Biochemical Liver Functions and Molecular Identification of Fasciola hepatica from Experimentally Infected Rat Model

The current study was performed to evaluate the liver function status as well as molecular characterization of the recovered worms in rats experimentally infected with F. hepatica. Sixteen male Wister rats aged 30 days were randomly allocated into two groups (n = 8). The first group was infected orally with 15 viable encysted metacercaria of F. hepatica per animal. The other group was kept non-infected (control group). At zero time (before infection), the 2nd, 4th, 6th, 8th, 10th, 12th and 14th weeks post-infection (WPI), blood and serum samples were collected via puncture of retro-orbital plexus of veins from each rat. Serum enzyme level (AST and ALT) and total protein were measured, and the serum protein profile was carried out using agarose gel electrophoresis. During the period of the experiment, serum ALT and AST activities and serum total globulins significantly increased while serum total proteins and albumin markedly decreased in the infected group. On the 14th WPI, the data of the electropherogram showed that globulin fractions (α1-, β- and γ-globulin) levels were significantly increased while α2-globulin was markedly decreased in the infected group. The molecular analysis confirmed the amplification of the ITS1, ITS2 and NDI genes of F. hepatica recovered from the infected liver of rats with amplicon sizes of 630, 510 and 560 bp, respectively. Sequencing of the amplified ITS gene resulted in the determination of 3 strains (PP108836, PP108837, and PP108838). Also, analysis of the ITS2 gene resulted in obtaining 3 isolates under the accession numbers (PP109065, PP109066, and PP109067). In conclusion, fasciolosis in the rat model is suitable for routine experimental infections and caused a pronounced liver dysfunction with discharging of the Fasciola eggs in the faeces and the development of adult stages in the bile ducts. Furthermore, molecular techniques are a sensitive tool for the identification and characterisation of the Fasciola parasite.

Abnormal liver enzymes: A review for clinicians

Liver biochemical tests are some of the most commonly ordered routine tests in the inpatient and outpatient setting,especially with the automatization of testing in this technological era.These tests include aminotransferases,alkaline phosphatase,gamma-glutamyl transferase,bilirubin,albumin,prothrombin time and international normalized ratio(INR).Abnormal liver biochemical tests can be categorized based on the pattern and the magnitude of aminotransferases elevation.Generally,abnormalities in aminotransferases can be classified into a hepatocellular pattern or cholestatic pattern and can be further sub-classified based on the magnitude of aminotransferase elevation to mild[<5×upper limit of normal(ULN)],moderate(>5-<15×ULN)and severe(>15×ULN).Hepatocellular pattern causes include but are not limited to;non-alcoholic fatty liver disease/non-alcoholic steatohepatitis,alcohol use,chronic viral hepatitis,liver cirrhosis(variable),autoimmune hepatitis,hemochromatosis,Wilson’s disease,alpha-1 antitrypsin deficiency,celiac disease,medication-induced and ischemic hepatitis.Cholestatic pattern causes include but is not limited to;biliary pathology(obstruction,autoimmune),other conditions with hyperbilirubinemia(conjugated and unconjugated).It is crucial to interpret these commonly ordered tests accurately as appropriate further workup,treatment and referral can greatly benefit the patient due to prompt treatment which can improve the natural history of several of the diseases mentioned and possibly reduce the risk of progression to the liver cirrhosis.

Assessment of biological functions for C3A cells interacting with adverse environments of liver failure plasma

