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1.
目的分析健康人及慢性HBV感染者T细胞亚群特点,探讨宿主细胞免疫功能与慢性HBV感染临床转归的关系。方法使用流式细胞仪检测30名健康人及137例各型HBV感染者外周血T细胞亚群。结果1.对照组与各型HBV感染者的外周血T细胞亚群比较:从慢性HBV携带(CHBVC)组、慢性乙型肝炎(CHB)组到肝炎后肝硬化(PHBC)组,患者外周血CD3^+T、CD4^+T和CD8^+T绝对值呈逐渐下降趋势,显著低于对照组(P〈0.05)。PHBC组CD4^+T/CD8^+T比值显著高于对照组和CHBVC组(尸〈0.05)。2.不同程度CHB组间外周血T细胞亚群比较:从CHB(轻度)组、CHB(重度)组到慢性重型乙型肝炎(CSUB)组,患者CD3^+F、CD4^+T、CD8^+T绝对值和CD4^+T/CD8^+T比值逐渐下降。CSHB组CD3^+T、CD4^+T和CD8^+T绝对值显著低于CHB(轻度)组(P〈0.05)。结论HBV慢性感染机制复杂,不同的临床转归患者T细胞亚群状态不同。慢性HBV感染后,肝脏损害程度严重的患者T细胞亚群功能低下及紊乱程度明显。  相似文献   

2.
HBV-DNA定量与乙肝标志物及谷丙转氨酶结果对比分析   总被引:2,自引:0,他引:2  
柳婉琼 《当代医学》2009,15(33):81-82
目的探讨血清中HBV—DNA定量与乙肝标志物(HBV—M)及谷丙转氨酶(ALT)之间的关系及临床意义。方法采用荧光定量聚合酶链式反应法(FQ—PCR)和ELISA法分别检测578例病人的血清HBV—DNA含量和HBV-M,自动生化分析仪检测ALT并对结果进行对比分析。结果HBsAg(+)、HBeAg(+)、HBcAb(+)组血清HBV—DNA检出率833%(259/2311),平均拷贝数1.1×10^8/ml。HBsAg(+)、HBeAb(+)、HBcAb(+)组血清HBV--DNA检出率33.5%(44/132),平均拷贝数5.9×10^8/ml。HBsAg(+)、HBcAb(+)组血清HBV-DNA检出率242%(14/58),平均拷贝数1.9×10^8/ml。HBeAb(+)、HBcAb(+)组血清HBV—DNA检出率78%(1/15),平均拷贝数3.5×10^3/ml。全阴性组血清HBVDNA检出率53%,平均峙贝数2.0×10^3/ml。HBsAg(+)、aBeAg(+)组的HBV--DNA阳性率高、定量值高,而HBsAg(+)、HBeAg(-)组HBV—DNA阳性率较低、定量值也较低,二者差异有显著性;HBsAg(-)者亦可检出HBV-DNA;HBV感染者ALT阳性的概率增大,但二者在数量上无相关性。结论同时检测血清乙肝标志物和HBV—DNA及谷丙转氨酶,对临床HBV感染、复制及传染性的判断具有重要意义。  相似文献   

3.
目的探讨临床中乙肝患者外周血的HBV抗原抗体的表达及病毒载量情况,并分析其与T细胞亚群之间的关系。方法选取我院2010年1~12月间的80例乙肝患者为研究组,另选取同期在我院体检的80例健康对象为对照组,然后采取荧光定量法检测HBV—DNA含量,微粒子酶免疫法检测HBV原抗体的表达,流式细胞术检测外周血T细胞亚群。结果HBV抗原抗体含量分为HBeAg阳性和HBeAg阴性,例数分别为50例、30例,对照组的CD3^+、CD4^+、CD8^+含量均明显高于HBeAg阳性组及HBeAg阴性组的CD3^+、CD4^+、CD8^+的含量(P〈0.05)。HBeAg阳性组及HBeAg阴性组的CD3^+、CD4~.CD8^+的含量比较无明显的差异(P〉0.05)。HBV—DNA含量分为三个亚组,〈104IU/mL组、(104--106)IU/mL组和(107--10。)IU/mL组,例数分别为20例、25例、35例。对照组、〈104IU/mL组和(104—10‘)U/mL组以及(10’~10。)U/mL组的CD3^+比较具有明显差异(P〈0.05);对照组和(107~10s)U/mL组的CD4^+含量比较具有明显的差异(P〈0.05),有统计学意义;对照组和(10^4—10^6)IU/mL组以及(10^7-10^8)IU/mL组的CD8^+比较差异有统计学有意义(P〈0.05)。(10L106)IU/mL组和(10^7-10^8)IU/mL组的CD8啥量均明显高于〈104IU/mL组,差异有统计学有意义(P〈0.05)。结论临床中乙肝患者的HBV抗原抗体和病毒载量均与T细胞亚群之间存在联系,并且其不同含量的T细胞亚群也存在差异,均异于常人。因此,临床中可以通过测定病毒载量与T细胞亚群,并有效了解患者的机体免疫状况,从而更好地指导临床治疗。  相似文献   

