红细胞免疫功能及外周血T淋巴细胞亚群在急性心肌梗死患者中的作用

目的：探讨红细胞免疫功能及外周血Ｔ淋巴细胞亚群在ＡＭＩ患者中的作用。方法：对３９例ＡＭＩ患者红细胞免疫功能一群进行检测,并与对照组比较。结果：Ａ发率,ＲＢＣ－Ｃ３ｂ明显低于对照组,ＣＤ４＾＋／ＣＤ８＾＋、ＲＢＣ－ＩＣ明显高于对照组,ＲＢＣ－Ｃ３ｂ与ＣＤ４＋／ＣＤ８＾＋呈显著负相关（ｒ＝－０．７５６,Ｐ〈０．０５）,ＲＢＣ－ＩＣ与ＣＤ４＾＋／ＣＤ８＾＋呈显著正相关（ｒ＝０．６１２,Ｐ〈０．０５）。结     

急性白血病多药耐药相关蛋白基因表达及其与免疫表型和FAB…

为探讨急性白血病（ＡＬ）患者多药耐药相关蛋白（ＭＲＰ）基因表达与ＦＡＢ亚型及免疫表型的关系，应用半定量逆转录－多聚酶链反应技术检测了５４例ＡＬ患者ＭＲＰ基因的表达。以正常人或非恶性血液病患者的单信核细胞为对照组，发现临床耐药组ＭＲＰ基因表达（中位数１．１８）高于完全缓解（ＣＲ）组（中位数０．２２，Ｐ＝０．０６５９）。ＡＬ各组ＭＲＰ基因表达均明显高于对照组（中位数）。ＭＲＰ基因表达与白血病ＦＡＢ亚型     

成人急性白血病免疫表型的特点

用流式细胞仪－单免疫荧光标记法检测了１２８例成人急性髓细胞白血病（ＡＭＬ），８３例急性淋巴细胞白血病（ＡＬＬ）及１７例慢性粒细胞白血病包变期患者骨髓细胞的免疫标志。常规用１０种单抗。有四种表型；①系列专一性；②系列非专一性；③仅表达ＨＬＡ－ＤＲ；④“裸型”。系列专一性表型在ＡＭＬ与ＡＬＬ中分别占５３．１％与７８．３％。我们认为根据ＦＡＢ分型法及免疫表型结果，采用反常免疫表型一词，能较客观地反映基免     

SLE患者血清抗亲环素A自身抗体及其特异免疫复合物的测定与意义

用离子交换色谱和凝胶过滤技术从小牛胸腺中提取、纯化亲环素 Ａ（ＣｙＰ Ａ）。 ＳＤＳ－ＰＡＧＥ分析为单一条带，分子量为 １７．８ＫＤ，与 ＣｙＰ Ａ标准品一致。用此 ＣｙＰ Ａ建立了检测抗 ＣｙＰＡ自身抗体（ＡＣＡ）的ＥＬＩＳＡ法。在免疫豚鼠获得抗血清基础上，又建工了ＥＬＩＳＡ法检测ＣｙＰＡ特异免疫复合物（ＣｙＰ Ａ－ＩＣ）。正常对照（ｎ＝１００） ＡＣＡ和 ＣｙＰ Ａ－ＩＣ阳性率均仅 １．０％． ＳＬＥ患者（ｎ＝１０１） ＡＣＡ阳性率为 ５０．５％， ＣｙＰ Ａ－ＩＣ为 ７４．２％。结果提示，血清 ＡＣＡ和 ＣｙＰ Ａ－ＩＣ测定对ＳＬＥ的诊断有较高的敏感性和特异性。     

抗精浆免疫抑制物抗体的补体结合功能测定及临床意义

目的探讨抗精浆免疫抑制物抗体（ＳＰＩＭ－Ａｂ）的作用机理。方法用补体结合试验（ＣＦＡ）测定了不明原因不育症患者ＳＰＩＭ－Ａｂ的补体结合功能，并与血清Ｃ３、Ｃ４、ＣＨ５０之间的关系进行了比较。结果２９例血清ＳＰＩＭ－Ａｂ阳性患者ＣＦＡ值为６．４２±１．５５Ｕ／ｍｌ，明显低于７１例血清ＳＰＩＭ－Ａｂ阴性患者的８．１１±１．６２Ｕ／ｍｌ（Ｐ＜０．０１）和３０例对照组的８．６０±１．８０Ｕ／ｍｌ（Ｐ＜０．０１）。且血清ＳＰＩＭ－Ａｂ水平与血清Ｃ３、Ｃ４、Ｃ５０呈显著的负相关（Ｐ＜０．０５～０．０１）。结论ＳＰＩＭ－Ａｂ能够与ＳＰＩＭ形成免疫复合物，激活补体，并可能对精子和受精卵产生免疫损伤，干扰生育。     

