新生儿病理性黄疸患儿血清胆红素、TBA及HS-CRP检测水平分析

目的探讨新生儿病理性黄疸患儿的血清总胆红素(TBIL)、非结合胆红素(UCB)、总胆汁酸(TBA)及超敏C-反应蛋白(HS-CRP)指标检测水平变化在新生儿黄疸(NJ)的临床应用价值。方法回顾性分析2016年11月-2017年2月间118例新生儿病理性黄疸患儿(病理组)和118例同期足月健康新生儿(对照组)检测上述研究对象的血清TBIL、UCB、TBA和HS-CRP的临床资料,比较上述指标在各组、新生儿病理性黄疸不同病情以及不同病因的差异。结果病理组检测TBIL、UCB、TBA和HS-CRP水平显著高于正常组,组间比较差异有高度统计学意义(P0.01)。重度黄疸患儿TBIL、UCB、TBA和HS-CRP检测水平明显高于中度黄疸患儿(T值分别为48.981,27.051,6.678,9.115,P值均0.05)和轻度黄疸患儿(T值分别为31.024,11.025,15.243,12.189,P值均0.01),中度黄疸组TBIL、UCB、TBA和HS-CRP检测水平高于轻度黄疸组(T值分别为3.487,4.101,3.754,4.001,P值均0.05)。感染性黄疸患儿的血清TBIL、UCB、TBA和HS-CRP检测水平明显高于其他3组(P0.05),阻塞性黄疸患儿的血清TBIL、UCB、TBA和HS-CRP检测水平高于溶血性黄疸患儿和母乳性黄疸患儿(P0.05))。溶血性黄疸患儿的血清TBIL、UCB、TBA和HS-CRP检测水平高于母乳性黄疸患儿(P0.05)。结论检测TBIL、UCB、TBA和HS-CRP水平在病理性黄疸进展中均呈升高趋势,其水平变化与病情严重程度、病因类型有一定的相关性。几个项目同时检测有利于临床上对新生儿黄疸的类型、病情进展等方面的判断,对新生儿病理性黄疸的早期诊治、病因分析及预后处理有一定的应用价值。     

新生儿病理性黄疸患儿血清总胆红素表达水平与病情严重程度的相关性分析

目的 探讨新生儿病理性黄疸患儿血清总胆红素表达水平与病情严重程度的相关性。方法 选取2019年3月～2020年2月在我院进行治疗的新生儿病理性黄疸患儿95例,评估患儿的病情严重程度,并测定所有患儿的血清总胆红素水平,分析新生儿病理性黄疸患儿血清总胆红素表达水平与病情严重程度的相关性。结果 95例新生儿病理性黄疸患儿中轻度45例,占比47.37%;中度38例,占比40.00%;重度12例,占比12.63%。轻度、中度、重度病理性黄疸患儿的性别、日龄、黄疸持续时间、出生时体重比较,差异无统计学意义(P0.05);中度、重度病理性黄疸患儿血清总胆红素水平均高于轻度病理性黄疸患儿,且重度病理性黄疸患儿血清总胆红素水平高于中度病理性黄疸患儿,差异有统计学意义(P0.05)。经Logistics回归分析结果显示,血清总胆红素高表达是病理性黄疸患儿病情加重的影响因素(OR1,P0.05)。结论 病理性黄疸患儿病情严重程度与血清总胆红素水平有关,血清总胆红素高表达会加重患儿病情严重程度。     

