活动性炎症性肠病与血小板参数的相关性及其临床意义

目的研究炎症性肠病(IBD)患者血液中血小板计数和平均血小板体积是否可以作为评价IBD活动性的参考指标。方法选取IBD病例160例,其中溃疡性结肠炎(UC)85例,克隆病(CD)75例;非IBD病例121例。摘录病例中的血小板计数和平均血小板体积。结果UC和CD病例中的血小板计数均比非IBD病例高,而平均血小板体积均比非IBD病例低,差异有统计学意义。血小板计数和平均血小板体积均与UC的炎症程度分级有相关关系,与CD的简易CD活性指数评分也有相关关系。结论血小板计数和平均血小板体积可作为评价IBD活动性的参考指标。     

比较血小板计数及其参数在急性脑梗死和急性心肌梗死中的临床意义

目的 探讨静脉血中血小板(PLT)计数、平均血小板体积(MPV)和血小板体积分布宽度(PDW)在急性脑梗死和急性心肌梗死中的变化及临床意义. 方法 2010年07月至2012年12月对65例急性心肌梗死患者、87例急性脑梗死患者和80例健康人各抽取静脉血2ml (EDTA-K2抗凝),全自动血球计数仪sysmexXE-2100测定PLT、MPV、PDW等3个参数,进行对比分析. 结果 急性脑梗死组、急性心肌梗死组和健康组比较PLT都明显下降,差异有统计学意义(P＜0.01),心肌梗死组比脑梗死组下降更明显(P＜0.01).正常对照组MPV明显低于其他2组,差别有统计学意义(P＜0.05),心肌梗死组和脑梗死组比较无明显差异;PDW三组比较无统计学意义. 结论 血小板参数的检测可间接反映血小板的功能,血小板功能异常是心脑梗死的一个独立危险因素,对心脑梗死的预防研究有一定的意义.     

肝硬化患者血小板4项参数的检测及临床意义

目的：分析肝炎肝硬化患者血小板参数测定的临床意义。方法：采用SysmexKX-21型血细胞分析仪测定94例肝炎肝硬化患者的血小板4项参数,并将健康体检者血小板参数作为对照组。结果：与对照组比较,肝硬化患者的血小板计数（PLT）、平均血小板体积（MPV）、血小板体积分布宽度（PDW）均明显下降（P〈0．05或〈0．01）,血小板压积（PCT）则明显升高（P〈0．01）,且随着Child-Pugh积分的增加,血小板4项参数异常程度逐渐加重。结论：血小板参数测定值有助于肝硬化患者的诊断及预后观察。     

血脂及年龄对血小板参数的影响和相关性分析

目的探讨血脂及年龄对血小板参数的影响。方法检测绵阳科学城地区5 315名体检者(19~86岁)空腹血清中胆固醇(TC)、甘油三酯(TG)含量和全血血小板(PLT)参数,应用SPSS软件分析血脂及年龄与血小板各参数的关系。结果 PLT与年龄呈负相关(P<0.01);平均血小板体积(MPV)随着年龄呈现先增高后降低的趋势。在老年人群中(>50岁),PLT与血脂呈正相关,而与年龄呈负相关(P<0.01);血脂异常对MPV的影响并不明显(P>0.05)。血脂(尤其是TC)与PLT、MPV均存在弱的相关性(P<0.01)。结论增龄、高血脂(特别是TC异常升高)与PLT和MPV变化密切相关,临床可通过动态监测PLT参数来观察PLT活性的变化。TC异常升高的年长者中存在PLT增多,在降脂治疗时应同时进行抗PLT治疗。     

急性脑出血血小板计数与血小板平均体积变化

有学者认为脑梗死急性期血小板 (ＰＬＴ)大量被消耗 ,使ＰＬＴ数减少 ,而血小板平均体积 (ＭＰＶ)在急性期及恢复期均增大 ,故考虑ＭＰＶ增大可能是脑梗死独立的危险因素[1] ,但对于脑出血患者急性期ＭＰＶ与ＰＬＴ的变化尚未见报道。本文分析了 2 16例急性脑出血患者的ＭＰＶ、ＰＬＴ的数值 ,旨在探讨脑出血急性期ＭＰＶ、ＰＬＴ的变化及其临床意义。1　材料与方法1·1　对象　 2 16例脑出血病人 ,其中男 118例 ,女 98例 ,年龄 4 2～ 84岁 ,平均 6 5 8岁。所有病例均符合第四届全国脑血管病学术会议制订的诊断标准 ,并经头颅ＣＴ检查确诊 …     

