检测类风湿因子IgM-RF,IgG-RF和IgA-RF在类风湿关节炎中的临床意义

目的了解IgM-RF,IgG-RF和IgA-RF在类风湿关节炎中的诊断意义。方法应用散射比浊法测定总RF含量,应用ELSIA方法检测IgM-RF,IgG-RF和IgA-RF。结果IgM-RF,IgG-RF和IgA-RF在RA中的检出率明显高于其它风湿病患者(P<0.05)。3种RF在RA中的浓度显著高于其它风湿组(P<0.05)。高活动期类风湿关节炎患者中IgM-RF和IgA-RF含量显著高于低活动期和稳定期的含量(P<0.05)。结论三种RF的检测能提高RF在RA中的检出率和特异性,对RA的诊断和活动度的观察有较大的临床意义。     

Determination of IgA,IgG,IgM Class-Specific Rheumatoid Factor and Its Clinical Evaluation

Solid Phase enzyme-linked Immunosorbent assay(ELISA) for detectingclass-specific rheumatoid factor (RF) was established.Aggregated rabbit lgG was used ascoating antigen and the presence of RF was demonstrated by F(ab')_2 fragment of anti-humanIg conjugated to horseradish peroxidase(HRP).The results showed that high levels ofIgM-RF,IgG-RF and IgA-RF were found in patients with rheumatoid arthritis.A positive cor-relation existed between IgM-,IgG-,IgA-RF and disease activity.The presence of vasculitis al-so correlated positively with the levels of 3 class-specific RFs.     

类风湿关节炎患者IgM-RF、IgA-RF、IgG-RF、IL-1RI、CDK2的检测及ROC评价

目的 探讨检测外周血类风湿因子(IgM-RF、IgA-RF、IgG-RF)、白细胞介素-1受体Ⅰ型(IL-1RI)和周期素依赖性蛋白激酶2(CDK2)水平对类风湿关节炎(RA)的实验诊断价值.方法 对象包括RA患者94例,其中活动期和非活动期各47例;系统性红斑狼疮(SLE)患者40例,其中活动期和非活动期各20例;急性上呼吸道感染(AURTI)患者20例;健康体检者20名(对照组).检测所有对象外周血血清IgM-RF、IgA-RF、IgG-RF、IL-1RI(ELISA定量检测)、CDK2(时间分辨荧光免疫分析)水平.对结果进行统计分析,绘制ROC曲线,计算曲线下面积(AUC).结果 RA活动期患者组与缓解期患者组比较CDK2、IgA-RF有统计学意义(P<0.05).RA活动期与RA缓解期患者组比较、RA患者组与SLE患者组比较、RA患者组与AURTI患者组比较、RA患者组与对照组比较,AUC分别为:IgM-RF(0.561,0.814,0.799,0.888)、Igh-RF(0.596,0.678,0.729,0.850)、IgG-RF(0.614,0.718,0.692,0.791)、IL-1RJ(0.646,0.691,0.762,0.835)、CDK2(0.803,0.753,0.741,0.840).结论 IgM-RF可能对RA具有较高的诊断和鉴别诊断意义,而CDK2可能对RA分期的鉴别诊断有较高价值.

Abstract：

Objective To assess the value of rheumatoid factors IgM-RF, IgA-RF, IgG-RF, interleukin-1 receptor type I (IL-1RI) and cyclin-dependent kinase 2 (CDK2) in the diagnosis of rheumatoid arthritis (RA). Methods IgM-RF, IgA-RF,IgG-RF, IL-1RI and CDK2 were detected in 47 patients with active RA, 47 with inactive RA, 20 with active systemic lupus erythematosus (SLE), 20 with inactive SLE, 20 with acute upper respiratory tract infection (AURTI), and 20 healthy controls using enzyme-linked immunosorbent assay (IgM-RF, IgA-RF, IgG-RF, IL-1RI) and time-resolved fluoroimmunoassay (CDK2). Results Patients with active and inactive RA showed significant differences in peripheral serum CDK2 and IgA-RF levels (P<0.05). Between active and inactive RA patients, RA patients and SLE patients, RA patients and AURTI patients, and RA patients and the control subjects, the area under curve (AUC) of the receiver operating characteristic curve (ROC) was 0.561, 0.814, 0.799, and 0.888 for IgM-RF, 0.596, 0.678, 0.729, and 0.850 for IgA-RF, 0.614, 0.718, 0.692, and 0.791 for IgG-RF, 0.646, 0.691, 0.762, and 0.835 for IL-1RI, 0.803, 0.753, 0.741, and 0.840 for CDK2, respectively. Conclusion IgM-RF may have high value in the diagnosis and differential diagnosis of RA, and CDK2 can be useful for differential diagnosis between active and inactive RA.     

