结节性动脉周围炎20例临床病理分析

目的：通过对本组病例的临床病理分析，探讨其病理改变，以提高对本病的诊断和鉴别诊断能力。方法：收集和复习20例结节性动脉周围炎的临床和病理资料，同时做PAS，PTAH，VG，IgG,IgM组织化学染色，结果；结节性动脉周围炎是一类以动脉坏死为主要特征，累及全层动脉的炎性病变，纤维素是特异性染色，坏死区或多或少呈阳性反应，IgG,IgM免疫组化染色呈棕色颗粒，结论：PA是以纤维蛋白样坏死为主要特征的临床疾病，其病因可能属变态反应性疾病。     

ANCA相关性小血管炎肾损害患者的护理

系统性血管炎(SV)是一组以血管炎为共同病理变化,以多器官、系统受累为主要临床表现的疾病,临床表现与受累血管的大小、类型及分布有关.临床上按病因将其分为原发性和继发性,其中原发性小血管炎占70%,主要侵犯小血管,如小动脉、细动脉、毛细血管和小静脉,以血管壁坏死性炎症、纤维素样坏死为病理特征,主要是指显微型多动脉炎(MPA)及韦格纳肉芽肿(WG).     

ANCA相关性小血管炎肾损害患者的护理

系统性血管炎(SV)是一组以血管炎为共同病理变化,以多器官、系统受累为主要临床表现的疾病,临床表现与受累血管的大小、类型及分布有关。临床上按病因将其分为原发性和继发性,其中原发性小血管炎占70%,主要侵犯小血管,如小动脉、细动脉、毛细血管和小静脉,以血管壁坏死性炎症、纤维素样坏死为病理特征,主要是指显微型多动脉炎(MPA)及韦格纳肉芽肿(WG)。此类患者以血清抗中性粒细胞胞浆抗体(ANCA)阳性为特征,故又称之为ANCA相关性小血管炎[1-2]。ANCA不仅可用于作为诊断的血清学标志,且同疾病活动性、复发及预后有一定的关系[3-5]。…     

自身免疫性溶血性贫血36例临床分析

目的研究自身免疫性溶血性贫血(AIHA)的临床特征。方法对36例AIHA的临床资料进行回顾性分析。结果发病年龄以青壮年为主,且女性多于男性;36例中病因明确者19例(52.8%),其中系统性红斑狼疮6例(31.6%);免疫分型以IgG+C3型多见,余依次为C3型、IgG型;C3型溶血、贫血程度最轻,IgG+C3组次之,含IgA或IgM组溶血、贫血程度最严重;C3型对激素反应效果最好,IgG+C3组次之,含IgM或IgA组疗效最差。结论AIHA免疫分型与临床特征及治疗效果相关,可为临床治疗提供依据。     

用全血清制备IgG-或IgM-特异性抗体的一种简易法

兔抗嗜异抗原血清用固相化的葡萄球菌蛋白A(PA)或刀豆球蛋白A(ConA)吸收,可分别选择性地除去IgG或IgM抗体。其方法是于室温中,将25毫升1∶5稀释的热灭能抗-嗜异抗血清与5毫升床容积的ConA琼脂糖珠或3.5毫升床容积的PA琼脂糖珠混合轻摇1小时。离心除去固相化的PA或ConA回收血清。用每种蛋白吸收时,均须连续进行两次以上。该方法比DEAE纤维素离子交换层析或葡聚糖凝胶G-200分子筛滤层析快速,并能产生更多的纯抗体。作者试验了上述常用的三种提纯IgM和IgG抗嗜异抗血清方法,并比较了它们的交叉污染,分离的难易及产量。结果表明,G-200层析回收IgM     

结节性多动脉炎尸检1例并文献复习

目的 探讨结节性多动脉炎的临床、病理学特点及鉴别诊断。方法 对1例结节性多动脉炎的尸体解剖病例进行病理学检查并复习文献。结果 结节性多动脉炎是一组以侵犯中、小型动脉为主的炎症，以节段性动脉管壁坏死为特征。结论 结节性多动脉炎是一种少见的系统性血管炎，临床表现多种多样，容易误诊。     

