单核细胞单层试验在预测IgG抗-M相关胎儿新生儿溶血病中的应用

目的探讨单核细胞单层实验(monocyte monolayer assay,MMA)是否能够用于IgG抗-M相关胎儿新生儿溶血病(hemolytic disease of fetus and newborn,HDFN)的预测。方法选取8例含有IgG抗-M的孕妇并采集血浆标本,其中有胎儿水肿等严重临床症状及无明显临床症状的各4例;8份血浆用二硫苏糖醇(dithiothreitol,DTT)灭活,与M抗原阳性红细胞孵育致敏后,将致敏红细胞与单核细胞混合进行吞噬试验,同时设立阳性及阴性对照,并计算吞噬率;采用t检验对2组吞噬率进行比较。结果4例发生严重抗-M相关HDFN的孕妇的MMA吞噬率分别为15.37%、13.05%、9.17%和24.50%,均值为15.52%;检出IgG抗-M但未发生HDFN的孕妇,其MMA吞噬率分别为8.74%、11.07%、5.12%和6.23%,均值为7.79%,2组吞噬率无差异(P>0.05)。2组吞噬率分别与阴性对照比较均无差异(P>0.05),但均明显低于阳性对照(P<0.05)。结论IgG抗-M介导单核细胞吞噬的能力较低,提示抗-M导致胎儿水肿的机制可能并非红细胞被吞噬破坏而发生的溶血,因此体外单核细胞单层实验可能不适用于IgG抗-M相关HDFN的预测。对于检出IgG抗-M的孕妇,现仍需通过定期监测胎儿大脑中动脉血流,来判断胎儿宫内贫血情况。

基于3,5-二溴水杨醛席夫碱镍配合物-氧化石墨烯电化学免疫传感器检测Anti-IgG含量的研究

应用物理吸附法将羊抗人IgG抗原直接固定于3,5-二溴水杨醛席夫碱镍配合物-氧化石墨烯修饰的金电极表面,制备电化学免疫传感器。采用循环伏安法和交流阻抗法对传感器进行表征,结果表明该传感器适合检测Anti-IgG浓度。同时探讨了缓冲液pH值、扫描速度、免疫反应温度、抗原与抗体配比对循环伏安峰电流的影响,结果表明在5-100mV/s扫速范围内,峰电流与扫速呈线性。孵育最优条件为25℃,h-IgG与Anti-IgG配比为1∶1。循环伏安法研究还表明Anti-IgG浓度在0.01-260μg/L范围内,线性关系良好,相关系数r^2=0.993,检出限（S/N=3）为0.006μg/L,据此建立了检测Anti-IgG浓度的新方法。

Waning of Anti-Spike IgG Antibody Titer after COVID-19 Vaccination: Myth or Reality?

This observational prospective study was conducted on 25 patients who had received a full 3-dose COVID-19 vaccination scheme with a follow-up ranging from 12 to 19 months after the last injection. The aim of the study was focused on a single biological indicator the anti-spike IgG antibody titer. The age of the patients ranged from 51 to 85 years old. 15 out 25 patients (60%) presented a comorbidity. Our data showed a persistent positive anti-spike IgG antibodies titer ranging from 105 to 5680 BAU/mL (mean: 2661 BAU/mL) in all patients. In view of these results, systematic administration of a SARS-CoV-2 vaccine booster is questionable and should be individually tailored according to the patient medical condition and the anti-spike IgG antibody level.

