肾病综合症患者凝血与血小板参数检测的临床价值

目的了解肾病综合症(NS)患者凝血与血小板参数变化的临床意义. 方法对30例肾病综合症患者的凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、纤维蛋白原(Fbg)、凝血酶时间(TT)四项凝血指标和血小板计数(PLT)、平均血小板体积(MPV)、血小板压积(PCT)、血小板分布宽度(PDW)等血小板参数进行测定,并与30例正常人进行对照. 结果 NS组与对照组相比,Fbg、PLT、MPV、PCT显著升高(p<0.01),APTT明显缩短(p<0.05),差别有显著性意义,而PT、PDW、TT变化不明显(p>0.05). 结论 NS患者存在高凝状态,上述指标的监测对NS病情分析和预防静脉血栓形成有重要临床价值.     

不同程度烧伤患者凝血功能变化及意义

目的探讨不同程度烧伤患者凝血指标包括血浆凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血酶时间(APTT)和纤维蛋白原含量(FIB)、D-二聚体(DD)以及血小板(PLT)计数的变化情况,为临床治疗方案的选择提供参考。方法回顾性分析2017年4月至2018年12月第一次烧伤并在我院接受治疗的183例烧伤患者,根据其烧伤程度分为轻度、中度、重度及特重度烧伤组,对各组凝血指标包括PT、APTT、FIB、TT以及DD和PLT进行检测,比较各组患者同类指标水平的差异;根据重度及特重度烧伤患者入院以后是否发生DIC将患者分成DIC组和非DIC组,分析两组患者入院时的FIB、PLT及DD水平,比较两组结果是否有差异。结果随着烧伤程度的加重,从轻度组到特重度组烧伤患者凝血指标及DD水平逐步增高,PLT水平逐步降低。其中特重度组的凝血指标及DD水平最高,轻度组最低,特重度组的PLT水平最低,而轻度组的PLT水平最高。四组之间两两比较结果如下:轻度组与中度组相比,DD结果有显著差异,其他指标不存在差异;与重度组比较,PT、APTT、TT、DD以及PLT有差异,FIB无差异;与特重度组相比,PT、APTT、FIB、TT、DD以及PLT均有差异;中度组与重度组比较,DD有差异,其他指标无差异;与特重度组相比PT、APTT、FIB、TT、DD以及PLT均有差异;重度组与特重度组相比,FIB、DD结果有显著差异,其他指标无差异。DIC组患者的血小板水平低于非DIC组(P<0.05),而FIB及DD水平高于非DIC组(P<0.05)。结论不同程度的烧伤患者的凝血指标、DD及PLT水平存在较大差异,尤其重度及特重度烧伤患者烧伤面积较大,及时监测患者凝血系统及纤溶系统指标,对患者病情判断、预防弥散性血管内凝血(DIC)的发生具有重要临床价值。     

肾病综合症患者凝血与血小板参数检测的临床价值

目的　了解肾病综合症 (NS)患者凝血与血小板参数变化的临床意义 .方法　对 30例肾病综合症患者的凝血酶原时间 (PT)、活化部分凝血酶时间 (APTT)、纤维蛋白原 (Fbg)、凝血酶时间 (TT)四项凝血指标和血小板计数(PLT)、平均血小板体积 (MPV)、血小板压积 (PCT)、血小板分布宽度 (PDW)等血小板参数进行测定 ,并与 30例正常人进行对照 .结果　NS组与对照组相比 ,Fbg、PLT、MPV、PCT显著升高 (p <0 .0 1) ,APTT明显缩短 (p<0 .0 5 ) ,差别有显著性意义 ,而PT、PDW、TT变化不明显 (p >0 .0 5 ) .结论　NS患者存在高凝状态 ,上述指标的监测对NS病情分析和预防静脉血栓形成有重要临床价值     