血清转铁蛋白、C反应蛋白和红细胞免疫功能检测对新生儿黄疸的诊断价值

目的探讨血清转铁蛋白(TRF)、C反应蛋白(CRP)和红细胞免疫功能水平检测在新生儿黄疸诊断中的价值。方法收集本院2016年3月—2018年3月新生儿科确诊的100例黄疸新生儿和80例足月健康新生儿,分别记为黄疸组和健康组。根据黄疸类型和总胆红素(TBIL)水平,将黄疸组分为生理性黄疸组(n=43)和病理性黄疸组(n=57);根据黄疸病情程度将黄疸组患儿分为轻中度黄疸组(n=69)和重度黄疸组(n=31)。检测新生儿的血清TRF、CRP、红细胞免疫复合物花环(RBC-ICR)、红细胞C3b受体花环(RBC-C3bR)、红细胞免疫亲和力受体(FEER)水平;比较黄疸组和健康组、黄疸各亚组上述指标水平差异。结果与健康组比较,黄疸组血清TRF、RBC-C3bR、FEER水平显著偏低,CRP、RBC-ICR水平显著较高,差异有统计学意义(P0.05);生理性黄疸组血清TRF、RBC-C3bR、FEER水平高于病理性黄疸组,CRP、RBC-ICR水平显著低于病理性黄疸组(P0.05);轻中度黄疸组血清TRF、RBC-C3bR、FEER水平显著高于重度黄疸组,CRP、RBC-ICR水平低于重度黄疸组,差异有统计学意义(P0.05)。结论黄疸新生儿血清TRF、CRP的表达和红细胞免疫功能呈异常状态,且不同类型和不同病情程度黄疸新生儿上述指标也存在显著差异,对临床诊断新生儿黄疸具有一定参考价值。     

新生儿黄疸患儿血清Alb、UBIL、ET-1水平与疾病严重程度的关系

目的探讨新生儿黄疸患儿血清清蛋白(Alb)、未结合胆红素(UBIL)、内皮素-1(ET-1)表达水平及其与疾病严重程度的关系。方法选取47例生理性黄疸患儿和79例病理性黄疸患儿,以同期足月80例健康新生儿作为健康对照组。测定所有研究对象血清UBIL、Alb、ET-1水平,同时测定病理性黄疸患儿血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰基转移酶(GGT)和碱性磷酸酶(ALP)水平。分析血清UBIL、Alb、ET-1水平与不同病因、有无核黄疸、不同病情程度之间的关系。结果 3组血清UBIL、Alb、ET-1水平比较差异有统计学意义(均P0.05),其中病理性黄疸组UBIL、ET-1水平明显高于生理性黄疸组(q=9.683、24.663,P0.05)和健康对照组(q=16.764、2.965,P0.05),而血清Alb水平低于生理性黄疸组(q=8.154,P0.05),但稍高于健康对照组(q=4.703,P0.05),生理性黄疸组血清UBIL、Alb、ET-1水平明显高于健康对照组(q=13.956、11.225、7.263,P0.05)。3组ALT、AST、胆红素(DBIL)、总胆红素(TBIL)比较差异有统计学意义(P0.05),其中病理性黄疸组ALT、AST、DBIL、TBIL水平明显高于生理性黄疸组(q=27.404、37.779、11.083、9.739,P0.05)和健康对照组(q=20.873、31.401、15.671、12.774,P0.05),生理性黄疸组ALT、AST、DBIL、TBIL明显高于健康对照组(q=4.298、10.452、4.645、3.184,P0.05)。病理性黄疸患儿血清UBIL、Alb、ET-1与ALT、AST均呈正相关关系(P0.05),血清UBIL、ET-1与DBIL、TBIL也呈正相关关系(P0.05),而病理性黄疸患儿血清Alb与DBIL、TBIL无相关性(P0.05)。不同病因黄疸患儿血清UBIL、Alb、ET-1水平比较差异均有统计学意义(P0.05),其中感染性黄疸患儿血清UBIL、ET-1水平明显高于母乳性黄疸、溶血性黄疸、其他围生因素黄疸患儿(qUBIL=7.039、5.565、8.575;qET-1=11.107、8.307、13.761,均P0.05),而血清Alb水平明显低于母乳性黄疸、溶血性黄疸、其他围生因素黄疸患儿(q=4.876,3.724,8.258,均P0.05)。重度黄疸患儿血清UBIL、ET-1水平明显高于中度黄疸患儿(P0.05),而血清Alb水平明显低于中度黄疸患儿(P0.05)。结论新生儿黄疸患儿血清Alb、UBIL、ET-1水平与疾病严重程度相关。     

