小儿感染性疾病红细胞内锌原卟淋测定及其临床意义

为了解小儿感染性疾病红细胞内锌原卟淋（ZPP）值及其临床。方法：对61例小儿感染性疾病进行ZPP及血红蛋白（Hb)，红细胞计数（RBC）及平均红细胞体积（MCV）的测定，以健康体检儿童作为对照，结果： 感染组儿童ZPP值明显高于对照组（P＜0．05），Hb、MCV值明显低于对照组（P＜0．05），RBC值无明显差异（P＜0．05）。不同性别之间ZPP、Hb、RBC、MCV值无统计学差异（P＜0．05）。肺炎、肺结核、肠炎的ZPP值较上呼吸道感染及皮肤感染患儿高，败血症患儿ZPP值最高，Hb、RBC、MCV值较低，但无统计学差异（P＜0．05）。结论：小儿感染性疾病存在铁代谢紊乱。应用ZPP筛查铁缺乏症时，应避免感染因素的干扰，ZPP也可作为儿童感染及感染严重程度的观察指标。     

锌原卟淋的研究进展

近年来的研究表明，锌原卟啉除了可以作为评价铁营养状况和辅助诊断铅中毒的重要实验指标外，还通过抑制血红素氧化酶的活性，参与血红蛋白的分解代谢，在控制新生儿胆红素形成，预防高胆红素血症方面具有潜在的治疗作用。本文主要介绍其基础研究方法和临床应用的研究进展。     

西宁市3—12岁儿童Hb—SFEP测定值的相关分析

本文通过要市４２６名３￣１２岁儿童Ｈｂ及ＦＥＰ二项值的测定，发现用全国建议的西它折算标准来判断本组儿童的贫血患病率为５１．７０％，其中非缺铁性贫血竞高达４４．４％。因此，建议为解决我国不同海拔高度地区血红蛋白低限值的标准制定，必须对所测样本作出严格的统一要求。     

铅污染区儿童血铅与锌原卟啉、红细胞参数相关性研究

目的 探讨铅污染区儿童血铅与锌原卟啉、红细胞参数相关性。方法 对云南某县铅锌矿区和县城非铅锌矿区2～9岁儿童共464人进行血铅（BPb）水平、红细胞参数及锌原卟啉（ZPP）水平调查，按血铅水平分为高、低血铅组并进行血Pb与红细胞参数（RBC、HB、HCT、MCV、MCH、MCHC、RDW）及ZPP相关性分析。结果儿童血铅浓度均值154．4ug／L，铅中毒率79．1％，ZPP均值2．7ug／gHb。血铅〉250ug／L时，血铅与红细胞参数具有相关性（RR：0．637）。高铅组血铅水平与RBC、ZPP有较强相关性（r分别为：-0．975、0．957）。RBC随血铅水平增高呈高度负相关，血铅水平〈200ug／L时，与zPP无相关性。血铅水平达～250ug／L、～300u∥L、～350ug／L时，血铅与ZPP具有较强相关性（r分别为：0．567、0．93、0．886）并呈高度正相关。结论随血铅水平的增高，RBC与血铅呈高度负相关，当血铅水平〉250ug／L时，血铅与ZPP具有高度正相关性，而当血铅水平〈200ug／L时，与ZPP相关关系不密切，因此ZPP不能作为铅中毒筛查指标。     

