β-fibrinogen gene -455A/Gpolymorphism and plasma fibrinogen level in Chinese stroke patients

目的　初步探讨β 纤维蛋白原基因启动子区 4 5 5A/G多态性和血浆纤维蛋白原水平的关系以及在缺血性脑血管病中的意义。方法　 91例脑梗死患者 (6 3 5± 10 1岁 )、74例无血栓老年对照组 (6 0 6± 10 8岁 )和 98例年轻对照组 (健康献血员 ) (37 5± 13 3岁 )。PCR RFLP (HaeⅢ )法分析 β 纤维蛋白原基因启动子区 4 5 5A/G多态性 ;血浆纤维蛋白原水平测定使用PT时间法。计量资料间比较使用t检验 ,由于纤维蛋白原浓度呈非正态分布 ,故检验前作对数转化 ;计数资料使用卡方检验。结果　H2等位基因频率在男性脑梗死组明显较老年对照组高 (2 2 7%和 7 1%,χ2 =5 5 6 ,P <0 0 2 ) ,在女性组中无统计学差异 ;在无血栓的所有人群中 (包括老年对照组和年轻对照组 ) ,H2等位基因频率随年龄增长的分布频率是 :≤ 4 0岁 ,2 1 3%;4 1- 5 9岁 ,15 4 %;≥ 6 0岁 ,10 2 %;男性老年和年轻对照组中 ,H1H1基因型人群血浆纤维蛋白原水平 (2 87± 96和 2 34± 5 8mg/dl)明显较H1H2 H2H2型 (331± 4 4和 30 7± 5 5mg/dl;t =2 5 3和 9 6 7,P <0 0 5 )低。在女性对照组中尚未发现同样现象。结论　男性人群血浆纤维蛋白原水平受β 纤维蛋白原基因启动子区 4 5 5A/G多态性的影响 ,H2等位基因可能     

高血压患者凝血、纤溶活性变化及硝苯地平缓释剂对它的影响

OBJECTIVE: To investigate the changes of coagulation and fibrinolysis status in patients with essential hypertension (EH) and observe the therapeutic effect of sustained-release nifedipine. METHODS: Ninety-nine EH patients were divided according to their diastolic blood pressure (DBP) into mild group (48 cases), moderate group (29 cases) and severe group (22 cases), and 25 patients among the groups were chosen at random to receive sustained-release nifedipine for 2 weeks. Twenty healthy subjects served as control group. Plasma D-dimer (DD), fibrin monomer (FM) and tissue-type plasminogen activator (tPA) levels were determined in all the subjects by enzyme-linked immunosorbent assay (ELISA). RESULTS: The plasma DD and FM levels were much higher, while tPA level was much lower in hypertensives than those of normal controls, exacerbating with the severity of the disease. DBP was positively correlated with plasma FM level (r=0.374,P<0.001). In patients with left ventricular hypertrophy, left ventricular enlargement and left atrial enlargement, higher levels of DD, FM and tPA were detected. Nifedipine treatment produced significant reduction in plasma DD and FM levels along with the increase in tPA level [DD: (40.7+/-23.5) mg/dl vs (23.8+/-16.5) mg/dl; FM: (7.0+/-1.6) ng/microliter vs (4.8+/-1.5) ng/microliter tPA: (0.31+/-0.14) ng/ml vs(0.41+/-0.05) ng/ml, P<0.001]. CONCLUSION: Enhanced coagulative activity and lowered fibrinolytic activity characterize EH patients and nifedipine may correct this disorder.     

Low-grade inflammation in white-coat hypertension.

