Application of neutrophil-lymphocyte ratio and red blood cell distribution width in diabetes mellitus complicated with heart failure

BACKGROUND Accumulating clinical evidence has shown that diabetes mellitus(DM)is a serious risk factor for cardiovascular disorders and an important factor for adverse cardiovascular events.AIM To explore the value of the combined determination of the neutrophil-lymphocyte ratio(NLR)and red blood cell distribution width(RDW)in the early diagnosis and prognosis evaluation of DM complicated with heart failure(HF).METHODS We retrospectively analyzed clinical data on 65 patients with type 2 DM(T2DM)complicated with HF(research group,Res)and 60 concurrent patients with uncomplicated T2DM(control group,Con)diagnosed at Zhejiang Provincial People’s Hospital between January 2019 and December 2021.The NLR and RDW values were determined and comparatively analyzed,and their levels in T2DM+HF patients with different cardiac function grades were recorded.The receiver operating characteristic(ROC)curves were plotted to determine the NLR and RDW values(alone and in combination)for the early diagnosis of HF.The correlation between NLR and RDW with the presence or absence of cardiac events was also investigated.RESULTS Higher NLR and RDW levels were identified in the Res vs the Con groups(P<0.05).The NLR and RDW increased gradually and synchronously with the deterioration of cardiac function in the Res group,with marked differences in their levels among patients with grade II,III,and IV HF(P<0.05).ROC curve analysis revealed that NLR combined with RDW detection had an area under the curve of 0.915,a sensitivity of 76.9%,and a specificity of 100%for the early diagnosis of HF.Furthermore,HF patients with cardiac events showed higher NLR and RDW values compared with HF patients without cardiac events.CONCLUSION NLR and RDW were useful laboratory indicators for the early diagnosis of DM complicated with HF,and their joint detection was beneficial for improving diagnostic efficiency.Additionally,NLR and RDW values were directly proportional to patient outcomes.

Influence of magnetic iron oxide nanoparticles on red blood cells and Caco-2 cells

The interactions of two types of cells (red blood cells, Caco-2 cells) with magnetic iron oxide nanoparticles (non-grafted, citrate-grafted, dendrimer-grafted) of 11 nm in size have been investigated. We focused on two important physiological parameters of the cells, the intracellular pH and the intracellular Ca2+ content. The results show that the nanoparticles do not have a significant influence on the pH and Ca2+ content of Caco-2 cells. The Ca2+ content of red blood cells is also not affected but the intracellular pH is slightly reduced.

Hyperhomocysteinemia and Increased Oxidative Stress Levels Are Associated with Impaired Membrane Fluidity of Red Blood Cells in Hypertensive and Normotensive Men: An Electron Spin Resonance Investigation

Hyperhomocysteinemia and oxidative stress may be strongly linked to hypertension, atherosclerosis and other cardiovascular diseases. The present study was performed to investigate possible relationships among plasma total homocysteine, plasma 8-iso-prostaglandin F2α (8-isoPG F2α: an index of oxidative stress), and membrane fluidity (a reciprocal value of membrane microviscosity) in hypertension. We measured the membrane fluidity of red blood cells (RBCs) in hypertensive and normotensive men using an electron spin resonance (ESR) and spin-labeling method. Membrane fluidity of RBCs was significantly decreased in hypertensive men compared with normotensive men. Plasma total homocysteine levels were significantly higher in hypertensive men than in normotensive men, and correlated with plasma 8-isoPG F2α. In contrast, plasma nitric oxide (NO)-metabolites (an index of endothelial function) were lower in hypertensive men than in normotensive men. The reduced membrane fluidity of RBCs was associated with increased total homocysteine and plasma 8-isoPG F2α levels and decreased plasma NO-metabolite levels. Multivariate regression analysis showed that, after adjusting for general risk factors, plasma total homocysteine and 8-isoPG F2α were significant determinants of membrane fluidity of RBCs, respectively. These results suggest that hyperhomocysteinemia and oxidative stress with endothelial dysfunction might have a close correlation with impaired rheologic behavior of RBCs and circulatory disorders in hypertensive men.