铅污染区儿童血铅与锌原卟啉、红细胞参数相关性研究

目的探讨铅污染区儿童血铅与锌原卟啉、红细胞参数相关性。方法对云南某县铅锌矿区和县城非铅锌矿区2～9岁儿童共464人进行血铅(BPb)水平、红细胞参数及锌原卟啉(ZPP)水平调查,按血铅水平分为高、低血铅组并进行血Pb与红细胞参数(RBC、HB、HCT、MCV、MCH、MCHC、RDW)及ZPP相关性分析。结果儿童血铅浓度均值154.4ugL,铅中毒率79.1%,ZPP均值2.7uggHb。血铅>250ugL时,血铅与红细胞参数具有相关性(RR:0.637)。高铅组血铅水平与RBC、ZPP有较强相关性(r分别为:-0.975、0.957)。RBC随血铅水平增高呈高度负相关,血铅水平<200ugL时,与ZPP无相关性。血铅水平达～250ugL、～300ugL、～350ugL时,血铅与ZPP具有较强相关性(r分别为:0.567、0.93、0.886)并呈高度正相关。结论随血铅水平的增高,RBC与血铅呈高度负相关,当血铅水平>250ugL时,血铅与ZPP具有高度正相关性,而当血铅水平<200ugL时,与ZPP相关关系不密切,因此ZPP不能作为铅中毒筛查指标。     

血锌原卟啉对缺铁性贫血早期诊断及疗效观察的临床意义

研究目的探讨血锌原卟啉（Ｚｐｐ）测定对小儿缺铁性贫血早期诊断及疗效的临床意义。研究方法铁缺乏患儿２３２例（１４０例伴贫血，９２例为非贫血铁缺乏），８０例正常儿童为对照组，进行血Ｚｐｐ测定研究。并对２０例血清铁蛋白正常的贫血患儿进行铁试验治疗。结果缺铁性贫血组及非贫血缺铁组的Ｚｐｐ值（分别为１．４２３±０．２５３μｍｏｌ／Ｌ及１．０４０±０．１３３μｍｏｌ／Ｌ）均明显高于对照组（０．５６６±０．１２１μｍｏｌ／Ｌ）（Ｐ＜０．０１）。铁试验治疗显示，随治疗的继续，Ｚｐｐ值逐渐下降，治疗８周后Ｚｐｐ下降正常，贫血纠正。结论Ｚｐｐ作为缺铁性贫血早期诊断及疗效观察的指标，具有很大的临床价值。     

血清降钙素原、前清蛋白和C-反应蛋白测定在感染性疾病中的临床意义

目的 探讨感染性疾病患儿血清降钙素原(PCT)、前清蛋白(PA)和CRP测定的临床意义.方法 感染儿童78例被分为细菌感染组(35例)与病毒感染组(43例).2组患儿均检测血清PCT、CRP和PA水平,并与35例年龄、性别相匹配的健康儿童各检测值进行比较.结果 1.以血清PCT≥0.5μg/L为阳性标准,细菌感染组PCT阳性率为80%(28/35例),病毒感染组为18.6%(8/43例);以血清CRP≥8 mg/L为阳性标准,细菌感染组CRP阳性率为68.6%(24/35例),病毒感染组为23.2%(10/43例).2.与健康对照组比较,细菌感染组PCT、CRP均明显升高(Pa<0.01),PA明显降低(P<0.01);细菌感染组PCT、CRP均高于病毒感染组(Pa <0.05),PA明显低于病毒感染组(P<0.01).结论 PCT、PA和CRP的检测对于细菌性感染和病毒性感染的鉴别诊断有一定价值.     

反复呼吸道感染儿红细胞免疫粘附功能及锌治疗

反复呼吸道感染儿红细胞免疫粘附功能及锌治疗（杭州市第一医院３１０００６）何内华，张锦铭，张玉芳反复呼吸道感染儿童的低免疫状态，常使临床抗感染治疗变得颇为棘手。８０年代后随着人类对红细胞免疫粘附（ＲＣＩＡ）功能的发现与认识，对疾病的免疫病理机制又有了新...     

