儿童hsCRP、白细胞计数和中性粒细胞比例在感染中的意义

目的:通过分析呼吸道感染患儿的超敏C-反应蛋白(hsCRP)、白细胞计数(WBC)及性粒细胞比值(N%)的检测结果,探讨hsCRP、WBC及N%在患儿感染中的临床意义和相关性。方法:回顾性分析1 196例该院2011年收治的呼吸道感染患儿,根据患儿感染的病原体分为细菌组、病毒组及支原体组,同时选择200例该院健康体检儿童为对照组,检测并比较各组hsCRP、WBC、hsCRP、N%。结果:统计分析显示,细菌组患儿的hsCRP、WBC及N%均显著升高,且多数情况下为hsCRP、WBC、N%同时升高或hsCRP升高伴WBC或N%升高,尤其以N%与hsCRP的相关性更明显;病毒组患儿的N%显著下降,hsCRP及WBC均正常;支原体感染患儿的hsCRP、WBC及N%升高不明显,多数为hsCRP、WBC、N%中一至两项轻度升高;在分层研究中,细菌组和支原体感染组N%和hsCRP呈正相关,高于WBC和hsCRP的相关性。结论:在呼吸道感染患儿中,联合检测hsCRP、WB、N%可有效鉴别细菌、病毒及支原体感染,进而指导临床治疗,尤其hsCRP与N%同时明显升高提示细菌感染,应根据病情及早选用有效的抗生素进行治疗。     

细菌感染快速诊断中CRP值和WBC数与NAP积分的探讨

目的探讨C-反应蛋白(CRP)、中性粒细胞碱性磷酸酶(NAP)积分、白细胞(WBC)数三项指标的检测在细菌感染中的临床诊断意义。方法收集32例已明确诊断的细菌感染病例,20例体检健康人病例,共52例,收集这些病例CRP值、NAP积分、WBC数三项指标的资料,运用统计学进行综合分析。结果细菌感染病人的CRP值、NAP积分、WBC数三项指标均有不同程度的异常。结论WBC数是早期诊断细菌感染快速廉价的指标,NAP积分是早期诊断细菌感染准确稳定的指标,CRP值是细菌感染疾病早期诊断快捷敏感的诊断优选指标。     

细菌感染快速诊断中CRP值和WBC数与NAP积分的探讨

目的探讨G-反应蛋白（CRP）、中性粒细胞碱性磷酸酶（NAP）积分、白细胞（WBC）数三项指标的检测在细菌感染中的临床诊断意义。方法收集32例已明确诊断的细菌感染病例,20例,体检健康人病例,共52例,收集这些病例CRP值、NAP积分、WBC数三项指标的资料,运用统计学进行综合分析。结果细菌感染病人的CRP值、NAP积分、WBC数三项指标均有不同程度的异常。结论WBC数是早期诊断细菌感染快速廉价的指标,NAP积分是早期诊断细菌感染准确稳定的指标,CRP值是细菌感染疾病早期诊断快捷敏感的诊断优选指标。     

降钙素原、C反应蛋白和白细胞计数在新生儿感染性疾病诊断中的应用

目的 研究降钙素原、C反应蛋白、白细胞计数在新生儿感染性疾病中的诊断. 方法 选择郴州市妇幼保健院2010年12月-2011年12月间收治的90例经病原学检测,临床诊断确诊为感染性疾病的患儿作为研究对象,另外选取40例健康新生儿作为对照,所有患儿确诊后采集清晨空腹静脉血,降钙素原检测采用双抗体夹心免疫检测,C反应蛋白采用免疫比浊法定量检测.降钙素原≥0.5 μg/L为阳性,C反应蛋白≥8 mg/L为阳性,白细胞计数≥20×109/L为阳性. 结果 新生儿感染组中PCT水平为(9.31±5.24)μg/L,CRP平均水平为(33.20±20.44)mg/L,白细胞计数(18.3±6.4)×109/L.与对照组相比差异有统计学意义,对照组PCT水平低于新生儿感染组,CRP水平低于新生儿感染组,白细胞计数低于新生儿感染组.且使用PCT、CRP联合诊断新生儿感染疾病的灵敏度为88.5％,特异度为79.2％,ROC工作特征曲线下面积为83.1％;为所有检测方法组合中特异度、灵敏度最高的诊断方法. 结论 本研究证明使用血清降钙素原、C反应蛋白、白细胞计数可以作为诊断新生儿感染性疾病的有效临床指标,对于临床诊断具有重要意义.     

