白癜风患者血清免疫球蛋白、补体、自身抗体检测及分析

目的 检测白癜风患者血清中免疫球蛋白IgG、IgA、IgM,补体C3、C4,抗核抗体(ANA)、抗甲状腺过氧化物酶抗体(A-TPO)、抗甲状腺球蛋白抗体(A-TG)的水平并进行比较分析.方法 收集门诊确诊为白癜风的患者血清168例和正常体检人群血清88例,性别、年龄分布无统计学差异,采用速率散射比浊法检测白免疫球蛋白IgG、IgA、IgM和补体C3、C4,采用ELISA法检测抗核抗体,采用电化学发光免疫分析法检测A-TPO、A-TG,结果用SPSS19.0统计软件进行分析.结果 白癜风患者组血清中免疫球蛋白IgG、IgA、IgM,补体C3、C4表达水平与正常人对照组差异不具有统计学意义(P＞0.05);白癜风组与正常对照组ANA阳性率分别为8.1％和5.7％,经比较差异不具有统计学意义(P＞0.05);两组间A-TPO的阳性率分别为18.8％和10.2％,差异有统计学意义(P＜0.05);两组A-TG阳性率分别为25.8％和4.5％,经比较差异具有统计学意义(P＜0.01).结论 部分白癜风患者存在体液免疫紊乱,在发病机制上可能与自身免疫性甲状腺疾病有相似之处;免疫球蛋白、补体及抗核抗体等免疫指标的检测在白癜风诊治中评价的意义不大.     

自身抗体联合体液免疫检测在SLE中的应用价值

目的 探讨联合检测自身抗体、免疫球蛋白和补体在系统性红斑狼疮(SLE)诊断和病情判断中的应用价值.方法 选取SLE患者54例、其他自身免疫性疾病患者32例和正常对照30例,采用间接免疫荧光法测定抗核抗体(ANA)、免疫印迹法测定抗核提取物抗体(抗ENA抗体)、散射免疫比浊法测定免疫球蛋白和补体C3、C4.结果 SLE患者的ANA、抗dsDNA、抗Sm、抗核小体、抗U1-nRNP、抗核糖体P蛋白、抗组蛋白抗体的检测阳性率分别为87.04％、59.26％、27.78％、29.63％,37.04％、12.96％、27.78％;SLE活动组中抗dsDNA和抗核小体抗体的阳性率高于SLE非活动组,差异具有统计学意义(P＜0.05);SLE活动组IgG、IgA、IgM水平高于正常对照组,C3、C4水平低于正常对照组,差异具有统计学意义(P＜0.01).结论 自身抗体联合免疫球蛋白和补体检测对SLE患者的临床诊断和病情判断有良好的参考价值.     

甲状腺自身抗体在自身免疫性甲状腺疾病诊断中的临床应用

目的 探讨患者血清甲状腺自身抗体——促甲状腺激素受体抗体(TRAb)、甲状腺过氧化物抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)浓度的变化,在自身免疫性甲状腺疾病(AITD)中桥本甲状腺炎(hashimoto,HT)和毒性弥漫性甲状腺肿(Graves' disease,GD)的诊断意义.方法 选取2015年2月至8月我院收治200例患者,其中桥本甲状腺炎100例,Graves病100例,以及50例健康志愿者作为对照组.采用电化学发光法(ECLIA)检测TRAb,用放射免疫法(RIA)检测TPOAb和TGAb,并对比上述指标的检测结果.结果 自身免疫性甲状腺疾病(AITD)显著高于健康对照组,Graves病患者TRAb水平显著高于桥本甲状腺炎患者,而且桥本甲状腺炎患者TPOAb、TGAb水平显著高于Graves病患者,均有显著差异(P＜0.05).结论 TPOAb、TGAb在桥本甲状腺病诊断中起重要作用.而TRAb对于Graves病有较高的灵敏度和特异性,可以作为诊断Graves病的特异性指标.     