增强化学发光免疫法检测乙型肝炎表面抗原的建立和评价

本法采用Ｌｕｍｉｎｏｌ－Ｈ２Ｏ２－ＨＲＰ系统建立了增强化学发光免疫法（ＥＬＥＩＡ）检测乙型肝炎表面抗原（ＨＢｓＡｇ），该发光信号的强度与血清中ＨＢｓＡｇ浓度呈线性关系，回归方程为：Ｙ＝０．４４４１Ｘ＋０．００６７，相关系数ｒ＝０．９９７１；批内变异系数为３．６％～９．３％、批间变异系数为１０．２％～１２．５％；回收率为８２．５％～１１５．０％；最小检测限为２０ｐｇ／ｍｌ；结果表明本法有灵敏性高，准确性和稳定性好的特点。     

咳嗽变异性哮喘患儿免疫的功能的研究

探讨咳嗽变异性哮喘的免疫发病机制。方法采用酶标法，散射比浊法，ＥＬＩＳＡ法，非反向高效液相色谱Ｍｉｌｌｅｒ改良法以及ＭｃＡｃ－ＡＰＡＡＰ法分别检测ＣＶＡ患儿血清ＩｇＥ、ＩｇＡ、ＩｇＧ、ＩｇＭ、ｉＧｇ亚类，维生素Ａ的水平以及Ｔ细胞亚群，并与正常健康儿童对照。     

乳腺癌多耐药基因产物的表达及其与预后因素的关系

应用免疫组化ＬＳＡＢ法对５８例原发性乳腺癌组织进行了ＭＤＲ１－Ｐｇｐ检测。结果显示Ｐｇｐ在３９例（６７．２４％）中有表达。Ｐｇｐ的表达与患者年龄、肿瘤体积、淋巴结转移情况、ＥＲ和ＰＲ及ＰＣＮＡ指数无显著关系。在浸润性导管癌中，Ⅲ级组Ｐｇｐ的表达率明显低于其它各组（Ｐ＜０．０５），Ｐｇｐ表达强度与ＧＳＴ－π表达有相关性的趋势（Ｐ＝０．０５９）．Ｐｇｐ强阳性组的ｃ－ｅｒｂＢ－２表达率明显高于阴性组（Ｐ＜０．０５）．研究表明，在原发性乳腺癌中自然存在ＭＤＲ１基因，分化差的乳腺癌ＭＤＲ１－Ｐｇｐ的表达率低，ＭＤＲ１－Ｐｇｐ的表达可能与ＧＳＴ－π和癌基因的增强有关。     

急性白血病多药耐药相关蛋白基因表达及其与免疫表型和FAB分型的关系

为探讨急性白血病（ＡＬ）患者多药耐药相关蛋白（ＭＲＰ）基因表达与ＦＡＢ亚型及免疫表型的关系，应用半定量逆转录－多聚酶链反应技术检测了５４例ＡＬ患者ＭＲＰ基因的表达。以正常人或非恶性血液病患者的单个核细胞为对照组。发现临床耐药组ＭＲＰ基因表达（中位数１．１８）高于完全缓解（ＣＲ）组（中位数０．２２，Ｐ＝０．０６５９）。ＡＬ各组ＭＲＰ基因表达均明显高于对照组（中位数０）。ＭＲＰ基因表达与白血病ＦＡＢ亚型无关。ＣＤ１３＋与ＣＤ１３－组ＭＲＰ基因表达有显著性差异（Ｐ＝０．００２９），而与其它细胞免疫表型无关。根据ＭＲＰ基因表达在ＡＬ各组的分布，将ＭＲＰ与β２微球蛋白之比大于１．０定为ＭＲＰ＋，临床耐药组ＭＲＰ＋占６６．６７％，明显高于ＣＲ组（２０％，Ｐ＝０．０２１３）     