An inverse lead air to lead blood relation: the impact of air-stream helmets

Summary At a secondary smelter (24 smelting workers, 13 refinery workers), data on exposure to lead were collected by systematic observation of hygienic behaviour, a questionnaire, personal sampling of lead dust in ambient air (PbA) and determination of lead in the blood level (PbB). The smelting workers showed a negative relation between PbA and PbB. The 53% variance in PbB levels in the smelting workers can be explained by the combination of PbA, the percentage of time an air-stream helmet is worn, the frequency of cigarette smoking at the workplace and the amount of spitting. Air-stream helmets and spitting contribute to a lower PbB, whereas smoking contributes to a higher PbB. Moreover, expected PbB levels were computed by using several regression equations for the relation between PbA and PbB, as suggested in the Final OSHA Standard for Occupational Exposure to Lead (OSHA 1978). As the percentage of time an air-stream helmet is worn increases, the deviation from the expected PbB falls substantially. The refinery workers showed the expected weak positive correlation coefficient between PbA and PbB. No direct relation between the PbB level and the observed hygienic behaviour could be established. However, there was a positive relation between the level of education and the level of PbB. Moreover, the level of education was related to the frequency of eating at the workplace and negative as far as the percentage of time gloves are worn is concerned. Our conclusion is that hygienic behaviour is a major factor that modifies the relation between PbA and PbB in groups of workers. Incorporation of hygienic behaviour in the PbA-PbB model substantially improves the accuracy of predicting PbB levels and makes unexpected outliers and/or systematic deviations from the expected relation understandable. Adding a behavioural approach to the toxicological approach appears to make sense in explaining the bias in the relation between PbA and PbB.     

C反应蛋白联合白细胞检测在新生儿感染性肺炎中的临床价值评价

目的:评估C反应蛋白(CRP)联合白细胞(WBC)检测在新生儿感染性肺炎中的临床价值,为新生儿感染性肺炎的早期诊断和治疗提供依据。方法:以2009年7月～2011年6月入院的123例新生儿感染性肺炎患儿为研究组,以健康新生儿为对照组,分析CRP和WBC的变化。结果:新生儿感染性肺炎患儿CRP、WBC较健康新生儿增高,尤以细菌性感染患者为著(P<0.05)。细菌性肺炎感染患者治疗前后CRP和WBC变化差异有统计学意义(P<0.05),且CRP变化幅度大于WBC。结论:对于细菌性肺炎的早期诊断和治疗监测CRP是较WBC更为灵敏和可靠的指标,两者联合检测可提高新生儿感染性肺炎的早期诊断率。     

Occurrence and determinants of increases in blood lead levels in children shortly after lead hazard control activities

This study is an examination of the effect of lead hazard control strategies on children's blood lead levels immediately after an intervention was conducted as part of the US Department of Housing and Urban Development's Lead-Based Paint Hazard Control Grant Program. Fourteen state and local government grantees participated in the evaluation. The findings indicated an overall average reduction in the blood lead levels of 869 children soon after the implementation of lead hazard controls. However, 9.3% of these children (n = 81) had blood lead increases of 5 microg/dL or more. Data routinely collected as part of the evaluation, as well as additional information supplied by the individual programs, were used to determine potential reasons for these observed increases in blood lead. A logistic regression analysis indicated that three principal factors were associated with the blood lead increases: the number of exterior deteriorations present in the child's home (prior to intervention), the educational level of the female parent or guardian of the child, and the child's age. The statistical analysis did not find evidence that children living in households that either did not relocate or relocated for less than the full work period were significantly more likely to have a blood lead increase equal to or greater than 5 microg/dL than children living in households that fully relocated. Statistical analyses also did not reveal any single interior strategy to be more or less likely than others to be associated with a blood lead increase of 5 microg/dL or more.     

A population-based study of blood lead levels in relation to depression in the United States

Purpose  

Lead is a known neurotoxicant. Several studies have suggested that occupational exposure to lead may lead to depression, anxiety and other psychiatric illness, but few studies have examined environmental lead exposure and depression. We evaluated the relationship between blood lead levels (BLL) and depression in a sample representative of the US population.     