Background:For its better differentiated hepatocyte phenotype,C3A cell line has been utilized in bioar-tificial liver system.However,up to now,there are only a few of studies working at the metabolic alter-nations of C3A cells under the culture conditions with liver failure plasma,which mainly focus on car-bohydrate metabolism,total protein synthesis and ureagenesis.In this study,we investigated the effects of acute liver failure plasma on the growth and biological functions of C3A cells,especially on CYP450 enzymes.Methods:C3A cells were treated with fresh DMEM medium containing 10%FBS,fresh DMEM medium containing 10%normal plasma and acute liver failure plasma,respectively.After incubation,the C3A cells were assessed for cell viabilities,lactate dehydrogenase leakage,gene transcription,protein levels,albu-min secretion,ammonia metabolism and CYP450 enzyme activities.Results:Cell viabilities decreased 15%,and lactate dehydrogenase leakage had 1.3-fold elevation in acute liver failure plasma group.Gene transcription exhibited up-regulation,down-regulation or stability for different hepatic genes.In contrast,protein expression levels for several CYP450 enzymes kept constant,while the CYP450 enzyme activities decreased or remained stable.Albumin secretion reduced about 48%,and ammonia accumulation increased approximately 41%.Conclusions:C3A cells cultured with acute liver failure plasma showed mild inhibition of cell viabilities,reduction of albumin secretion,and increase of ammonia accumulation.Furthermore,CYP450 enzymes demonstrated various alterations on gene transcription,protein expression and enzyme activities.

Liver function in COVID-19 infection

Coronavirus disease 2019(COVID-19)disease affects multiple organs,including anomalies in liver function.In this review we summarize the knowledge about liver injury found during severe acute respiratory syndrome coronavirus 2(SARSCoV-2)infection with special attention paid to possible mechanisms of liver damage and abnormalities in liver function tests allowing for the evaluation of the severity of liver disease.Abnormalities in liver function observed in COVID-19 disease are associated with the age and sex of patients,severity of liver injury,presence of comorbidity and pre-treatment.The method of antiviral treatment can also impact on liver function,which manifests as increasing values in liver function tests.Therefore,analysis of variations in liver function tests is necessary in evaluating the progression of liver injury to severe disease.

Abnormal liver function in children hospitalized with acute respiratory infection of adenoviruses:a retrospective study

Human adenoviruses(HAdVs)can cause acute hepatitis in immunocompromised patients.However,it is unclear whether HAdVs are contributors to hepatitis in immunocompetent children.In this study,the liver function test(LFT)results were retrospectively analyzed among children hospitalized(age<14 years)between January 2016 and October 2019 for acute respiratory infection caused by adenoviruses.Alanine transaminase(ALT)and aspartate aminotransferase(AST)levels were elevated in 7.74%and 46.89%of patients,respectively.All patients with>2 folds of the upper limit of ALT or AST levels were infected with HAdV-7 or HAdV-55.Significantly higher levels of ALT,AST,γ-glutamyl transpeptidase(γ-GT),and lower albumin levels were observed in the HAdV-7 infection group than in the HAdV-3 infection group.HAdV-55 infection led to significantly higherγ-GT,total bilirubin,and direct bilirubin levels than the other infection types.The records of four patients with serial monitoring of the LFT results were further analyzed.Multiple indicators remained abnormal during the entire hospitalization in these patients.These results indicate that HAdV infection is often accompanied by abnormal liver function,and HAdV-7 and HAdV-55 might be under-recognized contributors to hepatitis among children.

The Combined Diagnostic Accuracy of Serum Alpha Fetoprotein and Des-Gamma Carboxyprothrombin in Hepatocellular Carcinoma among Chronic Liver Disease Patients in Ilorin

