小儿急性白血病患者血浆纤维结合蛋白测定的临床意义

小儿急性白血病患者血浆纤维结合蛋白测定的临床意义张宝玺，郭稳捷河北医学院附属二院儿科ＴＨＥＣＬＩＮＩＣＡＬＳＩＧＮＩＦＩＣＡＮＣＥＯＦＰＬＡＳＭＡＦＩＢＲＯＮＥＣＴＩＯＮＤＥＴＥＣＴＩＯＮＩＮＣＨＩＤＨＯＯＤＡＣＵＴＥＬＥＵＫＥＭＩＡ￥ＺｈａｎｇＢａ...     

小儿白血病形态学、免疫学分型研究

小儿白血病形态学、免疫学分型研究程岩，田根全，袁文菊，杨小红青海省儿童医院ＴＨＥＲＥＳＥＡＲＣＨＯＦＭＯＲＰＨＯＬＯＧＩＣＡＮＤＩＭＭＵＮＯＬＯＧＩＣＡＬＣＬＡＳＳＩＦＩＣＡＴＩＯＮＯＦＴＨＥＰＥＤＩＡＴＲＩＣＬＥＵＫＥＭＩＡ￥ＹａｎＣｈｅｎｇｅｔａ...     

血小板质控初探

血小板质控初探袁光孚，张玉芳，保菊英，秦振庭西宁市第一人民医院ＣＡＭＰＡＲＩＳＩＯＮＯＦＤＩＦＦＥＲＥＮＴＭＥＴＨＯＤＳＦＯＲＰＬＡＴＥＬＥＴＣＯＵＮＴＩＮＧＡＴＨＩＧＨＡＬＴＩＴＵＤＥＱＩＮＧＨＡＩ￥Ｋｕａｎｇ－ＦｕＹｕａｎ．ｅｔａｌ（Ｘｉ－Ｎｉｎ...     

Y-1型计测板对红细胞微量压积测量效果的初步评价

Ｙ－１型计测板对红细胞微量压积测量效果的初步评价袁光孚，保菊英，王冀湘，耿广献西宁市一医院ＥＶＡＬＵＡＴＩＯＮＯＦＡＣＡＬＣＵＬＡＴＩＮＧＰＬＡＴＥＭＯＤＥＬＹ－ＩＦＯＲＴＨＥＭＥＡＳＵＲＥＭＥＮＴＯＦＭＩＣＲＯ－ＨＥＭＡＴＯＣＲＩＴ．￥ＹｕａｎＧｕ...     

不同日龄、不同病情新生儿血小板数量的观察

不同日龄、不同病情新生儿血小板数量的观察秦振庭，王广方北京医科大学第一临床医学院妇儿医院ＰＬＡＴＥＬＥＴＣＯＵＮＴＳＡＴＤＩＦＦＥＲＥＮＴＡＧＥＧＲＯＵＰＳＯＦＮＥＷＢＯＲＮＳ￥Ｃｈｅｎ－ＴｉｎｇＣｈｉｎｅｔａｌ（Ｗｏｍｅｎ＆Ｃｈｉｌｄｒｅｎｈｏｓｐ...     

小儿血液病骨髓活检的临床意义

小儿血液病骨髓活检的临床意义屠立明，沈亦逵，王若洁广东省人民医院儿科ＣＬＩＮＩＣＳＩＧＮＩＦＩＣＡＮＣＥＯＦＢＯＮＥＭＡＲＲＯＷＢＩＯＰＳＹＩＮＣＨＬＬＤＲＥＮＨＥＭＡＴＯＬＯＧＩＣＤＩＳＥＡＳＥＳ￥ＴｕＬｉｍｉｎｇ，ｅｔａｌ．（ＧｕａｎｇｄｏｎｇＰ...     