促甲状腺激素和甲状腺自身抗体在甲状腺疾病中的诊断价值分析

目的分析促甲状腺激素和甲状腺自身抗体在甲状腺疾病中的诊断价值。方法选取本院2018年6月至2019年3月收治的82例甲状腺疾病患者作为研究组,其中甲状腺机能减退症患者(甲减)29例、毒性弥漫性甲状腺病患者(GD)32例、桥本甲状腺炎患者(HT)21例。另外选择同期本院体检的30例健康者作为对照组。对所有研究对象的TSH、TRAb、TGAb以及TPOAb指标进行检测,汇总并观察不同疾病4种指标变化情况。结果 GD组、甲减组、HT组患者的TGAb、TPOAb血清水平明显高于对照组,差异具有统计学意义(P0.05);GD组患者TSH血清水平明显低于对照组,TRAb血清水平显著高于对照组(P0.05);甲减组患者TSH血清水平明显高于对照组,差异具有统计学意义(P0.05)。结论促甲状腺激素和甲状腺自身抗体可以一定程度反映患者甲状腺疾病情况,可为临床上提供诊断甲状腺疾病的原始资料,值得推广应用。     

Graves病中IgG亚型水平的变化

目的 Graves病(Graves′ disease, GD)作为一种自身免疫性甲状腺疾病,其发生存在免疫调节因素的参与,目前对IgG亚类在自身免疫性甲状腺疾病(autoimmune thyroid disease, AITD)中的研究主要集中于针对血清中特定自身抗原的IgG亚型的研究,并无血清整体IgG亚型变化的相关性研究.本研究观察GD患者血清整体IgG亚型水平的变化,并对于IgG亚型与甲状腺自身抗体变化的相关性进行分析,期望通过该研究进一步了解自身抗体介导AITD的机制.方法 随机收集哈尔滨医科大学附属第二医院就诊的初发GD(n=14)作为观察组,观察对象均为女性,排除其他可能影响甲状腺功能和机体免疫状态的因素.随机选取年龄、性别与观察组相匹配非甲状腺疾病健康者15例作为对照组.于清晨空腹采集患者血清,测定甲状腺功能、甲状腺自身抗体、IgG各亚型.结果 GD组血清中IgG1水平较对照组升高(P<0.05);IgG2 水平也较对照组升高,但与对照组相比差异无统计学意义(P>0.05);IgG3和IgG4水平下降明显(P<0.01).GD亚组血清IgG亚型与甲状腺自身抗体、甲状腺功能相关性分析显示各指标间无相关性(P>0.05).结论 Graves病中存在IgG亚型水平的变化.     

Th1/Th2细胞因子结合甲状腺自身抗体检测在自身免疫性甲状腺疾病中的诊断价值

研究Th1/Th2细胞因子和甲状腺自身抗体在自身免疫性甲状腺疾病(AITD)中的诊断价值。选择Graves病(GD)28例、甲亢甲炎(GDIII)15例、桥本甲亢(HTL)13例、桥本甲状腺炎(HT)21例、20名正常人,通过酶免法检测血清Th1型细胞因子γ干扰素(IFN-γ)和Th2型细胞因子白细胞介素-4(IL-4)的含量,与放免法测定的促甲状腺激素受体抗体(TRAb)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)进行相关分析。结果显示,IFN-γ水平HT>HTL>GDIII>GD,IL-4水平GD>GDIII>HTL>HT。GDIII和HTL组IFN-γ和IL-4水平均有统计学意义(P<0.05,P<0.01),GDIII和HTL组TGAb、TPOAb无统计学意义(P>0.05)。HT组IFN-γ与TGAb、TPOAb正相关(r分别为0.67,0.54,P<0.01),GD组IL-4与TRAb正相关(r=0.71,P<0.01)。Th1/Th2细胞因子失衡反映了AITD的病理改变和免疫功能紊乱,与甲状腺自身抗体检测相结合可成为AITD辅助诊断的指标。     

自身免疫性疾病患者血清抗bFGF自身抗体的检测及对疾病诊断价值的临床分析

为探讨自身免疫性疾病(autoimmune disease,AID)患者血清中抗碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)自身抗体水平及对患者的诊断价值,回顾性收集2015年3月至2017年5月医院收治的AID患者80例为观察组,取同期入院健康体检者80例为对照组。采用ELISA检测2组患者血清中抗bFGF抗体IgM和IgG水平。结果显示80例AID患者经过检测血清中抗bFGF自身抗体均得到确诊,排在前3位的分别为SLE、RA及慢性肾炎,分别占28.75%、22.50%和18.75%;观察组bFGF水平高于对照组(t=7.572,P0.05);观察组中SLE、不明原因发热患者抗bFGF IgM抗体与对照组比较差异无统计学意义;观察组RA、皮肌炎及特发性血小板减少性紫癜患者抗bFGF IgG抗体阳性率高于对照组(P0.05);观察组RA、慢性肾炎、皮肌炎、特发性血小板减少性紫癜患者抗bFGF IgM抗体水平高于对照组(P0.05)。由此AID患者血清中存在bFGF自身抗体水平升高现象,加强抗bFGF自身抗体水平测定有助于AID的诊断,值得推广应用。     