4.
目的探讨慢性乙型重型肝炎早期、中期、晚期病人的免疫和肝生化指标变化与预后的关系。方法检测120例慢性重型肝炎病人(早期60例,中期40例,晚期20例)和120例慢性乙型肝炎病人的T细胞亚群、HBV DNA载量、免疫学及肝功能指标,并总结分析其临床意义。结果晚期慢性乙型重型肝炎病人细胞免疫状态最差,与慢性乙型肝炎病人相比差异显著,NK细胞分别为(7.47±4.19)%vs(13.29±4.68)%,P〈0.05;CD4/CD8比值为(0.39±0.16)vs(1.12±0.26),P〈0.05;CD3^+(73.11±13.16)%vs(56.12±9.54)%;P〈0.05;CD8^+(56.74±13.91)%vs(34.26±10.58)%,P〈0.05;晚期慢性乙型重型肝炎的肝功能损害与慢性乙型肝炎相比同样有显著性差异:白蛋白分别为(20.82±3.46)g/L vs(43.11±5.74)g/L,P〈0.05;血清总胆红质(TB)(519.42±156.18)μmol/Lvs(25.91±17.38)μmol/L,P〈0.05;凝血酶元活动度(PTA)(15.21±6.38)%vs(92.45±10.56)%,P〈0.05。结论慢性乙型重型肝炎晚期病人的CD4/CD8、NK细胞显著下降,病人淋巴细胞亚群的失衡可加重肝脏的损伤。  相似文献   

5.
赵岩  赵颖 《中国乡村医生》2010,12(8):144-144
目的:通过收集HBsAg阳性人群血清进行HBV—DNA定量测定,分析HBV感染人体后不同年龄组、不同血清标志物模式病毒复制状况。方法:乙肝血清学标志物检查采用ELISA法,HBV—DNA检测采用实时荧光定量PCR法。结果:A、B、C、D四个年龄组模式Ⅰ(HBsAg+,HBeAg+/HBsAg+,HBeAg+,HBeAb+)间有显著差异,F=9.90(P〈0.01),模式Ⅱ(HBsAg+,HBeAb+/HBsAg+,HBeAb+,HBcAb+)和模式Ⅲ(HBsAg+.HBcAb)组间无差异,HBV—DNA阳性率(检测结果〉1.0×103copies/ml为阳性)模式Ⅰ与模式Ⅱ(u=9.60,P〈0.01)、模式Ⅰ与模式Ⅲ(u=4.61,P〈0.01)之间均有显著性差异,模式Ⅱ与模式Ⅲ(u=2.07,P〈0.05)有差异。结论:HbeAg阳性者病毒成高水平复制状态,并且不同年龄组间有差异。HBeAb阳性和无HBeAb者不能完全代表无病毒复制。乙肝免疫标示物和HBV—DNA的检测不能相互替代。  相似文献   

6.
目的探讨性别因素对慢性乙型肝炎病毒复制和免疫应答的影响程度。方法统计处理采用SPSS11.5软件。男性与女性病人之间年龄、血清病毒水平及外周血免疫细胞绝对计数的比较采用Mann—Whimey U检验,年龄与性别、血清病毒水平及外周血免疫细胞绝对计数之间的相关分析采用Spearman等级相关法,性别、年龄及外周血免疫细胞对血清病毒水平的影响程度采用最优尺度多元回归分析。结果男性与女性病人之间血清HBsAg水平无显著性差异(P〉0.05),男性病人血清HBeAg和HBV DNA水平显著高于女性病人(P=0.011,P=0.001);男性病人年龄显著低于女性病人(P=0.008),男性与女性病人之间单核细胞、淋巴细胞、CD3^+、CD19^+、CD56^+、CD4^+、CD8^+绝对计数及CD4^+,CD8^+比值均无显著性差异(P〉0.05)。年龄与血清HBsAg水平之间无显著相关性(P=0.481),年龄与血清HBeAg和HBV DNA水平之间呈显著负相关(P=0.009,P=0.012);年龄与单核细胞、CD19^+、CD56^+绝对计数之间无显著相关性(P〉0.05),与淋巴细胞、CD3^+、CD4^+、CD8^+呈显著负相关(P=0.002,P=0.000,P=0.021,P=0.000),与CD4^+/CD8^+比值呈显著正相关(P=0.000)。根据最优尺度多元回归分析的结果,男性性别为血清HBeAg保持阳性的主要因素(P=0.028),年龄及外周血免疫细胞绝对计数不是血清HBeAg保持阳性的主要因素(P〉0.05);男性性别为血清HBV DNA保持高水平的主要因素(P=0.002),年龄及外周血免疫细胞不是血清HBV DNA保持高水平的主要因素(P〉0.05)。结论男性慢性乙型肝炎有较高的血清HBV水平,其机制可能是男性病人有更高的HBV复制水平而不是有较低的免疫应答水平。  相似文献   

