应用龈沟液β2微球蛋白评估1型糖尿病患者康复状况

目的：通过比较1型糖尿病牙周炎患者与无系统性疾病的牙周炎患者龈沟液β2微球蛋白(beta2-mictoglobulin，β2-MG)水平的差异，探讨β2-MG水平与1型糖尿病患者康复状况的关系。方法：2002—12／2003—12复旦大学附属华山医院门诊收治1型糖尿病牙周炎患者60例，选取35例，为1型糖尿病牙周炎组，男17例，女18例，年龄40—75岁，病程1～3年；同期复旦大学附属眼耳鼻喉科医院牙周科收治牙周病患者35例，为对照组，男17例，女18例，年龄35—73岁，病程2—3年。纳入标准：①诊断标准：1型糖尿病牙周炎组符合1985年WHO标准诊断，并至少1年以上；对照组符合Page等所述标准。②未经过牙周病治疗。③口内无修复体。④附着丧失所累及的牙数≥20颗。⑤所选牙的牙周探诊深度4—8mm。⑥X射线片显示牙槽骨吸收。排除标准：半年内服用过抗生紊，过去3个月内服用非类固醇类抗炎药，有其他系统性疾病。用放射免疫方法测定1型糖尿病型牙周炎患者与无系统性疾病的牙周炎患者的龈沟液β2-MG水平。结果：35例1型糖尿病牙周炎患者龈沟液β2-MC．含量为(0．987&;#177;0．936)mg／L，35例对照组牙周炎患者龈沟液β2-MG含量为(2．276&;#177;0．928)mg／L，两组比较差异有非常显著性意义(P&;lt;0．01)。与牙周炎的严重程度成反比。直线相关分析结果表明：龈沟液β2-MC．含量与空腹血糖含量呈负相关关系。结论：龈沟液β2-MG水平在受局部环境影响的同时，也受全身因素调控。糖尿病患者因免疫功能低下，龈沟液β2-MG水平下降，从而加重牙周炎的发生。也可考虑将龈沟液β2-MG水平作为判断1型糖尿病患者康复的评价标准。     

β2-微球蛋白、a1-微球蛋白的测定对2型糖尿病早期肾病的诊断价值

目的探讨血、尿β2-微球蛋白（β2-MG）、a1-微球蛋白（a1-MG）检测对2型糖尿病早期肾病的诊断价值。方法采用放射免疫法测定94例2型糖尿病患者和25例正常体检者的尿微量白蛋白排泄率（UAER）,血、尿β2-MG和a1-MG。结果肾功能不全组、显性蛋白尿组、微量白蛋白阴性组与微量白蛋白组比较,除血β2-MG在微量白蛋白阴性和微量白蛋白组之间差异无统计学意义,其余差异均有统计学意义。结论尿β2-MG,血、尿a1-MG对2型糖尿病早期肾病有诊断价值,血β2-MG对2型糖尿病早期肾病无诊断价值。     

老年Ⅱ型糖尿病患者行空气净化前后血β2微球蛋白的变化

目的　探讨老年Ⅱ型糖尿病患者行空气净化后血β     

糖尿病肾病血清β2微球蛋白检验的价值分析

目的 研究血清β2微球蛋白在糖尿病肾病中的检验价值.方法 选取治疗的49例糖尿病肾病患者作为观察组,将同期49例健康体检者作为对照组,两组均抽取静脉血测定血清β2微球蛋白水平,对比两组β2微球蛋白水平.观察组不同病程及肾功能分期的血清β2微球蛋白水平.结果 观察组血清β2微球蛋白水平显著高于对照组(P<0.05);病程...     

