共查询到19条相似文献,搜索用时 46 毫秒
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摘要 目的:探讨超声弹性成像联合天冬氨酸氨基转移酶与血小板比率指数(APRI)、国际标准化比值/血小板比率(INPR)、基于4因子的肝纤维化指数(FIB-4)对自身免疫性肝炎(AIH)患者肝纤维化的诊断价值。方法:我院2021年1月-2022年12月收治的120例AIH患者均经肝脏组织穿刺活检并依据Metavir评估系统分为显著性肝纤维化组(F2-F4期,n=74)与非显著性肝纤维化组(F0-F1期,n=46),对比两组基线资料、超声弹性成像剪切波速度(SWV)、FIB-4、APRI、INPR。采用Logistic回归分析AIH患者发生显著性肝纤维化的影响因素。采用受试者工作特征(ROC)曲线评估SWV联合APRI、INPR、FIB-4对AIH患者显著性肝纤维化的诊断价值。结果:入组120例AIH患者穿刺活检结果显示:F0期15例(12.50%),F1期31例(25.83%);F2期35例(29.17%),F3期27例(22.50%),F4期12例(10.00%)。与非显著性肝纤维化组相比,显著性肝纤维化组患者INR、SWV、APRI、INPR、FIB-4值均升高,PLT水平降低,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,INPR、APRI、FIB-4及SWV升高是是AIH显著性肝纤维化的危险因素(P<0.05)。ROC结果显示,AIH患者APRI、INPR、FIB-4与SWV诊断肝纤维化程度的AUC均>0.700,且四项联合的诊断效能最高。结论:超声弹性成像参数SWV联合APRI、INPR及FIB-4对AIH患者显著性肝纤维化具有较高的诊断价值。 相似文献
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目的 通过对肝炎患者多种自身抗体检出率的比较,探讨其在自身免疫性肝炎中的临床诊断价值。方法 对75例自身免疫性肝炎(AIH)患者,64例非AIH肝炎患者和78例健康体检者进行自身抗体检测。采用免疫印迹法检测抗线粒体抗体-M2(AMA-M2)、抗肝肾微粒体-1抗体(LKM-1)、抗肝细胞胞质抗原-1抗体(LC-1)、抗可溶性肝抗原/肝‒胰抗原抗体(SLA/LP);采用间接免疫荧光法检测抗核抗体(ANA),并对各检测指标进行比对分析。结果 AIH组患者ANA、AMA-M2、LKM-1、LC-1、SLA/LP检测阳性率分别为100.0%、28.0%、9.3%、1.3%、10.7%均高于非AIH组患者的56.2%、3.1%、0.0%、0.0%、0.0%,且除LC-1外其余差异均具有统计学意义(P<0.05)。结论 联合检测ANA、AMA-M2、LKM-1、LC-1及SLA/LP对诊断自身免疫性肝炎具有重要的临床意义。 相似文献
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摘要 目的:探讨腺苷脱氨酶(ADA)在自身免疫性肝病患者血清中的变化及其临床意义。方法:利用酶法试剂盒检测自身免疫性肝病患者血清中的总ADA(tADA)及其同工酶ADA1和ADA2的活性变化,利用受试者工作曲线(ROC)分析总ADA、ADA1及ADA2活性的诊断价值。利用Spearman相关性分析自身免疫性肝病患者各指标之间的相关性。结果:与对照组相比,tADA和ADA2活性在自身免疫性肝病患者血清中均极显著升高(P<0.001),ADA1活性有一定程度升高(P=0.035)。不同自身免疫性肝病亚型患者之间的血清tADA、ADA1及ADA2活性均无显著差异。ROC分析显示,血清tADA和ADA2活性具有诊断价值,ADA1活性无诊断价值。tADA活性截断值取13.5 U/L时,诊断特异性为93.3%,敏感性为81.2%。血清ADA2活性截断值取9.5 U/L时,诊断特异性为85.0%,敏感性为83.3%。而ADA1无显著的诊断价值,ADA活性与白蛋白球蛋白比值呈显著负相关(r=-0.41,P=0.004),与球蛋白水平具有一定程度的正相关(r=0.34,P=0.018),与ALT呈弱正相关(r=0.29,P=0.042),与其他指标的相关性均无统计学显著性。结论:血清tADA及ADA2活性在自身免疫性肝病患者血清中显著升高,并且具有一定的诊断价值。 相似文献
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目的:探讨血清视黄醇结合蛋白4(retinol binding protein 4,RBP4)、中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin,NGAL)、Klotho蛋白在慢性肾脏病病情监测及预后评估中的价值。方法:收集我院2017年5月~2019年2月收治的297例慢性肾脏病患者为研究对象,依据肾小球滤过率(GFR)分为1期24例、2期46例、3期128例、4期66例、5期33例,并依据临床转归情况分为肾功能稳定组104例和肾功能恶化组193例;同期选择门诊健康体检者251例作为对照组。比较各组血清RBP4、NGAL、Klotho蛋白表达情况,并分析慢性肾脏病患者血清RBP4、NGAL、Klotho蛋白和GFR的相关性。结果:慢性肾脏病组血清RBP4、NGAL水平高于对照组,Klotho蛋白低于慢性肾脏病组(P0.05)。慢性肾脏病5期者血清RBP4、NGAL水平高于4期、3期、2期及1期者,Klotho蛋白低于4期、3期、2期及1期者,差异有统计学意义(P0.05)。慢性肾脏病患者血清RBP4、NGAL和GFR呈负相关,Klotho蛋白和GFR呈正相关(P0.05)。肾功能恶化组血清RBP4、NGAL水平高于肾功能稳定组,Klotho蛋白低于肾功能稳定组,差异有统计学意义(P0.05)。结论:血清RBP4、NGAL及Klotho蛋白表达水平的变化对了解慢性肾脏病患者病情程度及预后评估中有重要的参考价值,建议临床予以重视。 相似文献
