95例脑梗死患者血小板参数检测的临床意义

目的:探讨血小板参数与脑梗死患者发病的关系。方法:Sysmex XE-2100血细胞计数仪检测PLT、PCT、MPV、PDW。结果:脑梗死组PLT减少、MPV增高,有显著差异(P<0.05或P<0.01);PCT及PDW则无显著差异(P>0.05)。经有效治疗后MPV治疗后减小(P<0.05)。结论:MPV增高是脑梗死的独立危险因素,动态观察MPV对脑梗死的疗效观察有一定的临床意义。     

乌司他丁对泌尿系脓毒性休克患者血清PCT及 IL-6水平的影响

目的 :探讨乌司他丁对泌尿系脓毒性休克患者血清中前降钙素(procalcitonin,PCT)及白细胞介素-6(interleukin-6,IL-6)水平的影响。 方法 :选取30例泌尿系脓毒性休克患者,随机分为两组,每组15例,均给予常规抗休克和病因治疗。在此基础上,治疗组加用乌司他丁20万U溶于20 mL生理盐水中静脉注射,每天1次,连续3 d;对照组予以等量生理盐水作为安慰剂对照。另设正常对照组30例。应用双抗体夹心免疫发光法及双抗体夹心酶联免疫吸附法分别测定三组血清PCT及IL-6的含量。 结果 :PCT和IL-6水平在泌尿系脓毒性休克患者组显著高于正常对照组,且急性期显著高于恢复期,死亡组高于存活组。与安慰剂对照组相比,治疗组应用乌司他丁后,不同时相点的PCT、IL-6均明显降低(P<0.05,P<0.01)。 结论 :PCT和IL-6在泌尿系脓毒症发病机制中起预警作用,对该疾病的早期诊断及预后判断有重要应用价值。乌司他丁可降低泌尿系脓毒性休克患者血清PCT、IL-6水平,可改善泌尿系脓毒性休克患者的病情     

血清降钙素原对肝硬化并发自发性细菌性腹膜炎的诊断价值

[目的]探讨血清降钙素原（PCT）对肝硬化并发自发性细菌性腹膜炎的诊断价值。[方法]采用半定量固相免疫发光测量法测定17例肝硬化并发自发性细菌性腹膜炎患者血清PCT,免疫散射速率比浊法测定其血清C反应蛋白,常规方法检测外周血白细胞,同时与20例病毒性肝炎患者进行对照。[结果]血清PCT对腹膜炎诊断的敏感性（17／17）和特异性（20／20）均为100％,敏感性优于外周血白细胞计数（23．5％,4／17）（P〈0．01）,特异性优于C反应蛋白（5％,1／20）（P〈0．01）。[结论]血清PCT测定对肝硬化并发自发性细菌性腹膜炎诊断有重要价值。     

头孢克肟与奥硝唑联合康妇炎胶囊治疗盆腔炎性疾病临床对照研究

目的 探讨头孢克肟与奥硝唑联合康妇炎胶囊治疗盆腔炎性疾病的临床疗效及对复发率的影响.方法 将125例盆腔炎性疾病患者按照随机数字表法分研究组(63例)与对照组(62例).两组均给予头孢克肟与奥硝唑治疗,研究组在此基础上联合康妇炎胶囊治疗,观察14 d.比较两组临床疗效,比较治疗前后两组中医证候积分、血清降钙素原及C反应...     

降钙素原在儿科呼吸道感染中的应用

目的:儿科呼吸道感染患者,经常在无临床细菌感染相关证据的情况下,就已经开始接受抗生素治疗.细菌感染时,血清降钙素前体(PCT)浓度将会升高.本文旨在以儿童呼吸道感染患者中降钙素原的浓度来指导临床用药,以减少不必要的抗生素使用和减少耐药菌的产生.方法:198例儿童呼吸道感染病人被随机地分配到标准治疗组或PCT治疗组.(标准组n=98,PCT组n=100).标准治疗组按常规治疗方法进行治疗,另一组通过检测血清PCT浓度来决定治疗方案.结果:198例患儿临床背景相似,标准组88%被处方了抗生素,PCT组仅有43%使用了抗生素,且全部患儿愈后良好.结论:降钙素原在儿童呼吸道感染治疗中的指导作用可以减少抗生素的使用且不影响愈后.     

