血清骨桥蛋白水平与类风湿关节炎活动性的关系及在伴肺间质病变中的意义

Objective To investigate the association between serum level of osteopotin (OPN) and disease activity of rheumatoid arthritis (RA) patients, and explore the importance of OPN in the pathogenesis of interstitial lung disease (ILD) in RA. Methods Sixty-five RA patients and 20 healthy controls were pros-pectively enrolled. RA patients were divided into active group (n=43) and inactive group (n=22), and ILD groups (n=24) and non-ILD group (n=41). Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of OPN in patients with RA and healthy controls, and the relationship between OPN and other clinical and laboratory findings were analyzed. Results ① Serum OPN tended to be significantly higher in RA patients (median, 18.0 ng/ml) than in the healthy controls (median, 14.3 ng/ml), P<0.01; ②The serum level of OPN in RA patients showed a significant positive correlation with the course of disease, numbers of tender joints , ESR and CRP, but no positive relationship was found in number of swollen joints; ③ The serum level of OPN was significantly higher in RA-ILD patients (median, 20.0 ng/ml) than that in non-lLD (median, 17.0 ng/ml, P<0.05). And there was remarkable negative correlation between the concentration of serum OPN and the value of PaO2, but no association was found with pulmonary function %VC and %DLCO. ④ Compared with the non-ILD group, the ILD group had more active disease in terms of tender joint counts and swollen joint counts, ESR, CRP (P<0.01) and the serum titer of RF-IgM, (P<0.05). Conclusion OPN plays a role in the pathogenesis of RA and is related to the disease activity. It may serve as an active disease inflammatory marker of RA . OPN may be involved in the pathogenesis of RA related ILD and is associated with the severity of pulmonary damage.     

系统性红斑狼疮血液系统异常患者T细胞亚群的变化

系统性红斑狼疮(SLE)是一种多因素参与的自身免疫性疾病,国内外众多文献报道50％以上的SLE患者在其病程中可出现血液系统异常[1-3],主要表现为贫血、白细胞或血小板减少[4-5];有时血液系统异常也可作为首发症状,临床易与某些血液病相混淆[6-7].为探索T细胞亚群变化在SLE血液系统异常机制中的作用,我们采用流式细胞术检测SLE血液系统异常患者外周血T细胞亚群水平并与SLE血液系统正常患者及正常对照进行比较,现报告如下.     

血清骨桥蛋白水平与类风湿关节炎活动性的关系及在伴肺间质病变中的意义

Objective To investigate the association between serum level of osteopotin (OPN) and disease activity of rheumatoid arthritis (RA) patients, and explore the importance of OPN in the pathogenesis of interstitial lung disease (ILD) in RA. Methods Sixty-five RA patients and 20 healthy controls were pros-pectively enrolled. RA patients were divided into active group (n=43) and inactive group (n=22), and ILD groups (n=24) and non-ILD group (n=41). Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of OPN in patients with RA and healthy controls, and the relationship between OPN and other clinical and laboratory findings were analyzed. Results ① Serum OPN tended to be significantly higher in RA patients (median, 18.0 ng/ml) than in the healthy controls (median, 14.3 ng/ml), P<0.01; ②The serum level of OPN in RA patients showed a significant positive correlation with the course of disease, numbers of tender joints , ESR and CRP, but no positive relationship was found in number of swollen joints; ③ The serum level of OPN was significantly higher in RA-ILD patients (median, 20.0 ng/ml) than that in non-lLD (median, 17.0 ng/ml, P<0.05). And there was remarkable negative correlation between the concentration of serum OPN and the value of PaO2, but no association was found with pulmonary function %VC and %DLCO. ④ Compared with the non-ILD group, the ILD group had more active disease in terms of tender joint counts and swollen joint counts, ESR, CRP (P<0.01) and the serum titer of RF-IgM, (P<0.05). Conclusion OPN plays a role in the pathogenesis of RA and is related to the disease activity. It may serve as an active disease inflammatory marker of RA . OPN may be involved in the pathogenesis of RA related ILD and is associated with the severity of pulmonary damage.     