AITD甲状腺细胞Fas、FasL的单抗免疫组化测定

测定凋亡相关蛋白Fas、FasL在自身免疫性甲状腺疾病(AITD)病人甲状腺细胞中的表达,以研究细胞凋亡在AITD发病中的作用.本研究采用甲状腺粗针穿刺取甲状腺组织,然后用单克隆抗体免疫组织化学法和图像分析检测甲状腺细胞中Fas、FasL的表达,于电镜下观察结果.Graves病(GD)组Fas、FasL染色强度显著低于对照组(P＜0.01).桥本氏甲状腺炎(HT)组两者染色强度显著高于对照组(P＜0.01).这说明Fas、FasL这两种凋亡相关蛋白在HT病人甲状腺细胞中表达显著增强,而在GD病人中表达较少,进一步证实了细胞凋亡在AITD发病机制中具有重要作用.     

不孕及反复流产患者血清抗心磷脂抗体的检测

目的检测不孕及反复流产患者血清中的抗心磷脂抗体(ACA),探讨ACA的临床意义.方法应用酶联免疫吸附(ELISA)法检测105例原发或继发不孕患者(不孕组)、171例反复流产或有胚胎停育史患者(流产组)及40例正常对照组血清中的IgG、IgM及IgA-ACA 3种抗体.结果不孕组ACA总阳性率为44.76%,流产组为35.09%,均显著高于对照组(P＜0,01).不孕组及流产组的单纯IgG阳性率亦明显高于对照组(P＜0.05);而两组的单纯IgM阳性率与对照组相比,差异均无显著性意义(P＞0.05).结论ACA是导致不孕及反复流产的免疫学因素之一,IgG型的ACA比IgM型的更具临床意义     

促甲状腺激素、甲状腺过氧化物酶抗体和促甲状腺激素受体抗体检测在甲状腺疾病中的应用价值

探讨促甲状腺激素（TSH）、甲状腺过氧化物酶抗体（TPOAb）、促甲状腺激素受体抗体（TRAb）在甲状腺疾病中的诊断价值。对44例Graves病（GD）、29例桥本甲状腺炎（HT）、13例亚甲炎患者和26例正常对照,采用电化学发光免疫分析法测定TSH、TPOAb、TRAb的含量,分析其在几组病例中的意义。三病例组的TSH、TPOAb、TRAb含量与正常对照组比均有显著差异（P〈0.01）;HT组TPOAb的测值和阳性率又显著高于GD组,而GD组TRAb的测值和阳性率都显著高于HT组,经统计学检验两者均有显著意义（P〈0.05）。结果说明,TSH是甲状腺功能的非常敏感的特异性参数,TPOAb、TRAb的检测对鉴别诊断GD和HT有着重要意义。     

Thyroid disease, behavior, and psychopharmacology

The authors review psychiatric complications of thyroid disease and the use of psychotropic agents in hyper- and hypothyroid patients. Neuropsychiatric symptoms of hyperthyroidism tend to resolve with treatment of excessive thyroid production; those of hypothyroidism respond in a variable manner to thyroid replacement, but most patients improve substantially after becoming euthyroid. The judicious use of most psychotropics has its place even in the presence of overt thyroid disease. The important antithyroid effects of lithium should be noted when treating patients with thyroid disease. Routine monitoring of thyroid function in otherwise healthy patients taking antipsychotic agents, tricyclic antidepressants, or monoamine oxidase inhibitors (MAOIs) is not believed necessary.     

