婴儿肝炎综合征血清前白蛋白、腺苷脱氨酶和总胆汁酸联合检测的临床应用

目的探讨婴儿肝炎综合征(IHS)血清前白蛋白(PA)、腺苷脱氨酶(ADA)、总胆汁酸(TBA)的变化规律及其诊疗价值。方法应用全自动生化分析仪检测198例IHS患儿的血清PA、ADA、TBA,并与健康对照组比较。结果 IHS组PA浓度低于对照组,差异有统计学意义(t=2.512,P<0.05);IHS组ADA、TBA浓度均高于对照组,差异有统计学意义(t分别为3.517,8.753,P均<0.05)。单项检测时IHS患儿PA的阳性率为90.4%,ADA的阳性率为92.4%,TBA的阳性率为96.0%,联合检测三项指标阳性率可高达100%。结论联合检测血清PA、ADA、TBA水平能较早地反映肝脏合成及代谢功能,对IHS的病情判断和预后有重要的临床价值。     

抗核小体抗体测定在系统性红斑狼疮诊断中的应用价值

目的 探讨抗核小体抗体(AnuA)在系统性红斑狼疮(SLE)诊断中的敏感度和特异度,并了解其与其他自身抗体的关系.方法 用欧蒙免疫印迹法检测44例SLE患者、20例疾病对照组和20例正常对照组血清中的AnuA,同时检测抗dsDNA、抗Sm抗体和SSA抗体水平,分析其与AnuA的关系.结果 44例SLE患者中AnuA阳性率为36.4%,20例疾病对照组阳性率仅5.0%,20名正常对照组全部阴性;SLE组患者AnuA阳性率显著高于疾病对照组和正常对照组(P＜0.05),AnuA在SLE检测中的敏感度和特异度分别为36.4%和97.5%.结论 AnuA对SLE诊断的敏感度较好,特异度强,对抗Sm抗体、ssA抗体阴性的SLE的诊断有重要意义,是协助诊断SLE的一个新的特异性血清学指标.     

CK-MB/CK倒置22例CK-MB质量检测结果分析

目的:在CK-MB/CK倒置时,通过对CK-MB质量及其活性检测结果进行比较分析,为临床提供准确的结果.方法:样本先用日立7600/或7170全自动生化分析仪测定CK、CK-MB活性,检出CK-MB/CK倒置者再立即进行CK-MB质量测定.CK-MB质量采用免疫化学发光法进行检测,CK-MB活性采用选择性抑制法进行测定,并用(x±s)表示测定结果.结果:22例CK-MB/CK倒置的患者中,CK-MB质量平均水平为(6.88±19.96) ng/mL,CK-MB活性平均水平为(176.00±150.51) U/L.CK-MB活性及其质量的样品均数与总体均数进行t检验,CK-MB活性差异有显著性(t=5.059;P=0.000);CK-MB质量差异无显著性(t=0.700;P=0.471).结论:CK-MB/CK倒置时,CK-MB活性受到诸多因素的干扰,使测定结果远远高于真实值,出现假性升高的检测结果给临床造成误解,而CK-MB质量能够避免干扰,测定结果更准确可靠.     