蚕豆病复发因素的探讨(附257例随访病例报告)

蚕豆病复发因素的探讨（附２５７例随访病例报告）陈茂余，卓慧琼，衡德芳，罗运贵，肖彦勋四川省遂宁市人民医院ＥＸＰＬＯＲＡＴＩＯＮＴＯＲＥＣＵＲＲＥＮＴＦＡＣＴＯＲＳＯＦＦＡＶＩＳＭ－ＷＩＴＨＦＯＬＬＯＷＩＮＧＵＰＲＥＰＯＲＴＯＦ２５７ＣＡＳＥＳ￥Ｃｈｅ...     

小儿恶性组织细胞增生症血象及骨髓象分析

小儿恶性组织细胞增生症血象及骨髓象分析郭艺杰，王令仪武汉同济医科大学同济医院儿科ＡＮＡＬＹＳＩＳＯＦＨＥＭＯＧＲＡＭＡＮＤＢＯＮＥＭＡＲＲＯＷＰＩＣＴＵＲＥＳＩＮＭＡＬＩＧＮＡＮＴＨＩＳＴＯＣＹＴＯＳＩＳ￥ＧｕｏＹｉＪｉｅ，ｅｔａｌ（Ｄｅｐａｒｔｍｅ...     

新生儿依赖维生素K凝血因子活性的动态观察

新生儿依赖维生素Ｋ凝血因子活性的动态观察楼金吐，俞锡林，孔宏伟浙江医科大学附属儿童医院ＴＨＥＣＨＡＮＧＩＮＧＰＡＴＴＥＲＮＯＦＶＩＴＡＭＩＮＫ－ＤＥＰＥＮＤＥＮＴＦＡＣＴＯＲＳＩＮＮＥＯＮＡＴＥＳ￥ＬｏｕＪｉｎｔｕ，ｅｔａｌ．（Ｉｎｓｔｉｔｕｔｅｏｆ...     

早搏与心功能的关系及影响因素的研究

为探讨小儿早搏对心功能的影响，采用多普勒超声心动图测定４０例早搏患儿的单个早搏射血分数（ＰＢＥＦ）、心脏指数（ＰＢＣＩ）；单个非早搏的射血分数（ＮＰＢＥＦ）、心脏指数（ＮＰＢＣＩ）及实际的射血分数（ＡＥＦ）、心脏指数（ＡＣＩ）。同时研究这些指标与心电图和心肌酶的关系。结果显示：（１）早搏患儿ＰＢＥＦ、ＰＢＣＩ均小于ＮＰＢＥＦ、ＮＰＢＣＩ；病程长者ＰＢＥＦ、ＡＥＦ及ＡＣＩ均下降；室性早搏者的ＡＣＩ减少；早搏＞１０次／分者的ＡＥＦ及ＡＣＩ下降；Ｒ－Ｒ′／Ｒ－Ｒ比值小者的ＰＢＥＦ、ＡＥＦ及ＰＢＣＩ亦小；早搏ＱＲＳ－Ｔ综合波长者的ＰＢＥＦ及ＰＢＣＩ减少。（２）肌酸磷酸激酶同功酶（ＣＫ－ＭＢ）升高者的ＰＢＥＦ、ＡＥＦ、ＰＢＣＩ、ＡＣＩ均值的下降比ＣＫ－ＭＢ不升高者显著。研究提示，早搏＞１０次／分、Ｒ－Ｒ′／Ｒ－Ｒ＜０．６、ＱＲＳ－Ｔ综合波＞０．４秒和ＣＫ－ＭＢ＞１６ＩＵ／Ｌ者的心功能多受到影响，应予以积极治疗。     