Thyroid function, metabolic regulation, and depression

Evidence suggests that alterations in thyroid function are associated with depression. Thyroid hormones also play an essential role in regulating metabolism. They influence the balance between metabolic rate and caloric intake and thus affect body weight changes. Appetite and weight disturbances are common in the syndrome of depression. There may be changes in resting metabolic rate in depression as well. Hence an interrelationship between thyroid function, metabolic regulation, and depression is suggested. A basic model of metabolic regulation is presented and linked to changes in mood and various indices of thyroid function. The model is offered as an initial framework for studying endocrine and metabolic components of depression. Testable hypotheses are generated through the use of the model, and research strategies are discussed.     

Langerhans Cell Histiocytosis of the Lung and Thyroid, Co-Existing with Papillary Thyroid Cancer

A 24-year-old man presented to our center with a huge goiter compressing his airway. He had a previous diagnosis of Langerhans cell histiocytosis (LCH) of the lung. Core needle biopsy was consistent with histiocytosis. Thyroidectomy was performed. A very invasive mass was encountered at the time of surgery. Histopathology result was consistent with an invasive papillary cancer of thyroid co-occurring with LCH. Although association of LCH with different malignancies has been reported, co-existing invasive papillary thyroid cancer and LCH is a rare combination.     

Thyroid hormones, malnutrition, and biochemical composition of developing rat lung

We studied the effects of thyroid hormones and malnutrition on protein, DNA, and phospholipid content of the developing rat lung during the first month of life. Neonatal hypothyroidism significantly decreases the lung phospholipid content by 30-45% between 5 and 30 days of age whether the results are expressed per milligram DNA or per gram tissue. Administration of thyroxine for 3 days to hypothyroid rats increases significantly (20%) their total phospholipid content, mainly through its preferential effect on phosphatidylcholine (50% increase). Adult animal response to thyroid hormones is markedly different from that observed in young rats for most parameters examined. In malnourished rats, lung tissue phospholipids are decreased per cell but not per unit cell mass after 11 days of age. These results show that hypothyroidism has a specific effect on lung phospholipids during the neonatal period.     

Thyroid Peroxidase and Thyroglobulin Expression in Normal Human Thyroid Glands

The objective of the present study was to investigate thyroid peroxidase (TPO) and thyroglobulin (Tg) expression in normal thyroid tissue. Thirty-eight normal thyroids from fetuses(1) children, adults, and elderly subjects were evaluated. TPO and Tg expression was determined by analyzing at least 200 cells/specimen. A value of 80% was considered to be the threshold for TPO positivity. In terms of age, TPO expression occurs in fetuses along with follicle differentiation and is absent in solid follicles. TPO staining was cytoplasmic, and was more intense in the apical membrane in tissue from fetuses, children, and young adults. A perinuclear rang was found in tissue from older adults and from the elderly subjects. There was concomitant TPO and Tg expression in all groups studied. Tg expression was observed in all normal thyroids from all age groups. Tg expression was extremely variable (10-100% of the cells) and fainter than TPO expression.     

脑卒中后抑郁与梗死部位及甲状腺功能的相关性分析

目的:分析脑卒中后抑郁(PSD)与梗死部位及甲状腺功能的相关性分析,为早期干预治疗提供依据。方法:选择2011年1月-2013年12月我院收治的142例急性缺血性脑卒中患者,根据汉密尔顿抑郁量表(HAMD)评分8分判定为PSD,分析PSD与梗死部位、游离三碘甲状腺氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)等甲状腺功能指标的关系。结果:PSD的发生率为38.7%,左侧半球、皮质、前部的PSD发生率较高;入院第7d,非PSD组和PSD组FT3明显下降(t=6.45,14.33;P0.05)、FT4明显升高(t=8.13,16.52;P0.05),但PSD组TSH显著低于非PSD组(t=9.83,P0.05),与对照组比较无显著性差异(P0.05);入院第14d,非PSD组各甲状腺功能指标基本恢复正常,但PSD组FT3、FT4与对照组比较有显著性差异(t=8.40,9.15;P0.05);入院第2d、7d、14d,随着抑郁症状的加重,PSD患者血清FT3水平依次降低(F=29.59,22.37,12.13;P0.05)。结论:PSD与梗死部位及甲状腺功能异常密切相关,以左侧半球、皮质、前部的PSD发生率较高,且对HPT轴的抑制时间较长。寻找PSD的干预靶点并早期防治,有助于促进脑卒中的康复。