O型血孕妇产前血清IgG抗A(B)抗体效价积分评估HDN发生价值

目的:探究产前O型血孕妇血清中免疫球蛋白G(IgG)抗A(B)抗体效价积分对新生儿溶血(HDN)发生的预测价值。方法:回顾性选取2022年1月-2023年12月本院收治的101例O型血孕妇临床资料,根据新生儿是否发生HDN分为为HDN组(n=26)和非HDN组(n=75)。比较两组临床资料、产前血清中IgG抗A(B)抗体效价积分等。采用Spreaman相关分析分析孕妇血清中IgG抗A(B)抗体效价积分与HDN发生的相关性,受试者工作曲线(ROC)分析O型血孕妇血清中IgG抗A(B)抗体效价积分对HDN发生的预测价值。结果:HDN组孕妇产前血清IgG抗A(B)抗体效价均高于非HDN组,当产前血清的IgG抗A(B)抗体效价相同时,HDN组孕妇的血清IgG抗A(B)抗体效价积分明显于非HDN组(均P<0.05);Spearman相关分析,孕妇产前血清IgG抗A(B)抗体效价积分与HDN发生呈正相关(r=0.666,P<0.001);ROC曲线分析,O型血孕妇血清中IgG抗A(B)抗体效价积分预测HDN发生曲线下面积0.874,截断值54.88,灵敏度84.0%、特异度94.7%。结论:产前O型血孕妇血清中IgG抗A(B)抗体效价积分新生儿发生HDN概率呈正相关,且对HDN的发生有一定预测价值。

MOG-IgG相关疾病的研究进展

抗髓鞘少突胶质细胞糖蛋白免疫球蛋白G抗体(MOG-IgG)相关疾病(MOGAD)临床表现缺乏特异性,且极易误诊。现就MOGAD的流行病学、病因、发病机制、临床表型、抗体检测、MRI检查、诊断及治疗预后研究现状及进展进行综述,以期提高医护人员对该病的认识。

中国人视神经脊髓炎疾病谱NMO-IgG/anti-AQP4抗体检测方法学的比较

【目的】建立NMO-IgG/anti-AQP4抗体检测的间接免疫荧光法(IIF),细胞分析法(CBA)和荧光免疫沉淀法(FIPA)法;研究并比较不同的检测方法对中国人群NMO疾病谱的检测效率。【方法】建立3种检测NMO-IgG/anti-AQP4抗体的方法,包括IIF、CBA和FIPA。应用盲法检测病人血清106例,其中视神经脊髓炎(NMO)组24例,纵形扩展性脊髓炎(LETM)组22例,多发性硬化(MS)组30例,健康对照(HC)组30例;对其检测的阳性率进行分析。【结果】通过3种方法检测,发现NMO组NMO-IgG/anti-AQP4抗体阳性率分别为IIF(62.5%,15/24),CBA(91.7%,22/24)及FIPA(75.0%,18/22),LETM组为IIF(59.1%,13/22),CBA(86.4%,19/22)及FIPA(72.3%,16/22),MS组IIF、CBA及FIPA均为(3.3%,1/30)。正常对照组未见该抗体阳性表达。NMO组及LETM组血清NMO-IgG/anti-AQP4抗体阳性率明显高于MS和健康对照组。【结论】在中国人群NMO疾病谱患者中,IIF、CBA和FIPA的检测效率基本和美欧报道一致。IIF是该抗体检测的基础方法;CBA法看起来最为敏感;FIPA检测可以量化该抗体,可用于临床高通量大样品筛查。