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目的:研究红细胞体积分布宽度(RDW)对心力衰竭患者病情及预后转归的评估价值。方法:将我院心内科收治的110例心力衰竭患者(研究组)根据病情分为NYHAⅡ级30例、Ⅲ级46例、Ⅳ级34例,另选择同期健康体检者110例作为对照组。同时根据患者6个月内预后情况分为存活组(91例)和死亡组(19例)。比较分析各组患者RDW水平、死亡率,采用单因素和多因素logistic回归分析心力衰竭预后的影响因素。结果:研究组中,NYHAⅢ~Ⅳ级患者RDW水平明显高于对照组,且随着NYHA分级的增加,RDW水平明显升高(P0.05)。NYHAⅣ级患者死亡率明显高于NYHAⅡ、Ⅲ级患者(P0.05)。与死亡组比较,存活组年龄明显较小,入院时Hcy、CRP、GLU、RDW、NT-pro BNP明显降低,Hb、RBC、LVEF水平明显升高(P 0.05)。年龄、入院时NT-pro BNP和RDW是心力衰竭的独立危险因素,而LVEF水平是独立保护因素(P0.05)。结论:RDW可反映心力衰竭患者的病情严重程度,对于预后转归评估具有重要指导意义。 相似文献
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摘要 目的:探讨外周血红细胞分布宽度(RDW)、降钙素原(PCT)联合乳酸检测对新生儿败血症(NS)病情的评估价值。方法:选取2019年5月~2022年12月在本院收治的NS患儿132例为研究对象,根据新生儿危重症评分(NCIS)将NS组患儿分为非危重组(NCIS>90分,94例)和危重组(70≤NCIS≤90分,38例),比较两组外周血RDW、PCT、乳酸水平,采用受试者工作特征曲线(ROC)评价上述指标对危重NS的诊断价值,采用Spearman分析指标与病情严重的相关性。结果:危重组胎龄<37周占比高于非危重组,出生体重低于非危重组(P<0.05)。危重组患儿外周血RDW、PCT及乳酸水平均高于非危重组(P<0.05);ROC结果分析显示,外周血RDW、PCT、乳酸及其联合检测评估危重NS患儿的曲线下面积(AUC)分别为0.844、0.645、0.643、0.874(P均<0.05);Spearman显示,RDW、PCT、乳酸均与NS患儿病情严重程度呈正相关(P均<0.05)。结论:外周血RDW、PCT和乳酸均与NS患儿病情严重程度密切相关,临床可通过联合检测外周血RDW、PCT和乳酸水平来辅助评估NS患儿病情。 相似文献
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摘要 目的:探讨外周血血小板/淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)、纤维蛋白原(fibrinogen,Fib)水平对老年慢性阻塞性肺疾病急性加重(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)及病情程度的评估价值。方法:选取2020年1月至2022年12月期间我院呼吸与危重症医学科收治的老年AECOPD患者40例作为AECOPD组,根据病情程度将其分为Ⅰ级(n=9)、Ⅱ级(n=17)、Ⅲ级(n=14)。选取同期在我院门诊复诊的老年慢性阻塞性肺疾病稳定期(stable chronic obstructive pulmonary disease, SCOPD)患者40例作为SCOPD组。比较各组一般资料及PLR、Fib水平。采用logistic回归模型分析老年AECOPD的独立危险因素,通过受试者工作特征曲线(receiver operating characteristic curve, ROC)评估PLR、Fib对老年AECOPD的预测价值。结果:AECOPD组外周血PLR、Fib水平均高于SCOPD组(P<0.05);老年AECOPD不同临床分级患者PLR、Fib水平比较,差异有统计学意义(P<0.05),Ⅲ级最高,其次是Ⅱ级,Ⅰ级最低;Logistic回归分析显示,PLR、Fib的比值比分别为1.857、2.094,是老年AECOPD的独立危险因素(P<0.05);ROC曲线分析显示,PLR、Fib及二者联合预测老年AECOPD的曲线下面积分别为0.862、0.853、0.948,以二者联合预测价值最高(敏感度为87.50%,特异度为95.00%)。结论:外周血PLR、Fib水平与老年AECOPD患者病情程度相关,二者联合对老年AECOPD的诊断价值最高。 相似文献
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淋巴瘤通过放化疗可获得很高的治愈率。治疗过程中,疗效评估对于评价或调整治疗方案至关重要。基于病灶形态学改变的传统影像学技术如计算机断层扫描(computed tomography,CT)与磁共振成像(magnetic resonance imaging,MRI)技术在评估淋巴瘤疗效时存在一定的局限性;磁共振加权成像(diffusion-weighted imaging,DWI)结合水分子表观弥散系数(apparent diffusion coefficient,ADC)从分子水平反映疾病的病理生理状态,是一种功能成像新技术;而正电子发射断层显像/X线计算机体层成像(Positron emission tomography/computed tomography,PET/CT)将肿瘤的代谢与形态相结合,是一种新型的功能成像技术,已广泛应用于淋巴瘤患者的分期、疗效监测和预后评估中,可较其他影像学技术更准确的评估疗效;PET/MRI技术在淋巴瘤方面的临床应用研究目前尚处于初步阶段,其临床价值尚需进一步探讨。 相似文献