BACKGROUND: C-reactive protein (CRP), a marker of systemic low-grade inflammation, is frequently elevated in essential hypertension and predicts cardiovascular prognosis independently of conventional risk factors. The risk profile of white-coat hypertension is not yet completely clear. The aim of this study was to determine the levels of high-sensitivity CRP (hs-CRP) in white-coat hypertensive subjects. MATERIAL/METHODS: Thirty-six age-, sex-, and body mass index-matched white-coat hypertensive subjects, 36 essential hypertensive patients, and 36 normotensive subjects were included in the study. RESULTS: Hs-CRP levels were significantly higher in the essential hypertensive and white-coat hypertensive groups than in the normotensive group (0.66+/-0.29, 0.47+/-0.32, and 0.27+/-0.22 mg/dl, respectively, p<0.001). It was also higher in the essential hypertensive group than in the white-coat hypertensive group (p=0.014). CONCLUSIONS: Our data show that patients with white-coat hypertension have higher hs-CRP levels than normotensive patients and this may be an indication of increased risk.     

The effect of foods containing refined Konjac meal on human lipid metabolism

A total of 110 elderly people with hyperlipidemia were randomly assigned to one of two groups. The experimental group consumed an ordinary diet plus foods containing refined Konjac meal, and the control group consumed only the ordinary diet. The experiment was carried out for 45 days. The results indicate that for the experimental group blood levels of triglycerides (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) were significantly lowered (P less than 0.01) at the end of the trial, whereas high-density lipoprotein cholesterol (HDL-C) and apoprotein (AI) levels were significantly elevated (P less than 0.01). In contrast, for the control group, the changes in the above parameters were insignificant. The differences in TC, TG, LDL-C, and HDL-C levels between the two groups were statistically significant. The effects of refined Konjac meal on lipid levels in the blood were somewhat different between patients with hyperlipidemia and subjects with risk critical values only. For the former, TG and TC were decreased by 83.8 +/- 133.5 mg/dl, and 42.4 +/- 23.4 mg/dl, respectively; but for the latter, they are decreased only by -1.1 +/- 23.1 mg/dl and 8.3 +/- 18.2 mg/dl, respectively; the difference mentioned above is statistically significant (P less than 0.01).     

影响健康人血浆D-二聚体的因素

目的 研究影响健康人群血浆D-二聚体增高的因素.方法 选择健康体检者164例,按年龄将D-二聚体分为:≤49岁、50-59岁、60-69岁和≥70岁四组;按D-二聚体参考值上限232ng/ml,将D-二聚体分为三组:低值组(＜100ng/ml)、中值组(100-232ng/ml)和高值组(＞232ng/ml).实验室方法用乳胶增强免疫比浊法检测血浆D-二聚体含量.结果 各年龄组D-二聚体水平有统计学差异(P＜0.01),LogD -二聚体与年龄呈正相关(r=0.38,P＜0.05),回归方程为LogD -二聚体=1.38+0.01×年龄.二分类Logistic回归分析结果,年龄、纤维蛋白原、平均红细胞体积是D-二聚体的独立相关因素.结论 影响健康人血浆D-二聚体水平的因素是年龄、纤维蛋白原水平和平均红细胞体积.     

Serum immunoglobulins in leukaemia and malignant lymphoma

The serum immunoglobulin levels were studied in 25 healthy control subjects and 23 cases of leukaemia (6 cases of acute lymphatic leukaemia, 5 cases of acute myeloid leukaemia, 2 cases of chronic lymphatic leukaemia and 10 cases of chronic myeloid leukaemia) and 17 cases of malignant lymphoma (13 cases of Hodgkin's lymphoma and 4 cases of non-Hodgkin lymphoma). The mean levels of IgG, IgA and IgM in 25 control subjects were 1573.56 +/- 91.45 mg/dl, 209.64 +/- 12.55 mg/dl and 109.81 +/- 10.03 mg/dl respectively, those in 23 cases of leukaemia were 1338.23 +/- 109.74 mg/dl, 195.53 +/- 20.72 mg/dl and 127.47 +/- 13.29 mg/dl respectively and those in 17 cases of malignant lymphoma were 996.99 +/- 99.50 mg/dl, 147.47 +/- 19.61 mg/dl and 129.35 +/- 19.95 mg/dl respectively. The mean levels of IgG and IgA were found to be decreased in cases of leukaemia with elevated levels of IgM, however, it was found to be insignificant (p less than 0.4). The mean IgG, IgA and IgM levels were found to be almost identical in different leukaemia irrespective of cytological types except in 2 cases of chronic lymphatic leukaemia which showed low levels of IgG and IgA. The mean levels of IgG and IgA were found to be significantly decreased in malignant lymphoma (p less than 0.02). IgM levels were found to be increased in 3 cases of non-Hodgkin lymphoma.     

