Acute phase reaction and acute phase proteins

A review of the systemic acute phase reaction with major cytokines involved, and the hepatic metabolic changes, negative and positive acute phase proteins (APPs) with function and associated pathology is given. It appears that APPs represent appropriate analytes for assessment of animal health. Whereas they represent non-specific markers as biological effect reactants, they can be used for assessing nutritional deficits and reactive processes, especially when positive and negative acute phase variables are combined in an index. When such acute phase index is applied to separate healthy animals from animals with some disease, much better results are obtained than with single analytes and statistically acceptable results for culling individual animals may be reached. Unfortunately at present no cheap, comprehensive and easy to use system is available for assessing various acute phase proteins in serum or blood samples at the same time. Protein microarray or fluid phase microchip technology may satisfy this need; and permit simultaneous analysis of numerous analytes in the same small volume sample and enable integration of information derived from systemic reactivity and nutrition with disease specific variables. Applying such technology may help to solve health problems in various countries not only in animal husbandry but also in human populations.

A survey of biochemical and acute phase proteins changes in sheep experimentally infected with Anaplasma ovis

Objective: To determine the biochemical and acute phase proteins changes in sheep experimentally infected with Anaplasma ovis(A. ovis). Methods: One Iranian sheep naturally infected with A. ovis(parasitemia 0.02%) but with no other blood parasites based on blood smear and polymerase chain reaction methods was selected as donor, and it was splenectomized to induce high level of parasitemia. Then, three weeks after splenectomy when parasitemia was 6%, donor's blood was intravenously administered to each recipient animal. Five 5-6 months old Iranian male sheep without any blood parasites were selected as recipient animals. The percent of parasites, packed cell volume, serum biochemical parameters(urea, creatinine, bilirubin, aspartate aminotransferase activity, cholesterol, total protein, albumin, globulin, Fe), acute phase proteins(haptoglobin, total iron binding capacity, fibrinogen), were evaluated in sheep before and after being experimentally infected with A. ovis(until day 38). In addition, body weights of sheep were measured on days 0, 20 and 38. Results: In recipient sheep, microscopic examination of erythrocytes revealed a significant rise of parasitemia on days 12 and 15. The lowest level of packed cell volume in sheep was seen on day 15 post infection. A significant rise existed in mean urea and bilirubin(total, direct and indirect) on days 15 and 20. The increase of indirect bilirubin level was higher than direct bilirubin. Furthermore, serum Fe significantly increased on days 20 and 23. The mean total protein concentration significantly increased on day 38. A significant increase was found in the serum globulin concentration from days 20 and 27 to 38. Maximum values of haptoglobin were observed on days 27 and 30. Moreover, aspartate aminotransferase activity(from days 20-30) and cholesterol concentration(on day 20) significantly decreased. However, no significant changes were found in other parameters. Conclusions: Experimental ovine anaplasmosis caused by A. ovis could be associated with some changes in measured parameters, which presumably could be helpful for evaluation on staging of disease.

LPS Regulates Apolipoprotein E and A<i>β</i>Interactionswith Effects on Acute Phase Proteins and Amyloidosis

Interactions between apolipoprotein E (apo E) and amyloid beta (Aβ) are associated with the peripheral clearance of Aβ and are important to the development of neurodegenerative diseases. Interests in acute phase proteins (APP) as biomarkers for the early progression of Alzheimer’s disease indicate that the peripheral Aβ metabolism is perturbed and the role of nutritional diets are important to reduce APPs to maintain peripheral Aβ clearance with relevance to hepatic cholesterol homeostasis and brain amyloidosis. The role of nutriproteomic diets that reverse the effects of high fat diets are associated with the reduction in APPs, cholesterol homeostasis and improved clearance of Aβ. Nutritional diets that reduce the increase in plasma endotoxins (gut microbiotica) such as lipopolysaccarides (LPS) reduce the effects of LPS on cell membranes and increase the cellular uptake of Aβ by interactions with apo E. LPS alter hepatic lipid metabolism with an increase hepatic cytokines and APPs in plasma. Interactions between apo E and Aβ are altered by LPS with increased binding of LPS to apo E with effects on electrostatic alterations in Aβ oligomers. The role of LPS in neurodegenerative diseases includes the effects of LPS on alpha-synuclein metabolism with relevance to Parkinson’s disease and Alzheimer’s