Improving Oxygen Binding of Desiccated Human Red Blood Cells

Desiccating human red blood cells (RBCs) to increase their storage life has been the subject of intense research for a number of years. However, drying RBCs invariably compromises their integrity and has detrimental effects on hemoglobin function due to autoxidation. We have previously demonstrated an RBC desiccation and rehydration process that preserves RBC antigenic epitopes better than frozen RBCs. This study expands on those observations by examining what effects this desiccation process has on RBC hemoglobin function with respect to oxygen binding properties. In this paper, we examined RBCs from normal donors which were desiccated to 25% moisture content and stored dry for 2 weeks at room temperature prior to rehydration with plasma followed by structural and functional studies. Our data showed that approximately 98% of the RBCs were intact upon rehydration based on hemolysis assays. Oxygen dissociation curves for the desiccated/rehydrated RBCs showed a left shift compared to fresh RBCs (pO2 = 17 mmHg vs. 26 mmHg, respectively). The desiccated/rehydrated RBCs also showed an increase in methemoglobin compared to fresh RBCs (4.5% vs 0.9%, respectively). 2,3-Diphosphoglycerate concentration of the desiccated/rehydrated RBCs was reduced by 20%. In conclusion, although this RBC dehydration process preserves RBC integrity and hemoglobin oxygen binding properties better than most other dehydration techniques described so far, further optimization and long-term studies are needed to make this procedure acceptable for human transfusion.

新冠肺炎疫情对国内25家地级市中心血站全血制备成分血的供应影响分析

目的分析2017—2022年国内25家地市级中心血站全血制备的成分血供应情况是否受到新冠肺炎疫情的影响。方法采用回顾性研究方法,收集2017—2022年国内25家中心血站红细胞成分血、冰冻血浆、冷沉淀凝血因子、病原体灭活冰冻血浆、调剂红细胞成分血和冰冻血浆的发放数据,根据新冠疫情发生时间(2019年底),将发放数据分为两组,2017年、2018年、2019年为非新冠疫情组(简称非疫情组),2020年、2021年、2022年为新冠疫情组(简称疫情组)。结果2017—2022年,红细胞成分血发放量呈波动增长,2022年>2021年>2019年>2020年>2018年>2017年,2020年较2019年下降19724.12 U,呈负增长(–1.43%),与中心血站显著相关(P<0.05);冰冻血浆发放量呈逐年递增,2022年>2021年>2020年>2019年>2018年>2017年,与中心血站显著相关(P<0.05);冷沉淀凝血因子发放量基本呈逐年递增,2021年>2022年>2020年>2019年>2018年>2017年,2022年较2021年下降6303.72 U,呈负增长(–1.54%),与中心血站显著相关(P<0.05)。2020—2022年,病原体灭活冰冻血浆发放量呈波动增长;年度同比增长率2021年呈负增长,2022年呈正增长;调剂红细胞成分血发放量呈逐年递减,年度同比增长率呈负增长;调剂冰冻血浆发放量呈逐年递减,年度同比增长率呈负增长。结论国内25家中心血站全血制备成分血的供应情况地区差异大,受新冠疫情的影响程度亦不同,总体上对2020年的供应能力影响最显著,血液调剂是新冠疫情期间保证血液供应的措施之一。