高尔基体蛋白73及其基因检测对原发性肝癌诊断的价值

Objective To explore the diagnostic value of GP-/3 protein in gene detection in the patient of primary hepatic carcinoma, to discuss the joint roles of serum GP73 and AFP, and provide a novel method for the diagnosis for PHC and screening for high-risk population. Methods ELISA was used to detect the serum level of GP73 and AFP in 73 cases of PHC, 13 cases of hepatic cirrhosis, 32 cases of hepatitis and 62 cases of health people. SYBR Green real time fluorescence quantitative PCR was used to detect the relative value of GP73 mRNA in the peripheral blood cells of each group. Comparative Ct method was used to evaluate the relative expression levels. Eight cases of normal liver tissues and 8 cases of PHC tissues were detected at the same time to compare the relative expression levels. Results Kruskal-Wallis test showed that the serum levels of GP73 and AFP had significant differences between four groups(H value were 89. 6 and 52.0, P ＜ 0. 01) and the whole blood GP73 mRNA had no significant differences(H =4. 33, P ＞ 0. 05). Mann-Whitney test showed that the serum levels of GP73 had significant differences among PHC groups[166. 7 (162. 7-231.8) μg/L] and liver cirrhosis[57. 3 (46. 6-113. 6) μg/L], hepatitis[29. 6(26. 2-54. 5) μg/L], health group[25.1 (20. 8-29. 4) μg/L] (U value were 246, 297, 349, P ＜ 0. 01).The A FP levels of the four groups were 380. 9 (258.5-503.2) μg/L, 3.8 (1.3-14. 5) μg/L, 5. 1 (2. 4-7. 8)μg/L and 2. 8(2. 2-5.7) μg/L. It also showed significant differences (U value were 246,419 and 790,P ＜0. 01). The GP73 mRNA expression of PHC liver tissues(12. 64) was significant higher than normal liver tissues (1.00). The critical values for GP73 and AFP was determined to be 123. 2 μg/L and 10. 6 μg/L through the 8OC curves. Under the critical value the sensitivity of GP73 and AFP were 65.8% and 53.4% ,and the specificity of CP73 and AFP were 95.3% and 92. 5% respectively. Joint detection could increase the sensitivity up to 79. 5%, and achieve the high specificity of 90. 7%. Conclusions As a new diagnositic marker of primary hepatic carcinoma, GP73 protein has the very good sensitivity and specificity. The GP73 mRNA in the whole blood sample could not be used for the diagnosis of PHC. But it woule be a good molecular marker for diagnosis of PHC in the liver tissue sample. The joint detection of GP73 and AFP could improve PHC diagnostic performance, and provide an effective approcach to the PHC high-risk screening.     

妊娠晚期阴道菌群与妊娠结局的相关性研究

目的探讨妊娠晚期阴道菌群与妊娠结局的相关性。方法对该院580例妊娠晚期孕妇行常规产前阴道菌群检查,按检查结果将其分为阴性组(382例)和阳性组(198例),并将阳性组患者根据有无自觉症状分为无症状组(112例)和有症状组(86例),对各组患者的妊娠结局进行比较分析。结果有症状组与无症状组、阴性组比较,胎膜早破、产褥期感染、新生儿感染及病理性黄疸发生率均较高,差异有统计学意义(P0.05)。无症状组与阴性组比较,产褥期感染明显高于阴性组,差异有统计学意义(P0.05)。结论妊娠晚期孕妇阴道菌群失衡紊乱与不良妊娠结局密切相关,尤其是有症状的阴道菌群失衡紊乱孕妇。     

手足口病患儿血清心肌酶和超敏C反应蛋白的临床应用

目的探讨心肌酶和超敏C反应蛋白(hs-CRP)在手足口病患儿血清中的变化规律及其诊疗价值。方法应用日立7600全自动生化分析仪检测50例手足口病患儿的血清心肌酶和hs-CRP,并与30名健康体检儿童作对照。结果手足口病患儿乳酸脱氢酶、肌酸激酶、肌酸激酶同工酶、α-羟丁酸脱氢酶和hs-CRP在血清中的含量分别为(350.98±82.52)U/L、(177.36±130.29)U/L、(40.74±9.91)U/L、(281.14±68.05)U/L和(23.74±22.65)mg/L,异常率分别为52.0%、14.0%、56.0%、24.0%和76.0%,均高于对照组,差异有统计学意义(P0.05)。结论及时检测手足口病患儿血清心肌酶和hs-CRP能尽早发现其心肌损伤情况,指导临床诊疗。     