Introduction :Chronic liver disease (CLD) is a disease of public health importance. CLD is defined as a clinical syndrome of liver disease lasting for at least six months with histology showing varying degree of hepatocellular necro-inflammation and fibrosis with or without neoplastic transformation. The disease is a spectrum that manifests initially as chronic hepatitis which may progress to liver cirrhosis and ultimately hepatocellular carcinoma (HCC). The current practice in the field of Gastroenterology has shifted from invasive methods of diagnosing HCC to non-invasive methods using tumor biomarkers. Various biomarkers of HCC have been proposed, but the largest body of evidence exists with alpha-fetoprotein (AFP). Most of the studies on the combined diagnostic accuracy of AFP and des-gamma-carboxyprothrombin (DCP) were done in other populations outside Nigeria. It is necessary to determine the combined diagnostic accuracy of the two tumor markers for early detection of HCC in North-central Nigeria. Materials and Methods: This study was a cross-sectional study and ethical clearance was obtained from the ethical and research committee of UITH, Ilorin. A total of 190 participants consisting of 125 cases and 65 healthy controls that were age and sex-matched were studied. Patients with extra-hepatic malignancies were excluded. The serum levels of AFP and DCP were determined using the enzyme-linked immunoassay (ELISA) technique. A detailed questionnaire was used to document the socio-demographic characteristics, clinical features as well as results of laboratory/radiologic parameters. Percutaneous liver biopsy was carried out on patients that were fit. Test of association between categorical variables was carried out using the Chi-Square Test. The sensitivity, specificity, positive and negative predictive values of the two tumor markers were determined by the area under curve (AUC) at various cut-off levels using the receiver operating characteristic (ROC) curve analysis. Statistical significance was set at p value < 0.05. AFP Quantitative test kit (alfabeto-RiakiDainabot Radioisotope laboratory, Japan) and DCP Qualitative test kit (EiTest MONO P-II kit) were used to assay AFP and DCP respectively. Liver biopsy needle (Menghini needle) was used to carry out liver biopsy. Results: Using a cut-off of 400 ng/ml, the sensitivity of serum AFP for diagnosing HCC was 51.3%. The specificity of AFP at the same cut-off was 87.8%. The positive and negative predictive values were 92.8% and 49.3% respectively. Using a cut-off of 7.5 ng/ml, the sensitivity of serum DCP for diagnosing HCC was 57.1%. The specificity of DCP at the same cut-off was 63.4%. The positive and negative predictive values were 76.2% and 41.9% respectively while the accuracy was 59.2%. The diagnostic accuracy of combined serum AFP and DCP for diagnosis of HCC in University of Ilorin Teaching Hospital, Ilorin was 64.9%. The sensitivity of combined serum AFP and DCP for diagnosing HCC was 55.6%. The specificity of combined serum AFP and DCP was 95.6%. The positive and negative predictive values were 96.2% and 52.3% respectively. Conclusion: Combining these two tumour markers does not significantly improve the diagnostic accuracy of HCC and chronic HBV remains a strong aetiological agent of HCC in UITH, Ilorin.

富含sn-2位上α-亚麻酸的酶法酯交换二元油影响自发性高血压大鼠类固醇激素代谢的探索

该研究旨在探索富含sn-2位上α-亚麻酸的酶法酯交换二元油对自发性高血压大鼠(spontaneously hypertensive rat,SHR)类固醇激素分泌代谢的调控机理,为评价该二元油生理功效并提供数据基础。实验选用7周龄SHR,分为空白、二元油、羊尾油脂、亚麻籽油和菜籽油组,添加10%不同油脂饲料饲喂3个月。ELISA法测定血脂、肝激酶和性激素含量;q-PCR和Western-blot法检测类固醇激素相关基因和蛋白质表达量。结果显示,与空白组比较,二元油组大鼠血中低密度脂蛋白胆固醇降低、高密度脂蛋白胆固醇提高(P>0.05),肝激酶无显著性差异(P>0.05);睾酮水平高于菜籽油组,无显著性差异(P>0.05);二元油组和羊尾油脂组类固醇激素合成急性调节蛋白(synthesis acute regulatory protein,StAR)、胆固醇侧链裂解酶(CYP11A1)和细胞色素P45017A(CYP17A1)等基因和蛋白质表达显著高于菜籽油组(P<0.05)。由此,可以得出酶法酯交换二元油与其原料羊尾油脂相似,通过改善血脂和肝机能缓解SHR的病症,从而提高睾酮分泌,对其类固醇激素代谢具有有益影响。

