糖原磷酸化酶同工酶BB在急性心肌缺血诊断中的应用

急性心肌梗死 (ＡＭＩ)的早期诊断至关重要 ,心电图是最便捷、可靠、重复性最好的一种方法 ,如果将ＳＴ段抬高作为一种诊断标准 ,其特异性可达到 90 % ,但灵敏度只有 5 0 % ,无Ｑ波心肌梗死常常漏诊[1] 。因此 ,有效的生化指标一直成为研究热门 ,其中 ,心肌型肌酸磷酸激酶同工酶 (ＣＫ ＭＢ)是诊断心肌梗死 (ＭＩ)应用最广的指标 ,一直被认为是ＡＭＩ诊断的可靠的指标[2 ] ,目前ＣＫ ＭＢ的系列测定主要用于确定ＭＩ诊断[3 ] ;肌钙蛋白在血中出现时间与ＣＫ ＭＢ相似 ,持续时间较ＣＫ ＭＢ长 ,特异性优于ＣＫ ＭＢ[4] ,且有替代ＣＫ ＭＢ的…     

急性心肌梗死并发右束支传导阻滞与近期预后

急性心肌梗死 (ＡＭＩ)并发右束支传导阻滞 (ＲＢＢＢ)通常是大面积心肌梗死的表现 ,常常伴有泵衰竭 ,完全性房室传导阻滞 ,心律失常和高死亡率 ,是影响ＡＭＩ近期预后的一个重要因素[1] 。为此 ,笔者自 1997年开始前瞻性观察ＡＭＩ并发ＲＢＢＢ住院患者的血清肌酸激酶(ＣＫ)及其同工酶 (ＣＫ ＭＢ)水平 ,严重并发症及死亡率。现报告如下 :对象与方法　　 1 对象观察 1997年 1月～ 2 0 0 0年 8月本院住院的ＡＭＩ患者 16 0例 ,ＡＭＩ诊断按国际心脏病学会和协会及ＷＨＯ的缺血性心脏病的命名及诊断标准[2 ] 。 16 0例ＡＭＩ患者 ,其中经心电…     

急性心肌梗死86例有关生化诊断指标分析

肌酸磷酸激酶同功酶 (ＣＰＫ ＭＢ)、肌酸磷酸激酶(ＣＰＫ)、天冬氨酸转氨酶 (ＡＳＴ)、乳酸脱氢酶 (ＬＤＨ)在临床上广泛应用于检测心肌损伤 ,是传统的心肌酶学指标 ,文献上曾以系列测定ＣＰＫ ＭＢ作为发病 2 4ｈ内急性心肌梗死(ＡＭＩ)诊断的金指标。但上述酶的测定存在着一些不足之处 ,目前越来越受到临床重视的血清心肌肌钙蛋白Ｔ(ｃＴｎＴ)能高特异性、高敏感性地检测心肌细胞损伤。我们观察了ｃＴｎＴ、ＣＰＫ ＭＢ、ＣＰＫ、ＡＳＴ、ＬＤＨ在ＡＭＩ组及对照组中的动态变化 ,比较上述指标在ＡＭＩ诊断中的意义。1　资料与方法1 1　研…     

肌钙蛋白Ⅰ和肌红蛋白对老年不稳定型心绞痛患者预后的判断价值

一、对象与方法　　 1 研究对象 :2 0 0 0年 9月至 2 0 0 2年 3月我院住院治疗的老年不稳定型心绞痛 (ＵＡ)患者 44例 ,男 2 8例 ,女 16例 ,年龄 60～ 90岁 ,平均 (75± 15 )岁 ,按ＷＨＯ诊断标准入选 ,并按Ｂｒａｕｎｗａｌｄ分级标准进行分级。除外 :(1)肾脏和骨骼肌损伤 ;(2 )近 2周内发生急性心肌梗死 (ＡＭＩ) ;(3 )肌酸激酶同工酶 (ＣＫ ＭＢ)和肌酸激酶 (ＣＫ)升高超过正常参考值 (0～ 2 4Ｕ/Ｌ和 3 0～ 2 0 0Ｕ/Ｌ)上限 2倍以上 ;(4)其他心血管疾病。　　 2 研究方法 :ＵＡ患者入院时静脉取血检测 1次肌钙蛋白Ⅰ (ｃＴｎＩ)和肌红…     

心肌肌钙蛋白I在心血管疾病中的应用

心肌肌钙蛋白Ｉ在心血管疾病中的应用张丽王士雯赵玉生心肌缺血性损伤，特别是急性心肌梗塞（ＡＭＩ）是威胁人类生命的主要疾病之一，人们一直在努力寻找和探索对其诊断特异性好、灵敏度高的指标。近十年来，肌酸激酶（ＭＢ）同工酶（ＣＫ－ＭＢ）被认为是诊断ＡＭＩ的重...     