Erythrocyte saturated fatty acids and systemic inflammation in adults

ObjectiveThe role of saturated fatty acids (SFAs) in chronic disease remains controversial; inflammation is one pathway by which SFAs influence the risk for chronic disease. The aim of this study was to investigate the associations between red blood cell (RBC) phospholipid SFAs and systemic inflammation.MethodsAs part of a randomized controlled trial, we measured RBC phospholipid FA composition in 55 generally healthy adults twice at 3-mo intervals. We estimated associations of RBC total SFAs and two major SFA subtypes, palmitic and stearic acids, with C-reactive protein (CRP), interleukin (IL)-6, white blood count (WBC), and a composite inflammation measure using generalized estimating equations in multivariable FA substitution models.ResultsMean (±SD) SFA level across both visits was 45% ± 3% of the total RBC FAs, mainly palmitic (21% ± 1%) and stearic (17% ± 3%) acids. In models adjusted for age, sex, race, smoking, body mass index, statin use, aspirin use, transunsaturated FAs, and ω-3 FAs, SFAs were significantly associated with IL-6 (20% increase per 1 SD increment; 95% confidence interval [CI], 0.03%–43%; P = 0.05) and the composite inflammation measure (P = 0.05) and marginally associated with CRP (34% increase; 95% CI, −1% to 81%; P = 0.06), but not associated with WBC. Stearic acid was positively associated with CRP (35% increase; 95% CI, 2%–79%; P = 0.04). Palmitic acid was marginally associated with the composite inflammation measure (P = 0.06) and, upon additional ω-6 FA adjustment, significantly associated with IL-6 (15% increase; 95% CI, 0.4%–27%; P = 0.006).ConclusionsRBC SFAs, which represent longer-term dietary intake, are positively associated with inflammation. In particular, palmitic acid was associated with IL-6, and stearic acid was associated with CRP after multivariable adjustment.     

Smoking habits and levels of lead and cadmium in blood in urban women

Summary In 222 Dutch urban women lead (PbB)- and cadmium (CdB)-levels in blood were measured and related to smoking habits. PbB ranged from 40 ppb to 240 ppb and CdB rangedfrom 0.2 ppb to 4.4 ppb. Smokers had slightly higher PbB-levels and distinctly higher CdB-levels.     

C反应蛋白和白细胞数量变化监测在小儿呼吸道感染诊治中的临床意义

目的探讨C-反应蛋白联合白细胞(WBC)检测在小儿呼吸道病毒感染中的应用价值。方法收集某院儿科治疗的小儿呼吸道感染病例106例,儿童保健科51例,治疗前测CRP和WBC的水平,经过对症治疗后,病情痊愈,再次测CRP和WBC的水平,并进行比较。结果小儿呼吸道细菌感染组CRP、WBC分别为(90.5±20.7)ng/ml、(9.0±1.46)×109/L,显著高于病毒感染组及正常对照组(P﹤0.05);病毒感染组与对照组比较,差异无统计学意义(P﹥0.05)。治疗后,细菌感染组CRP迅速下降至(8.2±3.1)ng/ml。结论 CRP和WBC联合检测对小儿呼吸道感染的诊治具有一定的辅助指导意义。     

血清淀粉样蛋白A和白细胞计数对儿童呼吸道病毒感染诊断的应用价值

目的探讨血清淀粉样蛋白A(SAA)和白细胞计数(WBC)在儿童呼吸道病毒感染诊断中的应用价值。方法染组,同时选取289例健康体检儿童为对照组。检测5组患儿SAA和WBC结果,比较各组SAA、WBC水平差异,以及各组内不同年龄和不同性别间的差异。绘制ROC曲线,计算AUC,评价SAA、WBC对儿童呼吸道病毒感染诊断的应用价值。结果各病毒感染组SAA水平均显著高于对照组(P <0.01),病毒感染组中仅EB病毒感染组WBC水平与对照组比较差异有统计学意义(P <0.01),SAA、WBC诊断儿童呼吸道病毒感染的AUC分别为0.999、0.537。结论 WBC在诊断儿童呼吸道病毒感染方面有一定价值,但较低。SAA检测可以快速、有效的辅助诊断儿童呼吸道病毒感染,值得推广。     

