血清可溶性转铁蛋白受体水平与慢性阻塞性肺疾病患者认知障碍程度的相关性研究

背景目前,血清可溶性转铁蛋白受体(sTFR)水平与慢性阻塞性肺疾病(COPD)患者认知障碍的关系尚未完全明确。目的探讨血清sTFR水平与COPD患者认知障碍程度的相关性。方法选取2017年2月-2019年7月在西安交通大学第一附属医院就诊的COPD患者248例作为观察组,另选取同期健康体检者250例作为对照组;另根据贫血程度将COPD患者分为轻度组38例、中度组45例、重度组19例及非贫血组146例。比较对照组、观察组及轻度组、中度组、重度组、非贫血组患者血清sTFR、内皮素1 (ET-1)、铁调节素(hepcidin)、8-羟基脱氧尿苷酸(8-OHdG)、低氧诱导因子1α(HIF-1α)水平及蒙特利尔认知评估量表(MoCA)评分;血清sTFR水平、MoCA评分与COPD患者血清ET-1、hepcidin、8-OHdG、HIF-1α水平间的相关性分析及血清sTFR水平与COPD患者MoCA评分的相关性分析均采用Pearson相关分析。结果 (1)观察组患者血清sTFR、ET-1、hepcidin、8-OHdG、HIF-1α水平高于对照组,MoCA评分低于对照组(P<0.05)。(2)轻度、中度、重度组患者血清sTFR、ET-1、hepcidin、8-OHdG、HIF-1α水平高于非贫血组,MoCA评分低于非贫血组(P<0.05);中度、重度组患者血清sTFR、ET-1、hepcidin、8-OHdG、HIF-1α水平高于轻度组,MoCA评分低于轻度组(P<0.05);重度组患者血清sTFR、ET-1、hepcidin、8-OHdG、HIF-1α水平高于中度组,MoCA评分低于中度组(P<0.05)。(3) Pearson相关分析结果显示,血清sTFR水平与COPD患者血清ET-1 (r=0.482)、hepcidin(r=0.682)、8-OHdG(r=0.513)、HIF-1α(r=0.441)水平均呈正相关(P<0.05),MoCA评分与COPD患者血清ET-1 (r=-0.461)、hepcidin (r=-0.515)、8-OHdG(r=-0.485)、HIF-1α(r=-0.437)水平均呈负相关(P<0.05);血清sTFR水平与COPD患者MoCA评分呈负相关(r=-0.481,P<0.05)。结论随着贫血程度加重,COPD患者血清sTFR水平升高、认知障碍程度加重,且血清sTFR水平与COPD患者认知障碍程度有关。     

贫血患者血清转铁蛋白受体测定的临床意义

采用Ｄｏｔ－ＥＬＩＳＡ法定量测定了６８例不同贫血患者的血清转铁蛋白受体（ｓＴＩＲ）水平,发现缺铁性贫血,溶血性贫血和急性失血性贫血患者ｓＴＩＲ均显高于正常人（Ｐ〈０．００１）,而慢性再生障碍性贫血患者ｓＴｆＲ显著低于正常人（Ｐ〈０．００１）,缺铁性贫血ｓＴｆＲ水平与血清铁蛋白水平呈负相关（Ｐ〈０．００５）,溶血性贫血ｓＴｆＲ与网织红细胞计数呈正相关（Ｐ〈０．００５）,ｓＴｆＲ可以反映机体贮存铁和骨     

急性冠状动脉综合征病人血清可溶性Fas和可溶性Fas配体及可溶性白细胞介素2受体水平的临床价值

目的 :探讨血清可溶性Fas、可溶性Fas配体和可溶性白细胞介素 2受体水平与急性冠状动脉综合征 (ACS)之间的关系。方法 :应用酶联免疫吸附双抗体夹心 (ELISA)方法 ,测定了 3 5例ACS病人 (ACS组 )、2 3例稳定性心绞痛病人 (SAP组 )及 2 0例对照组受试者的血清可溶性Fas、可溶性Fas配体和可溶性白细胞介素 2受体水平。结果 :血清可溶性Fas和可溶性白细胞介素 2受体平均水平 ,ACS组明显高于SAP组和对照组 ,有显著性统计学差异 (P <0 0 1) ,而后两组比较无显著性差异 (P >0 0 5 )。 3组间血清可溶性Fas配体平均水平无显著性差异 (P >0 0 5 )。ACS组血清可溶性Fas水平与可溶性白细胞介素 2受体水平存在显著正相关 (γ =0 45 7,P <0 0 1)。结论 :研究表明ACS病人血清可溶性Fas、可溶性白细胞介素 2受体水平明显升高 ,提示其可能与ACS有关。血清可溶性Fas可能通过维持自身免疫炎性反应而导致ACS的发生发展。     