标本溶血对生化检验中肝功能、血脂、电解质、心肌酶指标的影响

目的分析标本溶血对生化检验中肝功能、血脂、电解质、心肌酶指标的影响。方法选取120例接受生化检验的患者,以随机数字分配法分为参照组(常规存放标本)、研究组(轻度标本溶血处理),每组60例。在同等实验条件下,采用生化分析仪检测并比较两组的肝功能指标[(总胆红素(TBIL)、直接胆红素(DBIL)、谷草转氨酶(AST)]、血脂指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、电解质指标(钾、钠、氯、钙)、心肌酶指标[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)]。结果研究组钾(6.22±0.31)mmol/L、氯(104.84±3.26)mmol/L、钙(3.01±0.19)mmol/L及CK(144.10±15.02)U/L、CK-MB(19.85±2.98)U/L均高于参照组的(4.11±0.09)、(95.65±6.56)、(2.25±0.11)mmol/L及(85.46±7.88)、(8.32±1.01)U/L(P<0.05);两组钠水平无差异(P>0.05)。研究组AST(84.45±3.62)U/L、TG(1.29±0.24)mmol/L、TC(9.74±1.03)mmol/L均高于参照组的(70.29±2.33)U/L、(0.78±0.07)mmol/L、(6.72±0.94)mmol/L,TBIL(8.22±1.08)μmol/L、DBIL(4.16±0.82)μmol/L低于参照组的(14.15±1.16)、(9.56±1.12)μmol/L(P<0.05);两组LDL-C和HDL-C水平无差异(P>0.05)。结论标本溶血可影响部分生化检验结果准确性,干扰临床对检验结果的判断,需要高度重视并尽量避免生化检验样本溶血,以保证其结果准确性。

标本溶血对电解质、心肌酶、肝功及血脂部分项目水平的影响观察

目的探究标本溶血在生化检验中对电解质、心肌酶、肝功及血脂水平的影响。方法抽取禹州市中医院2022年6月至2023年6月接受生化检验的78例体检者作为本次研究对象,所有受检样本随机分为两份,一份进行溶血处理,对两份样本的生化检验指标进行检测并对比。结果溶血后,体检者的钾、氯与钙的水平较溶血前均升高,两者差异存在统计学意义(P<0.05),而钠水平在溶血前、后未发生明显变化,差异无统计学意义(P>0.05)。体检者溶血后的肌酸激酶、肌酸激酶同工酶与N末端B型利钠肽前体水平较溶血前高,差异具有统计学意义(P<0.05)。溶血后,体检者的丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、总胆红素与总蛋白水平较溶血前高,差异具有统计学意义(P<0.05)。体检者在溶血后的总胆固醇与甘油三酯水平均高于溶血前,差异具有统计学意义(P<0.05),但体检者高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平在溶血前、后均未出现明显区别,差异无统计学意义(P>0.05)。结论标本溶血会造成体检者生化检验中多项指标发生变化,对生化检查结果造成影响,不利于后续对疾病的诊断与治疗。临床检验中应加强生化检验质量控制,尽可能避免标本出现溶血情况,提升生化检验结果的准确性。

加贝酯联合灯盏花素注射液治疗急性胰腺炎的临床效果

目的:探究加贝酯联合灯盏花素注射液治疗急性胰腺炎的临床效果。方法:选取2021年1月—2023年1月湖北科技学院附属第二医院收治的急性胰腺炎患者80例,以随机数字表法分为两组,对照组(加贝酯)及观察组(加贝酯联合灯盏花素注射液),各40例。对比两组临床症状改善时间(腹痛消失时间、腹胀消失时间、排便正常时间、排气正常时间)、肠黏膜功能[D-乳酸、内毒素、尿乳果糖(L)/甘露醇(M)]、炎症因子[肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]、肝功能[天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)]、肾功能[肌酐(Cr)、尿素]、心肌酶[乳酸脱氢酶(LDH)、肌酸激酶(CK)]、Toll样受体4(TLR4)mRNA、核因子κB(NF-κB)mRNA表达量。结果:观察组腹痛消失时间、腹胀消失时间、排便正常时间、排气正常时间均短于对照组,差异均有统计学意义(P<0.05)。治疗前,两组D-乳酸、内毒素、尿L/M水平对比,差异均无统计学意义(P>0.05);治疗后,两组D-乳酸、内毒素、尿L/M水平均下降,观察组均低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组TNF-α、IL-6、CRP水平对比,差异均无统计学意义(P>0.05);治疗后,两组TNF-α、IL-6、CRP水平均降低,观察组均低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组AST、ALT、Cr、尿素对比,差异均无统计学意义(P>0.05);治疗后,两组AST、ALT、Cr、尿素均下降,观察组均低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组心肌酶指标、TLR4 mRNA、NF-κB mRNA水平对比,差异均无统计学意义(P>0.05);治疗后,两组LDH、CK、TLR4 mRNA、NF-κB mRNA水平均下降,观察组均低于对照组,差异均有统计学意义(P<0.05)。结论:急性胰腺炎患者采用加贝酯联合灯盏花素注射液治疗效果显著,可降低炎症因子,改善肠黏膜功能,抑制TLR4 mRNA、NF-κB mRNA通路及有关因子表达,保护肝、肾、心功能。

