女性甲状腺癌的病理与预后分析

目的:探讨女性甲状腺癌的病理特点以及预后影响因素。方法:收集2005年1月至2009年8月,齐齐哈尔和平医院收治的女性甲状腺癌患者148例,回顾分析其临床病理特点以及预后影响因素。结果:病理检查显示131例(88.5%)甲状腺乳头状癌(PTC),6例(4.1%)为滤泡状癌(FTC),3例(2.0%)为髓样癌(MTC),6例(4.1%)为未分化癌(ATC);病理分期Ⅰ-Ⅱ期占45.3%,Ⅲ-Ⅳ期占54.7%;27例(18.24%)为周围组织侵犯,9例(6.1%)为远处转移,10例(6.76%)对侧甲状腺转移,56例(37.84%)颈部淋巴结转移;1年、3年、5年生存率依次为97.3%、93.2%、83.8%;年龄、病理床分期、病理类型、淋巴结转移、远处转移以及周围组织侵犯均是影响临床预后的重要因素(P0.05)。结论:女性甲状腺癌存在病理分期晚、病理分型差、淋巴结转移、远处转移及局部侵犯率高等不良预后因素,早期影像学检查对临床治疗具有指导意义。     

Interaction of Copper with Iron, Iodine, and Thyroid Hormone Status in Goitrous Patients

In many developing countries, men and women are at high risk of goiter and iron deficiency. The aim of the recent study is to assess the interaction of (Cu), with iron (Fe), iodine/iodide (I), and thyroid hormones in goitrous patients. Sixty goitrous male (GMPs) and 72 female patients (GFPs) were evaluated for the Cu, Fe, I, and thyroid hormones status in biological samples (serum and urine), and compared to non-goitrous subjects of both genders (M?=?106, F?=?120). The biological samples were analyzed for Cu and Fe concentration using atomic absorption spectrometer, while I was measured by the potentiometric method, prior to microwave-assisted acid digestion (MD). Quality control for the method was established with certified samples. Significantly higher mean values of Cu in serum, and urine samples of GMPs and GFPs, while lower value of Fe and I were observed as compared to control subjects (p?<?0.015), respectively. The mean values of free triiodothyronine (FT3) and free thyroxin (FT4) were found to be lower in goitrous patients of both genders than in the age-matched healthy controls (p?<?0.006 and 0.002), respectively, in contrast high mean values of thyroid-stimulating hormone (TSH) were detected in patients (p?<?0.009), as compared to non-goitrous subjects. It was observed that the deficiencies of Fe, I, and thyroid hormone in goitrous patients could be influenced by efficiency of Cu.     

Mechanism of Dimercaptosuccinic Acid Coated Superparamagnetic Iron Oxide Nanoparticles with Human Serum Albumin

To research the mechanism of dimercaptosuccinic acid coated‐superparamagnetic iron oxide nanoparticles (SPION) with human serum albumin (HSA), the methods of spectroscopy, molecular modeling calculation, and calorimetry were used in this paper. The inner filter effect of the fluorescence intensity was corrected to obtain the accurate results. Ultraviolet–visible absorption and circular dichroism spectra reflect that SPION changed the secondary structure with a loss of α‐helix and loosened the protein skeleton of HSA; the activity of the protein was also affected by the increasing exposure of SPION. Fluorescence lifetime measurement indicates that the quenching mechanism type of this system was static quenching. The isothermal titration calorimetry measurement and molecular docking calculations prove that the predominant force of this system was the combination of Van der Waals’ force and hydrogen bonds.     

Association of Iodine and Iron with Thyroid Function

Iodine and iron are essential elements for healthy thyroid function. However, little is known about the association of iron and iodine with thyroid function in the general US population. We investigated iron and iodine status in relation to concentrations of thyroid hormones. We included 7672 participants aged 20 and older from three surveys (2007–2008, 2009–2010, and 2011–2012) of the National Health and Nutrition Examination Survey. Serum thyroid measures (including free and total T3 and T4, and TSH), serum iron concentration, and urinary iodine concentrations were measured. Multivariate linear regression models were conducted with serum thyroid measures as dependent variables and combinations of serum iron concentration and urinary iodine concentration as predictors with covariate adjustment. Logistic regression models were performed with TSH levels (low, normal, and high) and combinations of serum iron concentration and urinary iodine concentration. Overall, 10.9% of the study population had low iron; 32.2 and 18.8% had low or high iodine levels, respectively. Compared with normal levels of iron and iodine, normal iron and high iodine were associated with reduced free T3 and increased risk of abnormal high TSH. Combined low iron and low iodine was associated with reduced free T3 and increased TSH. In addition, high iodine was associated with increased risk of abnormal high TSH in females but not in males. Thyroid function may be disrupted by low levels of iron or abnormal iodine, and relationships are complex and sex-specific. Large prospective studies are needed to understand the mechanisms by which iron interacts with iodine on thyroid function.     

