目的 探讨血浆中S-腺苷同型半胱氨酸(S-adenosine homocysteine,SAH)与冠状动脉狭窄程度的关系.方法 选取2018年1月～2019年12月于简阳市人民医院就诊的疑似冠状动脉粥样硬化性心脏病(coronary atherosclerotic heart disease,CHD)患者663例作为研究对象,根据冠状动脉造影检查结果,将患者分为CHD组(经冠状动脉造影确诊)(n=386)和对照组(n=277).采集空腹静脉血标本检测血清总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、脂蛋白(a)[Lipoprotein a,LP(a)]、同型半胱氨酸(homocysteine,Hcy)和SAH水平,采用Gensini积分法评估CHD组冠状动脉狭窄程度,并分析上述指标与其相关性.结果 CHD组患者LDL-C,LP(a),Hcy和SAH水平高于对照组,而HDL-C水平低于对照组,差异均具有统计学意义(t=3.71～14.70,均P<0.05);CHD组患者冠状动脉狭窄程度Genisini积分与患者LDL-C,LP(a),Hcy和SAH呈正相关(r=0.408～0.635,均P<0.05),而与HDL-C呈负相关(r=-0.404,P<0.05).结论 CHD患者血浆SAH水平明显升高,与传统血清学指标相比,血浆SAH浓度水平与冠状动脉病变程度的相关性最高,血浆SAH可能是一种新的生物学标志物用于CHD的临床诊断,在临床诊疗过程中可将血浆SAH用于评估冠脉病变情况,对于CHD的预防和诊疗具有重要意义.

目的 通过分析简阳地区不同孕期孕妇尿碘水平变化情况,为孕妇合理补充碘元素提供临床指导,提高新生儿出生质量.方法 按孕周将孕妇分组,以健康非妊娠妇女作为对照组,采用氧化还原法进行尿碘水平的检测.结果 2 227例孕妇尿碘检测结果中位数为229.6μg/L,碘缺乏、碘适量、碘超适量及碘过量的比率分别为37.6％、30.1％、23.5％及8.8％,各年尿碘水平构成比差异无统计学意义(x2=4.236,P＞0.05);孕早、中及晚期3组的孕妇尿碘中位数分别为226.5、231.1及221.4 μg/L,各孕期孕妇尿碘水平构成比差异无统计学意义(x2=7.605,P＞0.05);对照组与孕妇组各阶段尿碘水平构成比差异有学统计意义(x2=33.98,P＜0.05).结论 简阳地区孕妇尿碘缺乏比例略低于其他地区,孕妇碘营养水平较正常人严重缺乏,尿碘水平的检测对孕妇科学合理补碘具有重要作用.

25-羟基的维生素D[简称25-(O H)D]含量与心血管病症 、2型糖尿病 、骨质疏松与高血压以及肿瘤等病症都有关系,因此,进行25-(O H)D准确的检测可以有效预防相关疾病.可以使用RIA、ECLIA、ELISA、HPLC与CLIA以及LC-MS/MS等方式检测样本中25-(O H)D]水平.为此文本将对其检测方式与应用范围进行分析.

Objective To discuss the joint test value of serum tumor markers in improving the diagnostic effect of colorectal cancer during clinical diagnosis.Methods 66 patients with colorectal cancer and 66 patients with benign lesion hospitalized in our hospital during June 2014-June 2015 were selected as the observation group and the benign control group,respectively.66 healthy people received physical examination at the corresponding period were selected as the control group.Joint test of serum tumor markers was applied to patients in the three groups,and the testing resuhs were compared.Results The expression levels of serum CEA,CA19-9,CA125 and CA72-4 in patients of the observation group were higher than that in the benign control group and the control group,with the differences statistically significant (P ＜ 0.05);the sensitivity and specificity of joint test were obviously higher than that in single test.Conclusion Serum tumor marker joint test performs better sensitivity and specificity in the diagnosisi of colorectal cancer;it plays important significance in the early diagnosis of colorectal cancer and TNM staging.