类风湿性关节炎伴软骨损伤患者相关危险因素Logistic分析

目的：探讨与类风湿性关节炎伴软骨损伤患者相关危险因素。方法：分析2013年1月～2014年6月在我院接受治疗的类风湿关节炎患者的临床资料,观察组选择类风湿关节炎合并软骨损伤患者,对照组选择类风湿关节炎无软骨损伤的患者。结果：观察组患者外周血中RF-IgA、RF-IgM、ACCP、ESR及CRP水平明显高于对照组,差异具有统计学意义;三组不同X线分期患者外周血中RF-IgA、RF-IgM、RF-IgG水平不存在统计学差异,采用Bonferroni法检验发现,II期、III期患者血清中RF-IgA明显高于对照组,差异具有统计学意义。三组不同X线分期患者ACCP、CRP水平存在统计学差异,II期、III期患者血清中ACCP水平明显高于I期水平,差异具有统计学意义,III期患者血清中ACCP水平明显高于II期水平,差异具有统计学意义。II期、III期患者ESR、CRP水平高于I期患者,差异具有统计学意义;采用Logistic多因素回归方法进行分析,血清中RF-IgA、RF-IgM、ACCP、CRP及ESR水平升高是RA伴软骨损伤患者独立的危险因素。结论：血清中RF-IgA、RF-IgM、ACCP、CRP及ESR水平升高是RA伴软骨损伤患者独立的危险因素。     

99Tc-MDP对大鼠佐剂性关节炎PGE1和PGE2的影响

目的    观察⁹⁹Tc-MDP对佐剂性关节炎（AA）大鼠模型的影响,探讨⁹⁹Tc-MDP在类风湿关节炎（RA）治疗中的抗炎作用及其机制。方法    采用完全性弗氏佐剂足跖皮内注射法建立AA模型,随机将30只雄性Wistar大鼠分为正常对照组、AA模型组和⁹⁹Tc-MDP治疗组,治疗组在造模10d后给予⁹⁹Tc-MDP2.5mL/kg尾静脉注射治疗,1次/d,治疗15d;正常对照组和AA模型组给予相同体积的生理盐水尾静脉注射治疗,1次/d,治疗15d。观察大鼠左踝关节宽度、关节炎指数（AI）,以及应用酶联免疫吸附法（ELISA）检测血清中的PGE1和PGE2的水平。结果    ①AA模型组、⁹⁹Tc-MDP治疗组随着免疫时间的延长,左踝关节肿胀程度逐渐减轻, ⁹⁹Tc-MDP治疗组较AA模型组减轻明显（P＜0.05）;AA模型组和⁹⁹Tc-MDP治疗组关节炎指数逐渐下降,⁹⁹Tc-MDP治疗组较AA模型组下降明显（P＜0.05）;②各组血清中PGE1水平差异无统计学意义（P＞0.05）; AA模型组、⁹⁹Tc-MDP治疗组血清中PGE2水平均高于正常对照组（P＜0.05）,AA模型组高于⁹⁹Tc-MDP治疗组（P＜0.05）。结论    ⁹⁹Tc-MDP可以降低AA大鼠左下肢踝关节宽度、关节炎指数及血清中的PGE2的水平,对抑制AA大鼠的炎症有一定疗效。     