糖原磷酸化酶同工酶BB在心肌缺血时的改变

本研究通过长时间监测经皮冠状动脉腔内成形术(ＰＴＣＡ)术中、术后糖原磷酸化酶同工酶ＢＢ(ＧＰＢＢ)及其它酶学指标含量来探讨ＧＰＢＢ对诊断心肌缺血的作用及意义。1 研究对象 :行择期ＰＴＣＡ术病人 2 5例 [男 2 1例 ,女 4例 ,平均年龄 (6 0± 9)岁 ]。术后即刻及 1、2、4、6、8ｈ分别取血 ,测定ＧＰＢＢ、肌酸磷酸激酶 (ＣＰＫ)、肌酸激酶同工酶 (ＣＫ ＭＢ)、心肌肌钙蛋白Ｉ(ｃＴｎＩ)值。以常规体检的健康人 114例[男 6 3例 ,女 5 1例 ,年龄 2 5～ 5 1岁 ,平均 (38± 13)岁 ]为对照。2 测定方法 :ＣＰＫ、ＣＫ ＭＢ活性由本院生化室…     

无痛性心肌梗死37例临床分析

急性心肌梗死 (ＡＭＩ)最具特征性的症状是胸骨后压榨性疼痛 ,也可表现为不典型位置的放射痛。但有些ＡＭＩ患者可完全无疼痛表现〔1〕,给临床的诊断造成一定困难。本文探讨无痛性心肌梗死的临床特点 ,并进一步提高对其认识。1　对象与方法选自北京燕山石化职工医院 1995年 1月～2 0 0 0年 6月期间入院的ＡＭＩ 138例。ＡＭＩ的诊断参照 1997年ＷＨＯ标准 :①冠心病易患因素 ;②临床表现 ;③典型ＡＭＩ的心电图表现 ;④心肌酶 [肌酸激酶 同工酶 1(ＣＫ ＭＢ1)、乳酸脱氢酶 1(ＬＤＨ1)、天冬氨酸转移酶 (ＡＳＴ) ]升高达正常 2倍以上 ,其中…     

肌钙蛋白T与临床和流行病学标准对心肌梗死诊断的差异

作者比较了急性冠状动脉综合征 (ＡＣＳ)病人根据肌钙蛋白Ｔ浓度与临床或流行病学标准诊断心肌梗死 (ＭＩ)人数的差异 ,并评价了 3种不同诊断方法诊断为ＭＩ病人的预后。方法　将疑为ＡＣＳ急诊入院、年龄 1 9～ 96(中位数 69)岁的 559例患者列为研究对象 ,其中男 3 1 5例 ,女 2 44例。于病人入院时即采血进行传统心肌酶谱 (ＣＫ、ＣＫ ＭＢ、ＬＤＨ同功酶 )肌钙蛋白Ｔ浓度测定 ,以后分别于首次采血后的第 2、4、6ｈ和入院后的第 2、3、4ｄ(每天 2次 )进行上述生化指标测定。对病人进行 1 3～ 1 9(中位数 1 7)个月的随访。并用问卷调查病人…     

心肌肌钙蛋白I在心血管疾病中的应用

心肌肌钙蛋白Ｉ在心血管疾病中的应用解放军总医院张丽综述王士雯赵玉生审校心肌缺血性损伤，特别是急性心肌梗（ＡＭＩ）是威胁人类生命的主要疾病之一，人们一直在努力寻找和探索对其诊断特异性好、灵敏度高的指标。近十年来，肌酸磷酸激酶ＭＢ同功酶（ＣＫ－ＭＢ）被认...     

