目的 探讨血清脂蛋白(Lp)(a)、脂蛋白相关磷脂酶(Lp-PL)A2与老年急性脑梗死(ACI)患者颈动脉粥样硬化斑块性质的相关性.方法 ACI患者100例,其中颈动脉超声检查显示无斑块患者18例,稳定斑块患者28例,不稳定斑块患者54例;选取健康体检者100例为对照组.受试者均采用酶联免疫吸附试验检测血清Lp(a)、Lp-PLA2水平.结果 ACI组血清Lp(a)、Lp-PLA2水平均明显高于对照组(P<0.05).ACI患者中,与无斑块组比较,稳定性斑块组及不稳定性斑块组血清Lp(a)、Lp-PLA2水平均显著增高(P<0.05);与稳定性斑块组比较,不稳定性斑块组血清Lp(a)、Lp-PLA2水平均显著增高(P<0.05).Logistic回归分析结果显示,Lp(a)、Lp-PLA2及低密度脂蛋白(LDL-C)均是ACI患者CAS斑块稳定性的独立影响因素(P<0.05).相关性分析显示,ACI患者Lp(a)、Lp-PLA2水平均与LDL-C水平呈正相关.Lp(a)、Lp-PLA2诊断老年ACI患者CAS斑块稳定性的受试者工作特征(ROC)曲线下面积分别为0.729(95％CI:0.631～0.813)、0.768(95％CI:0.639～0.847);而二者联合诊断的曲线下面积为0.864(95％CI:0.659～0.956),优于单一指标检测.结论 血清Lp(a)、Lp-PLA2均与老年ACI患者颈动脉粥样不稳定斑块具有相关性,可作为颈动脉斑块稳定性的血清诊断标志物.

目的:探讨血清同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)及抗β2糖蛋白1抗体(aβ2-GP1)、抗心磷脂抗体(ACA)与脑梗死的关系.方法:选取192例脑梗死患者为研究对象,根据入院时美国国立卫生研究院脑卒中量表(NIHSS)评分分为轻度组(NIHSS评分<5分,n=103)、中度组(NIHSS评分=5～15分,n=57)和重度组(NIHSS评分≥16分,n=32);另选60名同期年龄、性别配对的体检健康志愿者为对照组.比较各组对象血清Hcy、hs-CRP及aβ2-GP1、ACA水平,受试者工作特征(ROC)曲线分析其诊断脑梗死的价值.结果:四组对象血清Hcy、hs-CRP及aβ2-GP1、ACA水平比较,差异有统计学意义(P<0.05),且重度组>中度组>轻度组>对照组(P<0.05);ROC曲线分析显示,血清Hcy、hs-CRP、aβ2-GP1、ACA的截断(Cut-off)值为9.72μmol/L、2.05 mg/L、14.28 RU/mL、8.93 RU/mL时,曲线下面积(AUC)分别为0.715、0.670、0.729、0.872,敏感度分别为77.60％、81.77％、83.85％、89.06％,特异度分别为53.33％、51.66％、61.67％、60.00％;联合检测的敏感度为94.27％,特异度为67.74％.联合检测诊断脑梗死的一致性较好.结论:血清Hcy、hs-CRP、aβ2-GP1、ACA水平与脑梗死的严重程度相关,在高风险人群脑梗死筛查中,aβ2-GP1、ACA的诊断价值高于Hcy、hs-CRP,四种指标联合检测可提高准确率.