左卡尼汀对血液透析患者促红细胞生成素所需剂量及微炎症状态的影响

目的 探讨左卡尼汀对维持性血液透析(MHD)患者使用重组人促红细胞生成素(rhEPO)的剂量及微炎症状态的影响.方法 将入选的326例MHD患者随机分为治疗组和对照组(每组163例),两组患者年龄、性别比、病程、常规治疗剂量等差异均无统计学意义,具有可比性.以维持患者血红蛋白(HB)水平在110～120 g/L,红细胞压积(HCT)水平在33％～35％为靶目标,对照组予以单纯rhEPO治疗,治疗组在予以rhEPO治疗基础上加予左卡尼汀治疗.8个月后,分别计算两组患者每周rhEPO的用量及促红细胞生成素反应指数(ERI),比较两组患者维持HB和HCT在靶目标水平所需每周rhEPO的用量及两组ERI的差异,同期监测血清超敏C反应蛋白(hs-CRP)等指标水平,观察患者微炎症状态的变化.结果 治疗组维持HB和HCT在靶目标水平所需每周rhEPO的平均用量低于对照组[(106±20) IU/kg vs (141±23)IU/kg],治疗组ERI低于对照组[(0.93±0.11) IU·L·kg 1·g-1 vs (1.35±0.29) IU·L·kg-1·g1],差异均有统计学意义(P＜0.05).治疗组患者治疗后hs-CRP水平较治疗前下降[(5.21±3.20) mg/L vs (10.33±2.54) mg/L,P＜0.05],且低于对照组治疗后水平(9.93±2.12) mg/L,P＜0.05];对照组患者hs-CRP水平在治疗前、后差异无统计学意义.结论 左卡尼汀可以减少MHD患者维持HB和HCT在靶目标水平所需rhEPO的用量,其机制可能与改善MHD患者微炎症状态、降低患者促红素抵抗性有关.     

A double-blind,double-dummy,randomized controlled,multicenter trial of 99Tc-methylene diphosphonate in patients with moderate to severe rheumatoid arthritis

Background:Clinical observational studies revealed that ⁹⁹Tc-methylene diphosphonate (⁹⁹Tc-MDP) could reduce joint pain and swollenness in rheumatoid arthritis (RA) patients. This multicenter, randomized, double-blind, double-dummy study aimed to evaluate the effects of ⁹⁹Tc-MDP plus methotrexate (MTX) vs. MTX alone or ⁹⁹Tc-MDP alone on disease activity and structural damage in MTX-naïve Chinese patients with moderate to severe RA.Methods:Eligible patients with moderate to severely active RA were randomized to receive ⁹⁹Tc-MDP plus MTX (n = 59) vs. MTX (n = 59) alone or ⁹⁹Tc-MDP (n = 59) alone for 48 weeks from six study sites across four provinces in China. The primary outcomes were the American College of Rheumatology 20% improvement (ACR20) response rates at week 24 and changes in modified total Sharp score at week 48.Results:At week 24, the proportion of participants achieving ACR20 was significantly higher in the MTX + ⁹⁹Tc-MDP combination group (69.5%) than that in the MTX group (50.8%) or ⁹⁹Tc-MDP group (47.5%) (P = 0.03 for MTX + ⁹⁹Tc-MDP vs. MTX, and MTX + ⁹⁹Tc-MDP vs.⁹⁹Tc-MDP, respectively). The participants in the MTX + ⁹⁹Tc-MDP group and the ⁹⁹Tc-MDP group had significantly less important radiographic progression than the participants in the MTX group over the 48 weeks (MTX + ⁹⁹Tc-MDP vs. MTX: P = 0.03, ⁹⁹Tc-MDP vs. MTX: P = 0.03, respectively). There was no significant difference in terms of adverse events (AEs) among the groups. No serious AEs were observed.Conclusions:This study demonstrated that the combination of ⁹⁹Tc-MDP with MTX inhibited structural damage and improved disease activity in RA patients compared with MTX and ⁹⁹Tc-MDP monotherapies, without increasing the rate of AEs. Additional clinical studies of ⁹⁹Tc-MDP therapy in patients with RA are warranted.Trial Registration:Chictr.org, ChiCTR-IPR-14005684; http://www.chictr.org.cn/showproj.aspx?proj=10088.     

子宫肌瘤腹腔镜剥除术中止血药物效果分析

目的 探讨垂体后叶素与缩宫素在腹腔镜下肌壁间子宫肌瘤剥除术的临床效果。方法 选取2015年10月~2016年12月行腹腔镜下子宫肌瘤剥除术的患者60例,分成两组各30例。治疗组注射6IU垂体后叶素+10ml生理盐水,对照组注射20U缩宫素+10ml生理盐水,按照两组的用药情况,观察比较血压变化和其他情况。结果 治疗组与对照组比较,手术时间明显减少（98.13±5.07min vs 110.83±8.03min,t=-7.324,P=0.000）,术中出血量明显减少（67.50±10.24ml vs 97.83±16.10ml,t=-8.705,P=0.000）,血红蛋白术前术后变化（9.67±2.09g/L vs 11.53±2.21g/L,t=-3.362,P=0.001）。术中用药后15min,治疗组收缩压上升,显著高于对照组（150.77±5.57mmHg vs 142.03±5.21mmHg,t=6.273,P=0.000）。结论 腹腔镜下肌壁间子宫肌瘤剥除术应用垂体后叶素止血效果明显优于缩宫素,但会引起短暂性血压升高,临床使用应结合患者病情个性化选择。     