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目的:研究血小板/淋巴细胞比值(PLR)在老年2型糖尿病(T2DM)患者肾功能损害及病情评估中的应用价值。方法:测定506例T2DM患者及250例健康体检者(对照组)的血常规、血糖、血脂、肝肾功等生化指标,并收集尿液测定尿白蛋白/肌酐比值(ACR)。根据《糖尿病肾病防治专家共识(2014年版)》,将T2DM患者分为DN组(n=279)和非DN组(n=227),并根据ACR将DN组分为微量白蛋白尿组(n=165,30~300 mg/24 h)、大量白蛋白尿组(n=114,≥300 mg/24 h)。比较各组患者临床指标,分析PLR与老年T2DM患者并发DN的相关性。结果:与对照组比较,非DN组、DN组HbAlc、FPG、2h PG、Scr、BUN、PLT、PLR明显升高,LYM明显下降(P0.05);与非DN组比较,微量白蛋白尿组HbAlc、2h PG、Scr、UAER、eGFR明显升高,大量白蛋白尿组HbAlc、FPG、2h PG、Scr、BUN、UAER、eGFR、PLT、PLR明显升高,LYM明显下降(P0.05);与微量白蛋白尿组,大量白蛋白尿组FPG、Scr、BUN、UAER、eGFR、PLT、PLR明显升高,LYM明显下降(P0.05)。多因素logistics回归分析显示HbAlc、PLR是T2DM患者进展为DN的独立危险因素,而eGFR则是保护性因素(P0.05)。HbAlc、eGFR、PLR联合预测T2DM患者并发DN的敏感性、特异性分别为83.1%,特异度为81.9%,均显著高于三个指标单独评估的敏感性、特异性(P0.05)。结论:PLR是老年T2DM患者肾功能损害的独立危险因素,综合HbAlc、eGFR、PLR有助于老年T2DM患者并发DN及病情评估。 相似文献
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Two critical genes (HLA-DRB1 and ABCF1)in the HLA region are associated with the susceptibility to autoimmune pancreatitis 总被引:1,自引:0,他引:1
Ota M Katsuyama Y Hamano H Umemura T Kimura A Yoshizawa K Kiyosawa K Fukushima H Bahram S Inoko H Kawa S 《Immunogenetics》2007,59(1):45-52
We have previously reported that autoimmune pancreatitis (AIP) is a bioclinical entity characterized by high serum immunoglobulin G4 concentrations and association with the HLA-DRB1*0405-DQB1*0401 haplotype. However, the precise identity of gene(s) within this haplotype directly responsible for AIP pathogenesis is yet to be established. To dissect the genetic contribution of the incriminated haplotype, we have now performed an association analysis within the human leukocyte antigen (HLA) region using various types of polymorphic markers. Genomic DNAs from 43 AIP patients and 213 unrelated Japanese controls were used in this analysis. In each DNA sample, we established the genotype of 25 microsatellite markers distributed throughout the HLA region, that of single nucleotide polymorphism within the 5'-flanking regions of the TNFA and IkBLI (also known as NFKBIL1) as well as HLA class I and II genes. The HLA-linked susceptibility regions for AIP were localized to two segments: HLA-DRB1 (*0405; OR = 3.20, P = 0.00063, Pc = 0.0016) -DQB1 (*0401; OR = 3.29, P = 0.00046, Pc = 0.0069) in the HLA class II and C3-2-11 microsatellite (allele 219; OR = 2.96, P = 0.0076, Pc = 0.099) in the HLA class I regions. Upon stratification analysis in search for a synergistic effect given the extensive linkage disequilibrium within the major histocompatibility complex, it was established that each segment contributed to disease pathogenesis. The two critical HLA regions for susceptibility to AIP are limited to the HLA-DRB1*0405-DQB1*0401 in the class II and the ABCF1 proximal to C3-2-11, telomeric of HLA-E, in the class I regions. 相似文献