肝病患者血小板计数及平均血小板体积检测的临床意义

目的探讨肝病患者血小板计数(PLT)及平均血小板体积(MPV)检测的临床意义。方法抽取肝病患者(包括慢性肝炎、重症肝炎、肝癌、肝硬化)及健康对照者静脉血2mL,采用Sysmex XT-1800i全自动血细胞分析仪检测PLT和MPV。结果重症肝炎、肝硬化、肝癌患者PLT显著低于对照组,而MPV高于对照组,慢性肝炎组PLT稍低于对照组,MPV基本正常。结论通过监测PLT和MPV,对初步评价肝病患者肝脏受损程度及患者出血倾向有着重要的指导意义。     

肝硬化患者血小板参数变化分析

目的 研究肝硬化患者血小板参数的变化，并探讨其临床意义。方法 采用日本SF－3000型血细胞分析仪检测62例肝硬化患者血小板计数（PLT），血小板平均体积（MPV），血小板分布宽度（PDW）并与肝功能分级（Child-Pugh积分法）比较。结果 肝硬化组PLT、MPV较对照组显著降低（P＜0．05），而PDW升高（P＜0．05），肝硬化A级组PLT，B级、C级组PLT、MPV显著降低，B级、C级组PDW显著升高。结论 血小板参数可间接反映血小板功能，肝功能损害可能是血小板功能异常的主要原因。     

血小板参数的变化在急性脑梗死患者中的临床意义

目的 检测外周血血小板参数的变化在急性脑梗死(CI)患者诊疗中应用价值.方法 应用全自动血细胞分析仪,对82例急性脑梗死患者及50例健康体检者(对照组)进行血小板参数[主要指血小板计数(PLT)、未成熟血小板比率(IPF)、血小板平均体积(MPV)、血小板分布宽度(PDW)]的检测,82例患者按不同发病时间段分为1～7d及8～14d两个检测组各41例,分别与对照组进行血小板参数的比较.结果 CI发病1～7d组与健康对照组比较,IPF值两组比较差异有显著统计学意义(P＜0.01),PLT、MPV、PDW两组对比差异有统计学意义(P ＜0.05); CI发病8～14d组与健康对照组比较,PDW两组比较差异有统计学意义(P＜0.05),PLT、MPV、IPF两组比较差异无统计学意义(P＞0.05).结论 监测急性脑梗死患者外周血血小板参数不同时间段的变化,有助于临床观察脑梗死患者病情的疗效及预防、预后的判断.     

东莞市儿童维生素D缺乏现状及与血小板参数的相关性研究

目的 了解东莞市儿童维生素D(VD)缺乏的现状及其与血小板参数的相关性。方法 采用回顾性调查的方法,选取自2017年1月－2018年3月期间在东莞市儿童医院健康体检并进行血常规和血清25-(OH)D检测的6个月~14岁儿童2 337例,分析VD缺乏、VD不足的发生率及其与血小板参数的相关性。结果 入组儿童VD缺乏和不足检出率分别为14.46%和25.03%,VD缺乏和不足检出率均为婴幼儿组＜学龄前组＜学龄组,VD缺乏检出率男女童差异无统计学意义(P>0.05),而VD不足检出率男童低于女童。随着年龄增长,25-(OH)D水平及血小板(PLT)计数降低,平均血小板体积(MPV)以及血小板分布宽度(PDW)则升高,差异具有统计学意义(P<0.05);不同性别之间25-(OH)D水平及血小板参数差异无统计学意义(P>0.05);VD不足和缺乏组与正常组之间的PLT计数、MPV、PDW差异具有统计学意义(P<0.05);而VD不足组和缺乏组之间差异无统计学意义(P>0.05)。进一步以VD分组为因变量,进行多因素Logistic回归分析,结果显示,VD缺乏和VD不足与年龄增加、MPV增高、PDW降低呈显著相关(P<0.05)。结论 东莞市6个月~14岁儿童中VD缺乏和不足检出率均较高,随年龄增大,VD缺乏逐渐增加,需加强干预。此外,VD缺乏和不足可能与MPV增高及PDW降低具有一定的相关性。     

Association of vitamin K deficiency with bone metabolism and clinical disease activity in inflammatory bowel disease

Objective

Inflammatory bowel disease (IBD) is a chronic inflammatory process in the digestive tract and patients with IBD develop osteopenia. Although vitamins K and D are important for maintaining bone health and inhibiting inflammation, their roles in patients with IBD are not clear. We investigated the roles of vitamins K and D in the bone health and inflammation in patients with IBD.

Methods

Bone mineral density (BMD) of patients with IBD (Crohn’s disease [CD], n = 47, and ulcerative colitis [UC], n = 40) was measured with dual-energy X-ray absorptiometry. Vitamin K and D levels of patients with IBD and healthy volunteers (n = 41) were evaluated by measuring serum undercarboxylated osteocalcin and 1,25 dihydroxyvitamin D, respectively. Clinical activity index was evaluated in patients with CD and UC.