丙酮酸钠对2型糖尿病大鼠体外贮存红细胞形态结构和功能的影响

目的:观察加有丙酮酸钠的红细胞保存液对2型糖尿病(T2DM)大鼠体外贮存红细胞(RBC)形态结构和功能的影响。方法:雄性SPF级SD大鼠30只,随机分为3组(n=10):非T2DM常规RBC保存液(A组)、T2DM常规RBC保存液(B组)、T2DM丙酮酸钠RBC保存液(C组)。尾静脉取血滤白细胞后,分别于贮存0 d(T0)、7 d(T1)、14 d(T2)、21 d(T3)、28 d(T4)观测各组RBC的形态结构,检测RBC中二磷酸甘油酸(2,3-DPG)、活性氧(ROS)、丙二醛(MDA)及乳酸(LA)的含量,对体外贮存14 d的RBC进行PKH26标记,于静脉回输后1h、4 h、10 h、16 h测定RBC在体内的存活率。结果:T0时A组RBC形态完好,明显优于B组和C组;随贮存时间延长,各组RBC形态逐渐变成棘球形,B组和C组RBC棘形发生率明显高于A组,C组棘形发生率低于B组(P<0.05);与A组比较,不同时点B组和C组2,3-DPG含量下降,ROS、MDA增加(P<0.05),其中C组2,3-DPG含量高于B组、ROS和MDA含量低于B组(P<0.05);各时点B组LA含量均高于A组和C组(P<0.05),在T2-T4时C组LA含量低于A组(P<0.05);RBC标记回输后,A组RBC存活率明显高于B、C组,B组RBC存活率显著低于C组(P<0.05)。结论:添加丙酮酸钠的改良RBC保存液对2型糖尿病大鼠体外贮存RBC具有一定保护作用,其机制可能与抗氧化作用有关。

Expression of B Locus Beta 2 (<i>BLB2</i>) Gene at Cytolytic and Latent Immune Response Stages of Immunocompetence in Nigerian Indigenous Chickens

An economically-important trait in poultry for which gene identification continues to be a challenge is immune response. The objective of the study was to quantitate the expression of major histocompatibility complex (MHC) class II BLB2 gene at cytolytic and latent immune response stages in Nigerian indigenous chickens. A total of 108 Nigerian indigenous chickens (NIC) were sourced across the South-western states in Nigeria. The birds were inoculated with sheep red blood cells (SRBC), after which blood samples were obtained (5 days post-inoculation) and antibody haemagglutination test was carried out to place the birds into groups of high and low antibody titre levels. The categorisation of the birds resulted in six groups of normal feather high, normal feather low, naked neck high, naked neck low, frizzle feather high and frizzle feather low antibody groups. A total of 48 chicks were selected from the progeny for gene expression studies. Surgical excision of thymus and spleen was carried out for the detection of cytolytic and latent responses of the birds. β-actin was used as the endogenous control and the critical threshold method (2–ΔΔCт) was carried out for the determination of fold change. The fold change of spleen tissue expression at cytolytic immune response of the birds was 30,362.44 compared to latent response 294.07;and the fold change of thymus expression at cytolytic immune response of the birds was 51.98 compared to latent response 5.24. At both cytolytic and latent stages of immune response to SRBC antigen, BLB2 expression in the spleen was comparatively higher than in the thymus and the height of transcriptional activity was associated with the cytolytic stage. The birds of high titre at both the cytolytic and the latent responses had higher mRNA expression. This study concluded that BLB2 gene expression in the Nigerian indigenous chicken was induced at the cytolytic stage and repressed at the latent stage. During avian infections, the category of high immune response birds would perform better than the low immune response counterpart;and the protective response that BLB2 gene offers will be repressed from one time point to the other.

红细胞内peroxiredoxin-2抗氧化作用研究进展

红细胞没有细胞核,是特殊的体细胞,在机体运输氧气和二氧化碳中起重要作用。红细胞携氧导致红细胞不断暴露于内源性和外源性活性氧族(ROS)所引起的氧化损伤中。由于红细胞没有细胞器,不能合成新蛋白以替代损伤的蛋白质,因此红细胞建立了强大的抗氧化及损伤修复系统来及时清除ROS并保护细胞免受过氧化损伤。硫氧还蛋白过氧化物酶(Prx2)是红细胞内含量最丰富的抗氧化蛋白,能清除红细胞内内源性低浓度的过氧化氢(H2O2),在红细胞抗氧化损伤中起非常重要的作用。