新生儿黄疸患儿血清非结合胆红素及白蛋白检测的应用价值分析

目的观察和分析新生儿黄疸患儿血清非结合胆红素(UCB)及白蛋白(ALB)检测的应用价值。方法选取285例新生儿黄疸患儿作为研究对象,对其血清UCB、总胆红素(TBIL)、ALB及β_2微球蛋白(β_2-MG)水平进行检测和比较。结果重度黄疸的新生儿血清UCB、TBIL、UCB/ALB、β_2-MG水平均显著高于中度黄疸患儿(P0.05)。有核黄疸的新生儿血清UCB、TBIL、UCB/ALB、β_2-MG水平均显著高于无核黄疸患儿(P0.05)。感染性黄疸患儿的血清UCB、TBIL、UCB/ALB、β_2-MG水平显著高于其他3种病因类型(P0.05)。结论新生儿黄疸患儿的血清UCB及UCB/ALB水平与其病情严重程度和病因类型具有一定的相关性。     

血清CK、CK-MB、cTnⅠ水平变化在新生儿黄疸鉴别诊断及病情评估中的应用价值

目的 探讨血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白Ⅰ(cTnⅠ)水平变化在新生儿黄疸鉴别诊断及病情评估中的应用价值。方法 选取2018年1月至2020年1月我院102例新生儿黄疸作为观察组,另选取102例健康新生儿作为对照组。统计两组及观察组不同类型黄疸、不同病情程度血清CK、CK-MB、cTnⅠ水平,Spearman分析血各指标与总胆红素(TBIL)、胆汁酸、病情程度相关性,绘制受试者工作曲线(ROC)分析血各指标单一及联合诊断新生儿黄疸类型价值。结果 (1)观察组血清CK、CK-MB、cTnⅠ水平高于对照组(P<0.05);(2)新生儿黄疸CK、CK-MB、cTnⅠ水平与TBIL、总胆汁酸均呈正相关(r₁=0.565,r₂=0.722,r₃=0.691,r₄=0.576,r₅=0.769,r₆=0.715,P<0.05);(3)病理性黄疸患儿血清CK、CK-MB、cTnⅠ水平高于生理性黄疸患儿(P<0.05);...     

CRP、PCT在新生儿细菌感染性黄疸早期诊断中的应用价值

目的探讨血清C反应蛋白(CRP)、降钙素原(PCT)在新生儿细菌感染性黄疸早期诊断中的应用价值。方法选取2013年1月-2016年10月医院生产的细菌感染性黄疸患儿75例作为感染性黄疸组,选取同期生产的新生儿生理性黄疸患儿62例作为生理性黄疸组,检测感染性黄疸组治疗前后及生理性黄疸组CRP、PCT水平及经皮胆红素值(TcB),并分析各指标间的关系。结果感染性黄疸组治疗前CRP、PCT、TcB水平显著高于生理性黄疸组(P0.05);感染性黄疸组中,轻度组治疗前CRP、PCT、TcB低于中度组、重度组,中度组低于重度组(P0.05);轻度组治疗10dPCT水平低于中度组、重度组,中度组低于重度组,差异有统计学意义(P0.05),3组治疗10dCRP比较差异无统计学意义(P0.05)。Pearson相关分析显示,TcB与CRP、PCT呈正相关关系(r=0.412、0.543,P0.05)。结论 CRP、PCT可作为辅助诊断新生儿细菌感染性黄疸的重要指标。     