慢性HBV感染不同状态下HBsAg定量的临床意义

目的 探讨HBsAg定量在慢性HBV感染自然史的不同阶段及HBV相关肝硬化中的临床意义。 方法 纳入慢性HBV感染患者185例,其中无肝硬化患者根据自然史分为免疫耐受组(n=34)、HBeAg阳性慢性乙型肝炎(chronic hepatitis B,CHB)组(n=25)、非活动携带组(n=24)及HBeAg阴性CHB组(n=34),肝硬化患者分为HBeAg阳性组(n=33)及HBeAg阴性组(n=35)。检测患者血清HBsAg、HBV DNA、ALT等指标。 结果 无肝硬化的慢性HBV感染患者HBsAg水平由高到低为:免疫耐受组[(4.60±0.32)log₁₀IU/ml)]、HBeAg阳性CHB组[(4.36±0.45)log₁₀IU/ml]、非活动携带组[(3.51±0.30)log₁₀IU/ml]、HBeAg阴性CHB组[(3.62±0.35)log₁₀IU/ml]。无肝硬化患者,年龄与HBsAg水平呈负相关(P=0.000);ALT与HBsAg水平无相关性(P=0.152)。免疫耐受及HBeAg阳性CHB组HBsAg水平与HBV DNA呈正相关(P=0.000,P=0.009)。HBeAg阳性肝硬化患者HBsAg水平[(4.27±1.33) log₁₀IU/ml]与HBeAg阴性患者[(3.81±1.07) log₁₀IU/ml]相似,HBsAg与年龄及ALT无相关性(P>0.05)。 结论 HBsAg水平在HBeAg阳性患者中可反映HBV DNA复制情况。无论有无肝硬化存在,HBsAg水平都不能反映肝组织炎性情况。     

糖皮质激素联合抗真菌治疗变应性支气管肺曲霉菌病32例疗效分析

目的 总结分析糖皮质激素联合抗真菌治疗32例变应性支气管肺曲霉菌病(ABPA)患者的临床特点及疗效,以提高对ABPA的认识。方法 回顾分析2009年5月~2014年3月经江苏省人民医院确诊为ABPA的32例患者治疗前及治疗后2个月的临床表现、影像学特征、实验室检查结果及随访情况。结果 32例患者其中男性16例,女性16例,确诊年龄为23~83岁,患者中位年龄52岁。临床表现主要为咳嗽、咳痰、喘息、胸闷、咳痰栓、肺部哮鸣音等,影像学表现以斑片影、中央性支气管扩张、黏液栓为主。所有患者均经糖皮质激素联合抗真菌治疗2个月后症状、体征明显改善,肺部影像斑片影、黏液痰栓明显减少。治疗2个月后外周血嗜酸性粒细胞比例由15.04%±9.66%5.06%±5.03%;血清总IgE由1591.52±735.24IU/ml下降至533.37±349.69IU/ml,烟曲霉特异性IgE由13.99±21.32IU/ml下降至8.72±17.53IU/ml,红细胞沉降率由24.75±22.12mm/h下降至14.63±12.90mm/h,血清CEA由5.80±4.39ng/ml下降至3.36±1.66ng/ml,差异有统计学意义(P均<0.05)。相关性分析显示,治疗前、后外周血嗜酸性粒细胞比例均与血清总IgE水平呈正相关(分别为r=0.623,P=0.000;r=0.472,P=0.006);治疗前血清CEA水平与血清总IgE水平呈正相关(r=0.615,P=0.000)。结论 咳嗽、咳痰、喘息为ABPA最常见的临床症状,糖皮质激素联合抗真菌治疗可明显提高疗效;症状的好转、影像学表现的改善及血清总IgE、外周血嗜酸性粒细胞比例、烟曲霉特异性IgE抗体、血沉的下降可作为ABPA疗效评估的指标。     

Changes in serum leptin levels during r-hGH treatment in growth hormone-deficient children