静注免疫球蛋白及地塞米松对特发性血小板减少性紫癜患儿免疫功能的影响

探讨大剂量地塞米松 (DEX)及静注免疫球蛋白 (IVIG)治疗 ,对特发性血小板减少性紫癜 (ITP)患儿外周血 T淋巴细胞亚群及免疫球蛋白的影响 ,在以DEX、IVIG治疗 ITP患儿 ,治疗前后各抽血一次 ;以 APAAP法测定 T淋巴细胞亚群 ,以单向琼脂免疫扩散法测定免疫球蛋白。结果表明 1.ITP患儿外周血 CD4+ 降低 ,CD8+增高 CD4+ /CD8+ ,显著降低。单纯 DEX组治疗后 ,CD4+、CD8+均显著降低 ,CD4+ /CD8+升高 ,Ig A、Ig G、Ig M降低 ;单纯 IVIG组治疗后 ,CD8+显著降低 ,CD4+ /CD8+升高 ,Ig G显著升高。2 .单纯 DEX组治疗后 ITP患儿外周血白细胞计数显著高于治疗前 ,单纯 IVIG组与 IVIG加 DEX组治疗前后无显著差异。治疗过程中院内交叉感染率单纯 DEX组为 31.43% ,单纯 IVIG治疗组为 2 5 % ,IVIG加 DEX组为2 8.5 7%。因此 ,本文认为 ITP患儿外周血 T淋巴细胞亚群表达异常 ,IVIG及 DEX治疗均干扰了 ITP患儿机体的免疫状态     

甲状腺球蛋白抗体和甲状腺过氧化物酶抗体在儿童免疫性血小板减少症中的表达及临床意义北大核心CSCD

目的观察免疫性血小板减少症(immune thrombocytopenia,ITP)患儿血清甲状腺球蛋白抗体(thyroglobulin antibody,TGAb)、甲状腺过氧化物酶抗体(thyroid peroxidaseantibody,TPOAb)的表达情况。方法前瞻性选择2019年10月至2021年10月收治的120例ITP患儿作为ITP组,另选择60例非ITP患儿作为非ITP组。根据ITP临床分型将ITP组患儿分为新诊断ITP(n=53)、持续性ITP(n=42)与慢性ITP(n=25)。比较ITP组与非ITP组、不同ITP临床分型患儿临床资料,分析ITP患儿血清TGAb、TPOAb表达情况,及其与ITP临床分型的关系。结果ITP组CD_(3)^(+)、CD_(4)^(+)比例及血小板计数低于非ITP组,CD_(8)^(+)比例及TGAb、TPOAb水平高于非ITP组(P<0.05);慢性ITP患儿CD_(3)^(+)、CD_(4)^(+)比例及血小板计数低于新诊断ITP、持续性ITP患儿,CD_(8)^(+)比例及TGAb、TPOAb高于新诊断ITP、持续性ITP患儿(P<0.05)。经logistic回归分析结果显示,CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、TGAb、TPOAb表达水平变化与慢性ITP的发生密切相关(P<0.05);绘制决策曲线,结果显示,在高风险阈值0.0~1.0范围内TGAb联合TPOAb评估儿童ITP临床分型的净收益率始终>0,有临床意义。结论TGAb、TPOAb在ITP患儿中呈异常表达,且与患儿ITP临床分型有关。     

Elevated common acute lymphoblastic leukemia antigen expression in pediatric immune thrombocytopenic purpura.

Bone marrow examination is often performed in thrombocytopenic children to distinguish immune thrombocytopenic purpura (ITP) from acute leukemia. We describe a patient with thrombocytopenia and 50% common acute lymphoblastic leukemia antigen (CALLA) positivity in his marrow who was subsequently shown to have ITP. CALLA (CD10) is a surface antigen found in early B-lymphocytes and is elevated in most cases of childhood acute lymphoblastic leukemia (ALL). This case prompted us to prospectively study the frequency of immature lymphocyte populations in children with ITP. Fourteen patients with acute ITP and five with other conditions were studied. The two groups were comparable with respect to age: ITP mean, 4.3 (range 0.3-15.5) years; control mean, 5.8 (0.6-13.8) years. The ITP group had a significantly higher percentage of CD10 positive bone marrow lymphocytes (p = 0.007). Five of the 10 patients younger than 4 years of age in the ITP group had CD10 levels of greater than 30%, which is in the leukemic range, whereas none of the control patients had a CD10 levels of greater than 17% (p = 0.003). There was good correlation between CD10 positivity and B4 positivity indicating that both of these markers arise from the same population of immature B-lymphocytes. None of the ITP patients who were older than 4 years had a CD10 level of greater than 30%. We conclude that it is common to have an increase in the proportion of immature lymphocytes in the marrow of young children with ITP. The cause of this increase in CD10 positive cells is unknown.(ABSTRACT TRUNCATED AT 250 WORDS)     

Immunological study of childhood acute ITP at onset.