红细胞分布宽度、C反应蛋白与白蛋白比值、尿白蛋白与肌酐比值联合检测在2型糖尿病并发症预测中的应用

目的 探讨红细胞分布宽度(RDW)、C反应蛋白与白蛋白比值(CAR)、尿白蛋白与肌酐比值(UACR)联合检测在2型糖尿病(T2DM)并发症预测中的应用价值。方法 选取T2DM并发症患者与T2DM无并发症患者各104例作为研究对象,分别纳入观察组与对照组。收集2组病历资料,比较2组一般资料、RDW、CAR、UACR水平差异,并通过受试者工作特征(ROC)曲线分析RDW、CAR、UACR单用与3者联合应用对T2DM并发症的预测效能。结果 与对照组比较,观察组的餐后2 h血糖(2 hPG)、糖化血红蛋白(HbAlc)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、RDW、CAR、UACR水平更高,高密度脂蛋白胆固醇(HDL-C)水平更低,差异有统计学意义(P<0.05)。相关性分析结果显示,RDW与2 hPG、HbAlc、TC、LDL-C均呈正相关,与HDL-C呈负相关;CAR与2 hPG、HbAlc、TC、LDL-C均呈正相关,与HDL-C呈负相关;UACR与2 hPG、HbAlc、TC、LDL-C均呈正相关,与HDL-C呈负相关。Logistic回归分析显示,RDW、CAR、UACR均是T2DM患者并发糖尿病视网膜病变(DR)、糖尿病肾脏疾病(DKD)、糖尿病周围神经病变(DPN)、冠心病(CAD)的影响因素(P<0.05)。ROC曲线分析显示,RDW、CAR、UACR单独检测及3项联合应用预测T2DM并发症的AUC分别为0.753、0.858、0.885、0.915。与RDW、CAR、UACR单独检测比较,3项联合应用对T2DM并发症的预测效能更高(Z=3.221、2.605、2.334,P<0.05)。结论 RDW、CAR、UACR水平升高与T2DM患者并发症的发生密切相关,RDW、CAR、UACR单独应用对T2DM并发症均有一定预测价值,但3项联合应用对T2DM并发症的预测效能更高。

重症胰腺炎CT影像与病情进展及血清淀粉酶、红细胞分布宽度、脂质运载蛋白2的关系

目的探究重症胰腺炎CT影像与病情进展及血清淀粉酶(AMS)、红细胞分布宽度(RDW)、脂质运载蛋白2(LCN2)的关系。方法回顾性收集2019年3月~2022年12月的105例重症胰腺炎患者临床资料,根据患者临床预后结果分为预后良好组(n=77)和预后不良组(n=28),比较两组患者CT影像结果[胰周外炎症CT评分(EPIC)、改良CT严重指数(MCTSI)]及血清AMS、RDW、LCN2水平,利用ROC曲线分析各指标对重症胰腺炎预后的评估价值。结果预后不良组器官功能衰竭数多于预后良好组(P=0.039),APACHEⅡ评分水平高于预后良好组(P=0.001);预后不良组EPIC、MCTSI评分高于预后良好组(P<0.001),血清AMS、RDW、LCN2水平均高于预后良好组(P<0.001);相关性分析显示,EPIC、MCTSI评分与血清AMS、RDW、LCN2水平呈正相关关系(r=0.591、0.668、0.684,0.573、0.637、0.652,P<0.001);EPIC、MCTSI评分评估重症胰腺炎预后的曲线下面积为0.791、0.762,敏感度为82.14%、67.86%,特异性为64.94%、72.73%;血清AMS、RDW、LCN2评估重症胰腺炎预后的曲线下面积为0.758、0.754、0.851,敏感度为64.29%、78.57%、78,57%,特异性为76N.62%、66.23%、80.52%;血清AMS、RDW、LC2联合评估重症胰腺炎预后的曲线下面积为0.925,敏感度为92.86%,特异性为79.22%。结论重症胰腺炎患者较高的EPIC、MCTSI评分以及血清AMS、RDW、LCN2水平与预后不良有关,上述CT评分与血清学指标水平呈正相关关系,且均可用于评估患者病情进展后的不良结局,血清学指标联合评估效能最高。

