脑利钠肽与超声心动图在川崎病诊断中的意义

目的探讨脑利钠肽(brain natriuretic peptide,BNP)与超声心动图在川崎病急性期及恢复期诊断中的临床意义。方法选取川崎病患儿35例为病例组,以发热、皮疹为主诉的肺炎支原体或病毒感染的48例患儿为对照组,测其急性期与恢复期脑利钠肽及左、右冠状动脉内径值,并做相关分析。结果川崎病患儿急性期脑利钠肽值明显高于恢复期,且差异有统计学意义;川崎病患儿恢复期冠状动脉内径值明显高于急性期,且差异有统计学意义。结论应用超声心动图检测冠状动脉扩张是在恢复期诊断川崎病的重要手段,而脑利钠肽可作为急性期诊断川崎病的生化指标之一。     

Adhesion of sickle neutrophils and erythrocytes to fibronectin

The pathophysiology of vaso-occlusive crisis in sickle cell disease involves interactions among blood cells, plasma proteins, and vessel wall components. The initial goal of this work was to quantify the adhesion of sickle red blood cells (RBCs) to fibronectin immobilized on glass under both static and dynamic shear stress conditions. High-power microscopic inspection of static assay plates showed striking numbers of adherent neutrophils as well as RBCs. Sickle neutrophils and RBCs were significantly more adherent to fibronectin than the corresponding normal cells in static adhesion assays. Adhesion of both sickle neutrophils and sickle RBCs in dynamic adhesion assays was promoted by a period of static incubation preceding initiation of shear stress conditions. Adherent neutrophils remained attached at shear stresses up to 51 dyne/cm2; most adherent RBCs were attached at shear stresses up to 13 dyne/cm2, but detached at a shear stress of 20 dyne/cm2. Sickle neutrophil adhesion was enhanced significantly by autologous plasma. Elevated levels of plasma interleukin-6 (IL-6; but not IL-1 or IL-8) were found in 6 of 9 sickle cell disease samples examined, and elevated levels of tumor necrosis factor were found in 2 of 9 samples. Plasma IL- 6 levels correlated positively with both the number of sickle neutrophils adherent to fibronectin and the ability of sickle plasma to enhance adhesion of normal neutrophils to fibronectin. These data suggest possible roles for neutrophil activation and for fibronectin in mediating sickle neutrophil and RBC adhesion.