D-二聚体在糖尿病早期肾损伤中的临床意义

目的 研究D-二聚体在糖尿病早期肾损伤中的临床意义。方法 回顾性纳入2019年9月至2020年9月衡水市中医医院收治的100例糖尿病患者作为研究对象。收集患者临床资料、肾脏生物学标志物如尿微量白蛋白、尿肌酐、尿微量白蛋白与尿肌酐比值(ACR)及D-二聚体水平,根据ACR数值将研究对象分为单纯糖尿病组53例(ACR<3.4mg/mmol)和糖尿病早期肾损伤组47例(ACR≥3.4mg/mmol),另选50例健康体检人群作为健康对照组,比较这3组D-二聚体水平并且分析ACR与D-二聚体的关系。结果 糖尿病早期肾损伤组的D-二聚体的水平明显高于单纯糖尿病组和健康对照组,差异均有统计学意义(P<0.01)。Spearman相关分析结果进一步表明,D-二聚体与ACR呈显著正相关(r=0.794,P<0.001)。结论 D-二聚体与早期肾损伤标志物ACR具有显著相关性。D-二聚体对糖尿病早期肾损伤的诊断具有重要的临床价值。     

30例D-二聚体假性增高的数据分析

目的探讨30例临床检测中血浆D-二聚体水平>FDP水平的原因及相关资料分析。方法收取临床检测过程中首次出现血浆D-二聚体水平>FDP水平的标本30例。分别用血浆D-二聚体检测试剂(STA-LIATEST D-DI和STA-LIATEST D-DI PLUS)检测。并对其进行数据比较和原因分析。结果血浆D-二聚体检测试剂STA-LIATEST D-DI与STA-LIATEST D-DI PLUS数据相比较,[3.63(2.89~10.49)μg/mL vs 0.36(0.26~1.00)μg/mL,P<0.0001],两组数据的差别具有统计学意义。30例患者中21例患者类风湿因子(rheumatoid factor,RF)水平异常,>20 IU/mL(正常参考值上限)。9例患者类风湿因子水平正常,<20 IU/mL。结论血浆D-二聚体检测试剂STA-LIATEST D-DI PLUS对于D-二聚体水平假性增高的标本有很强的的纠正能力。血浆D-二聚体水平>FDP水平时,绝大多数是由于类风湿因子干扰造成的,少部分原因不明确,可能由其他异嗜性抗体导致。     

凝血功能和尿微量白蛋白测定对妊娠高血压疾病早期诊断的意义

目的探讨围产期孕妇血浆D-二聚体、凝血功能和尿微量白蛋白测定对妊娠高血压疾病早期诊断的价值。方法采用免疫金标法、散射光测试法及免疫透射比浊法对51例妊娠高血压疾病患者和22例正常孕妇血浆D-二聚体含量、凝血功能及尿微量白蛋白进行测定,并分析比较各组间的差异。结果妊娠高血压疾病患者组与正常孕妇组血浆D-二聚体、凝血功能和尿微量白蛋白含量增高,两组比较有显著性差异（P〈0.05）。结论产前血浆D-二聚体、凝血功能和尿微量白蛋白测定对病情监测、预防出血及并发症的发生有重要的临床意义。     

糖尿病患者血浆纤维蛋白原及D-二聚体水平变化及意义

目的探讨糖尿病患者血浆纤维蛋白原及D-二聚体水平变化及其测定的临床意义。方法采用胶乳免疫比浊法测定糖尿病组及健康对照纽血浆D-二聚体水平，同时用Clauss法测定纤维蛋白原水平，比较组间差异。结果糖尿病组纤维蛋白原水平明显高于对照纽（P〈0．01），有并发症组D-二聚体水平明显高于无并发症组。结论血浆纤维蛋白原及D-二聚体可作为糖尿病患者病情发展变化的一项重要指标。     

