轮状病毒肠道外感染与血清甘露聚糖结合蛋白水平的关系研究

目的 探讨轮状病毒肠道外感染患儿血清甘露聚糖结合蛋白(MBP)水平的变化及其与轮状病毒肠道外感染的关系.方法 采用双抗体夹心酶联免疫吸附法(ELISA)测定76例轮状病毒肠道外感染患儿和63例单纯轮状病毒肠炎患儿不同病程中的血清MBP水平以及50例健康对照组小儿血清MBP水平.结果 轮状病毒肠道外感染患儿急性期血清MBP为(176.35±113.12)μg/L,明显低于单纯轮状病毒肠炎急性期水平(392.27±128.96)μg/L以及健康对照组小儿MBP血清水平(676.25±248.63)μg/L,差异有显著性(P＜0.001);轮状病毒肠道外感染患儿恢复期血清MBP水平为(358.63±106.54)μg/L,低于单纯轮状病毒肠炎恢复期水平[(558.49±173.24)μg/L]以及健康对照组小儿血清MBP水平,差异有显著性(P＜0.001);轮状病毒肠道外感染导致的肺炎、肝损害、心肌损害以及中枢神经系统损害急性期患儿血清MBP水平分别为(198.24±126.47)μg/L、(169.34±124.38)μg/L、(184.62±123.64)μg/L、(180.74±126.86)μg/L,差异无显著性(P＞0.05).结论 轮状病毒肠道外感染患儿急性期及恢复期血清MBP水平明显低于单纯轮状病毒肠炎急性期及恢复期血清MBP水平,但轮状病毒肠道外感染导致的不同肠道外脏器损害患儿急性期血清MBP水平无显著差异;轮状病毒肠道外感染的发生与血清MBP水平低下密切相关.     

血清甘露聚糖结合蛋白水平变化与重症轮状病毒感染的关系

目的探讨重症轮状病毒感染患儿血清甘露聚糖结合蛋白(MBP)水平的变化及其与重症轮状病毒感染的关系。方法采用双抗体夹心酶联免疫吸附法(ELISA)测定56例重症轮状病毒感染患儿和48例普通轮状病毒肠炎患儿不同病程中的血清MBP水平以及43例健康对照组儿童血清MBP水平。结果重症轮状病毒感染患儿急性期血清MBP水平明显低于普通轮状病毒肠炎急性期及健康对照组,差异有统计学意义(P<0.01);重症轮状病毒感染患儿恢复期血清MBP水平仍低于普通轮状病毒肠炎恢复期及健康对照组,差异有统计学意义(P<0.05)。结论重症轮状病毒感染患儿急性期及恢复期血清MBP水平明显低于普通轮状病毒肠炎急性期及恢复期血清MBP水平;重症轮状病毒感染的发生与血清MBP水平低下关系密切。     

轮状病毒肠道外感染的研究进展

近年来,不断有轮状病毒肠炎患儿在病程中出现各种肠道外脏器损伤的报道,主要见于肺、心、肝胆、肾以及神经系统的损伤,并且在部分受累器官中已找到明确的证据,提示轮状病毒可能存在新的发病机制和感染途径,但目前仍未完全清楚.     

轮状病毒的肠道外感染

近年来发现轮状病毒（ＲＶ）可发生肠道外感染,常见于中枢神经系统,呼吸系统及肠管外的其他消化器官感染,这提示ＲＶ可能在存在新的感染途径和感染机制,为其感染的预防和临床治疗提出了新的课题。     

轮状病毒肠炎的肠道外表现

目的 分析轮状病毒（RV）肠炎的肠道外表现。方法 对155例RV肠炎患儿的临床资料进行回顾性分析。结果 RV肠炎的同时，出现呼吸系统表现，88例并鼻塞，流涕，咳嗽，气促，26例肺部闻及罗音，肺炎6例，支气管炎34例。神经系统表现抽搐6例，前囟隆起1例。5例伴皮疹。丙氨酸转氨酶增高26例，天冬氨酸转氨酶增高89例。心肌酶谱中乳酸脱氢酶增高23例，羟丁酸脱氢酶增高13例，肌酸激酶增高104例。X线胸片检查肺纹理增粗34例，双肺斑片影6例；心电图检查：窦性心动过速38例，T波改变7例，右室高电压3例，左室高电压，室早伴室性融合波，完全性右束支传导阻滞，不完全性右束支传导阻滞各1例；脑电图1/7例异常，头颅CT检查1例示左颞叶低密度灶，1例示左侧豆状核点状钙化，脑沟略增宽等。结论 RV可发生肠道外感染，以呼吸系统和中枢神经系统受累居多，病毒血症可能是RV多系统播散的途径。     

轮状病毒肠道外感染发病机制的研究进展

轮状病毒是一种双链RNA病毒,其基因序列已经基本查明.它是引起婴幼儿严重腹泻最常见的病原体,不仅可以引起胃肠道疾病,还可导致全身各个脏器的病变,发病机制和多个因素有关.肠道外发病可能是免疫功能异常(或正常)的情况下,轮状病毒穿透胃肠道屏障通过血液播散,感染肠道外多个器官所致.     