Comparative evaluation of acute phase proteins by C-reactive protein(CRP)and serum amyloid A(SAA)in nonhuman primates and feline carnivores

The feasibility of a commercially available assay for C-reactive protein(CRP,CRP for humans:hCRP,and CRP for dogs:vCRP)and a trial reagent of serum amyloid A(SAA,vSAA for animals)were applied to the measurement of acute phase proteins in zoo animals,particularly in nonhuman primates and feline carnivores was evaluate.Results showed that hCRP and vSAA methods were applicable to measure CRP and SAA in Haplorhini.There was a highly signifcant correlation between both parameters with remarkably high correlation coefcient.A higher proportion of Bonnet macaques in Haplorhini,and the linear regression with good correlation between hCRP and vSAA levels were observed.Reference values in healthy Bonnet macaques were hCRP(46.86±30.97 nmol/L)and vSAA(9.06±1.95μg/mL).Although Ring-tailed lemur,which belonging to Strepsirrhini,showed low vSAA concentrations(reference values:1.08±0.47μg/mL),vSAA in patients was apparently elevated.The vCRP and vSAA methods were applicable to measurements of CRP and SAA in feline carnivores for highly signifcant correlation between both parameters.Theses two methods were also been deteded in lions,tigers and cheetahs.vSAA assays can be applied to measure SAA levels in other carnivores and herbivores.In conclusion,vSAA systems have potential utility as diagnostic tools for health screening and prediction in zoo animals.

Effects of montelukast sodium combined with pidotimod on acute phase protein and immune function in children with acute bronchitis

Objective: To observe the effects of montelukast sodium combined with pidotimod on acute phase protein (APP) and indexes of immunologic function in pediatric acute bronchitis treatment. Methods: A total of 180 cases children with acute bronchitis acted as research objects were randomly divided into control group (n=65) and observation group (n=63). On the basis of conventional therapy, control group was treated by plus pidotimod. On this base, observation group was treated with montelukast sodium. The changes of acute phase proteins (CRP, HP, a1-AAG and CER) and immune function (CD3+, CD4+, CD8+ and CD4+/CD8+) levels before and after treatment were observed after 2 months. Results: Before treatment, CRP, HP, a1-AAG, CER, CD3+, CD4+, CD8+ and CD4+/CD8+ levels of two groups had no statistically significant difference;CRP, HP, a1-AAG, CER, and CD8+ levels of control and observation groups decreased significantly after treatment, the decreases of observation group were more obvious than that of control group, and the levels after treatment were significantly lower than that of control groups. The levels of CD3+, CD4+ and CD4+/CD8+ in two groups after treatment were significantly higher than those before treatment. For observation group, the levels of CD3+, CD4+ and CD4+/CD8+ increased more significantly after treatment, which were significantly higher than that of the control group. Conclusion: Using Montelukast sodium combined with pidotimod can effectively reduce the children's acute phase protein levels, improve immune function, which has clinical value for the treatment of children with acute bronchitis.

Effects of glucocorticoid combined with antibiotics on serum infection indexes, acute phase proteins and stress hormones in patients with severe pneumonia

Objective: To study the effects of glucocorticoid combined with antibiotics on serum infection indexes, acute phase proteins and stress hormones in patients with severe pneumonia. Methods: a total of 80 patients with severe pneumonia who were hospitalized between August 2014 and January 2017 were retrospectively analyzed and divided into the routine treatment group (n=46) who received conventional antibiotic therapy and the combined treatment group (n=34) who received glucocorticoid combined with antibiotic therapy, and the differences in infection indexes, acute proteins and stress hormones were compared between the two groups of patients before and after treatment. Results: The differences in serum levels of infection indexes, acute phase proteins and stress hormones were not statistically significant between the two groups before treatment. After 1 week of treatment, serum infection indexes CRP and PCT levels of observation group were lower than those of control group;serum acute phase proteins α1-AT, α1-AG and CER levels were lower than those of control group;serum stress hormones Cor, AngⅠ and AngⅡ levels were lower than those of control group. Conclusion:Glucocorticoid combined with antibiotics can effectively inhibit systemic infection and stress and optimize the illness in patients with severe pneumonia.