冠心病患者可溶性肿瘤坏死因子受体的改变与临床意义

目的：观察冠心病患者可溶性肿瘤坏死因子受体（ＳＴＮＦＲ）的改变与临床意义。方法：ＳＴＮＦＲ采用酶联免疫双抗体夹心法测定。结果：血清ＳＴＮＦＲ（ｎｇ／ｍｌ）在急性心肌梗死患者（３．５５±２．０１，ｎ＝２９）和冠心病心肌缺血患者（１．９９±０．６２，ｎ＝２３）中均较正常对照有所升高（０．９３±０．２９，ｎ＝６１，Ｐ均＜０．０１），急性心肌梗死并发心力衰竭死亡时ＳＴＮＦＲ升高达正常值７．７倍（７．２３±１．６０，ｎ＝５），心肌缺血患者中心功能ＩＩ、ＩＶ级（２．５３±０．４６，ｎ＝７）较Ｉ、Ｉ级者（１．７３±０．５０，ｎ＝１６）升高明显（Ｐ＜０．０１）。结论：冠心病患者中ＳＴＮＦＲ水平与病情严重程度密切相关，并能预测急性心肌梗死患者预后。     

Immunochemical Determination of Serum Transferrin: Reference Values,Correlation with Serum Total Iron-Binding Capacity and Value in the Diagnosis of Iron Deficiency Anaemia and Anaemia of Chronic Disorders

Immunologically determined reference values of serum transferrin are presented for adults and children. A good correlation between serum transferrin and total iron-binding capacity values was found. In 2 groups of anaemic patients - 51 patients with iron deficiency anaemia and 45 patients with anaemia of chronic disorders - serum transferrin determination distinguishes the two groups of anaemic patients from normals somewhat better than TIBC determination.     

Up-regulation of transferrin receptor 1 in chronic hepatitis C: Implication in excess hepatic iron accumulation.

BACKGROUND/AIMS:: To clarify the mechanism of excess hepatic iron accumulation in chronic hepatitis C, we investigated the expressions of transferrin receptor 1 and divalent metal transporter 1 in hepatocytes, both of which are involved in cellular iron uptake, in relation to the degree of hepatic iron accumulation and hepatic fibrosis by immunohistochemistrical study. METHODS:: Forty-six hepatic tissues with chronic hepatitis C and five normal hepatic tissues were examined. Chemical detection of hepatic iron accumulation was performed by Perl's Prussian blue stain. The immunohistochemistrical study was performed by avidin-biotin complex method with alkaline phosphatase. RESULTS:: In chronic hepatitis C: (1) Hepatic iron accumulation was significantly increased in relation to the advance of the fibrosis. (2) Divalent metal transporter 1 decreased significantly in relation to the advance of hepatic fibrosis. (3) Transferrin receptor 1 expression was always detected, although not in normal hepatic tissues; there was no relation between expression levels and the degree of hepatic fibrosis. CONCLUSIONS:: These data demonstrated that the transferrin receptor 1 expression was up-regulated irrespective of the degree of hepatic iron accumulation, suggesting that the up-regulation of transferrin receptor 1 might act as one of the key mechanisms implicated in the accumulation of hepatic iron in chronic hepatitis C.     

Up-regulation of Transferrin Receptor Expression in Hepatocytes by Habitual Alcohol Drinking Is Implicated in Hepatic Iron Overload in Alcoholic Liver Disease