目的 探讨磁共振成像(MRI)弥散张量成像(DTI)参数联合血清抗心磷脂抗体(ACA)、抗β2糖蛋白1抗体(aβ2-GP1)在脑梗死诊断中的应用价值.方法 回顾性选取2015年6月至2017年1月在承德医学院附属医院接受治疗的脑梗死患者131例作为观察组,同时选取同期在神经内科接受治疗的非脑梗死患者50例作为对照组.观察组根据病灶大小分为小面积梗死组58例,中面积梗死组41例,大面积梗死组32例;根据严重程度分为轻度组67例,中重度组64例;根据预后效果分为预后良好组90例,预后不良组41例.比较两组血清ACA、aβ2-GP1差异,同时比较不同梗死面积、严重程度及预后患者血清ACA、aβ2-GP1以及各向异性分数(FA)值、表观扩散系数(ADC)值差异.结果 观察组血清ACA、ab2-GP1分别为(8.95±1.87)、(14.87±3.35)RU/mL,明显高于对照组,差异均有统计学意义(P<0.05).随着梗死面积增加,患者病灶FA值和ADC值降低,而血清ACA、aβ2-GP1升高,差异均有统计学意义(P<0.05).观察组中重度患者FA值和ADC值分别为0.38±0.10和(2.88±0.91)×10-3mm2/s,均明显低于轻度患者,而ACA和aβ2-GP1分别为(9.82±1.32)、(16.46±3.08)RU/mL,均明显高于轻度患者,差异均有统计学意义(P<0.05).观察组预后不良患者FA值和ADC值分别为0.36±0.12和(2.62±0.94)×10-3 mm2/s,均明显低于预后良好患者,而ACA和aβ2-GP1分别为(10.55±1.15)、(17.26±3.12)RU/mL,明显高于预后良好患者,差异均有统计学意义(P<0.05).FA值、ADC值联合血清ACA、aβ2-GP1预测患者预后不良的ROC曲线面积为0.911,明显高于各参数单独预测的0.715、0.768、0.793和0.820,P<0.05.结论 MRI DTI参数FA值、ADC值以及血清ACA、aβ2-GP1与脑梗死梗死面积、严重程度及预后有关,且在联合预测患者预后方面有一定应用价值.

目的 探讨承德地区亚甲基四氢叶酸还原酶(MTHFR)基因C677T多态性与妊高征发病的关系.方法 358例孕妇中妊高征患者32例(妊高征组),其中妊娠期高血压组14例,轻度子痫前期组10例,重度子痫前期组8例,326例为正常妊娠(对照组).采用PCR-荧光探针法,检测并分析358例孕妇外周血中MTHFR基因C677T的分型;同时,检测血浆同型半胱氨酸(Hcy)的水平.结果 妊高征疾病组中C677/T677基因型与正常对照组比较,差异有统计学意义(P<0.05);妊高征疾病组中C677/C677基因型与正常对照组比较,差异有统计学意义(P<0.05);妊高征疾病组中T677等位基因频率(51.6％)高于正常对照组(33.1％),差异有统计学意义(P<0.05);妊娠期高血压组、轻度子痫前期组和重度子痫前期组与对照组比较,T677/T677基因型、C677/T677基因型、C677/C677基因型和T677等位基因频率,差异均无统计学意义(P>0.05).妊高征组和正常对照组中,MTHFR基因存在突变者较无突变者的血浆同型半胱氨酸水平更高,差异有统计学意义(P<0.01).结论 承德地区MTHFR基因C677T多态性和高水平的血浆同型半胱氨酸可能与妊高征的发病有关,T677等位基因可能是妊高征的易感基因.

Objective:To investigate the relationship between methylene tetraphydrofolate reductase(MTHFR) gene polymorphism and gestational diabetes mellitus.Methods:A total of 130 pregnant women with gestational diabetes who delivered in the obstetrics department of Affiliated Hospital of Chengde Medical University from December 2017 to December 2020 were selected as the disease group, and 120 healthy pregnant women during the same period were selected as the control group.Distribution of MTHFR C677T genotype and plasma homocysteine levels were compared between the two groups.Results:The TT genotype frequency of disease group (55/130, 42.31%) was higher than that of control group (18/120, 15.00%). CT genotype frequency (50/130, 38.46%) was higher than that of control group (28/120, 23.33%). The frequency of T allele (160/260, 61.54%) was higher than that of control group (64/240, 26.67%). There were statistically significant differences between the two groups ( χ2 were 21.56 and 27.67, both P<0.05). Plasma homocysteine level in TT type and CT type was significantly higher than that in CC type, and the difference was statistically significant ( t= 7.82 and 6.38, P<0.05); T allele and homocysteine levels were associated with gestational diabetes ( OR=4.40, 95% CI: 2.50~7.75. OR=1.16, 95% CI: 1.03~1.30). Conclusions:MTHFR C677T allele mutation leads to elevated plasma homocysteine level, which is an important genetic risk factor for gestational diabetes mellitus.