Transferrin and Iron Uptake by the Brain: Effects of Altered Iron Status

Transferrin (Tf) and iron uptake by the brain were measured in rats using 59Fe-125I-Tf and 131I-albumin (to correct for the plasma content of 59Fe and 125I-Tf in the organs). The rats were aged from 15 to 63 days and were fed (a) a low-iron diet (iron-deficient) or, as control, the same diet supplemented with iron, or (b) a chow diet with added carbonyl iron (iron overload), the chow diet alone acting as its control. Iron deficiency was associated with a significant decrease and iron overload with a significant increase in brain nonheme iron concentration relative to the controls. In each dietary treatment group, the uptake of Tf and iron by the brain decreased as the rats aged from 15 to 63 days. Both Tf and iron uptake were significantly greater in the iron-deficient rats than in their controls and lower in the iron-loaded rats than in the corresponding controls. Overall, iron deficiency produced about a doubling and iron overload a halving of the uptake values compared with the controls. In contrast to that in the brain, iron uptake by the femurs did not decrease with age and there was relatively little difference between the different dietary groups. 125I-Tf uptake by the brains of the iron-deficient rats increased very rapidly after injection of the labelled proteins, within 15 min reaching a plateau level which was maintained for at least 6 h. The uptake of 59Fe, however, increased rapidly for 1 h and then more slowly, and in terms of percentage of injected dose reached much higher values than did 125I-Tf uptake.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effects of Vitamin C Supplementation on Performance,Iron Status and Immune Function of Weaned Piglets

Two experiments were conducted to evaluate the effects of vitamin C supplementation on performance, iron status and immune function of pigs during the 21-day post-weaning period. In experiment one, 48 crossbred pigs (Chester White ‐ Large White ‐ Yorkshire), weaned at 30 days of age and weighing 7.7 ± 0.9kg, were allotted to diets containing either 0 or 300 mg/kg vitamin C. In experiment two, 96 crossbred pigs (Chester White ‐ Large White ‐ Yorkshire), weaned at 20 ± 2 days and weighing 7.1 ± 0.5kg, were allotted to diets containing 0,75 or 300 mg/kg vitamin C. Six replicate pens were assigned to each treatment in experiment one while experiment two had eight replicates. All pens housed two barrows and two gilts. In both experiments, no improvement (P > 0.05) in growth rate, feed intake or feed conversion was observed as a result of vitamin C supplementation. Plasma iron concentration increased (P < 0.10) with increased vitamin C in the diet while free and total iron binding capacity were unaffected by treatment. There were no differences in the intradermal response to the mitogen phytohemaggutinin used as an indicator of cellular immunity (P > 0.05). In trial 2, the plasma levels of the immunoglobulin IgG showed a linear (P = 0.07) increase with increasing levels of vitamin C and the same trend was noted in trial 1. Antibody titers to bovine serum albumin also tended to increase in both trials but the increases were not statistically significant. In conclusion, the overall results of these experiments indicate that weanling pig performance is not improved as a result of vitamin C supplementation. Whether or not vitamin C plays a role in stimulating humoral immune function in pigs requires further study since the results of our experiments do not completely rule out the possibility that such a role exists.     