目的：探讨血清胱抑素C（C y s-c）在糖尿病肾病早期诊断中的临床价值。方法收集我院内分泌科180例糖尿病住院病人，同时检测血清Cys-c、血肌酐（Cr）、24小时尿微量白蛋白(MA)和24小时尿蛋白含量。利用尿MA是早期肾损害的敏感指标，将病人按24小时尿MA含量分为A组（<30mg）单纯糖尿病组、B组（30mg-300 mg）早期糖尿病肾病组、C组（>300mg）糖尿病肾病组三组。然后比较各组Cys-c、血Cr和24小时尿蛋白水平。结果只有C组Cys-c结果与其余两组Cys-c结果差异具有显著性（P<0.05），A、B两组Cys-c结果差异无显著性（P>0.05）。而B、C组24小时尿蛋白水平与MA呈正相关，只有C组中有5例血Cr升高。结论 Cys-c在肾病早期诊断中的敏感性仅仅优于血Cr，肾病的早期诊断应联合应用有价值的诊断指标，使病人得到及时正确的诊断。

目的：评价SYSMEX XE-5000全自动血细胞分析仪电阻抗法和光学法对大血小板检测结果的可靠性。方法将240例我院住院患者空腹抗凝静脉全血,经SYSMEX XE-5000进行血小板（PLT）电阻抗法(PLT-I)和光学法(PLT-O)检测和手工计数,结果与显微镜计数法结果(PLT-M)比较.运用SPSS11.0和Excel对相关数据进行统计分析。结果正常体积血小板组3种方法之间结果无统计学差异(P>0.05)；大血小板组PLT-I和PLT-O结果假性降低,PLT-I法结果低于PLT-O法结果，差异有统计学意义(P<0.05)，PLT-I、PLT-O结果与PLT-M 法结果差异有统计学意义(P<0.05)。结论正常血小板体积标本SYSMEX XE-5000使用PLT-I 血小板计数结果正确可靠,但在大血小板标本仪器计数血小板不可靠,仪器结果只能起提示作用,需与显微镜手工计数法相结合保证血小板结果的准确性。

目的:探讨学龄前儿童末梢血中铜、锌、钙、镁、铁5种微量素的水平及与健康状况的关系.以及其水平过高或过低的应对措施.方法:利用北京博晖创新光电技术股份有限公司生产的BH5100原子吸收光谱仪对2010年3月～9月,来我院健康体检及儿保门诊的1087例0～6儿童进行末梢血中钙、镁、铜、铁、锌五种微量元素检测并统计分析.结果:微量元素缺乏前三位的是,锌元素缺乏率为31.00%,铁元素缺乏率为26.31%,钙元素缺乏率为14.17%.铁、锌、钙在各年龄组中均明显低于正常值的下限.不同性别间钙、铁、锌、铜、镁元素失衡均无差异.不同年龄组儿童缺铁比率有差异,随年龄增长而明显降低,而铁、锌元素失衡在1-3岁年龄组明显.结论:儿童时期是生长发育最旺盛时期,对微量元素需求量大,尤其是对铁、锌和钙的需求量大,如摄入不足,易出现微量元素的缺乏.

目的:探讨在全自动生化分析仪应用中某些试剂间存在的交叉污染。方法:分别以谷丙转氨酶(ALT)、三酰甘油(TG)为研究对象。在检测了直接胆红素(DBIL)后检测ALT,分别在检测了高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)后检测TG。观察DBIL试剂对ALT检测的影响,HDL-C和LDL-C试剂对TG检测的影响。结果:DBIL试剂对ALT检测有明显负干扰,HDL-C和LDL-C试剂对甘TG检测有明显正干扰。结论:在全自动生化分析仪应用中,某些生化试剂间存在交叉污染。为了尽量减少试剂间交叉污染,在加强洗涤试剂针的同时,更重要的是合理安排项目间组合顺序。