P2X7 receptor activation causes phosphatidylserine exposure in canine erythrocytes

AIM To determine if activation of the ATP-gated P2X7 receptor channel induces phosphatidylserine(PS) exposure in erythrocytes from multiple dog breeds.METHODS Peripheral blood was collected from 25 dogs representing 13 pedigrees and seven crossbreeds. ATP-induced PS exposure on canine erythrocytes in vitro was assessed using a flow cytometric Annexin V binding assay.RESULTS ATP induced PS exposure in erythrocytes from all dogs studied. ATP caused PS exposure in a concentrationdependent manner with an EC50 value of 395 μmol/L. The non-P2X7 agonists, ADP or AMP, did not cause PS exposure. The P2X7 antagonist, AZ10606120, but not the P2X1 antagonist, NF449, blocked ATP-induced PS exposure.CONCLUSION The results indicate that ATP induces PS exposure in erythrocytes from various dog breeds and that this process is mediated by P2X7 activation.

不同配方保存液对2型糖尿病患者贮存式自体红细胞保护作用的对比研究

目的本研究旨在探讨不同配方保存液对体外贮存期红细胞损伤的影响,以提供2型糖尿病(T2DM)患者红细胞适宜贮存条件。方法收集2021年6月—2022年1月择期手术的糖尿病患者和非糖尿病患者各20例。糖尿病患者红细胞分别储存于不同配方保存液中(保存液a、保存液b和保存液c)以筛选出适宜保存液(DO-o),观测非糖尿病患者常规保存液组(NC组)、糖尿病患者常规保存液组(DO-c组)和糖尿病患者新型保存液组(DO-o组)中,红细胞的形态结构和功能代谢的变化。结果在T0(红细胞分离后即刻)、T1(贮存7天)、T2(贮存14天)、T3(贮存21天)和T4(贮存28天)时,各组内红细胞计数、血红蛋白(Hemoglobin,Hb)、Na^(+)和pH值逐渐降低(P<0.05),K^(+)浓度逐渐增高(P<0.05)。保存液b中红细胞计数明显多于a和c组(P<0.05),T2、T3和T4时,保存液a和b组Hb量高于c组(P<0.05);T3和T4时,保存液b组中Na^(+)浓度高于另外两组(P<0.05);T2、T3和T4时,保存液a组和c组中K^(+)浓度高于b组(P<0.05)。在各个时间点,溶血率、游离血红蛋白(FHb)、乳酸(LA)、乳酸脱氢酶(LDH)在各组内和组间差异具有统计学意义(P<0.05)。在各时间点,DO-o组溶血率、FHb、LA和LDH低于DO-c组(P<0.05);各组内ATP逐渐降低,差异有统计学意义(P<0.05),T1、T2和T4时,DO-o组ATP高于DO-c组(P<0.05)。结论新型保存液可以显著改善T2DM患者红细胞贮存损伤。