流式细胞术与微柱凝胶技术检测O型孕妇IgG anti-A(B)相关性分析及临床意义

目的研究流式细胞术与微柱凝胶技术检测孕妇IgG anti-A(B)相关性;探讨流式细胞术与微柱凝胶技术检测孕妇IgG anti-A(B)优、缺点及临床意义。方法选取O型孕妇27例,其丈夫血型为:A型(13例)、B型(10例)和AB型(4例)。β-巯基乙醇消化孕妇血浆以灭活IgM anti-A(B),消化后的血浆即为母液。生理盐水倍比稀释母液直至稀释管稀释倍数为1∶1024。流式细胞术检测母液管和稀释管IgG anti-A(B)总平均荧光强度(MFI)和IgG anti-A(B)阳性百分率(%)。微柱凝胶技术仅检测稀释液管IgG anti-A(B)效价。分析流式细胞术与微柱凝胶技术检测孕妇IgG anti-A(B)结果的相关性。结果①微柱凝胶技术检测孕妇IgG anti-A(B)效价分别与流式细胞术母液IgG anti-A(B)总MFI和IgG anti-A(B)阳性百分率成正相关(r=0.4726,P=0.0073;r=0.6158,P=0.0002),且IgG antiA(B)总MFI和IgG anti-A(B)阳性百分率成正相关(r=0.9185,P<0.0001);②流式细胞术按血型分组,不管是A型或B型,也不管是母液或稀释液管,IgG anti-A(B)总MFI和IgG anti-A(B)阳性百分率均成正相关(r=0.9020,P<0.0001;r=0.9043,P<0.0001)(r=0.8913,P<0.0001;r=0.8706,P<0.0001);③以微柱凝胶技术为金标准,取正常参考值1∶64作Cutoff值,得到流式母液管IgG anti-A(B)阳性百分率受试者工作曲线(ROC)面积(Area=0.8238,P=0.0041)大于IgG anti-A(B)总MFI的ROC面积(Area=0.7405,P=0.03289);④微柱凝胶技术检测孕妇IgG anti-A(B)效价1∶64时,其流式稀释管1∶64与稀释管1∶128的IgG anti-A(B)阳性百分率有显著差异(P=0.0044)。结论①流式细胞术与微柱凝胶技术检测孕妇IgG anti-A(B)其结果存在相关性;②相对于微柱凝胶技术,流式细胞术检测IgG anti-A(B)方法更简单、效率更高、敏感性更好。

The Positivity Rate of Epstein-Barr Virus Anti-Viral Capsid Antigen IgG among Children with Infectious Mononucleosis in Diyala-Iraq

Background: Epstein-Barr virus (EBV) is a double-stranded linear DNA human herpesvirus that is transmitted primarily through saliva during childhood. Although the majority of primary EBV infections are clinically asymptomatic, clinical cases are presented as infectious mononucleosis (IMN) syndrome. Objectives: This study was conducted to explore the rate of EBV anti-VCA IgG among children who were clinically suspected as having IMNin Diyala province. Subjects and Methods: This is a cross sectional study that was carried out during 2018 in Diyala province-Iraq. A total of 370 blood samples were collected from 190 children under 15 years of age who were clinically suspected as having IMN, and 180 apparently healthy children as controls. The anti EBV VCA IgG antibodies were detected in serum using the VCA IgG ELISA kit (from Dia.Pro Diagnostic Bioprobessrl-Italy). Statistical analysis was carried out using the SPSS-version 25. A statistical significance was considered whenever the P value was ≤ 0.05. Results: The results showed that the IgG positivity rate among suspected IMN patients was insignificantly higher in the age group 10 - 14 years old children (80.8%, P = 0.364). In control subjects the highest positivity rate was in the age group of 1 - 4 years with a statistically significant difference (79.5%, P = 0.002). In suspected IMN patients, the age group of 10 - 14 years had the highest mean concentration ± SD of anti-VCA IgG 44.018 ± 38.644 arbitrary units per milliliter (arbU/ml), while in controls, the highest value 38.018 ± 34.908 (arbU/ml) was in the age group of 1 - 4 years, with insignificant difference in either group (P = 0.257 and 0.072, respectively). The results also showed that in both suspected IMN patients and control subjects, females showed higher IgG positivity rate (70.6%, and 75.5%) compared to males (64.8%, and 65.1%) with insignificant difference in both groups (P = 0.392 and 0.126) respectively. Similarly, the IgG mean concentration ± SD was insignificantly higher in females in both suspected IMN patients and control subjects (P = 0.447 and 0.256) respectively. 21 (87.5%) of IgM positive suspected IMN patients were also IgG positive with a statistically significant association (P = 0.028). Conclusion: The positivity rate of anti-EBV VCA IgG among apparently healthy subjects in Diyala province was 70.6%, which increases by age with slight association with clinical suspicion of infectious mononucleosis.