化学发光法与乙肝病毒DNA荧光定量在乙肝检测中的应用价值

目的:明确化学发光法(CLIA)、乙肝病毒DNA荧光定量技术在乙肝检测中的价值。方法:选取285例乙肝患者和280例肝硬化患者为检测对象,分别对样本进行CLIA、乙肝病毒DNA荧光定量分析,统计相关检测数据。结果:乙肝组HBsAg、HBsAb、HBeAg、HBeAb、HBcAb水平均明显低于肝硬化组(P<0.05),HBV-DNA水平明显高于肝硬化组,随着HBV-DNA水平上升,乙肝患者的肝功能指标均有不同程度提高(P<0.05)。经Pearson相关性分析,HBV-DNA和HBsAg、HBsAb、HBeAg、HBeAb、HBcAb均为负相关(t=-0.876、-0.956、-0.974、-0.922、-0.981)。结论:CILA、乙肝病毒DNA荧光定量检测技术在乙肝检测中都有一定价值,两者之间为负相关,可为乙肝诊断、预后评估提供参考信息。

525例新生儿高胆红素血症病因构成及其对肝肾功能与心肌酶谱影响的研究

目的研究新生儿高胆红素血症患儿的病因构成以及不同程度胆红素水平对新生儿肝肾功能及心肌酶谱的影响,来了解该院新生儿高胆红素血症的主要病因以及不同程度胆红素水平对新生儿的危害,以便进行早期预防和及时治疗。方法回顾性分析2022年1月-2023年12月本院收治的525例新生儿高胆红素血症患儿的临床资料,根据TBIL水平将其分为轻度组、中度组、重度组,同期选择60名健康新生儿作为对照组,探究不同程度新生儿高胆红素血症对新生儿心肌酶谱、肝脏、肾脏的影响。结果在525例新生儿高胆红素血症患儿中,新生儿溶血、妊娠糖尿病、胎膜早破、宫内窘迫、早产儿是引起新生儿高胆红素血症的主要病因,部分病例存在多种病因混合情况。对照组、轻度组、中度组、重度组的新生儿的TBIL水平差异有统计学意义(P<0.05);四组间肝功能(ALT、AST、GGT)差异有统计学意义(P<0.05);肾功能比较CREA差异有统计学意义(P<0.05),BUN差异无统计学意义(P>0.05);心肌酶谱比较中CK、CK-MB、LDH差异有统计学意义(P<0.05);AST、GGT、ALT、CREA、CK、CK-MB、LDH与TBIL水平呈显著正相关(P<0.05),而BUN与TBIL水平无相关。结论新生儿高胆红素血症患儿中,新生儿溶血、妊娠糖尿病、胎膜早破、宫内窘迫、早产儿等围生期因素是病因的主要构成,且随着TBIL水平升高,对肝脏、肾脏、心脏等功能的损害程度也会增加,因此需要预防可能导致新生儿高胆红素血症的相关病因,并且密切关注患儿的肝脏、肾脏、心脏功能,及时监测病情进展,并采取相应治疗措施。