血清TgAb水平在分化型甲状腺癌术后转移复发中的预测价值

目的:探讨完全切除甲状腺组织后血清甲状腺球蛋白(TG)阴性时,血清抗甲状腺球蛋白抗体(Tg Ab)对分化型甲状腺癌(DTC)术后复发/转移的预测价值。方法:选择2013年4月-2015年4月我院收治的57例完全切除甲状腺组织,TG阴性且Tg Ab阳性的DTC患者临床病历资料,并将其分为复发/转移组(20例)和无复发/转移组(37例)。采用放射免疫分析法测定并比较两组患者的血清TG、Tg Ab水平,分析Tg Ab对DTC复发/转移诊断的灵敏度、特异度、阳性预测值以及阴性预测值,采用Logistic回归分析DTC复发/转移的独立危险因素。结果:复发/转移组的血清Tg Ab水平为72~3850 IU/m L,高于无复发/转移组的18~3638 IU/m L,差异有统计学意义(P0.05)。其中Tg Ab对DTC复发/转移诊断的灵敏度为85.71%,特异度为83.33%,阳性预测值为75.00%,阴性预测值为90.91%。经Logistic回归分析发现,Tg Ab水平为100≤Tg Ab204 IU/m L、204≤Tg Ab≤1000IU/m L、1000 IU/m L是DTC复发/转移的独立危险因素(OR=1.267,2.853,6.791,P0.05)。结论:Tg Ab可作为评估完全切除甲状腺组织、TG阴性且Tg Ab阳性的DTC患者复发/转移的重要指标,其值越高,复发/转移发生的可能性越大。     

硝苯地平与硫酸镁治疗妊娠高血压综合征的临床疗效及对患者血清肌 酐、HSP70 及尿微量白蛋白水平的影响

目的:探讨硝苯地平联合硫酸镁对妊娠高血压综合征患者血清肌酐、HSP70及尿微量白蛋白水平的影响。方法:选取近5年在我院接受治疗的妊娠高血压综合征患者60例,随机分为实验组和对照组,每组30例。对照组患者采用硫酸镁治疗,实验组患者采取硝苯地平联合硫酸镁治疗。观察并比较治疗前后两组患者血清肌酐(Scr)、血尿素氮(BUN)、血尿酸(UA)热休克蛋白70(HSP70)及24 h尿微量白蛋白水平以及收缩压及舒张压的变化。结果:与治疗前相比,两组患者Scr、BUN、UA、HSP70及24 h尿微量白蛋白水平和收缩压及舒张压均显著降低(P0.05);与对照组相比,实验组患者上述指标均明显降低(P0.05)。结论:硝苯地平联合硫酸镁能够降低妊娠高血压综合征患者血压,保护患者肾功能。     

生血宁片联合琥珀酸亚铁片治疗妊娠期缺铁性贫血患者的疗效及对铁代谢的影响

目的:探讨生血宁片联合琥珀酸亚铁片治疗妊娠期缺铁性贫血患者的疗效及对铁代谢的影响。方法:选取2015年2月-2017年2月我院收治的妊娠期缺铁性贫血患者200例为研究对象。将其以随机数字表法分成对照组(n=100)和研究组(n=100)。对照组予以口服琥珀酸亚铁片治疗,研究组则予以生血宁片联合琥珀酸亚铁片治疗,两组均连续治疗4周。分别比较两组临床疗效、治疗前后血液学指标、治疗前后铁代谢指标以及不良妊娠结局情况。结果:研究组治疗总有效率明显较对照组升高(P0.05)。治疗后两组患者血红蛋白(Hb)、红细胞(RBC)、平均红细胞体积(MCV)以及平均红细胞血红蛋白浓度(MCHC)水平均明显高于治疗前,且研究组高于对照组(P0.05)。治疗后两组患者血清铁、转铁蛋白饱和度(TSAT)水平均明显高于治疗前,且研究组又明显高于对照组(P0.05)。与对照组比较,研究组不良妊娠结局发生率降低(P0.05)。结论:生血宁片联合琥珀酸亚铁片治疗妊娠期缺铁性贫血患者的临床疗效显著,改善患者血液学指标以及铁代谢水平,降低不良妊娠结局发生风险,值得临床推广应用。     

食盐加碘后甲状腺摄 ~（131）I率的变化及其与尿碘的关系

目的：了解食盐加碘后健康人及甲亢患者甲状腺摄131I率的变化及其与24小时尿碘含量的相关性,探讨甲状腺摄131I率与碘营养状况的关系。方法：对比食盐加碘前后健康体检者及甲亢患者甲状腺摄131I率的变化,分析健康体检者甲状腺摄131I率、晨尿碘浓度及经肌酐校正的尿碘含量与24小时尿碘含量的相关关系。结果：健康人及甲亢患者食盐加碘后3、6及24小时甲状腺摄131I率均显著降低;健康体检者甲状腺摄131I率与24小时尿碘含量呈负相关（r=-0.7651,P〈0.001）,晨尿碘浓度与24小时尿碘含量呈正相关（r=0.8231,P〈0.001）,经肌酐校正的尿碘含量与24小时尿碘含量呈正相关（r=0.9054,P〈0.001）。结论：食盐加碘对甲状腺摄131I率有显著影响,应重新确立甲状腺摄131I率的正常范围及甲亢的诊断标准;经肌酐校正的尿碘含量较晨尿碘浓度能更准确地反映碘营养状况;甲状腺摄131I率可作为评估个体碘营养状况的指标,可以稳定地反映近期的碘营养状况。     