乙型肝炎肝硬化、酒精性肝硬化和自身免疫性肝硬化凝血相关参数比较

目的 比较乙型肝炎肝硬化、酒精性肝硬化和自身免疫性肝硬化凝血参数和血小板计数的表达差异,探讨不同病因引起的肝硬化凝血指标差异的临床意义.方法 回顾性分析2019年6月至2020年12月住院的肝硬化患者的临床资料,根据病因将肝硬化分为3组:乙肝肝硬化组、酒精性肝硬化组和自身免疫性肝硬化组.比较3组患者凝血指标和血小板计数的差异,并进一步比较分析Child-Pugh分级相同的情况下,3组患者的凝血相关指标表达水平差异.计量资料采用Kruskal-Wallis H检验,进一步两两比较采用Dunn-test进行多重比较.结果 3组患者凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)和凝血酶时间(TT)和血小板计数(PLT)等指标,差异有统计学意义(P值均<0.05).其中,乙肝肝硬化组PT、INR、APTT、TT均较自身免疫性肝硬化组表达水平明显增高(P值均<0.01),Fib、PLT水平明显降低(P值均<0.01).乙肝肝硬化组较酒精性肝硬化组TT水平明显增高(P值<0.001),Fib和PLT水平明显降低(P值均<0.05).酒精性肝硬化组PT、INR和APTT较自身免疫性肝硬化组明显延长(P值均<0.01).Child-Pugh分级为A级患者中,乙肝肝硬化组较酒精性肝硬化和自身免疫性肝硬化组TT明显延长,Fib明显降低(P值均<0.05),乙肝肝硬化和酒精性肝硬化组较自身免疫性肝硬化组PT和INR明显延长(P值均<0.05).Child-Pugh分级为B级患者中,乙肝肝硬化组较自身免疫性肝硬化组PT和INR明显延长(P值均<0.01).乙肝肝硬化组较酒精性肝硬化组TT明显延长,Fib和PLT明显降低(P值均<0.05).Child-Pugh分级为C级患者中,仅仅乙肝肝硬化组与自身免疫性肝硬化组TT差异具有统计学意义(P值<0.05),3组患者其他凝血指标差异均无统计学意义(P值均>0.05).结论 乙肝肝硬化、酒精性肝硬化和自身免疫性肝硬化患者凝血指标和血小板计数存在差异,联合凝血指标和血小板计数检测和病因综合判断肝硬化患者的病情和预后,为患者的后期治疗提供可靠依据.     

手术大出血和急性髓系白血病患者血小板数量变化及与凝血指标的关系

目的:分析手术中大量失血和急性髓系白血病患者血小板减少与凝血功能的关系。方法:选择本院手术大出血患者(手术大出血组)、急性髓系白血病患者(急性髓系白血病组)各30例,体检健康人群30例为健康对照组,平行检测三组血小板计数(PLT)、血浆纤维蛋白原(FIB)含量及凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和国际标准化比值(INR),比较各指标组间差异,分析各组PLT与凝血指标的相关性。结果:手术大出血组、急性髓系白血病组PLT明显低于健康对照组(P0.01),急性髓系白血病组更低(P0.01);急性髓系白血病组PT、APTT较健康对照组显著延长(P0.01),手术大出血组较急性髓系白血病组PT、APTT延长,INR升高(P0.01);手术大出血组FIB水平较健康对照组显著降低(P0.01)。相关性分析表明,急性髓系白血病患者PLT与FIB水平呈负相关(r=-0.374,P0.05)。结论:术中大量出血患者PLT高于急性髓系白血病患者,但凝血功能较差,出血风险较大。     

中药脑血宝制剂对凝血和血小板聚集率的影响

目的和方法:本研究在体内、体外实验的基础上,通过测定血浆中活化的部分凝血活酶时间(APTT)、凝血酶原时间(PT)、抗凝血酶III(AT-Ⅲ)活性、凝血酶时间(TT)、纤维蛋白原(Fng)、纤溶酶原(Plg)的变化以及血浆中血小板聚集率来观察脑血宝制剂对血液凝固过程不同阶段和血小板聚集率的影响,分析其抗血栓作用的机制。结果:脑血宝预防组,血浆中APTT、PT均比血栓组延长(P＜0.05,P＜0.01),AT-Ⅲ的活性高于血栓组(P＜0.05,P＜0.01),Fng含量低于血栓组,TT延长,Fng和TT呈负性相关关系,血小板聚集率明显低于血栓组(P＜0.05,P＜0.01)。结论:脑血宝制剂对凝血的多个环节均有抑制作用,从而对抗血栓的形成。     

