AFP、PIVKA-Ⅱ、Ferritin联合应用在肝癌诊断及疗效监测中的效能评价

目的评价单独及联合应用甲胎蛋白(AFP)、异常凝血酶原(PIVKA-Ⅱ)、铁蛋白(Ferritin)指标在肝癌诊断及预后评估中的效能。方法回顾性分析10个月内在苏州大学附属第二医院核医学科就诊的体检、门诊、住院患者的AFP、PIVKA-Ⅱ、Ferritin检测数值,按照临床诊断信息分为健康体检组(74例)、肝炎肝囊肿组(63例)、肝硬化组(40例)、腺瘤增生组(76例)及肝癌组(788例),比较各指标在各肝相关分组中的表达水平差异。通过Passing-Bablok回归性分析及Kappa分析评价AFP与PIVKA-Ⅱ的应用特性。通过ROC曲线及Kappa分析比较各指标单独及联合应用在诊断肝恶性肿瘤的效能。比较各指标对肝恶性肿瘤预后的评估价值。结果3指标在各分组中的表达差异明显,AFP在健康人群阳性检出率为4.05%,在肝癌组阳性检出率为57.61%;PIVKA-Ⅱ在健康体检组阳性检出率为4.05%,在肝癌组阳性检出率为64.47%;Ferritin在健康体检组阳性检出率为12.16%,在肝癌组阳性检出率为34.90%。分析AFP与PIVKA-Ⅱ指标相关性,Y=0.0786 X+1.5675,线性度偏差显著;一致性分析,Kappa值为0.381,一致性一般。多指标联合应用在肝癌组的诊断效能高于单一指标,ROC曲线下面积为0.802,在腺瘤增生+肝癌组中诊断的ROC曲线下面积为0.771;在肝癌诊断中,AFP、Ferritin、PIVKA-Ⅱ3项联检的灵敏度为88.96%,特异性为80.24%,高于单项目检测的灵敏度,在良恶性肿瘤诊断中,3项联检的灵敏度为82.52%,特异性为78.53%。3指标在肝癌治疗前后差异明显,AFP在治疗前后中位数由4.11ng/mL下调至3.2ng/mL,Ferritin在治疗前后中位数由244ng/mL下调至223ng/mL,PIVKA-Ⅱ在治疗前后中位数由161mIU/mL下调至24.78mIU/mL;秩和检验分析治疗前后数值差异,AFP:P<0.0247;Ferritin:P<0.4842;PIVKA-Ⅱ:P<0.0001,AFP、PIVKA-Ⅱ指标变化有更强的临床一致性和预后指导价值。结论3项传统肝癌检测指标在良恶性疾病中表达差异明显,其中两个核心指标AFP与PIVKA-Ⅱ一致性较差,但互补性强,联检可以有效提高阳性检出率。相较于腺瘤增生+肝癌综合诊断,多指标联检对单纯肝癌的诊断效能更高。AFP与PIVKA-Ⅱ的疗效监测价值更高。

Iron and ferritin effects on intensive care unit mortality:A metaanalysis

BACKGROUND The effect of serum iron or ferritin parameters on mortality among critically ill patients is not well characterized.AIM To determine the association between serum iron or ferritin parameters and mortality among critically ill patients.METHODS Web of Science,Embase,PubMed,and Cochrane Library databases were searched for studies on serum iron or ferritin parameters and mortality among critically ill patients.Two reviewers independently assessed,selected,and abstracted data from studies reporting on serum iron or ferritin parameters and mortality among critically ill patients.Data on serum iron or ferritin levels,mortality,and demographics were extracted.RESULTS Nineteen studies comprising 125490 patients were eligible for inclusion.We observed a slight negative effect of serum ferritin on mortality in the United States population[relative risk(RR)1.002;95%CI:1.002-1.004].In patients with sepsis,serum iron had a significant negative effect on mortality(RR=1.567;95%CI:1.208-1.925).CONCLUSION This systematic review presents evidence of a negative correlation between serum iron levels and mortality among patients with sepsis.Furthermore,it reveals a minor yet adverse impact of serum ferritin on mortality among the United States population.