Leptin isa protein hormone which consistsof1 6 7amino acids,which is synthesized and secreted byadipocytes under the modulation and control of obgenes.Its main function is to balance the energyintake againstexpenditure of body.Recently,a directhormonal modulation of circulating leptin levels hasbeen suggested.Hormoneswith metaboliceffects suchas insulin,cortisol and thyroxine have been identifiedas possible regulators of leptin expression and thecomplex interplay of them in the modulation of l…     

应用ELISA检测尿螨病患者血清总IgE和粉螨特异性IgE水平

目的:探讨 IgE和粉螨特异性IgE在尿螨病诊断中的应用价值。方法:用 ELISA法对69例尿螨病患者进行血清总IgE、螨特异性IgE的检测。结果:尿螨病患者血清总IgE及螨特异性IgE水平分别为89±22IU/ml、71±22IU/ml,而正常对照组血清总IgE及螨特异性IgE水平分别为35±27IU/ml、29±18IU/ml,两者相比差异有显著性（P<0.01～0.05）。其中轻度、中度、重度螨感染者的血清总IgE及螨特异性IgE水平分别为82±18IU/ml、95±24IU/ml、106±26IU/ml和 65±19IU/ml、78±24IU/ml、84±23IU/ml,相互比较差异有显著性（P<0.01）。结论:尿螨病患者血清总IgE和粉螨特异性IgE水平均明显增高,其病变程度与血清总IgE和粉螨特异性IgE水平似有一定关系。     

Therapeutic Effect of Integrative Traditional Chinese and Western Medicine on 51 SARS Patients and Its Influence on Their TLymphocyte Subsets

Severeacuterespiratorysyndrome(SARS)isanewlyariseninfectiousdiseasewithrespiratorytractasthechiefpathwayoftransmission.Thisisespecial lytrueforSARSpatientsofseveretypeduetoitsse riouscondition,whichresultsinhighmortalityandgreatdifficultiesinitstreatment.InordertoexploretheeffectivewaysintreatmentofSARS,clinicalstudiesontreatmentofSARSbyintegrativeChineseandwesternmedicine(ICWM)havebeencarriedoutbytheauthorsandthepreliminarysummaryisre portedasfollows.METHODSClinicalMaterials　　 T…     

高效液相色谱法测定草酸钙结石大鼠尿中草酸含量

目的 建立高效液相色谱法(HPLC)检测大鼠尿液中草酸含量。方法 将SPF级雄性健康Wistar大鼠24只采用随机数字表法分为空白对照组(n=12)和乙二醇组(n=12)。空白对照组给予去离子水喂养,每天以1 ml生理盐水灌胃;乙二醇组给予1%乙二醇自由饮水喂养,每天2%氯化铵2 ml灌胃。造模28 d后收集两组大鼠24 h尿液,采用HPLC法测定尿中草酸含量,并与铬酸钾氧化甲基红催化光度法的结果进行比较。HPLC法采用色谱柱Aglient 5TC-C₁₈(250×4.6 mm,5 μm),以甲醇(0.1 mol/L)、醋酸铵水溶液(15∶85)为流动相,流速为1.2 ml/min,紫外检测波长为314 nm,柱温20 ℃。结果 大鼠尿液中高、低浓度草酸标准曲线分别为y=5909.1x+378730,R²=0.9984和y=7810.5x-16635,R²=0.9967;最低检测浓度为5 μg/ml,大鼠尿液中草酸高浓度线性范围为62.50~2000.00 μg/ml,低浓度线性范围为6.25~100.00 μg/ml。平均回收率为95.1%,日内及日间精密度分别为3.4%~10.8%和3.8%~9.4%。HPLC法和铬酸钾氧化甲基红催化光度法均显示乙二醇组大鼠尿草酸浓度和24 h尿草酸含量显著高于空白对照组[尿草酸浓度:(736.35±254.52)μg/ml比(51.56±36.34)μg/ml,(687.35±234.53)μg/ml比(50.24±42.34)μg/ml;24 h尿草酸含量:(11.23±4.12)mg比(0.87±0.45)mg,(9.89±3.55)mg比(0.77±0.65)mg;P均＜0.01];两种方法检测出的尿草酸浓度和24 h尿草酸含量差异无统计学意义(P均＞0.05)。结论 HPLC法简单快速、回收率高、精密度好,与铬酸钾氧化甲基红催化光度法检测结果一致,适用于大鼠尿中草酸含量的测定。     

Studies on the Relationship between Urokinase Plasminogen Activator(uPA)and Human Sperm Motility

