 0. 05)。重症组心肌酶谱、免疫球蛋白和NSE指标的异常率均显著高于轻症组和对照组,差异有统计学意义(P 0. 05)。结论血清和脑脊液心肌酶谱、免疫球蛋白和NSE在VE的诊断、评估和判断病情轻重、治疗效果及预后等方面具有较大的临床应用价值。     

天麻多糖对环磷酰胺所致免疫功能低下小鼠体液免疫功能的影响

目的探讨天麻多糖对环磷酰胺所致免疫功能低下小鼠体液免疫功能的影响。方法环磷酰胺制造免疫功能低下小鼠模型。实验设盐酸左旋咪唑对照组、模型组、天麻多糖高剂量组、天麻多糖中剂量组、天麻多糖低剂量组。造模后给予天麻多糖治疗10 d。实验结束处死小鼠,比较各组小鼠胸腺指数、脾指数、血清Ig A、Ig G和Ig M及溶血素水平。结果与模型组比较,天麻多糖中、高剂量组显著升高血清Ig A、Ig G及血清溶血素水平(P0.01),多糖高剂量组升高脾指数和胸腺指数,多糖中剂量组明显升高血清Ig M水平(P0.05)。结论天麻多糖可以缓解环磷酰胺对小鼠体液免疫功能的抑制作用。     

类风湿关节炎血清植物性食物过敏原特异性IgG和IgE检测

目的检测类风湿关节炎患者4种植物性食物过敏原Ig G和Ig E水平,探讨类风湿关节炎与食物过敏的相关性。方法收集2013年9月至2014年5月深圳市第六人民医院50例类风湿关节炎患者和45例健康人血清,采用酶联吸附法检测血清花生、大豆、榛子、小麦4种食物过敏原特异性Ig G和Ig E水平。结果类风湿关节炎组与正常组血清花生、大豆特异性Ig G比较差异有统计学意义(1.31±0.36 vs.1.08±0.35;1.22±0.33 vs.1.07±0.32;均P0.01);血清榛子、小麦特异性Ig G,血清花生、大豆、榛子、小麦特异性Ig E比较差异无统计学意义(P0.05)。老年性类风湿关节炎组(年龄≥60岁)与非老年类风湿关节炎组(年龄60岁)血清花生、大豆、榛子、小麦食物过敏原特异性Ig G、Ig E比较差异无统计学意义。结论类风湿关节炎与食物过敏有相关性,食物过敏与类风湿关节炎发病年龄无明显相关性。     

乙型肝炎患者血清免疫球蛋白和补体C3/C4检测的意义

目的探讨检测慢性乙型肝炎、乙型肝炎肝硬化和乙型肝炎肝衰竭患者血清免疫球蛋白(Ig G、Ig M、Ig A)和补体C3、C4水平的意义。方法在32例慢性乙型肝炎、33例乙型肝炎肝硬化和35例乙型肝炎肝衰竭患者,采用速率散射免疫比浊法检测血清免疫球蛋白(Ig G、Ig M、Ig A)和补体C3、C4。结果乙型肝炎肝衰竭患者血清Ig A水平为(4.06±1.20)mg/L,显著高于慢性乙型肝炎[(3.18±1.23)mg/L,P0.05]和乙型肝炎肝硬化患者[(3.21±1.53)mg/L,P0.05];C3水平为(0.33±0.02)g/L,显著低于慢性乙型肝炎[(0.54±0.25)g/L,P0.05]和肝硬化患者[(0.60±0.05)g/L,P0.05];三组其他指标无显著性相差(P0.05)。结论血清Ig G、Ig M、Ig A和补体C3、C4水平检测对肝脏疾病的诊断有一定的临床意义。     