Ferritin and mortality in hemodialysis patients with COVID-19:A systematic review and meta-analysis

Objective:To investigate the difference in serum ferritin levels between deceased and surviving regular hemodialysis patients with COVID-19.Methods:We conducted a systematic search across four databases following the PRISMA statement guidelines.Studies reporting ferritin levels and mortality of regular hemodialysis patients with COVID-19 were included.Employing the random-effects model,we performed a meta-analysis to determine the mean difference in serum ferritin levels between the studied groups,along with their corresponding 95%confidence intervals.The meta-analysis was carried out using Review Manager 5.4 and Stata 16.Results:A total of 1013 patients from seven studies were included in this study.Our meta-analysis showed higher mean serum ferritin in the deceased compared to surviving regular hemodialysis patients with COVID-19,with a mean difference of 449.43 ng/mL[95%CI(244.07,654.80),P<0.0001;I2=58%,P=0.003].Conclusions:Our study found a higher mean of serum ferritin levels in the deceased compared to surviving regular hemodialysis patients with COVID-19.

Serum ferritin and the risk of early-onset colorectal cancer

BACKGROUND The incidence of early-onset colorectal cancer(EO-CRC)is rising in the United States,and is often diagnosed at advanced stages.Low serum ferritin is often incidentally discovered in young adults,however,the indication for endoscopy in EO-CRC is unclear.AIM To compare serum ferritin between patients with EO-CRC and healthy controls(HCs),and examine the association of serum ferritin in EO-CRC with patient-and disease-specific characteristics.METHODS A retrospective study of patients<50 years with newly-diagnosed EO-CRC was conducted from 1/2013-12/2023.Patients were included if serum ferritin was measured within 2 years prior to 1 year following CRC histologic diagnosis.To supplement the analysis,a cohort of HCs meeting similar inclusion and exclusion criteria were identified for comparison.A sensitivity analysis including only patients with serum ferritin obtained at or before diagnosis was separately performed to minimize risk of confounding.RESULTS Among 85 patients identified with EO-CRC(48 females),the median serum ferritin level was 26 ng/mL(range<1-2759 ng/mL).Compared to HCs(n=80211),there were a higher proportion of individuals with EO-CRC with serum ferritin<20 ng/mL(female 65%,male 40%)versus HCs(female 32.1%,male 7.2%)age 29-39 years(P=0.002 and P<0.00001,respectively).Stage IV disease was associated with significantly higher serum ferritin compared to less advanced stages(P<0.001).Serum ferritin obtained before or at the time of diagnosis was lower than levels obtained after diagnosis.Similar findings were confirmed in the sensitivity analysis.CONCLUSION Severe iron deficiency may indicate an increased risk of EO-CRC,particularly at earlier stages.Further studies defining the optimal serum ferritin threshold and routine incorporation of serum ferritin in screening algorithms is essential to develop more effective screening strategies for EO-CRC.

Controlled coupling and characterization of oyster (Crassostrea gigas) ferritin with gold nanostars

Ferritin has good thermal stability,resistance to certain acids and bases,and targeting,and has broad application prospects in the synthesis of gold nanostars(AuNS).In this study,we screened monodisperse AuNS with uniform particle size and morphology through a one-step synthesis method and coupled the synthesized AuNS with oyster ferritin(GF1).The results showed that the surface plasmon resonance(SPR)peaks of the coupled GF1@AuNS changed signifi cantly,and the changes in infrared spectra and potential confirmed the success of the synthesis,while the microscopic morphology showed an increase in particle size and surface peak coverage.Furthermore,GF1@AuNS does not induce cell death in the 100µmol/L range,is highly stable in physiological environments,and exhibits good X-ray attenuation in micro-computed tomography.Due to the unique functional activity of ferritin and AuNS,GF1@AuNS has potential applications in food detection and drug development in the future.

Association between Serum Ferritin Levels and Metabolic-associated Fatty Liver Disease in Adults:a Cross-sectional Study Based on the NHANES

Objective Ferritin,initially acting as an iron-storage protein,was found to be associated with metabolic diseases.Our study was designed to investigate the association between serum ferritin and metabolic-associated fatty liver disease(MAFLD)using data from the National Health and Nutrition Examination Survey(NHANES)of the United State of America.Methods A cross-sectional study was conducted,enrolling a total of 2145 participants from the NHANES in the 2017–2018 cycles.Hepatic steatosis and liver fibrosis were assessed by ultrasound images and several non-invasive indexes.Multiple regression analysis was conducted to determine the associations between serum ferritin concentration and MAFLD and liver fibrosis.Results The analysis revealed that participants with higher serum ferritin levels(Q3 and Q4 groups)had a higher prevalence of MAFLD than those with the lowest serum ferritin levels[Q3 vs.Q1:OR=2.17(1.33,3.53),P<0.05 in fatty liver index(FLI);Q4 vs.Q1:OR=3.13(1.91,5.13),P<0.05 in FLI].Additionally,participants with the highest serum ferritin levels(Q4 group)displayed a higher prevalence of liver fibrosis[Q4 vs.Q1:OR=2.59(1.19,5.62),P<0.05 in liver stiffness measurement;OR=5.06(1.12,22.94),P<0.05 in fibrosis-4 index],with significantly increased risk observed in participants with concomitant diabetes[OR=7.45(1.55,35.72),P=0.012].Conclusion Our study revealed that elevated serum ferritin levels are associated with a higher prevalence of MAFLD and advanced liver fibrosis in patients.Elevated serum ferritin levels combined with diabetes are important risk factors for liver fibrosis.