缺氧缺血性脑病新生儿胆红素与血红素加氧酶1的变化

目的:观察新生儿缺氧缺血性脑病发生过程中胆红素与血红素加氧酶1活性的变化,探讨两者在缺氧缺血性脑病发生发展中的作用。方法:选择1998-01/2003-12西安交通大学第一医院产科出生并收住新生儿病房的患儿200例。纳入标准:①窒息儿根据新生儿生后Apgar评分0-3分为重度窒息,4～7分为轻度窒息。②缺氧缺血性脑病患儿临床诊断符合新生儿缺氧缺血性脑病标准。③高胆红素血症的诊断标准符合足月儿胆红素>205μmol/L。④新生儿黄疸诊断标准血清胆红素>85μmol/L时,临床出现肉眼黄疸。依据缺氧缺血程度分为2组,窒息组和缺氧缺血性脑病组。窒息组分为轻度、重度2个亚组,缺氧缺血性脑病组分为轻度,中度,重度3个亚组,每个亚组40例,对照组选择同期出生的健康新生儿40例,与窒息组和缺氧缺血性脑病组患儿的胎龄和出生体质量差异无显著性。取患儿股静脉血4mL,采用生化分析仪测定窒息组和缺氧缺血性脑病组患儿的胆红素值,并在急性期(3d内)和恢复期(10d内)用464nm和530nm双波长分光光度法测定样品反应物中胆红素生成量代表血红素加氧酶1活性,以每秒每升血清生成胆红素量为单位(μkat/L)。同时测定正常对照组新生儿的胆红素值和血红素加氧酶1活性。对样本均数比较采用方差分析。结果:①胆红素水平:轻度窒息组明显高于重度窒息组和对照[(325.62±39.1),(243.64±37.6),(305.70±51.3)μmol/L,F=10.89,P<0.01]。轻度、重度缺氧缺血性脑病组胆红素水平接近[(89.4±8.1),(86.7±3.9)μmol/L]。②胆血红素加氧酶1活性:重度窒息组急性期血红素加氧酶1活性值明显高于轻度窒息组急性期和恢复期,重度窒息组恢复期和对照组(F=38.63,P<0.01);重度缺氧缺血性脑病组急性期血红素加氧酶1活性明显高于恢复期,也明显高于轻度和中度缺氧缺血性脑病组(急性期和恢复期)(F=8.93,P<0.01)。③黄疸发生率:轻度窒息组发生高胆红素血症22例,生理性黄疸12例,黄疸发生率85%;重度窒息组发生高胆红素血症6例,生理性黄疸3例,黄疸发生率23%。对照组发生高胆红素血症20例,生理性黄疸12例,黄疸发生率80%。缺氧缺血性脑病组无高胆红素血症发生,轻度缺氧缺血性脑病组发生生理性黄疸6例,黄疸发生率15%;重度缺氧缺血性脑病组发生生理性黄疸5例,黄疸发生率13%。结论:当不同程度缺氧缺血使新生儿脑损伤时,血红素加氧酶1活性增加致胆红素的抗氧化作用途径开放,胆红素水平降低。提示胆红素水平、血红素加氧酶1活性能反映缺氧缺血性脑病患儿的病情严重程度,对缺氧缺血性脑病的诊断及预测预后具有一定的参考价值。     

血清总胆汁酸测定在新生儿黄疸中的应用

目的　探讨血清总胆汁酸 (TBA)测定对新生儿黄疸患儿肝功能损伤的诊断意义。方法　采用循环酶速率法检测 198例各类黄疸患儿血清TBA水平。结果　生理性黄疸患儿的TBA与对照组差异无显著性 ,而病理性黄疸患儿的TBA水平明显高于对照组 ,其中细菌感染组和病毒感染组的TBA有很高的异常率 ,分别为 87.5 %和 90 .4 %。结论　当常规肝功能指标改变不明显时 ,血清TBA检测是一项新生儿病理性黄疸患儿较为灵敏的肝实质损伤的指标 ;新生儿病理性黄疸患儿随其TBA的变化 ,有可能存在不同程度的胆汁淤积     

血清总胆汁酸测定在新生儿黄疸中的应用

目的探讨血清总胆汁酸(TBA)测定对新生儿黄疸患儿肝功能损伤的诊断意义.方法采用循环酶速率法检测198例各类黄疸患儿血清TBA水平.结果生理性黄疸患儿的TBA与对照组差异无显著性,而病理性黄疸患儿的TBA水平明显高于对照组,其中细菌感染组和病毒感染组的TBA有很高的异常率,分别为87.5%和90.4%.结论当常规肝功能指标改变不明显时,血清TBA检测是一项新生儿病理性黄疸患儿较为灵敏的肝实质损伤的指标;新生儿病理性黄疸患儿随其TBA的变化,有可能存在不同程度的胆汁淤积.     