日本血吸虫病人群获得性免疫与再感染IV.治后9个月人群特异性抗体水平与再感染

目的　了解血吸虫病洲岛型流行区居民血清抗 AWA、重组 PMY和 Teg Ag的抗体亚类水平及其与居民再感染的关系。方法　 137例行 5 0 mg/ kg吡喹酮顿服。 7周后粪检 ,阳性者再次治疗 ,4周后经再次粪检证实为阴性。经 1个感染季节后再粪检并采血 ,用 EL ISA法检测抗 3种抗原的抗体亚类水平。结果　观察对象治前感染率 2 8.5 % ,治后再感染率 6 .6 % ;抗 AWA的 Ig G4和 Ig A峰值出现在 2 0～ 2 9岁 ,Ig E的峰值在 40～ 49岁 ,Ig G2 则在 2 0～ 2 9岁和 40～ 49岁 ,抗 AWA的 Ig E与 Ig G4的水平呈正相关 ;男性抗 AWA和 PMY的抗体亚类水平显著高于女性 ;感染状态不同的 4组中 ,再感染组抗 AWA的特异性总 Ig G和 Ig G4较其他 3组高。结论　特异性抗体水平与年龄之间没有明显关系 ;抗 AWA的 Ig G4可能在易感个体内起着一种封闭性抗体的作用 ;抗 AWA的 Ig E反应伴随着 Ig G4的反应。     

慢性荨麻疹合并甲亢临床分析

目的探讨慢性荨麻疹与甲状腺功能亢进(甲亢)的关系。方法选择2014年1~12月在我院就诊的慢性荨麻疹合并甲亢患者50例作为A组;以同期在我院治疗的单纯甲亢患者50例作为B组;随机选取在我院进行健康体检的健康者50例作为对照组(C组)。检测三组患者的FT3、FT4、TSF、甲状腺自身抗体与血清总Ig E水平,并观察三组患者的自体血清皮肤试验(ASST)结果。结果 A组患者TGAb、TPOAb、ASST阳性率均高于C组(P0.05);A、B两组患者FT3、FT4、总Tg E水平均高于C组,超敏促甲状腺激素(s TSH)水平低于C组,差异具有统计学意义(P0.05);A、B两组患者上述指标比较差异无统计学意义(P0.05)。结论甲状腺自身抗体TPOAb、TGAb以及血清总Ig E在慢性荨麻疹合并甲亢的发病中起到一定的作用,自身血清皮肤试验(ASST)指标对于诊断慢性荨麻疹合并甲亢具有一定的临床价值。     

Evaluation of the Serum Levels of Immunoglobulin and Complement Factors in b-thalassemia Major Patients in Southern Iran

Background: Beta-thalassemia major is one of the major health problems in our country. Many studies have confirmed the fact that, these patients have an increased susceptibility to bacterial infections. Objective: In this study, we have assessed the humoral immune system in 68 thalassemic patients by measuring their serum concentration of Immunoglobulin G (IgG), IgM, IgA, C3 and C4 in order to find out a responsible immune defect. Methods: Sixty eight b-thalassemia major patients were enrolled randomly from referrals to Dastgheib clinic of thalassemia. The same number of case controls with matched age and sex were selected from healthy people without any history of recent or recurrent infections. Serum IgG, IgM, IgA, C3 and C4 levels were assessed using Single Radial Immunodiffusion (SRID). Results: Serum levels of IgG, IgM & IgA were significantly higher (P<0.01) and those of C3 and C4 were significantly lower (P<0.01) in thalassemic patients than the controls. Considering the result of analytic tests, it was revealed that, thalassemia patients show much more increase in serum immunoglobulin levels as they get older. Splenectomized patients had higher serum IgG and IgA levels than non-splenectomized patients but had no difference in serum IgM, C3 and C4. Serum ferritin level had no correlation with the changes of humoral immunity; however, patients with serum ferritin level >2500ng/ml had higher serum IgM level. Conclusion: These results can be due to continuous exposure to antigens, repeated infections, chronic liver disease and splenectomy but not iron overload. The only probable cause of humoral immune deficiency found in these patients is a defect in serum complement levels.     

血浆同型半胱氨酸与系统性红斑狼疮关系的探讨

目的探讨系统性红斑狼疮(SLE)与血浆同型半胱氨酸(Hcy)间的关系,并分析影响SLE患者Hcy的代谢因素.方法 60例SLE患者和正常对照组45例,测定并分析血浆Hcy水平与叶酸、维生素B12、IgG、IgA、IgM、C3、C4、C反应蛋白(CRP)、血沉(ESR)各指标之间的关系.结果 (1)SLE组血浆Hcy、IgG、IgA、IgM、CRP、ESR水平均显著高于正常对照组(P<0.05);叶酸、维生素B12 、C3、C4均显著低于正常对照组(P<0.05).(2)SLE组患者Hcy与IgG、IgA、IgM、CRP呈正相关,与叶酸、维生素B12、C3、C4水平呈负相关(P<0.05),与ESR无相关性.(3)正常组血浆Hcy浓度与各指标无相关性.结论 Hcy水平升高与SLE密切相关,SLE患者普遍有高Hcy血症,血浆Hcy的检测对于SLE病人有临床应用价值.     