择期心脏手术患者术中回收自体血液红细胞2,3-二磷酸甘油酸和游离血红蛋白水平的变化研究

目的探讨心脏择期手术中自体血液回收对回收红细胞2,3-二磷酸甘油酸(2,3-DPG)和游离血红蛋白(FHb)浓度的影响。方法选择15名择期心脏手术的患者,使用自体血液回收机在术中收集并洗涤回收的血液。测定和比较回收洗涤红细胞、患者自体静脉血红细胞和贮存2周的库存红细胞的2,3-DPG水平、f Hb的浓度及溶血率;进一步测定和比较回收洗涤红细胞贮存在4 h(21-24℃)和24 h(1-6°C)上述指标的变化。2,3-DPG水平测定采用化学比色法,FHb浓度使用分光光度仪检测。结果 15名患者术中均没有输注异体红细胞。患者静脉血、回收洗涤红细胞在0 h、4 h、24 h和库血保存2周的2,3-DPG值(μmol/g Hb)分别为12.73±6.52、17.94±6.91、15.17±11.61、15.38±5.85和2.62±3.13,其中回收洗涤红细胞0 h 2,3-DPG含量明显高于静脉血(P<0.01)和库血(P<0.01),和4 h、24 h的2,3-DPG值相比均无明显变化(P<0.05)。患者静脉血、回收洗涤红细胞在0 h、4 h、24 h和库血保存2周溶血率(%)分别为0.07±0.05、0.51±0.27、1.11±0.42、1.75±0.69和0.07±0.05,其中回收洗涤红细胞0 h溶血率明显高于静脉血(P<0.01)和库血(P<0.01),明显低于回收洗涤红细胞4 h溶血率(P<0.01)和24 h溶血率(P<0.01)。结论在心脏手术中回收的患者自体血液中的红细胞被轻度破坏,但供氧能力较好。

ACP215型血液处理仪制备冰冻红细胞的方法学评价

目的应用ACP 215型血液处理仪制备甘油化红细胞、去甘油化红细胞,观察去甘油化红细胞的质控指标,并对操作方法和制备效果进行评价。方法随机取10袋红细胞悬液(2U/袋),于采血后10天应用215型血液仪处理制备甘油化红细胞,-70℃冰箱保存30天,37℃融化,再应用215型血液处理仪制备去甘油化红细胞。解冻红细胞洗涤前后留取样本检测冰冻红细胞质量。结果红细胞回收率(84±4)%,游离血红蛋白浓度(0.31±0.12)g/L,体外溶血试验(33±15)%,甘油残余量(6.3±2.4)g/L。细菌培养试验阴性。结论ACP 215型血液处理仪可全程自动化无菌制备冰冻红细胞,人为操作误差小,产品质量保证,值得推广。

ICU患者血液成分输注的临床观察

目的了解ICU患者血液成分输注情况、输血量、输注疗效及合理性。方法回顾性调查本院2012年ICU收治的共计600名患者的临床资料、输血情况和实验室检查,根据是否输血分为输血组和非输血组,按疾病诊断分为13组,对血液成分的使用情况、输血指征及疗效做统计学分析。结果 1)ICU患者输血率43.83%(263/600),其中52.47%(138/263)的患者输注≥3种血液成分;以消化系统急重症、癌症和多发伤患者输血最多,占输血患者的50.95%(134/263)。2)ICU患者中35%(210/600)、21.33%(128/600)、32.67%(196/600)和20.67%(124/600)分别输注了红细胞、血小板、血浆和冷沉淀。3)ICU输红细胞患者中49.5%(104名)患者输注了全科18%的红细胞(298.5 U),人均输注量(2.82±1.0)U;26.2%(56名)患者输注了60.8%红细胞(1 010 U),人均输注量(18.36±7.67)U,以消化系统急重症、癌症、多发伤为主,共116名,占输红细胞患者的55.24%。4)95%输红细胞患者输血前Hb区间估计为[63.36,75.28],输血后Hb区间估计为[71.22,85.44](P<0.05)。96.9%(124/128)输血小板患者输血前Plt<75×109/L,30%(58/196)输血浆或冷沉淀患者凝血功能指标PT、APTT或FIB值低于正常范围。结论 4成以上的ICU患者输注了血液成分,以多种血液成分联合输注为主;大部分患者输注了少量的红细胞,少部分患者输注了大量的红细胞,红细胞用量占据前3位的疾病为消化系统急重症、癌症和多发伤。ICU患者临床输血中红细胞和血小板输注合理,血浆和冷沉淀输注合理性有待提高。