Differences in Acute Phase Reactants between Gout and Pseudogout

Objectives: To define clinical differences in the acute phase response and serum acute phase reactants between gout, pseudogout and crystal-induced arthritis in the presence of non-articular infections (CAI). Patients and Methods: Eleven patients with definite gout, 12 patients with pseudogout and 5 patients with CIA were included in the study. Results: The erythrocyte sedimentation rate (ESR) was significantly different between gout (68.2 ± 49.9 mm/Hr) and CIA (113.8 ± 37.2 mm/Hr) but not between gout and pseudogout (83.9 ± 45.6 mm/Hr) or between pseudogout and CIA. The C-reactive protein (CRP) was significantly increased between gout (10.1 ± 7.9 mg/dL) and pseudogout (18.9 ± 9.8 mg/dL), gout and CIA (36.5 ± 12.4 mg/dL) as well as between pseudogout and CIA. The peripheral white cell count was significantly different between gout (9.27 ± 3.7 k/μL) and CIA (16.5 ± 6.8 k/μL), and between pseudogout (8.9 ± 3.2 k/μL) and CIA. Conclusions: Measurement of ESR and CRP are helpful in crystal-induced arthritis. The CRP has more discriminating utility than the ESR in distinguishing between gout, pseudogout and CIA. Peripheral wbc is most useful for differentiating crystal-induced arthritis from CIA.

牙周感染对脑梗死患者APP及IL-6水平的影响

目的:探讨急性脑梗死患者急性期反应蛋白(acute phase protein,APP)和白介素-6(interleukin-6,IL-6)水平的变化,以及牙周感染的全身抗体反应对脑梗死患者APP及IL-6水平的影响。方法:随机选择首次发作急性脑梗死患者88例,健康对照组40例,并依据牙龈卟啉单胞菌IgG抗体(P.g-IgG)水平高低分为Pg-IgG抗体阳性[Pg-IgG(+)]组与Pg-IgG抗体阴性[Pg-IgG(-)]组。分别利用酶联免疫吸附试验和全自动血凝分析仪检测各组受试者超敏C反应蛋白(high-sensitivity C-reactive protein,Hs-CRP)、纤维蛋白原(fibrinogen,Fg)以及IL-6的血清浓度。结果:急性脑梗死患者Hs-CRP、Fg以及IL-6明显高于健康受试者;Pg-IgG(+)组Hs-CRP和IL-6明显高于Pg-IgG(-)组;Hs-CRP和IL-6与Pg-IgG正相关。结论:牙龈卟啉单胞菌的全身扩散或其引起的全身抗体反应可通过促进Hs-CRP和IL-6水平的升高而增加脑梗死的患病风险。

血清SA、Fuc、APP测定对AFP(-)HCC的诊断价值

本文对31例血清甲胎蛋白(AFP)阳性原发性肝细胞性肝癌(HCC)、33例AFP(—)HCC、35例肝硬化和58例正常献血清唾液酸(SA)、岩藻糖(Fuc)及五种急性期蛋白(APP)[a_1-酸性糖蛋白(a_1-AG)、结合珠蛋白(HP)、a_1-抗胰蛋白酶(a_1-AT)、前白蛋白(PA)和转铁蛋白(TF)]同时进行测定.结果表明AFP(—)肝癌组患者血清SA、Fuc、a_1-AG、HP及a_1-AT均显著高于对照组,其中,Fuc、a_1-AG与HP又比AFP(+)肝癌组为高.因此可将上述五项指标视为AFP(—)肝癌患者血清肿瘤标志物.此外,还发现肝癌患者血清两种结合蛋白的糖类含量高与血清a_1-AG。