血清β2-微球蛋白对糖尿病肾病早期诊断的价值

[目的]探讨血清β2-微球蛋白对糖尿病肾病早期诊断的价值。[方法]采用免疫比浊法、改良JAFF法和紫外一谷氨酸脱氢酶法检测120例糖尿病患者及120例正常人血清β2-MG、Cr和Urea的含量。[结果]糖尿病组血清β2-MG与正常对照组存在显著性差异（P〈0．01），其阳性率为70．8％比Cr和UREA阳性率高。[结论]血清β2-MG是糖尿病肾病早期诊断的灵敏指标，具有重要的临床价值。     

洛丁新对2型糖尿病尿β2—微球蛋白影响的临床观察

糖尿病肾病(ＤＮ)通常在糖尿病发生10～20年后出现,若诊治不及时,病情发展,临床出现肾功能下降和血压的升高。因此,对早期ＤＮ的治疗十分重要。尿β2—微球蛋白(ＭＧ)是仅次于白蛋白尿的发现早期ＤＮ的指标之一。我们应用洛丁新(北京诺华制药有限公司生产)治疗2型糖尿病伴尿β2—ＭＧ升高的患者,以观察其对尿β2—ＭＧ的影响。1　材料与方法1.1　研究对象　2型糖尿病(诊断依据ＷＨＯ1985年颁布的标准)患者无高血压,两次检测24小时尿中β2-ＭＧ>02μｇ/ｍｌ,共15例。血尿素氮、血清肌酐水平正常。男7例,女8例,平均年龄565±78岁,临床病程10±…     

血清β2微球蛋白及尿微量白蛋白在糖尿病肾病中的应用

目的：探讨糖尿病肾病患者血清β2徽球蛋白及尿微量白蛋白（ALB）变化与临床意义。方法：用全自动化学免疫发光法对本院60例已确诊糖尿病肾病患血清β2微球蛋白及尿ALB进行了测定。结果印糖尿病肾病患者血清13：微球蛋含量为x=2581．1±17．8与正常组x＝1230．7（ng／L）±18．8比较P〈0．01有显著差异：同时尿ALB含量为x=60μgmin±7．8与正常组x=9．0μg／min±11比较P〈0．01有显著差异。结论：糖尿病肾病患者血清β2微球蛋白及尿ALB显著增高，这为临床诊断、治疗、愈后观察提供依据．     

糖尿病肾病尿β2-微球蛋白、转铁蛋白的测定

目的 探讨尿β2-微球蛋白、转铁蛋白对糖尿病肾病的临床价值.方法 分别采用放射免疫法和速率散射比浊法测定了正常人105例,糖尿病患者73例的尿β2-微球蛋白(β2-MG)及尿转铁蛋白(Tf)的含量,以观察其变化.结果 糖尿病患者尿β2-微球蛋白和尿转铁蛋白与正常对照组之间差异均有统计学意义(P＜0.01).结论 尿β2-微球蛋白、转铁蛋白对早期诊断糖尿病肾病均有良好的诊断价值.     

血清及尿液β2微球蛋白检测在糖尿病肾病分期中的诊断价值

目的 探讨血清及尿液β2微球蛋白在糖尿病肾病不同发展阶段中的诊断价值.方法 采用免疫比浊法测定305例不同发展阶段DN患者的血和尿β2-MG,其中DN1 36例,DN2 46例,DN3 65例,DN4 78例,DN5 80例,并与健康对照组进行比较.结果 DN1期患者的血清及尿β2-MG值均正常;DN2期患者中4例患者血β2-MG增高（4/46,8.7%）,尿β2-MG均正常;DN3期患者中26例患者血β2-MG增高（26/65,40.0%）,15例尿β2-MG增高（15/65,23.1%）;DN4期患者中70例患者血β2-MG增高（70/78,89.7%）,60例尿β2-MG增高（60/78,76.9%）;80例DN5期患者中80例患者血β2-MG增高（80/80,100.0%）,78例尿β2-MG增高（78/80,97.5%）.DN3-5期患者血清及尿液检测结果与健康对照组比较差异有统计学意义（P〈0.01）.结论 血清β2-MG和尿β2-MG联合检测对DN的诊断具有一定价值,可一定程度提高DN的诊断率.     