结核性胸膜炎患者ADA和anti-PPD-IgG检测的诊断价值

目的探讨胸水腺苷脱氨酶(ADA)和血清抗结核抗体(anti-PPD-IgG)检测在结核性胸膜炎诊断上的价值。方法对2002～2006年确诊的结核性胸腔积液95例、恶性胸腔积液32例,漏出液16例患者的胸腔积液、血清进行ADA和anti-PPD-IgG检测,并对结果进行统计学分析。结果结核组与非结核组胸水ADA和血清anti-PPD-IgG检测均有显著差异(P<0.01),统计二项联合检测敏感性、特异性、准确性分别为91.6%、97.9%和93.7%,均高于单项检测(p<0.01)。结论联合检测胸水ADA和血清anti-PPD-IgG可提高结核性胸膜炎诊断的敏感性和诊断率。

O型血孕妇IgG抗A(B)抗体效价与新生儿溶血病和高胆红素血症关系及预测价值

目的:探究O型血孕妇IgG抗A(B)抗体效价意义及预测新生儿溶血病(HDN)和高胆红素血症价值。方法:回顾性收集2020年1月-2022年6月本院接诊的98例O型血孕妇临床资料,检测孕妇血型、抗体效价,比较O型血孕妇IgG抗A(B)抗体效价表达,新生儿确诊HDN发病情况,分析O型血孕妇IgG抗A(B)抗体效价与新生儿HDN和高胆红素血症发病相关性及预测价值;结果:O型血孕妇IgG抗A(B)抗体效价≤1:32占比(69.4%、62.2%)较高,新生儿发生HDN中放散阳性病例(14.6%)高于游离阳性(7.3%);新生儿HDN和高胆红素血症的发生率与母体抗体效价正相关,效价越高新生儿溶血病和高胆红素血症发生率越高(均P<0.05);受试者工作特征曲线分析,IgG抗A(B)抗体联合检测评估新生儿HDN和高胆红素血症的曲线下面积为0.896、0.881,检测效能高于单独检测(P<0.05)。结论:O型血孕妇IgG抗A(B)抗体效价与新生儿HDN和高胆红素血症的发生具有相关性,对HDN和高胆红素血症有良好诊断价值,提示临床对于效价高的孕妇应加强观察并早期干预。

Arsenic Exposure and Association with Hepatitis E IgG Antibodies

Arsenic is a known toxic chemical, has immuno-modulatory properties, and can change the susceptibility of infection in humans. Acute hepatitis E is an infectious disease;it can be self-limiting, but in severe cases, can cause acute-on-chronic liver failure. The presence of IgG anti-HEV (hepatitis E IgG antibody) in blood represents a past hepatitis E infection in an individual. Very few studies have investigated the association between arsenic levels and hepatitis E seroconversion in humans. The primary objective of this study was to assess the relationship between total urinary arsenic and speciated urinary arsenic (urinary arsenous acid, urinary arsenic acid, urinary arsenobetaine, urinary arsenocholine, urinary dimethylarsinic acid, urinary monomethylarsonic acid) and the presence of IgG anti-HEV. The 2011-2012, 2013-2014, and 2015-2016 National Health and Nutrition Examination Survey (NHANES) III data sets were analyzed, with participants aged 20 years and older (n = 7061). We used weighted logistic regression to determine the association between total and speciated urinary arsenic concentrations and IgG anti-HEV. For each analyte considered, a separate weighted logistic regression model was fitted. Each of these models regressed log-transformed analyte levels on the log-odds of the presence of IgG Anti-HEV. To evaluate the relationships between the urinary arsenic measurements, pairwise Pearson correlation coefficients were determined for each of the urinary arsenic measurements. Of the human subjects included, 6628 (93.9%) were negative for IgG Anti-HEV while 433 (6.1%) were positive for IgG anti-HEV. Total urinary arsenic was associated with 1.161 times greater odds of IgG anti-HEV (95% CI: [1.035, 1.303]) for each unit increase in concentration on a log-scale. For speciated urinary arsenic measurements, the odds ratios and 95% CI’s were: arsenobetanine 1.168 [1.075, 1.270], arsenocholine 1.201 [0.944, 1.529], dimethylarsinic acid 1.183 [1.009, 1.386], monomethylacrsonic acid 1.095 [0.915, 1.310], aresnous acid 0.907 [0.762, 1.079], and arsenic acid 1.951 [0.905, 4.209]. Our analysis indicates that total urinary arsenic, arsenobetanine, and dimethylarsinic acid are significantly associated with the odds of the presence of IgG anti-HEV. Future prospective studies are required to evaluate the association between hepatitis E infection and arsenic exposures.

