抗着丝点抗体与抗核抗体在原发性胆汁性肝硬化的临床意义

目的探讨抗着丝点抗体(ACA)在原发性胆汁性肝硬化(PBC)中的临床意义。方法收集67例抗线粒体抗体(AMA)和AMA-M2阳性PBC患者的临床资料,检测其抗核抗体(ANA)和ACA、生化、凝血酶原活动度(PT)及免疫指标等。结果 ACA阳性组27例,ACA和ANA均阴性组40例。ACA阳性组脾肿大的发生率高于ACA和ANA阴性组(77.8% vs. 40.0%,P=0.002)。ACA阳性组黄疸的发生率、血清总胆红素(TBIL)水平、IgG水平和IgG异常升高率明显低于ACA和ANA阴性组[25.9% vs. 55.0%,P=0.018;(41.62±45.96)μmol/L vs. (88.49±99.13)μmol/L,P=0.012;(13.90±2.75)g/L vs. (18.32±6.34)g/L,P=0.002;29.4% vs. 60.0%,P=0.044]。两组在其他临床表现、肝功能及其他免疫指标的差异无统计学意义。结论单一ACA阳性PBC患者疾病的进展比ACA和ANA阴性患者更加隐匿。ACA阳性PBC患者是PBC的一个特殊类型。     

个体化免疫抑制抗凝疗法在抗心磷脂抗体阳性胎儿生长受限治疗中的应用

目的探讨个体化免疫抑制抗凝疗法在抗心磷脂抗体阳性胎儿生长受限治疗中的应用。方法选择2008年1月至2010年12月在我院诊断为胎儿生长受限且抗心磷脂抗体阳性孕妇80例为研究对象,随机分为两组：个体化免疫抑制抗凝疗法组和常规治疗组各40例。记录分娩情况。结果免疫抑制抗凝疗法组胎儿双顶径、股骨长增加、出生体重均明显高于常规治疗组（P〈0.05）两组在分娩时间上无明显差别。两组均无明显副反应出现。结论根据FGR患者的具体情况给予个体化治疗,才能提高疗效。     

Arterial spin labeling: Clinical applications

Arterial spin labeling (ASL) is a magnetic resonance imaging perfusion technique that enables quantification of cerebral blood flow (CBF) without the use of intravenous gadolinium contrast. An understanding of the technical basis of ASL and physiologic variations in perfusion are important for recognizing normal variants and artifacts. Pathologic variations in perfusion can be seen in a number of disorders including acute and chronic ischemia, vasculopathy, vascular malformations, tumors, trauma, infection/inflammation, epilepsy and dementia.     

Serum Glucose and Potassium Ratio as Risk Factors for Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage

Objective: Cerebral vasospasm is associated with poor prognosis in patients with aneurysmal subarachnoid hemorrhage (SAH), and biomarkers for predicting poor prognosis have not yet been established. We attempted to clarify the relationship between serum glucose/potassium ratio and cerebral vasospasm in patients with aneurysmal SAH. Methods: We studied 333 of 535 aneurysmal SAH patients treated between 2006 and 2016 (123 males, 210 females; mean age 59.7 years; range 24-93). We retrospectively analyzed the relationship between cerebral vasospasm grade and clinical risk factors, including serum glucose/potassium ratio. Results: Postoperative angiography revealed cerebral vasospasm in 112 patients (33.6%). Significant correlations existed between the ischemic complication due to cerebral vasospasm and glucose/potassium ratio (P < .0001), glucose (P = .016), and potassium (P = .0017). Serum glucose/potassium ratio was elevated in the cerebral vasospasm grade dependent manner (Spearman's r = 0.1207, P = .0279). According to the Glasgow Outcome Scale (GOS) score at discharge, 185 patients (55.5%) had a poor outcome (GOS scores 1-3). Serum glucose/potassium ratio was significantly correlated between poor outcome (GOS scores 1-3) and age (P < .0001), serum glucose/potassium ratio (P < .0001), glucose (P < .0001), potassium (P = .0004), white blood cell count (P = .0012), and cerebral infarction due to cerebral vasospasm (P < .0001). Multivariate logistic regression analyzes showed significant correlations between cerebral infarction due to cerebral vasospasm and serum glucose/potassium ratio (P = .018), glucose (P = .027), and potassium (P = .052). Conclusions: Serum glucose/potassium ratio in cases of aneurysmal SAH was significantly associated with cerebral infarction due to cerebral vasospasm and GOS at discharge. Therefore, this factor was useful to predict prognosis in patients with cerebral vasospasm and aneurysmal SAH.     

系统性红斑狼疮患者抗心磷脂抗体的检测及其临床意义

目的测定ACA在SLE中出现的频率及其在SLE中的临床意义.方法应用酶联免疫吸附试验(ELISA)对30例SLE患者血清中ACA进行检测,并以正常人血清作对照.结果1.正常人IgG、IgM、IgA型ACA的结合指数(BI)值分别为1.48±0.43、1.46±0.43和1.00±0.33.2.SLE组BI值IgG-ACA、IgM-ACA、IgA-ACA分别为3.04±1.25、3.07±1.61、1.96±1.05,与正常组BI值比较差异均有显著性意义(P＜0.05).3.ACA与SLE患者部分临床表现如血小板减少、血管炎、肾脏病变、雷诺现象及实验室指标如低补体C3有一定的相关关系.4.ACA与抗核抗体(ANA)之间呈直线相关,ANA分别与IgG-ACA相关,r＝0.912;与IgM-ACA相关,r＝0.870;与IgA-ACA相关,r＝0.758.P值均＜0.01.结论1.SLE组ACA值显著高于正常对照组.2.ACA与SLE患者血管损害、血小板减少等密切相关.3.各型ACA与ANA存在直线相关关系,说明ACA值可以作为评价SLE病情严重程度的指标之一.     