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目的:自身免疫性肝病的发病机理至今尚未明确,与多种疾病之间存在着联系,临床诊断具有一定的难度。本研究利用超声弹性成像技术定量分析自身免疫性肝病的病理特征,探讨该技术的诊断价值,为自身免疫性疾病的治疗提供诊断依据。方法:选取我院2011年3月-2013年6月收治的自身免疫性肝病患者182例,随机分为观察组和对照组。观察组98例患者采用弹性成像定量分析的方法进行诊断,对照组84例则采用常规病理学诊断。观察并比较两组患者的诊断准确率及诊断耗时。结果:观察组检出94例,诊断率为95.92%;对照组检出81例,诊断率为96.43%,两组诊断准确率比较无明显差异(P0.05)。观察组平均诊断耗时为5.6 h;对照组平均诊断耗时为11.6 h,观察组诊断时间比对照组短,差异具有统计学意义(P0.05)。结论:弹性成像定量分析对自身免疫性肝病的诊断准确率与病理活检诊断具有较好的一致性,且诊断耗时短、患者依从性好,值得在临床中进一步推广应用以辅助病理诊断,避免误诊或漏诊现象发生。 相似文献
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The purpose of regenerative medicine is to restore or enhance the normal function of human cells, tissues, and organs. From a clinical point of view, the use of stem cells is more advantageous than differentiated cells because they can be collected more easily and in larger quantities, their proliferation capacity is more pronounced, they are more resistant in cell culture, their aging is delayed, they are able to form a number of cell lines, and they are able to promote vascularization of tissue carriers. The therapeutic use of stem cells for disease modification, immunomodulation, or regenerative purposes are undoubtedly encouraging, but most studies are still in their early stages, and the clinical results reported are not clear with regard to therapeutic efficacy and potential side effects. Uniform regulation of the clinical application of stem cells is also indispensable for this highly customizable, minimally invasive, individualized therapeutic method to become a successful and safe treatment alternative in many different autoimmune and autoinflammatory disorders. 相似文献
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Autoimmune diseases (ADs) arise from an abnormal immune response of the body against substances and tissues normally present in the body. More than a hundred of ADs have been described in the literature so far. Although their etiology remains largely unclear, various types of ADs tend to share more associated genes with other types of ADs than with non-AD types. Here we present GAAD, a gene and AD association database. In GAAD, we collected 44,762 associations between 49 ADs and 4249 genes from public databases and MEDLINE documents. We manually verified the associations to ensure the quality and credibility. We reconstructed and recapitulated the relationships among ADs using their shared genes, which further validated the quality of our data. We also provided a list of significantly co-occurring gene pairs among ADs; with embedded tools, users can query