Background Hepatic iron overload is often seen in alcoholic liver disease (ALD). We previously reported that the expression of 4-hydroxy-2-nonenal-protein adducts, which is a lipid peroxidative product and can be used as a marker of radical-mediated cellular damage, was increased in iron-overloaded hepatocytes with ALD. However, the mechanism of hepatic iron overload in ALD has not been clarified. In this study, to elucidate the mechanism of hepatic iron overload in ALD, we immunohistochemically investigated the expression of transferrin receptor (TfR), which mainly acts for cellular iron uptake.
Methods Hepatic tissues were obtained from 31 patients with ALD and 5 normal livers by percutaneous needle biopsy under laparoscopy or ultrasound guidance. Chemical detection of hepatic iron accumulation was performed by Perls' Prussian blue stain. Immunohistochemical detection of TfR expression was done using human monoclonal anti-TfR antibody (TR104) according to the avidin-biotin complex method with alkaline phosphatase.
Results Excess iron accumulation was found in 22 hepatic tissues with ALD but not in any normal hepatic tissues. TfR expression was increased in hepatocytes of 18 hepatic tissues with ALD but was not detected in any normal hepatic tissues. The mean duration of abstinence of patients who demonstrated positive TfR expression in hepatocytes was significantly shorter than that of patients who demonstrated negative TfR expression (positive: 14 days; negative: 30 days). However, total ethanol consumption, daily ethanol intake, and serum aspartate aminotransferase and γ-glutamyl transpeptidase values on admission were not significantly correlated with TfR expression in hepatocytes.
Conclusions The up-regulation of TfR expression in hepatocytes is implicated in hepatic iron overload in ALD, and habitual alcohol drinking is an important factor for the induction of TfR expression.     

Serum Iron and Transferrin Saturation in Women with Special Reference to Women with Low Transferrin Saturation

Serum iron and total iron binding capacity (TIBC) were determined in a population sample of 1462 women in age strata between 38 and 60. Serum iron and TIBC values were similar in the various ages studied but with a slight trend towards higher serum iron and lower TIBC values in the upper ages. Transferrin saturation was used to divide the material arbitrarily into women with and without iron deficiency. The dividing point chosen was 16%. The women thus defined as iron deficient had lower mean haemoglobin values than women in the total population sample and were more often anaemic. They had also lower MCV, MCH and MCHC indices than women in the total population sample. Of these indices, MCH seemed to discriminate the state of iron deficiency better than MCV and MCHC. Except for an increased mean menstrual blood loss no obvious cause of iron deficiency could be found in these women with low transferrin saturation.     

HBV感染与肝癌患者血清可溶性IL—2受体及T淋巴细胞亚群的变化及意义

用ＥＬＩＳＡ及ＡＰＡＡＰ法分别检测了３９例乙型肝炎病毒（ＨＢＶ）感染者、１５例者ＨＢＶ感染的肝癌患者及２０例正常人的血清可溶性白细胞介素－２受体（ＳＩＬ－２Ｒ）和外周血Ｔ淋巴细胞亚群结果显示,肝癌及ＨＢＶ感染者（Ｐ〈０．０１）。吕患者及ＨＢＶ感染者ＣＤ３、ＣＤ４、ＣＤ８、ＣＤ４／ＣＤ８与对照相比均有显著差异（Ｐ〈０．０５）,而肝癌与ＨＢＶ感染者相比无显著差异（Ｐ〉０．０５）。提示ＨＢＶ感染者及肝癌     

心律失常患者血清可溶性白细胞介素－2受体的变化及意义初探

应用酶标双抗体夹心法（ＥＬＩＳＡ）测定３０例心律失常患者（其中心房颤动１２例、室性早搏９例、房性早搏９例）血清可溶性白细胞介素－２受体（ＳＩＬ－２Ｒ）的水平。以３２例不伴心律失常的心脏病患者作对照，并与３０例正常人作比较。三组血清ＳＩＬ－２Ｒ水平分别为３７０．１±１８１．８，１８４．５±９６．５，７９．１±２７．４ｕ／ｍｌ，心律失常组高于对照组和正常组（Ｐ均＜０．００１）；对照组ＳＩＬ－２Ｒ水平亦高于正常组（Ｐ＜０．００１）；不同类型心律失常患者的血清ＳＩＬ－２Ｒ水平比较差异无显著性（Ｐ＞０．０５）。提示心律失常患者可能存在免疫功能紊乱；ＳＩＬ－２Ｒ可作为衡量心律失常患者的细胞免疫活性的一个指标。     

