乳腺癌患者血清CYFRA21-1检测的临床价值

目的 :检测乳腺癌患者血清中CYFRA2 1 1水平 ,探讨其在乳腺癌的术前诊断和术后随访监测中的应用价值。方法 :采用放免法测定 34例乳腺良性疾病患者术前、4 7例乳腺癌患者术前和术后 4周及 56例乳腺癌术后随访患者的血清CYFRA2 1 1水平 ,进行对照分析。结果 :乳腺良性疾病无 1例阳性 ;乳腺癌术前阳性率仅 2 1% ,但两者血清CYFRA2 1 1水平有明显差异 ;4 7例乳腺癌患者手术前与术后 4周血清CYFRA2 1 1水平相比有显著差异 ;56例乳腺癌患者术后随访 8例转移复发者中 6例阳性 ,无转移复发者均阴性 ,转移复发者血清CYFRA2 1 1水平较无转移复发者明显增高 ,两者相比差异有极显著性。结论 :血清CYFRA2 1 1检测对乳腺癌特异性高 ,但对乳腺癌术前诊断价值不大 ,对乳腺癌转移复发的监测有非常重要意义。     

Serum metrix metalloproteinase-9 combined with homocysteine, IL-6, TNF-α, CRP, HbA11c and lipid profile in the incipient diabetic nephropathy with or without macrovascular diseases

Objective: To evaluate the changes of serum matrix metalloproteinase-9 (mmp-9) in patients of incipient diabetic nephropathy with or without macrovascular disease and to analyze the factors associated with homocysteine(hcy), interleukin-6(IL-6), tumor necrosis factor-alpha (TNF-α), highly sensitive C-reactive protein (hsCRP), HbA1c and lipid profile in those patients in order to know whether this marker or other factors are more important to induce diabetic macrovascular disease. Methods: Type 2 diabetes mellitus(T2DM) subjects with incipient diabetic nephropathy with or without macrovascular disease were selected for participation and divided into 2 groups. The patients in group 1(n= 38) used insulin, and patients in group 2 (n = 34) were treated with an oral antidiabetic drug. Then serum mmp-9, hcy, IL-6 and TNF-αin these patients were measured, and compared to the healthy subjects as control (n= 16). The results were analyzed by SPSS13. Results: Serum mmp-9 and hcy of the patients having incipient diabetic nephropathy with macrovascular disease were higher than that of patients without macrovascular disease (P<0. 01). For insulin-injected patients, whether they accompanied with macrovascular diseases or not, the serum levels of mmp-9, hcy, IL-6 and TNF-αwere all lower, but no significant statistics compared with non-insulin used patients or the healthy subjects. The serum level of mmp-9 was more correlated with the serum hcy in antidiabetic drug used patients. (P<0. 000) Conclusion: The serum level of mmp-9 plays an important role of pathogenesis in the macrovascular disease in the incipient diabetic patients, and the serum level of hcy also can reflect the severely degree of macrovascular disease in these patients, insulin can reduce these markers.     

糖尿病家族青春期多囊卵巢综合征胰岛素抵抗的临床特征和治疗

目的:探讨糖尿病(DM)家族青春期多囊卵巢综合征(PCOS)胰岛素抵抗(IR)的程度及应用二甲双胍治疗的效果。方法:选择父亲或母亲被确诊患DM的7例青春期PCOS患者为实验组,以无DM家族史的28例青春期PCOS患者为对照组。测体重指数(BM I)、基础体温(BBT),抽血测FSH、LH、PRL、T、E2、P,行75g葡萄糖耐量试验(OGTT)和胰岛素释放试验(IRT)。计算空腹血糖胰岛素比率(FGIR)、糖负荷120m in血糖胰岛素比率(G120/I120)及稳态模型的胰岛素抵抗指数(HOMA-IR)。确诊IR患者进行包括二甲双胍在内的综合治疗,每3月重复检测1次上述指标。结果:实验组7例均超重(BM I≥25),其比率明显高于对照组(7/7vs12/28,P<0.01);实验组IR患病率亦明显高于对照组(7/7vs 9/21,P<0.01),且IR程度明显高于对照组IR患者(HOMA-IR为14.35vs 6.02,P<0.01)。两组接受二甲双胍综合治疗的IR患者治疗6月后空腹胰岛素(I0)比治疗前明显降低(32.47vs 40.36,P<0.05),胰岛素敏感性(IS)明显提高(FGIR为3.42 vs2.99,P<0.05),T降低,并有3例卵巢恢复排卵。结论:DM家族青春期PCOS患者可能存在较重IR,坚持二甲双胍综合治疗可减轻IR程度并恢复卵巢排卵功能。     

母血三联指标筛查胎儿神经管畸形和染色体异常的研究

①目的探讨检测孕娠中期母血清三联指标甲胎蛋白(AFP)、绒毛膜促性腺激素β亚单位(Freeβ-hCG)和游离雌三醇(μE3),筛查胎儿神经管畸形及染色体异常的临床意义。②方法对来我院进行产前检查的518例孕妇,在知情同意情况下(签定协议书)进行超声及血清标记物筛查,总计筛查96例。采用化学发光法测定AFP、Freeβ-hCG和μE3水平,用随机中文筛查软件计算风险值,对高风险孕妇再进行羊水细胞染色体核型分析并给予确诊。随访所有孕妇至胎儿出生。③结果96例孕妇中,有高危因素者22例,筛查出4例18-三体综合征高风险孕妇,但羊水细胞核型均为正常,其中3例已经分娩,无异常胎儿。未筛查的422例孕妇中,发生死胎1例,新生儿先天性直肠阴道瘘1例,先天性心脏病1例。④结论广泛宣传并开展胎儿神经管畸形及染色体异常的产前筛查,可以降低围生儿死亡率及出生缺陷率。     

老年肺炎患者病毒IgM抗体检测分析

近年来病毒性肺炎和支气管炎相对突出[1].本文将我院呼吸内科收治的87例老年肺炎患者作为调查对象,了解患者中7种常见病毒感染的血清学和临床特点. 1 资料与方法 1.1 一般资料我院呼吸内科收治的87例老年患者,诊断符合肺炎标准,收集病史、临床资料,胸部X线及部分辅助检查.住院后当日或次日取静脉血.