目的 探讨亚甲基四氢叶酸还原酶(MTHFR)基因C677T位点多态性及甲状腺功能与妊娠期糖尿病的相关性.方法 选取承德医学院附属医院51名患有妊娠期糖尿病的孕妇作为病例组,同期60名正常妊娠孕妇作为对照组.运用PCR-荧光探针法检测两组的MTHFR C677T基因多态性.采用全自动免疫分析仪进行甲状腺功能指标的测定.应用全自动生化分析仪检测两组研究对象的血浆同型半胱氨酸水平.对比两组孕妇甲状腺功能、同型半胱氨酸和MT H FR基因型分布情况,探讨MT H FR基因多态性及甲状腺功能与妊娠期糖尿病的关系.结果 妊娠期糖尿病组与对照组比较,基因型分布差异有统计学意义(P<0.01);妊娠期糖尿病组T等位基因频率为61.76％,C等位基因频率为38.24％,与对照组比较,其差异有显著性(P<0.01).妊娠期糖尿病组与对照组甲状腺功能和同型半胱氨酸水平比较,其同型半胱氨酸和促甲状腺激素的水平高于对照组,差异有统计学意义(P<0.05).不同基因型孕妇的甲状腺功能和同型半胱氨酸水平比较,无论是病例组还是对照组内,存在MTHFR基因C677T突变者,其甲状腺功能和同型半胱氨酸水平较无基因突变者有所不同,即TT基因型孕妇和CT基因型孕妇促甲状腺激素和同型半胱氨酸水平较CC基因型孕妇更高,差异有统计学意义(P<0.05).妊娠期糖尿病组内甲状腺功能与同型半胱氨酸的相关性分析,血清促甲状腺激素水平与血浆同型半胱氨酸水平呈明显正相关(P<0.01).二元Logistic回归分析结果显示,高水平的促甲状腺激素和同型半胱氨酸是导致孕妇罹患妊娠期糖尿病的重要危险因素.结论 MT H FR基因C677T位点多态性、同型半胱氨酸和甲状腺功能可能与妊娠期糖尿病的发生有关,T等位基因、升高的同型半胱氨酸和促甲状腺激素可能是妊娠期糖尿病的重要危险因素.

Kawasaki disease (KD), also known as mucocutaneous lymph node syndrome, is an acute systemic vasculitis syndrome that mainly occurs in infants under 5 years of age. In the current manuscript, we were aiming to analyze the role of neutrophil extracellular traps (NETs) in the pathogenesis of KD, especially their interplay with peripheral blood mononuclear cells (PBMCs). Neutrophils were exposed to 20 nM phorbol myristate acetate (PMA), we found that neutrophils of KD patients were more likely to form NETs compared with healthy controls (HCs). Furthermore, PBMCs were cultured with NETs for 24 h, and we observed that NETs significantly increased the cell viability, suppressed cell apoptosis, and enhanced the pro-inflammatory cytokines production and NF-κB activation in PBMCs from KD patients. In addition, with the stimulation of NETs, the expression of vascular endothelial growth factor A (VEGF-A) and hypoxia-inducible factor-1α (HIF-1α) were increased, which were related with the pathological mechanism of KD. At last, we examined the activation of phosphoinositide 3 kinase (PI3K)/Akt signaling, and we found NETs treatment obviously enhanced the activation of PI3K and Akt. In conclusion, these findings suggested that the formation of NETs may alter the biologic responses of PBMC and affect the vascular injury in KD.

