目的 了解铅中毒时患儿血液多项元素发生的改变.方法 选取龙岗区人民医院89例确诊为铅中毒的儿童作为血铅异常组,另外选取89例同期该院门诊体检的血铅水平正常儿童作为正常对照组.分别检测2组研究对象的全血微量元素6项(铅、锰、铜、锌、铁、镁)和血清钙水平.结果 血铅异常组患儿铁水平低于正常对照组,锰水平高于正常对照组,差异有统计学意义(P＜0.05).相关性分析显示,血液铅与铁呈负相关关系,差异有统计学意义(r=-0.229,P=0.031).锰与铁、锌与铁、铁与镁呈正相关关系,差异有统计学意义(r=0.506,0.272,0.257;P=0.000,0.010,0.016).结论 铅中毒时,血液铁水平降低而锰水平升高.

目的 检测不同程度铅中毒患儿和对照组患儿铁代谢指标(铁和铁蛋白)水平,分析当铅中毒时,血铅水平是否会引起铁代谢的异常改变.方法 参考1991年美国疾病预防控制中心制定的儿童铅中毒指南将铅中毒儿童分为3组:铅中毒轻度组(100μg/L≤血铅<200μg/L)、铅中毒中度组(200μg/L≤血铅<450μg/L)、铅中毒重度以上组(血铅≥450μg/L).并以同期门诊铅中毒筛查中血铅水平正常的25例儿童作为对照组(血铅<100μg/L).分别检测每组儿童血中铅、铁及铁蛋白水平,并对各组结果进行统计分析比较.结果 血中铁和铁蛋白水平随铅水平升高而呈降低趋势(P<0.001).相关回归分析结果显示,铅与铁和铁蛋白均呈负相关(r=-0.582、-0.569,P<0.001).结论 铅中毒会引起血中铁和铁蛋白水平降低而导致铁代谢异常.

Objective To explore the diagnostic value of urine retinol binding protein (RBP) ,beta‐N‐acetyl amino glycosidase enzymes(NAG) combined with serum cystatin C (CysC) detection in early kidney damage of type 2 diabetes mellitus (T2DM ) . Methods Totally 58 cases of T2DM complicating in our hospital were selected as the group A ,54 cases of simple T2DM (group B) and 52 individuals undergoing the physical examination(group C) .The urine RBP ,NAG and serum CysC were detected in three groups ,their differences were compared .The positive rates for detecting early diabetic renal damage were compared between the single index detection and combined detection .Results The levels of urine RBP ,NAG and serum CysC level in the group A were significantly higher than those in the group B and C ,the differences were statistically significant (P< 0 .05);the levels of urine RBP ,NAG and serum CysC level in the group B were significantly higher than those in the group C ,the differences were statistical‐ly significant(P<0 .05);The positive rates of single detection of RBP ,NAG and CysC were 87 .93% ,86 .21% and 84 .48% respec‐tively ,the positive rate of 3‐index combined detection was 94 .83% ,which was significantly higher than that of single index detec‐tion ,the difference was statistically significant (P<0 .05) .Conclusion Urine RBP ,NAG and serum CysC are the sensitive indexes in early diabetic renal damage .The 3‐index combined detection has better comprehensive sensitivity and possesses higher clinical ap‐plication value .

Objective To investigate the correlation between serum level of tumor antigen(CEA),neuron specific CYFRA21-1(NSE),and the pathological stage of non small cell lung cancer(NSCLC).Methods 86 patients with NSCLC were studied by clinical,pathological and imaging examination.The serum levels of NSE,CYFRA21-1 and CEA were detected by chemiluminescence immunoassay,and the correlation between them was analyzed.Results serum tumor markers CEA,CYSRA21-1 levels were increased gradually with the increase of NSCLC in patients with T and N,and the difference was statistically significant(P <0.05).And the level of NSE was significantly different between T1 and T3(P <0.05),and the difference was not statistically significant(P > 0.05).By analysis,NSCLC,N,T and CEA were positively correlated with the level of and CYSRA21-1(r=0.56,0.71,P <0.05).Conclusion the preopera-tive serum CEA and CYSRA21-1 levels in patients with NSCLC can be used to determine the pathological staging, which has a high clinical application and wide spread value.

目的：分析原发性胆汁性肝硬化（PBC ）合并自身免疫性疾病患者免疫指标及补体水平变化，探讨其与病情评估及诊断的临床意义。方法收集PBC患者85例作为研究对象，根据是否合并其他免疫自身疾病分为PBC组46例，PBC合并自身免疫疾病组39例。其中PBC合并干燥综合征（SS）8例、甲状腺炎22例、系统性红斑狼疮3例、类风湿关节炎（RA ）6例。并随机抽取健康对照组50例，检测三组免疫指标、补体水平并进行比较，并对PBC合并自身免疫疾病组免疫指标及补体水平与肝功能指标（TBIL）及凝血酶原活动度（PTA）进行相关性分析。结果 PBC组、PBC合并自身免疫疾病组及对照组在免疫球蛋白G（IgG）、免疫球蛋白M（IgM）、免疫球蛋白A（IgA）、CD4＋、CD8＋、自然杀伤细胞（NK）、C3、C4方面比较差异均有统计学意义（P＜0．05），其中PBC合并自身免疫疾病组的IgG、IgM、IgA、CD4＋水平最高，CD8＋、NK、C3、C4水平均为最低。三组CD4＋／CD8＋水平比较，差异无统计学意义（P＞0．05）。对 PBC合并自身免疫疾病组免疫指标及补体水平与 TBIL及 PTA 进行相关性分析，发现IgG、IgM均与TBIL呈正相关（P＜0．05），C3、C4均与TBIL呈负相关（P＜0．05）。IgG、IgM、IgA、CD4＋均与PTA呈负相关（P＜0．05），CD8＋、NK、C3、C4均与PTA呈正相关（P＜0．05）。结论原发性胆汁性肝硬化合并自身免疫疾病患者的免疫指标（IgM、IgG、IgA、CD4＋、CD8＋、NK）和补体（C3、C4）水平在其病程中的变化体现了重要的相关性，联合检测免疫指标、补体，以及其与TBIL及PTA相关分析对于其病情评估和诊断有重要的临床意义。