Serum tumor markers (carcinoembryonic antigen, carbohydrate antigen 19-9, carbohydrate antigen 72-4, carbohydrate antigen 24-2, ferritin) and gastric cancer prognosis correlation

BACKGROUND Gastric cancer is a kind of malignant tumor which is prevalent all over the world.Although some progress has been made in the treatment of gastric cancer,its prognosis is still not optimistic,so it is of great significance to find reliable prog-nostic indicators to guide the treatment and management of patients with gastric cancer.AIM To explore the relationship between serum levels of five biomarkers[carcinoem-bryonic antigen(CEA),carbohydrate antigen(CA)19-9,CA72-4,CA24-2,and ferritin]and prognosis in patients with gastric cancer.METHODS This study included 200 patients with gastric adenocarcinoma,and conducted an in-depth analysis of their baseline characteristics,relationship between tumor markers and staging,and prognosis.The study found that CA19-9 has a signi-ficant correlation with tumor stage,the average levels of CA24-2,CEA,CA72-4 and ferritin were slightly increased disregarding the stage of tumor.Survival analysis showed that increases in CEA,CA19-9,CA24-2,and ferritin were all associated with shortened overall survival of patients.Further multivariate ana-lysis revealed that elevated serum CA72-4 levels were an inde-pendent adverse prognostic factor.RESULTS This study reveals that there is a significant correlation between the expression levels of serum tumor markers CEA,CA19-9,CA72-4,CA24-2 and ferritin in patients with gastric cancer and prognosis,and can be used as important indicators for prognostic evaluation of gastric cancer.In particular,markers that appear abnormally elevated initially may help identify gastric cancer patients with poor prognosis.CONCLUSION Serum CEA and CA19-9 play an important role in the prognosis assessment of gastric cancer,and are effective tools to guide clinical practice and optimize individualized treatment strategies for gastric cancer patients.

葡萄铁蛋白基因Ferritin的鉴定、克隆及其在果实发育不同时期对氨基酸铁复合肥喷施的响应

【目的】铁蛋白Ferritin在植物生长发育过程中发挥重要作用,其在果树中的生物学功能尚未见报道。克隆葡萄Ferritin家族基因并揭示其在果实发育不同时期的表达模式及其对叶面喷施氨基酸-铁(Fe)复合肥处理的响应差异,可为研究果树铁素营养与代谢的分子机制提供理论依据。【方法】通过同源克隆法从‘马瑟兰’中克隆Ferritin家族基因,利用生物信息学手段分析葡萄Ferritin及其编码蛋白的详细特征;设置叶面喷施氨基酸-Fe复合肥处理,利用荧光实时定量PCR技术分析Ferritin在葡萄果实发育不同时期的表达特征及其对叶面喷施处理的差异响应。【结果】在葡萄基因组中检索并克隆获得4个Ferritin家族基因,命名为VvFer1—VvFer4,分布于第6、8和13号三条染色体上,均含有7个长度不一的内含子,且主要定位于叶绿体和细胞核。本文所选16种植物Ferritin蛋白序列的一致性高达61.48%,系统发育树分析表明同一属的Ferritin同源蛋白如十字花科的拟南芥和芜菁,茄科的烟草和马铃薯,豆科的大豆、落花生和鹰嘴豆,大戟科的橡胶树、木薯和蓖麻,蔷薇科的苹果、桃和草莓,遗传进化关系较近,葡萄VvFer3和茄科同源蛋白遗传关系最近。葡萄VvFer基因在五年生‘马瑟兰’果实发育不同时期、不同组织中的表达水平差异较大,其中,VvFer3在不同组织中的表达量均最高,最大值出现在硬核期至成熟期的果实中,其次是VvFer2和VvFer4。‘马瑟兰’葡萄发育不同时期果实中的Fe含量略有差异,从幼果期开始逐渐增加,并在转色期果实中达到最高值,从转色期到成熟期略有下降,但仍高于幼果期和硬核期果实中的Fe含量,叶面喷施处理显著提高了成熟期果实中的Fe含量、乌头酸酶ACO(aconitase)、硝酸还原酶NIR(nitrite reductase)和琥珀酸脱氢酶SDH(succinate dehydrogenase)的酶活性。VvFer2—4在转录水平易受叶面喷施铁肥的诱导而显著增强,且与葡萄组织/器官分布和果实发育的不同时期密切相关,VvFer2在葡萄发育整个周期仅在果实中对叶面喷施铁肥处理比较敏感,VvFer3在所有组织中仅从幼果期至转色期对叶面喷施铁肥有响应,VvFer4在葡萄发育整个周期的韧皮部和叶片中持续受叶面喷施铁肥的诱导,而在果实中仅从幼果期至转色期对叶面喷施铁肥有响应;VvFer1在本文所选组织中的表达量相对较低,但很均匀,且在转录水平对叶面喷施铁肥没有响应。【结论】从葡萄中克隆并鉴定了4个铁蛋白基因Ferritin,其在葡萄发育不同时期、不同组织中的表达水平差异较大,并在转录水平易受叶面喷施铁肥的诱导;VvFer3在葡萄所有组织中的整体表达量最高(特别是果实中最为突出),且在幼果期至转色期易受铁肥叶面喷施的调控。