儿童血铅与胎儿期铅污染的关系

目的了解儿童血铅水平与胎儿期铅污染的关系。方法采集1～5岁儿童手指血和新生儿出生时的脐带血,用原子吸收石墨炉法测定血铅浓度。结果1122例儿童血铅平均为（0.42±0.15）μmol/L,血铅值≥0.483μmol/L的儿童占27.54％;127例新生儿脐带血铅平均为（0.16±0.12）μmol/L,血铅值≥0.483μmol/L的新生儿占0.79％。结论儿童血铅水平高主要是环境污染和生活行为引起,儿童在胎儿期血铅的本底水平已较高,所以预防儿童铅中毒应从孕妇做起。     

High blood lead levels in recreational indoor-shooters

Introduction  Recreational shooting in indoor firing ranges is very popular in Germany. Lead-containing ammunition is still in use. Therefore we checked the blood lead levels (BLL) from 129 subjects doing several types of shooting disciplines. Methods  In total, BLLs of 129 shooters (nine female) from 11 different shooting ranges with a mean age of 49 years were measured. The blood samples were taken after the volunteers had given written informed consent. Determination of lead was carried out by graphite furnace atomic absorption (GF-AAS) under strict internal and external quality control schemes. Results  While individuals shooting only with airguns (n = 20) showed a median BLL of 33 μg/l (range 18–127 μg/l), those who were also users of .22 lr weapons (n = 15) turned out to have a median of 87 μg/l (range 14–172 μg/l). Shooters of .22 lr and large calibre handguns (9 mm or larger) (n = 51) had median 107 μg/l (range 27–375 μg/l) and those only using large calibre handguns (n = 32) had median 100 μg/l (range 28–326 μg/l). The IPSC-group (n = 11) had the highest median with 192 μg/l (range 32–521 μg/l). Conclusion  Our results show clearly that many shooters have high blood levels; some of them are still exceeding threshold limit values (TLVs) for lead exposed workers. Especially for younger women there is a high potential risk if they become pregnant. So there is a clear need for improving the situation whether by use of lead-free ammunition or by better ventilation systems.     

婴幼儿血铅水平及其影响因素

目的　了解婴幼儿的血铅水平及其影响因素。　方法　用石墨炉原子吸收光谱法测定2 6 2例婴幼儿末梢血铅浓度 ,并进行铅中毒影响因素的调查。　结果　婴幼儿血铅算术平均值为0 .4 3μmol/L,范围为 0 .10～ 1.4 5 μmol/L,铅中毒发生率为 37.0 2 % (97/2 6 2 )。不同性别、不同年龄婴幼儿血铅水平及铅中毒发生率差异无显著性 (P>0 .0 5 ) ,各年龄婴幼儿血铅等级分布以 I级最高 ,婴幼儿铅中毒属 II～ III级。饭前不洗手、经常在马路边玩耍、经常看彩色书刊后不洗手、父母职业、住房为 1990年以后建造的是影响婴幼儿血铅水平的因素。　结论　婴幼儿已受到不同程度的铅损伤 ,应引起家长及有关方面的重视     

牛磺酸对铅中毒大鼠红细胞免疫功能损伤的治疗作用

目的　了解牛磺酸对铅中毒大鼠红细胞免疫功能的影响。方法　把30只Wistar大鼠随机分为正常对照组、铅染毒对照组、治疗组,每组10只动物。对照组用蒸馏水灌胃,其余组用6 g/L醋酸铅溶液按每次60 mg/kg灌胃;染毒30 d后,治疗组动物用400 mg/kg的牛磺酸每天灌胃1次,正常对照组及铅染毒对照组用等剂量蒸馏水灌胃,连续30 d。采用酵母菌花环试验测定红细胞C3b受体花环率(RBC- C3b -RR)和红细胞免疫复合物花环率(RBC- CIC -RR)。结果　染毒对照组RBC C3b RR明显低于正常对照组(P<0 .01),其RBC- CIC- RR明显高于正常对照组(P<0 .01),治疗组的RBC- C3b- RR明显高于染毒组(P<0. 01),而其RBC CIC RR明显低于染毒组(P<0. 05)。结论　牛磺酸对铅中毒大鼠红细胞免疫功能的损伤具有明显的保护作用。     