原发性高血压患者体液免疫水平的变化及影响因素

目的观察原发性高血压患者的体液免疫水平及其分布特征。方法随机选取我院住院的原发性高血压患者112（男68,女44）例为观察对象,以同期的健康体检者73例（排除继发性高血压及其他免疫系统疾病）为对照,分析不同性别、年龄、病期、脉压差及不同并发症组各组间体液免疫水平及其分布特征。结果与对照组相比较,男女原发性高血压患者IgG水平显著增高（P<0.05）;且随着年龄的增长、病情的加重,血清IgG和IgA的含量及抗核抗体（ANA）和核抗原抗体（ENA）检出率显著增加（P<0.05）。脉压差<60mmHg者IgG、IgA的水平显著高于对照组（P<0.05）;并发心脑血管损害者血清IgG和ANA的含量异常升高（P<0.05）。结论原发性高血压患者体液免疫水平升高,其分布与年龄、高血压分级、脉压差和并发症有关。     

Assessment of humoral immune response in patients with chronic hepatitis C virus infection

Hepatitis C infection is a major public health problem worldwide. Hepatitis C virus (HCV) infection has been identified as a major causative agent of post-transfusion hepatitis. The host immune response to HCV infection is composed of both non- specific immune response, including interferon (IFN) production and natural killer (NK) cell activity and a virus-specific immune response, including humoral and cellular components. Susceptibility to infection has been related to immunological disturbances. Several studies have provided experimental evidence of disorders of both cellular and humoral immunity. Humoral Immunity is dependent mainly on immunoglobulins and little data are available about serum immunoglobulin values in chronic hepatitis C. The present study aimed to evaluate humoral immune response by measuring the concentration of serum immunoglobulin isotypes (IgG, IgM, IgA) and IgG-subclasses level (IgG1-4) in chronic hepatitis C patients and healthy controls. This study included 50 patients with chronic hepatitis C. All of them had positive serum anti-HCV antibodies, positive serum HCV-RNA by PCR, and histologically-proven chronic hepatitis. The results were compared with 25 healthy controls. Total IgG, IgA and IgM were assayed by nephelometry. IgG subclasses were assayed using human IgG subclasses enzyme immunoassay. Serum protein electrophoresis was performed in agarose gel. The results showed that no significant difference in serum immunoglobulin levels were found among patients with chronic hepatitis C of minimal liver damage( Knodell index < or =3) and patients with mild liver disease (Knodell index > 3). A significant increase in total serum IgG, IgG1 and IgG2 levels were found in patients with chronic hepatitis than in healthy controls but no difference was found in IgG3 and IgG4 in both patients and controls. Mean serum IgM was increased in patients with HCV infection compared with healthy controls. No significant difference was found in IgA level in both the patients and healthy controls. Our data revealed an increase of humoral immune response in chronic hepatitis C infection. This is evidenced by an elevation in serum immunoglobulin isotypes; IgG and its subclasses IgG1 and IgG2 and IgM. These findings may provide some new insights into the antibody response to HCV.     

大动脉炎患者体液免疫功能、细胞免疫功能检测及意义

目的探讨大动脉炎患者体液免疫功能及T淋巴细胞亚群变化的临床意义。方法检测31例大动脉炎患者(观察组)和30例体检正常者(对照组)IgG、IgA、IgM、IgE、C3、C4、CD3+、CD4+、CD8+、CD4+/CD8+水平。结果观察组IgG、IgM、IgE、C3、CD4+CD4+/CD8+水平较对照组明显升高而C4、CD3+水平明显下降(P均<0.05);IgA、CD8+两组间无显著差异。结论大动脉炎患者的体液免疫和T淋巴细胞亚群水平在发病时变化明显,对该病的发病机制研究和临床诊断有重要意义。     