gene co-occurrences and construct customized co-occurrence network with genes of interest. To make GAAD more straightforward to experimental biologists and medical scientists, we extracted additional information describing the associations through text mining, including the putative diagnostic value of the associations, type and position of gene polymorphisms, expression changes of implicated genes, as well as the phenotypical consequences, and grouped the associations accordingly. GAAD is freely available at http://gaad.medgenius.info. 相似文献
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目的:原发性胆汁性肝硬化(PBC)与自身免疫性肝炎(AIH)的临床表现存在相似性,因而不易鉴别及诊断。本研究对免疫球蛋白在PBC和AIH中的表达情况进行比较并分析其意义,为两种疾病的鉴别和诊断积累临床资料。方法:选取2011年10月-2012年10月在我院接受治疗的原发性胆汁性肝硬化患者20例作为PBC组,另选取20例同期入院治疗的自身免疫性肝炎患者作为AIH组。利用免疫组化法检测两组患者病变组织中免疫球蛋白IgM和IgG的表达水平,比较两组细胞的阳性表达率,并对阳性细胞含量进行评分。结果:PBC组:17例患者显示IgM阳性(85%),3例患者显示IgG阳性(15%),IgM与IgG比值1,IgM评分为3.2±0.8,IgG评分为1.5±0.6;AIH组:18例患者显示IgG阳性(90%),2例患者显示IgM阳性(10%),IgM与IgG比值1,IgM评分为1.2±0.7,IgG评分为2.4±0.9。PBC组的IgM评分明显高于AIH组,而AIH组的IgG评分则明显高于PBC组,差异具有统计学意义(P0.05)。结论:检测IgG和IgM的表达水平对原发性胆汁性肝硬化与自身免疫性肝炎的临床诊断具有较高的敏感性和特异性,可作为鉴别两种疾病的依据之一,值得进一步推广应用。 相似文献
17.
《Nucleosides, nucleotides & nucleic acids》2013,32(8-9):1147-1152
The aim of this presentation is to inform about Lesch Nyhan Disease from the point of view of the affected boys and their families living with the condition from day to day and also to show the importance of research in treating and managing the disease (In Caring for Children with Lesch Nyhan Disease—A Guide for Parents and Professionals; McCarthy, G.T., Ed.; PUMPA and Chailey Heritage Clinical Services: East Sussex, UK, 2002). 相似文献
18.
Marco Lenzi 《FEMS microbiology reviews》1994,14(3):247-252
Abstract: The identification of the hepatitis C virus (HCV) and the availability of serological tests for the identification of its infection has deeply changed our view of autoimmune hepatitis. In fact, we have learned that autoantibodies such as anti-nuclear, anti-smooth muscle and anti-liver kidney microsomes, cannot be considered specific any longer for the diagnosis, of autoimmune hepatitis, since they are frequently found in association with HCV. The new clinical entity characterized by the association of autoantibodies with signs of HCV infection is presently under evaluation. This, in order to understand what is the prevalent mechanism, viral or autoimmune, operating in these patients and to chose the best treatment regimen. 相似文献
19.
景观分类与评价的生态原则 总被引:178,自引:15,他引:178
在分析景观定义的基础上 ,概述了景观分类的生态学原则 ,提出了自然、经营和人工等不同景观类型的特性和研究重点 ,并对景观的独特性、多样性、功效性、宜人性及美学价值的评价进行了探讨 .文章还介绍了景观保护的概念和实践 相似文献