大肠癌患者血清和组织中sIL-2R水平变化及其意义

目的 研究大肠癌患者血清和组织中可溶性白细胞介素2受体(soluble interleukin-2 receptor,sIL-2R)水平变化的临床意义.方法 采用双抗体夹心ELISA法对44例大肠癌患者手术前后,28例大肠息肉患者,30例健康体检者血清sIL-2R水平进行检测;并检测大肠癌及大肠息肉患者组织中该项指标的浓度.结果 大肠癌患者血清中sIL-2R为209.27±127.42 pmol/L,明显高于大肠息肉患者的66.27±14.91 pmol/L和健康体检者的58.45±13.62 pmol/L(P均<0.001).大肠癌组织中sIL-2R为233.66±170.22 pmol/L,明显高于大肠息肉组织的83.96±21.11 pmol/L(P<0.001).大肠癌C、D期血清和组织中sIL-2R水平明显高于A、B期(P<0.001).大肠癌患者根治性手术组术后1个月sIL-2R水平明显下降(P<0.001),而姑息性手术组虽有下降但不明显(P>0.05).结论 动态观察血清和组织中sIL-2R的变化可作为大肠癌的诊断、手术方法的选择、疗效评价及预后监测有意义的参考指标.     

胃癌患者血清和组织中sICAM-1水平的临床观察及其意义

目的研究胃癌患者血清及组织中可溶性细胞间粘附分子-1(sICAM-1)变化的临床意义。方法采用双抗体夹心ELISA法,对58例胃癌患者手术前后、32例胃良性疾病患者及36例健康体检者血清sICAM-1水平进行检测;同时检测了胃癌及胃良性疾病者活检组织中sICAM-1的浓度。结果胃癌患者血清sICAM-1为9.193±4.198mg/L,明显高于胃良性疾患者(0.614±0.061mg/L)和健康体检者(0.577±0.145mg/L,P＜0.001)。胃癌组织中sICAM-1(9.764±3.744mg/L)明显高于胃良性疾病胃粘膜组织(0.624±0.063mg/L,P＜0.001)。胃癌按Ⅰ～Ⅳ级分期的不同,sICAM-1在血清和组织中均逐渐增高,且各期之间进行比较均P＜0.001其中Ⅰ期(11例)、Ⅱ期(10例)、Ⅲ期(22例)术后血清sICAM-1均明显下降(各自P＜0.001);而Ⅳ期患者(15例)手术前后无明显变化且有所增高;手术切除组(46例,根治或姑息手术)术后sICAM-1明显降低(P＜0.001),探查者或胃空肠吻合术者(12例),术后血清sICAM-1反而增高。结论动态观察血清及组织sICAM-1的变化可作为胃癌的诊断、手术方法的选择、疗效评价及预后监测有意义的参考指标。     

Fasting (Acute Energy Deprivation) in Man: Effect on Polymorphonuclear Granulocyte Functions,Plasma Iron and Serum Transferrin

The effect of 10 days of total fasting (energy deprivation) on blood polymorphonuclear granulocyte functions, leukocyte numbers, iron and transferrin levels was evaluated in 14 healthy, normal-weight males. Granulocytes from 7 of the subjects were tested in vitro. A statistically significant depression was noted in their bactericidal capacity against Staph. aureus. The 14 subjects showed a marked decrease in the stainable activity of granulocyte alkaline phosphatase and decreases were noted in plasma iron and serum transferrin levels. The iron saturation of serum transferrin was unchanged. Thus, impairment of granulocyte bactericidal functions may occur secondarily to short-term total energy deprivation, in the absence of iron deficiency.     

慢性肝病患者血清可溶性细胞间粘附分子-1和透明质酸水平的变化及意义

目的:探讨血清可溶性细胞间粘附分子-1(sICAM-1)和透明质酸(HA)与肝纤维化及肝损害的关系。方法:用ELISA法检测正常人、慢性肝炎肝硬变患者血清sICAM-1;用RIA法测定正常人、慢性肝炎及肝硬变患者血清HA。结果:慢性肝病患者各组血清sICAM-1均显著高于正常人,各组间存在显著的差异。血清HA水平在慢性肝炎中度组、重度组、肝硬变组明显高于正常人。在不同临床类型的慢性肝病患者中HA血清水平也存在显著的差异。病情越重,血清sICAM-1和HA水平越高。两者与血清草酰乙酸转氨酶(AST)、总胆红素、球蛋白呈显著正相关,与血清白蛋白呈显著负相关。结论:慢性肝病患者血清sICAM-1和血清HA可作为判断肝纤维化及肝损伤程度的指标。     