THE RELATIONSHIP BETWEEN SERUM LIPID LEVELS AND NUTRIENT INTAKE IN HEALTHY INHABITANTS OF URBAN AND RURAL SHANGHAI

The serum lipid levels (mean +/- SD) of 3312 healthy urban and rural inhabitants over 40 years of age in Shanghai were studied. The results were: cholesterol 166.7 +/- 30.9 mg/ml, triglyceride 81.1 +/- 42.3 mg/dl, HDL-cholesterol (HDLc) 57.4 +/- 11.6 mg/dl, HDL2c 20.6 +/- 9.8 mg/dl and HDL3c 37.1 +/- 7.8 mg/dl. Dietary surveys were carried out in 512 of these subjects and their average daily nutrient intake was estimated to be: total calories 2,577 Kcal, proteins 656 g (50.7 g of vegetable proteins), fat 69.1 g (P/S ratio 0.70), carbohydrates 423 g, cholesterol 282 mg, dietary fibres 23.5 g, sodium 4993 mg, potassium 2,618 mg and magnesium 575 mg. The serum lipid levels of urban and rural inhabitants were compared. Total cholesterol levels were significantly higher in urban inhabitants of all age groups and of both sexes, while triglyceride levels were significantly higher in urban inhabitants of certain age groups. However, HDLc levels, particularly HDL2c levels were significantly higher in rural inhabitants of most age groups and of both sexes. The above differences were probably the result of differences in dietary patterns and nutrient intake between urban and rural inhabitants.     

Plasma CRP, apolipoprotein A-1, apolipoprotein B and Lpa levels according to thyroid function status

BACKGROUND: Altered lipid profile is a well-known manifestation of thyroid dysfunction. Recently, serum Lp(a) and C-reactive protein (CRP) have emerged as new cardiovascular risk factors, but studies on changes of these markers with respect to thyroid function status have produced variable results. To better understand the effects of thyroid dysfunction on the development of atherosclerosis, we investigated plasma CRP and lipid profiles such as apoA1, apoB, and Lp(a) in cases with differing severities of thyroid dysfunction. METHODS: Fifty four patients with hyperthyroidism, 35 patients with subclinical hyperthyroidism, 33 patients with overt hypothyroidism, 190 patients with subclinical hypothyroidism and 100 age- and sex-matched healthy control subjects were evaluated. Serum high sensitivity (hs)-CRP and Lp(a) were measured by immunonephelometry. RESULTS: No significant differences were found in serum hs-CRP, Lp(a), HDL-C or ApoA1 in different thyroid function groups. Serum total cholesterol and LDL-C levels were significantly lower in cases of hyperthyroidism than in cases of overt hypothyroidism, subclinical hypothyroidism or subclinical hyperthyroidism, or in healthy control subjects (p <0.01). Serum triglyceride levels were higher in overt hypothyroidism than in hyperthyroidism or healthy controls (p <0.05). Serum apoB levels were significantly lower in hyperthyroidism than in overt hypothyroidism, subclinical hypothyroidism or in healthy control subjects (p <0.01). These differences were consistently significant after adjustment for age and BMI. CONCLUSIONS: Serum CRP and Lp(a) levels, risk factors for atherosclerosis, were not found to be significantly affected by the degree of thyroid dysfunction. Increased risk of atherosclerosis in hypothyroidism does not appear to be associated with non-traditional cardiovascular risk factors, such as serum CRP, Lp(a) or apoA1 levels.     

