急性白血病的甲襞微循环及临床意义

对４０例急性白血病（ＡＮ）患者进行甲襞微循环观察，按田牛提出的加权积分法进行综合定量分析。ＡＬ患者甲襞微循环各类积分值均显著高于正常对照组（Ｐ＜０．００１）。化疗后总积分值显著升高（Ｐ＜０．００１），缓解期显著下降（Ｐ＜０．０５）。总积分值与血红蛋白浓度、血小板计数均呈显著负相关（γ分别为－０．３１７和－０．２４１，Ｐ分别＜０．０１和０．０５）。甲襞微循环观察分析有助于深入研究ＡＬ患者病情变化和监测微血管对化疗药物毒性的反应。     

传染病与微循环

目的探讨常见传染病的发病机理与微循环功能障碍的关系及药物治疗的效果。方法对各型病毒性肝炎、乙型脑炎、麻疹、细菌性痢疾、伤寒、流腮等常见传染病患者均进行甲襞微循环检测及动态观察和定量研究。结果对２５６例各型病毒性肝炎患者观察发现均有管襻、流速的不同变化，其加权值分值在１．６６±５．５之间，积分值依急性肝炎＞慢性肝炎＞肝硬化＞亚重肝，依次呈顺序递增变化。各型肝炎甲襞微循环的异常率分别为：急肝（５８．８６％）、慢迁肝（６８． ９６％）、慢活肝（６９． ２３％）、肝硬化（８８．８８％）、亚重肝（１０％），其异常率依病型呈顺序递增。病情好转时微循环功能均有不同程度改善。乙型脑炎：对３７例已脑患者急性期检测发现其加权积分值依病型不同而各异：轻型 ２± １． ９６，普通型 ３． ５± ２， ９８，重型及极重型 ４． ９±２．３３，Ｐ＞０．０５～＜０．０１，加权积分值依轻、普、重型呈规律性递增．恢复期依病情改善微循环功能障碍均有改善，其值分别为：１．１±１．１３；１．５０±１．３；１．６９±１．４０。麻疹：检测出疹期患者４０例，其异常率为８２．５％（３３例），其加权积分值为２．９５±１．２７，明显高于正常值，Ｐ＜０．０１。其中１５例合     

尿毒症患者血液透析前后的甲襞微循环

观察１８例慢性肾功能不全尿毒症终末期患者甲襞微循环的改变及其中１１例用血液透析治疗的患者第一次血透前与血透４～８次（平均５．９次）后甲襞微循环的变化，结果表明，尿毒症患者甲襞微循环加权积分综合判断，中度异常者占８３．３％，重度异常者占１６．７％。其中１１例作血透的患者在治疗前与治疗后总积分值分别为６．９０±０．７２与５．１０±０．７０，二者有非常显著差异。提示尿毒症患者甲襞微循环障碍经血透治疗后可有明显改善，但仍在中度异常范围。给尿毒症患者进行甲襞微循环检查，对其病情的估价有着一定的临床意义。     

成人各型病毒急性肝炎的微循环障碍

对２８０例成人甲、乙、丙、丁、戊型病毒急性肝炎和４０例正常成人进行甲襞微循环对比观察，结果显示：成人各型病毒急性肝炎组存在明显微循环障碍，与对照组差异非常显著（Ｐ＜０．０１）。加权积分法评价，单纯感染积分值最低，二联感染次之，三联感染最高，积分值越高，微循环障碍越重。应用改善肝脏微循环的药物，可望取得较好疗效。     

102例部队良性关节痛患者体表多部位血流量研究

用ＬＤＦ３多普勒微循环血流计检查１０２例部队良性关节痛患者体表多部位的血流量。结果：舌尖２．８９±４．００Ｖ，舌下２．９３±０．４８Ｖ，下唇３．０９±０．８９Ｖ，甲襞３．０２±０．５７Ｖ，耳垂２．８６±０．３７Ｖ，左膝眼３．５６±０．７５Ｖ，右膝眼３．３５±０．３７Ｖ，左犊鼻３．５２±０．６８Ｖ，右犊鼻３．３３±０．８１Ｖ。除耳垂外，各部位检测结果均明显低于正常人组（Ｐ＜０．０１或０．００１）。研究结果表明，良性关节痛患者膝关节局部和全身均存在有明显微循环障碍表现。     