Magnetic resonance imaging focused on the ferritin heavy chain 1 reporter gene detects neuronal differentiation in stem cells

The neuronal differentiation of mesenchymal stem cells offers a new strategy for the treatment of neurological disorders.Thus,there is a need to identify a noninvasive and sensitive in vivo imaging approach for real-time monitoring of transplanted stem cells.Our previous study confirmed that magnetic resonance imaging,with a focus on the ferritin heavy chain 1 reporter gene,could track the proliferation and differentiation of bone marrow mesenchymal stem cells that had been transduced with lentivirus carrying the ferritin heavy chain 1 reporter gene.However,we could not determine whether or when bone marrow mesenchymal stem cells had undergone neuronal differentiation based on changes in the magnetic resonance imaging signal.To solve this problem,we identified a neuron-specific enolase that can be differentially expressed before and after neuronal differentiation in stem cells.In this study,we successfully constructed a lentivirus carrying the neuron-specific enolase promoter and expressing the ferritin heavy chain 1 reporter gene;we used this lentivirus to transduce bone marrow mesenchymal stem cells.Cellular and animal studies showed that the neuron-specific enolase promoter effectively drove the expression of ferritin heavy chain 1 after neuronal differentiation of bone marrow mesenchymal stem cells;this led to intracellular accumulation of iron and corresponding changes in the magnetic resonance imaging signal.In summary,we established an innovative magnetic resonance imaging approach focused on the induction of reporter gene expression by a neuron-specific promoter.This imaging method can be used to noninvasively and sensitively detect neuronal differentiation in stem cells,which may be useful in stem cell-based therapies.

Association of Serum Ferritin Levels and Thyroid Hormones

Thyroid metabolism is orchestrated by the action of various minerals and trace elements including iron, iodine, selenium, and zinc. Iron deficiency, specifically deficiency in serum ferritin levels, is one of the common causes of thyroid dysfunction. Our objective was to evaluate the relationship between serum ferritin levels and circulating thyroid hormones. For this, a retrospective analysis was performed on 16,512 individuals who tested for serum levels of ferritin and thyroid profile at Vibrant America Clinical Laboratories. Subjects were stratified based on the serum levels of ferritin. Age (p −0.03232, p < 0.0001). Analysis of Linear association by Pearson’s correlation exhibited a considerable correlation between varying serum ferritin levels with all tested thyroid hormones. The study concludes that serum ferritin levels were associated with thyroid hormone synthesis and metabolism in individuals with optimal levels of circulating ferritin.