Correlation between coagulation function, tumor stage and metastasis in patients with renal cell carcinoma: a retrospective study

Background  The coagulation function in carcinoma patients is abnormal, but in renal cell carcinoma the extent and relationships of coagulation function remain unclear. This study retrospectively investigated the relationships between coagulation function, clinical stage and metastasis in patients with renal cell carcinoma.

Methods  A total of 350 consecutive patients admitted to our Urology Department from 2004 to 2010 were diagnosed with renal cell carcinoma by histolopathologic examination and were included in this study. A total of 231 cases of renal benign tumors were considered as the control group. Fibrinogen, prothrombin time, activated partial thromboplastin time and international normalized ratio were evaluated in all subjects. Tumor size, clinical stage, lymph node metastasis, and distant metastasis were evaluated using radiologic imaging, intraoperative findings, and histological studies.

Results  The preoperative plasma fibrinogen levels of patients with renal cell carcinoma ((383.9±146.7) mg/dl) were significantly higher than those of the control group ((316.7±62.0) mg/dl) (P <0.01). We divided the renal cell carcinoma group into stages Ia, Ib, II, III, and IV. The fibrinogen values were (315.6±64.6) mg/dl, (358.3±91.1) mg/dl, (465.6±164.7) mg/dl, (500.0±202.1) mg/dl, and (585.8±179.7) mg/dl, respectively. There were no significant differences in fibrinogen values between stage Ia and control groups. However, results of other stages showed significant differences when compared to control group values (P <0.01). Using the cutoff value of 440 mg/dl, which defines hyperfibrinogenemia, plasma fibrinogen levels had a positive predictive value of 39.8% and a negative predictive value of 93.3% for predicting distant metastasis, with a sensitivity of 64.7% and specificity of 83.3%.

Conclusions  Preoperative plasma fibrinogen levels are elevated in patients with renal cell carcinoma with distant metastasis or lymph node metastasis. Potential metastasis is more likely if the tumor size larger than 4 cm. Increased preoperative plasma fibrinogen levels, especially hyperfibrinogenemia, may be an indicator of metastasis.

     

依那普利对血压正常的非ST段抬高型心肌梗死患者血浆纤维蛋白原D-二聚体的影响

目的：探讨依那普利对血压正常的非ST段抬高型心肌梗死患者血浆纤维蛋白原（FIB）、D-二聚体的影响。方法：选择血压正常的非ST段抬高型心肌梗死患者89例,按随机单盲的原则分为常规治疗组（44例）和依那普利组（45例）：常规治疗组予以抗凝、抗栓等药物治疗;依那普利组在常规治疗的基础上加用依那普利5mg/d口服。两组在治疗前和治疗后第1周、2周、4周、6周分别进行血浆FIB、D-二聚体的测定。结果：治疗后依那普利组FIB、D-二聚体水平在第1周、2周时分别为（8.47±0.87）g/L、（0.95±0.11）mg/L;（7.98±0.89）g/L、（0.92±0.11）mg/L。常规治疗组FIB、D-二聚体水平在第1周、2周时分别为（8.45±0.89）g/L、（0.93±0.11）mg/L;（8.26±0.89）g/L、（0.89±0.11）mg/L。两组比较差异无统计学意义（P〉0.05）。至第4周时,依那普利组FIB、D-二聚体水平分别为（6.55±0.98）g/L、（0.76±0.08）mg/L,明显低于常规治疗组（7.20±0.79）g/L、（0.85±0.11）mg/L,差异具有统计学意义（P〈0.01）。结论：依那普利具有降低心肌梗死患者血浆FIB、D-二聚体的作用,其机理可能与改善心肌梗死后凝血-纤溶系统功能有关。     