Background: Acute myocardial infarction (AMI) is a common cardiovascular disease with high morbidity and mortality. Many recent studies have demonstrated that serum miRNA-499 levels are increased in the early stages of AMI. However, studies documenting the levels of miRNA-499 in AMI have had inconsistent results. Therefore, this study aimed to systematically evaluate the role of circulating miRNA-499 as a biomarker for AMI. Methods: According to the inclusion and exclusion criteria, a preliminary literature search was performed in the PubMed, Embase, and Cochrane databases up through October 2018. The meta-analysis was conducted used Review Manager 5.3 and Stata 12.0 software. The overall sensitivity, the overall specificity, the positive likelihood ratio (PLR), the negative likelihood ratio (NLR), the diagnostic odds ratio (OR), the receiver operating characteristic curve (AUROC), and the 95% confidence interval were presented to assess the diagnostic value of miRNA-499 in patients with AMI. Results: 16 articles that met the criteria were included in the qualitative synthesis. The studies included 1991 patients with AMI and 1950 healthy controls. The overall sensitivity of miRNA-499 for diagnosing AMI was 0.878 [95% CI: 0.827-0.915] and the specificity was 0.904 [95% CI: 0.831-0.947]. The PLR was 9.151 [95% CI: 4.993-16.770], and the NLR was 0.135 [95% CI: 0.092-0.199]. The overall diagnostic OR and 95% confidence interval were 67.776 and 27.994-164.092, respectively. The area under the AUROC was 0.95, and the 95% confidence interval was 0.920-0.960. Conclusions: In summary, miRNA-499 has a high diagnostic value in the diagnosis of AMI, and miRNA-499 may still be a valuable diagnostic marker for AMI. Furthermore, additional rigorously designed experiments with large sample sizes are needed to demonstrate the diagnostic value of miRNA-499 for AMI.

目的 探讨白细胞介素(IL)-17对老年类风湿关节炎(RA)患者成纤维样滑膜细胞增殖和趋化因子分泌的影响及作用机制.方法 选取行关节置管术的老年RA患者,从术中切除的新鲜滑膜组织中分离滑膜成纤维细胞进行培养.3-(4,5-二甲噻唑-2)-2,5-二苯基四氮唑溴盐(MTT)法检测IL-17对细胞增殖的影响;蛋白芯片试剂盒检测滑膜成纤维细胞上清液趋化因子〔中性粒细胞激活肽(ENA)-78、IL-8、生长相关癌基因(GRO)、单核细胞趋化蛋白(MCP)-1〕的水平;流式细胞术检测滑膜成纤维细胞表面IL-17受体(IL-17R)的表达.在成纤维样滑膜细胞中分别加入MEK1/2信号通路抑制剂(PD98059)、核转录因子(NF)-κB信号通路抑制剂(LY294002)、STAT3信号通路抑制剂(AG490)、RANKL信号通路抑制剂(小白菊内酯),孵育60 min后加IL-17刺激72 h,荧光定量PCR法检测ENA-78、IL-8、GRO、MCP-1 mRNA表达水平.结果 IL-17对滑膜成纤维细胞各时间点刺激指数差异均有统计学意义(P<0.05),其中刺激72 h滑膜成纤维细胞增殖能力最强.IL-17刺激滑膜成纤维细胞48 h后,滑膜成纤维细胞分泌的ENA-78、IL-8、GRO、MCP-1水平均明显高于对照组(P<0.05).流式细胞术显示,加入抗IL-17R抗体组IL-17R表达水平明显高于同型对照组(P<0.05).滴加PD98059、LY294002、AG490后,ENA-78、IL-8、GRO、MCP-1 mRNA表达量均明显低于空白对照组(P<0.05);而滴加小白菊内酯后与空白对照组差异无统计学意义(P>0.05).结论 IL-17可促进老年RA成纤维样滑膜细胞增殖及趋化因子表达;IL-17可能通过MEK1/2、NF-κB、STAT3信号通路诱导滑膜成纤维细胞趋化因子表达.