慢性肝病患者血清可溶性细胞间粘附分子-1和透明质酸水平及其意义

目的：探讨血清可溶性细胞间粘附分子－１和透明质酸（ＨＡ）与肝纤维经及肝损害的关系。方法：用ＥＬＩＳＡ法检测正常人、慢性直炎肝硬化血清ＳＩＣＡＭ－１。用ＲＩＡ法测定正常人、慢性肝炎肝硬化患者血清ＨＡ。结果：慢性肝病且血清ＳＩＣＡＭ＿１均显著高于正常人,各组间存在显著差异;血清ＨＡ水平在慢性肝炎中度组、重度组,肝硬化组明显高于正常人。在不同临床类型的慢性肝病患者中ＨＡ血清水平也存在显著差异,病情越重,     

消化道恶性肿瘤患者可溶性白细胞介素－2受体的检测及其临床评价

本研究应用ＥＬＩＳＡ法对５０例食管癌、６３例胃癌、４４例大肠癌患者进行血清ＳＩＬ－２Ｒ检测，结果表明：三组肿瘤愚者血清ＳＩＬ－２Ｒ水平均显著高于对照组；有淋巴结转移者显著高于无转移者；随肿瘤病理分期的增加血清ＳＩＬ－２Ｒ水平也增加，Ⅲ、Ⅳ期显著高于Ⅰ、Ⅱ；手术切除肿瘤和化疗有效的病例ＳＩＬ－２Ｒ水平下降，肿瘤复发则升高。     

Soluble transferrin receptor in Aboriginal children with a high prevalence of iron deficiency and infection

OBJECTIVES: Aboriginal children in tropical Australia have a high prevalence of both iron deficiency and acute infections, making it difficult to differentiate their relative contributions to anaemia. The aims of this study were to compare soluble transferrin receptor with ferritin in iron deficiency anaemia (IDA), and to examine how best to distinguish the effect of iron deficiency from infection on anaemia. METHODS: We conducted a prospective study of 228 admissions to Royal Darwin Hospital in children from 6 to 60 months of age. Transferrin receptor concentrations were measured by a particle-enhanced immunoturbidimetric assay and ferritin by a microparticle enzyme immunoassay. RESULTS: On multiple regression, the best explanatory variables for haemoglobin differences (r2=33.7%, P<0.001) were mean corpuscular volume (MCV), red cell distribution width (RDW) and C-reactive protein (CRP); whereas transferrin receptor and ferritin were not significant (P>0.4). Using > or =2 abnormal indices (MCV, RDW, blood film)+haemoglobin <110 g/l as the reference standard for IDA, transferrin receptor produced a higher area under the curve on receiver operating characteristic curve analysis than ferritin (0.79 vs. 0.64, P<0.001) or the transferrin receptor-ferritin index (0.77). On logistic regression, the effect of acute infection (CRP) on haemoglobin was significant (P<0.001) at cut-offs of 105 and 110 g/l, but not at 100 g/l when only iron deficiency indicators (MCV, RDW, blood film) were significant. CONCLUSIONS: Transferrin receptor does not significantly improve the diagnosis of anaemia (iron deficiency vs. infection) over full blood count and CRP, but in settings with a high burden of infectious diseases and iron deficiency, it is a more reliable adjunctive measure of iron status than ferritin.     

Soluble transferrin receptor in the study of fetal erythropoietic activity

In order to evaluate fetal erythropoiesis we measured red blood cells, hemoglobin, hematocrit, serum transferrin receptor (sTfR), and iron status parameters in fetuses undergoing percutaneous umbilical blood sampling, and in normal newborns at term. We found high levels of sTfR in fetuses and newborns as compared with normal adults (3,149 ± 181 vs. 1,881 ± 137 ng/ml, P < 0.00001). Concentrations of sTfR correlate with gestational age and red blood cell numbers (r = 0.441, P < 0.001; r = 0.366, P = 0.06). sTfR concentrations do not show correlation with iron status parameters. The increased sTfR concentration is consistent with the fact that fetal life is characterized by cell proliferation and tissue growth. sTfR concentration correlates with gestational age and numbers of red blood cells, and can therefore be considered a good indicator of fetal erythropoiesis. It is conceivable that, during intrauterine life, sTfR expression is independent from iron status. sTfR determination will help in reaching a better understanding of some aspects of fetal physiology, and will help elucidate the physiopathology of fetal hematological diseases. © 1996 Wiley-Liss, Inc.