标本溶血对生化检验中电解质、心肌酶、肝功能、血脂水平的影响

目的:分析标本溶血对生化检验中电解质、心肌酶、肝功能、血脂水平的影响。方法:选取2021年10月—2023年11月苏州市吴中区第二人民医院96名健康体检者作为研究对象,受检者均采集2份血液标本,按照标本处理方法分为两组,对照组无溶血操作,观察组实施溶血处理,两组进行生化检验。对比两组生化检验结果,包括钾离子、钙离子、氯离子、钠离子、肌钙蛋白I(cTnI)、脑利钠肽(BNP)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、总胆红素(TBiL)、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总蛋白(TP)、直接胆红素(DBiL)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平。结果:观察组钾离子、钙离子、氯离子、cTnI、BNP、CK、CK-MB、TBiL、AST、ALT、TP、TG、TC水平高于对照组,DBiL水平低于对照组(P<0.001)。两组钠离子、HDL-C、LDL-C水平对比,无统计学差异(P>0.05)。结论:标本溶血会影响生化检验中电解质、心肌酶、肝功能、血脂水平,为确保生化检验准确率,需要在标本处理时加强防范,避免出现溶血反应,影响临床诊疗工作的开展。

喹乙醇对小鼠肝脏和肾脏的毒性作用研究

按毒理学方法给小鼠灌喂不同剂量喹乙醇,探讨喹乙醇对小鼠肝、肾脏功能的影响。结果表明:随着喹乙醇剂量的增加,血液中AST、ALT活性及BUN、Cre含量均升高,CHE活性先升高再下降,血清TP、ALB含量则明显下降。这些变化表明蛋白质合成代谢减慢,分解代谢加强,引起动物生长速度减慢。剖检时肝脏肿大、瘀血,质脆易碎,1/10LD50组和1/5 LD50组肝细胞变性、坏死,肾小管上皮细胞高度肿胀、变性、脱落,肾小球囊腔变狭窄。电镜下1/5 LD50组小鼠肝细胞部分细胞质溶解,细胞器减少,线粒体受损;肾脏近曲小管上皮细胞胞质部分溶解,线粒体嵴有缺损,有液泡,肾小球足细胞部分融合,证实了喹乙醇对肝肾的器质性损害。

年龄和性别与血清肝功能相关酶的关系探讨

目的探讨健康人群血清肝功能相关酶与年龄和性别的关系。方法依据个体的年龄和性别进行分组,通过全自动生化分析仪测定血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(γ-GT)和碱性磷酸酶(ALP)活性。结果年龄和性别不同的群体,血清肝功能相关酶活性有所不同。对3～60岁之间相同年龄段的群体,男性血清ALT、AST和γ-GT活性均高于女性;男性血清ALP活性在50岁前高于女性,而50岁后低于女性。在3～60岁之间的相同性别群体,血清γ-GT活性随年龄增加而升高;血清ALT活性先随年龄增加而升高,40岁后随年龄增加而降低;AST和ALP活性随年龄增加会出现两次峰值。结论年龄和性别是影响血清肝功能相关酶活性的因素,血清肝功能相关酶的正常参考范围制定应考虑个体的年龄和性别差异。