Objective:To study the influence of microcyte on platelet count of BC-5800 hemotologic analyzer.Methods:Patients in our hospital blood samples,select the mean corpuscular volume(MCV)<70fl specimens of 65 Patients,MCV was 70-81.9fl specimens of 52 Patients,MCV,and RDW were normal in 50 patients specimens,in the BC-5800 hematology analyzer at the same time,each of the second sample take manual mircroscopic counting means,the results were analyzed statistically.Results:MCV<70fl group,the platelet count increased,BC-5800 hematology analyzer and microscopic examination results between France and platelet count was significantly diffent;in MCV was 70-81.9fl group,RDW increase the platelet count increased false,There were significant difference between the two methods,RDW normal little effect on the results,on significant difference between the two methods;MCV and RDW was normal specimens no significant difference between the two methods.Conclusion:Using the BC-5800 hematology analyzer when the platelet count,and MCV<70fl specimens and MCV and RDW is 70-81.9fl increased significantly and markedly abnormal platelet histogram of specimens should be manually reviewed the results of platelet count.

目的:探讨UF-100全自动尿沉渣分析仪(UF-100)、优利特[Uritest-500B)尿干化学分析仪11联和显微镜法检测尿液有形成分的差异及其影响因素.方法 取本院门诊及住院患者尿标本1200例,用三种方法分别检测,以显微镜检查方法为标准,另两种方法的结果分别与镜检结果比较.结果 :UF-100全自动尿沉渣仪对RBC的检出阳性符合率为83.96%、假阳性率为23.48%、假阴性率为16.04%;对WBC的检出阳性符合率为88.35%、假阳性率为14.41%、假阴性率11.65%;对管型的检出阳性符合率为80.64%,假阳性率为40.46%、假阴性率19.35%.优利特对RBC的检出阳性符合率为90.07%、假阳性率为8.23%、假阴性率为9.92%,对WBC的检出阳性符合率为88.59%、假阳性率为8.56%、假阴性率为11.41%.对管型的检出阳性符合率为96.30%,假阳性率为14.75%、假阴性率3.70%.结论 全自动尿沉渣分析仪、尿干化学分析仪检测结果与显微镜镜检相比较,准确率较高,但结果间存在一定的假阳性和假阴性,二者依然无法替代显微镜镜检.全自动尿沉渣分析仪只能对尿液沉渣检查起过筛作用,需三者联合应用可提高检验质量,保证结果的准确度.

Objective To discuss the significance of glycosylated hemoglobin(HbA1c) and urine microalbumin combined(mAlb) test in the diagnosis and surveillance of early diabetic nephropathy.Methods 124 cases of statistical diabetes mellitus(DM) and 86 healthy individuals were detcted glycated hemoglobin(HbA1c) and urinary microalbumin(mAlb).Results According to HbA1c levels,the patients with DM were divided into three groups of low,medium,high-value.In the low and median value groups,urinary mAlb level had no statistical difference compared with the healthy congroup(P0.05),while had statistical difference compared with the high value group(P0.01).with HbA1c levels increase,urine mAlb level showed a rising trend with a significant positive correlation(r= 0.538,P0.01).Conclusion In DM patients,HbA1c levels and the level of urinary mAlb have positive corretalion,their levels are closely related to the severity of DM nephropathy combined detection of HbA1c and mAlb has important significance to early diagnosis of DM nephratathy,treatment and controlling the disease course.

目的探讨糖化血红蛋白在糖尿病监测中的临床意义。方法采用免疫比浊法及已糖激酶法分别测定糖化血红蛋白(HbAlc)和空腹血糖(FBG)的含量。结果治疗前FBG和HbAlc均明显高于正常对照组(P<0．01);治疗后的FBG和HbAlc与治疗前比较,下降明显(P<0．01)。结论 HbAlc值可判断近2个月血糖波动情况,是监测糖尿病发生、发展的良好指标。