过敏性紫癜患儿血清可溶性血管细胞黏附分子-1及可溶性细胞间黏附分子-1表达的意义

目的 检测过敏性紫癜(HSP)患儿血清可溶性血管细胞黏附分子-1(sVCAM-1)及可溶性细胞间黏附分子-1(sICAM-1)表达,并探讨其临床意义.方法 酶联免疫吸附法(ELISA)测定53例HSP患儿(其中急性期37例,恢复期16例)及25例健康儿童血清sVCAM-1、sICAM-1水平,分别比较其急性期和恢复期及有或无肾损害HSP患儿上述因子表达水平.结果 HSP急性期患儿血清sVCAM-1和sICAM-1水平明显高于恢复期和健康对照组(Pa＜0.01);肾损害组血清sVCAM-1、sICAM-1明显高于无肾损害组(Pa＜0.01).结论 sVCAM-1、sICAM-1参与HSP病理生理过程,与疾病分期相关;血清sVCAM-1、sICAM-1水平增高可作为儿童HSP肾损害的判断指标之一.     

幼年型类风湿性关节炎患儿血清可溶性细胞间黏附分子-1变化

目的　研究可溶性细胞间黏附分子 1(sICAM 1)在幼年型类风湿性关节炎 (JRA)患儿中的变化。方法　用双抗体夹心ELISA方法检测 38例 (2 0例全身型 ,8例多关节型和 10例少关节型 )活动期与缓解期JRA患儿和 15例正常对照患儿血清sICAM 1水平。结果　 1.活动期全身型、多关节型及少关节型JRA患儿血清sICAM 1水平均较正常对照明显增高 (P <0 .0 0 1) ,全身型较少关节炎型明显增高 (P <0 .0 5 ) ;2 .治疗后全身型血清sICAM 1水平明显降低 (P <0 .0 0 1) ,但仍高于正常对照组 ,多关节型与少关节型治疗后sICAM 1水平较治疗前虽有下降 ,但无显著差异 (P >0 .0 5 )。结论　ICAM 1在JRA的发病机制中起一定作用 ,血清sICAM浓度与病变类型有关 ,但不适合作为病情缓解指标     

支气管哮喘患儿血清可溶性细胞间黏附分子-1的临床意义

目的探讨可溶性细胞间黏附分子1(sICAM1)在儿童哮喘发病机制中的作用。方法采用ELISA双抗体夹心法测定16例哮喘患儿急性发作期血清中sICAM1水平,以10例健康儿童为对照。结果哮喘患儿发作期血清sICAM1明显高于对照组(P<0.001)。且sICAM1与IgE呈显著正相关(r=0.603P<0.05)。结论sICAM1参与哮喘的发病,并可作为哮喘发病的检测指标。     

哮喘患儿血清补体活化成分及可溶性细胞黏附分子的水平变化及意义

我们于2002年1月30日～11月30日检测了30例哮喘患儿发作期和发作缓解后血清补体活化片段(sCSb-9)和细胞间黏附分子-1(sICAM-1)和血管内皮细胞间黏附分子-1(sVCAM-1)变化,以探讨它们之间的关系及在哮喘发病中的意义。     

重症肺炎患儿血清可溶性细胞间黏附分子-1水平的变化及临床意义

目的探讨重症肺炎患儿血清可溶性细胞间黏附分子-1(sICAM-1)水平的变化,以及不同病原体所致重症肺炎血清sICAM-1的水平及其临床意义。方法采用双抗体夹心酶联免疫吸附法测定40例重症肺炎患儿和43例普通肺炎患儿急性期、恢复期、以及48例健康对照组小儿血清sICAM-1水平。结果重症肺炎急性期血清sICAM-1水平明显高于重症肺炎恢复期,差异有非常显著性(P<0.01);与普通肺炎急性期与健康对照组比较,差异有非常显著性(P<0.01);重症肺炎恢复期血清sICAM-1水平与普通肺炎恢复期及健康对照组比较,则差异均无显著性(P>0.05);重症细菌性肺炎、病毒性肺炎、支原体肺炎、病毒与细菌混合感染性肺炎急性期血清sICAM-1水平比较,差异均无显著性(P>0.05)。结论重症肺炎患儿急性期血清sICAM-1水平较普通肺炎急性期明显增高,但不同病原体所致重症肺炎血清sICAM-1水平变化无统计学意义;sICAM-1参与了重症肺炎的炎症过程,其水平的高低可以作为肺炎病情轻重的判断指标之一。     