小剂量锌对反复呼吸道感染患儿红细胞锌、T细胞亚群的影响及临床意义

反复呼吸道感染(RRI)是儿科常见病,发病率在20%以上。目前已公认免疫力低下是其主要致病因素,临床中发现小剂量补充锌剂能改善儿童的锌营养状况及免疫功能[1]。我们通过对42例低锌水平RRI患儿的红细胞锌及T细胞亚群进行动态观察、对照比较,以期进一步了解小剂量锌剂补充对RRI发病的干预机理与疗效。资料与方法一、对象按1987年全国小儿呼吸道会议制定的标准确诊为RRI患儿42例,年龄1~7岁,全部普查血清锌,低于正常水平11.47μmol/L者,按随机分配原则分为补锌组26例(男14例、女12例)及对照组16例(男9例、女7例)。二、方法补锌组采取常规…     

小儿急性白血病多药耐药基因表达的动态观察及其临床意义

为探讨小儿急性白血病 (AL)多药耐药基因MDR1表达的临床价值 ,检测2 8例AL患者 4 8份标本的MDR1基因 ,并对其中 2 0例患儿进行了动态观察。结果 ,小儿急性白血病在治疗的不同阶段其MDR1的阳性率不同 :化疗前的阳性率为 2 5 % ,MDR1阳性与MDR1阴性患者的完全缓解率 (CR)分别为 33%和 92 % (P <0 .0 1) ,耐药组的阳性率为 80 % ,而非耐药组的阳性率为 16 % (P <0 .0 1)。复发组的MDR1阳性率为 75 % ,而持续缓解组的MDR1阳性率为 16 % (P <0 .0 5 )。正常人MDR1阳性率为零。结果表明检测MDR1对判断化疗效果和估计预后均有很重要的作用 ,同时可为临床合理选择化疗方案提供一个客观指标     

INFECTIOUS HEPATITIS IN CHILDREN FOLLOW-UP OF 300 CHILDREN

300 consecutive children admitted to hospital with infectious hepatitis were followed up until they had‘recovered’. One month after leaving hospital only 28% were fully recovered; the remainder still showed relevant symptoms and/or signs and/or biochemical abnormality. Symptoms and signs resolved quickly but abnormal levels of serum glutamic pyruvic transaminase persisted for up to 6 months, and an abnormal reaction to the zinc sulphate turbidity test (ZSTT) for much longer.     

白血病患儿脑脊液热应激蛋白水平测定及临床意义探讨

为了探讨热应激蛋白（HSPs）与白血病化疗及分类的关系，应用Western斑点、印迹方法，检测了54例白血病患儿71份脑脊液HSP90、70、60、27水平。结果：（1）化疗后骨髓缓解期HSP90、7O、6O、27均明显高于危象期（P＜0．01和P＜0．05）；（2）与非肿瘤组对比危象期HSP70、60、明显降低（P＜0．01），缓解期HSP90、27明显增高（PMO．01）；（3）从双份标本结果发现，HSPS总体水平由低向高发展预后好，而持续低水平或由高向低发展预后差；（4）急性淋巴细胞性白血病患JLHSP70、6O明显高于急性非淋巴细胞性白血病。提示：HSPS参与白血病的免疫防护，与白血病的分类有密切关系。HSPS水平的测定对指导白血病治疗及预后的评价具有重要意义。     

THE RESULTS OF IMMUNOSUPPRESSIVE THERAPY IN CHRONIC RENAL DISEASES IN CHILDREN AND THE ASSESSMENT OF ERYTHROBLASTS BEHAVIOUR

Immunosuppressive therapy (6-Mercaptopurine) has been used in 33 children with chronic renal diseases resistant to other therapeutic methods. Peripheral blood counts were done in all the children and in 18 of them bone marrow examinations were performed. The results of immunosuppressive therapy were encouraging; many compleie and partial remissions being obtained. Children with nephrotic syndrome showed low percentages of erythroblasts in bone marrow. This was not observed in children suffering from chronic glomerulo- and pyelonephritis. Immunosuppressive therapy provoked increase of erythroblasts in bone marrow of children with nephrotic syndrome.     