轮状病毒肠道外损害105例临床分析

目的 了解新疆奎屯地区2005年1月～2007年1月轮状病毒(RV)感染及其肠道外损害的状况.方法 对105例RV感染患儿的各系统损害从临床表现、实验室检查等方面作临床统计.结果 单纯RV感染者20例(19%);RV感染肠道外损害85例(81%),包括呼吸系统、循环系统、中枢神经系统及其他消化系统损害.结论 RV感染致肠道外病变表现多样化,以呼吸道、心脏、神经系统受累常见,提示RV感染者有新的感染途径及靶器官.     

甘露聚糖结合凝集素与感染免疫性疾病

本文综述甘露聚糖结合凝集紊(MBL)的分子结构和分子生物学作用,重点介绍MBL的分子遗传学特点及与感染和自身免疫性疾病发病的关系。指出MBL缺陷与系统性红斑狼疮、类风湿性关节炎等自身免疫性疾病的易感性密切相关,对处于抗感染的生理脆弱期(6个月-2岁)的婴幼儿尤为重要。应深入研究中国人群(各民族)的血清MBL水平、基因突变类型。     

轮状病毒的肠道外感染

近年来发现轮状病毒 (RV)可发生肠道外感染 ,常见于中枢神经系统、呼吸系统及肠管外的其他消化器官感染 ,这提示着 RV可能存在新的感染途径和感染机制 ,为其感染的预防和临床治疗提出了新的课题。     

深圳地区学龄前儿童血清甘露聚糖结合凝集素分析

目的：甘露聚糖结合凝集素是机体天然免疫的关键组成成分,该研究探讨学龄前儿童血清甘露聚糖结合凝集素的水平及分布特征,为预防儿童感染提供指导依据。方法：随机留取深圳市三所幼儿园118名3～6岁儿童的血清标本,其中男性62例,女性56例,通过酶联免疫吸附法测定血清甘露聚糖结合凝集素的水平。结果：深圳地区学龄前儿童血清甘露聚糖结合凝集素的浓度为779.07±268.98 ng/mL,其中男性值为783.89±252.30 ng/mL,女性值为773.65±288.29 ng/mL,均值无性别差异（P>0.05）。血清甘露聚糖结合凝集素低于500 ng/mL的儿童有16名,占13.6%,其中50～500 ng/mL有14名,50 ng/mL以下2名。结论：深圳地区学龄前儿童血清甘露聚糖结合凝集素的分布范围为779.07±268.98 ng/mL,可为临床和科研工作者提供参考,对血清甘露聚糖结合凝集素低于正常值下限的儿童可以适当使用抗生素预防感染。     

正常青春前期、青春后期儿童血中Leptin水平与生长激素结合蛋白关系的研究

目的研究Ｌｅｐｔｉｎ与营养、生长的关系。方法对４９例正常青春前期及４８例正常青春后期儿童进行身高、体重测量及血Ｌｅｐｔｉｎ、生长激素结合蛋白（ＧＨＢＰ）检测。结果正常青春前期儿童血Ｌｅｐｔｉｎ水平在女孩（４９１±２７９）μｇ／Ｌ,较男孩（３７１±３５５）μｇ／Ｌ略高,但无显著性差异（Ｐ＞００５）;在青春后期女孩（１２７９±７７２）μｇ／Ｌ,较男孩（４３４±３２５）μｇ／Ｌ显著升高（Ｐ＜００１）。无论青春前期还是青春后期男、女孩血中Ｌｅｐｔｉｎ水平均与ＧＨＢＰ、体重指数（ＢＭＩ）显著相关。结论Ｌｅｐｔｉｎ很可能是一种营养与生长间的调节因子并且可能具有多种功能。     

Procalcitonin and C-reactive protein levels in neonatal infections

In order to assess the potential of procalcitonin measurement in the management of neonatal sepsis, daily variations in serum procalcitonin (measured by an immunoluminometric assay) were evaluated in 94 control and infected newborn infants in comparison to C-reactive protein (measured by an immunonephelometric method). High levels of procalcitonin correlated with bacterial invasion and showed no discrepancies with C-reactive protein. Procalcitonin increased (up to 400 μg 1^-1) and returned to the normal range (< 0.1 g1^-1) more quickly than C-reactive protein, suggesting that procalcitonin may be an early marker of favourable outcome. Another finding is a significant procalcitonin peak on the first day of life in the control group, independent of any infectious stimulus. In conclusion, procalcitonin seems to be an interesting marker of neonatal sepsis but additional investigations are needed to understand better its mechanism of synthesis in order to determine its clinical usefulness.     

