Novel shell/core particles for automated turbidimetric immunoassays

Recent innovations in particle design have led to the development of highly sensitive and reproducible immunoassay methods for the Du Pont aca discrete clinical analyzer. Key advances include the synthesis and use of particles less than 1 micron in diameter with high refractive index cores surrounded by thin, chemically reactive shells. The cores are prepared by emulsion polymerization to a well-defined size that depends on the choice of monomer and the requirements for turbidimetric signal. Methods for measuring therapeutic drugs (e.g., theophylline) involve particles with polystyrene cores; other methods require cores with higher refractive indices such as polyvinylnaphthalene. The shells are critical for overall method performance because they bind covalently the immunochemicals of interest. Polyglycidyl methacrylate shells have been used effectively to attach antigens and haptens to the particle surface.     

Automated measurement of a constitutive isotype of serum amyloid A/SAA4 and comparison with other apolipoproteins

A constitutive isotype of serum amyloid A (SAA4) is present mostly in high density lipoprotein (HDL) and a little in other lipoproteins. In this study, we developed an automated method for measuring SAA4 concentration in serum by kinetic nephelometry of anti-SAA4 antibody-coated latex agglutination. Rabbit antibodies generated by immunization of recombinant SAA4 were found to have no apparent reactivity with acute phase SAA. The values determined by this method and by the previous enzyme immunoassay showed good agreement (r=0.862). Serum SAA4 values of 26 healthy adults ranged from 37–109 mg/L (mean; 62 mg/L). Their SAA4 concentrations were not significantly related with those of apolipoprotein A-I, A-II, B, C-II, C-III or E. Also, SAA4 did not correlate with cholesterol in preparation after removal of very low density lipoprotein and low density lipoprotein. These suggest the unique behavior of SAA4 in lipoprotein metabolism, while what contributes to variation of SAA4 levels in serum, especially in HDL, remains to be clarified. J. Clin. Lab. Anal. 11:363–368, 1997. © 1997 Wiley-Liss, Inc.     

踏车运动对老年稳定型心绞痛患者的影响

目的:探讨踏车运动对老年稳定型心绞痛患者的影响。方法:141例老年稳定型心绞痛患者随机分成治疗组(68例)和对照组(73例),治疗组进行踏车运动和常规药物治疗,对照组实行常规药物治疗,疗程4个月。使用放射免疫法检测实验前后血浆TXA2及免疫比浊法检测CRP、LDL-C和HDL-C水平,监测实验过程中心率及血压变化,比较实验前后两者有无差异,并调查对比两组实验结束后1月内心绞痛的发生率。结果:治疗组有2例患者因不能耐受退出研究。对照组治疗后血浆CRP、TXA2和LDL-C水平分别下降58.30%、45.64%和36.04%,HDL-C升高0.71%;治疗组治疗后血浆CRP、TXA2和LDL-C水平分别下降65.47%、38.29%和36.18%,HDL-C升高2.11%;治疗组较对照组CRP下降明显,差异有显著性意义(P<0.05);但两组间TXA2、LDL-C下降及HDL-C升高无明显差异(P>0.05)。治疗前后两组间血压、心率变化无明显差异。两组治疗后均进行随访1个月,治疗组(5/66)较对照组(16/73)心绞痛发生率明显减少,差异有显著性意义(P<0.05)。结论:踏车运动能明显降低老年稳定型心绞痛患者心绞痛发生率,其机制可能与降低CRP表达有关。     

深静脉血栓患者C反应蛋白1059 G/C基因多态性的研究

本研究旨在探索C反应蛋白(C-reactive protein,CRP)1059G/C基因多态性在深静脉血栓(deep veinthrombus,DVT)中的分布及其临床意义。应用聚合酶链反应-限制性片段长度多态性(polymerase chain reaction-restriction fragment length polymorphism,PCR-RFLP)基因分型技术检测61例DVT患者和60例对照组CRP1059G/C基因多态性,并统计各基因型及等位基因的频率。结果显示,病例组CRP1059G/C基因型及等位基因突变频率与对照组比较差异无统计学意义(p>0.05)。结论 :CRP1059G/C基因多态性存在一定的人种及地域差异,是否是DVT患者遗传性危险因素尚有待进一步研究。     