以尿激素标记物探讨职业噪声暴露与纺织女工月经功能的关系

目的 通过测定纺织女工尿样中生殖内分泌激素的代谢产物 ,探讨职业噪声暴露与月经功能的关系。方法 以某市纺织厂女工作为暴露组和内对照组 ,社区非噪声暴露女工作为外对照组 ,测量职业噪声暴露水平 ,并通过问卷了解月经情况。用酶免疫学方法测定月经周期尿中的孕酮代谢产物孕二醇 - 3-葡萄糖酸甙 (PdG)和卵泡刺激素 (FSH) β亚单位 ,并以此来判断排卵周期和确定排卵日。用广义线性模型校正重复观测间的相关性 ,并用线性回归模型和Logistic回归模型分析职业噪声暴露对纺织女工月经功能的影响。结果 高噪声暴露〔 >10 0dB(A)〕使女性月经周期长度缩短 ,经统计学分析 ,差异有显著性 (P <0 0 5 )。同时 ,噪声暴露与较短月经周期的发生也有一定的相关关系 (OR =1 6 35 ,95 %CI :0 94 4 ,2 830 ) ,并使较短黄体期的发生率增加 (OR =1 711,95 %CI :1 0 18,2 818)。噪声暴露与长月经周期 (>4 0d)的发生存在明显的负相关 (OR =0 339,95 %CI :0 12 3,0 932 )。噪声暴露对纺织女工的痛经和有无排卵影响并不明显。结论 纺织厂职业噪声暴露可能对纺织女工的月经功能产生影响 ,使月经周期缩短 ,并使短黄体期的发生率增加。用酶免疫学方法测定尿中的PdG、FSH来评价环境和职业暴露对月经功能的影响 ,可应用?

不同抗凝剂对肝移植受者FK506血药浓度测定的影响及临床意义

目的探讨不同抗凝剂对肝移植受者他克莫司(FK506)血药浓度测定的影响及临床意义。方法采集肝移植受者静脉全血34份,使用乙二胺四乙酸二钾(EDTA-K2)、枸橼酸钠和肝素锂抗凝剂分别抗凝同一份血样本,在IMx型免疫分析仪上用微粒子酶免疫分析法(MEIA)测定FK506血药浓度。结果肝素锂组与EDTA组差异无统计学意义(P=0.660),呈正相关(r=0.982 8)。枸橼酸钠组与EDTA组差异有统计学意义(P=0.000),呈正相关(r=0.961 3)。枸橼酸钠组与肝素锂组差异有统计学意义(P=0.000),呈正相关(r=0.939 8)。结论肝素锂组与EDTA组几乎无偏差,但是枸橼酸钠组分别与EDTA组和肝素锂组存在一定程度的负偏差。枸橼酸钠对MEIA测定FK506血药浓度有一定的影响,应优先考虑EDTA或肝素锂抗凝剂采集全血样本。

高胆红素血症新生儿肝功能及心肌酶学动态观察

目的观察新生儿高胆红素血症患儿治疗前后的肝功能及心肌酶的各项指标变化,探讨高胆红素血症患儿是否存在肝脏、心肌损伤以及损伤程度。方法抽取28例高胆红素血症患儿治疗前与治疗后的静脉血(无明显肉眼可见溶血),分离血清,测定28例患儿入院时和治疗后血清肝功能及心肌酶。结果治疗前后心肌酶各项指标均有显著性差异(P<0.01);肝功能中天门冬氨酸氨基转移酶、碱性磷酸酶、γ-谷氨酰基转移酶、球蛋白有显著性差异(P<0.01);总胆汁酸亦有明显变化(P<0.05);而丙氨酸氨基转氨酶、胆碱酯酶和白蛋白于治疗前后无明显变化(P>0.05)。以上结果表明,新生儿高胆红素血症患儿胆道功能可能有异常,肝脏处理胆汁能力下降,血浆蛋白合成与消耗受影响。因此,新生儿高胆红素血症对肝脏的某些功能有一定程度的影响,但对肝细胞损害少。结论新生儿高胆红素血症患儿可产生不同程度心肌损伤和肝脏某些功能的异常改变,但此损伤为可逆性,及时治疗后肝功能及心肌酶可恢复正常。