7.
目的:分析HBeAg阳性慢性乙型肝炎患者、HBeAg阳性乙肝病毒携带者外周血T淋巴细胞上CD28表达情况及其与HBV病毒载量的关系。方法采集健康人、HBeAg阳性乙肝病毒携带者、HBeAg阳性慢性乙型肝炎患者的外周血,抗体标记,采用流式细胞技术检测CD4^+、CD8^+、CD4^+CD28^+、CD8^+CD28^+T淋巴细胞,同时检测肝功能HBV DNA。结果慢性乙型肝炎组、乙肝病毒携带组CD4^+CD28^+T细胞、CD8^+CD28^+T细胞百分率明显低于健康对照组(P〈0.05);HBV DNA≥107组CD8^+CD28^+T细胞百分率低于HBV DNA<107组(P〈0.05)。结论乙型肝炎病毒感染者CD8^+T细胞上CD28的低表达与高病毒载量有关。  相似文献   

8.
目的研究慢性乙肝病毒携带者(AsC)的细胞免疫功能变化及临床意义,探讨其与血清HBVDNA的关系。方法对120例慢性乙肝病毒携带者和60例健康人应用流式细胞仪直接免疫荧光法检测外周血T淋巴细胞亚群的百分率,并进行比较。结果乙肝病毒携带者外周血CD3^+、CD4^+细胞数百分率及CD4/CD8与健康对照组比较明显降低(P〈0.01);CD8^+细胞数百分率较健康对照组明显升高(P〈0.01);血清HBVDNA(+)组与HBVDNA(-)组相比,CD3^+细胞数百分率无统计学差异(P〉0.05),CD4^+细胞数百分率及CD4^+/CD8^+比值明显降低(P〈0.01),CD8^+细胞数百分率明显升高(P〈0.01)。将HBVDNA(+)组按高、中、低病毒载量分组进行比较,各项指标均无统计学意义(P〉0.05)。但CD4^+、CD4^+/CD8^+在数值上呈下降趋势,CD8^+呈上升趋势。结论HBV感染后可导致乙肝病毒携带者细胞免疫功能降低,HBVDNA复制进一步加重紊乱。  相似文献   

9.
陈勇  王胜义  查健 《吉林医学》2009,30(23):2934-2936
目的:观察腹腔镜下阑尾切除术对小儿细胞免疫功能的影响。方法:对40例慢性阑尾炎患儿,随机分为腹腔镜组和开腹组,分别于术前及术后1d、3d监测T细胞亚群CD3^+、CD4^+、CD4^+/CD8^+的变化。结果:与术前比较,术后1d两组CD3^+、CD4^+显著降低(P〈0.05),而CD8^+明显升高(P〈0.05),CD4^+/CD8^+比值降低(P〈0.01),术后3d均恢复至正常水平。但LA组术后1d的CD8^+升高幅度及CD3^+、CD4^+、CD4^+/CD8^+比值降低幅度均明显低于OA组(P〈0.05或P〈0.01)。结论:开腹或腹腔镜下阑尾切除术均可抑制小儿细胞免疫功能,但腹腔镜手术对细胞免疫功能的影响相对较小。  相似文献   

10.
目的探讨脓毒症患者T淋巴细胞亚群水平与APACHEⅡ评分的相关性。方法采用流式细胞仪测定60例脓毒症患者(脓毒症组)和柏例同期住院的非脓毒症患者(对照组)的外周血CD4^+T、CD8^+T细胞水平,并计算CD4^+T/CD8^+T细胞比值和APACHEⅡ评分。按疾病转归将60例脓毒症患者分成死亡组(n=22)和存活组(n=38),比较上述检测指标水平。结果脓毒症组的CD4^+T、CD4^+T/CD8^+T细胞水平明显低于对照组,差异有统计学意义(P〈0.01);死亡组患者CD4^+T、CD4^+T/CD8^+T细胞水平明显低于存活组,差异有统计学意义(P〈0.01)。结论脓毒症患者APACHEⅡ评分与外周血CD4^+T(r=-0.474,P〈0.01)和CD4^+T/CD8^+T细胞比值(r=-0.425,P〈0.01)呈显著负相关。  相似文献   

11.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

12.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

13.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

14.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

15.
Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P<0.01);the MAP decreased(P<0.01)and the HR increased drastically(P<0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.  相似文献   

16.
Objective:To investigate the gene expression of osteoprotegerin(OPG) and osteoclast differentiation factor(ODF) in the bone tissue of patients with hip fracture due to osteoporosis. Methods:OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers(over 50 years old) with hip fracture(Observer Group) and 30 cases of hip facture sufferers with no osteoporosis(Control group) were analyzed with the Semi-Quantitative RT-PCR method. Results:The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion:Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.  相似文献   

17.
Objective:To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas(SPTP). Methods:Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin(HE) staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results:Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin(9/9 cases), AAT(9/9 cases), NSE(9/9 cases), ACT(7/9 cases), CK20(2/9 cases), CgA(1/9 cases), S-100(3/gcases), PR(4/gcases), Syn(3/9 cases) and CD56(5/9cases), negative in CEA and ER. Conclusion:SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.  相似文献   

18.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

19.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

20.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

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