急性心肌梗死合并急性左心衰患者血清铁调素/铁蛋白比值与临床救治效果的关系

目的 探讨急性心肌梗死合并急性左心衰竭(简称急性左心衰)患者血清铁调素/铁蛋白比值与临床救治效果的关系。方法 将绵阳市中心医院2020年1月至2023年5月收治的303例急性心肌梗死合并急性左心衰患者作为研究对象,根据其治疗1周的临床救治效果分为有效组与无效组,观察两组入院时、治疗1周时血清铁调素、铁蛋白及其比值变化情况,统计并比较两组一般资料及其他实验室指标包括血红蛋白、高敏肌钙蛋白、N端脑利钠肽前体等,通过点二列相关性分析入院时血清铁调素、铁蛋白及其比值与患者临床救治效果的关系,并通过受试者工作特征(ROC)曲线评价入院时血清铁调素、铁蛋白及其比值预测患者救治效果的价值;同时选取2023年5月至2023年10月医院收治的另外68例急性心肌梗死合并急性左心衰患者作为验证对象,通过ROC曲线进一步验证血清铁调素/铁蛋白比值对患者救治效果的预测价值。结果 本研究根据纳入、排除标准共选取308例患者为研究对象,最终303例患者完成救治效果评价,其中有效257例(84.82%)。与有效组比较,无效组入院时、治疗1周时血清铁调素及其与铁蛋白比值均较高,血清铁蛋白水平较低(P<0.05)。与入院时比较,有效组治疗1周时血清铁调素及其与铁蛋白比值均降低,血清铁蛋白水平均升高(P<0.05),但无效组入院时、治疗1周时血清铁调素、铁蛋白及其比值差异无统计学意义(P>0.05)。两组入院时高敏肌钙蛋白、N端脑利钠肽前体、血红蛋白水平比较差异有统计学意义(P<0.05)。点二列相关性发现,患者临床救治效果与入院时血清铁调素水平及其与铁蛋白比值呈正相关(r>0,P<0.05),与入院时血清铁蛋白水平呈负相关(r<0,P<0.05)。ROC曲线发现,入院时血清铁调素、铁蛋白及其比值对患者救治效果均有一定预测价值,且二者比值预测价值更高。加以验证的ROC曲线结果显示,入院时血清铁调素/铁蛋白比值对患者救治效果仍有良好的预测价值。结论 急性心肌梗死合并急性左心衰患者入院时血清铁调素/铁蛋白比值与临床救治效果有关,可辅助临床早期预测患者救治效果,指导救治方案的及时调整。

Effect of Glycosylation on the Physicochemical Properties,Structure and Iron Bioavailability of Ferritin Extracted from Tegillarca granosa

Iron deficiency anemia(IDA)is a major global health problem.Tegillarca granosa has been considered as an excellent source of iron given its high content of iron-binding protein,ferritin.The aim of the present study was to determine the physicochemical properties,protein structures,and iron uptake of ferritin extracted from T.granosa,and to evaluate the potential impacts of chitosan glycosylation on these characteristics.Based on Box-Behnken design and response surface methodology,the optimal conditions for glycosylation included a ferritin/chitosan mass ratio of 4:1,a pH of 5.5,a reaction time of 10 min,and a reaction temperature of 50℃.Glycosylation caused decreased surface hydrophobicity and elevated water-holding capacity of ferritin due to the introduction of hydrophilic groups.Additionally,glycosylation improved antioxidant capacity of ferritin by 20.69%–189.66%,likely owing to the protons donated by saccharide moiety to terminate free radical chain reaction.The in vitro digestibility of ferritin was elevated by 22.56%–104.85%after glycosylation,which could be associated with lessβ-sheet content in secondary structure that made the glycosylated protein less resistant to enzymatic digestion.The results of the iron bioavailability in Caco-2 cells revealed that ferritin(78.85–231.77 ngmg^(−1))exhibited better iron bioavailability than FeSO4(51.48–114.37 ngmg^(−1))and the values were further elevated by glycosylation with chitosan(296.23–358.20 ngmg^(−1)),which may be related to the physicochemical properties of ferritin via glycosylation modification.These results provide a basis for the development of T.granosa derived ferritin and its glycosylated products,and can promote the utilization of aquatic resources.

鼠伤寒沙门氏菌细菌铁蛋白(Bfr)的生物信息学分析及原核表达载体构建

为了获得高纯度的鼠伤寒沙门氏菌细菌铁蛋白(Bfr),试验利用生物信息学软件对Bfr的结构、翻译后修饰和抗原表位等进行预测分析;通过PCR扩增鼠伤寒沙门氏菌Bfr基因,将其与pET-32a(+)载体连接并转化至大肠杆菌BL21(DE3)感受态细胞中,通过SDS-PAGE分析和Western-blot检测表达及纯化后的目的蛋白。结果表明:Bfr由476个氨基酸组成,分子式为C_(1440)H_(2406)N_(476)O_(606)S_(85),相对分子质量为38808.87,理论等电点为5.25;无信号肽和跨膜区,二级结构包含α-螺旋(81.01%)、无规则卷曲(13.19%)、β-折叠(3.16%)和延伸链(1.90%);含有9个线性B淋巴细胞抗原表位和5个T淋巴细胞抗原表位,以及10个磷酸化位点和10个互作蛋白,Bfr和Bfrd蛋白表面匹配良好、结合稳定。试验成功克隆出Bfr基因,其大小约为476 bp,获得大小约为35 ku的高纯度重组蛋白Bfr。说明Bfr蛋白具有良好的反应原性,有可能成为鼠伤寒沙门氏菌的疫苗开发和疾病诊断的候选蛋白。