Anti- MSP-1_(19) antibody (IgG) and reactive oxygen species (ROS) response against malaria infection in pregnancy in South Western Nigeria

Objective:Although immunity to malaria is reduced in pregnancy,the maternal immune system still continues to respond to malaria infection by the production of antibodies.IgG has been reported to play significant role in immune response against P.falciparum.Anti-MSP-119 antibody and reactive oxygen species have been shown to be protective against malaria infection in children.This work assessed the response of anti-MSP-119 antibody（a promising blood stage vaccine candidate antigen） and oxidative stress in 250 pregnant women.Methods: Blood samples were collected in dry and wet seasons.Plasmodium falciparum infection was determined by microscopy, anti-MSP-119 IgG level was investigated using ELISA.Malondiadelhyde（MDA） and reduced glutathione （GSH） were used as indicators of oxidative stress and they were quantified spectrophotometrically.Results: Parasitaemia was significantly higher（P【0.05） in wet than dry season and its level decreased with gravidity.There was a significant increase（P【0.05） in anti-MSP-119 IgG and MDA levels in the dry than wet season.Anti-MSP-119 IgG and MDA levels were significantly higher in P.falciparum positive primigravidae than P.falciparum negative primigravidae in both wet and dry seasons.In wet season anti-MSP-119 IgG level was significantly increased（P【0.05） in P.falciparum positive multigravidae than P.falciparum negative. The anti-MSP-119 IgG and MDA were significant higher in P.falciparum positive multigravidae than primigravidae. Reduced glutathione（GSH） level was significantly reduced（P【0.05） among malaria positive than malaria negative patients in both seasons.Conclusion:This study suggests that IgG and MDA response were positively associated with the presence of malaria infection.

Expression of TTV-ORF2 Protein for Detection of Anti-TTV IgG Antibodies in Human Sera

The present study describes the cloning and expression of ORF-2 region of TTV genome and the use of expressed peptide in developing immunoassay for detection of anti-TTV antibodies in serum. Presence of TTV-DNA in serum was detected by PCR amplifying N-22 region of ORF-1 of TTV genome. This was followed by genotyping of TTV by RFLP using N-22 amplicon. Using genotype-1 positive serum as the source of TTV, the ORF-2 region was amplified by PCR and subsequently cloned and expressed in pET-19b vector. The expressed protein, identified as 20 kDa protein on SDS-PAGE gel, was purified by affinity chromatography and then used as antigen to develop western blot assay for detection of anti-TTV antibodies in serum. Analysis of sera for anti-TTV antibodies and their comparison with presence of TTV-DNA, produced encouraging results. There was a good relation between presence of anti-TTV and TTV-DNA in these sera samples. Anti-TTV antibodies could be detected in all TTV-DNA positive sera irrespective of the presence of TTV-genotype. This investigation demonstrates that ORF-2 peptide may be used in developing immunoassay for identification of TTV infection.