We attempted to search for any specific change in the immune system during the onset of childhood acute immune thrombocytopenic purpura (ITP) in order to clarify the pathophysiology of acute ITP by examining the lymphocyte subset, lymphocyte blastogenic response, serum complements, and immunoglobulins in 18 patients with childhood acute ITP and 18 controls (control values after normalization). At the onset of acute ITP, the levels of serum complements and IgG and IgA were found to be within the normal ranges, but serum IgM levels were greater than 200 mg/dL in six cases among 18 patients. Lymphocyte blastogenic response to phytohemagglutinin (PHA) and concanavalin A (ConA) was depressed in patients relative to controls (PHA: p less than 0.05, ConA: p less than 0.01). Lymphocyte blastogenic response to pokewood mitogen (PWM) was lower than that of the control, but no statistical significance was observed. There was no difference in the proportion of CD3, CD4, CD8, SmIg, SmIgG, SmIgM, SmIgA, and SmIgD. The CD4/CD8 ratio was not different from that of controls. The proportion of CD38 was higher than that of control, but no significant difference from the control was observed. Increase in the serum IgM level and proportion of CD38 and depressed lymphocyte blastogenic response may be the influence of preceding infection. It has been reported that the CD4/CD8 ratio is depressed due to an increase in the CD8 level in acute and convalescent phases of viral infection. However, the proportion of CD8 was not necessarily increased in our patient in whom preceding infection was obvious. The immunological status of the patients with acute ITP at onset differs from that after infection.     

特发性血小板减少性紫癜患者血小板抗体及淋巴细胞亚群的研究

目的探讨血小板相关抗体(PAIgG)和T淋巴细胞亚群的变化,在特发性血小板减少性紫癜(ITP)免疫发病机制中的作用、临床意义。方法采用间接免疫荧光法测定30例ITP患者及20例正常对照组的PAIgG,20例ITP患儿治疗后复查PAIgG。同时采用流式细胞仪直接免疫荧光法检测外周T血淋巴细胞亚群。结果ITP组PAIgG阳性率为80%,正常对照组为20%(P<0.001),ITP组PAIgG明显高于正常对照组(P<0.001),20例ITP患儿治疗后复查PAIgG,其数值明显下降,差异有显著性(P<0.001)。T淋巴细胞亚群中,ITP组CD3、CD4、CD4/CD8显著低于正常对照组(P<0.01),CD8则显著高于正常对照组(P<0.01)。结论抗血小板相关抗体对提高ITP的诊断、疗效及预后的判断有一定的实用价值,T淋巴细胞亚群的变化能较好的反映ITP的病理机制。     

白细胞相关免疫球蛋白样受体-1在免疫性血小板减少症患儿中的表达

目的 观察白细胞相关免疫球蛋白样受体-1（LAIR-1）在免疫性血小板减少症（ITP）患儿中的表达变化,探讨其在ITP发病中可能的机制。方法 采用流式细胞术检测40例ITP患儿外周血CD4+ T细胞、CD8+ T细胞及CD19+CD20+ B细胞膜LAIR-1的表达率;ELISA检测ITP患儿血清中可溶性LAIR-1（sLAIR-1）含量及实时荧光定量PCR法检测ITP患儿LAIR-1 mRNA表达水平。32名同龄健康儿童作为对照组。结果 ITP组CD19+CD20+ B细胞比例高于对照组（P+ T细胞比例低于对照组（P+ T细胞、CD8+ T细胞膜LAIR-1的表达低于对照组（PP结论 ITP患儿中CD4+ T细胞、CD8+ T细胞膜上LAIR-1表达降低,血清sLAIR-1表达增高,提示LAIR-1可能是导致ITP患儿免疫失衡的重要因素。     