病毒性肝炎肝纤维化患者血浆的细胞间粘附分子—1测定及其临床意义

目的探讨细胞间粘附分子－１（ＩＣＡＭ－１）与病毒性肝炎肝纤维化的关系。方法用ＥＬＩＳＡ法检测了３９例病毒性肝炎肝纤维化患者和３０例健康人血浆ｓＩＣＡＭ－１、Ⅳ型胶原、层粘连蛋白含量。结果显示病毒性肝炎肝纤维化患者血浆ｓＩＣＡＭ－１、Ⅳ型胶原、层粘连蛋白水平显著高于健康组，且在肝纤维化分级中呈ｃｈｉｌｄ Ｃ＞ｃｈｉｌｄ Ｂ＞ｃｈｉｌｄ Ａ，相关性分析显示ｓＩＣＡＭ－１与Ⅳ型胶原、层粘连蛋白水平呈正相关（ｒ＝０．７９～０．８９，ｒ＝０．６２～０．７３）。结论病毒性肝炎肝纤维化患者血浆ｓＩＣＡＭ－１升高与肝细胞损伤有关，可反映肝纤维化的严重程度。     

Analytical and clinical evaluation of creatine kinase MB mass assay by IMx: comparison with MB isoenzyme activity and serum myoglobin for early diagnosis of myocardial infarction.

We analytically and clinically evaluated Abbott's IMx assay for creatine kinase (CK) isoenzyme MB (CK-MB) in serum. Over a 1-year period, the method was more specific but less precise than catalytic isoenzyme measurements by electrophoresis or immunoinhibition. Sera from different individuals without electrophoretic evidence of CK-MB but containing macro CK type 1 (n = 20), mitochondrial CK (n = 5), or CK-BB (n = 5) were scored as CK-MB negative by the IMx. Likewise, CK-MB-negative by the sera remained so after addition of purified human CK-MM (< or = 7600 U/L) or CK-BB (< or = 8100 U/L). For 39 patients admitted for suspicion of uncomplicated acute myocardial infarction (precordial pain for < or = 4 h), the diagnostic performance of the IMx CK-MB assay on admission and 4 h later was superior to that of total CK activity and compared well with that of CK-MB activity measured by electrophoresis or immunoinhibition. An admission, myoglobin showed a higher diagnostic sensitivity, specificity, and predictive value than did CK-MB and was the most informative test. Diagnostic performance on admission and 4 h later was further improved by considering positivity for myoglobin and for CK-MB by IMx and for the change in each over the first 4 h of hospitalization as criteria. Twelve hours after admission, diagnostic performance was further improved for all CK and CK-MB methods but began to decline for myoglobin.     

Clinical and analytical evaluation of different methods for measurement of creatine kinase isoenzyme MB

We evaluated the clinical and analytical performance of the new immunochemiluminometric assay (ICMA; Ciba Corning) for measurement of creatine kinase isoenzyme MB (CK-MB), and compared it with three other methods: immunoradiometric assay (IRMA; International Immunoassay Labs); immunoinhibition assay (Seradyn); and an immunoinhibition/column method (Du Pont). Intra-test precision for all kits was good. We evaluated 32 patients' samples by all four methodologies. Only one of the four methods (aca, Du Pont) showed evidence of linearity. Efficiency in the diagnosis of myocardial injury in our study ranged from 53% (Seradyn) to 96% (Du Pont). We evaluated serial specimens from 20 separate patients by the IRMA and the ICMA to determine whether myocardial injury could be diagnosed earlier by the ICMA. In patients with acute myocardial infarction, the ICMA displayed positive values earlier and longer than the IRMA, suggesting that the ICMA is suited for screening for myocardial damage in hospitalized patients.     

