成人过敏性紫癜35例临床分析

目的 分析成人过敏性紫癜(HSP)临床特点,以提高临床诊治水平.方法 对1993年9月至2005年12月天津医科大学总医院血液科收治的35例成人HSP患者的发病特点、临床表现、相关实验室检查等方面资料进行回顾性分析.结果 成人HSP以男性及青壮年患者为主.冬季为主要发病季节.上呼吸道感染及进食鱼、虾、蟹等为主要诱因.多数患者以皮肤损害为首发表现.混合型HSP多见.所有患者在病程中均先后出现皮肤损害,双下肢为皮疹最易侵犯的部位.有关节损害者15例(42.9%).有胃肠道损害者20例(57.1%).有肾脏损害者20例(57.1%).结论 成人过敏性紫癜的临床特点有其特殊性,易发生严重肾损害和多器官受累.     

蒽环类药物治疗非霍奇金淋巴瘤心脏毒性的临床研究

蒽环类化疗药物作为一种疗效肯定的抗恶性肿瘤药物在临床上已得到广泛应用,但该类药物的心脏毒性也日益引起人们的关注.现对我院收治的94例非霍奇金淋巴瘤(NHL)患者应用蒽环类化疗药物后出现的心脏毒性进行临床分析.     

骨髓增生异常综合征的发病机制

骨髓增生异常综合征 (MDS)作为一种独立疾病体系被正式命名二十余年了。围绕该病病理机制 ,人们从临床及实验室方面进行了深入研究 ,逐渐认识到其骨髓造血单克隆性、免疫低监视性、转归趋癌性 ,即在病理本质上属造血系统肿瘤性疾病 (见WHO新编《髓系及淋巴系肿瘤性疾病分类》)。统一此方面认识 ,有益于推动对MDS逐步成癌机制的研究 ,避免将不同质疾病误诊为一种综合征同治。1　造血单克隆性MDS的造血单克隆性主要表现在造血细胞成分和功能上。成分上 ,MDS患者的造血细胞有胞膜、胞浆及胞核异常。胞膜异常包括某些造血因子 (如SCF、G…     

海洛因依赖者Th1/Th2类细胞因子的变化

目的:研究Th1/Th2类细胞因子在海洛因依赖者中的变化,了解海洛因依赖者的免疫学状况.方法:利用细胞因子诱生技术及酶联免疫吸附试验(ELISA)检测30例海洛因依赖者及24名正常人外周血单个核细胞PBMC,体外刺激培养上清中Th1细胞的代表性细胞因子IFN-γ、IL-2及Th2细胞的代表性细胞因子IL-4、IL-6的分泌,比较海洛因依赖者与正常人上述细胞因子水平的差异.结果:海洛因依赖者IL-2、IFN-γ水平降低,而IL-4、IL-6水平增高,与正常对照比较有显著性差异.结论:海洛因依赖者存在Th1/Th2功能紊乱,主要表现为Th1细胞功能降低,Th2细胞功能亢进,这可能是海洛因依赖者感染性疾病发生率高的重要原因之一.     

环孢霉素A治疗再生障碍性贫血的疗效和机制

环孢霉素Ａ治疗再生障碍性贫血的疗效和机制张乃红综述邵宗鸿审校环孢霉素Ａ（ＣｓＡ）是土中霉菌的代谢产物，是由１１个氨基酸残基组成的一种环化多肽。自１９８４年Ｆｉｎ－ｌａｙ首次报道应用ＣｓＡ治疗重型再生障碍性贫血（ＳＡＡ）获得成功至今，ＣｓＡ已广泛应用于...     

重型再生障碍性贫血患者血清G-CSF水平的变化

目的：观察重型再生障碍性贫血－Ⅰ型（ＳＡＡ－Ⅰ型）患者血清粒细胞集落刺激因子（Ｇ－ＣＳＦ）水平的变化及其与病情、疗效和预后的关系。方法：采用酶联免疫法对ＳＡＡ－Ⅰ型患者治疗前血清和治疗过程中Ｇ－ＣＳＦ水平进行检测。结果：３６例ＳＡＡ－Ⅰ型患者中２７例（７５％）治疗前血清Ｇ－ＣＳＦ水平高于正常，与血清Ｇ－ＣＳＦ水平正常患者相比较，后者达到治疗有效所需疗程较短，且疗效较好；对７例患者进行动态观察显示，随着病情逐渐好转，患者血清Ｇ－ＣＳＦ水平逐渐恢复正常。结论：检测重型再生障碍性贫血患者血清Ｇ－ＣＳＦ水平有助于判断患者的病情及预测其预后。     

获得性再生障碍性贫血发病机制的研究进展

获得性再生障碍性贫血是未知病因通过免疫途径破坏骨髓造血干祖细胞所致的一种骨髓衰竭症,免疫异常是该病发病的中心环节,本文就其发病机制近年来的研究进展作一综述。     

对1例严重车祸患儿双亲的关护

我们的直升飞机向着远离市中心的急诊部飞去 ,那里有我们要接的第一个病人 ,在飞行的 1 0 min里 ,我们知道了该病人是一个 1 2岁女孩在车祸中受伤 ,心脏骤停 ,在放置了多头胸导管后恢复了脉搏 ,她头部严重受伤且可能有骨盆及长骨骨折 ,尽管给予输液 ,血压仅仅维持在 1 2 .0 k Pa,我们同时知道这个女孩受惊的双亲也在赶向我们要去的地方 ,他们仅仅知道和女儿一起参加礼拜的青年们遇到车祸 ,他们的女儿是严重受伤者之一。我们到了急诊室 ,一个镇静的急诊人员向我们报告了病人的最新病情 ,当我们在病人床边评估病人的病情时 ,一个护士告诉我们…     