血浆B型利钠肽联合D-二聚体在慢性心力衰竭患者中的检测及临床意义

目的 研究血浆B型利钠肽(brain natriuretic peptide,BNP)联合D-二聚体检测在慢性心力衰竭患者中的诊断价值.方法 将2013年1月至6月来我院就诊和体检的人群分为3组:慢性心力衰竭患者组60例、有器质性心脏病但心功能正常的患者组20例和健康对照组30例,对三组患者的血浆B型利钠肽和D-二聚体进行比较并判断其与慢性心力衰竭的相关性.结果 血浆B型利钠肽联合D-二聚体检测能反映慢性心力衰竭的程度.结论 血浆B型利钠肽联合D-二聚体检测在慢性心力衰竭患者中具有很高的诊断价值,可以作为诊断慢性心力衰竭的辅助诊断检测.     

D-二聚体和肌钙蛋白I在急性心肌梗死与主动脉夹层早期鉴别中的应用

目的 探讨D-二聚体、肌钙蛋白I(cTnI)在急性心肌梗死(acute myocardial infarction,AMI)与主动脉夹层(aortic dissection,AD)早期鉴别中的诊断价值.方法 选取2019年1月至2020年12月来我院住院治疗的相关病例进行回顾性分析,比较2组患者一般资料、入院后首次D-二聚体及cTnI的检测水平;绘制ROC曲线分析D-二聚体、cTnI及二者联合检测对AMI与AD早期鉴别的诊断价值.结果(1)2组患者年龄、高血压、高血脂、糖尿病病史比较,差异具有统计学意义(P<0.05),男性比例比较,差异无统计学意义(P>0.05);(2)AD组患者血浆D-二聚体水平显著高于AMI组患者,AMI组患者血浆cTnI水平显著高于AD组患者,差异均具有统计学意义(P<0.05);(3)ROC曲线显示,D-二聚体鉴别诊断AMI和AD的AUC为0.955,95％CI在0.930～0.981之间,最佳界点值为1.40μg/mL,灵敏度、特异性为0.877、0.934;cTnI鉴别诊断AMI和AD的AUC为0.843,95％CI在0.801～0.885之间,最佳界点值为0.07ng/mL,灵敏度、特异性为0.886、0.705;D-二聚体联合cTnI鉴别诊断AMI和AD的AUC为0.982,95％CI在0.969～0.994之间,灵敏度、特异性为0.930、0.958,差异具有统计学意义(P<0.05).结论 D-二聚体、cTnI联合检测对急性心肌梗死与主动脉夹层的早期鉴别有较高的诊断价值.     

血凝、血液动力学和脂代谢指标在糖尿病肾病患者中的检测价值

目的 探索血凝指标D-二聚体(D-dimer,D-D)、纤维蛋白原(fibrinogen,FIB)、血黏度指标和脂代谢指标总胆固醇(cholesterol,CHOL)、三酰甘油(triglyceride,TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)在糖尿病肾病患者中检测的临床价值.方法 选择本院2型糖尿病无并发症患者49例,早期糖尿病肾病患者62例,糖尿病肾病终末期患者55例,非糖尿病性肾病早期患者50例,终末期43例.健康对照组30例.检测各组D-D、FIB、CHOL、TG、HDL-C、LDL-C和血流变指标进行比较分析.结果 与正常对照组相比,糖尿病组血清D-D、CHOL、TG水平升高,HDL-C水平降低,血流变相关指标升高.早期糖尿病肾病组D-D、FIB、CHOL、TG水平升高,HDL-C水平降低,血流变相关指标升高.早期糖尿病肾病组D-D、FIB、血浆黏度高于糖尿病组,其全血黏度1/200s高于普通早期肾病组,糖尿病终末期肾病组D-D水平高于早期糖尿病肾病组,全血黏度1/5s和全血黏度1/s则低于早期糖尿病肾病组,全血黏度1/30s和全血黏度1/s水平高于普通终末期肾病组(P<0.05).结论 在糖尿病及其并发症发生发展的过程中,血凝指标和血流动力学指标呈现显著变化,对相关指标进行检测和治疗过程中的监测有助于疾病的早发现和全面管理.     

