目的观察低危及中高危特发性膜性肾病(IMN)患者外周血淋巴细胞亚群间的差异并分析其与24 h尿蛋白定量(24 hUPro)和血清白蛋白(Alb)之间的相关性及接受不同疗法后的变化。方法将150例经临床和肾脏病理确诊为IMN的患者,按随机数字表法分...目的观察低危及中高危特发性膜性肾病(IMN)患者外周血淋巴细胞亚群间的差异并分析其与24 h尿蛋白定量(24 hUPro)和血清白蛋白(Alb)之间的相关性及接受不同疗法后的变化。方法将150例经临床和肾脏病理确诊为IMN的患者,按随机数字表法分为对照组、观察1组和观察2组,每组50例,每组患者再按照其入组时24 h UPro和Alb基线水平分为低危组(60/150)和中高危组(90/150)2亚组。所有患者均给予常规对症治疗,对照组患者采用改良Ponticelli方案,观察1组患者在对照组治疗基础上同时应用中药肾俞穴敷熨的方法,观察2组患者在对照组治疗基础上同时应用中药俞募配穴敷熨的方法。流式细胞仪测外周血淋巴细胞亚群中CD3+/CD45+、CD3+CD8+/CD45+、CD3+CD4+/CD45+、CD3-CD19+/CD45+、Treg/CD4+及CD4+/CD8+,比较2亚组间上述指标治疗前差异及与24 h UPro和Alb的相关性,及不同疗法对其影响。结果 (1)治疗前中高危组IMN患者较低危组24 h UPro、CD3+CD4+/CD45+、CD3-CD19+/CD45+和CD4+/CD8+明显升高(P<0.05),Alb、CD3+CD8+/CD45+和Treg/CD4+明显下降(P<0.05)。且中高危组IMN患者24 h UPro与CD3+/CD45+、CD3+CD8+/CD45+及Treg/CD4+间均呈负相关(P<0.05),与CD3-CD19+/CD45+及CD4+/CD8+间均呈正相关(P<0.05);而Alb与CD3-CD19+/CD45+及CD4+/CD8+间均呈负相关(P<0.05),与CD3+/CD45+、CD3+CD8+/CD45+及Treg/CD4+间均呈正相关(P<0.05)。(2)2亚组治疗后在24hUPro、CD3+CD4+/CD45+、CD3-CD19+/CD45+和CD4+/CD8+下降及Alb、CD3+CD8+/CD45+和Treg/CD4+提升方面,观察2组效果最优(P>0.05)。结论 (1)中高危组IMN患者较低危组存在明显的淋巴细胞亚群紊乱,且中高危IMN患者淋巴细胞亚群除CD3+CD4+/CD45+外余者均与24 h UPro及Alb之间存在明显的相关性,监测外周血淋巴细胞亚群变化可能有助于指导评估中高危IMN患者治疗;(2)中药俞募配穴敷熨联合改良Ponticelli方案对淋巴细胞亚群紊乱改善疗效最优。展开更多
A total of 36 surface soil profiles were set at the wetlands in Qilihai Ancient Lagoon Wetlands,Tianjin,the surface soils of 0-20 cm depth were sampled at various use types of lands to provide information on the conce...A total of 36 surface soil profiles were set at the wetlands in Qilihai Ancient Lagoon Wetlands,Tianjin,the surface soils of 0-20 cm depth were sampled at various use types of lands to provide information on the concentrations of heavy metals in the coastal wetlands.Total concentrations of arsenic(As),cadmium(Cd),copper(Cu),lead(Pb),chromium(Cr)and zinc(Zn)were determined using inductively coupled plasma atomic absorption spectrometry(ICP-AES)to address the pollution levels in the sampling sites.The results showed that the concentrations of Cd,Cu in the soils disturbed by human activities intensively,the Phragmites australis marshes,the farmland,the brushes decreased in turn;among the sites,the concentrations of As,Cd and Cu were the highest in the soil of build-up areas,while the concentrations of Pb and Zn were the higher in the soil of farmland.The mean concentrations of Cu,Cr,Cd,Pb,Zn and As in the soils of 0-20 cm depth were 38.74 mg/kg,83.52 mg/kg,0.19 mg/kg,34.27 mg/kg,121.7 mg/kg and 18.77 mg/kg,respectively.The contamination indices of As were on the high pollution level in the soils of farmland and disturbed by human activities intensively;the concentrations of Cd in the soils of the marshes and farmland were at the moderate pollution level,while that in the soil disturbed by human activities intensively was at high pollution level.The values of comprehensive contamination index demonstrated that the variation of As contents was the maximum in the soils,Cd pollution reached to a high level.Geoaccumulation index showed that As pollution was at moderate level,and Cd,Cu and Zn pollution were at slight level,and the Pb and Cr pollution wasn't found in the build-up areas.展开更多