视网膜色素变性患者的甲襞微循环

观察３１例视网膜色素变性患者的甲襞微循环，并同３１例相匹配的正常人做为对照，结果发现：色变组的管袢数为４．１８±１．６１，对照组为５．３０±２．１１。二组间有显著性差异（Ｐ＜０．０５），其它指标如管径、管袢长度、形态和流态积分值、袢周积分和总积分值，二组间无差异；色变组有１４例出血和／或渗出，而对照组只有５例，其意义尚需进一步观察。根据其结果可以认为视网膜色素变性患者眼底微循环的改变纯系局部的而不伴全身微循环障碍。     

治疗缺血性心脑血管病过程中微循环与血液流变性变化的关系

利用微量阿司匹林（Ｍ－ＡＳＡ）和安慰剂对老年缺血性心脑血管病病人的不同效应，探讨甲襞微循环与血液流变性的相互关系。结果表明服用Ｍ－ＡＳＡ后的微循环各指标积分值和血液流变性的血沉值及血沉Ｋ值较服药前明显下降（Ｐ＜０．０１），而血球压积较服药前明显上升（Ｐ＜０．００５）；但全血粘度值服药前后无明显改变（Ｐ＞０．０５）。服用安慰剂前后的微循环各指标积分值和血液流变性的各指标均无明显改变（Ｐ＞０．０５），由此表明微循环和血液流变性的某些指标在特定条件下既有相关性又有差异性     

化工类有害成分对中老年人甲襞微循环的影响

对９５名长期接触甲苯、苯、丁二醇、石油醚、丙酮等有害成分的香料厂中老年作业人员进行甲襞微循环观察，并以２８８名健康人作对照。观察结果采用田牛加权积分法计分评定，结果表明：接触组的微血管形态积分、血液流态积分、袢周状态积分与总积分值均明显高于非接触对照组（Ｐ＜０．０１，Ｐ＜０．００１）。提示：长期接触化工类有害成分可导致中老年人微循环功能障碍。     

中风偏瘫肩—手综合征甲襞微循环的变化及针刺对其的影响

为研究中风偏瘫肩—手综合征（ＳＨＳ）甲襞微循环的变化及针刺对其的影响，检查２６例ＳＨＳ患侧针刺前后及２０例对照组的甲襞微循环。结果表明，ＳＨＳ患侧甲襞微循环各类积分值均显著高于对照组（Ｐ＜０．００１）；且其总积分值和肩痛及手肿轻重程度有关。针刺后其流态、管周状态及总积分的积分值均显著下降（Ｐ＜０．０１０．００１）。结果提示，ＳＨＳ患侧甲襞微循环存在明显障碍且和临床表现轻重程度有关；针刺治疗能使其微循环障碍得到明显改善     

甘糖酯对缺血性脑血管病患者红细胞变形能力及甲襞微循环的影响

观察了４０例缺血性脑血管病患者应用甘糖酯治疗前后红细胞滤过指数和甲襞微循环的改变。结果显示：治疗前患者红细胞滤过指数明高于正常人（Ｐ＜０．００１），治疗后红细胞滤过指数明显低于治疗前（Ｐ＜０．００１），且治疗２０天后红细胞滤过指数与正常人无明显差异（Ｐ＞０．０５）；治疗前甲襞微循环血管形态血液流态、袢周状态及总积分值均明显高于正常人（Ｐ＜０．００１），治疗后各项指标均有不同程度的改善。     

产后的微循环与血液流变性变化

对４０例产后妇女甲襞微循环、血液流变进行观察，发现产后微循环有不同程度的障碍，血液流变学检查发现其全血高切、低切粘度，全血高切、低切还原粘度，血浆纤维蛋白原等升高；实验结果提示，血液聚集性和凝固性升高，红细胞变形能力下降。     

当归、川芎嗪注射液影响血瘀大鼠转归的血液动力学基础

目的:探讨活川芎嗪、当归注射液对血瘀大鼠血液动力学的影响。方法:颈动脉放血复制血瘀大鼠模型,通过微循环观察、器官血流和血液流变学测定方法,观察川芎嗪、当归对血瘀大鼠血液动力学的影响。结果:血瘀时微循环明显障碍,主要表现为微血流变慢和血细胞聚集;经川芎嗪、当归注射液治疗后,微循环改善,血细胞粘附率和聚集率降低,器官微区血流量明显增加,与NS组比较有显著性差异(p<0．05)。结论:川芎嗪、当归注射液能明显改善血瘀大鼠微循环障碍, 降低血小板聚集率,增加器官血流灌流量。     

