小儿肺炎血渗透压改变与合理输液的临床研究

目的：观察支气管肺炎血渗透压改变,确定有无并发抗利尿激素异常分泌综合征(SIADH),并根据其变化进行合理的液体疗法。方法：采静脉血作电解质、血糖、尿素氮等测定,以公式计算出血渗透压。根据血渗透压的高低确定输液量和张力。结果：200例患儿中重症肺炎32例,病程极期有14例发生抗利尿激素异常分泌综合征(43.8%),普通肺炎中8例血渗透压降低(4.8%)。均采用适当限制入量、提高液体张力而获治愈。结论：支气管肺炎极期常并发SIADH,应合理调整输液成分和液量。     

Characteristics of active sodium and potassium transport in erythrocytes of healthy infants and children

Erythrocytes were analysed for adenosine triphosphatase (total and sodium-potassium activated) activities, concentrations of sodium and potassium ions and ATP in normal individuals from birth to adulthood age. A decrease of Na+, K+-ATPase activity and an increase of the sodium concentration was seen in infants aged 1-3 and 4-8 months. A decrease of Na+, K+-ATPase was seen during puberty. A correlation was seen between the Na+, K+-ATPase activity and the Na+-K+ ratio. Different influences which might lead to the observed changes in Na+, K+-ATPase activity and erythrocyte sodium concentration are discussed.     

Sodium and potassium concentrations in red blood cells and plasma in children with congenital heart defect

The sodium and potassium concentrations of the red blood cells and plasma were investigated in 93 children with cardiac disease, most of them with congenital heart defect, and in 48 healthy children of the same age. The red blood cell sodium and potassium concentrations were constant within a narrow range in normal subjects, but varied profoundly in pathological conditions. Digitalis treatment caused RBC Na+ and plasma K+ levels to increase and the RBC K+ level to decrease by blocking the Na+-K+ pump. The highest RBC Na+ concentration was observed in critically ill patients with congestive heart failure treated with digoxin. An augmented RBC sodium value was found in heart malformations with left to right shunt and in congestive cardiomyopathy that was not treated, whereas in patients with right to left shunt lower RBC sodium, higher RBC potassium and plasma potassium values were registered without any treatment. In cases of hyperkinetic circulation without any congenital heart defect the value of RBC sodium was definitely low. A low sodium and a high potassium level of the RBC were found after total correcting heart surgery. It is concluded that measurement of changes in sodium and potassium concentrations of the red blood cells is not a reliable method for assessment of the efficacy of digitalis treatment. The results point to the accompanying phenomena at a cellular level in heart disease.     

不同类型肺炎支原体肺炎儿童血浆凝血酶调节蛋白和D-二聚体的变化

目的：探讨不同类型肺炎支原体肺炎（MPP）儿童血浆凝血酶调节蛋白（TM）和D-二聚体（D-D）的变化及其在儿童MPP发病机制中的作用。方法：52例MPP患儿,其中表现为大叶性肺炎者30例作为大叶性肺炎组,表现为间质性肺炎者22例作为间质肺炎组;30例健康儿童作为对照组。分别采用酶联免疫吸附法、乳胶增强免疫比浊法测定血浆TM和D-D水平。结果：大叶性肺炎组、间质性肺炎组、对照组血浆TM水平（中位数）分别为23.83、15.56、8.78μg/L,3组比较差异有统计学意义（P<0.01）,其中大叶性肺炎组和间质性肺炎组血浆TM水平均明显高于对照组（P<0.01）,且大叶性肺炎组血浆TM水平高于间质性肺炎组（P<0.05）。大叶性肺炎组和间质性肺炎组血浆D-D水平（中位数）均明显高于参考值中位数（P<0.01）;大叶性肺炎组血浆D-D水平明显高于间质性肺炎组（0.35μg/mL vs 0.13 μg/mL, P<0.01）,且大叶性肺炎组血浆D-D升高比例明显高于间质性肺炎组（87% vs 59%,P<0.05）。结论：血浆TM 和D-D水平在MPP患儿中存在不同程度升高,表现为大叶性肺炎者升高更明显,提示血管内皮细胞损伤和血液高凝状态参与了MPP的发病机制。     

癫癎患儿丙戊酸钠治疗后体重指数和血浆甘丙肽的变化

No abstract available     

肺炎支原体肺炎患儿免疫功能变化及其临床意义的研究

目的观察肺炎支原体患儿免疫功能的变化。方法选择30例肺炎支原体患儿作为观察对象，同时选择30例健康小儿作为对照组，于病程5—7天采集外周血，分别检测CD23、IgG、IgA、IgM、CD3、CD4、CD8等免疫指标。结果肺炎支原体组小儿血清CD23、IgA均高于正常对照组（均P〈0．05），CD3低于正常对照组（P〈0．05），而CD4、CD8、CD4／CD8、IgG、IgM无明显变化（均P〉0．05）。结论肺炎支原体肺炎患儿B淋巴细胞活化增强，体液免疫功能亢进，细胞免疫功能抑制。