Proteomic approach for acute-phase proteins of hemolymph and muscles in Scylla serrata challenged by a pathogenic bacterium

Acute-phase response is documented to be a significant mechanism of innate immunity in vertebrates and invertebrates.In this study,proteomic methodologies were applied for different protein expressions in hemolymph of Scylla serrata challenged by Vibrio parahaemolyticus after immunization,and in muscles of the crabs separately chal-lenged by V.parahaemolyticus,V.anguillarum and Aeromonas hydrophila.Up-regulated cryptocyanin is documented in the hemolymph and up-regulated calexcitin,wingless(fragment)and tachykinin-related peptide in the muscle as acute-phase proteins.All the four altered proteins were responsible for bacterial stress,but cryptocyanin seemed to be a memory response protein against the chal-lenge by a live bacterium after immunization of the live cells.These up-regulated proteins can be indicative of an understanding of immunity of a crab.

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。

不同时期RMPP患儿支气管肺泡灌洗液SPA表达及与肺功能的关系

目的探讨不同时期难治性支原体肺炎(refractory mycoplasma pneumoniae pneumonia,RMPP)患儿支气管肺泡灌洗液中表面活性物质相关蛋白-A(surfactant protein A,SPA)的表达水平及与肺功能的关系。方法选取2021年1月—2023年1月南通市第一人民医院收治的62例RMPP患儿为对象,以同期行支气管镜异物取出术且无肺部感染的50例患儿为对照组。RMPP患儿于急性期、恢复期行支气管肺泡灌洗液中SPA检测以及肺功能指标检测[第1秒用力呼气容积(forced expiratory volume in one second,FEV_(1))、用力肺活量(forced vital capacity,FVC)、FEV_(1)/FVC],对照组同样如此。比较三者检测结果差异,使用Pearson分析RMPP患儿支气管肺泡灌洗液中SPA水平与肺功能指标的相关性。结果RMPP患儿肺泡灌洗液中的SPA急性期(59.82±12.64)μg/L、恢复期(129.91±24.86)μg/L高于对照组,差异有统计学意义(P<0.05)。RMPP急性期、RMPP恢复期的FEV_(1)、FVC、FEV_(1)/FVC(80.95±6.88)%、(88.41±5.75)%较对照组低,差异有统计学意义(P<0.05);RMPP患儿于急性期时肺泡灌洗液中的SPA较恢复期低,FEV_(1)、FVC、FEV_(1)/FVC较恢复期低,差异有统计学意义(P<0.05);RMPP患儿肺泡灌洗液中SPA水平与FEV_(1)、FVC、FEV_(1)/FVC呈正相关(P<0.05)。结论RMPP患儿病情处于急性发展阶段的情况下其支气管肺泡灌洗液中的SPA表达相较病情恢复阶段更低,同时RMPP患儿支气管肺泡灌洗液中SPA水平与其肺功能指标呈正相关性。

Inflammation: Complexity and significance of cellular and molecular responses

Inflammation is a multifaceted cellular and molecular response triggered by injury,infection,or various pathological conditions.Serving as a protective defense mechanism,the inflammatory response involves clinical signs like redness,swelling,pain,and increased body temperature.Immune cells,notably neutrophils and macrophages,play key roles in orchestrating this response.The delicate balance between proinflammatory and anti-inflammatory mediators,including cytokines and chemokines,regulates the inflammatory cascade.While acute inflammation is crucial for tissue repair,chronic inflammation may indicate an imbalance,contributing to conditions like autoimmune diseases.Understanding these mechanisms is vital for developing therapeutic strategies and managing chronic diseases.