The relationship between serum selenium levels and frequent wheeze in children

As an antioxidant, selenium stimulates Th1 immune response against viral infections, and may play a role in the pathogenesis of frequent wheeze due to respiratory viral infections during the first year of life. We investigated the level of selenium in children with frequent wheeze who had no atopic diseases and no family history of atopy to determine whether selenium has an effect on the severity of the diseases. Sixty-one children with frequent wheeze who were in the asymptomatic period and had had no infectious disease for two months and an equal number of age- and sex-matched children, as a control group, without atopy or allergy or systemic diseases were enrolled in the study. In the study group, we determined the levels of serum selenium, total IgE, mixed specific IgE, and total eosinophil count, and we performed epidermal prick tests. Serum selenium levels were (mean and SEM) 61.95 +/- 1.23 microg/L in the study group and 72.71 +/- 1.28 microg/L in the control group (p < 0.001), and there was a negative correlation between the serum selenium levels and number of wheeze attacks during the previous year (r = -0.655; p < 0.001). As a result, selenium may play a role in the progression of respiratory infections during childhood and can be accepted as a risk factor for development of wheezing.     

The relationship between maternal serum zinc levels during pregnancy and birthweight

A retrospective follow-up study to ascertain the relationship between the level of serum zinc and its rate of change during gestation and birthweight was conducted in 476 women of lower socioeconomic status. Serum zinc concentrations measured at approximately 16 (early) and 32 weeks (later) in gestation were both found to be significant predictors of birthweight. Even after controlling for gestational age at birth and other determinants of birthweight, for each microgram/dl increase in serum zinc early and later in pregnancy, birthweight increased by 5.8 and 8.6 g, respectively. Furthermore, after adjustment for initial zinc levels both the total change (beta = -7.0, P = 0.0007) and the rate of change (beta = -60.8, P = 0.007) in serum zinc during pregnancy were inversely associated with birthweight, i.e., the larger the fall in serum zinc during pregnancy, the smaller the infant. Low serum zinc level (less than 60 micrograms/dl) late in pregnancy was associated with greater than a five-fold increase in the odds (OR = 5.8, 95% CI = 1.8, 16.4) of giving birth to a low birthweight infant. The results of this study suggest a threshold for maternal serum zinc below which the prevalence of low birthweight increases rapidly.     

甘露糖结合蛋白基因多态性与川崎病相关性的研究

目的　探讨甘露糖结合蛋白 (MBP)基因第 5 4号密码子GGC→GAC变异与川崎病 (KD)的关系。方法　采用PCR RFLP法对中国汉族 16 0例健康儿童及 95例川崎病患儿的MBP基因多态性进行检测。结果　中国汉族健康儿童MBP基因多态性分布与文献报道的中国香港地区华人及丹麦高加索人群无统计学差异。川崎病患儿MBP基因GGC/GAC基因型频率明显高于健康对照组 (45 2 %vs 2 5 0 % ,P <0 0 5 ) ,而GGC/GGC基因型频率显著低于健康对照组 (5 1 6 %vs 73 8% ,P <0 0 5 )。川崎病患儿GAC等位基因频率明显高于健康对照组(2 5 8%vs 13 8% ,P <0 0 5 ) ,而GGC等位基因频率明显低于健康对照组 (74 2 %vs 86 2 % ,P <0 0 5 )。结论　川崎病发病受遗传背景影响 ,与MBP第 5 4号密码子基因多态性密切相关。     

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目的了解反复呼吸道感染(RRTI)儿童血清甘露聚糖凝集素(MBL)水平及第一外显子54密码子的突变率,探讨血清MBL水平与RRTI的关系。方法用ELISA方法检测2000～2003年在重庆医科大学附属儿童医院就诊的65例RRTI儿童和238名正常儿童血清MBL水平,测定其中11例低MBL血症的RRTI儿童的免疫学指标(IgG、IgA、IgM、C3、C4),并用聚合酶链反应(PCR)限制性内切酶片段长度多态性分析(RFLP)方法与55名正常儿童MBL第一外显子54密码子基因多态性进行分析。结果RRTI儿童出现低血清MBL水平频率明显多于正常儿童(χ2=6.96,P<0.05),其MBL54密码子突变率亦明显增高(P<0.05),低血清MBL血症导致RRTI主要在2岁以前,血清MBL水平越低,感染频率越高,其C3、C4水平也越高。结论儿童MBL54密码子突变导致低MBL血症在2岁以前有反复呼吸道感染的倾向,MBL水平越低,感染机率越高。