老年高血压病患者心房颤动易感性与C-反应蛋白-717A/G多态性的关系

目的探讨C-反应蛋白（CRP）-717A/G多态性与老年高血压病患者心房颤动易感性的关系。方法选择75例合并心房颤动（房颤组）及94例无心房颤动（对照组）的老年高血压病患者,聚合酶链反应-限制性片段长度多态性（PCR-RFLP）方法检测CRP-717A/G基因型,比较两组基因型及等位基因频率分布,以及各基因型对血脂参数、高敏C反应蛋白（hs-CRP）的影响。结果房颤组hs-CRP水平（P=0.000 0）及左心房直径（P=0.000 0）均显著高于对照组,房颤组AA基因型频率（P=0.025 3）及A等位基因频率也显著高于对照组（P=0.028 0）。无论是房颤组抑或对照组,均未发现CRP-717A/G多态性对各临床参数有影响。结论老年高血压病合并房颤患者hs-CRP水平显著升高,CRP-717 A等位基因与房颤易感性相关。     

MMP-9、Hs-CRP、MMP1/TIMP1水平检测对缺血性脑卒中患者预后的影响

目的 探讨血清内基质金属蛋白酶9(MMP-9)、超敏C反应蛋白(Hs-CRP)以及MMP1/TIMP1的水平检测对缺血性脑卒中患者预后的影响与相关性.方法 回顾性分析75例缺血性脑卒中患者的临床资料,并采用回归分析检测患者的预后与MMP-9、Hs-CRP、MMP1/TIMP1水平的相关性.结果 治疗后预后不良组患者的MMP-9、Hs-CRP以及MMP1/TIMP1水平显著低于预后良好组,缺血性脑卒中患者的预后与MMP-9、Hs-CRP、MMP1/TIMP1水平有显著的相关性(P＜0.05).结论 缺血性脑卒中患者的MMP-9、Hs-CRP、MMP1/TIMP1水平能够提示患者缺血性脑卒中的严重程度.     

外周血超敏C-反应蛋白、Th1/Th2细胞因子与老年肺部感染的关系研究

目的：探讨老年肺部感染患者外周血超敏C-反应蛋白（ hs-CRP）及Th1/Th2细胞因子的变化。方法选取2013年8月至2014年8月广州市红十字会医院收治的肺部感染患者共51例为肺部感染组,取同期于我院行健康体检者共48例为对照组,比较两组患者外周血肿瘤坏死因子-α（ TNF-α）、干扰素-γ（ IFN-γ）、白细胞介素-6（ IL-6）、IL-8及hs-CRP水平。结果与对照组比较,肺部感染组治疗前外周血TNF-α、IFN-γ水平均显著降低,IL-6、IL-8、hs-CRP水平均显著增高,差异有统计学意义（ P<0.05）。肺部感染组治疗后外周血TNF-α、IFN-γ水平均显著提高,IL-6、IL-8、hs-CRP水平均显著降低,但与对照组比较差异仍有统计学意义（ P<0.05）。结论 hs-CRP及Th1/Th2细胞因子参与老年肺部感染的病理生理过程,是老年肺部感染临床诊治及预后判定的可靠综合指标。     