牡荆水提物对蓖麻油腹泻小鼠的治疗作用研究

[目的]研究牡荆水提物对蓖麻油致小鼠腹泻的治疗作用,评价牡荆提取物的抗腹泻功效,为开发新型天然药物或植物提取物饲料添加剂提供理论依据。[方法]选取48只18~22 g SPF级昆明小鼠,随机分为6组:对照组、模型组、洛哌丁胺组及牡荆水提物高、中、低剂量组,每组8只,雌雄各半。牡荆水提物高、中、低剂量组小鼠灌胃16、8、4 g/kg BW牡荆水提物,对照组和模型组小鼠灌胃等剂量的生理盐水,洛哌丁胺组小鼠灌胃5 mg/kg BW洛哌丁胺,连续灌胃5 d。第5天给药后0.5 h,模型组、洛哌丁胺组及牡荆水提物高、中、低剂量组小鼠灌胃0.5 mL蓖麻油灌胃造模,对照组灌胃等量生理盐水。造模后的小鼠单笼单只饲喂。连续4 h观察小鼠腹泻情况,4 h后小鼠采血并断颈处死,每组随机取4只小鼠的肝脏、小肠各两份,一份制作组织切片;另一份用以提取RNA,检测空肠通道蛋白和肝脏急性期蛋白mRNA表达情况。[结果]模型组小鼠腹泻评分和腹泻指数均极显著高于对照组(P<0.01),说明蓖麻油腹泻模型造模成功。与模型组相比,洛哌丁胺组和牡荆水提物高剂量组小鼠腹泻评分和腹泻指数均极显著或显著降低(P<0.01;P<0.05);牡荆水提物高剂量组小鼠血清中白细胞介素1β(IL-1β)、IL-6、IL-10含量均显著或极显著降低(P<0.05;P<0.01)。肝脏组织病理结果显示,牡荆水提物高、中、低剂量组小鼠肝索结构清晰,肝细胞排列紧密,仅少量肝细胞轻度肿胀,并伴少量炎性细胞浸润。肠道组织病理结果显示,牡荆水提物高、中、低剂量组小鼠空肠黏膜层、肌层、浆膜层均清晰可见,黏膜层绒毛上皮内见大量空泡,但均未见明显坏死或炎症反应。与模型组相比,牡荆水提物高剂量组小鼠空肠中NHE8、NHE3、AQP3、AQP4表达量均无显著差异(P>0.05),NHE2表达量显著降低(P<0.05),急性期蛋白TRF和CRP表达量均显著降低(P<0.05)。[结论]牡荆水提物对蓖麻油导致的小鼠腹泻模型具有较好的治疗作用,对肝脏和小肠黏膜具有一定的保护作用,作用机制可能与其降低血清中IL-6、IL-10含量,以及在一定程度上降低NHE2表达、抑制TRF和CRP的表达有关。

复方福尔可定联合孟鲁司特钠治疗小儿急性支气管炎的临床效果

目的探究复方福尔可定联合孟鲁司特钠治疗小儿急性支气管炎的临床效果。方法选择2020年12月至2022年12月我院收治的106例急性支气管炎患儿作为研究对象,采用随机数字表法将其分为对照组和联合组,各53例。对照组采用孟鲁司特钠治疗,联合组在对照组基础上加用复方福尔可定治疗。比较两组的治疗效果。结果联合组的治疗总有效率为94.34%,显著高于对照组的81.13%(P<0.05)。联合组的体温恢复、咳嗽消失、咳痰消失、肺部体征消失时间及住院时间均短于对照组(P<0.05)。治疗后,联合组的潮气量(V-T)、达峰时间比(TPEF/TE)高于对照组,呼吸频率(RR)、呼吸时间比(Ti/Te)低于对照组(P<0.05)。治疗后,联合组的α1-酸性糖蛋白(α1-AG)、结合珠蛋白(HP)、超敏C反应蛋白(hs-CRP)、半胱氨酰白三烯(CysLTs)、单核细胞趋化蛋白-4(MCP-4)、降钙素原(PCT)水平低于对照组(P<0.05)。结论复方福尔可定联合孟鲁司特钠治疗小儿急性支气管炎的效果显著,可加快病情恢复,减轻气道炎症,改善肺功能。