大量输血对车祸多发伤患者凝血四项指标变化的影响

目的:探究大量输血对输血科车祸多发伤患者凝血四项指标变化的影响。方法:选取2017年1月至2019年8月我院输血科收治的车祸多发伤患者105例作为研究对象,根据输血量分为大量输血组(输血量>2000 ml,n=57)与少量输血组(输血量≤2000 mL,n=48)。比较两组临床资料、输血前、输血后1 d、5 d凝血四项指标:纤维蛋白原(Fibrinogen,FIB)、凝血酶原时间(Prothrombin time,PT)、凝血酶时间(Thrombin time,TT)、活化部分凝血活酶时间(Activated partial thromboplastin time,APTT)以及血小板(Platelet,PLT)变化趋势。结果:输血后1 d大量输血组FIB、PLT低于输血前及少量输血组,PT、APTT、TT长于输血前及少量输血组(P<0.05);输血后5 d两组FIB、PLT高于输血后1 d,PT、APTT、TT短于输血后1 d(P<0.05),组间无明显差异(P>0.05);大量输血组凝血障碍发生率高于少量输血组(P<0.05)。结论:大量输血应用于车祸多发伤患者可显著增加凝血功能障碍风险,需密切监测凝血四项指标,适时合理补充PLT,以促进凝血功能恢复。     

新生儿高胆红素血症患儿胆红素的变化与继发性血小板增多症及凝血异常的临床研究

目的探究高胆红素血症新生儿血清胆红素的变化与继发性血小板增多症和凝血功能异常的关系。方法选取2016年6月~2017年6月于我院新生儿科住院的35例高胆红素血症患儿作为观察组,另取同期35例血清胆红素正常的新生儿作为对照组,比较两组新生儿外周血PLT、APTT、PT、TT、Fib水平以及继发性血小板增多症发生率。根据患儿血清总胆红素(TBiL)水平分为257μmol/L组和257μmol/L组,对比二组患儿PLT、APTT、PT、TT、Fib水平以及继发性血小板增多症发生率。观察血小板增多症患儿与PLT正常患儿TBiL恢复正常的时间。结果 1.观察组患儿外周血PLT、APTT、PT、TT水平高于对照组,Fib低于对照组,差异有统计学意义(t=8.14、7.33、7.54、4.64和5.18,均P0.05);观察组与对照组患儿继发性血小板增多症发病率分别为19.9%和5.9%,差异有统计学意义(χ2=6.94,P0.05);2.257μmol/L组PLT、APTT、PT、TT和FIB与257μmol/L组均具有显著的差异(t=2.56、2.71、2.11、2.23和2.45,P0.05)存在显著差异。而继发性血小板增多症发病率在两组之间不存在显著的统计学差异(χ2=2.58,P0.05);3.血小板增多症患儿外周血TBiL恢复正常时间为(10.2±3.4)d,PLT正常患儿外周血TBiL恢复正常时间为(8.3±1.5)d,两组差异有统计学意义(t=6.46,P0.05)。结论新生儿高胆红素血症可引起PLT增多和凝血功能异常;2.随着血清TBiL水平升高,凝血功能受损加重;3.继发性血小板增多症可延长患儿血清TBiL恢复正常时间。     

复方丹参注射液抗脂多糖诱导的兔弥漫性血管内凝血

目的: 研究复方丹参注射液对脂多糖(LPS)诱导的兔弥漫性血管内凝血(DIC)的作用。方法: 用LPS诱导兔DIC模型。凝固法测定纤维蛋白原含量,全自动凝血分析仪检测活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)和纤维蛋白原含量;全自动血细胞分析仪进行血小板计数;全自动血浆分析仪测定谷丙转氨酶(ALT)以及血尿素氮(BUN);发色底物法测定蛋白C及抗凝血酶Ⅲ的活性。观察复方丹参注射液对LPS诱导的兔DIC的拮抗作用。结果: 兔耳缘静脉持续滴注LPS,观察到:APTT和PT显著延长;血小板计数和纤维蛋白原含量明显减少;ALT和BUN显著升高;蛋白C和抗凝血酶Ⅲ的活性明显降低。给予复方丹参注射液后,APTT和PT的延长明显缩短;血小板计数和纤维蛋白原的含量均明显恢复;ALT和BUN显著下降;蛋白C及抗凝血酶Ⅲ的活性显著改善。结论: 复方丹参注射液对LPS诱导的兔DIC有良好的拮抗作用。     