THE GROWTH OF THE KIDNEYS IN CHILDREN WITH VESICOURETERIC REFLUX

Abstract. In a retrospective study, 69 kidneys with VUR were divided into 2 groups: One group (A) where VUR stopped within 1 year after operation or conservative treatment and a second group (B) where VUR continued for more than 1 year. Group A had somewhat more severe grades of reflux than group B. The number of infections were practically the same in the two groups. The length of the kidneys was measured at the time of diagnosis and compared with the length at the most recent urography after VUR stopped (group A) on average 2 years and 3 months later and with the most recent urography while VUR was still present (group B) on average 1 year and 9 months later. It was found that 85% in group A had increased in absolute length while the figure was 60% in group B. If the relative growth is calculated (the kidneys' length in relationship to L₁ - L₃ distance), 60% in group B had decreased while only 30% in group A had decreased.     

血液病患儿细小病毒B_(19)感染的检测及临床意义

人细小病毒B19（HumanParvovirrusB19，HPVB19）与人类多种疾病密切相关，可通过接触和使用血液制品等在人群中传播［1］，本文采用聚合酶链反应（PCR）技术检测45例血液病患儿血清HPVB19－DNA，结果总阳性率为26．6％，其中急性白血病占38．8％（7／18），ITP占40．0％（4／10），过敏性紫癜占8．3％（1／12），再障5例均为阴性；同时检测对照组10名正常儿童均为阴性。将病例组与对照组进行比较有显著意义（P＜0．05）。     

SIGNIFICANCE OF MONOSOMY 7 IN MYELOID LEUKEMIAS IN CHILDREN

Loss of chromosome 7 material, either as complete loss of one chromosome-monosomy 7 (-7)- or as deletion of the long arm (7q-), is the most common cytogenetic abnormality in childhood myelodysplastic syndrome (MDS) and juvenile myelomonocytic leukemia (JMML), seen in approximately 30% of the cases. Only 4-5% of childhood acute myeloid leukemia (AML) cases show -7/7q-. Monosomy 7 in children has often been considered to represent a distinct hematologic disorder described as the monosomy 7 syndrome. Loss of chromosome 7 occurs in a heterogeneous group of myeloid disorders and recent data give no support to the concept of monosomy 7 as a distinct syndrome. Only patients with a diagnosis of JMML fit what previously has been referred to as the monosomy 7 syndrome. There are no major clinical differences between JMML with and without -7. Unlike what has been found in adults, monosomy 7 is not a poor prognostic factor in childhood MDS. However, -7 in AML is associated with a very poor prognosis. AML with 7q-, in contrast, has an outcome similar to AML with normal karyotype. Stem cell transplantation is the treatment of choice and should be performed as early as possible.     

小儿急性白血病骨髓细胞糖皮质激素受体表达及其临床意义

本文应用放射配体结合法测定了３０例ＡＬＬ骨髓细胞ＧＣＲ为７８７３±３００２位点／细胞；１７例ＡＮＬＬ为６１１３±１６２２位点／细胞（Ｐ＜０．０５）。形态学分型Ｌ１型１７例，ＧＣＲ为７２６７±３１７８位点／细胞；Ｌ２型１３例，ＧＣＲ为７６５０±３３６２位点／细胞（Ｐ＞０．０５）。临床分型标危型ＡＬＬ１４例，ＧＣＲ为８９９８±１９６３位点／细胞；高危型９例为５８４７±３８８５位点／细胞（Ｐ＜０．０５）。对１８例ＡＬＬ经联合化疗完全缓解前后比较发现，ＧＣＲ分别为８１１５±３２５８位／细胞和４６６９±２１０６位点／细胞（Ｐ＜０．０１）。本实验同时测定了ＡＬＬ和ＡＮＬＬ患儿血浆皮质醇浓度，平均分别为１１２．２０±４１．１４ｎｇ／ｍｉ和１０４．６５±４３．４９ｎｇ／ｍｌ，相关系数分别为ｒ＝０．１５和０．１１，说明ＧＣＲ表达水平不受皮质醇含量的影响。