血清急性时相反应蛋白联合白细胞介素在细菌性感染性疾病的诊断价值分析

目的:分析血清急性时相反应蛋白联合白细胞介素对细菌性感染性疾病的诊断价值。方法:选取2022年10月—2023年10月于菏泽市牡丹区高庄镇中心卫生院检查确诊的感染性疾病患儿162例作为研究对象,以细菌培养结果为“金标准”,将86例细菌性感染性疾病患儿划分为试验A组,将76例非细菌感染性疾病患儿划分为试验B组。选取同时期于我院接受治疗的非感染性疾病患儿86例,将其划分为对照组。抽取所有患儿空腹血清,检测急性时相反应蛋白、白细胞介素,分析其对细菌性感染性疾病的诊断价值。结果:对照组患儿急性时相反应蛋白相关指标铜蓝蛋白(CER)、C反应蛋白(CRP)、降钙素原(PCT),白细胞介素相关指标白细胞介素-6(IL-6)、白细胞介素-8(IL-8)低于试验A组,差异有统计学意义(P<0.05)。试验B组患儿急性时相反应蛋白相关指标CER、CRP、PCT,白细胞介素相关指标IL-6、IL-8水平低于试验A组,差异有统计学意义(P<0.05)。急性时相反应蛋白、白细胞介素检测阳性均低于二者联合检测。急性时相反应蛋白、白细胞介素灵敏度和准确度均低于联合诊断,差异有统计学意义(P<0.05)。结论:血清急性时相反应蛋白、白细胞介素相关指标在细菌性感染性疾病中呈现异常高表达,说明清急性时相反应蛋白、白细胞介素相关指标与细菌性感染性疾病密切相关,且两者对细菌性感染性疾病检测有着较高的诊断效能。

Clinical and Experimental Study of Effect on Acute Phase Protein of Multiple Organ Dysfunction Syndrome Treated with Dachengqi Decoction

Objective: To investigate the level of acute phase proteins (APP)-synthesized in hepatocytes in pathogenic process of multiple organ dysfunction syndrome (MODS) and the effect of Dachengqi Decoction (DCQD) on it. Methods: The levels of C-reactive protein (CRP),α1-acid glycoprotein (AAG), α1-antitrypsin total (α1AT), α2-macroglobulin (α2-MG), ceruloplasmine (CP), hepatoglobin (HP) and transferrin (TF) synthesis were determined in 32 cases of MODS patients and rat models of MODS induced by acute infective peritonitis and mesenterial artery ischemia-reperfusion.Results: The serum APP level in MODS patients was increased and higher than that in the control group (P < 0. 01 ). After 3 days of DCQD treatment it reduced significantly (P <0. 05). Serum APP level in MODS model was also increased significantly, and after 3 days of DCQD treatment, it reduced significantly (P < 0. 05). The APP secreting level of rat hepatocytes cultured in vitro raised after stimulated and activated by lipopolysacchride, which was reduced after cultured with rabbits serum containing different concentration of effective ingredients of DCQD. The APP inhibiting effect of DCQD was dose dependent. Conclusion: Purgation therapy with DCQD could reduce the stimulation of pathogenic factors on hepatocytes, protect tissues and organs from damage caused by excessive inflammatory reaction.Original article on CJIM(Chin) 1998; 18(8): 453

双向电泳-质谱技术筛选肝癌血清标记物

采用双向电泳-质谱技术筛选肝癌特异的血清蛋白标记物,以利于肝癌的早期诊断和治疗.肝癌、肝炎和正常三组各20例血清先采用超声、高丰度蛋白去除、脱盐预处理以优化双向电泳,图像分析三组血清图谱寻找差异点,基质辅助激光解吸飞行时间质谱对差异点进行鉴定.结果显示,通过样品预处理,血清上样体积平均增加3～4倍,参考胶点数由218个增至332个,白蛋白和免疫球蛋白明显减弱,水平条带明显减少.图谱比较所得37个差异点,经鉴定为7种蛋白.与正常组比较,转铁蛋白、甲状腺素运载蛋白在肝炎和肝癌组低表达,α-1抗胰蛋白酶、凝聚素、铜蓝蛋白、触珠蛋白在肝炎和肝癌组均高表达.α-1抗胰蛋白酶在肝癌组较肝炎组高表达,而热休克蛋白27只在肝癌组表达.上述结果提示,双向电泳-质谱技术可发现肝癌发生发展过程中血清蛋白表达谱质或量的变化,从而为肝癌的早期诊断及治疗奠定基础.