卵巢癌患者外周血D-二聚体、FIB水平与IL-6动态变化的研究

目的:探讨卵巢癌患者血浆D-二聚体、纤维蛋白原(FIB)、白细胞介素6(IL-6)动态变化及其对卵巢癌诊断中的价值和临床意义。方法:选择卵巢癌患者65例、35例卵巢良性肿瘤患者和30例健康体检者做对照,取卵巢癌患者和对照组的血清及血浆,用胶乳凝集法测定血浆中的D-二聚体、FIB含量,用ELISA法测定IL-6水平。结果:卵巢癌患者FIB、IL-6、D-二聚体水平明显高于对照组和卵巢良性肿瘤组,差异有显著统计学意义(P<0.05);卵巢良性肿瘤患者FIB、IL-6、D-二聚体水平与正常对照组无显著差异(P>0.05),癌症组FIB、IL-6、D-二聚体随着临床分期的升高而递增,相关性分析表明,FIB与IL-6、D-二聚体呈正相关(r=0.31,r=0.56)。结论:FIB、IL-6、D-二聚体联合检测对于卵巢癌的早期诊断、分期及判断预后具有重要的临床价值。     

骨科大手术围手术期血浆D-二聚体检测的临床意义

目的 探讨骨科大手术围手术期血浆D-二聚体动态检测对深静脉血栓(DVT)形成早期诊断中的临床意义.方法 2009年10月至2010年11月,采用紫外免疫比浊法于入院时、术后2h和术后1、2、3、4、6、8、10、15 d动态测定本院92例骨科大手术患者(髋关节置换术28例、膝关节置换术40例、髋部周围骨折手术24例)血浆D－二聚体浓度,分析其动态变化特点.按照彩超检查结果将患者分为DVT组与非DVT组,比较两组各时间点的D-二聚体水平.结果 与术前相比,92例患者术后血浆D-二聚体浓度均升高,术后2h即达2000 μg/L以上,其中有10例D-二聚体浓度呈持续性或进行性升高,术后1d达高峰(3588±512)μg/L,并呈持续升高状态,术后15 d仍有(2494±394)μg/L,而其他82例患者D-二聚体值能较快地下降,其峰值仅持续3d,术后4d即降至500 μg/L以下.双下肢深静脉彩超检查后确认10例持续升高患者发生DVT(DVT组),82例D-二聚体水平迅速下降患者未发生DVT(非DVT组),DVT的发生率为10.87％.与非DVT组比较,DVT组患者术前D－二聚体水平接近,术后2h和术后1、2、3、4、6、8、10、15 d D-二聚体水平均升高(均P＜0.05).结论 骨科大手术围手术期血浆D-二聚体浓度的动态监测对术后并发DVT早期诊断具有重要价值.     

吕梁地区健康孕妇不同孕期D-二聚体的参考区间建立

目的 1.观察就诊于我院的孕妇血浆D-二聚体水平的变化趋向,明确妊娠因素对孕妇血浆D-二聚体水平的影响。2.建立吕梁市健康孕妇不同孕期D-二聚体的参考区间。3.探讨本研究所确立的参考区间对产科凝血止血相关疾病诊疗的指导意义。方法选取2016年7月至2017年2月就诊于山西省汾阳医院的健康孕产妇632例、健康非孕妇女100例、DIC孕妇10例、静脉血栓孕妇15例,运用胶乳免疫比浊法定量检测其血浆D-二聚体的浓度。以健康孕妇的检测数据制定D-二聚体的相应参考区间,并和所选健康非孕妇女、DIC孕妇、静脉血栓孕妇的检测数据进行比对分析。结果 1.孕妇血浆D-二聚体水平显著高于非孕妇女人群,现阶段临床检验科室所使用的D-二聚体疾病界定值主要针对的是非孕人群,不适用于孕妇群体;孕妇血浆D-二聚体水平随孕周增加而逐渐增高。2.吕梁市健康孕妇人群血浆D-二聚体的95%参考区间为:≤13w:≤0.835 mg/L;14-27w:≤1.87 mg/L;≥28w:≤2.91mg/L。3.采用本研究所制定的参考区间来评估10例DIC孕妇和15例静脉血栓孕妇的D-二聚体检测值,均判断为为阳性结果,初步验证了本研究所制定的参考区间的有效性。结论本研究初步建立了基于胶乳免疫比浊法的吕梁市孕妇血浆D-二聚体参考区间。运用该参考区间可以提高D-二聚体对孕妇人群凝血止血相关疾病的诊断价值。     