红细胞分布宽度预测2型糖尿病患者支架内再狭窄

目的探讨红细胞分布宽度(RDW)对皮冠状动脉介入治疗(PCI)的2型糖尿病患者植入药物洗脱支架后发生支架内再狭窄(ISR)的预测价值。方法回顾性分析因不稳定型心绞痛入院、行PCI治疗植入药物洗脱支架的582例2型糖尿病患者的临床资料,其中292例在支架植入术后进行了冠状动脉造影随访,平均随访8个月。根据冠状动脉造影检查结果,将患者分为支架内再狭窄组(n=45)和非再狭窄组(n=247)。详细记录患者病史资料(年龄、性别、吸烟、既往病史)、实验室检查结果(RDW、C反应蛋白水平等),以及心脏彩超、冠状动脉造影等结果。结果 ISR组体质指数和吸烟史均比非ISR组高(P<0.05)。ISR组RDW、C反应蛋白水平在入院和随访时均比非ISR组高。与非ISR组相比,ISR组的支架长度更长、直径更小。单因素分析显示,RDW与ISR呈正相关(P<0.01)。多元回归分析显示,体质指数、吸烟、RDW、C反应蛋白、支架长度、支架直径是药物洗脱支架ISR的预测因子(P<0.01)。结论糖尿病患者在具备同样的危险因素情况下,RDW对植入药物洗脱支架的不稳定型心绞痛患者发生ISR有预测作用,慢性炎症参与了ISR的形成过程。

中晚期NSCLC患者血清D-D、RDW和β_(2)-MG水平变化及其对预后的预测价值分析

目的研究中晚期非小细胞肺癌(NSCLC)预后情况并分析其与患者血清D-二聚体(D-D)、红细胞分布宽度(RDW)、β_(2)微球蛋白(β_(2)-MG)水平的关系。方法回顾性分析2016年6月至2019年1月我院75例中晚期NSCLC患者临床资料,根据预后分为死亡组39例和存活组36例,比较两组血清D-D、RDW、β_(2)-MG水平差异,分析其对中晚期NSCLC患者预后的预测价值。结果75例中晚期NSCLC患者随访期间死亡39例(52.00%),中位总体生存(OS)时间、无进展生存(DFS)时间分别为18.0(95%CI:14.9~21.1)、12.0(95%CI:10.1~13.9)个月;化疗前死亡组血清D-D、RDW、β_(2)-MG水平明显高于存活组(P<0.05),化疗后两组比较无明显差异(P>0.05);D-D、RDW、β_(2)-MG与OS时间和DFS时间呈明显负相关性(P<0.05),且单纯化疗者D-D、RDW、β_(2)-MG与OS时间和DFS时间均呈明显负相关性(P<0.05);D-D、RDW和β_(2)-MG为影响晚期NSCLC患者预后的独立因子(P<0.05);预测中晚期NSCLC患者死亡的AUC分别为0.638、0.709、0.865(P<0.05)。结论中晚期NSCLC患者预后较差且与血清D-D、RDW、β_(2)-MG水平紧密相关,检测D-D、RDW、β_(2)-MG可为评估患者预后提供参考依据。

高血糖对非胰岛素依赖型糖尿病患者红细胞（Ca^（2＋）－Mg^（2＋））－ATP酶的影响

为了解高血糖对非胰岛素依赖型糖尿病（ＮＩＤＤＭ）患者红细胞膜（Ｃａ２＋－Ｍｇ２＋）－Ａｒｐ酶的影响，采用改良的Ｈａｎａｈａｎ和Ｌｕｔｈｒａ法测定了红细胞膜（Ｃａ２＋－Ｍｇ２＋）－ＡＴＰ酶活性。结果表明，ＮＩＤＤＭ患者红细胞膜（Ｃａ２＋－Ｍｇ２＋）－ＡＴＰ酶活性降低，且与空腹血糖、糖化血红蛋白、果糖胺及红细胞变形指数呈负相关，后者与红细胞内Ｃａ２＋浓度呈正相关。说明（Ｃａ２＋－Ｍｇ２＋）－ＡＴＰ酶活性下降时，红细胞变形能力降低，可能与患者红细胞膜蛋白的过度糖化及细胞内Ｃａ２＋浓度的增高有关。