急性ITP患儿外周血调节性T细胞及相关细胞因子的研究

目的检测急性特发性血小板减少性紫癜(AITP)患儿外周血CD4+CD25+调节性T细胞(regulationTcells,Tr细胞)及相关细胞因子的变化,探讨它们在AITP发病机制中的作用。方法流式细胞仪分别检测AITP患儿和正常健康儿童外周血Tr细胞的数量,ELISA法检测血清中相关细胞因子的含量,并进行相关性分析。结果AITP患儿外周血Tr细胞的数量明显低于正常对照组[(2.83±1.05)%vs(5.07±0.59)%,P<0.05];AITP患儿血清中IL-10、转化生长因子β1(TGF-β1)的含量均也低于正常对照组[IL-10:(29.48±13.69)pg/mlvs(43.10±14.95)pg/ml;TGF-β1(170.04±91.58)pg/mlvs(254.75±130.41)pg/ml,P<0.05],差异有显著性。AITP患儿外周血Tr细胞的比例与血清中IL-10、TGF-β1的含量都呈正相关(r1=0.54,r2=-0.66,P<0.05)。结论急性ITP患儿外周血中Tr细胞数量的减少及相关细胞因子含量的降低可能与急性ITP的细胞免疫失调有关。     

特发性血小板减少性紫癜儿童外周血调节性T细胞的变化

目的：研究特发性血小板减少性紫癜(ITP)患儿外周血CD4+CD25+CD127-及CD3+CD4-CD8-调节性T细胞（Treg）的变化及意义。方法：采用免疫荧光流式细胞技术检测33例ITP患儿及21例正常儿童外周血CD4+CD25+CD127-及CD3+CD4-CD8- Treg水平。结果：ITP患儿CD4+CD25+CD127-及CD3+CD4-CD8- Treg百分比明显低于正常儿童,分别为(2.7±1.7)％ vs (4.8±1.6)％;(5.2±3.1)％vs (8.1±3.5)％(P<0.01)。结论：ITP患儿CD4+CD25+CD127-及CD3+CD4-CD8- Treg百分率降低,提示其可能参与了ITP的发病机制。     

急性特发性血小板减少性紫癜患儿免疫功能变化及其临床意义

目的检测特发性血小板减少性紫癜(ITP)患儿的免疫功能并探讨ITP的发病机制。方法抗血小板抗体(PAIgG)测定采用放射免疫法,IgA、IgG、IgM测定采用WL-快速免疫消浊比浊法,T淋巴细胞亚群测定采用APAAP法,血清IL-2、sIL-2R和IL-6测定采用ELISA法。结果 ITP患儿的IL-2、IL-6,IgA、IgM、CD8及IL-2R表达均明显升高(P<0.01),CD4+、CD4+/CD8+细胞均明显减少(P<0.01)。结论细胞免疫及体液免疫异常共同参与ITP致病机制,调节淋巴细胞亚群平衡有助于寻找ITP治疗的新途径。     

急慢性ITP患儿细胞免疫功能变化及临床意义

目的 　观察ITP患儿细胞免疫功能的变化及临床意义。方法　 采用流式细胞仪单克隆抗体免疫荧光法动态检测 3 5例急慢性ITP患儿的T淋巴细胞亚群、NK细胞。结果 　急慢性组均有CD4+、CD4+ CD8+显著降低 ,CD8+显著升高 ,P <0 0 1;慢性组CD3+、CD4+ CD8+显著低于急性组 ,P <0 0 5 ,NK细胞在慢性组中显著降低P <0 0 1。激素不降低急性组CD4+,丙球升高慢性组的CD4+、NK细胞两者分别能降低急慢性组的CD8+。 结论 　急慢性组均有T细胞亚群比例失调 ,慢性型更为明显 ,CD4+ CD8+、NK细胞对判断病程、预后有一定意义 ,激素不增加感染机会。