类风湿关节炎患者免疫球蛋白变化及相关因素分析

目的研究类风湿关节炎(RA)患者血清免疫球蛋白(Ig)的变化及与实验室指标相关性。方法选取100例RA患者病历资料,统计其IgM、IgG、IgA值,并与白细胞计数(WBC)、红细胞计数(RBC)、血红蛋白(HB)、血小板计数(PLT)、前白蛋白(PA)、总蛋白(TP)、白蛋白(ALB)、球蛋白(GLO)、C3、C4及红细胞沉降率(ESR)、超敏C反应蛋白(CRP)等实验室指标进行相关性分析。结果 (1)RA患者免疫球蛋白IgG异常率最高(40%),其次为IgA(17%),IgM(7%),IgG异常率高于IgA(P0.05),IgG、IgA同时升高占12%,IgG、IgM同时升高占2%,IgG、IgM、IgA同时升高的占1%。(2)与免疫球蛋白正常组比较,免疫球蛋白升高RA患者Hb、PA与ALB是降低的,TP与GLO以及ESR显著上升;与免疫球蛋白正常组比较,免疫球蛋白下降RA患者类风湿因子(RF)明显升高(P0.05);(3)相关性分析显示,RA患者IgG与WBC、HB、PA呈负相关,与ALB、GLO、抗链球菌溶血素O(ASO)和ESR呈正相关;IgA与GLO、ASO与ESR呈正相关;IgM与HB、ALB呈负相关,与GLO、RF和ESR呈正相关(P0.05)。结论 RA的发病过程中以IgG异常为主,并且与RA患者的贫血,炎症严重程度有一定的关系。     

苍南地区感染婴儿特异性抗体检测的临床应用

目的探讨苍南地区婴儿TORCH感染情况。方法对苍南地区临床拟诊为非细菌感染性疾病患几采用酶免疫斑点技术检测TORCH血清特异性抗体IgM和IgG。结果500例标本中，检出弓形体特异性IgM 0例，IgG 1例；风疹病毒特异性IgM 11例，IgG49例；巨细胞病毒特异性IgM 43例，IgG 159例；单纯疱疹病毒特异性IgM14例，IgG 77例。TORCH—IgM的总感染率为13．60％（68／500）。TORCH检测IgM阳性者以婴儿肝炎综征为主，其次是呼吸道感染、黄疸。结论酶免疫斑点技术检测TORCH血清特异性抗体IgM和IgG,具有方法简单、敏感性高、特异性强、结果快速等优点。     

运用间接免疫双荧光染色法检测肺炎支原体抗体

运用美国ZeusScientificInc提供的肺炎主原体抗体检测试剂盒，检测了21例婴幼儿肺炎和41例中老年支气管肺炎患者的血清特异性IgM和IgG。肺炎患儿IgM阳性率14．5％，IgG阳性率33．3％，中老年支气管肺炎IgM阳性率17％，IgG阳性率36．5％．该法采用导流氨酸盐标记羊抗人IgM和IgG混合未标记抗体的罗丹明双荧光染色，具有特异、灵敏、简便、快速的优点，可及时给临床提供诊断指标．     

骨关节炎患者免疫球蛋白的变化及其相关因素分析

目的研究骨关节炎(OA)患者血清免疫球蛋白(Ig)的变化及其影响因素。方法收集214例OA住院患者资料为研究组,收集70名健康体检者作为健康对照组,观察其免疫球蛋白的变化,并分析其与总蛋白(TP)、前白蛋白(PA)、白蛋白(ALB)、红细胞沉降率(ESR)、抗溶血性链球菌O(ASO)、类风湿因子(RF)、超敏C反应蛋白(hs-CRP)关系。结果与健康对照组相比,研究组血清IgG水平升高(P0.01),IgA、IgM升高,但差异无统计学意义(P0.05);与免疫球蛋白正常参考值比较,研究组IgG异常40例(18.7%);IgA异常18例(8.4%),IgM异常9例(4.1%);相关性分析显示:IgG与TP、hs-CRP、ESR呈正相关,IgA与淋巴细胞(LYMPH)、TP、补体蛋白3(C3)、CRP、ESR、RF呈正相关,IgM与ASO呈正相关(P0.01);IgG与中性粒细胞(NEUT)、PA、补体蛋白4(C4)呈负相关,IgA与ALB、NEUT呈负相关,IgM与PA呈负相关(P0.05或P0.01)。结论 OA患者血清免疫球蛋白升高,以IgG最为显著,且与炎症反应指标呈正相关,免疫反应可能参与了OA发病。     

Polyarteritis nodosa presenting with hypertensive encephalopathy.

Polyarteritis nodosa (PAN) is a rare cause of malignant hypertension. As far as we are aware, hypertensive encephalopathy has not been described in the literature as a presenting feature of PAN.     

POLYARTERITIS NODOSA PRESENTING WITH HYPERTENSIVE ENCEPHALOPATHY

Polyarteritis nodosa (PAN) is a rare cause of malignant hypertension.¹ As far as we are aware, hypertensive encephalopathy has not been described in the literature as a presenting feature of PAN.     

Polyarteritis nodosa in a patient with type 1 autoimmune hepatitis

Polyarteritis nodosa is a systemic necrotizing vasculitis that affects small- and medium-sized arteries. Liver involvement in patients with polyarteritis nodosa has been described, and ranges from asymptomatic elevation of aminotransferases to hepatic aneurysm rupture. We describe the case of a patient with type 1 autoimmune hepatitis and compensated liver cirrhosis who developed classic polyarteritis nodosa, complicated with cytomegalovirus and repeated urinary tract infections. After a long bedridden hospitalization, the patient's condition was stabilized. She is currently in good health, with well-controlled blood pressure, and stable kidney and liver function. To our knowledge, this is the first case report in the literature with concurrent appearance of both diseases.     