Results

BMD was low in patients with CD and UC. Serum undercarboxylated osteocalcin levels were significantly higher in patients with CD, but not with UC, compared with healthy subjects, indicating that bone vitamin K is insufficient in patients with CD. The levels of undercarboxylated osteocalcin were significantly correlated with the clinical activity index of CD, although they were not correlated with BMD. The levels of 1,25 dihydroxyvitamin D were significantly lower in patients with CD and UC than in healthy subjects. The levels of 1,25 dihydroxyvitamin D were inversely correlated with BMD in patients with UC and were not correlated with the clinical activity index of CD.

Conclusion

Vitamins K and D are insufficient in patients with IBD. Insufficiency of vitamin K is suggested to be associated with inflammatory processes of CD.     

Graves病患者血小板参数变化的研究

.甲亢初发组MPV、PDW和P-LCR分别与甲亢缓解组、健康对照组比较均升高,差异均有统计学意义(P<0.01).甲亢缓解组PDW为0.1102±0.0113,健康对照组为0.1136±0.0094,两组比较差异有统计学意义(P<0.05).结论 PC在甲亢缓解患者中高于健康对照者,甲亢初发患者的MPV、PDW和P-LCR均明显高于甲亢缓解者和健康对照者,治疗后上述指标可逐渐恢复正常.     

Role of diet and nutrition in inflammatory bowel disease

Inflammatory bowel diseases (IBDs) are closely linked to nutrition. The latest research indicates that diet and nutrition are significantly involved in the etiopathogenesis of the disease, although their specific role throughout its clinical course still remains unclear. This study reviewed how diet and nutrition are associated with IBD development and management. Even though specific diets have been shown to bring about positive outcomes, there is currently no scientific consensus regarding an appropriate diet that would benefit all IBD patients. We suggest that individualized dietary recommendations are of the greatest importance and that diets should be planned to provide individual IBD patients with specific nutrient requirements while keeping all the clinical aspects of the patients in mind. Further research is clearly necessary to investigate nutritional factors involved in IBD development and, especially, to evaluate the applications of the diets during the course of the disease.     

Pattern of alcohol consumption and its effect on gastrointestinal symptoms in inflammatory bowel disease

Alcohol consumption is a potential trigger for flare in inflammatory bowel disease (IBD) flare because of alcohol's pro-oxidant effects and its deleterious effects on gut barrier function. The association with alcohol consumption and IBD flare is unclear. To test this hypothesis, we evaluated the pattern of alcohol consumption and its self-reported effect on gastrointestinal (GI) symptoms in patients with IBD. We recruited 129 consecutive patients: 52 patients with Crohn's disease, 38 patients with ulcerative colitis, and 39 patients with irritable bowel syndrome (IBS). All the participants completed a validated questionnaire on disease activity (the Crohn's disease activity index or ulcerative colitis clinical activity index, respectively) validated questionnaires to quantify alcohol consumption by National Institute of Alcohol Abuse and Alcoholism criteria, and two structured questionnaires we designed to access patients' perception of the effect of alcohol on their GI symptoms and on overall GI symptom severity. The pattern of current, light, moderate, and heavy alcohol consumption in inactive IBD was similar to the general U.S. population. Specifically, of the 90 inactive IBD patients, 56 (62%) were current drinkers, compared with 61% in the general U.S. population. Of current drinkers, 75% of IBD (N = 42) and 43% of IBS (N = 9) reported a worsening of GI symptoms with alcohol consumption (P = .01); however, overall GI symptom severity did not differ when compared with quantity of alcohol consumed. Patients with inactive IBD drink alcohol in quantities similar to the general population. Current drinkers with inactive IBD are more likely to report worsening of GI symptoms with alcohol than current drinkers with IBS.     

益生菌改善炎症性肠病患者的临床效果观察

目的探讨益生菌在炎症性肠病患者中的应用效果。方法选取2015年8月-2016年4月中山市博爱医院收治的炎症性肠病患者60例,以随机数字表法分为对照组和观察组各30例。对照组给予美沙拉嗪肠溶片治疗,观察组在对照组基础上加用益生菌治疗,比较两组的治疗效果以及炎症因子水平。结果观察组总有效率为96.67%,明显高于对照组80.00%,治疗后两组CRP、IL-6、ESR水平均低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05)。结论益生菌在炎症性肠病临床治疗中的应用有助于促进炎症反应消退,使患者早日康复,值得临床推广应用。     