Anti-HCV-core specific IgM in porphyria cutanea tarda

Aim Analysis of the prevalence of scrum IgM antibodies directed against the HCV-core antigen (HCV-IgM) in patients with Porphyria cutanea tarda (PCT), taking into account the hepatic histological picture, liver biochemical markers and the PCI biochemical indices. Background Hepatic damage, especially that due to HCV infection, has been previously reported as a PCT trigger. HCV-IgM reactivity, a marker of chronic HCV hepatitis, suggested to be related to active virus replication could also be related to the PCT clinical course. Methods Blood samples of 97 patients, previously analyzed for a panel of clinical, histological and laboratory variables, followed in our Centre for Porphyria. stored at - 80°C, were available to be retrospectively assayed for anti-HCV-core IgM (HCV-IgM. ELISA). Results 61% HCV-IgM positivity was found, with no apparent significant relationship with the respective histological hepatitis classification. PCT remission phase, and PCT familiarity, when evaluated on overall patients. The levels of HCV-IgM presented u peculiar behaviour when correlated to the serum AST values. In fact, there was a significant positive correlation in those with HCV-IgM < 4 and a not significant, inverse correlation in the remaining group. These two groups showed other differences: the HCV-IgM levels were correlated to histology, PCT remission and to the markers of liver disease (such as AST and ALT) only in the first group. Conclusion a relationship between IgM response, PCT activity and the underlying liver disease is suggested.     

胃疡宁丸联合瑞巴派特片治疗胃溃疡活动期的临床研究

目的探讨胃疡宁丸联合瑞巴派特片治疗胃溃疡活动期患者的临床疗效。方法选取2018年1月—2018年12月在中国人民解放军联勤保障部队第九八九医院治疗的胃溃疡活动期患者124例,随机分为对照组和治疗组,每组各62例。对照组口服瑞巴派特片,0.1 g/次,3次/d。治疗组在对照组基础上口服胃疡宁丸,3.0 g/次,3次/d。两组患者均治疗8周。观察两组患者临床疗效,同时比较治疗前后两组患者幽门螺杆菌(Hp)根除率及血清C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-8(IL-8)、胃泌素(GAS)、生长抑素(SS)、血管内皮生长因子(VEGF)和前列腺素E2(PGE2)水平。结果治疗后,对照组和治疗组临床有效率分别为79.03%和93.55%,两组比较差异有统计学意义(P0.05)。治疗后,对照组Hp根除率为77.42%,显著低于治疗组的91.94%,两组比较差异有统计学意义(P0.05)。治疗后,两组患者血清CRP、PCT、IL-8、GAS、SS水平均显著降低(P0.05),而VEGF和PGE2水平显著升高(P0.05),且治疗组这些血清指标明显好于对照组,两组比较差异具有统计学意义(P0.05)。结论胃疡宁丸联合瑞巴派特片治疗胃溃疡活动期有更高的溃疡愈合率及幽门螺杆菌根除率,能有效的降低血清炎症因子。     

黄栀花口服液联合阿莫西林克拉维酸钾治疗小儿急性上呼吸道感染的临床研究

目的 探讨黄栀花口服液联合阿莫西林克拉维酸钾干混悬剂医治小儿急性上呼吸道感染的临床效果.方法 选取2017年1月—2018年1月在南阳市中心医院就诊的150例急性上呼吸道感染患儿,根据用药的差别分为治疗组、对照组(每组75名).对照组患儿口服阿莫西林克拉维酸钾干混悬剂,7～12岁儿童1袋半/次,2～7岁1袋/次,9个月...     