食盐加碘后甲状腺摄131I 率的变化及其与尿碘的关系

目的：了解食盐加碘后健康人及甲亢患者甲状腺摄131I 率的变化及其与24 小时尿碘含量的相关性,探讨甲状腺摄131I 率与 碘营养状况的关系。方法：对比食盐加碘前后健康体检者及甲亢患者甲状腺摄131I 率的变化,分析健康体检者甲状腺摄131I 率、晨 尿碘浓度及经肌酐校正的尿碘含量与24小时尿碘含量的相关关系。结果：健康人及甲亢患者食盐加碘后3、6 及24 小时甲状腺 摄131I 率均显著降低;健康体检者甲状腺摄131I 率与24 小时尿碘含量呈负相关（r=－0.7651, P<0.001）,晨尿碘浓度与24 小时尿碘 含量呈正相关（r=0.8231, P<0.001）,经肌酐校正的尿碘含量与24 小时尿碘含量呈正相关（r=0.9054, P<0.001）。结论：食盐加碘对甲 状腺摄131I 率有显著影响,应重新确立甲状腺摄131I 率的正常范围及甲亢的诊断标准;经肌酐校正的尿碘含量较晨尿碘浓度能更 准确地反映碘营养状况;甲状腺摄131I率可作为评估个体碘营养状况的指标,可以稳定地反映近期的碘营养状况。     

血清Cys C、RBP和尿mALB检测对肾小球滤过功能及肾功能损伤诊断分析

目的:探讨血清胱抑素C(Cys-C)、视黄醇结合蛋白(retinol binding protein,RBP)及尿尿微量白蛋白(m Alb)检测对肾小球肾炎的滤过功能及肾功能损伤的诊断价值。方法:以我院2017年12月至2018年12月收治的42例肾小球肾炎患者作为观察组、39例健康体检合格者为对照组,比较两组血清Cys-C、RBP及m Alb水平,观察组不同预后者肾功能指标水平,观察组不同预后者血清Cys C、RBP及尿m ALB水平,两组血清Cys C、RBP及尿m ALB检出率。结果:观察组血清Cys C、RBP及尿m ALB水平均显著高于对照组[(2.73±0.72)mg/L vs(0.85±0.21)mg/L,(104.72±21.36)mg/L vs(37.69±8.91)mg/L,(39.51±4.02)mg/L vs(7.08±1.26)mg/L](P0.05);10例CRF/CKD和病情缓解或无进展24h尿蛋白水平无显著差异(P0.05),血肌酐、尿素氮显著高于病情缓解或无进展组[(105.76±12.37)μmol/L vs(92.09±11.01)μmol/L,(17.02±2.73)μmol/L vs(7.15±1.06)μmol/L](P0.05);CRF者血清Cys C、RBP及尿m ALB水平均显著高于病情缓解或无进展者[(3.91±0.56)mg/L vs (2.08±0.35)mg/L,(182.36±31.23)mg/L vs(47.08±9.35)mg/L,(258.68±70.27)mg/L vs (16.03±3.24)mg/L](P0.05);血清Cys C、RBP及尿m ALB阳性检出率分别为83.33%、76.19%、73.80%,联合检测率为92.85%,联合检出率显著高于单项指标检出率(P0.05)。结论:血清Cys C、视黄醇结合蛋白及尿m ALB三者联合检测有效率较高,可用作评估肾小球肾炎患者的滤过功能及肾功能损伤,观察患者预后。     