免疫治疗前后不明原因习惯性流产患者ACA、封闭抗体表达的变化

目的 探讨健康妊娠妇女与不明原因习惯性流产妇女（unexplained recurrent spontaneous abortion;URSA）免疫治疗前后ACA（抗心磷脂抗体）、APLA（封闭抗体）表达差异,评价ACA、APLA在指导再次妊娠中的作用.方法 采用酶联免疫试验分别测定健康对照组和不明原因习惯性流产患者治疗前后ACA、APLA的变化.结果 免疫治疗后165例不明原因习惯性流产患者有126例再次妊娠,其中妊娠超过6个月的有112例,14例再次发生早期流产不明原因习惯性流产患者治疗前ACA、APLA阳性百分率分别是30.5%（51/165）、9.2%,健康对照妇女ACA、APLA百分率为4.0%、28.0%,健康对照组ACA阳性百分数低于不明原因习惯性流产患者,APLA高于不明原因习惯性流产患者,两组ACA、APLA表达有显著性差异.免疫治疗后不明原因习惯性流产患者封闭抗体阳性百分率为78.3%,与治疗前相比,免疫治疗可增加APLA的表达.免疫治疗后ACA阳性率为26.1%.与治疗前相比ACA没有明显变化.结论 淋巴细胞主动免疫治疗能提高不明原因习惯性流产患者再次妊娠的成功率,APLA对指导习惯性流产患者妊娠及对再次妊娠的结局有良好的参考价值,但ACA不能作为一个独立的指标评价或指导再次妊娠.     

参龙宁心胶囊联合索他洛尔治疗室性早搏的临床研究

目的 探讨参龙宁心胶囊联合盐酸索他洛尔片治疗室性早搏的临床疗效。方法 选取2018年8月—2021年4月在郑州市中心医院就诊的108例室性早搏患者,按照随机数字表法将全部患者分为对照组和治疗组,每组各54例。对照组口服盐酸索他洛尔片,80 mg/次,1次/d。治疗组在对照组治疗的基础上口服参龙宁心胶囊,2.0 g/次,3次/d。两组患者连续治疗3个月。观察两组的临床疗效,比较心电图指标、心功能指标和血清指标。结果 治疗后,治疗组总有效率92.59%高于对照组总有效率77.78%(P<0.05)。治疗后,两组的QT离散度、Tp-e间期、室早总数均显著降低（P<0.05）;治疗组的QT离散度、Tp-e间期、室早总数低于对照组,差异有统计学意义（P<0.05）。治疗后,两组的左室射血分数（LVEF）显著升高,左心室收缩末内径（LVESD）、左心房内径（LAD）显著降低（P<0.05）;治疗后治疗组的LVEF高于对照组,LVESD、LAD低于对照组,差异有统计学意义（P<0.05）。治疗后,两组的N前端脑钠肽（NT-pro BNP）、抗心磷脂抗体（ACA）水平显著...     

ACA的间接免疫荧光法显示多种动物细胞的着丝点

用硬化性肌膜炎患者的ACA血清的间接免疫荧光法显示了多种动物细胞和癌细胞的着丝点。包括淋巴细胞,Hela、Hep-2、CHO、HL60、水螅、眼虫和草履虫。实验表明处于不同进化阶段的动物细胞及癌细胞均存在有同源的高度保守的着丝点蛋白。     

Isolation and Comparison of Natural and Recombinant Human CENP-A Autoantigen

Anticentromere antibodies (ACA) are associated with systemic sclerosis (scleroderma) patients exhibiting the more benign or so called limited manifestation of the disease (lSSc). ACA reactivity is directed against multiple polypeptide targets, the smallest of which is designated CENP-A. CENP-A is not an abundant cellular constituent; therefore to maximize recovery, we developed a protocol with a minimum of steps to isolate CENP-A from a human cell line. The trace cellular amount of this protein clearly dictated the production of its recombinant counterpart to facilitate determination of the role of the CENP-A antigen in scleroderma pathogenesis. Here we describe the eukaryotic expression of CENP-A cDNA using baculovirus-mediated infection of insect cells. The non-fusion recombinant protein spans the natural residues of the human CENP-A protein and rCENP-A followed the same chromotographic sequence for purification as did the natural source. The availability of thebona fideantigen provided a critical standard upon which to document authenticity of the recombinant polypeptide. The two forms of this antigen have been compared and shown to exhibit similar physical and antigenic properties.     

典型偏头痛和普通型偏头痛的TCD检查

对２５例典型偏头痛和３５例普通型偏头痛的ＴＣＤ进行对照研究，结果发现典型偏头痛发作期ＭＣＡ和ＰＣＡ在头痛侧平均血流速度明显加快，提示血管痉挛。普通型偏头痛发作期头痛侧与症状侧平均血流速度差异无显著性，典型偏头痛与普通型偏头痛的发病机理可能存在本质区别，前者多数由血管因素所致。