Homocysteinemia in hypertensive patients with renal target organ damage (mild renal dysfunction)

The prevalence of high plasmatic levels of homocysteine in hypertensive patients with mild renal dysfunction (MRD) defined by 2003 European Hypertension Society Guidelines (men plasmatic creatinine between 1.3 and 1.5; women plasmatic creatinine between 1.2 and 1.4 mg/dl) has not been previously reported. To evaluate this item 18 MRD patients were recruited (54% males, mean age 59.2 +/- 17.3 years, mean plasmatic creatinine 1.30 +/- 0.12 mg/dl). They were compared with a control group of hypertensives with normal renal function (n = 87, 42,9% males, mean age 53.6 +/- 12.3 years, mean plasmatic creatinine 0.83 +/- 0.21 mg/dl) and a group of 29 chronic renal failure patients (51.7% males, mean age 56.9 +/- 15.0 years, mean plasmatic creatinine 2.39 +/- 0.95 mg/dl). Age and sex differences are not significant, plasmatic creatinine levels are different among three groups (p <0.001, t student test). Basal homocysteine levels of CRF (19.3 +/- 7.1 micromol/l) were higher than those of control group (11,0 +/- 4,3 micromol/l) and MRD patients (14.8 +/- 5.5 micromol/l; p = 0.027 vs. CRF and p = 0.007 vs. control, Mann-Whitney test). Mean creatinine clearance was 30.3 +/- 11.5 ml/min for CRF group, significantly lower than MRD patients creatinine clearance (54.5 +/- 9.4 ml/min, p <0.001, t student test) and control ones (88,9 +/- 18,9 ml/min, p <0.001, t student test). Hypertensive patients with mild renal dysfunction showed higher and pathological levels of homocysteinemia as compared with controls, this finding might be related to the higher cardiovascular risk described in this group of patients.     

β-FIBRINOGEN PROMOTER-455 G／A （HaeⅢ） POLYMORPHISM PREDICTION OF PLASMA FIBRINOGEN BUT NOT OF ISCHEMIC CEREBROVASCULAR DISEASE

Objective The-455 G/A (HaeⅢ) polymorphism of β-fibrinogen gene influences levels of plasma fibrinogen. We further investigated whether it influences the risk of isehemie cerebrovaseular disease. Methods We accumulated 134 acute isehemic eerebrovaseular disease (ICVD) eases and compared their -455 G/A status with a control group (n=166). The β-fibrinogen gene -455 G/A polymorphism was analyzed for all subjects by PCR-RFLP with the restrictive enzyme HaeⅢ. Results Plasma fibrinogen was higher in AA homozygous participants (341mg/dL) than in participants carrying the G allele: GA (290mg/dL), GG (298mg/dL) in the control group. Plasma fibrinogen was also higher in AA homozygous patients (353mg/dL) than in eases carrying the G allele: GA (287mg/dL), GG (302mg/dL) in the ICVD group. However, there was no significant association between β-fibrinogen gene -455 G/A polymorphism and ICVD group. Conclusions Although a small effect cannot be excluded, β-fibrinogen gene -455 G/A polymorphism is an independent predictor of plasma fibrinogen, but not of isehemie cerebrovaacular disease.     

Relationship between iron deficiency anaemia and serum lipid levels in Indian adults