系统性红斑狼疮外周血Th1、Th2类细胞因子与血液系统损害的关系

目的 探讨系统性红斑狼疮（SLE）外周血Th1、Th2类细胞因子与血液系统损害间的关系.方法 选取SLE合并血液系统损害患者49例（损害组）,另选26例SLE无血液系统损害患者（对照组）.采用ELISA法检测两组外周血IL-2、IL-6、IL-10、TNF-α水平.结果 损害组外周血IL-6、TNF-α水平分别为（22.47±10.86）、（64.82±24.86） pg/mL,对照组分别为（17.53 ±8.55）、（50.14±22.95） pg/mL,P均＜0.05.损害组单纯贫血者IL-10为（45.67±14.32） pg/mL,低于对照组（58.31±19.59） pg/mL,P＜0.05;两系损害者IL-6及TNF-α水平分别为（24.44±10.60）、（67.72±27.88） pg/mL,均高于对照组（P均＜0.05）.损害组IL-6、IL-10水平与血小板计数呈负相关（r分别为-0.365、-0.049,P均＜0.05）.结论 Th2细胞因子在SLE血液系统损害的发生机制中起重要作用,特别是针对血小板损伤;Th1细胞因子在这方面处于次要地位.     

血清骨桥蛋白水平与类风湿关节炎活动性的关系及在伴肺间质病变中的意义

Objective To investigate the association between serum level of osteopotin (OPN) and disease activity of rheumatoid arthritis (RA) patients, and explore the importance of OPN in the pathogenesis of interstitial lung disease (ILD) in RA. Methods Sixty-five RA patients and 20 healthy controls were pros-pectively enrolled. RA patients were divided into active group (n=43) and inactive group (n=22), and ILD groups (n=24) and non-ILD group (n=41). Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of OPN in patients with RA and healthy controls, and the relationship between OPN and other clinical and laboratory findings were analyzed. Results ① Serum OPN tended to be significantly higher in RA patients (median, 18.0 ng/ml) than in the healthy controls (median, 14.3 ng/ml), P<0.01; ②The serum level of OPN in RA patients showed a significant positive correlation with the course of disease, numbers of tender joints , ESR and CRP, but no positive relationship was found in number of swollen joints; ③ The serum level of OPN was significantly higher in RA-ILD patients (median, 20.0 ng/ml) than that in non-lLD (median, 17.0 ng/ml, P<0.05). And there was remarkable negative correlation between the concentration of serum OPN and the value of PaO2, but no association was found with pulmonary function %VC and %DLCO. ④ Compared with the non-ILD group, the ILD group had more active disease in terms of tender joint counts and swollen joint counts, ESR, CRP (P<0.01) and the serum titer of RF-IgM, (P<0.05). Conclusion OPN plays a role in the pathogenesis of RA and is related to the disease activity. It may serve as an active disease inflammatory marker of RA . OPN may be involved in the pathogenesis of RA related ILD and is associated with the severity of pulmonary damage.     

复发性多软骨炎10例临床分析

目的:提高对复发性多软骨炎这一少见疾病临床特征的认识,以期早期诊断、合理干预。方法:回顾性分析10例复发性多软骨炎患者的临床资料。结果:10例患者中男性8例、女性2例,发病年龄20~78岁,平均年龄49岁。全部患者均有耳、鼻、喉、眼、关节或呼吸道等部位的受累表现。首诊症状表现为耳瘘1例,支气管哮喘和(或)支气管炎5例,丹毒2例。全部患者均行自身抗体检查。合并呼吸道受累者7例,其中5例行肺功能检查,7例行胸部CT检查,4例行支气管镜检查。5例喉部受累者中3例行喉镜和(或)喉部CT检查。10例患者均接受了糖皮质激素和(或)免疫抑制剂治疗,合并呼吸道感染者予抗菌药物治疗。全部患者的症状经治疗后均有不同程度的改善。结论:复发性多软骨炎临床表现复杂且早期表现不典型,容易误诊漏诊。累及呼吸道者病情常较严重。糖皮质激素及免疫抑制剂治疗有效。熟悉该病临床表现、检查手段和诊断标准对早期诊治有重要意义。     