支气管镜介入治疗对RMPP患儿的疗效及其对外周血CRP、SF、IL-8水平及CD4^(+)/CD8^(+)比值的影响

目的探讨支气管镜介入治疗对难治性肺炎支原体肺炎(RMPP)患儿的疗效及其对外周血C反应蛋白(CRP)、铁蛋白(SF)、白细胞介素(IL)-8水平及CD4^(+)/CD8^(+)比值的影响。方法选取2020年12月至2022年12月河北省儿童医院收治的195例确诊为RMPP患儿作为研究对象,采用随机数字表法分为对照组和介入组(病程≥14 d归为晚期介入组、病程<14 d归为早期介入组)。根据临床疗效将130例接受支气管镜介入治疗的患儿分为有效组和无效组。对照组进行常规治疗,晚期介入组和早期介入组在对照组的基础上实施支气管镜介入治疗。比较对照组、晚期介入组和早期介入组临床疗效、临床症状与体征改善情况;检测并比较对照组、晚期介入组和早期介入组外周血CRP、SF、IL-8水平及CD4^(+)/CD8^(+)比值;比较对照组、晚期介入组和早期介入组不良反应发生率;比较有效组和无效组外周血CRP、SF、IL-8水平及CD4^(+)/CD8^(+)比值。采用受试者工作特征(ROC)曲线分析外周血CRP、SF、IL-8、CD4^(+)/CD8^(+)比值对支气管镜介入治疗RMPP疗效的预测价值。结果早期介入组总有效率高于对照组和晚期介入组,差异均有统计学意义(P<0.05);对照组和晚期介入组总有效率比较,差异无统计学意义(P>0.05)。早期介入组咳嗽持续时间、发热持续时间、住院时间均短于对照组和晚期介入组,差异均有统计学意义(P<0.05)。对照组、晚期介入组和早期介入组治疗后外周血CD4^(+)/CD8^(+)比值均高于治疗前,CRP、SF、IL-8水平均低于治疗前,差异均有统计学意义(P<0.05);早期介入组治疗后外周血CD4^(+)/CD8^(+)比值均高于对照组和晚期介入组,CRP、SF、IL-8水平均低于对照组和晚期介入组,差异均有统计学意义(P<0.05)。早期介入组出现不良反应8例,晚期介入组出现不良反应10例,均暂停灌洗操作后很快恢复。对照组未出现上述不良反应。无效组外周血CRP、SF、IL-8水平均高于有效组,CD4^(+)/CD8^(+)比值低于有效组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,CRP、SF、IL-8、CD4^(+)/CD8^(+)比值联合检测预测支气管镜介入治疗RMPP无效的曲线下面积、灵敏度、特异度分别为0.871、81.81%、83.80%。结论早期应用支气管镜介入治疗对RMPP的疗效较好,可改善患儿外周血CRP、SF、IL-8水平及CD4^(+)/CD8^(+)比值,且外周血CRP、SF、IL-8、CD4^(+)/CD8^(+)比值联合检测有助于预测支气管镜介入治疗RMPP的疗效。