Both iron deficiency anaemia and dyslipidaemia are widely prevalent public health problems, especially in the Indian population. Some link has been suggested between the two potentially morbid conditions but a sufficient Indian study could not be found in this regard. This study was planned to find the changes in serum lipid profile in adult Indian patients with iron deficiency anaemia and the effect of oral iron therapy on them. Seventy patients with iron deficiency anaemia and 70 age and sex matched healthy controls, in the age group of 18-35 years were investigated for any possible changes in serum lipid profile ie, triglycerides, total cholesterol, high density lipoprotein cholesterol, very low density lipoprotein cholesterol and low density lipoprotein cholesterol. The patients were followed up after 3 months of oral iron therapy. The results are shown as mean +/- standard deviation. Triglycerides and very low density lipoprotein cholesterol levels were found to be significantly (p < 0.001) elevated in the iron deficiency anaemia group (151.87 +/- 48.06 mg/dl and 30.40 +/- 9.71 mg/dl) as compared to controls (109.99 +/- 30.81 mg/dl and 21.96 +/- 6.69 mg/dl), whereas levels of low density lipoprotein cholesterol were found to be significantly (p = 0.02) lower in patients (90.96 +/- 41.55 mg/dl) as compared to controls (105.24 +/- 26.45 mg/dl). However, after treatment (in 43 patients) there was significant (p < 0.001) reduction in the levels of triglycerides and very low density lipoprotein cholesterol (111.56 +/- 26.87 mg/dl and 22.30 +/- 5.36 mg/dl) when compared to their pretreatment levels (154.70 +/- 53.89 mg/dl and 30.93 +/- 10.84 mg/dl), whereas low density lipoprotein cholesterol levels did not show any significant change. These findings indicate that iron deficiency anaemia in Indian adults is attended by abnormal serum lipid profile, which responds significantly to iron therapy.     

围手术期肠外营养支持对不同营养状态Crohn病患者免疫球蛋白、体重以及与感染有关并发症的影响

目的探讨围手术期肠外营养支持对不同营养状态Crohn病患者的免疫球蛋白、体重和并发症的影响.方法将在本院确诊、计划手术治疗的32例Crohn病患者按术前有无营养不良分组,体重下降在15%～30%者为营养不良组,共16例;体重下降＜15%者为对照组,共16例.两组患者均在手术前1周和手术后3周应用肠外营养(PN)支持(共4周);于PN前后测定血清中IgM、IgG和IgA水平、肝功及体重变化.监测术后并发症.结果两组患者的IgM水平于PN前均高于正常值[对照组(133±16)mg/dl,营养不良组(139±41)mg/dl;正常值(110±35)mg/dl;P=0.04];PN治疗后营养不良组患者明显下降[(105±29)mg/dl,P=0.02)],达到正常水平,对照组无明显变化[(129±13)mg/dl,P=0.34].两组患者的IgA和IgG水平于PN前在正常范围,PN后无明显变化(P值在0.20～0.57之间).体重对照组PN前后无明显变化[PN前(55.6±6.1)kg,PN后(56.3±6.0)kg;P=0.46],营养不良组较PN前升高[(PN前(45.8±8.9)kg,PN后(48.0±8.8)kg;P=0.005)].对照组患者与感染有关性并发症较营养不良组多(对照组4例,25%;营养不良组2例,12.5%;P=0.13),但无统计学差别.结论围手术期应用肠外营养支持,能改善有明显营养不良Crohn病患者的体液免疫状态,增加体重;而无明显营养不良的患者获益较少.     

急性心肌梗死患者D二聚体质量浓度与远期预后的关系

目的 探讨急性心肌梗死(acute myocardial infarction,AMI)患者D二聚体(D-dimer)质量浓度与病情严重程度和远期心源性死亡的关系。方法 选取2013年1月至2020年1月收入首都医科大学附属北京友谊医院的AMI患者3 990例,根据D-dimer质量浓度分为3组:≤0.50 mg/L、0.51～0.80 mg/L、≥0.81 mg/L,平均随访时间为2.1 (1.0～4.0) 年。应用Cox比例风险回归模型评估D-dimer对心源性死亡的影响。结果 D-dimer≥0.81 mg/L组患者年龄较大、女性居多、体质量指数较低,既往合并高血压、糖尿病者较多,3支病变较为多见,住院期间肾小球滤过率较低,N末端B型利钠肽原峰值明显升高,左室射血分数<50%患者比例明显升高。D-dimer≥0.81 mg/L组患者在随访期间累计心源性病死率(18.7%)高于D-dimer≤0.50 mg/L组(2.3%)和D-dimer 0.51～0.80 mg/L组(6.1%),且校正其他危险因素后,D-dimer能独立预测AMI患者的心源性死亡(HR=1.71,95%CI:1.34~2.18,P<0.001)。结论 D-dimer能反映AMI患者病情的严重程度,且D-dimer升高可在一定程度上预测AMI患者远期心源性死亡事件发生率升高。     