血清尿酸水平与老年轻度高血压患者的内皮功能相关性分析

目的:探讨血清尿酸水平与老年轻度高血压患者的内皮功能相关性。方法:选取我院2020年1月到2020年12月共收治的200例老年轻度高血压患者作为研究对象,所有患者均为未使用过降压药物治疗,将其分为轻度高血压组。另选取同期收治的200例高血压常规药物治疗患者作为重度高血压组与200名健康者作为对照组,对比三组患者血清尿酸水平与血管内皮功能。对观察组所有患者依照血清尿酸水平进行分组,将血清尿酸水平208-360μmol/L的患者分为低尿酸组,共计136例,将血清尿酸水平≥360μmol/L的患者分为高尿酸组,共计64例。对比两组患者的一般临床指标、血管内皮功能与氧化应激指标,并分析血清尿酸水平与老年轻度高血压患者的内皮功能相关性。结果:重度、轻度高血压组与对照组患者NO、ET-1、SUA水平对比差异显著,具有统计学意义(P<0.05);高尿酸组与低尿酸组患者TG、TC、DBP、SBP水平对比无明显差异(P>0.05),高尿酸组患者Cr水平高于低尿酸组,组间对比,差异具有统计学意义(P<0.05);高尿酸组与低尿酸组患者T-AOC、GSH-Px、LHP、MDA、NO、ET-1水平对比差异显著,高尿酸组患者LHP、MDA和ET-1水平明显高于低尿酸组,高尿酸组患者T-AOC、GSH-Px、NO水平明显低于低尿酸组,组间对比,差异具有统计学意义(P>0.05);Spearman相关分析结果显示:TG、TC、Cr、DBP、SBP与血尿酸水平无明显相关性(P>0.05),T-AOC、GSH-Px、NO与血清尿酸水平呈负相关(P<0.05),LHP、MDA、ET-1与血清尿酸水平呈正相关(P<0.05)。结论:血清尿酸水平与老年轻度高血压患者的内皮功能具有明显相关性,而且证明血尿酸水平的升高可能由患者氧化应激导致,因此氧化应激水平也是引起血管内皮功能障碍的一种潜在机制,希望本研究结果能够为高血压患者的疾病控制提供参考意见。     

乌司他丁可降低重症肺炎患者的血清炎性因子水平并改善肺功能

为探讨乌司他丁对重症肺炎血清炎性指标、肺功能的影响,为临床应用提供有利的支持,本研究选取2015年1月至2017年6月期间在我院治疗的重症肺炎患者150例作为本次研究的对象,其中接受常规治疗联合乌司他丁治疗的患者83例(乌司他丁组),只接受常规治疗的患者67例(对照组)。比较两组患者治疗前后血清抗炎介质及促炎介质水平,并比较治疗前后的肺功能相关指标、肺表面活性蛋白水平,分析乌司他丁对重症肺炎血清炎性指标、肺功能改善情况。结果表明,治疗前两组患者的血清抗炎及促炎介质指标,差异无统计学意义(p>0.05),而治疗7 d后,乌司他丁组均明显低于对照组,且乌司他丁组肺功能相关指标明显优于对照组,肺表面活性蛋白水平明显低于对照组,差异具有统计学意义(p<0.05);本研究表明,乌司他丁可降低重症肺炎患者的血清炎性因子水平,改善肺功能,具有一定的临床推广价值。     

Effects of exposure to high temperatures on serum,urine and sweat concentrations of iron and copper

The objective of this research was to determine the acute effect of a maximum test until exhaustion in normothermia and hyperthermia, and after repeated exposure to heat at high temperatures on the homeostasis of Fe and Cu.The sample was composed of twenty-nine male university students. The participants were divided into a control group (CG) and an experimental group (EG). All of them underwent an incremental test until exhaustion in normothermia and hyperthermia before and after the repeated exposure of EG to heat at high temperatures, consisting of 9 heat acclimatisation sessions in the sauna. Samples of urine and blood were taken before and after each test. Additionally, sweat samples were collected in the hyperthermia test. The samples were frozen at −80 °C for further analysis by ICP-MS.None of the metal concentrations in serum were affected by hyperthermia or exposure to heat. Urinary Fe increased in CG in the hyperthermia test before Heat exposure at High Temperature (HEHT)(p < 0.05) and in both groups after HEHT (p < 0.05). In EG there was an increase in the urinary excretion of Cu after HEHT (p < 0.01) in both trials. Fe suffered a decrease in sweat in EG after exposure to heat (p < 0.05).The concentrations of Fe and Cu in serum were not affected by acute exercise and exposure to high temperatures. However, there was a decrease in excretion of Fe in sweat due to HEHT, and an increase in urinary excretion in both. Therefore, we think that in conditions of high temperatures for long periods of time, attention should be paid to the body levels of these metals.     