Plasminogenactivators(PAs)arehighlyselectivetrypsin--likeserineproteaseabletoconverttheinactiveplasminogen,azymogenpresentinmostextracellularfluids,intoplasmin,alsoatrypsin--likeproteaseofbroadspecificity['].SeminalplasmalevelsofPAsinmenshowup60to100foldhigherthaninbloodplasma['].ThetwoknownPAs,urokinase--type(uPA)andtissue-type(iPA)aresecretedbyalargenumberofcellsandarethoughttoexhibitmultiplefunctionsinextracellularproteolysisaccompanyingtissueremodelingandcellmigration[']'Duetotheseprop…     

Antagonistic effects of trasilast on proliferation and collagen synthesis induced by TGF-\sB<Subscript>2</Subscript> in cultured human trabecular meshwork cellsin cultured human trabecular meshwork cells

Summary Whether tranilast had antagonistic effect on proliferation inhibition and collagen synthesis promotion induced by TGF-\sB₂ in cultured human trabecular meshwork cells was investigated. Suspension of 1×10⁴ cultured human trabecular meshwork cells of 3–5 passage was distributed in each well of a 96-well disk and divided into control group and experimental group. After 24 h, 0 μg/ml (control), 12.5 μg/ml, 25 μg/ml, 50μg/ml tranilast with 3.2 ng/ml TGF-\sB₂ were added into the incubation medium. Another 24 h later, proliferation and collagen synthesis in cultured human trabecular meshwork cells were examined respectively by using tetrazolium-based semiautomated colormetric (MTT) assay and³H-proline incorporation with liquid scintillation technique. The results showed absorbance (A) values of the experimental groups were 0.9036±0.3017, 1.1361±0.1352, 1.2457±0.1524 according to the different concentrations of tranilast, and 0.8956±0.1903 of the control group. In comparison with the control group, 25 μg/ml (q=3.23,P<0.05), 50 μg/ml (q′=4.70,P<0.01) tranilast significantly antagonized the decrease of theA values induced by TGF-\sB₂ in the cultured human trabecular meshowrk cells. In comparison with the control group [817.37±124.21 cpm/10⁴ cells], 12.5 μg/ml (620.33±80.46 cpm/10⁴ cells,q′=4.26,P<0.05), 25 μg/ml (59.4.58±88.13 cpm/10⁴ cells,q′=4.81,P<0.01), 50 μg/ml (418.64±67.90 cpm/10⁴ cells,q′=8.62,P<0.01) tranilast significantly inhibited the incorporation of³H-proline into the cultured human trabecular meshwork cells promoted by TGF-\sB₂ in a dose-dependent manner. It was concluded that tranilast had the antagonistic effect on the proliferation inhibition and collagen synthesis promotion induced by TGF-\sB₂ in the cultured human trabecular meshwork cells. Da Banghong, female, born in 1973, Resident. This project was supported by a grant from the National Natural Sciences Foundation of China (No. 38970758).     

碘海醇清除率在慢性肾脏病儿童肾功能评价方面的应用

目的评价碘海醇清除率评估慢性肾脏病儿童肾小球滤过率的准确性,评估单次采血法和干血滤纸片法在碘海醇清除率应用中的可行性。方法纳入慢性肾脏病儿童45例,同时进行锝99m-二乙烯三胺五乙酸(99mTc-DTPA)血浆清除率与碘海醇血浆清除率测定,评价两种方法测得的肾小球滤过率的相关性和一致性。分析碘海醇单次取血法及干血滤纸片法与碘海醇双次采血法的一致性。结果 45例患儿均完成碘海醇血浆清除率测定。其中36例患儿同时完成99mTcDTPA血浆清除率测定,13例患儿完成干血滤纸片碘海醇清除率测定。碘海醇血浆清除率与99mTc-DTPA血浆清除率具有较好的相关性和一致性(r=0.941,P<0.01),两者结果的差值较小,为(6.53±11.6)ml/(min·1.73 m2)。碘海醇单次取血法和干血滤纸片法测定的清除率与碘海醇双次取血血浆清除率均具有较好的相关性(r=0.958,r=0.950),差值分别为(4.26±9.06)ml/(min·1.73 m2)和(0.48±10.89)ml/(min·1.73 m2)。结论碘海醇血浆清除率是一种安全、可靠的评估慢性肾脏病儿童肾功能的方法,单次取血法与干血滤纸片法使碘海醇清除率测定更简便、可行。     