D-二聚体、纤维蛋白原在类风湿性关节炎患者外周血中的含量测定

目的通过检测D-二聚体、纤维蛋白原在类风湿性关节炎（RA）中含量的变化,同时测定超敏C反应蛋白、红细胞沉降率及类风湿因子等指标,判断D-二聚体、纤维蛋白原与病情活动度的关系,以指导临床治疗。方法RA组50例、健康对照组30例、骨关节炎组30例,分别测定3组上述指标的变化,采用X2检验、各组之间进行LSD-t检验、直线相关统计学分析。结果RA组中D-二聚体、纤维蛋白原、超敏C反应蛋白、红细胞沉降率及类风湿因子水平均明显升高,RA治疗前后相比D-二聚体、纤维蛋白原、超敏C反应蛋白变化明显,而红细胞沉降率及类风湿因子水平变化不明显,提示D-二聚体、纤维蛋白原、超敏C反应蛋白对RA病情活动度的判断上更为敏感,且D-二聚体、纤维蛋白原均与超敏C反应蛋白、红细胞沉降率呈正相关,与类风湿性因子无相关性。结论RA患者中D-二聚体、纤维蛋白原水平升高,可与超敏C反应蛋白、红细胞沉降率等指标一起判断疾病活动度,上述指标联合检测有助于与其他类型关节炎相鉴别,同时为RA患者进行改善微循环治疗提供有力依据。     

Depression, anxiety, health-related quality of life, and disability in patients with overt and subclinical thyroid dysfunction

BACKGROUND: Thyroid dysfunction may impair the quality of life (QoL) and may cause psychological symptoms. The aim of this study is to investigate prospectively the effects of thyroid dysfunction on quality of life, levels of depression/anxiety and the changes in these variables after treatment. METHODS: A total of 160 subjects, consisting of an overt hypothyroidism group (n = 33), a subclinical hypothyroidism group (n = 43), an overt hyperthyroidism group (n = 51), a subclinical hyperthyroidism group (n = 13), and a healthy control group (n = 20) were included in the study. All groups were evaluated with the Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Short Form-36 (SF-36), and Brief Disability Questionnaire (BDQ). Health-related quality of life (HRQL) was measured by SF-36. RESULTS: Anxiety and depressive symptoms were more severe in patients with overt hypo- and hyperthyroidism (p <0.001). The QoL was worse in overt or subclinical hyper- and hypothyroidism groups than in the control group [p = 0.013 for physical composite score (PCS); p = 0.002 for mental composite score (MCS)]. Psychological symptoms and QoL were improved in overt and subclinical hypothyroidism and overt hyperthyroidism groups as a result of the treatment. The overt hyper- and hypothyroidism groups showed more improvement than the subclinical groups. CONCLUSIONS: This study suggests that restoration of euthyroidism is accompanied by improvement on QoL and psychological symptoms in all groups except the subclinical hyperthyroidism group. Controlled, randomized studies in larger groups are, however, necessary.     

