慢性肾衰患者血液透析前后血浆心钠素和环核苷酸水平的变化

心钠素和环核苷酸水平的变化对于肾脏的基础和临床研究具有十分重要的意义。为了进一步观察心钠素和环核苷酸水平在肾功能不全发病中的作用,本文对34例CRF病人血液透析前后血浆ANF、cAMP、cGMP水平进行分析。结果显示,CRF患者透析前血浆ANF、cAMP、cGMP含量均显著高于健康人(p<0.001),cAMP/cGMP比值则显著低于健康人(p<0.01)。而经过血透后ANF、cAMP,cGMP含量又明显下降(p<0.001),提示CRF的发病机理与ANF、cAMP、cGMP水平的改变有密切的关系。同时初步分析了这些变化的原因及意义。因此,我们认为测量血浆ANF、cAMP、cGMP水平的变化,对CRF患者的诊治有一定的指导意义。     

血浆与血小板中NPY、NT在慢性肾功能衰竭患者血液透析中的变化及意义

采用RIA法检测40例慢性肾功能衰竭(CRF)患者血液透析(以下简称血透)过程中,血浆和血小板中神经肽Y(NPY)、神经降压素(NT)的含量变化及其临床意义。并以30例健康人作为对照。结果显示,①CRF患者血透前血浆NPY、NT含量分别为432.34±52.27ng/L、138.44±80.35ng/L;血透后分别为324.52±48.16ng/L、211.6±124.69ng/L。②CRF患者血透前血小板中NPY、NT含量分别为34.86±18.82ng/L、41.12±24.12ng/L;血透后分别为66.97±21.81ng/L、14.89±12.56ng/L。结果表明,CRF患者存在NPY及NT分泌异常。NPY与NT作为体内重要的神经递质,参与了肾脏病及其并发高血压的病理生理过程。     

SEROLOGICAL AND MOLECULAR ANALYSIS OF HLA IN ISRAELI PRIMARY SCLEROSING CHOLANGITIS PATIENTS

HLA class I and class II were investigated in 15 Israeli primary sclerosing cholangitis patients and compared to healthy controls. None of the well established serological specificities were found to be associated with the disease. HLA-DR52 is serologically defined, but its subtypes DR52a, DR52b, and DR52c cannot be precisely defined by serological means. Therefore, we have used HLA-DNA typing in order to assign the DR52 splits in PSC patients. Genomic DNA was amplified by PCR, dot-blotted and hybridized with sequence specific oligonucleotide probes defining the known HLA-DR52 associated alleles. Only 4 out of the 15 PSC patients tested were found to express DRB3*0101 the allele that encodes DR52a. Of the remaining 11 patients, 9 expressed DRB3*0202 haplotypes, with 2 patients expressing both DRB3*0101 and DRB3*0202, and the remaining 2 patients expressed no DRB3 allele. Our data indicate that there is no apparent association between PSC and the HLA antigens and alleles studied including the alleles of the DRB3 locus in the Israeli population. Thus HLA pheno/genotyping of PSC patients in the Israelis will not be useful for early and/or differential diagnosis of this disease.     

STUDY OF HLA CLASS I/II AND T LYMPHOCYTE SUBSETS IN KUWAITI VITILIGO PATIENTS

HLA polymorphisms of class I and class II MHC were investigated in 40 Kuwaiti vitiligo patients and in 40 controls using microcytotoxicity assay. HLA-B21, Cw6 and DR53 were increased significantly in patients compared to controls (P= 0.00001, 0.00001 and P= 0.0053 respectively) while HLA-A19, DR52, were significantly decreased (P= 0.00236,0.05, respectively). Total T-cells, T4 and T8 were measured as CD2, CD4 and CD8 respectively by flow cytometry. Vitiligo patients showed significant increase in CD4 compared to controls (P= 0.03). Our findings suggest that HLA-B21 and Cw6 and DR53, are susceptible genes of vitiligo, while A19 and DR52 are protective genes in the Kuwaiti population.     