Objective To investigate the clinical effect of Warfarin Sodium Tablets combined with Low Molecular Weight Heparin Sodium Injection in treatment of postpartum venous thromboembolism. Methods Patients (67 cases) with postpartum venous thromboembolism in the Affiliated Hospital of Chengde Medical University from July 2010 to July 2015 were randomly divided into the control group (34 cases) and the treatment group (33 cases). Patients in the control group were sc administered with Low Molecular Weight Heparin Sodium Injection at postpartum 12 h, 100 IU/kg, twice daily. Patients in the treatment group were po administered with Warfarin Sodium Tablets on the basis of the control group, first dose 2.5 mg, once daily, adjusting the amount of warfarin according to the results, when the international normalized ratio of prothrombin time was 2 to 3, the Low Molecular Weight Heparin Sodium Injection was discontinued.. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and vascular patency and adverse events in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 73.53％ and 90.91％, respectively, and there was difference between two groups (P < 0.05). After treatment, the vascular patency rates in the control and treatment groups were 73.53％ and 84.85％, respectively, and there was difference between two groups (P < 0.05). After treatment, the incidence rates of post thrombosis syndrome in the control and treatment groups were 35.29％ and 12.12％, respectively, and there was difference between two groups (P < 0.05). Conclusion Warfarin Sodium Tablets combined with Low Molecular Weight Heparin Sodium Injection has clinical curative effect in treatment of postpartum venous thromboembolism, can increase vascular patency, with good safety, which has a certain clinical application value.

Objective To study the changes and critical value establishment of D-dimer(D-D) in pregnancy related venous thromboembolism(VTE). Methods 90 cases pregnancy in our hospital from 2016 January to 2017 January were chose,90 cases pregnancy were divided into early (12 weeks) pregnancy, medium(24 weeks)pregnancy and late(36 weeks) pregnancy group,and each group was 30 cases. 90 cases pregnancy were including 32 cases VTE pregnancy and 58 cases non-VTE pregnancy. Another 30 normal persons were chose to be control group. The levels of D-D were detected by immunoturbidity method. Results There were no differences in the level of D-D between control group and early pregnancy group. Compared with the normal control group,the levels of D-Din medium pregnancy and late pregnancy group were higher(P< 0. 05). Compared with the normal control group,the levels of D-D in VTE pregnancy and non-VTE pregnancy group were higher(P < 0. 05). Compared with the non-VTE pregnancy group,the levels of D-D in VTE pregnancy group were higher(P < 0. 05). The most widespread of ROC was 0. 915(SD:0. 031; 95％CI: 0. 85 ～ 0. 98),the sensitivity was 0. 86,the specificity was 0. 90 and the critical value of D-D was 0. 55 mg / L. Conclusion The level of D-D in VTE pregnancy is higher than normal non-pregnancy person. For VTE pregnancy,we should use the adjusted D-D critical value for diagnosing VTE.