探讨临床检验白细胞计数、C-反应蛋白与红细胞沉降量在儿童肺炎中的诊断意义

目的 通过临床对儿童肺炎患儿检验白细胞计数、C-反应蛋白与红细胞沉降量,分析该检测在儿童肺炎中的诊断价值.方法 选取某院2010年1月～2011年1月所收治的儿童肺炎患儿100例进行血清检测.C-反应蛋白的检测采用免疫比浊法,红细胞沉降量的检测采用韦斯特伦法,白细胞计数的检测采用全自动三分类血球计数仪,观察患者检测后的数据结果,并进行分析评价以上指标检测在儿童肺炎中的诊断价值.结果 经过临床检查所有患者均为浸润类型肺炎患儿,其中32例患儿为肺泡型,68例患儿为间质型,而肺泡型患儿血清中的C-反应蛋白与红细胞沉降量水平要明显高于间质型肺炎(P/0.05),但是白细胞计数之间差异无统计学意义(P＞0.05).结论 白细胞计数与红细胞沉降量水平在儿童肺炎患儿中的检测中受到一定的限制,而C-反应蛋白可以作为首选诊断标准,在临床中具有非常重要的意义.     

孕期被动吸烟对脐血铅、镉水平的影响

目的探讨孕期被动吸烟对脐血铅、镉的影响。方法采用无火焰原子吸收法测定68例无被动吸烟对照组、134例被动吸烟研究组(分为重型组、轻型组)的母血、脐血铅、镉水平,并测定2组孕妇的新生儿的体重、Apgar评分对数据进行分析比较。结果对照组,研究组(重型组、轻型组)的脐血铅水平分别为(21.88±1.48)μg/L,(33.88±1.55)μg[(38.02±1.58)μg/L,(30.20±1.45)μg/L],脐血膈水平为(0.26±0.26)μg/L,(0.49±0.39)μg/L[(0.50±0.47)μg/L,(0.48±0.38),μg/L]。研究组与对照组比较及重、轻型组分别与对照组比较,母血、脐血铅、镉水平的差异均有统计学意义(P<0.05);脐血铅是母血铅的80%~90%;脐血镉明显低于母血镉(P<0.05)。研究组新生儿Apgar评分低于对照组(P<0.05),2组新生儿体重差异无统计学意义。结论孕期被动吸烟可以使脐血铅、镉水平明显升高。     

脐血铅、初乳铅含量对新生儿神经行为发育的影响

目的 探讨在宫内低水平铅暴露状态下,新生儿脐血铅含量及初乳铅铅含量与神经行为发育的关系.方法 随机选取南京市妇幼保健院医院产科2010年1-4月出生的足月新生儿170例.以脐血铅和初乳铅铅含量作为新生儿铅暴露的指标,新生儿神经行为NBNA发育评分作为效应指标.结果 高暴露组和低暴露组在新生儿主动肌张力、原始反射和神经行...     

Lead levels in milk and blood from donors to the Breast Milk Bank in Southern Brazil

Brazilian scientific literature on the adverse effects of lead on the general population is still very limited. Lead, a potentially toxic substance, has become a public health problem due to its effects, mainly those affecting the central nervous system and on the synthesis of heme. The aim of this study is to evaluate the level of lead exposure of donors to the Breast Milk Bank in the city of Londrina, Parana, by estimating the levels of that metal in milk and blood samples. This is a cross-sectional study conducted during the period between January and July 2007. All mothers enrolled as donors in the Breast Milk Bank were included in this study. A total of 92 volunteers presenting the following inclusion criteria were evaluated in the project: volunteers who were healthy, without any chronic disease, full-term pregnancy, breastfeeding between the 15th and 210th day after giving birth, and living in the city of the study. Lead in milk and blood was quantified using the inductive coupled plasma mass spectroscopy (ICP-MS) technique. All mothers signed a consent form approved by the Research Ethics Committee from Londrina State University. The median lead concentration in milk samples was 3.0 μg/L, varying from 1.0 to 8.0 μg/L. The median of lead in blood was of 2.7 μg/dl, varying from 1.0 to 5.5 μg/dl. In Spearman correlation analysis, significant but modest correlations could be observed between the concentration of lead in blood and in milk (r_s=0.207, p=0.048), hemoglobin and ALAD activity (r_s=−0.264, p=0.011), level of lead in blood and mother’s age (r_s=0.227, p=0.029). However, for hematocrit and hemoglobin, the correlation was higher (r_s=0.837, p<0.001). No statistically significant associations were found between concentrations of lead in milk and blood and demographic variables studied, obtained through interviews and validated questionnaire. The mean of milk/blood lead ratio was equal to 0.11. In general, the values found in the present study are similar to those obtained in populations in other countries, and are within background levels.