Anti-Müllerian hormone concentrations in maternal serum during pregnancy

BACKGROUND: In females, anti-Müllerian hormone (AMH) is expressed only by the ovary. AMH is secreted by the granulosa cells of ovarian follicles and appears to regulate early follicle development. AMH is detected in serum from women of reproductive age and its levels vary slightly with the menstrual cycle, reaching the peak value in the late follicular phase. This study investigated serum AMH levels throughout gestation and after delivery in healthy pregnant women. METHODS: This cross-sectional study recruited pregnant women and healthy non-pregnant women, 84 in total. AMH, FSH and E2 were measured in the follicular phase, in the three trimesters of pregnancy and in early puerperium. RESULTS: Estradiol and FSH levels followed the expected patterns during gestation. During the follicular phase of the menstrual cycle AMH levels were 1.9 +/- 0.5 ng/ml. In the three trimesters of pregnancy and in early puerperium AMH levels were: 2.1 +/- 0.56, 2.4 +/- 0.64, 1.95 +/- 0.6 and 2.05 +/- 0.55 ng/ml respectively. No significant modifications were found in AMH levels during pregnancy and in the early puerperium. CONCLUSIONS: This study has obtained information on AMH and on the possible relationship with FSH. We hypothesize that the profile of the new marker of ovarian activity AMH may indicate that initial non-cyclic ovarian follicular activity during pregnancy is not abolished. Moreover FSH, does not seem to play a direct role on AMH synthesis and secretion.     

Reproductive hormones and blood pressure during pregnancy

The mechanisms involved in cardiovasular changes during human pregnancy and the complicated aetiology of gestational hypertension are unclear. Reproductive hormones have known effects on the cardiovascular system in the non-pregnant state and in animal systems, but their effects in human pregnancy are uncertain. In this study of pregnant women, the effects of serum concentrations of relaxin, progesterone and oestradiol on arterial blood pressure were studied. Higher serum concentrations of progesterone and relaxin, but not oestradiol, in early pregnancy were related to lower mean systolic blood pressures in the second and third trimesters. No relationship was found between hormonal concentrations and diastolic blood pressures. However, women with a diastolic blood pressure of >90 mmHg in late pregnancy showed statistically significant lower relaxin concentrations in early pregnancy in comparison with women whose diastolic blood pressure was 相似文献   

大剂量激素对脑创伤家兔脑微循环及血液流变性的影响

为探讨大剂量激素对脑创伤后脑微循环及血液流变性的影响，将２４只家兔随机等分为３组：标准对照组、损伤对照组和地塞米松治疗组。分别在伤前０．５ｈ、伤后０．５ｈ、１ｈ、２ｈ、３ｈ测量软脑膜微动脉管径和血流速度的变化及伤后３ｈ血液流变学指标。结果表明：大剂量激素在伤后０．５ｈ就能明显地扩张损伤处软脑膜的微动脉并使血流速度明显加快。伤后３ｈ能明显降低血沉、全血粘度、红细胞压积及纤维蛋白原含量，并明显增强红细胞的变形能力，降低其聚集性。这些结果表明大剂量激素能明显改善脑创伤后家兔的脑微循环及血液流变性     

新正天丸对偏头痛血瘀证甲襞和球结膜微循环的影响

目的 :探讨偏头痛血瘀证病人甲襞和球结膜微循环的改变及新正天丸治疗后的影响。方法 :对照观察 3 6例偏头痛血瘀证病人发作期、治疗后和 2 8例正常人甲襞微循环 ,检测 2 8例偏头痛病人球结膜微循环 ,并与 2 6例正常人相比较 ,重点观察甲襞和球结膜微循环的形态、流态及血管袢周围状态等多项指标 ,并以加权积分法计算其积分值。结果 :与对照组相比 ,发作期存在明显的甲襞和球结膜微循环改变 ,主要表现在毛细血管管径缩小 ,管袢形态异常 ,袢周出血。经新正天丸治疗后 ,管袢清晰度增强 ,血流速度加快 ,红细胞聚集性下降 ,加权积分法示治疗前后甲襞和球结膜微循环有显著性改变 (P <0 .0 5～ 0 .0 1)。结论 :甲襞和球结膜微循环障碍可能是偏头痛血瘀证的重要病理特征 ,新正天丸对其微循环障碍可能有改善作用。     

Effects of pregnancy and delivery on the availability of plasma tryptophan to the brain: relationships to delivery-induced immune activation and early post-partum anxiety and depression.