Objective To investigate the association of Tim-1 protein expression and its gene polymorphism with nutritional parameters in patients with systemic lupus erythematosus (SLE).Methods Peripheral blood samples were collected from 126 patients with SLE.Serum Tim-1 protein levels were detected by ELISA,and the Tim-1 gene-416G＞C,-1454G＞A polymorphism was detected by PCR-RFLP.Prealbumin,ceruloplasmin,and retinol conjugated protein levels were determined by immunoturbidimetry.Ferritin and 1,25-dihydroxy vitamin D3 levels were detected by electrochemiluminescence.Results Concentrations of serum Tim-1 protein,prealbumin,ceruloplasmin,retinol binding protein,ferritin,and 1,25-dihydroxy vitamin D3 were 249.7±30.2 pg/mL,226±42 μg/mL,363±95 μg/mL,29.4± 13.2 μg/mL,355± 164 ng/mL,and 26.4-± 11.5 ng/mL,respectively.In the-416G＞C site,GG,GC,and CC genotypes accounted for 11.9％,57.1％,and 31.0％,respectively.In the-1454G＞A site,GG,GA,and AA genotypes accounted for 67.5％,26.2％,and 6.3％,respectively.The Tim-1 protein concentration did not differ significantly between the different genotypes of the-416G＞C site (F=0.575,P=0.564) or-1454G＞A site (F=1.255,P=0.289).Tim-1 level was significandy negatively correlated with prealbumin (r =-0.176,P =0.033),and positively correlated with ceruloplasmin (r =0.205,P =0.014) and 1,25-dihydroxy vitamin D3 (r=0.166,P=0.042).The serum prealbumin level decreased significantly (P=0.027) in patients harboring the GG genotype in the-1454G＞A site,whereas the serum 1,25-dihydroxy vitamin D3 level decreased significandy (P =0.024) in patients with the AA genotype in the-1454G＞A site.Conclusion Serum Tim-1 protein level and the-1454G＞A polymorphism of Tim-1 gene are associated with the nutritional function of patients with SLE.

Objective To analyse the variation of C-reactive Protein,Interleukin-6 and D-Dimer in the Pre-therapy and Post-treatment Period of the DVT,to explore the significance of the three indexes.Methods 30 patients documen-ted with acute phase of lower limb DVT(DVT group)and 30 healthy individuals(normal control group)were included in this study,The plasma level of CRP,IL-6 and D-Dimer in both groups and the difference of perimeters between the lower limbs before and 3,7 days after the treatment in DVT group were recorded.Results The plasma level of CRP, IL-6 and DD of DVT group before the treatment were statistically higher than those of normal control group (P<0.05).The plasma level of CRP,IL-6 and the difference of perimeters between the lower limbs statistically reduced af-ter the treatment.The plasma level of CRP and IL-6 decreased vitally than before after the treatment 3,7 days(P<0.05),but the level of DD increased than before after the treatment 3 days(P<0.05),then it began to reduced also.Af-ter the treatment 7 days,the level of the three indexes were all statistically lower than the treatment 3 days(P<0.05). Conclusion Inflammatory factors possibly play an important role in acute phase of DVT.There was a crucial clinical value to combine detect the CRP,IL-6 and DD levels of serum in patients with acute DVT in its early diagnosis,occur-rence,development and prognosis.

Objective:To analyze and explore the clinical value of combined detection of antinuclear antibodies and antinuclear antibodies in the diagnosis of autoimmune diseases.Method: 1103 blood samples were submitted to our hospital,antinuclear antibody detection and antinuclear antibody spectrum detection were simultaneously tested.Antinuclear antibodies were detected by indirect immunofluorescence,and antinuclear antibodies were detected by Western blot.The data of patients with positive results were collected and analyzed statistically.Results: The positive results of antinuclear antibody test accounted for 6.32％of all patients,and the diagnosis accuracy was 78.21％;Detection of antinuclear antibody spectrum of blood test positive patients accounted for 4.78％of all patients,the diagnosis results showed that antinuclear antibody spectrum diagnosis rate was 91.32％,and the two methods were both positive patients for inspection,found that the highest accuracy is 94.67％.Conclusion: Simultaneous detection of antinuclear antibodies and antinuclear antibody spectrum can effectively improve the accuracy of the detection results,and is worthy of promotion.