Development and clinical evaluation of a microcentrifugal analyzer method for determining creatine kinase MB isoenzyme

We have adapted to a microcentrifugal analyzer an immunoinhibition assay for measuring the activity of creatine kinase MB by using an inhibitory antibody for the M monomer. The method actually measures half the MB activity, but results are not multiplied by two because atypical isoenzymes of creatine kinase, including BB, IgG-BB, and the isoenzyme derived from mitochondria, are also detected, if they are present. Results correlated well with an electrophoresis method for 36 serum samples. Myocardial infarction was assessed in 175 patients admitted to our coronary-care unit, with respect to sensitivity (100%) and specificity (98%) when a decision point of 100 U/L (30 degrees C) was chosen for total creatine kinase activity (dithiothreitol-activated) and 6 U/L (30 degrees C) for the isoenzyme (by immunoinhibition). Atypical isoenzymes are easily recognized and confirmed by electrophoresis when the MB activity (by immunoinhibition) exceeds 6 U/L and 20% of the total creatine kinase activity.     

Creatine kinase isoenzyme MB determination on the ACA: dependence on serum matrix and other effectors

Creatine kinase isoenzyme MB catalytic activities in human serum, determined by ACA ion exchange chromatography and immunoinhibition, differ significantly, the correlation coefficient being 0.88. The reasons for this variation are interference of antibodies with the creatine kinase B subunit in the immunoinhibition assay, nonreproducible elution of creatine kinase isoenzyme MB from the ion exchange resin in the ACA pack, due to varying protein concentrations in the serum samples and increasing elution of creatine kinase isoenzyme MM from the ion exchange column caused by a preceding partial inactivation of creatine kinase isoenzyme MM. Pretreatment of serum samples with a solution containing magnesium sulphate, maleate and 2-oxoglutarate (solution A) prior to determination of creatine kinase isoenzyme MB catalytic activities on the ACA significantly improves the sensitivity and specificity of the method; the correlation coefficient for the values from the ACA and immunoinhibition then becomes 0.92. Dilution of serum samples with bovine serum albumin solution is now practicable.     

Evaluation of the optimized bioluminescent assay for the determination of total creatine kinase and creatine kinase MB activities

A very sensitive, optimized bioluminescent assay for certain kinase and creatine kinase MB activities is tested. We evaluated reagent blanks, sensitivity, precision and compared the results with those of the spectrophotometric immunoinhibition test. The main advantage of the new method is a detection limit of less than 1 U/l which, together with a high precision (s = 0.1 at detection limit), allows determinations of the creatine kinase MB activity even in normal sera in about 20 minutes. A disadvantage of the manual procedure is that it may be necessary to include up to five pipetting steps.     

Mass concentration and activity concentration of creatine kinase isoenzyme MB compared in serum after acute myocardial infarction

We compared three current methods (immunoinhibition, "Isomune-CK" immunoprecipitation, and the Tandem-E CKMB II immunoenzymometric assay) for determination of creatine kinase (CK; EC 2.7.3.2) isoenzyme MB in serum. Although results inter-correlated well, the immunoinhibition assay gave higher activity values. Atypical CK forms did not interfere with the immunoprecipitation and immunoenzymometric methods. In acute myocardial infarction the catalytic properties of CK decreased with the enzyme's age, as reflected by a steady increase in activation energy of the catalyzed reaction. In septicemia patients with very low CK and CK-MB catalytic activity, mean CK-MB mass concentration exceeded the upper reference limit, suggesting an increased rate of loss of activity concentration in these patients' sera. Because of the assay's lesser susceptibility to conformational changes at the active site of the enzyme, we suggest that measurement of CK-MB mass concentration is better suited for infarct sizing than measurement of catalytic activity.     

Sysmex CA-1500全自动血凝仪PT-der法和Von-Clauss法检测纤维蛋白原的分析

目的评价Sysmex CA-1500全自动血凝仪PT-der法和Von-Clauss法测定血浆纤维蛋白原（Fib）的相关性和准确性。方法采用Sysmex CA-1500全自动血凝仪PT-der法和Von-Clauss法分别测定755例血液标本的血浆Fib浓度;高Fib浓度标本的稀释比例为1∶8、2∶7、3∶6、4∶5、5∶4、6∶3,以稀释比例为横坐标,以2种方法测得的Fib浓度为纵坐标,进行简单线性回归分析。结果 Fib：2.0~〈6.0g/L时,Von-Clauss法检测Fib值高于PT-der法（P〈0.01）;Fib：〈2.0g/L,〉6.0g/L时,PT-der法检测Fib值高于Von-Clauss法（P〈0.01）。PT-der法和Von-Clauss法检测的线性回归方程分别为：Y=4.537 7 X＋1.551 3（R2=0.897 3）,Y=7.792 2 X＋0.290 0（R2=0.980 5）。结论 Von-Clauss法能较好地反映人体内具有凝血功能的Fib水平。     