高尔基体蛋白73在原发性肝癌中的诊断价值

目的评价分析原发性肝癌（PHC）患者血清高尔基体蛋白73（GP73）的变化规律,探讨GP73和甲胎蛋白（Are）联合检测对原发性肝癌诊断和高危人群普查的意义。方法采用酶联免疫法检测70例原发性肝癌、40例肝硬化、40例肝炎患者的血清GP73、AFP水平,并与60名健康对照者进行比较。结果原发性肝癌组血清GP73的含量与肝硬化组、肝炎组及健康对照组比较,差异有统计学意义（U值分别为ii4．6、157．5、170．9,P〈O．01）,各组血清AFP的含量差异亦有统计学意义（u值分别为355．7、392．2、393．1,P均〈O．61）。通过ROC曲线确定诊断原发性肝癌的临界值：GP73为123．2pg／L,AFP为10．6la,g／L。这两个临界值下原发性肝癌组患者血清GP73、AFP单项检测的敏感度分别为64．3％和55．7％,特异度分别为92．1％和91．4％,二者联合检测的敏感度可达80％,特异度（90％）维持在较高水平。结论GP73蛋白作为一种新的诊断原发性肝癌的肿瘤标志物,具有很好的敏感度和特异度。血清GP73和AFP联合检测可有效提高原发性肝癌诊断,为原发性肝癌的诊断和普查提供了一种新的敏感、特异、简便快捷的方法。     

血清CK-MB质量及其活性检测结果对比分析

目的通过对血清肌酸激酶同工酶（creatine kinase isoenzyme,CK-MB）质量及其活性检测结果进行比较分析,为临床提供合理的检测选择依据。方法依据CK-MB活性与CK活性结果是否倒置分为倒置组（22例）和非倒置组,非倒置组又分为正常组（53例）和升高组（32例）,样本均用日立7600或7170全自动生化分析仪分析,CK-MB质量采用免疫化学发光法进行检测,CK、CK-MB活性采用酶免疫抑制法进行测定。组内质量及活性比较采用Spearman等级相关分析;由于数据方差不齐,组间多重比较采用Mann-Whitney Test。结果组内质量及活性Spearman等级相关分析结果分别为：倒置组CK-MB质量为（6.88±19.96）ng/ml,CK-MB活性为（176.00±150.51）U/L,r=0.249;P=0.082;正常组CK-MB质量为（3.82±4.66）ng/ml,CK-MB活性为（12.04±6.89）U/L,r=0.435,P=0.001;升高组CK-MB质量为（45.72±62.28）ng/ml,CK-MB活性为（67.22±106.23）U/L,r=0.838,P=0.000。倒置组与正常组比较,CK-MB活性差异有统计学意义（Z=-6.782,P〈0.001）;CK-MB质量无统计学差异（Z=-0.617,P〉0.537）。结论在CK-MB/CK非倒置时,CK-MB质量及其活性检测结果无明显差异,选择CK-MB活性检测更经济实惠;而CK-MB/CK倒置时,CK-MB活性受到诸多因素的干扰,使测定结果高于真实值,出现假性升高,而CK-MB质量能够避免干扰使测定结果更准确。     

低位水囊引产的最新临床应用和分析

目的:探讨低位水囊引产的最新临床应用及效果.方法:采用简单随机抽样法将某医院分娩的100例过期妊娠患者分为对照组(缩宫素引产)及观察组(低位水囊引产),各50例,比较两组临床应用效果.结果:观察组软产道裂伤率、剖宫产率、宫缩过频发生率、胎儿窘迫发生率均低于对照组,差异有统计学意义(P<0.05);引产前两组宫颈评分无明显差异,引产后差异有统计学意义(P<0.05);两组新生儿Apgar评分差异有统计学意义(P<0.05).结论:在过期妊娠引产中低位水囊应用效果更佳,可作为优选引产方案推广使用.     

老年髋关节置换术后护理

随着我国逐渐步入人口老龄化,老年性股骨胫骨折患者越来越多,老年人股骨头血液循环很差,骨折后容易坏死须行人工髋关节置换术,基于老年人骨质疏松,骨质脆性增加,关节不灵活,对外界反应迟钝,易受到外力失去平衡跌倒引起骨折,因骨折住院治疗人数逐年增加,髋部骨折是老年人常见疾病.人工髋关节置换术已经成为治疗老年髋关节损伤疾病的常用方法,人工髋关节置换不仅能有效的解除髋关节疾病患者的病情,纠正畸形,而且能够更极大地恢复患者关节功能,随着人工髋关节置换术的广泛开展,术后康复越来越受到重视,正确的康复指导,可促进患者肢体功能恢复,预防并发症的发生,提高患者的生活质量,增加手术效果.