心理干预对2型糖尿病患者心理健康状况的影响

目的探讨心理干预对2型糖尿病患者心理健康状况的影响,为临床干预提供理论依据。方法对122例2型糖尿病患者采用症状自评量表进行评定,根据评定结果予以有针对性的心理干预,观察6个月。于心理干预6个月末再次采用症状自评量表进行评定,并与全国成人常模进行对比分析。结果2型糖尿病患者心理干预前症状自评量表总分、总均分及躯体化、抑郁、焦虑、恐怖因子分均显著高于全国成人常模（P〈0.05或0．01）;心理干预后症状自评量表总分及躯体化、抑郁、恐怖因子分均显著低于心理干预前（P〈0．01）,但总分及抑郁、焦虑因子分仍显著高于全国成人常模（P〈0.05）。结论2型糖尿病患者存在有不同程度的心理问题,焦虑抑郁问题尤为显著,心理干预能明显改善患者的心理健康状况,对促进患者的康复具有重要意义。     

MRS联合DTI评估2型糖尿病脑白质改变

目的 采用磁共振弥散张量成像(DTI)及氢质子磁共振波谱(¹H-MRS)方法探讨2型糖尿病(T2DM)患者双侧半卵圆中心白质结构及代谢产物的改变。方法 收集T2DM患者(T2DM组)和健康体检人员(对照组)各30例,行MRS及DTI检查,测量双侧半卵圆中心ADC值与FA值,N乙酰天门冬氨酸(NAA)、肌酸(Cr)和胆碱(Cho)的含量,计算NAA/Cr、Cho/Cr、Cho/NAA比值,并比较两组间差异。结果 T2DM组左、右侧半卵圆中心ADC值升高(t=9.51、2.06)、FA值降低(t=6.08、3.67)、NAA/Cr值降低(t=3.06、2.31)、Cho/NAA升高(t=5.68、2.24),左侧半卵圆中心Cho/Cr升高(t=5.67),与对照组比较差异均有统计学意义(P均<0.05)。结论 DTI联合MRS可反映T2DM患者双侧半卵圆中心局部神经纤维结构及代谢产物的异常改变;DTI联合MRS技术可早期发现由T2DM引发的认知功能损害。     

Urinary excretion of beta 2-microglobulin in myeloma patients

The levels of beta 2-microglobulin in urine and serum were determined in 39 patients with myelomatosis. In 25 patients the serum beta 2-microglobulin was elevated, and in seven of the patients with increased serum beta-microglobulin the urinary excretion of the protein was also increased. It was concluded that the increased urine beta-microglobulin indicates a renal tubular disorder.     

Cerebrospinal fluid beta 2-microglobulin in AIDS related central nervous system involvement

We measured cerebrospinal fluid (CSF) and serum beta 2-microglobulin (beta 2-M) in Acquired Immunodeficiency Syndrome (AIDS) patients with or without clinical evidence of central nervous system (CNS) involvement. The CSF beta 2-M level was significantly higher than the serum level in AIDS patients with neurological symptoms, but not in AIDS without neurological symptoms, suggesting an increased shedding of this protein in CSF, as a result of rapid cellular turnover within CNS. CSF beta 2-M level increases both in Human Immunodeficiency Virus type 1 (HIV-1) related and in opportunistic CNS syndromes, confirming that beta 2-M is a non specific marker of CNS involvement in AIDS. Nevertheless, the highest CSF beta 2-M values were observed in patients with severe dementia and autoptic diagnosis of multifocal giant cells encephalitis (MGCE) without other opportunistic diseases. This observation could have important implications for monitoring AIDS dementia complex in AIDS patients. Finally, 5 out of 7 (71%) AIDS patients with cryptococcal meningitis showed a decline in CSF beta 2-M level well related to the decrease of cryptococcal antigen (Crypto-Ag) titres and the clinical remission. This data suggests that CSF beta 2-M determination could be used as a useful test in monitoring efficacy of therapy of CNS pathologies in AIDS patients.     

Serum beta2-microglobulin in controls and cancer patients.

Serum beta2-microglobulin levels have been measured in 210 cancer and control patients to assess the significance of this investigation in cancer patients. Subjects studied included patients with breast and gastrointestinal cancer, corresponding control patients in both categories, and healthy volunteers. The composition of these groups allowed an assessment of the relative importance of changes related to cancer, benign disease, age and sex. A significant rise in serum beta2-microglobulin levels with advancing age was demonstrated in the control subjects. Mean levels were also consistently higher in females than in males in each patient group. After statistical correction for these age and sex effects, mean values remained significantly higher in each of the various cancer groups than in their controls. Patients with more advanced breast cancer had higher levels than those with 'early' disease, as did patients with stomach cancer compared to those with colo-rectal cancer. One possible interpretation is that levels increase with increasing tumour bulk, and therefore the estimation of serum beta2-microglobulin may be useful as one of a battery of tests in the management of cancer patients.     