硬膜外注药治疗腰椎间盘突出症对患者体液免疫因子的影响

为观察三膜外注药对腰椎间盘突出症患者体液免疫因子的影响，将61例腰椎间盘突出症患者按椎间盘突出程度分为两组，A组髓核突出≥0．5c m，B组＜0．5cm，采用单向免疫扩散法检测硬膜外注药前后两组血清IgG,IgA,IgM和C3等体液免疫指标的变化，并与31例正常人（对照组）进行比较，结果显示：A组治疗前血清IgG,IgM和B组和对照组增高（P＜0．05），B组与对照组比较无明显差异（P＞0．05），治疗后A组各项指标达到正常范围，表明腰椎间盘突出症患者存在免疫反应性炎症及体液免疫异常，且其严重程度与椎间盘突出程度呈正相关，硬膜外注药可调节患者的免疫功能紊乱状态，消除受胃神经根的免疫反应性炎症     

慢性阻塞性肺病合并糖尿病患者免疫功能变化及其意义

目的 研究慢性阻塞性肺疾病合并糖尿病的免疫功能变化并探讨临床意义.方法 78例COPD稳定期病例分为COPD合并糖尿病(COPD+DM)组和COPD组,同时选择20例健康人作为对照组,分别测定周血细胞免疫、和体液免疫.结果 COPD+ DM组IgA、IgG、IgM、CD4+水平均低于COPD组和对照组,CD8+水平高于COPD组和对照组,CD4 +/CD8+倒置更为明显,差异均有统计学意义(P＜0.05),而CD3+水平在各组之间无差异(P＞0.05).结论 糖尿病加重COPD免疫功能失调,控制糖尿病对于提高COPD免疫功能有重要意义.     

免疫球蛋白及补体水平检测对A群轮状病毒性肠炎患儿的

目的 分析免疫球蛋白及补体水平检测对A群轮状病毒性肠炎患儿的临床意义.方法 选取2010年12月-2012年12月我院收治的A群轮状病毒性肠炎患儿56例（轮状病毒性肠炎组）及体检健康儿童56例（对照组）,检测两组IgG、IgA、IgM及补体C3、C4水平.结果 轮状病毒性肠炎组患儿IgG和IgA水平低于对照组（P＜0.05）;两组IgM、C3和C4水平比较,差异均无统计学意义（P＞0.05）.结论 A群轮状病毒性肠炎患儿体液免疫功能方面存在着一定的紊乱现象,免疫球蛋白及补体水平检测可以有效地监测患儿体液免疫状况,为进一步的治疗提供科学依据.     

支原体肺炎患儿血清体液免疫检测的临床研究

目的探讨支原体肺炎(MP)患儿体液免疫IgG、IgM、IgA在其发病机制中的作用。方法分析我院收治的36例支原体肺炎患儿作为病例组,同期42例健康患儿作为对照组。检测两组小儿血清免疫球蛋白IgG、IgM、IgA含量,并进行比较。结果支原体肺炎患儿血清IgG、IgM显著高于对照组,P<0.0001,P<0.0001;血清IgA水平两组比较差别无统计学意义,P=0.74。结论支原体肺炎病儿体液免疫IgG、IgM应答增强,在其发病机制中起重要作用。     

Retrospective analysis on the impact of tuberculosis on patients with systemic lupus erythematosus (SLE)

Up to now, there have been few reports concerning changes in lupus activity and immune indices of tuberculosis in patients with systemic lupus erythematosis (SLE). A retrospective investigation was given to survey the case data of SLE patients companied with tuberculosis that were treated in our hospital from 2001 to 2010 and compared with that of sex- and age-matched patients with single SLE. Changes in autoantibodies, lupus activity, inflammatory indices, positive rates of tuberculin (PPD) test and tuberculosis antibody (TB-Ab) of both groups were observed. It was indicated by results that ANA antibody level and positive rates of anti-Sm, anti-SSA and anti-SSB antibodies were significantly lower in the TB group than those in the control group (P < 0.05); C3 and C4 levels were significantly higher in the TB group than those in the control group; damage of hematological system (predominantly platelet) was less severe in the TB group than that in the control group (P < 0.05); no significant differences in IgG, IgM and IgA were noted between two groups (P > 0.05); ESR, C-reactive protein and LDH levels were significantly higher in the TB group than those in the control group (P < 0.05); PPD-IgG were significantly higher in the TB group than those in the control group (P < 0.05). These results suggested that after SLE patients were infected with tuberculosis, immune function was altered and lupus activity was inhibited as well.