AN ANALYSIS OF HLA CLASS II GENE POLYMORPHISM IN BRITISH AND GREEK IDIOPATHIC MEMBRANOUS NEPHROPATHY PATIENTS

Fifty-two British and 29 Greek idiopathic membranous nephropathy (IMN) patients were analysed for DRB, DQA1, DQB1 and DPB1 gene polymorphism using second exon amplification and sequence-specific oligonucleotides (SSO). In addition 100 British and 92 Greek controls were analysed. A highly significant increased frequency of the DRB 1*0301 allele was found in IMN patients from Britain (80%), when compared to controls (27%, OR 10.6, P= 0.000004). A lower frequency of DRB 1 *0301 was observed in Greek IMN patients (33%), but this was just significant before correction, when compared to Greek controls (15%, OR 3, P= 0.02). The DRB3 allele most often associated with DRB 1 *0301 was DRB3*0101 (OR 4.2, P= 0.00025) in British patients and DRB3*0201/2 (OR 11, P=0.006) in Greek patients. In Greek IMN patients a decrease in DR16 was found (OR 0.08, P=0.004), and the overall incidence of DR2 was significantly lowered when both sets of IMN patients were combined (OR 0.21, χ² 17.6, P= 0.00013). The incidence of DQA1 *0501 was raised in both Greek (96%vs. 66%, OR 9.7, χ² 6.9, P= 0.009) and British IMN (85%vs. 45%, OR 7.4, χ² 20, P= 0.00007) patients. This gives some support to a proposal for a major role for this allele in IMN. However, DQB1 *0201 was also raised in both Greek (50%vs. 21%, OR 3.6, χ² 8.1, P= 0.005) and British (90%vs. 44%, OR 10, χ² 21.7, P=0.00004) IMN patients. The DQA1*0102 allele was significantly lowered in Greek IMN patients (15%vs. 32%, OR 0.05, 12.2, P=0.0008), probably reflecting a lowering in the DR16 haplotype. No significant difference was observed in the frequencies of DPB alleles in patients and controls. It is concluded that DRB 1*0301 has the strongest association with British Caucasoid IMN. The Greek Caucasoid IMN association with DRB 1*0301 is weaker, and a role for other alleles has not been eliminated.     

中国南方汉族人群HLA—DQB1基因对系统红斑狼疮的易感性研究

应用ＰＣＲ－ＲＦＬＰ核苷酸分型方法，探讨了我国南方浙江沪汉族人群ＨＬＡ－ＤＱＢ１基因多态性与系统红斑狼疮（ＳＬＥ）的遗传关联性，对４８例ＳＬＥ患者的血样分析表明，ＳＬＥ患者具有显著高的ＤＱＢ１＊０６０１等位基因频率（３０．２１％，ＲＲ＝２．８９１９，Ｐｃａｒｒ＝０．０１１２，ＥＦ＝０．２０），ＤＱＢ１＊０６０１可能是一易感基因，而ＤＱＢ１＊０３０１（２．０８％，ＲＲ＝０．１１０８，Ｐｃｏｒｒ＝０，     

CHEMOTHERAPY—ONE OF THE CAUSES OF TRANSIENT LOSS OF HLA ANTIGENS AND LYMPHOCYTE POLYREACTIVITY IN PATIENTS WITH BLOOD DISEASES AND MALIGNANCIES

Modifications of HLA antigens (transient loss or polyreactivity) were found in thirty-two of fifty-five examined patients with blood diseases (leukaemia, reticulosis, reticulo- and lymphosarcoma, lymphogranuloma, erythroblastoma) and malignant tumours. In two cases of acute myelosis transient alteration of HLA-A 2 antigen in HLA-A 28 was demonstrated. The relationship of HLA antigenic modification to chemotherapy was established, both by analysis of individual cases and by statistical evaluation of serological results in patients with or without chemotherapy (0.01 < P < 0.001). Chemotherapy is thus one of the causes for the development of HLA antigen modifications in blood diseases and malignant tumours.     

糖尿病患者血清PIH、CT水平的变化

目的:了解糖尿病患者血清甲状旁腺素(PTH)、降钙素(CT)的变化。方法:应用RLA法测定了71例糖尿病患者血清甲状旁腺素和降钙素含量,并与35名健康人作对照。结果:并发糖尿病肾病者血清PTH、CT均升高(p<0.01),并随糖尿病肾病的严重程度而增加,且与肌酐浓度呈正相关(p<0.001)。结论:糖尿病患者一旦发生糖尿病肾病,就存在血清PTH、CT含量的异常。     

NPY与NT在血液透析中的变化及其意义

采用放射免疫分析法检测３０例维持性血液透析（ＨＤ）患者ＨＤ过程中血浆ＮＰＹ与ＮＴ的含量，并以３０例正常人作为对照。结果显示：ＨＤ患者血浆ＮＰＹ与ＮＴ水平均显著增高（Ｐ〈０．０１）。与ＨＤ前比较，ＨＤ后ＮＰＹ水平明显下降（Ｐ〈０．０１）。ＮＴ水平则明显增高（Ｐ〈０．０１）。于ＨＤ １ｈ测得动脉血浆ＮＰＹ水平明显高于静脉血（Ｐ〈０．０１）。１９例ＨＤ高血压病人ＮＰＹ与ＮＴ水平均显著高于非高血压组（Ｐ〉     