急性ST段抬高型心肌梗死患者的hs-CRP/ALB变化对预后的预测价值

目的探讨急性ST段抬高型心肌梗死(STEMI)患者的高敏C-反应蛋白(hs-CRP)/白蛋白(ALB)变化对预后的预测价值.方法选取2014年7月至2018年7月收治的80例急性STEMI患者,收集患者一般资料、高危因素、相关检查结果和实验室指标.所有患者均予以介入治疗并术后随访,截至2019年7月,记录主要心血管不良事件(MACE)发生情况.根据患者随访结果,将患者分为MACE组(16例)与非MACE组(64例),比较两组一般资料、高危因素和实验室指标.采用多因素Logistic回归分析明确MACE的危险因素.绘制hs-CRP/ALB预测MACE的受试者工作特征(ROC)曲线,分析hs-CRP/ALB对MACE的预测价值.并以最佳截断值将患者分为两组,绘制Kaplan-Meier生存曲线,比较两组生存情况.结果80例患者随访结束后,MACE发生率20%(16/80).MACE组与非MACE组性别、体质量指数、心率、收缩压、舒张压、高血压史、冠心病史、吸烟史、甘油三脂(TG)、总胆固醇(TC)、血白细胞计数(WBC)、B型利钠肽(BNP)、D-二聚体(DD)及ALB比较差异无统计学意义(P>0.05).MACE组年龄、糖尿病史占比、血清BNP、hs-CRP及hs-CRP/ALB高于非MACE组,左室射血分数(LVEF)低于非MACE组,差异有统计学意义(P<0.05).经Logistic多元回归分析,年龄、糖尿病、BNP、hs-CRP及hs-CRP/ALB是MACE的危险因素,LVEF是MACE的保护因素(P<0.05).hs-CRP/ALB预测急性STEMI患者介入术后MACE的ROC曲线下面积(AUC)0.918(95%CI0.855~0.978),hs-CRP的AUC 0.741(95%CI0.697~0.845),hs-CRP/ALB对MACE的预测价值更高.当hs-CRP/ALB=0.58时的预测价值最高,此时敏感度为87.5%,特异度为79.7%.根据ROC曲线分析结果,将患者分为hs-CRP/ALB≥0.58组(31例)与hs-CRP/ALB<0.58组(49例).截至2019年7月,hs-CRP/ALB<0.58组的生存率为95.92%(47/49),较hs-CRP/ALB≥0.58组的80.65%(25/31)相对更高,且生存时间更长,Kaplan-Meier生存曲线的差异有统计学意义(Log-rank P=0.039).结论年龄、糖尿病史、BNP、hs-CRP/ALB是急性SIEMI患者介入术后MACE的危险因素,LVEF是MACE的保护因素,且hs-CRP/ALB对急性STEMI患者介入术后的MACE有较大预测价值,不同hs-CRP/ALB值的患者生存情况也不同,hs-CRP/ALB<0.58的患者生存率更高,生存时间更长.     

Increased levels of serum transferrin receptor and serum transferrin receptor/log ferritin ratios in men with prostate cancer and the implications for body-iron stores

The serum transferrin receptor (sTfR) is a sensitive indicator of iron-deficiency erythropoiesis that is not affected by inflammation. Concentrations of this molecule are inversely correlated with body-iron stores, and increased body-iron stores are associated with an increased risk of cancer of the liver and lungs. However, an association between iron status as assessed on the basis of sTfR and prostate cancer has not been previously investigated. We measured sTfR and serum ferritin by means of an enzyme immunoassay in 27 men with newly diagnosed, untreated prostate cancer and in 72 controls. Our study population ranged in age from 38 to 78 years. The mean serum ferritin concentration in men with prostate cancer was 44.8% lower than that in men without this tumor ( P < .05). In contrast, the mean values of sTfR and sTfR/log serum ferritin were 32% and 60% higher, respectively, in men with prostate cancer than in those without this tumor ( P < .05). Differences between groups persisted after we took into account inflammation (alpha 1-acid glycoprotein > 1 g/L, C-reactive protein > 10 mg/L; P < .05). Among the entire study population and among men without inflammation, a higher percentage of subjects (29%-31%) than of controls (14%-22%) had sTfR values greater than 8 mg/L, suggestive of iron-deficiency erythropoiesis ( P < .05). The odds ratios for men with prostate cancer to have sTfR values of less than 2.9 mg/L (suggestive of increased body-iron stores) was 0, compared with 1.745 to 3.65 for the same men to have sTfR values greater than 8 mg/L. sTfR was negatively correlated with log ferritin ( r = -.422, P < .05) but did not correlate with tissue inflammation, tumor stage, or acute-phase proteins. It appears that prostate cancer is not associated with increased body-iron stores.