胆固醇对绝经前、后正常女性骨密度影响的初步探讨

目的:观察血清胆固醇对绝经前、后女性骨密度的影响.方法:用常规酶法测定血清总胆固醇(CHOL);用双能X线吸收法(DEXA)骨密度仪测定腰椎前后位正位总体(Ll-4)、左侧髋部总体、股骨大转子区、股骨颈和Ward's三角区骨密度(BMD).结果:胆固醇与绝经前女性Ll-4和Ward's区骨密度呈负相关,与绝经后女性BMD无关,校正年龄和BMI后CHOL与绝经前、后女性BMD均无关.结论:胆固醇对绝经前后女性骨密度可能无影响.     

Evaluation of Oxidative Stress, Antioxidant Status and Serum Vitamin C Levels in Cancer Patients

Taking into account the importance role of lipid peroxidation and antioxidants in the prevention and incidence of cancer, the present study was carried out to determine oxidative stress, serum total antioxidant (TAS), and vitamin C levels in cancer patients. Malondialdehyde(MDA), total antioxidant status, and vitamin C levels of 57cancer patients aged 19–80 years and 22 healthy subjects (control group) aged 22–76 years were evaluated. Serum concentrations of MDA as thiobarbitaric acid complexes were measured by fluorometry method, the serum TAS by using commercial test kits from Randox Laboratories, and vitamin C by using spectrocolorimetric method. The mean serum MDA concentrations of all cancer groups except lung cancer were significantly higher than control group (P < 0.004). The mean total antioxidant status was insignificantly higher than control group. The mean serum vitamin C level was significantly lower in patients as compared to the healthy subjects (PV < 0.0001). In conclusion, an alteration in the lipid peroxidation with concomitant changes in antioxidant defense system in cancer patients may be due to excessive oxidative stress. Serum low levels of vitamin C in the different type of cancer patients in spite of adequate daily intake may be due to increased utilization to scavenge lipid peroxides as well as their sequestration by tumor cells.     

小儿幽门螺旋杆菌感染与缺铁性贫血的相关性分析

目的:分析并探讨小儿幽门螺杆菌感染与缺铁性贫血的相关性。方法:选择2012年2月至2013年2月本院门诊患儿412例,行血常规、血清铁、血清铁蛋白、HP-IgG抗体检测。结果:HP感染患儿IDA26例,IDA患病率为20.4%(26/127),HP未感染患儿IDA19例,IDA患病率为6.7%(19/285)。两者比较差异有统计学意义(x2=17.21,P=0.00)。对比两组患儿MCV、MCH、MCHC指标,差异具有显著性(P均0.05)。45例IDA患儿中26例有HP感染,感染率为57.8%(26/45),367例非IDA患儿中有101例HP感染,感染率为27.5%(101/367)。两者比较差异有统计学意义(x2=17.21,P=0.00)。结论:HP感染同IDA发病有显著相关性,HP感染可以是导致IDA的原因。     

血清胆红素水平与缺血性卒中的相关性研究

目的：脑卒中是威胁人类健康三大疾病之一,是我国成人致残的首要原因,其中80％是缺血性卒中。本文意在研究血清胆红素水平与缺血性卒中严重程度、发病机理以及颈动脉粥样硬化斑块的关系,以进一步为防治缺血性卒中的发生、发展提供新的途径。方法：选择缺血性脑卒中患者（观察组）150例和同期健康体检者（对照组）150例,分别测定两组的血清总胆红素水平（TBIL）、间接胆红素（DBIL）、直接胆红素（IBIL）,并对病例组进行TOAST分型、NIHSS评分及颈部血管超声检查。比较两组间血清胆红素,及观察组内不同分型组间血清胆红素的差异。结果：缺血性卒中患者TBIL、DBIL水平显著高于正常对照组,差异具有统计学意义（P〈0．05）。缺血性卒中患者按TOAST分型各亚型间血清TBIL、DBIL、IBIL水平差异无统计学意义（P〉0．05）。中重型脑梗死组与轻型脑梗死组比较,血清TBIL、DBIL、IBIL浓度均明显升高,差别具有统计学意义（P〈0．05）。缺血性卒中患者中有动脉粥样硬化斑块形成组血清TBIL、DBIL水平低于颈部动脉内膜光滑、完整者组,差别有统计学意义（P〉0．05）。结论：缺血性卒中患者血清胆红素升高,参与急性应激反应,可能作为衡量缺血性卒中严重程度的指标之一;高水平血清胆红素可能预防颈动脉粥样硬化斑块的形成,从而预防缺血性卒中的发生。