文摘目的观察低危及中高危特发性膜性肾病(IMN)患者外周血淋巴细胞亚群间的差异并分析其与24 h尿蛋白定量(24 hUPro)和血清白蛋白(Alb)之间的相关性及接受不同疗法后的变化。方法将150例经临床和肾脏病理确诊为IMN的患者,按随机数字表法分为对照组、观察1组和观察2组,每组50例,每组患者再按照其入组时24 h UPro和Alb基线水平分为低危组(60/150)和中高危组(90/150)2亚组。所有患者均给予常规对症治疗,对照组患者采用改良Ponticelli方案,观察1组患者在对照组治疗基础上同时应用中药肾俞穴敷熨的方法,观察2组患者在对照组治疗基础上同时应用中药俞募配穴敷熨的方法。流式细胞仪测外周血淋巴细胞亚群中CD3+/CD45+、CD3+CD8+/CD45+、CD3+CD4+/CD45+、CD3-CD19+/CD45+、Treg/CD4+及CD4+/CD8+,比较2亚组间上述指标治疗前差异及与24 h UPro和Alb的相关性,及不同疗法对其影响。结果 (1)治疗前中高危组IMN患者较低危组24 h UPro、CD3+CD4+/CD45+、CD3-CD19+/CD45+和CD4+/CD8+明显升高(P<0.05),Alb、CD3+CD8+/CD45+和Treg/CD4+明显下降(P<0.05)。且中高危组IMN患者24 h UPro与CD3+/CD45+、CD3+CD8+/CD45+及Treg/CD4+间均呈负相关(P<0.05),与CD3-CD19+/CD45+及CD4+/CD8+间均呈正相关(P<0.05);而Alb与CD3-CD19+/CD45+及CD4+/CD8+间均呈负相关(P<0.05),与CD3+/CD45+、CD3+CD8+/CD45+及Treg/CD4+间均呈正相关(P<0.05)。(2)2亚组治疗后在24hUPro、CD3+CD4+/CD45+、CD3-CD19+/CD45+和CD4+/CD8+下降及Alb、CD3+CD8+/CD45+和Treg/CD4+提升方面,观察2组效果最优(P>0.05)。结论 (1)中高危组IMN患者较低危组存在明显的淋巴细胞亚群紊乱,且中高危IMN患者淋巴细胞亚群除CD3+CD4+/CD45+外余者均与24 h UPro及Alb之间存在明显的相关性,监测外周血淋巴细胞亚群变化可能有助于指导评估中高危IMN患者治疗;(2)中药俞募配穴敷熨联合改良Ponticelli方案对淋巴细胞亚群紊乱改善疗效最优。
基金Under the auspices of the National Natural Science Foundation of China(4136101841101084)
文摘A total of 36 surface soil profiles were set at the wetlands in Qilihai Ancient Lagoon Wetlands,Tianjin,the surface soils of 0-20 cm depth were sampled at various use types of lands to provide information on the concentrations of heavy metals in the coastal wetlands.Total concentrations of arsenic(As),cadmium(Cd),copper(Cu),lead(Pb),chromium(Cr)and zinc(Zn)were determined using inductively coupled plasma atomic absorption spectrometry(ICP-AES)to address the pollution levels in the sampling sites.The results showed that the concentrations of Cd,Cu in the soils disturbed by human activities intensively,the Phragmites australis marshes,the farmland,the brushes decreased in turn;among the sites,the concentrations of As,Cd and Cu were the highest in the soil of build-up areas,while the concentrations of Pb and Zn were the higher in the soil of farmland.The mean concentrations of Cu,Cr,Cd,Pb,Zn and As in the soils of 0-20 cm depth were 38.74 mg/kg,83.52 mg/kg,0.19 mg/kg,34.27 mg/kg,121.7 mg/kg and 18.77 mg/kg,respectively.The contamination indices of As were on the high pollution level in the soils of farmland and disturbed by human activities intensively;the concentrations of Cd in the soils of the marshes and farmland were at the moderate pollution level,while that in the soil disturbed by human activities intensively was at high pollution level.The values of comprehensive contamination index demonstrated that the variation of As contents was the maximum in the soils,Cd pollution reached to a high level.Geoaccumulation index showed that As pollution was at moderate level,and Cd,Cu and Zn pollution were at slight level,and the Pb and Cr pollution wasn't found in the build-up areas.