Stability of alpha 1-microglobulin, beta 2-microglobulin and retinol binding protein in urine

The stability of alpha 1-microglobulin (alpha 1M), beta 2-microglobulin (beta 2M) and retinol binding protein (RBP) in urine was determined in 135 random samples from children with renal disease, febrile illness, malignancy, and from controls. Immediately after voiding, samples were divided into two portions, one of which was alkalinized. After identical transit times and laboratory handling the pH and concentrations of the individual proteins in each pair were measured. beta 2M was unstable in urine of pH less than 7 and grossly so below pH 6. In some instances beta 2M was low or undetectable even in the alkalinized samples when alpha 1M and RBP levels were raised, suggesting that degradation of beta 2M may have occurred prior to voiding. Concentrations of alpha 1M and RBP were significantly lower in the non-alkalinized fractions at pH less than 7, although to lesser degree than for beta 2M. Contrary to previous reports, we conclude that the stability of all 3 proteins is affected by urinary pH and recommend that this be measured and alkalinisation performed at the time of voiding.     

Cysc、NAG、β_2-微球蛋白在肾损伤患者中的应用

目的分析评价胱抑素C(Cysc)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、β2-微球蛋白(β2-MG)、血尿素氮(BUN)、血肌酐(Scr)5项生物学指标在诊断系统性红斑狼疮、糖尿病和高血压疾病所致早期肾损伤患者中的临床效能。方法收集本院高血压患者61例,系统性红斑狼疮患者62例,糖尿病患者59例,对照组56例。采用免疫透射比浊法测定Cysc,采用胶乳增强免疫比浊法测定β2-MG,采用两点法测定NAG,酶法测定血Scr,UV-GLDH法测定血清BUN,并对数据进行统计学分析。结果病例组血BUN和Scr浓度与对照组比较差异无统计学意义(P0.05),而Cysc、尿β2-MG和NAG浓度与对照组比较,差异有统计学意义(P0.01)。SLE、糖尿病、高血压所致早期肾损伤各诊断指标ROC曲线下面积最大的分别为血NAG、尿β2-MG和Cysc。在诊断早期肾损伤患者中联合检测较单项指标阳性率高,以联合检测Cysc、尿β2-MG和NAG这3项肾功能指标组阳性率最高,达88.7%,明显高于2项联合检测(77.4%、70.9%、66.1%)。结论对诊断系统性红斑狼疮、糖尿病、高血压所致早期肾损伤灵敏度、特异度最佳的诊断生物学指标分别为血NAG、尿β2-MG和Cysc。三者联合检测具有较高的检出率、灵敏度和特异度,对肾损伤患者的早期诊断具有重要的临床价值,适于在临床工作中推广使用。     

IA-2 antibody-negative status predicts remission and recovery of C-peptide levels in type 1 diabetic patients treated with cyclosporin

OBJECTIVE: The use of cyclosporin in recent-onset type 1 diabetes has demonstrated the potential for immune intervention in the treatment and prevention of the disease. However, a proportion of patients failed to respond to cyclosporin treatment. Indicators of resistance to immune intervention would be valuable for the most effective use of such therapies in disease prevention. The aim of this study was to determine whether presence of IA-2 antibodies is such a marker. RESEARCH DESIGN AND METHODS: IA-2 antibodies were determined by radioligand binding assay in sera from patients recruited into the Canadian-European cyclosporin trial. Insulin dose requirements and glucagon-stimulated C-peptide secretion were analyzed in patients grouped according to IA-2 antibody status at entry. RESULTS: Cyclosporin treatment had no significant effect on frequency of IA-2 antibodies during the 1 year of treatment. Cyclosporin caused significant reduction in insulin requirements and significant increases in C-peptide secretion mainly in patients negative for IA-2 antibodies. Analysis of GAD antibodies in combination with antibodies to IA-2 indicated that the group most resistant to cyclosporin were IA-2 antibody positive, GAD antibody negative. CONCLUSIONS: The results demonstrate that IA-2 antibody analysis is valuable in identifying individuals for whom immunosuppressive treatment would be most effective.