脓毒症患者急性时相蛋白的动态联合检测

目的 研究血清急性时相蛋白水平在脓毒症和重度脓毒症患者炎症过程中的变化及其临床意义。方法 采用全自动特定蛋白定量分析方法,分组动态测定1、3、7、1 4和2 1 d 5个时间点2 9例脓毒症( SP)组和2 7例重度脓毒症( SSP)组患者的C反应蛋白( CRP)、a1酸性糖蛋白( AAG)、铜蓝蛋白( CER)以及结合珠蛋白( HP)的血清含量,并与3 0例健康体检者进行对照分析。结果 1 SP组:CRP和AAG在炎症早期1 d内就显著升高( P<0 .0 1和P<0 .0 5) ,其中CRP3 d达高峰,AAG3～7d达高峰,AAG持续高峰时间达1 4 d,CRP和AAG各时间点间差异显著( P均<0 .0 1 ) ;CER无显著升高( P>0 .0 5) ,各时间点差异不显著( P>0 .0 5) ;HP早期也显著升高( P<0 .0 5) ,但各时间点差异无显著性( P>0 .0 5)。2 SSP组:CRP和AAG均显著升高( P均<0 .0 1 ) ,高峰持续时间均长达1 4 d,各时间点间差异非常显著( P<0 .0 1 ) ;CER7d前呈下降趋势( P<0 .0 5) ,各时间点间差异有显著性( P<0 .0 5) ;HP在1 4 d才显著升高,2 1 d达峰值( P均<0 .0 5) ,各时间点间差异有显著性( P<0 .0 5)。组间趋势变化比较:CRP、AAG和HP差异均有显著性( P均<0 .0 5) ,CER差异无显著性( P>0 .0 5)。结论 CRP早期升高是感染的敏感指标,CRP和AAG高峰持续时间延长提示重度感染;

四种急性时相蛋白对肝硬化继发感染的早期诊断价值的探讨

目的 :探讨各种急性时相蛋白 (APP)对肝硬化继发感染早期诊断的临床价值及各项 APP对感染预测的参考值。方法 :采用全自动速率散射比浊法对 5 1例肝硬化患者进行 4种 APP〔C反应蛋白 (CRP)、α1 酸性糖蛋白 (AAG)、铜蓝蛋白 (CER)和触珠蛋白 (HPT)〕的动态检测 ,2 5例肝硬化继发感染者中 14例于感染控制后再行监测 ,并与非肝硬化感染组、非肝硬化无感染组进行对比分析。结果 :肝硬化继发感染患者入院第 2日CRP、AAG、HPT显著高于无继发感染组 ,以正常人群的 APP水平上限为标准 (即 8mg/ L ) ,则 CRP对感染诊断的敏感度及特异度分别为 88.0 0 %和 76 .92 % ;如 CRP以肝硬化无感染组的 95 %正常值为参比值上限 (即16 mg/ L) ,则特异度为 92 .31% ;其它 3项 APP的敏感度较低 ,但特异度高 ;如 CRP和 AAG两项指标结合判断 (即同时 CRP≥ 8mg/ L ,AAG≥ 12 5 0 mg/ L为参比值 ) ,本资料中感染特异度判断达 10 0 %。 CRP以 8mg/ L为参考值上限 ,外周血白细胞计数高于 10× 10 9/ L 为异常 ,则 CRP与外周血白细胞计数相比 ,入院第 2日肝硬化并感染患者的异常率分别为 88.0 0 %和 31.82 %。对 14例感染控制前后患者的 APP动态监测发现 ,CRP呈显著负相关 ,而其它 3项指标差异不显著。结论 :CRP,AAG和 HPT对诊断肝?