血清可溶性细胞间黏附分子-1与重症肺炎的关系研究

目的：血清可溶性细胞间黏附分子-1（sICAM-1）是人体内重要的细胞表面黏附分子，参与机体众多的免疫反应及炎症反应，但其在重症肺炎患儿中的表达情况，以及与重症肺炎的关系，则未见系统的研究。该研究探讨血清sICAM-1在重症肺炎发病过程中的变化及其与重症肺炎的关系。方法：采用双抗体夹心酶联免疫吸附法测定50例重症肺炎患儿和56例普通肺炎患儿不同病程中的血清sICAM-1水平，以及52例健康对照组小儿血清sICAM-1水平。结果：重症肺炎急性期血清sICAM-1为402.36±31.24 μg/L，明显高于其恢复期水平的198.56±12.63 μg/L，差异具有显著性(P<0.01),与普通肺炎急性期的278.86±36.24 μg/L及健康对照组 180.74±21.46 μg/L比较，差异亦有显著性(P<0.01)；重症肺炎恢复期血清sICAM-1水平与普通肺炎恢复期的193.42±23.65 μg/L及健康对照组比较，则差异无显著性（P >0.05）；重症细菌性肺炎、病毒性肺炎、支原体（MP）肺炎、病毒与细菌混合感染性肺炎急性期血清sICAM-1分别为412.15±18.36 μg/L、386.25±31.62 μg/L、398.41±16.83 μg/L、389.76±24.88 μg/L，差异均无显著性（P>0.05）；重症肺炎经治疗后痊愈病例及好转病例急性期血清sICAM-1分别为396.18±22.31 μg/L，392.79±37.43 μg/L，差异也无显著性（P >0.05）。结论：sICAM-1可能参与了重症肺炎的炎症过程，其水平变化可以作为重症肺炎的诊断及病情轻重的判断指标之一。［中国当代儿科杂志，2007，9（6）：537-539］     

血清可溶性细胞间黏附分子-1在儿童过敏性紫癜中的临床意义

目的 观察过敏性紫癜患儿血清可溶性细胞间黏附分子-1（soluble intercellular adhesion molecul-1．sICAM-1）的含量变化，探讨其在儿童过敏性紫癜中的作用及临床意义。方法 采用酶联免疫吸附双抗体夹心法（ELISA）检测观察组63例过敏性紫癜患儿不同时期血清sICAM-1含量，其中合并紫癜性肾炎41例，未合并紫癜性肾炎22例，分别与健康儿童对照组24例比较。结果 观察组患儿早期血清sICAM-1含量均较对照组升高，恢复期下降（t=4．335，5．448，P均〈0．01）；未合并紫癜性肾炎患儿早期和恢复期血清sICAM一1含量与对照组比较无显著性差异（P〉0．05）；紫癜性肾炎患儿早期血清。ICAM-1含量较未合并紫癜性肾炎患儿和对照组明显增高（P均〉0．01），恢复期仍高于对照组（P〈0．05）。结论 ICAM-1可能通过血管内皮炎症性变化机制参与过敏性紫癜的病理生理过程，血清。ICAM-1含量变化与损害程度有关，急性期血清sICAM-1含量增高可作为儿童过敏性紫癜肾脏损害的早期指标。     

呼吸道合胞病毒毛细支气管炎患儿鼻咽分泌物白细胞介素-2水平的变化

目的探讨呼吸道合胞病毒(RSV)毛细支气管炎(毛支)患儿急性期鼻咽分泌物(NS)IL-2水平的改变及其临床意义。方法采用ELISA双抗体夹心法检测58例RSV毛支患儿急性期NS中IL-2含量。并根据临床评分标准、血氧饱和度、供氧和住院时间等不同标准,对疾病严重程度进行分析。结果入院时77.6%患儿血氧饱和度<95%;吸氧时间(4.8±3.4)d。RSV毛支患儿急性期NS中IL-2含量变化很大(0~3417μg/L),中位数76μg/L。各疾病严重程度组间比较,IL-2水平无显著性差异(P>0.05);IL-2与各疾病严重因素无明显相关性(P均>0.05)。结论RSV毛支患儿急性期NS中IL-2水平与RSV毛支无关,其改变可能系其他原因所致。     

镇江地区哮喘患儿血清白细胞介素5、8和可溶性白细胞介素2受体表达情况调查分析

目的调查镇江地区哮喘患儿血清中白细胞介素(IL)-5、IL-8、可溶性白细胞介素2受体(SIL-2R)表达情况及其意义。方法采用酶联免疫吸附试验测定镇江地区100例哮喘患儿发作期、缓解期和100例正常对照组儿童血清IL-5、IL-8、sIL-2R表达的水平。结果血清中IL-5、IL-8、sIL-2R水平在哮喘发作期患儿血清中的表达水平均明显高于哮喘缓解期和正常对照儿童,差异有统计学意义(P<0.05)。结论血清中IL-5、IL-8、sIL-2R的表达水平与支气管哮喘的发生密切相关,检测3种细胞因子的水平,提高对支气管哮喘的诊断、治疗和病情的监测。     

Serum interferon-gamma, interleukin-4, and interleukin-6 in infants with adenovirus and respiratory syncytial virus infection