急性冠状动脉综合征患者ALDH2基因型和红细胞体积分布宽度变化的关系

目的分析我国急性冠状动脉综合征(acute coronary syndrome,ACS)患者乙醛脱氢酶2(ALDH2)基因多态性与红细胞体积分布宽度(RDW)变化的关系。方法收集128例ACS患者临床基线数据,按不同RDW区间进行分类,对患者相关的临床数据及ALDH2基因型分布频率,以及等位基因分布频率进行比较,并分析ALDH2基因多态性及冠状动脉病变严重程度与RDW水平的相关性。结果将RDW按四分位数分为4组,不同RDW组间ACS患者其超敏C反应蛋白Q1~Q4组分别为:(4.12±0.77)、(5.89±0.89)、(5.01±0.76)、(7.66±0.95)mg/L和血肌酐Q1~Q4组分别为:(70.3±19)、(76.8±21)、(74.1±23)、(86.5±24)μmol/L,差异均有统计学意义(P<0.05)。4组间ALDH基因型分布差异有统计学意义(P<0.05),G和A等位基因分布的频率差异也有统计学意义(P<0.05)。ALDH基因型与Gensini积分呈显著相关(r=-0.154,P<0.05),ALDH2基因型多态性对RDW大小存在显著性影响(r=-0.386,P<0.05)。结论我国ACS患者中ALDH2基因多态性与RDW存在密切的相关性。

不同比例的成分血输注对急性创伤性凝血病患者预后的影响

目的分析不同比例成分输血用于急性创伤性凝血病(ATC)患者对其预后的影响。方法回顾性分析2022年1月至2023年1月期间在本地区开展输血的ATC患者总共96例的病历资料,依据不同成分血输注比例分成对照组(依据3∶1比例输注悬浮红细胞以及新鲜冰冻血浆)50例和观察组(依据1∶1比例输注悬浮红细胞以及新鲜冰冻血)46例,观察两组血制品应用情况;输血前后血红蛋白(Hb)、血小板计数(PLT)、凝血酶原时间(PT)、活化部分的凝血酶原时间(APTT)、国际标准化比值(INR)、纤维蛋白原(FIB)及D-二聚体(D-D)水平;血液钙离子(Ca^(2+))以及钾离子(K^(+))浓度;预后情况。结果两组24 h红细胞输注量、红细胞输注总量、血小板输注量以及冷沉淀输注量比较,差异无统计学意义(P>0.05);观察组的血浆输注量高于对照组,差异有统计学意义(P<0.05)。输血前,两组Hb、PLT水平比较,差异无统计学意义(P>0.05);输血后,两组Hb、PLT水平均有所升高,差异有统计学意义(P<0.05),但组间相比,差异无统计学意义(P>0.05)。输血前,两组PT、APTT、INR、FIB及D-D水平比较,差异无统计学意义(P>0.05);输血后,两组PT、APTT、INR、FIB及D-D水平均有所降低,且观察组低于对照组,差异有统计学意义(P<0.05)。输血前,两组Ca^(2+)、K^(+)浓度比较,差异无统计学意义(P>0.05);输血后,两组Ca^(2+)、K^(+)浓度均有所提高,差异有统计学意义(P<0.05),但组间比较,差异无统计学意义(P>0.05)。观察组的治愈率高于对照组,差异有统计学意义(P<0.05);观察组未治愈率及死亡率低于对照组,差异有统计学意义(P<0.05)。结论和按照3∶1比例输注成分血相比,按照1∶1比例输注成分血能更好改善ATC患者的凝血功能,提升其预后水平,值得采用。