贫血与非贫血孕妇Hb、VA、SF、Zn、IFA表达差异及相关性探究

目的探究贫血与非贫血孕妇血红蛋白(Hb)、维生素A(VA)、铁蛋白(SF)、锌(Zn)及内因子抗体(IFA)表达差异,并分析各指标表达与孕妇贫血的相关性。方法选取2022年8月至2023年4月我院收治的102例贫血孕妇为贫血组(Hb<110g/L),另选取同期102例非贫血孕妇为非贫血组,检测两组Hb、VA、SF、Zn、IFA表达水平,分析孕妇贫血的影响因素,将贫血组根据外周血Hb水平进行贫血程度划分[轻度(100g/L≤Hb<110g/L)、中度(70g/L≤Hb<99g/L)],比较不同贫血程度孕妇、不同孕期贫血孕妇Hb、VA、SF、Zn、IFA表达差异,分析Hb、VA、SF、Zn、IFA表达水平与贫血孕妇孕期、贫血程度的相关性,并分析Hb、VA、SF、Zn、IFA表达对中度贫血的预测价值。结果两组孕周、妊娠期合并症相比,差异有统计学意义(P<0.05);贫血组中度、轻度贫血孕妇Hb、VA、SF、Zn均低于非贫血组,IFA高于非贫血组(P<0.05),中度贫血孕妇Hb、VA、SF、Zn表达水平低于轻度贫血孕妇,IFA表达水平高于轻度贫血孕妇(P<0.05);不同孕期贫血孕妇Hb、VA、SF、Zn表达水平比较,孕晚期<孕中期<孕早期,IFA表达水平比较,孕早期<孕中期<孕晚期(P<0.05);Hb、VA、SF、Zn与贫血孕妇孕期、贫血程度呈负相关,IFA与贫血孕妇孕期、贫血程度呈正相关(P<0.05);孕周、妊娠期合并症、Hb、VA、SF、Zn、IFA是孕妇贫血的影响因素(P<0.05);Hb、VA、SF、Zn、IFA联合预测中度贫血的AUC为0.933,大于各参数单独预测(P<0.05)。结论贫血孕妇Hb、VA、SF、Zn、IFA表达明显异常,且Hb、VA、SF、Zn、IFA与贫血孕妇孕期、贫血程度联系密切,联合检测对预防孕妇中度贫血具有重要价值。

血清乳酸脱氢酶、β2微球蛋白、铁蛋白联合改良WHO预后积分系统预测骨髓增生异常综合征预后不良的价值

目的探讨血清乳酸脱氢酶(LDH)、β2微球蛋白(β2-MG)、铁蛋白(SF)联合改良WHO预后积分系统(WPSS)评分对骨髓增生异常综合征(MDS)预后不良的预测价值。方法选取110例MDS患者作为研究对象,均检测血清LDH、β2-MG、SF水平。根据生存情况将患者分为病死组与存活组,比较2组血清LDH、β2-MG、SF水平和改良WPSS评分。分析MDS预后不良的危险因素及血清LDH、β2-MG、SF水平和改良WPSS评分单独及联合对MDS预后不良的预测价值。结果MDS预后不良发生率为40.20%(41/102)。病死组血清LDH、β2-MG、SF、改良WPSS评分和染色体核型预后不良比率均高于存活组,差异有统计学意义(P<0.05)。Cox回归模型分析结果显示,血清LDH、β2-MG、SF水平和改良WPSS评分升高、染色体核型预后不良是MDS预后不良的危险因素(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,血清LDH、β2-MG、SF水平联合改良WPSS评分预测MDS预后不良的灵敏度和曲线下面积(AUC)分别为95.12%、0.918,均显著高于各指标单独预测(P<0.05)。结论血清LDH、β2-MG、SF水平和改良WPSS评分对MDS预后不良均具有一定的预测价值,但4项指标联合预测价值更高。

血清铁蛋白作为急性时相反应蛋白在布鲁菌病中的应用

目的:比较急、慢性布鲁菌病(简称布病)患者治疗前和治疗中外周血铁蛋白水平,评估血清铁蛋白与急、慢性布病炎性反应和布病治疗转归的关系。方法:选取急、慢性期且未接受抗生素治疗的布病患者各36例作为治疗前组;抗生素治疗10 d左右的急、慢性期布病患者各36例作为治疗中组;选取健康体检者25例作为对照组。采用酶联免疫吸附试验测定各组样本的血清铁蛋白水平,统计分析血清铁蛋白水平在各组间的差异。结果:治疗前急、慢性期和对照组血清铁蛋白水平具有明显差异(P<0.01);急、慢性组铁蛋白水平均比对照组明显增高(P<0.01);急性铁蛋白水平比慢性组明显升高(P<0.01)。治疗中急、慢性期和对照组血清铁蛋白水平具有明显差异(P<0.01);急、慢性布病组铁蛋白水平均比对照组明显增高(P<0.01);急性布病铁蛋白水平比慢性布病明显降低(P<0.01)。治疗中急性期、慢性期布病铁蛋白水平均比治疗前明显降低(P<0.001)。结论:血清铁蛋白与布鲁菌病的炎症反应程度有关,可用于监测布鲁氏菌病的炎症反应程度和评估治疗效果。