Analysis Concentration of <i>Toxoplasma gondii</i>on Anti-Toxoplasma IgG-IgM Antibody Levels, and the Outcomes of Pregnancy in Mice Balb/c

Introduction: Toxoplasma gondii is an obligate intracellular protozoan parasite that can infect any warm blood vertebrae, and if first trimester pregnant woman infected, it may cause abortion. The objective is to prove the effect of the Toxoplasma gondii concentration in anti-toxoplasma IgG-IgM antibody levels, and the outcomes of Balb/c mice pregnancies. Materials and Methods: The study was conducted in Balb/c mice with inclusion criteria, and was conditioned pregnant. The pathogen strains of Toxoplasma gondii tachyzoite injected intraperitoneally. The blood samples were taken serially to be tested for anti-toxoplasma IgG-IgM antibody levels. After the mice were injected with tachyzoite, they are assessed every day to observe their body weight, vaginal bleeding, and labor. Anti-toxoplasma IgG-IgM antibody levels examined using qualitative mouse IgG-IgM antibody ELISA KIT. Results: Anti-toxoplasma IgM antibody levels increased significantly after 24 hours of injection tachyzoites in all dose groups, and remained high through day 21. Anti-toxoplasma antibody IgG levels increased significantly after 72 hours post injection and remained elevated until day 21. The incidence of abortion is 100% in mice which injected tachyzoite levels 1 × 103 and 1 × 104, and the incidence of abortion approximately 2 - 4 days post injection. 100% of mice that were injected with tachyzoites 1 × 101 and 1 × 102 have labor at term. Physical anomaly was found in baby mice from mice that were injected with tachyzoite 1 × 102. Conclusion: There is a significant correlation between the concentrations of Toxoplasma gondii tachyzoite with anti-toxoplasma IgG-IgM antibody levels, and there is a significant relationship between the concentrations of tachyzoite with abortion.

孕晚期孕妇VE-Cad水平和IgG抗体效价联合检测对新生儿溶血病的产前诊断价值

目的研究孕晚期孕妇血浆血管内皮钙黏蛋白(VE-Cad)水平与血清IgG抗A/B抗体效价联合检测在新生儿溶血病(HDFN)产前诊断中的临床价值。方法选择研究对象为2020年1月至2022年1月入资中县人民医院的100例O型血Rh(D)阳性孕晚期孕妇,所有孕妇与其配偶的血型均不相同,测定孕妇血浆VE-Cad水平与IgG抗A/B抗体效价。根据HDFN发生情况划分为研究组(n=50)与对照组(n=50),研究组发生HDFN,对照组未发生HDFN。比较两组孕妇的血浆VE-Cad水平与血清IgG抗A/B抗体效价并分析其与患儿总胆红素的相关性,选取受试者工作特征(ROC)曲线分析HDFN产前诊断中VE-Cad水平与IgG抗A/B抗体效价的临床价值。结果研究组孕妇的血浆VE-Cad水平与血清IgG抗A/B抗体效价明显高于对照组,差异有统计学意义(P<0.05)。研究组孕妇血清IgG抗A/B抗体效价与新生儿总胆红素无明显相关性(P>0.05),而孕妇血浆VE-Cad水平与新生儿总胆红素呈正相关(r=0.426,P<0.05)。ROC曲线分析显示,孕妇血浆VE-Cad水平诊断HDFN的曲线下面积(AUC)、敏感度、特异度依次为0.763、80.96%、63.17%,血清IgG抗A/B抗体效价诊断HDFN的AUC、敏感度、特异度依次为0.863、88.11%、71.06%;VE-Cad水平与IgG抗A/B抗体效价联合检测诊断HDFN的AUC、敏感度、特异度依次为0.916、92.87%、84.22%。结论孕晚期孕妇血浆VE-Cad水平与血清IgG抗A/B抗体效价联合检测用于HDFN产前诊断中的临床价值优于单一VE-Cad水平或IgG抗A/B抗体效价,产前诊断效果显著。