BACKGROUND: There is now evidence that the availability of plasma tryptophan is decreased during pregnancy and the puerperium and also in patients with major depression and inflammation. The aims of the present study were to examine: (i) the effects of pregnancy and delivery on plasma tryptophan and the amino acids known to compete for the same cerebral uptake mechanism (CAAs), valine, leucine, tyrosine, phenylalanine and isoleucine; (ii) the relationships between the availability of plasma tryptophan and postpartum depression or anxiety; and (iii) the relationships between the availability of plasma tryptophan to the brain and inflammatory markers, such as serum interleukin-6 (IL-6), interleukin-1 receptor-antagonist (IL-1RA) and the leukaemia inhibitory factor receptor (LIF-R). METHODS: The above variables were measured in 13 healthy non-pregnant and in 98 pregnant women 3 to 6 days before delivery and 1 and 3 days after delivery. On each occasion the parturient women completed the state version of Spielberger State-Trait Anxiety Inventory (STAI) and the Zung Depression Rating Scale (ZDS). RESULTS: Plasma tryptophan and the tryptophan/CAA ratio were significantly lower at the end of term and after delivery than in the plasma of non-pregnant, healthy women. The tryptophan/CAA ratio was significantly lower in the early puerperium than at the end of term. There were no significant relationships between the availability of plasma tryptophan and either post-partum depression or changes in the STAI or ZDS scores in the early puerperium. The changes in the tryptophan/CAA ratio from the end of term to the early puerperium were significantly and inversely related to serum IL-6, IL-IRA and LIF-R. CONCLUSIONS: The results show that the reduction in the availability of plasma tryptophan from the end of term to the early puerperium is related to immune activation; and that the lowered availability of plasma tryptophan is not related either to depressive or anxiety symptoms in the early puerperium or to post-partum depression ensuing some months later.     

妊高征患者产前及产后血小板活化状态的研究

采用流式细胞术对４２例正常晚孕妇女及５０例妊高征患者产前及产后７２小时Ｐ－选择素进行对比研究。结果：妊高征患者Ｐ－选择素含量明显大于正常晚孕妇女，Ｐ－选择素含量在轻、中及重度妊高征患者呈递增趋势，差异均有显著性，产后７２小时其Ｐ－选择素含量降至正常晚孕妇女水平。提示：Ｐ－选择素可作为妊高征早期诊断及监测病情的一个重要指标     

颅高压与脑软膜微循环障碍

借助一种新技术，测定活体动物的颅内压，在测定过程中，应用微循环显微镜通过颅骨窗观察了脑软膜的微循环。结果表明，随着颅高压增高，脑软膜的微循环障碍就越严重，表现出严重的细胞聚集和脑软膜微血管的扩张，最后脑软膜微循环停止流动，动物死亡。实验提示：临床上脑高压症必须早治，要在脑微循环障碍出现临床症状之前。     

妊娠高血压综合征孕妇血小板及血液流变学指标的观察分析

目的:对妊娠高血压综合征孕妇血小板参数及血液流变学指标进行观察分析。方法:选择妊高征待产孕妇45例(妊高征组),正常妊娠待产孕妇45例(正常妊娠组),正常非妊娠期妇女45例(对照组)作为研究对象。测定3组妇女红细胞压积、红细胞数量、血红蛋白浓度、血小板参数、纤维蛋白原浓度、全血及血浆粘度。结果:(1)妊高征组血小板平均容积、血小板容积分布宽度和大血小板比率高于对照组及正常妊娠组(P<0.05);(2)妊高征组全血粘度及血浆粘度均高于正常妊娠组(P<0.05);正常妊娠组均高于对照组(P<0.05)。结论:妊高征孕妇血小板参数及血液流变学指标的变化较正常妊娠组及对照组有显著性意义,说明血小板活化及血液流变学改变参与了妊高征的发生、发展过程。