术前血小板功能对冠脉搭桥患者出血的预测价值

目的 探讨术前血小板功能对冠脉搭桥患者出血的预测价值.方法 选取96例行冠脉搭桥术患者作为研究对象,根据术后24h胸引流总量是否大于500mL分为正常术后出血组(58例)及严重术后出血组(38例);术前,通过血小板计数(PLT)及全血凝固分析法(测定血凝四项),对比两组患者术前PLT、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及纤维蛋白原(FIB)的差异性,综合分析术前血小板功能与冠脉搭桥患者出血的关系.结果 严重术后出血组患者术前,PLT为170.36±38.4×109/L、PT为16.8 ±5.2 s、APTT为40.7 ±13.7 s、中位TT为18s、FIB为4.21 ±1.32 g/L;正常术后出血组患者术前,PLT为196.32±50.5×109/L、PT为14.2±3.2 s、APTT为35.1 ±8.2 s、中位TT为13s、FIB为4.82±0.74 g/L;严重术后出血组患者术前的PLT及FIB显著低于正常术后出血组(P＜0.05),PT、APTT及中位TT显著长于正常术后出血组(P＜0.05);两组患者的MA值和血小板抑制率(INHADP、INHAA)差异显著(P＜0.05);术前PLT对冠脉搭桥患者术后出血具有预测价值(OR =2.11,95％ CI: 1.80 ～ 2.36,P＜0.01),术前FIB对冠脉搭桥患者术后出血具有一定的预测价值(OR=1.90,95％ CI:1.70～2.04,P＜0.05).结论 冠脉搭桥患者术后出血与术前血小板功能具有相关性,通过测定PLT及FIB评价术前血小板功能,对冠脉搭桥患者出血具有预测价值.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.     

A comparative study of the effects of dimebon,obsidan, finoptin,and cordaron on the functional state of ischemic focus and size of necrotic zone in experimental myocardial infarction

Dimebon, an antihistamine agent, exerts a moderate antianginal effect, improving the function of ischemic focus in the myocardium and decreasing the necrotic zone in experimental myocardial infarction. Dimebon is less active than obsidan, finoptin (except for the size of the necrotic zone), and cordaron. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 122, No. 12, pp. 642–644, December, 1996     

Effects of sex steroid hormones on lipid peroxidation and glutathione antioxidant system in rat skin

Effects of estradiol and testosterone on the intensity of lipid peroxidation and contents of glutathione redox system components in the dermis and epidermis of rat skin were studied. Only estradiol induced considerable dose-dependent and tissue-specific biphasic antioxidant effects on the skin. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 128, No. 12, pp. 663–666, December, 1999     

Adhesion and growth of CaCo2 cells on surface-modified PEEK substrata

A series of surface-functionalized poly(ether ether ketone) (PEEK) films has been prepared by selective wet-chemistry; they are hydroxylated polymer (PEEK-OH) obtained by reduction, aminated polymer (PEEK-[]-NH2) prepared by coupling a diisocyanate reagent to PEEKOH (PEEK-[]-NCO) followed by hydrolysis, and carboxylated and aminocarboxylated polymers (PEEK-[]-GABA and PEEK-Lysine) resulting from the coupling of aminoacids to PEEK-[]-NCO. The aminated and carboxylated substrata promoted the adhesion and growth of CaCo2 cells in the presence of serum. Fibronectin (FN), an extra-cellular matrix protein, has been covalently fixed and/or adsorbed on various PEEK substrata, in the presence or not of a polymeric surfactant (Pluronic F68). The performances of the FN-grafted substrata (PEEK-[]-FN(1) and PEEK-[]-FN(2)) were significantly higher than those of reference substrata simply coated with FN (PEEK-OH(+FN)(1) and (2), PEEK-[]-NH2(+FN)(1) and (2)), considering the adhesion and spreading of CaCo2 cells in the absence of serum. Moreover, the stability of the adherent cells on the FN-adsorbed substrata dramatically depended on the experimental conditions applied during the PEEK coating with FN.