炎症性肠病122例临床分析

目的 探讨炎症性肠病（IBD）患者的临床治疗现状.方法 调查122例IBD患者的临床特点及诊疗特征.结果 122例IBD患者中,54例为溃疡性结肠炎（UC）,病变范围以广泛结肠为主,就诊医院中位数3家,使用氨基水杨酸制剂、糖皮质激素、免疫抑制剂、生物制剂和抗生素分别为100.0％（54/54）,55.6％（30/54）,24.1％（13/54）,7.4％ （4/54）,75.9％（41/54）;68例为克罗恩病（CD）,病变范围以空回肠＋结肠为主,就诊医院中位数4家,使用过氨基水杨酸制剂、糖皮质激素、免疫抑制剂、生物制剂和抗生素分别为95.6％（65/68）,58.8％（40/68）,47.1％（32/68）,11.8％ （8/68）,79.4％（54/68）.CD患者使用免疫抑制剂、喹诺酮类抗生素均高于UC患者,使用中草药治疗的低于UC患者,差异有统计学意义（P＜0.05）.结论 目前治疗IBD的主要药物有氨基水杨酸制剂、糖皮质激素、免疫抑制剂、生物制剂.     

Familial aggregation of inflammatory bowel disease in a Mediterranean area

To evaluate familial aggregation of inflammatory bowel disease (IBD) in the Mediterranean area and to estimate the disease risk in first degree relatives. 427 patients with IBD were consecutively interviewed in order to obtain a complete pedigree of first degree relatives. Sufficient information was obtained in 98% of 2,685 family members. The prevalence ratio of IBD in family members was estimated and compared to the prevalence ratio of IBD in general population; the ratio was then standardized by age since the prevalence of the disease is age-dependent. The lifetime risk was assessed by the Kaplan Meier method. Thirty index cases (7%) had at least one affected first degree relative. As compared with the general population, first degree relatives of the 427 patients with IBD had a 4.38-fold increase in the age corrected risk of having the same disease. The Kaplan-Meier curve showed a higher risk at 25 years of age for offsprings (3%) than for parents (1%) and siblings (1%) whereas the crude ratio showed a higher risk for siblings (1.9%) compared to parents (0.8%) and offsprings (1%). In the Mediterranean area, the familial prevalence of IBD is higher than in the general population and comparable to North European rates.Abbreviations CD Crohn's disease - IBD inflammatory bowel disease - UC ulcerative colitis     

Contraceptive use among women with inflammatory bowel disease: A systematic review

Background

There are theoretical concerns that use of hormonal contraceptives by women with inflammatory bowel disease (IBD) might increase disease relapse and risk of other adverse health outcomes, including thrombosis. In addition, there are concerns that IBD-related malabsorption might decrease the effectiveness of orally ingested contraceptives. The objective of this systematic review was to evaluate the evidence on the safety and effectiveness of contraceptive use among women with IBD.

Study Design

We searched the PubMed database for peer-reviewed articles relevant to contraceptive use and IBD that were published in any language from inception of the database through February 2009. We used standard abstract forms and grading systems to summarize and assess the quality of the evidence.

Results

From 207 articles, we identified 10 studies that met our inclusion criteria. Evidence from five cohort studies (Level II-2, fair to good) suggests no increased risk of IBD relapse with use of oral contraceptives. Evidence from two pharmacokinetic studies (not graded) suggests that women with mild ulcerative colitis and those with an ileostomy following a proctocolectomy with small ileal resections have plasma concentrations of steroid hormones after oral ingestion of higher doses of combined oral contraceptives that are similar to the plasma concentrations among healthy volunteers. No studies were found that examined the risk of thrombosis among women with IBD who used hormonal contraceptives.

Conclusions

Limited evidence suggests there is no increased risk of disease relapse among women with IBD who use oral contraceptives, and there seem to be no differences in the absorption of higher-dose combined oral contraceptives between women with mild ulcerative colitis and small ileal resections and healthy women.     

伴有代谢综合征的冠心病患者外周血小板平均体积变化的研究

目的:探讨伴有代谢综合征(MS)的冠心病患者外周血小板平均体积的变化及其临床意义。方法:选择95例心绞痛型冠心病患者为冠心病组,根据冠心病组患者是否伴有MS分为2个亚组,伴MS组(25例)和不伴MS组(70例),同期选择健康体检者70例为正常对照组。测量身高、体重、血压,测定血糖、血脂和血小板参数如血小板计数(PLT)、血小板平均体积(MPV)等相关指标,分析MPV与伴有MS的冠心病之间的关系。结果:冠心病组患者外周血MPV(11.0±3.5)fl较正常对照组(8.9±0.50)fl明显增高(P<0.05)。伴MS组和不伴MS组的外周血MPV(11.6±5.3)fl和(10.7±5.3)fl均明显高于正常对照组(P<0.05),相关分析表明,MPV与BM I(r=0.371,P<0.01)、SBP(r=0.231,P<0.05)、DBP(r=0.211,P<0.05)、TC(r=0.292,P<0.01)、TG(r=0.268,P<0.05)、FPG(r=0.210,P<0.05)呈明显正相关,而与HDL-C呈明显负相关(r=-0.212,P<0.05);随着MS的组分增加,外周血MPV未表现出同步性增高,差...