The effect of papaverine,euphylline, and dibazol on the rate of the coronary circulation,the oxygen demand of the heart,and the work of the heart

Summary Experiments were performed on anesthetized cats. The author studied the effect of papaverine, euphylline, and dibazol on the volume velocity of the blood outflow from the coronary sinus, the oxygen uptake by the heart and the work of the heart. As shown by the experiments the changes of arterial blood pressure, minute volume, the work of the heart, and the frequency of the heart beat do not play a decisive role in the increase of the volume velocity of the coronary blood flow under the effect of the drugs under investigation. The changes of the volume velocity of the coronary blood flow and the heart oxygen uptake under the effects of the above vasculo-dilating preparations are strikingly parallel.Presented by Active Member AMN SSSR V. V. Zakustov     

Immunological responses of the toad, Xenopus laevis, to the antigens of the ciliate, Tetrahymena pyriformis

Toads, Xenopus laevis, were immunized with the ciliate Tetrahymena pyriformis and their sera examined for specific anti-Tetrahymena precipitating, immobilizing, agglutinating and lytic antibodies 65–75 days later. Precipitating antibodies were detected in whole antiserum by ring and Ouchterlony tests against soluble antigens of Tetrahymena. Immobilizing, agglutinating and lytic antibodies against living ciliates were also detected in whole serum. Antibody activity was localized in the serum fraction corresponding with mammalian γ-globulin after starch block electrophoresis and this was confirmed by immunoelectrophoresis. After fractionation on Sephadex G-200 precipitating antibodies were found to correspond with γG immunoglobulins and non-precipitating antibodies with both γM and γG. These results are comparable with the situation which exists in rabbits immunized against Tetrahymena pyriformis.     

Effect of exercise on the tissue respiration of the brain,skeletal muscle,heart, liver,kidneys, and spleen

Summary The effects of a single sustained physical exercise on the respiration of various tissues of rats were investigated with the aid of Warburg's method. The animals were made to run on a treadmill for 90 min, i.e., until distinct signs of fatigue. The oxygen uptake of skeletal muscles was increased, and that of brain and kidneys reduced, both by a statistically significant margin. Changes in the respiration of liver, heart, and spleen were not statistically significant.The authors attribute increased respiration of skeletal muscles during physical exercise to intensified carbohydrate metabolism in muscle and the concomitant increase in the activity of the oxidative systems of muscle.The observed inhibition by severe physical exercise of the oxygen uptake of brain may have been caused by the inhibitory effects of serotonin and, possibly, corticosteroids, or still other active substances whose level rises in the organism of a tired animal.Oxygen uptake in the kidneys was probably reduced by an adaptive lowering of the activity of that organ's respiratory enzymes, which was the result of a markedly diminished renal blood supply during physical effort.     

Effect of the progestogen, allylestriol, on the bursal development of the chicken

Fertile eggs were dipped on the fifth day of incubation into varying concentrations of allylestriol (AE), a synthetic progesterone, and testosterone propionate (TP). Concentrations of AE higher than 0.1% inhibited hatchability. The AE inhibited the differentiation of the bursal mesenchyme and follicular development and subsequently resulted in bursectomy. The AE caused bursectomy in 40–50 times lower concentrations than did TP. An unusual lymphocyte accumulation occurred around the postcapillary venules in the bursal mesenchyme of AE-treated birds. This observation suggested that inhibition of mesenchyme differentiation may lead to a modification in bursal function. The AE modification of bursal development was compared to those produced by TP. We demonstrated that AE caused immunosuppression of the B-cell system.