心脏肌钙蛋白Ⅰ诊断急性心肌梗死的价值

目的：探讨血清心脏肌钙蛋白Ⅰ在急性心肌梗死（ＡＭＩ）中的诊断价值。方法：急性心肌梗死（ＡＭＩ）组患者２０例,不稳定型心绞痛（ＵＡ）组３１例,陈旧性心肌梗死（ＯＭＩ）组１１例,危重病患者８７例（非心血管疾病）。ＡＭＩ组患者系列采血测定血清ｃＴｎＩ和ＣＫ－ＭＢ,ＵＡ与ＯＭＩ组,危重患者组均入院后次日晨取血１次。     

Exploration of the immunoreactivity of the Traditional Chinese medicine Shenrouyangzhentang to vasoactive intestinal polypeptide

AIM: To study the immunoreactivity of the Chinese medicine Shenrouyangzhentang to vasoactive intestinal polypeptide (VIP) and its therapeutic mechanism.METHODS: The immunoreactivity of the Chinese medicine Shenrouyangzhentang to VIP was detected in the plasma of 20 normal people and 20 patients with Piyinxu (Spleen Yin deficiency) using the radioimmunoassay (RIA) method.RESULTS: The maximum binding rate B₀/T was 53.29%, the non-specific binding rate N₀/T was 1.170%, and the VIP standard curve was Y = 0.81983 + 0.44319X - 0.28927X², R² = 0.990. The VIP content in Shenrouyangzhentang was 106.6 ng/L ± 20 ng/L), while it was 90.16 ng/L ± 15 ng/L in normal human plasma and 63.25 ng/L ± 11 ng/L in the plasma of Pixinxu patients. The difference between normal plasma and Pixinxu patient plasma was statistically significant (P < 0.05).CONCLUSION: The Chinese medicine Shenrouyangzhentang demonstrated VIP immunoreactivity similar to that of normal plasma. The (vasoactive intestinal polypeptide) VIP content in Pixinxu patient plasma was lower than that in healthy subjects (P < 0.05).     

中药复方 慎柔养真汤 中血管活性肠肽的探讨

目的中药复方慎柔养真汤中是否含有血管活性肠肽（ＶＩＰ），以探索该药治疗消化系统疾病的作用机理．方法用放射免疫分析药盒，对中药复方慎柔养真汤煎剂，２０例正常人和２０例脾阴虚证患者血浆中ＶＩＰ的含量进行检测．结果最大结合率Ｂ０／Ｔ＝５３２９０％；非特异性结合率Ｎ／Ｔ＝１１７０％；拟合曲线方程Ｙ＝０８１９８３＋０４４３１９Ｘ０２８９２７Ｘ２，拟合度Ｒ２＝０９９０；中药中ＶＩＰ＝１０６６ｎｇ／Ｌ±２０ｎｇ／Ｌ，与正常人相比较无显著性差异，但有升高趋势；正常人血浆中ＶＩＰ＝９０１６ｎｇ／Ｌ±１５ｎｇ／Ｌ；脾阴虚患者血浆中ＶＩＰ＝６３２５ｎｇ／Ｌ±１１ｎｇ／Ｌ，与正常人相比较有显著性差异（Ｐ＜００５）．结论中药复方慎柔养真汤煎剂中有ＶＩＰ或ＶＩＰ前体复合物，其ＶＩＰ水平略高于正常人血浆，而脾阴虚患者血浆中ＶＩＰ水平低于正常人．     

Dysfunction of peripheral blood dendritic cells from patients with chronic hepatitis B virus infection

AIM: To identify the property of dendritic cells (DCs) of peripheral blood monocytes (PBMC) in patients with chronic HBV infection. METHODS: Twenty patients with persistent HBV infection were included in this study, 10 healthy subjects being used as a control group. The peripheral blood mononuclear cells (PBMC) of T cell-depleted populations were incubated and induced into mature dendritic cells in the RPMI-1640 medium in the presence of cytokines GM-CSF, IL-4, FLt-3,TNF-alpha and 100mL.L(-1 )of fetal calf serum for a total of 10-12 days. The expressions of surface markers on DCs were evaluated using flow cytometric analysis. ELISA method was used to determine the cytokine levels of interleukin-12 (IL-12) and IL-10 in the supernatant produced by DCs. For detection of the stimulatory capacity of DCs to T cell proliferation, mytomycin C-treated DC were incubated with allogenic T cells. RESULTS: A typical morphology of mature DCs from healthy subjects and HBV-infected patients was induced in in vitro incubation, but the proliferation ability and cellular number of DCs from HBV-infected patients significantly decreased compared with healthy individuals. In particular, the expression levels of HLA-DR, CD80 (B7-1) and CD86 (B7-2) on DC surface from patients were also lower than that from healthy individuals (0.46 vs 0.92 for HLA-DR, 0.44 vs 0.88 for CD80 and 0.44 vs 0.84 for CD86,P<0.05). The stimulatory capacity and production of IL-12 of DCs from patients in allogenic mixed lymphocyte reaction (AMLR) significantly decreased, but the production level of nitric oxide (NO) by DCs simultaneously increased compared with healthy subjects (86 +/- 15 vs 170 +/- 22 micromol.L(-1), P <0.05). CONCLUSION: The patients with chronic HBV infection have the defective function and immature phenotype of dendritic cells, which may be associated with the inability of efficient presentation of HBV antigens to host immune system for the clearance of HBV.     