动态监测病毒性肺炎患儿Th1、Th2细胞因子及铁蛋白水平的临床意义

目的 探究动态监测病毒性肺炎患儿辅助性T细胞1 (Th1)、Th2细胞因子及铁蛋白(SF)水平的临床意义。方法 选取西安交通大学附属红会医院2023年1月至2024年2月114例病毒性肺炎患儿为研究组,另选80名同期来院体检的健康儿童为对照组。所有患儿均接受临床治疗,比较研究组与对照组及研究组治疗前后血清Th1、Th2细胞因子、Th1/Th2及SF水平。根据患儿入院病情严重程度将研究组患儿分为轻症组(n=68)、重症组(n=46),比较2组血清Th1、Th2细胞因子、Th1/Th2及SF水平。采用Spearman相关系数分析血清Th1、Th2细胞因子及SF水平与病毒性肺炎患儿病情的相关性。结果 研究组治疗前血清白细胞介素2 (IL-2)、γ干扰素(IFN-γ)、Th1/Th2水平显著低于对照组,IL-4、IL-10、SF水平显著高于对照组,差异均有统计学意义(均P <0.05);治疗后,研究组血清IL-2、IFN-γ、Th1/Th2水平均显著升高,IL-4、IL-10、SF水平均显著降低(均P <0.05);轻症组血清IL-2、IFN-γ、Th1/Th2水平显著高于重症组,IL-4、IL-10、SF水平显著低于重症组,差异均有统计学意义(均P <0.05);Spearman相关性分析显示,病毒性肺炎患儿病情与血清IL-2、IFN-γ、Th1/Th2呈显著负相关(P <0.05),与IL-4、IL-10、SF水平呈显著正相关(P <0.05)。结论病毒性肺炎患儿Th1细胞因子水平下调,Th2细胞因子水平上调,Th1/Th2失衡,血清SF水平升高,且Th1、Th2细胞因子及SF水平与病情呈显著相关性,Th1、Th2细胞因子及血清SF水平对治疗情况具有一定的评估价值。

血清铁蛋白、IL-6、TNF-α表达水平与高炎症表型急性呼吸窘迫综合征患者病情严重程度及早期预后的相关性

目的 分析血清铁蛋白(SF)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)表达水平与高炎症表型急性呼吸窘迫综合征(ARDS)患者病情严重程度及早期预后的相关性。方法 回顾性选取2020年1月至2022年12月在北京市昌平区医院就诊的高炎症表型ARDS患者124例为研究对象。根据临床诊断结果分为轻度组(n=29)、中度组(n=51)、重度组(n=44)。根据入院治疗1个月后患者情况将其分为存活组(n=83)、死亡组(n=41)。检测并比较各组SF、IL-6、TNF-α表达水平变化,并分析高炎症表型ARDS中SF、IL-6、TNF-α表达水平与病情严重程度、早期预后的相关性。结果 轻度组SF、IL-6、TNF-α表达水平分别为(127.41±13.57)μg/L、(65.24±10.04) pg/mL、(43.17±8.26) ng/mL,均低于中度组[(241.55±17.03)μg/L、(127.05±12.19) pg/mL、(71.82±9.05) ng/mL]和重度组[(378.34±20.04)μg/L、(186.73±15.25) pg/mL、(104.50±11.46) ng/mL],中度组SF、IL-6、TNF-α表达水平均低于重度组,差异均有统计学意义(P<0.05)。存活组SF、IL-6、TNF-α表达水平分别为(156.25±9.06)μg/L、(71.52±11.36) pg/mL、(51.60±7.92) ng/mL,均低于死亡组[(419.72±23.64)μg/L、(216.82±13.51) pg/mL、(161.25±12.36) ng/mL],差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,SF、IL-6、TNF-α水平表达与高炎症表型ARDS患者病情严重程度、早期预后均呈正相关(r=0.424、0.516、0.460,r=0.503、0.602、0.437;P<0.05)。结论 高炎症表型ARDS患者均伴有严重炎症反应,且SF、IL-6、TNF-α表达水平与病情严重程度、早期预后均呈正相关,需密切监测指标变化,可为病情严重程度、早期预后评估提供一定依据。

联合检测血清铁蛋白和甲胎蛋白在原发性肝癌患者中应用效果的研究

目的研究检测原发性肝癌患者血清铁蛋白和甲胎蛋白获得的临床效果。方法选取2022年1-12月就诊144例原发性肝癌患者,将其作为研究对象进行组别划分。其中144例原发性肝癌患者为研究组,100名正常人员为对照组,比较两组的甲胎蛋白(AFP)和血清铁蛋白(SF)测定结果、AFP和SF阳性率。结果研究组的血清AFP和SF测定结果较对照组明显,且与对照组的AFP和SF阳性率比较,研究组数值更高(P<0.05)。结论经血清铁蛋白和甲胎蛋白联合检测原发性肝癌,发现实际诊断价值较高,能发挥良好的应用效果。