Evaluation of a new automated system for the determination of ck-mb isoforms

We evaluated a new analyzer (Cardio REP) specifically designed for cardiac CK-MB isoenzyme and isoforms activity, with a performance time of 24 minutes. Ten AMI patients, with times elapsed between the onset of chest pain and admission to hospital ranging from 30 minutes to 4 hours, were monitored every 3–4 hours until the 16th hour of hospitalization. In each serum sample, in addition to total CK-MB and CK-MB isoforms measured by the Cardio REP analyzer, we also assayed total CK activity, CK-MB activity by immunoinhibition method, CK-MB mass concentration, CK-MB isoforms by REP method, troponin T, and myoglobin. The precision study demonstrated acceptable within assay and between assay CVs% for total CK-MB (8.1 and 10.4), MB₁ (9.1 and 14.2), and MB₂ (9.1 and 8.2) isoforms. The method was found to be linear up to 371 U/L for MB₂ isoform fraction and up to 516 U/L for total CK-MB. Results for CK-MB obtained with the Cardio REP correlated well with those for CK-MB activity obtained with the immunoinhibition method (r = 0.869) and those of CK-MB mass concentration (r = 0.923). The sensitivity of the Cardio REP CK isoforms method was found to be greater than that of the REP CK isoforms method. Time to first increased value of MB₂/MB₁ ratio and MB₂ isoform was earlier in comparison to that for CK-MB mass concentrations and similar to that for myoglobin, a marker that, however, lacks specificity. The diagnostic efficiency of CK-MB isoforms and the availability of a real-time, fully automated method for their measurement suggest the utilization of this biochemical marker in emergency for the early diagnosis of AMI.     

A sensitive bioluminescent immunoinhibition test for CK-B subunit activity and a CK-MB specific ELISA compared: correlation with agarose electrophoresis and influence of CK-isoenzyme profile on results

Searching for alternatives to the imprecise spectrophotometric tests for low-concentration creatine kinase (EC 2.7.3.2) isoenzyme MB (CK-MB), we investigated the analytical performance of two potentially superior approaches--a bioluminescent immunoinhibition assay (I, LKB-Wallac) and an ELISA (enzyme-labeled immunosorbent assay) technique (II, Hybritech)--in comparison with an electrophoretic method (III, Beckman). Only I showed good between-day precision (CV 8.3%) at the upper reference limit, allowing reproducible assay of CK-B subunit activity down to at least 3 U/L. In conditions where CK isoenzyme assays remained unaffected by CK-MM concentrations, test results were proportional to the amount of CK-MB in the sample up to at least 50 U/L for I, 120 micrograms/L for II, and 100 U/L for III (r greater than 0.998 by linear regression analysis). For CK-MB-positive samples, the data by I correlated more closely with values by III (n = 24; r = 0.994) than did results by II (n = 15; r = 0.909), but both methods were equally effective in discriminating between samples with or without electrophoretically supranormal CK-MB activity (93% sensitivity). II was entirely CK-MB specific, whereas CK-B activity by I was consistently (18/18) increased in CK-MB-negative samples containing CK-BB (n = 6; r = 0.996) or macro CK, types 1 or 2 (n = 12; r = 0.930). I is highly sensitive for screening for increased non-MM CK activity, the nature of which should be subsequently clarified by electrophoresis.     

酶法和Jaffe速率法测定血清肌酐的方法学比较

目的：了解酶法和Jaffe速率法测定血清肌酐结果的偏倚大小，为室间评估结果分组提供依据。方法：按照美国全国临床实验标准委员会（NCCLS）EP9－A文件进行评估，将测得的数据进行相关回归分析。计算两方法间的偏倚。结果．；酶法和Jaffe速率法测定肌酐，其回归方程式Y＝1．005X＋17．9（Y为Jaffe速率法，X为酶法），相关系数r=0.998，有明显恒定偏倚。结论：必须对不同方法原理的肌酐室间评估结果作分组处理。