Objective To investigate the predictive value of plasma lipoprotein associated phospholipase A 2 (Lp-PLA2 ) in cere-bral infarction(CI) after transient cerebral ischemia attack (TIA).Methods Plasma Lp-PLA2 level was detected in 112 TIA pa-tients ,and the incidence rate of CI was observed on 7 ,30 ,90 d after TIA.Then the grouping was performed according to the Lp-PLA2 level ,and the predictive value of Lp-PLA2 in the risk of CI occurrence after TIA was evaluated.Results Among 112 patients with TIA ,27 cases (24.1% ) developed CI within 90 d;there were 17 cases(63.0% ) of CI after TIA in the Lp-PLA2 >207 μg/L group ,which were significantly higher than that in the 175-207 μg/L group and <175 μg/L group (P<0.05);moreover the CI occurrence in TIA patients was mainly concentrated within 7 d after onset ;the patients of Lp-PLA2 ≥175μg/L were mainly distrib-uted in the moderate and high risk groups of ABCD2 score system ;in ROC curve of Lp-PLA2 for predicting CI after TIA ,with Lp-PLA2 ≥194 μg/L as the diagnostic critical point ,the sensitivity was 0.730 and specificity was 0.680.Conclusion Lp-PLA2 may be an effective risk predictive indicator of CI occurrence after TIA ,and can improve the adverse outcome of TIA patients.

目的 对抗核糖体P0蛋白抗体、抗dsDNA抗体等自身抗体在SLE及其他自身免疫性疾病诊断中的意义进行深入的分析和研究.方法 收集收治的110例自身免疫性疾病患者(56例SLE、26例类风湿关节炎、10例干燥综合征、4例强直性脊柱炎、5例系统性血管炎、6例混合性结缔组织病、3例皮肌炎)的基本资料,应用蛋白印迹法对患者体内的血清抗核糖体P0蛋白抗体、抗dsDNA抗体、抗-sm、抗核小体抗体、抗组蛋白抗体等自身抗体的水平进行分析和研究,进而衡量自身抗体在自身免疫性疾病诊断中的意义.结果 本次研究的110例自身免疫性疾病患者的血清抗核糖体P0蛋白抗体、抗dsDNA抗体、抗-sm、抗核小体抗体、抗组蛋白抗体诊断SLE的敏感性分别是38.26%、53.66%、28.18%、34.55%、30.9%.特异性分别是99.19%、99.83%、99.09%、96.45%、86.43%.抗核糖体P0蛋白抗体在本研究的110例患者中的阳性率为11.82%,抗dsDNA抗体在本研究的110例患者中的阳性率为17.27%,抗-sm抗体在本研究的110例患者中的阳性率为3.64%,抗核小体抗体在本研究的110例患者中的阳性率为4.55%,抗组蛋白抗体在本研究的110例患者中的阳性率为10.91%.结论 抗核糖体P0蛋白抗体、抗dsDNA抗体等自身抗体在自身免疫性疾病诊断中有良好的应用价值,在实际的操作过程中要注意选择多种类型的抗体进行组合,可以实现各种抗体之间的相互补充,有利于提高身免疫性疾病诊断的正确率.

Objective:Objective: To observe the therapeutic effect of interventional catheter thrombolysis combined with anticoagulation therapy and simple anticoagulant therapy for postpartum lower extremity deep venous thrombosis(DVT).Methods: 34 cases of postpartum with central type or mixed type lower extremity deep venous thrombosis were collected in our hospital from January 2006 to February 2016,divided into anticoagulation group and intervention treatment group,the anticoagulation group 23 cases,intervention treatment group 11 cases.The clinical therapeutic effect and the incidence of PTS with 6 to 14 months follow-up of the two groups were compared.Results: There was significance statistical between the two groups about the difference of thigh and calf circumference before and after treatment(P<0.05);After treatment,compared with anticoagulation group,there was significance statistical between thigh circumference and calf circumference in the intervention group(P<0.05).During the follow-up period,compared with the simple anticoagulation group,the Villalta score and the distribution of patients class number in the intervention group the difference were statistically significant(P<0.05).Conclusion: The therapeutic effects of interventional catheter thrombolysis combined with anticoagulant therapy is better than simple anticoagulant therapy in the treatment of postpartum deep vein thrombosis,Worthy of clinical promotion.