AECA AND ANCA IN PATIENTS WITH PREMATURE ATHEROSCLEROSIS

Autoimmunity is suggested to play a pathogenetic role in premature atherosclerosis. Since atherosclerosis and vasculitis seem pathogenetically related, we hypothesized that ANCA, an important antibody in vasculitis, plays a role in atherosclerosis as well. We therefore investigated the prevalence of ANCA in patients with premature atherosclerosis and related the presence of these antibodies to levels of AECA and markers of inflammation. Methods & Results: In a cohort of 286 patients with premature atherosclerosis the prevalence of ANCA was 5.6% (16/286). All had perinuclear ANCA. More females were ANCA-positive (8M/8F vs. 200M/70F, p=0.03). In a nested case-control study, comparing the 16 ANCA-positive patients with 32 controls, levels of AECA were higher in the first (7.32±0.91U vs. 5.52±0.41U, p<0.05). Conclusion: ANCA does not seem to play a major role in premature atherosclerosis. Whether elevated levels of AECA in ANCA-positive patients with premature atherosclerosis reflect more extended vascular disease remains to be determined.     

HLA DR AND DQ RFLP ANALYSIS IN CROHN'S DISEASE

A study of 109 Swedish patients and 85 healthy Swedish controls with Crohn's disease (CD) by HLA class II RFLP genotyping was carried out. There was no significant association for any single DR or DQ specificity or phenotypic combination of DR and/or DO specificities among our study group of Caucasian extraction.     

ANTI-TISSUE ANTIBODIES AND IMMUNOGLOBULIN LEVELS IN RELATION TO HLA AND OTHER MARKERS IN ICELANDIC FAMILIES

Studies of 521 sera from the Icelandic cousin marriage project were made to assess the incidence of various anti-tissue antibodies and the levels of immunoglobulins, as these were considered to be useful markers of the humoral immune response. Comparisons were made between these parameters and the HLA-A and B antigens, the blood groups, the immunoglobulin allotypes (Gm, Km and Am), the properdin factor (Bf), and other markers. These investigations offered another approach to the study of the sites of action of immune response genes in man. Because the immune response may be expected to differ for each individual and depend at least in part, on the degree of exposure to different antigens, no absolute correlation was expected. There was, however, a marked association between certain IgG anti-tissue antibodies and HLA antigens. This was most marked for HLA-A10, B18 and B27, but not for HLA-A1 or B8. The comparison of immunoglobulin levels with HLA antigens, was less striking, although HLA-A2 appeared to be associated with low levels of IgE. There were also some associations between immunoglobulin levels and ABO blood groups.     

黄芪对维持性血液透析病人细胞免疫功能的影响

２１例维持性血液透析病人，在透析治疗的同时，加用黄芪注射液治疗，３个月后患者的免疫功能获得明显改善。与正常人相比，ＭＨＤ患者外周血ＣＤ８５细胞，血清ｓｉＬ－２Ｒ水平，血清ＴＮＦ含量均明显升高；而外周血中ＣＤ４／ＣＤ８比值和淋巴细胞ｍＩＬ－２Ｒ阳性细胞数明显下降，显示ＭＨＤ患者的细胞免疫功能降低。     

婴儿痉挛症的临床与脑电图分析

本文报告了65例临床有典型发作的婴儿痉挛症患儿的临床与EEG资料分析结果,发作年龄多为生后3个月—8个月;早产,难产,出生前后窒息等因素为主要原因之一;发作形式以点头或鞠躬样屈曲样痉挛为主(62％);发育迟缓或智力低下占多数(85％);EEG检查高度失律者占多数(57％);婴儿痉挛症EEG不一定呈现高度失律,高度失律EEG多半是婴儿痉挛症。     

儿童抽动障碍的临床与脑电图分析

目的:探讨抽动障碍(TD)患儿的临床及脑电图(EEG)特征。方法:对70例TD患儿的临床及EEG资料进行比较和回顾性分析。结果:70例TD患儿中EEG正常63例(90%),异常7例(10%)。其中4例表现为典型的癫癎样放电,另3例表现为阵发高幅θ节律。结论:本组病例EEG的异常率与患儿的发病性别、病程、分娩方式存在一定的对应关系,EEG可作为评估病情严重程度的客观依据。     

CONTRAST STUDY ON CT AND BA IN 3000 PATIENTS

Brain atlas(BA)is an important diagnostictechnique after CT and MRI·By clinical experi-ence,there were some advantages in BA·BA cansupplement shortage of CT·But there was also someshortages in BA·The contrast study between CTandBA in3000patients was reported as follows now:Data and MethodGeneral data:In3000patients,male was1490cases(49·7%),female was1510cases(50·3%)·Largest age was82years old·Smallest age was3days·Clinical disease examined:Acute cerebrovascu-lar diseases we…     

癌症患者的血液流变性改变及其意义

观察２７例癌症患者的血液流变学指标，血浆粘度、红细胞聚集指数、血沉及纤维蛋白原含量升高，与正常对照组相比具显著性差异（ｐ＜０．０１）。探讨了癌症患者血液流变学改变及其意义，为抗凝治疗提供了依据。