女性绝经后类风湿关节炎性激素水平与白细胞介素-6的相关性研究

类风湿关节炎 (rheumatoidarthritis,RA)是一种常见的自身免疫性疾病 ,其病因目前尚不清楚 ,但多数学者认为它是由多种因素共同作用而导致的滑液微环境失平衡 ,形成严重的滑膜炎。RA多见于女性 ,女性RA发病的停经后峰、妊娠期RA病情缓解 ,产后复发或加重、口服避孕药可以预防RA的发生或缓解RA的症状等都提示性激素在RA的发病中可能占有重要地位。RA的滑膜巨噬细胞分泌多种细胞因子 ,其中以白细胞介素 (IL) 1、肿瘤坏死因子 (TNF)和IL 6与RA的关系最为密切。近期的研究发现 ,健康人随年龄增长IL 6水平升高 ,且与血清硫酸脱氢表雄…     

体外诱导对万古霉素中介耐药表皮葡萄球菌耐药性的研究

万古霉素是目前治疗耐甲氧西林葡萄球菌感染的惟一有效药物 ,对万古霉素的耐药问题已引起广泛关注[1] 。本研究通过对一株体外诱导的对万古霉素中介耐药的表皮葡萄球菌细胞壁厚度和胞质蛋白的研究 ,初步探讨葡萄球菌对万古霉素的耐药机制。一、材料与方法1.体外诱导耐药菌株及药敏测定 :(1)菌株鉴定和药敏 :表皮葡萄球菌 4 388的鉴定使用ＶＩＴＩＫＡＭＳ系统 ,最小抑菌浓度 (ＭＩＣ)的测定采用稀释法 ,结果判定参照ＮＣＣＬＳ颁布的标准。 (2 )体外诱导耐药菌株[2 ] :将表皮葡萄球菌 4 388依次接种在万古霉素浓度成倍增加的ＭＨ琼脂培养基…     

多发性肌炎误诊四例分析

多发性肌炎 (polymyositis ,PM )是一种以横纹肌慢性、非化脓性炎性病理损伤为特征的自身免疫病 ,1863年由德国的Wagner首次报告。尽管随着医学的发展 ,对PM的认识日趋全面和深入 ,但由于其病因至今尚不明确及临床表现复杂多变 ,临床上仍有较多的误诊和漏诊 ,而其它疾病误诊为PM比较少见。现将我科自1997年8月—200l年8月收治的4例院外误诊为PM的病例报告如下 ,以提高对本病的认识。1临床资料1.1一般资料4例中男女各2例 ,年龄50～72岁 ,此次确诊前病史1个月～5年。表现为肌无力2例 ,肌痛1例 ,同时存在肌无力和肌痛1例。治疗前均行血清肌…     

第53例脓毒败血症--化脓性脑膜炎--右下肢静脉血栓

病历摘要 患者男,41岁.因寒颤、高热1个月,加重伴右下肢肿痛1周,于2003年4月5日入院.患者于入院前1个月受凉后出现发冷、发热,最高体温39.5℃,在某医院用左氧氟沙星4 d后热退,2 d后再次发热,伴明显寒颤及胸闷、憋气,无咳嗽、胸痛等.患者间断就医,对症予以退热药及中药治疗,体温可短时下降,伴大汗,数小时后再次寒颤、高热.入院前1周出现右膝关节疼痛,并逐渐出现红肿,呈进行性加重,伴持续高热,来我院就诊.患者既往有糖尿病史2年,血糖波动于6～14 mmol/L,间断服用二甲双胍治疗,2年内体重下降10 kg.查血糖16.9 mmol/L,血常规:白细胞(WBC)14.6×109/L,中性0.9,血红蛋白(Hb)101 g/L,血小板(PLT)142×109/L.尿常规:尿糖(+++),酮体(+++),胆红素(+),蛋白(+),潜血(+++),白细胞微量.