Blood cell counts and nonalcoholic fatty liver disease: Evidence from Mendelian randomization analysis

BACKGROUND Previous research has highlighted correlations between blood cell counts and chronic liver disease.Nonetheless,the causal relationships remain unknown.AIM To evaluate the causal effect of blood cell traits on liver enzymes and nonalcoholic fatty liver disease(NAFLD)risk.METHODS Independent genetic variants strongly associated with blood cell traits were extracted from a genome-wide association study(GWAS)conducted by the Blood Cell Consortium.Summary-level data for liver enzymes were obtained from the United Kingdom Biobank.NAFLD data were obtained from a GWAS meta-analysis(8434 cases and 770180 controls,discovery dataset)and the Fingen GWAS(2275 cases and 372727 controls,replication dataset).This analysis was conducted using the inverse-variance weighted method,followed by various sensitivity analyses.RESULTS One SD increase in the genetically predicted haemoglobin concentration(HGB)was associated with aβof 0.0078(95%CI:0.0059-0.0096),0.0108(95%CI:0.0080-0.0136),0.0361(95%CI:0.0156-0.0567),and 0.0083(95%CI:00046-0.0121)for alkaline phosphatase(ALP),alanine aminotransferase(ALT),aspartate aminotransferase,and gammaglutamyl transferase,respectively.Genetically predicted haematocrit was associated with ALP(β=0.0078,95%CI:0.0052-0.0104)and ALT(β=0.0057,95%CI:0.0039-0.0075).Genetically determined HGB and the reticulocyte fraction of red blood cells increased the risk of NAFLD[odds ratio(OR)=1.199,95%CI:1.087-1.322]and(OR=1.157,95%CI:1.071-1.250).The results of the sensitivity analyses remained significant.CONCLUSION Novel causal blood cell traits related to liver enzymes and NAFLD development were revealed through Mendelian randomization analysis,which may facilitate the diagnosis and prevention of NAFLD.

Normal Reference Value of Red Blood Cell Count of Chinese Presenile Men and Geographical Factors

This paper aims at providing a scientific basis for unifying the normal reference value standards of red blood cell count of Chinese presenile men. The paper, using microscopical counting method, studies the relationship between the normal reference values of 38,061 samples of red blood cell count of presenile men and eight geographical factors in 297 units in China. It is found that the correlation of geographical factors and the normal reference value of red blood cell count of presenile men is quite significant （F=303.00, P=-0.000）. By using the method of stepwise regression analysis, one regression equation is inferred. It is concluded that if geographical data are obtained in a certain area, the normal reference value of red blood cell count of presenile men in this area can be reckoned by using the regression analysis. Furthermore, according to the geographical factors, China can be divided into eight regions： Northeast China Region, North China Region, Shanxi-Shaanxi-Irmer Mongolia Region, Middle and Lower Reaches of the Changjiang River Region, Southeast China Region, Northwest China Region, Southwest China Region and Qinghai-Tibet Plateau Region.

Usefulness of white blood cell count to mean platelet volume ratio for predicting long-term prognosis after primary percutaneous coronary intervention in patients with acute coronary syndrome

Background and Objective The white blood cell count to mean platelet volume ratio(WMR)has recently been described as a predictor of cardiovascular events in patients who undergo percutaneous coronary intervention(PCI).The aim of this study was to investigate the usefulness of admission WMR in predicting outcomes in patients with acute coronary syndrome(ACS).

Effect of sodium nitroprusside on the microrheological properties of red blood cells in different media

Red blood cell(RBC)aggregation as well as their deformation significantly affects blood microrheology.These processes depend on various factors,one of which is concentration of the nitric oxide,one of the main signaling molecule in the bloodstream.The purpose of this study was to investigate the effect of nitric oxide on the microrheological properties of red blood cells(RBCs)in RBC samples of various media after the addition of nitric oxide donor sodium nitroprusside in vitro.Microrheological properties were measured using laser aggregometer and ektacytometer based on diffuse light scattering and diffraction of laser light on a suspension of RBCs,respectively.The study found that heparin-stabilized blood showed increased RBC aggregation and deformation with sodium nitroprusside concentrations of 100,and 200M,while EDTA-stabilized blood showed slightly decreased aggregation and unchanged deformation.With washed RBCs in dextran solution,the addition of sodium nitroprusside(in the concentrations of 100,and 200M)resulted in decreased aggregation and increased deformation.These-ndings aid in our understanding of nitric oxide's effect on RBC microrheological properties.

An Experimental Study on RBC Count and Serum Potassium Concentration Changes During Compression Transfusion of WBC-removal Whole Blood

Objective： To observe changes in RBC count, changes, RBC morphology, and serum potassium during compressed transfusion of WBC-removal whole blood. Methods： Prepared human WBC-removal whole blood and connected transfusion apparatus with different sizes of intravenous detaining needles （18G, 20G, 22G and 24G）. Observed RBC count and serum potassium concentration under different pressures （100 mmHg, 200 mmHg, and 300 mmHg） as blood flowed out of the pinhead end of the intravenous detaining needle. Samples obtained with the 20G needle were smeared on glass slides, and RBC morphologic changes were observed under an oil immersion lens. Results： RBC count and serum potassium changed slightly under different pressures with different sizes of intravenous detaining needles as blood flowed through the transfusion apparatus. In addition, the observation of blood samples under a common light microscope revealed that coarse- prick, oblong, and spindle cell counts in the visual fields increased gradually as the pressure increased. Additionally, a portion of cells had undergone splintering. Conclusions： While applying 18G, 20G, 22G and 24G intravenous detaining needles for blood transfusion under less than 300 mmHg of pressure, no significant RBC count change was found in blood samples in the short term. However, there were significant RBC morphologic changes. The results could offer more basis to ensure the clinical safetv of oatients undereoing blood transfilsion.