Interaction of peptidoglycans with anti-IgGs and with complement.

This report describes the interaction of peptidoglycan (Streptococcus group A, Staphylococcus epidermidis and Micrococcus lysodeikticus) with 2 serum mediator systems, namely with the anti-IgG system and with complement. The observation that the majority of rabbits hyperimmunized with A-variant streptococcal vaccine produced anti-group carbohydrate antisera containing anti-IgGs and antibodies directed to peptidoglycan suggested that the production of these 2 latter antibodies was related. This view was supported by the finding of a monoclonal 7S anti-IgG with antibody specificity for the pentapeptide of peptidoglycan as evidenced by inhibition of the coprecipitation of 7S anti-IgG with antigen-antibody complexes by the pentapeptide. Inhibition of the anti-idiotype reaction by the pentapeptide provided further evidence for the antibody specificity of 7S anti-IgG for peptidoglycan. When added to normal human sera all peptidoglycan preparations inhibited the hemolytic activity of the sera. Consumption of C3 in C2 deficient serum and consumption of C2 in normal serum indicated the activation of both known complement pathways. Activation of the classical pathway of complement was more efficient since 50 mug of peptidoglycan consumed approximately 70% of C2 per ml normal serum whereas more than 2 mg of the same preparations was required to inactivate 17-24% of C3 in C2 deficient sera. Each of the different peptidoglycan preparations consumed similar amounts of complement in all 20 sera tested. This finding suggested that activation of the classical complement pathway by peptidoglycan was not mediated by anti-peptidoglycan antibodies present in only 20-40% of normal human sera.     

异病酚静脉全麻下复合氯胺酮或曲马多行纳屈酮快速阿片脱毒的效果比较

Toreleasetheseverewithdrawalsymptomsoftheheroinad-dicts,weinjecttheNaloxineinthegeneralanesthesia.160volun-teersreceivedRODwereperformedunderthecombinedanesthesiawithpropofol,midazolamandketamine.1Subjectsandmethods1.1Subjects160volunteerswhoaccordingwiththediagnosticstandardoftheICD-10abouttheopiate-addiction,male:145,fe-male15.Age:(30±6),theeldestwas45yearsold.Themeanbodyweightwasabout(58±8)kg.Educationalbackground:pri-maryschool118cases,juniorhighschool:24casesandseniorhighschool/seco…     

The comparison of effects of rapid opiate detoxification with ketamine complex and with tramadol and naltrexone under general anesthesia with propofol

Objective To release the heroin addicts‘ sufferings,we made rapid opiate detoxification by injecting naloxine under the general anesthesia.Method 160 volunteers were divided at randon into two groups:Group A were performed under the combined anesthesia with propofol,midazolam and kelamine.Group B were performed under the combined anesthesia with propofol with midazolam and tramadol.The vital signs were recorded and the withdrawal syndrome of the volunteers were assessed during the whole process.Result All of the withdrawal symptoms scores 24 hours after ROD in group B were lower than its pre-treatment;The symptoms of the thirs,tsleeping disturbance,nausea and vomiting,skeletal muscular pains and anorexia scores in group A were also lower than its pre-treatment;and no too much differeence belween group A and group B.But tearing,anxiety and diarrhea scores in group A were almost the same as the pre-treatment and higher than group B.Both groups received of the naloxone treatment smoothly,and remained in the hospital for about 3 days.Conclusion The effect of rapid opiate detoxification of naltrexone with the ketamine or tramadol under anesthesia is obvious.The tramadol is better than others.     