目的 分析产妇分娩前检测凝血四项、D-二聚体及血小板的临床意义.方法 260例产妇,根据是否伴有疾病分为正常妊娠组(120例)和妊娠伴其他疾病组(140例).两组产妇分娩前检测凝血四项[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原定量(FIB)]、D-二聚体(DD)及血小板计数(PLT),比较两组产妇的凝血四项、D-二聚体、血小板计数水平.结果 正常妊娠组产妇D-二聚体水平为(0.32±0.20)mg/L、纤维蛋白原定量水平为(4.00±1.80)g/L,均显著低于妊娠伴其他疾病组产妇的(0.48±0.21)mg/L、(4.80±1.90)g/L,差异具有统计学意义(P<0.05).正常妊娠组凝血酶原时间、活化部分凝血活酶时间明显长于妊娠伴其他疾病组产妇,差异具有统计学意义(P<0.05).两组产妇凝血酶时间比较差异无统计学意义(P>0.05).正常妊娠组产妇血小板计数为(155.6±47.6)×109/L,明显高于妊娠伴其他疾病组产妇的(142.7±45.8)×109/L,差异具有统计学意义(P<0.05).结论 产妇在产前进行凝血四项、D-二聚体、血小板计数指标检查,能够对产妇的凝血功能进行判定,对产妇产前出血及产后出血的诊治起到指导作用,对预防弥散性血管内凝血(DIC)及血栓栓塞性疾病具有重要的指导意义.

目的 探讨急性肺栓塞患者血清同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)和D-二聚体(DD)联合检测的临床意义.方法 选取急性肺栓塞患者50例(观察组),体检健康者48例(对照组).观察组于入院当天、对照组于体检时取静脉血检测血清Hcy、hs-CRP、DD水平,统计三者阳性率,分析血清Hcy、hs-CRP、DD水平与肺栓塞严重程度的关系.结果 观察组血清Hcy、hs-CRP、DD水平及阳性率均高于对照组(P均＜0.01).随肺栓塞严重程度增加,患者血清Hcy、hs-CRP和DD水平均逐渐升高(P均＜0.05).观察组血清Hcy、hs-CRP、DD水平均与肺栓塞严重程度呈正相关(r分别为0.73、0.69、0.76,P均＜0.05).联合检测血清Hcy、hs-CRP、DD水平诊断急性肺栓塞的AUC为0.885、敏感性为0.894、特异性为0.794,均高于三项单独检测.结论 急性肺栓塞患者血清Hcy、hs-CRP和DD水平均升高,且均与肺栓塞严重程度呈正相关,三者联合检测可提高急性肺栓塞早期诊断价值.

目的：探讨类风湿性关节炎（rheumatoid arthritis，RA）患者血清基质金属蛋白酶－3（MMP－3）的水平变化及意义。方法收集RA患者90例，其中活动期45例（活动期组），缓解期45例（缓解期组），另收集健康体检者45例为健康对照组。采用流式液相蛋白定量技术（ CBA）检测RA患者血清IL－17、IL－18、IL－6的水平，采用酶联免疫法（ ELISA）检测MMP－3的水平。结果活动期组、缓解期组MMP－3、IL－17、IL－18、IL－6的水平显著高于健康对照组（ P＜0．01）；活动期组MMP－3、IL－17、IL－18、IL－6的水平显著高于缓解期组（ P＜0．01）；活动期RA患者MMP－3与抗CCP抗体、RF、CRP、ESR、IL－17、IL－18、DAS58评分、关节压痛数、关节肿胀数呈正相关。结论 MMP－3与RA病理性炎症损伤及疾病的进展有关，MMP－3与IL－17、IL－18、IL－6联合检测可作为RA早期诊断及疗效判断的依据。