BACKGROUND: To characterize adenoviral (ADV) infection, the clinical symptoms, laboratory findings and serum cytokine concentrations were evaluated in ADV patients and compared with those in patients with respiratory syncytial virus (RSV) infections. METHODS: A total of 63 patients who had been diagnosed with ADV infections or RSV on an antigen detection test were enrolled in the present study between December 2002 and March 2004. Forty patients had RSV infection and 23 patients had ADV infection. Serum cytokine (interleukin [IL]-4,6 and interferon [IFN]-gamma) concentrations were analyzed. Concentration of IL-6 in both infection groups was analyzed regardless of whether the patients had been given steroids (dexamethaxone or prednisolone). In addition, IL-6 levels were measured on day 1 and 4 of hospitalization. RESULTS: A strong inflammatory response was observed in patients with ADV infection. Serum IL-6 levels in patients with ADV infection on day 4 of hospitalization were significantly higher than those in patients without steroids treatment or in patients with RSV infection. IL-4, and IFN-gamma were not significantly different. CONCLUSION: Patients with ADV infections who were given steroids had a temporary increase of IL-6, which might have indicated the development of a severe clinical course if not been administered.     

Palivizumab prophylaxis of respiratory syncytial virus infection in high-risk infants

Palivizumab prophylaxis significantly reduces hospitalization for respiratory syncytial virus (RSV) disease in preterm infants. However, palivizumab is very expensive. Data from a New Zealand cost-effectiveness analysis were considered by representatives of the Infectious Diseases and Immunisation, Fetus and Newborn, and Respiratory Committees of the Paediatric Society of New Zealand. Prophylaxis in all high-risk groups was associated with net cost. The consensus panel recommends that the priority for palivizumab be given to babies discharged on home oxygen with chronic lung disease, followed by babies born at 28 weeks or less gestation.     

婴幼儿呼吸道合胞病毒感染特点及支气管肺炎细胞免疫等指标的变化

目的　了解近年来苏州地区婴幼儿呼吸道合胞病毒 (RSV)的感染特点及支气管肺炎 (支肺 )细胞免疫等指标改变情况。方法　应用直接免疫荧光法 (DFA)对 2 6 72份下呼吸道感染婴幼儿鼻咽分泌物行RSV抗原检测 ;用间接免疫荧光法 (IFA)对 2 0例RSV支肺婴幼儿血液进行细胞免疫指标测定 ;用酶联免疫法(ELISA)测其血清IFN r、IL 4及IgE。设同龄健康对照组。结果　婴幼儿RSV感染率以冬春季最高(49.13% ) ,夏秋季最低 (4.6 0 % ) (χ2 =4 11.2 2　P <0 .0 0 1) ;1岁以内组 (不包括新生儿 )婴幼儿RSV感染率高于 1～ 2岁组 (χ2 =12 .34　P <0 .0 0 5 ) ,1～ 2岁组高于 2～ 3岁组 (χ2 =8.0 8　P <0 .0 0 5 ) ;男性婴幼儿RSV感染率高于女性 (χ2 =6 .6 7　P <0 .0 0 5 ) ;RSV支肺婴幼儿存在较低的CD3+ (% )、CD4 + (% )、CD8+ (% )水平 (5 3.17± 5 .4 8、34.4 8± 3.6 7、2 2 .5 4± 2 .93,P均 <0 .0 0 1)及较高HLA DR+ (% )水平 (2 3.70± 3.97,P <0 .0 0 5 ) ;血清IFN r(kU/L)、IL 4 (kU/L)水平则分别低于、高于健康组 (0 .38± 0 .2 0　P <0 .0 0 5 ;5 2 .18± 2 9.99,P <0 .0 5 ) ,而血清IgE(kU/L)差异无显著性 (P >0 .0 5 )。结论　婴幼儿RSV感染具有明显地区性和季节周期性 ;年龄越小其RSV感染率越高 ;RSV支肺     

Duration of hospitalization in previously well infants with respiratory syncytial virus infection

To describe the typical hospital course of infection in previously well infants hospitalized with respiratory syncytial virus (RSV) infection, we reviewed the charts of 196 patients with laboratory-proved respiratory syncytial virus infection in the 1987-1988 respiratory disease season. Eighty-seven of the children had been previously well. Their mean duration of hospitalization was 3.4 days. Previously well infants younger than 6 weeks of age experienced significantly longer hospitalizations and more days of supplemental oxygen and were more likely to require intensive care than were older children. Children older than 12 weeks of age were hospitalized for a mean of 2.5 days and did not require intensive care. Oxygen saturation was measured in the emergency room for 67 of the previously well infants; in 42 oxygen saturation was at least 90% whereas in 25 saturation was less than 90% or infants were receiving supplemental oxygen at the time of measurement. Decreased initial oxygen saturation was associated with a prolonged hospitalization (5.3 vs. 3.2 days, P less than 0.01) and with more days of supplemental oxygen (4.4 vs. 1.5 days, P less than 0.01). We conclude that among previously well infants admitted to the hospital with respiratory syncytial virus infection, infants younger than 6 weeks of age are at increased risk for a prolonged and more severe hospital course than are older children.