替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的观察与护理

[目的]总结替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的观察与护理。[方法]对25例无法手术切除的晚期结直肠癌病人采用替吉奥胶囊联合亚叶酸钙、奥沙利铂方案进行治疗,同时加强心理护理、毒副反应的观察与护理等。[结果]治疗过程中出现Ⅰ级和Ⅱ级神经毒性8例,恶心、呕吐、食欲下降12例,骨髓抑制5例,变态反应1例,经处理后均好转;1例病人死亡,其余病人均顺利进行治疗。[结论]加强替吉奥联合亚叶酸钙及奥沙利铂治疗晚期结直肠癌病人的护理,可保证治疗的顺利进行。     

缩腺液治疗扁桃体炎的疗效观察及其护理

扁桃体炎是儿童常见病、多发病,传统药物治疗可暂缓症状,但不能根治;手术治疗痛苦大、出血多、费用高,常合并有并发症。我科运用缩腺液治疗扁桃体炎3 0例收到了良好的效果。现报告如下。1　对象与方法1.1　对象　本科于2 0 0 2年—2 0 0 3年共收治扁桃体炎病人5 0例,年龄为7岁～2 0岁,分两组进行。缩腺液治疗组3 0例,男13例,女17例;其中重度12例,中度9例,轻度9例;对照组2 0例,男9例,女11例;其中重度8例,中度7例,轻度5例。两组病人年龄、性别、病情严重程度基本一致,差异无统计学意义(P >0 .0 5 )。1.2　方法　对照组采用药物治疗,静脉输注…     

艾滋病合并结核病及马尔尼菲青霉病患者的护理

目的 通过分析艾滋病合并结核病及马尔尼菲青霉病患者的临床资料,提高对三病并存的护理认识.方法 分析并总结26例艾滋病合并结核病及马尔尼菲青霉病住院患者的临床特点、治疗及护理方法.结果 本组患者治愈5例,好转13例,死亡8例.存活患者随访6～30个月均未复发.结论 三病并存时临床表现复杂,无特异性,护理难度大,应仔细观察病情,及早诊治,精心护理,对改善预后有重要意义.     

艾滋病合并结核病及马尔尼菲青霉病患者的护理

目的通过分析艾滋病合并结核病及马尔尼菲青霉病患者的临床资料,提高对三病并存的护理认识。方法分析并总结26例艾滋病合并结核病及马尔尼菲青霉病住院患者的临床特点、治疗及护理方法。结果本组患者治愈5例,好转13例,死亡8例。存活患者随访6～30个月均未复发。结论三病并存时临床表现复杂,无特异性,护理难度大,应仔细观察病情,及早诊治,精心护理,对改善预后有重要意义。     

Coping and compensation strategies of patients with disseminated encephalomyelitis and of patients with schizophrenic psychoses]

In ten patients with schizophrenic psychosis and ten patients with multiple sclerosis, the coping and compensation strategies were examined by means of semistructured interviewing. The following categories were considered: 1. avoidance; 2. habituation and/or adaptation to the disease; 3. efforts to compensate the deficits by will-power; 4. efforts to train certain types of behaviour; 5. self-treatment; 6. disease awareness and insight. Examples for these categories are given for both groups of patients. There is a surprising similarity in the statements made by the schizophrenic patients and those with multiple sclerosis. All of the patients with multiple sclerosis had developed coping strategies against psychological symptoms. It is suggested that the neuropsychological deficits in multiple sclerosis resemble the symptoms of reduced energetic potential observed in schizophrenia. In both groups efforts should be made to activate the compensation strategies by adequate training procedures.     

Experience with the treatment of atrial fibrillation with cordarone and digoxin

Paraxysmal and recent cardiac fibrillations have been treated in 42 patients with cordaron combined with digoxin. The arrest of fibrillation was achieved for 5 days in 29 patients (69%) suggesting high efficacy of the combination.