3340例住院患儿血清25-羟维生素D水平的临床观察

目的:了解3 340例住院患儿血清25-羟维生素D[25-(OH)D]的基线水平和儿科常见疾病谱、不同年龄段、不同性别及季节的25-(OH)D水平,并分析其与临床指标之间的相关性。方法:随机选取3 340例住院患儿,ELISA方法检测血清25-(OH)D的水平,并用Pearson相关分析探讨25-(OH)D水平与患儿临床指标如肝功能、心肌酶谱、免疫球蛋白、T淋巴细胞亚型、甲状腺功能的相关性。结果:3 340例患儿中男1 850例,女1 490例,平均血清25-(OH)D水平为(33.00±13.42)ng.m^(-1)。新生儿疾病患儿血清25-(OH)D水平最低,其次是原发性肾病综合征、过敏性紫癜及幼年类风湿性关节炎患儿。足月儿较早产儿血清25-(OH)D水平高。除新生儿外,随年龄增加,患儿血清25-(OH)D水平逐渐降低,不足百分比逐渐增加。不同年龄组男性、女性25-(OH)D水平无显著差异。住院患儿夏季25-(OH)D水平最高。25-(OH)D与体质指数(BMI)、ALT、AST、磷酸肌酸激酶(CK)、磷酸肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、游离T_4(FT_4)、游离T_3(FT_3)呈正相关,与AKP、免疫球蛋白E(Ig E)、免疫球蛋白M(Ig M)呈负相关。结论:住院患儿维生素D不足发生率较高,不同疾病其不足程度不同,血清25-(OH)D水平与BMI、过敏、心肌受损、甲状腺功能可能有一定的相关性。

血清Hcy与多项肝酶学指标在肝病中的临床应用价值

目的:了解同型半胱氨酸(Hcy)与α-岩藻糖苷酶(AFU)、天冬氨酸氨基转移同工酶(ASTm)、谷氨酸脱氢酶(GLDH)、腺苷脱氨酶(ADA)、血清天冬氨酸转氨基酶(AST)、丙氨酸转氨基酶(ALT)、γ-谷氨酰转肽酶(GGT)和5’-核苷酸酶(5’-NT)等肝酶学指标在肝病诊断中的价值。方法:分别采用酶联免疫吸附试验(ELISA)和全自动生化分析仪对Hcy及上述肝酶学指标在356例各种肝病患者和115例正常人血清中的变化进行检测和分析。结果:急性病毒性肝炎时Hcy、AFU、ASTm、GLDH、ADA、AST、ALT、GGT和5’-NT均显著增高,ALT、AFU、ASTm和AST的ROC曲线下面积(AUC)分别为0.875、0.853、0.830和0.825,阳性率分别为100%、78.9%、87.8%和97.8%;肝炎肝硬化时Hcy、ASTm、GLDH、ADA、AST、GGT和5’-NT均显著升高,胆碱酯酶(CHE)显著降低,ADA、AST、5’-NT、GGT和CHE的AUC分别为0.764、0.761、0.752、0.748和0.721,阳性率分别为90.1%、73.2%、67.6%、76.1%和62.0%;重型病毒性肝炎时Hcy、AFU、ASTm、GLDH、ADA、AST、ALT、GGT和5’-NT均显著增高,CHE显著降低,AST、ALT、ASTm、CHE、AFU、GLDH和Hcy的AUC分别为0.876、0.840、0.792、0.792、0.751、0.729和0.725,阳性率分别为100%、100%、93.6%、100%、72.3%、91.5%和100%;原发性肝癌时Hcy、AFU、ASTm、GLDH、ADA、AST、GGT和5’-NT均显著升高,CHE显著降低,AFU、5’-NT和GGT的AUC分别为0.822、0.814和0.811,阳性率分别为90.9%、86.4%和97.7%。肝病患者血清Hcy与CHE活性呈显著负相关(r=-0.36,P<0.01)。结论:对急性病毒性肝炎诊断意义较大的指标为ALT、AFU、ASTm和AST;对肝炎后肝硬化诊断意义较大的指标为ADA、AST、5’-NT、GGT和CHE;对重型病毒性肝炎诊断意义较大的指标为AST、ALT、ASTm、CHE、AFU、GLDH和Hcy;对原发性肝癌诊断意义较大的指标为AFU、5’-NT和GGT;所有指标对慢性病毒性肝炎和酒精型肝炎的临床意义都较低。Hcy和CHE的联检或可更有助于全面准确地评估肝病患者肝损害的程度。