The Prevalence and Levels of Anti-HEV IgG in the Population of Jiangsu Province, China

Objective To investigate the prevalence and levels of anti-HEV IgG in the population of Jiangsu Province.Methods Total of 2 656 samples from Qindong and 11 463 samples from Anfeng were colleted.The antiHEV antibody was qualitatively and quantitatively detected using ELISA kits and the references had been established.Results The positive rates of anti-HEV IgG in male and female were 55.6%and 40.1%,respectively.The positive rate of anti-HEV IgM in male and female were both 3.4%.In opposite to anti-HEV IgG,the positive rate of anti-HEV IgM in Anfeng was significant higher than that in Qindong.The mean anti-HEV IgG titers for6 age groups were 0.94,0.92,1.07,1.46,1.27,1.19 and 0.68,1.31,1.08,1.14,1.31,1.68 IU/ml,in Qindong and Anfeng region,respectively.The positive rate of anti-HEV IgG tended to increase with age and the titer of antiHEV IgG was associated with age(R>0.90).Conclusions The results in this study showed that HEV was widely prevalent in both Qindong and Anfeng of Jiansu Province and the prevalence and the anti-HEV IgG titer were associated with gender and age.

复发性流产患者子宫动脉血流参数、胰岛素抵抗与血清ACA-IgG/AEMAb的表达变化及其临床意义

目的:探讨复发性流产(RSA)患者子宫动脉血流参数、胰岛素抵抗与血清抗子宫内膜抗体(AEMAb)/抗心磷脂抗体IgG(ACA-IgG)的表达变化及其临床意义。方法:选取86例有复发性流产史的孕妇为RSA组,80例无异常妊娠史的孕妇为正常妊娠组。比较两组孕妇妊娠第6~10周空腹胰岛素(FINS)、空腹血糖(FBG)、ACA-IgG、AEMAb、胰岛素抵抗指数(HOMA-IR)、子宫动脉搏动指数(PI)及阻力指数(RI)、子宫动脉收缩期最大血流速度与舒张末期血流速度的比值(S/D);Spearmen、Pearson分析RSA患者PI、RI、S/D与胰岛素抵抗、血清指标的相关性。结果:两组孕妇FBG无统计学差异(P>0.05)。RSA组孕妇PI、RI、S/D大于正常妊娠组(P<0.05);ACA-IgG、AEMAb阳性率及血清HOMA-IR、FINS浓度高于正常妊娠组(P<0.05)。Spearmen相关性分析显示,PI、S/D、RI与ACA-IgG、AEMAb表达水平呈正相关(P<0.05)。Pearson相关性分析显示,PI、S/D、RI与HOMA-IR、FINS水平呈正相关(P<0.05)。结论:RSA患者S/D、PI、RI、ACA-IgG及AEMA阳性表达率、HOMA-IR、FINS均高于正常妊娠孕妇;RSA孕妇PI、RI、S/D与HOMA-IR、FINS、ACA-IgG、AEMAb均呈正相关。