骨髓单个核细胞Coombs试验阳性的血细胞减少患者补体水平变化及其意义

Objective To investigate the variation of bone marrow complement level in cytopenia pa-tients with positive BMMNC-Coombs test(CBCPC), and probe the role of complement in destroying hemato-poietic cells of CBCPC patients. Methods One hundred and twenty-four patients with CBCPC and twenty-three healthy donors as controls were enrolled in this study. The levels of CI-150, C3, C4, C5b-9 were tested with ELISA. The auto-antibodies on bone marrow hematupoietic cells (BMHC) were examined with flow cy-tometry. Results The level of C5b-9 in bone marrow(BM) of untreated CBCPC patients [(119.8 ± 54.0)μg,/L] was significantly higher than that of recovered patients [(100.7 ± 33.4) μg/L] or normal controls [(93.9 ± 28.8) μg/I.] (P < 0.05). The levels of CH50 in BM of untreated or recovered CBCPC patients [(33.3 ± 11.5) kU/L, (30.8 ± 10.3) kU/L] were significantly higher than that of normal controls [(24.1 ±6.4) kU/L] (P < 0.05). The level of C3 in BM of untreated or recovered CBCPC patients [(4.9 ± 2.2) mg/ L], (5.0 ± 3.5) mg/L] was significantly lower than that of normal controls [(7.0 ± 5.6) mg/L] (P < 0.05). The level of complement in peripheral blood was consistent with that in BM. CH50 in BM of CBCPC patients was negatively correlated with their C3 (r = - 0. 303, P = 0. 007) and positively correlated with their C5b-9(r = 0. 241, P = 0. 003) levels. The level of C5h-9 in BM of CBCPC patients was higher in the BMHC-IgM positive group [(117.6 ± 55.7) μg/L] than in the BMHC- IgM negative group [(99.2 ± 26.2)μg/L] (P < 0. 05). The positive rate of CD34+ -IgG or CD34 + -IgM of CBCPC patients was positively corre-lated with their C5 b-9 level (r = 0. 593, P = 0.000, r = 0. 326, P = 0. 049). The reticulocyte percentage (r =0. 421, P = 0.000) and serum indirect bilirubin level (r = 0. 230, P = 0. 032) of CBCPC patients were posi-tively correlated with their CHSO level. Conclusions The hematocytopenia of CBCPC patients might be re-lated to the hematopoietic cells destruction caused by auto-antibedy activated complements.     

骨髓单个核细胞Coombs试验阳性的血细胞减少患者补体水平变化及其意义

Objective To investigate the variation of bone marrow complement level in cytopenia pa-tients with positive BMMNC-Coombs test(CBCPC), and probe the role of complement in destroying hemato-poietic cells of CBCPC patients. Methods One hundred and twenty-four patients with CBCPC and twenty-three healthy donors as controls were enrolled in this study. The levels of CI-150, C3, C4, C5b-9 were tested with ELISA. The auto-antibodies on bone marrow hematupoietic cells (BMHC) were examined with flow cy-tometry. Results The level of C5b-9 in bone marrow(BM) of untreated CBCPC patients [(119.8 ± 54.0)μg,/L] was significantly higher than that of recovered patients [(100.7 ± 33.4) μg/L] or normal controls [(93.9 ± 28.8) μg/I.] (P < 0.05). The levels of CH50 in BM of untreated or recovered CBCPC patients [(33.3 ± 11.5) kU/L, (30.8 ± 10.3) kU/L] were significantly higher than that of normal controls [(24.1 ±6.4) kU/L] (P < 0.05). The level of C3 in BM of untreated or recovered CBCPC patients [(4.9 ± 2.2) mg/ L], (5.0 ± 3.5) mg/L] was significantly lower than that of normal controls [(7.0 ± 5.6) mg/L] (P < 0.05). The level of complement in peripheral blood was consistent with that in BM. CH50 in BM of CBCPC patients was negatively correlated with their C3 (r = - 0. 303, P = 0. 007) and positively correlated with their C5b-9(r = 0. 241, P = 0. 003) levels. The level of C5h-9 in BM of CBCPC patients was higher in the BMHC-IgM positive group [(117.6 ± 55.7) μg/L] than in the BMHC- IgM negative group [(99.2 ± 26.2)μg/L] (P < 0. 05). The positive rate of CD34+ -IgG or CD34 + -IgM of CBCPC patients was positively corre-lated with their C5 b-9 level (r = 0. 593, P = 0.000, r = 0. 326, P = 0. 049). The reticulocyte percentage (r =0. 421, P = 0.000) and serum indirect bilirubin level (r = 0. 230, P = 0. 032) of CBCPC patients were posi-tively correlated with their CHSO level. Conclusions The hematocytopenia of CBCPC patients might be re-lated to the hematopoietic cells destruction caused by auto-antibedy activated complements.