Changes of IL-6 and relevant cytokines in patients with hepatocellularcarcinoma and their clinical significance

AIM To study the changes of IL-6,IL-2, sIL-2R and TNF ir patients with hepatocellular carcinoma(HCC)and their clinical significance.METHODS IL-6, IL-2, sIL-2R and TNF were detected by avidin-biotin-system ELISA, double-sandwichELISA respectively in 60 patients with HCC and 36 patients with liver cirrhosis (LC) and 66 healthy persons.RESULTS The levels of IL-6, sIL-2R and TNF increased, but IL-2 level was lower in patients with HCCthan that in normal controls (NC) (t test, t=8.21, 4.71, 3.87, 2.13, P<0.01 or 0.05). IL-6 level in HCCwas 10 fold higher than NC, and also much higher than LC. IL-6 level was higher in later stage than that inearlier stage. There was a positive correlation between IL-6 and sIL-2R, TNF, while no positive correlationwas found between IL-2 and IL-6, sIL-2R in HCC.CONCLUSION The remarkably higher level of IL-6 is helpful for the early diagnosis of HCC.     

血清GLS和AFP联合测定对原发性肝癌诊断的意义

探讨联合测定血清GLS和AFP对肝癌诊断的临床意义。测定肝癌、非癌肝病患者血清神经节苷脂(GLS)和AFP含量,然后分组统计、分析结果,肝癌组GLS(799±226)mg/L显著高于非癌患者(481±104),后者与正常人(466±65)无明显差异。测定血清GLS对肝癌诊断敏感度、特异度、准确度、诊断效率分别为82．4％、94．7％、89．7％和78．0％,具有显著临床价值。肝癌组GLS和／或AFP升高为阳性者达97．3％,显著高于良性肝病组,可用于初筛肝癌;GLS与AFP都升高为阳性者达到52．7％,而非癌肝病和正常人组都为0,可用于确诊肝癌。结果显示肝癌患者血清GLS显著增多;测定血清GLS对肝癌诊断、监测及预后分析具有显著临床价值。血清GLS与AFP联合测定对肝癌诊断具有更显著的临床意义。     

血清雌激素与肝细胞癌转移的关系

目的了解血清雌激素升高与原发性肝细胞癌（ＨＣＣ）转移的关系．方法应用放射免疫分析法（ＲＩＡ）对ＨＣＣ患者血清雌二醇（Ｅ２）含量进行了检测，并应用原位杂交研究外源性Ｅ２对肝癌细胞系ＣＢＲＨ７９１９血管内皮生长因子（ＶＥＧＦ）和层粘蛋白受体（ＬＮＲ）表达的影响．结果ＨＣＣ患者血清Ｅ２水平较正常者显著升高，且ＨＣＣ有转移者血清Ｅ２水平较无转移者亦显著升高；原位杂交结果显示，外源性Ｅ２能够增加ＣＢＲＨ７９１９细胞表达ＶＥＧＦ和ＬＮＲｍＲＮＡ．结论血清Ｅ２水平增高与ＨＣＣ转移密切相关，它有可能通过促进ＶＥＧＦ和ＬＮＲ的合成而影响肿瘤的转移过程．     

Influence of IFNα-2b and BCG on the release of TNF and IL-1 by Kupffer cells in rats with hepatoma

!NTRODUCTIONKuPffer eells are residential macroPhages in the1 iver,which Play a eritieal role in the maintenaneeof normal liver function and in immunal surveilaneeof hePatoeellular earcinoma(HCC)and othereaneers〔l].The bio一ogieal immune modulants havebeen used for treating Patients with HCC and othereaneers[2〕.In our previous studies,the eombineduse of biological immune modulants showed bettereffeets.The normal rats and hePatoma rats indueedby DEN(Diethylnitrosamine)were treated …