^89Sr联合“云克”治疗多发性骨转移癌的临床观察

目的评价^89Sr与＂云克＂联合应用治疗多发性骨转移癌的疗效。方法各种骨转移132例,随机分组治疗,第一组42例患者仅静脉注射^89Sr,3～4mCi;第二组50例患者^89Sr联合＂云克＂治疗,^89Sr用量不变,并与静脉注射^89Sr后的第5d开始用＂云克＂连续5d;第三组40例患者静脉滴注博宁,10d一疗程。结果第一组镇痛有效率为71.4%,疼痛缓解持续时间平均14±2周。第二组联合用药组镇痛有效率达88%,疼痛缓解持续时间平均18±2.5周。第三组镇痛有效率42.5%,疼痛缓解持续时间平均2周。3组疗效有显著统计学差异（P〈0.05）。结论不论＂博宁＂、89Sr单独使用还是与‘云克’联合用药都是治疗多发骨转移的有效止痛方法,相比之下,联合用药可明显提高镇痛疗效。     

不同化疗方案对肺癌合并慢性肾衰竭患者肾功能的影响

目的 观察TC、DC、GC、PC 4种化疗方案对非小细胞肺癌合并慢性肾衰竭(代偿期)患者肾功能的影响。 方法 选择67例首次化疗的非小细胞肺癌患者,化疗前处于慢性肾衰竭(代偿期),患者年龄41~70岁,按所接受的方案分为4组:1TC组:紫杉醇135mg/m²,d1+卡铂 AUC 5,d1,21天重复;2DC组:多西他赛75mg/m²,d1+卡铂 AUC 5,d1,21天重复;3GC组:吉西他滨1000mg/m²,d1,8+卡铂 AUC 5,d1,21天重复;4PC组(只限于非鳞癌患者):培美曲塞500mg/m²,d1+卡铂 AUC 5,d1,21天重复;以肾小球滤过率代表其肾功能,检测化疗前及2程化疗后肾小球滤过率,比较不同化疗方案前后患者肾功能的变化。 结果 治疗前,4组患者肾小球滤过率为TC组77.1±16.41ml/min,DC组71.82±12.41ml/min,GC组74.86±10.42ml/min,PC组59.45±9.07ml/min;2程化疗后肾小球滤过率为TC组69.76±8.89ml/min,DC组66.21±13.5ml/min,GC组70.71±9.4ml/min,PC组61.75±10.77ml/min。TC组化疗后肾小球滤过率较前下降7.33±2.46ml/min,DC组化疗后肾小球滤过率较前下降5.61±2.63ml/min,差异均有统计学意义(P<0.05); GC组及PC组化疗前后肾小球滤过率改变差异无统计学意义(P>0.05);TC组化疗后肾小球滤过率下降程度高于DC组, 差异有统计学意义(P<0.05)。 结论 对于非小细胞肺癌合并慢性肾衰竭(代偿期)患者,使用GC、PC方案化疗对肾功能无明显不良影响,而TC、DC方案可能引起肾功能下降,其中TC方案引起的肾功能不良反应程度高于DC方案。     

AML患者治疗前后LDH、IL-2、IL-12水平的变化及临床意义

目的:观察急性髓细胞性白血病(AML)患者化疗前后血中LDHI、L-2与IL-12的水平变化,探讨各指标的临床意义。方法:初次治疗的白血病患者共36例,经DA方案化疗两个疗程后有不同程度缓解26例,测定治疗前后血中LDHI、L-2与IL-12水平,并与对照组相比较。未缓解10例只比较治疗前后的LDH结果。结果:缓解组26例,其中LDH治疗前为(454.3±113.6)U/L,显著高于对照组(96.7±28.6)U/L,治疗后LDH为(211.5±57.6)U/L显著降低;IL-2治疗前为(13.8±11.4)U/L,显著低于对照组(33.6±8.4)pg/ml,治疗后IL-2为(35.4±15.3)U/L显著升高;IL-12治疗前为(19.3±6.5)ng/ml,显著低于对照组(31.3±13.8)U/L,治疗后为(40.2±17.3)ng/ml显著升高。未缓解10例治疗前LDH为(653.2±326.4)U/L,治疗后为(512.3±286.7)U/L,差异无显著性。结论:白血病患者化疗后骨髓示缓解者其LDH较化疗前显著降低,IL-2与IL-1均较化疗前显著升高。