支气管哮喘儿童纤维蛋白原、单体聚合功能及D-二聚体变化对照研究

目的:研究哮喘儿童血浆纤维蛋白原、单体聚合功能和D-二聚体水平变化,为儿童哮喘临床诊治提供指导。方法:选择2007～2010年三年间本院儿科住院病例及儿童保健门诊健康查体儿童.分为哮喘组82例、支气管肺炎组80例、正常对照组80例采用微机辅助血浆Fg活性自动测定系统,检测三组儿童血浆纤维蛋白原水平、单体聚合功能变化及D-二聚体水平,并对三组指标进行比较。结果:哮喘组患儿血浆Fg、FMPV、ODmax、FMPV/ODmax及D-D水平明显高于肺炎组(P<0.01);哮喘组患儿血浆Fg、FMPV、ODmax、FMPV/ODmax及D-D水平明显高于对照组(P<0.01);肺炎组患儿与对照组患儿比较血浆Fg、FMPV、ODmax、FMPV/ODmax及D-D水平增高,但均无统计学意义(P>0.05)。结论:哮喘儿童血浆纤维蛋白原、单体聚合功能和D-二聚体水平升高,存在高凝状态。     

急性脑梗死患者同型半胱氨酸及凝血纤溶相关指标的检测及意义

目的：探讨同型半胱氨酸（Hcy）、凝血及纤溶指标对判断急性脑梗死疾病的进展与预后的意义.方法：收集45例急性脑梗死患者（急性脑梗死组）和30例健康体检者（对照组）外周血,检测血浆中Hcy、纤维蛋白原、D-二聚体和纤溶酶原的含量,采用美国国立卫生研究院卒中量表（NIHSS）评分、改良Rankin量表（mRS）评分对急性脑梗死患者疾病的进展及预后进行评估和分组,观察不同预后与不同进展各组患者血浆Hcy、纤维蛋白原、D-二聚体和纤溶酶原的含量变化.结果：急性脑梗死组患者血浆Hcy、纤维蛋白原、D-二聚体含量高于对照组,差异有统计学意义（P＜0.01）;急性脑梗死组患者血浆中纤溶酶原的含量低于对照组,差异有统计学意义（P＜0.01）;与急性脑梗死疾病进展组相比,非进展组患者的Hcy、纤维蛋白原及D-二聚体含量较低,纤溶酶原含量较高,差异有统计学意义（P＜0.05）;急性脑梗死患者预后良好组与不良组的Hcy、纤维蛋白原及纤溶酶原的差异无统计学意义（P＞0.05）,预后良好组D-二聚体含量较预后不良组明显降低,差异有统计学意义（P＜0.05）.结论：检测Hcy及凝血纤溶相关指标的含量可有效判断急性脑梗死患者病情、预后和进展,D-二聚体含量与患者的预后相关.     

严重急性呼吸综合征后骨坏死的血液学改变及相关基因检测

目的探讨严重急性呼吸综合征(SARS)后骨坏死的病因学,以便用于非创伤性骨坏死的早期诊断和易感人群的筛选。方法取61例SARS后骨坏死患者空腹肘静脉血。另取健康人群52名为对照,应用酶联免疫吸附法等试验定凝血、纤溶指标,应用实时聚合酶链反应(PCR)仪测定因子V G1691A(FV Le iden)变、凝血酶原G20210A突变。结果SARS后骨坏死患者血液学因素改变明显,其中蛋白C(PC)、活化蛋白C抵抗(APC-R)、抗凝血酶Ⅲ(AT-Ⅲ)、纤溶酶原激活抑制物(PAI)、纤溶酶原(PLG)。两组比较,差异有统计学意义(109%±20%vs 85%±34%、8.0 U/m l±4.3U/m l、16 U/m l±14 U/m l、197 s±46 s vs 192 s±63 s、104%±14%vs 84%±29%、94%±15%vs69μ/m l±23μ/m l,P<0.01)。骨坏死组和对照组均未发现因子V Le iden突变和凝血酶原G20210A的突变。结论SARS后骨坏死患者存在高凝低纤溶倾向,对骨坏死易感人群可以进行高凝和低纤溶指标的筛选,PC、AT-Ⅲ、PAI、APC-R、PLG可作为骨坏死易感因素的筛选指标。SARS后骨坏死与因子V Le iden和凝血酶原G20210A突变无关。