Polyarteritis nodosa complicated by antiphospholipid syndrome

Polyarteritis nodosa is a necrotizing vasculitis of small and medium-sized arteries that spares the smallest blood vessels (arterioles, venules, and capillaries). Antiphospholipid syndrome is an autoimmune disorder characterized by venous or arterial thrombosis and/or by fetal losses, associated with antiphospholipid antibodies. The association of both diseases is infrequent. This case report discusses a male patient with a diagnosis of polyarteritis nodosa who, after 7 years of being diagnosed with vasculitis, showed ischemic lesions in his legs associated with high titers of anticardiolipin antibodies, along with angiographic and histologic evidence of thrombosis. Despite immunosuppressive and anticoagulant therapy, his lesions progressed, and both legs had to be amputated.     

Polyarteritis nodosa

Polyarteritis nodosa (PAN) is the systemic necrotizing vasculitis on small and median muscular vessels. Recent studies reveal that PAN consists of classical PAN and microscopic polyangitis (MPA). MPO-ANCA, which is one of anti-neutrophil cytoplasmic antibody (ANCA), is involved in the pathogenesis of MPA. In future, by the progress of research of ANCA, the definition or criteria of systemic vasculitis including PAN or MPA will be changed.     

Polyarteritis Nodosa

Polyarteritis nodosa, as a diagnosis, has been progressively narrowed from a collection of ill-defined vasculitides to its current definition as a systemic transmural necrotizing vasculitis that usually affects medium-sized muscular arteries and sometimes small muscular arteries, commonly within the kidneys, gastrointestinal tract, skin, nerves, joints, and muscles. In this review, we will highlight the clinical features and classification of this disease and emphasize that more accurate diagnosis of subtypes leads to more effective treatment.     

Spontaneous perirenal haematoma due to polyarteritis nodosa

Polyarteritis nodosa (PAN) is a systemic disease which involves the kidneys in 70% of cases. We report a case in which the pre-operative diagnosis was perirenal abscess or perirenal tumour, but at operation a perirenal haematoma was found. After pathological examination, it was recognised as renal involvement with PAN. The diagnosis of PAN is often difficult. Renal arterial changes, including aneurysm formation, are frequent. Since Kussmaul and Maier first described PAN in 1866, diagnosis has remained difficult because it is based upon tissue examination obtained at biopsy or post-mortem. In this report we present a case of renal involvement of PAN resulting in a perirenal haematoma due to spontaneous rupture of intrarenal arterial aneurysms.     

Renal involvement of polyarteritis nodosa: CT and MR findings

Background  To evaluate the imaging findings in patients with renal involvement of Polyarteritis nodosa (PN) to diagnose as early as possible. Materials and methods  Four patients diagnosed as having PN participated in the present study. Two patients underwent abdominal dynamic CT, one underwent only pre- and post-contrast CT, and the remaining patient underwent only noncontrast CT and MR imaging, including dynamic contrast study. Results  The common findings of CT and MR imaging were diffuse enlargement, multiple small wedge-shaped less-enhanced areas on dynamic contrast study, and indistinctness of the margin between the cortex and medulla on equilibrium-phase CT. Renal arteriogram showed multiple microaneurysms on arterial phase image in all four cases, and PN was diagnosed. The common CT and MR findings of renal involvement of PN mimicked those of pyelonephritis, when microaneurysms were not demonstrated. Conclusion  The differentiation between PN and pyelonephritis on CT and MR imaging is difficult. Therefore, the radiologist should be familiar with the imaging findings of renal involvement of PN. When PN is suspected, angiography should be performed as early as possible to make a definite diagnosis.     

氩氦靶向治疗诱导肺癌细胞凋亡及其相关蛋白的表达

目的 探讨氩氮刀除冷冻直接杀伤肺癌细胞外的可能治疗机制.方法 建立小鼠肺腺癌动物模型,氩氯刀冷冻后,末端标记法(TUNEL)原位检测细胞凋亡,免疫组织化学SABC法检查bcl-2和bax表达.结果 在冷冻中心区,细胞死亡形成以坏死为主;在冷冻周边区,光镜形态学检查及TUNEL染色可见细胞凋亡,并有两次凋亡高峰出现.免疫组化结果显示,bcl-2蛋白表达在冷冻前后无明显变化,bax蛋白在冷冻后其表达上调.结论 氩氯刀可以引起冷冻区周边部分细胞发生凋亡,其凋亡机制有bax蛋白参与,而与bcl-2无关.为增加冷冻疗效,术后可结合放化疗.