IgG抗-AB对血型抗体效价与胎儿新生儿溶血病患儿血清总胆红素相关性分析的影响

目的探讨ABO胎儿新生儿溶血病(ABO hemolytic disease of the fetus and newborn,ABO-HDFN)患儿O型母亲血清经IgG抗-AB吸收前后抗-A或抗-B效价水平与患儿血清总胆红素的相关性。方法选取2020年1—12月送检北京市血液中心119名确诊为ABO-HDFN的患儿及母亲血清标本,并收集患儿的临床资料。对患儿进行溶血三项试验、血清总胆红素(TBIL)测定,母亲血清经IgG抗-AB吸收前后进行IgG抗-A或抗-B效价检测,对IgG抗体效价水平及患儿TBIL结果进行统计学分析,并比较IgG抗体不同效价水平对应的TBIL结果差异,用Spearman检验分析吸收IgG抗-AB前后IgG抗-A或抗-B效价与TBIL结果的相关性。结果O型母亲血清经IgG抗-AB吸收后IgG抗-A或抗-B效价在各水平上时所对应的TBIL结果存在差异(F=8.401、19.622,P均<0.05);母亲血清经IgG抗-AB吸收前IgG抗-A或抗-B效价与新生儿TBIL结果无显著相关性(r=0.181、0.248,P>0.05);母亲血清经IgG抗-AB吸收后IgG抗-A或抗-B效价与新生儿TBIL结果呈正相关(r=0.487、0.629,P均<0.05)。结论O型母亲血清经IgG抗-AB吸收后IgG抗-A或抗-B效价与ABO-HDFN患儿TBIL结果呈正相关,通过检测经IgG抗-AB吸收后母亲血清IgG抗-A或抗-B效价水平可以准确地预测新生儿血清总胆红素升高趋势。

某品牌抗sp100抗体IgG检测试剂盒的性能评价

目的对郑州安图生物工程股份有限公司生产的抗sp100抗体Ig G检测试剂盒进行性能评价,为原发性胆汁性胆管炎(PBC)的辅助诊断提供可靠指标。方法参照美国临床和实验室标准协会(CLSI)的EP文件评价抗sp100抗体IgG检测试剂盒的灵敏度、精密度、线性区间、准确度、抗干扰等性能,同时与参比试剂盒进行临床比对。结果抗sp100抗体Ig G检测试剂盒的空白限(LoB)、检出限(LoD)、定量限(LoQ)分别为1.0、2.0、3.0 AU/ml,重复性的变异系数(CV)<4.00%,中间精密度的CV<6.00%,线性区间为10~200 AU/ml,准确度符合要求[回收率R在90%~110%之间];标本中的血红蛋白、三酰甘油、胆红素、生物素水平分别为3000 mg/dl、6000 mg/dl、50 mg/dl、250 ng/ml时,干扰率在±10%范围内。抗sp100抗体IgG检测试剂盒与两个参比试剂盒检测结果的总符合率分别为98.40%和99.20%,一致性均较好(Kappa=0.950、0.975,P<0.001)。结论该试剂盒性能良好,可满足临床检测抗sp100抗体IgG水平的需要。

自身免疫性肝炎临床误诊分析

目的探讨自身免疫性肝炎(AIH)的诊治措施及误诊原因、防范措施。方法回顾性分析2020年1月—2022年5月收治的AIH误诊为病毒性肝炎21例的临床资料。结果21例主要症状为食欲缺乏、乏力、黄疸、发热,伴腹胀12例,恶心5例,胸闷和胸痛4例,呕吐及关节痛各3例。体形消瘦,巩膜及皮肤黏膜黄染明显。查血丙氨酸转氨酶和天冬氨酸转氨酶升高;7例γ-谷氨酰转肽酶升高,碱性磷酸酶和总胆红素升高各6例。腹部B超检查示肝大18例,肝内回声不均。初期外院诊断为病毒性肝炎,予相应治疗15 d无好转,遂转我院。查血抗平滑肌抗体(SMA)、抗核抗体(ANA)阳性,血γ-球蛋白、IgG升高,结合肝炎病毒血清学检测阴性及相关病史,遂明确诊断为AIH。误诊时间18~21 d。确诊后,18例予泼尼松单独治疗,3例予泼尼松联合硫唑嘌呤治疗。治疗1年后随访,患者病情稳定,无复发。结论AIH发病较隐匿,以年轻女性高发,临床表现多样且无特异性,易误诊为病毒性肝炎,行肝炎病毒血清学检查及ANA、SMA、抗肝肾微粒体、免疫球蛋白或肝组织病理检查可区分二者,确诊后应及时予有效治疗,以改善患者预后。