A diagnostic test: combined detection of heparin-binding protein,procalcitonin, and C-reactive protein to improve the diagnostic accuracy of bacterial respiratory tract infections

BackgroundRespiratory tract infection (RTI) is one of the most common diseases worldwide, and its incidence is rising year by year due to environmental pollution. Sputum culture remains the gold standard for RTI diagnosis, but its performance is limited by difficulties related to the sampling and testing of the sputum specimens. Heparin-binding protein (HBP), procalcitonin (PCT), and C-reaction protein (CRP) are Inflammatory markers. They have the advantage of being fast, accurate and reproducible, but limited by their sensitivity and specificity. We explored the clinical value of the combined detection of them in the diagnosis of bacterial RTIs.MethodsPatients who fulfilled the inclusion criteria were selected as the case group, healthy age- and sex-matched subjects were enrolled as a control group. The subjects’ HBP, PCT, and CRP levels were detected. The case group was further divided into two groups according to the bacterial culture results, and the differences in the markers were statistically analyzed. The receiver operating characteristic (ROC) curves were drawn, and the areas under the ROC curve (AUCs) were calculated to analyze the diagnostic values of each marker and their combination in parallel for bacterial RTIs.ResultsThe plasma HBP, PCT, and CRP levels of patients in the bacterial and non-bacterial infection groups were significantly higher than those of patients in the healthy control group, and were positively correlated to the severity of the disease. for HBP with an AUC of 0.785 [95% confidence interval (CI): 0.686–0.884], a sensitivity of 0.821, a specificity of 0.771; PCT with an AUC of 0.767 (95% CI: 0.664–0.870), a sensitivity of 0.773, a specificity of 0.791, and CRP with an AUC of 0.748 (95% CI: 0.642–0.854), a sensitivity of 0.839, a specificity of 0.696 in the bacterial and non-bacterial infection groups. The combined detection of HBP + CRP had the optimal diagnostic performance, with an AUC of 0.797 (95% CI: 0.698–0.895; P<0.001), a sensitivity of 0.809, a specificity of 0.800.ConclusionsThe combined detection of HBP and CRP is valuable for diagnosing bacterial RTIs and may guide the development of reasonable treatment protocols in clinical settings.     

支气管扩张合并感染患者血清suPAR、PCT和CRP水平及其临床意义

目的分析支气管扩张合并感染患者血清可溶性尿激酶型纤溶酶原激活物受体(soluble urokinase-type plasminogen activator receptor,suPAR)、降钙素原(procalcitonin,PCT)和C反应蛋白(C-reactive protein,CRP)水平的检测意义。方法收集2016年5月—2019年5月在广安市人民医院就诊的100例支气管扩张合并感染患者(研究组),根据病情严重程度将其分为轻度(n=23)、中度(n=56)、重度(n=21)3个亚组;将同期30例健康体检者纳入对照组。比较研究组各亚组间及研究组与对照组受试者血清suPAR、PCT、CRP水平差异,应用受试者工作特征曲线(receiver operating characteristic curve,ROC)及曲线下面积（area under curve,AUC）评价suPAR、PCT、CRP及三者联合对支气管扩张合并感染的诊断价值。结果研究组血清suPAR、PCT、CRP水平高于对照组(P<0.05);研究组各亚组间血清suPAR、PCT、CRP水平差异有统计学意义(P<0.05),各指标水平轻度组低于中、重度组,中度组低于重度组(P<0.05);血清suPAR、PCT、CRP水平与受试者是否患支气管扩张合并感染密切相关(P<0.05)。suPAR AUC为0.951(P<0.05),临界值为5.88 ng/mL,敏感性、特异性分别为0.850、1.000;PCT AUC为0.943(P<0.05),临界值为0.13 ng/mL,敏感性、特异性分别为0.860、0.967;CRP AUC为0.921(P<0.05),临界值为5.16 mg/L,敏感性、特异性分别为0.830、0.933;三者联合预测AUC为0.989,敏感度、特异度分别为0.950、1.000,优于各自单独预测(P<0.05)。结论血清suPAR、PCT、CRP水平升高与支气管扩张合并感染发生、发展密切相关,联合检测对支气管扩张合并感染诊断有一定价值。