Study on the packed volume and the void ratio of idealized human red blood cells using a ?nite-discrete element method

Numerical simulations are performed to examine the packing behavior of human red blood cells(RBCs). A combined ?nite-discrete element method(FDEM) is utilized, in which the RBCs are modeled as no-friction and no-adhesion solid bodies. The packed volume and the void ratio of a large number of randomly packed RBCs are clari?ed,and the effects of the RBC shape, the mesh size, the cell number, and the container size are investigated. The results show that the packed human RBCs with normal shape have a void ratio of 28.45%, which is slightly higher than that of the ?at or thick cells used in this study. Such information is bene?cial to the further understanding on the geometric features of human RBCs and the research on RBC simulations.

Analysis of Mechanical Behavior of Red Blood Cell Membrane with Malaria Infection

Human red blood cells (RBCs) are responsible to transport oxygen and carbon dioxide for human bodies. The physiological functions of RBCs are greatly influenced by their mechanical properties. When RBC is infected by Malaria parasite called Plasmodium falciparum, it shows progressive changes in mechanical properties and loses its deformability. The infected red blood cells (IRBCs) develop properties of cytoadherence (stickiness) and rosetting (the binding of non-infected RBCs to parasitized RBCs). In this paper to analyze the mechanical properties and deformability of the IRBC, we applied stress-stretch ratio relation of its biomembrane .To express this constitutive relation, we proposed a mathematical model (Neo-Hookean model) based on membrane theory. On this model, we present continuous stress-stretch ratio curves for the relation derived from the model for different intracellular developmental stages of the parasite, to determine the mechanical properties of IRBC. The analytical results obtained from the mathematical model are more closed with the experimental data [1] which demonstrates the validity of the model. By restricting our attention to spherically symmetric deformation in the final schizont stage of parasite development, the pressure-extension ratio relation curve also adapted from the proposed strain energy function. The change in osmotic pressure versus volumetric ratio has been also considered for IRBC before hemolysis.

Cellular Profiles in Peripheral Blood Accompanying Particular Asthmatic Response Types

Background: Patients with allergic bronchial asthma develop various asthmatic response types to bronchial challenge with allergen, such as immediate (IAR), late (LAR), dual late (DLAR) or delayed (DYAR), displaying different clinical, immunologic and pharmacologic features. This study deals with count changes of particular blood cells accompanying the IAR, LAR and DYAR. Methods: In 63 patients developing 22 IAR, 26 LAR and 15 DYAR, the repeated allergen challenges were supplemented with recording of blood cell counts, Th1/Th2 ratio, leukotrines B4 (LTB4) and C4 (LTC4), eosinophil cationic protein (ECP), myeloperoxidase (MPO), and histamine in blood, and intracellular IFN-γ and IL-4 in peripheral blood mononuclear cells. Results: The IAR was accompanied by increased eosinophil and basophil counts, increased serum concentrations of histamine, LTC4 and ECP, decreased Th1/Th2 ratio in favour of Th2 cells, and increased intracellular IL-4. The LAR was associated with increased eosinophil and neutrophil counts, increased serum concentrations of LTC4 and LTB4, unchanged Th1/Th2 ratio, and increased intra-cellular IL-4. The DYAR was accompanied by increased total leukocyte, neutrophil, monocyte, lymphocyte and thrombocyte counts, increased serum concentrations of LTB4 and MPO, increased Th1/Th2 ratio in favour of Th1 cells, and increased intracellular IFN-γ. Conclusions: These results provide evidence for different involvement of particular blood cell types and different hypersensitivity mechanisms in IAR, LAR and DYAR. The monitoring of peripheral blood cell counts seems to be an useful supplementary parameter to the bronchial challenge with allergen.

炎症因子联合检测在妊娠期糖尿病患者中的应用价值

目的 分析炎症因子联合检测在妊娠期糖尿病(GDM)患者中的应用价值。方法 选取2022年1月至2024年4月在厦门大学附属第一医院进行治疗的98例GDM患者作为观察组,另选取同期在厦门大学附属第一医院进行产检的40例健康孕妇作为对照组。检测白细胞计数(WBC)、降钙素原(PCT)、白细胞介素-6(IL-6)、C-反应蛋白(CRP)水平,根据糖耐量筛查结果对GDM严重程度进行分级,并根据是否发生不良妊娠结局,将GDM患者分为妊娠结局不良组和妊娠结局良好组。绘制受试者工作特征(ROC)曲线分析血清炎症因子对GDM患者发生不良妊娠结局的预测价值。结果 观察组WBC、PCT、IL-6、CRP水平高于对照组,差异均有统计学意义(P<0.05)。轻度、中度、重度GDM患者分别有58、25、15例。不同严重程度GDM患者WBC、PCT、IL-6、CRP水平比较,轻度患者<中度患者<重度患者,任意两两比较,差异均有统计学意义(P<0.05)。观察组不良妊娠结局总发生率高于对照组,差异有统计学意义(P<0.05)。妊娠结局良好组有46例患者,妊娠结局不良组有52例患者。妊娠结局不良组WBC、PCT、IL-6、CRP水平高于妊娠结局良好组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,WBC、PCT、IL-6、CRP单独预测GDM患者发生不良妊娠结局的曲线下面积(AUC)分别为0.690、0.805、0.820、0.753,4项指标联合检测的AUC为0.947。结论 GDM患者WBC、PCT、IL-6、CRP水平升高,且这些指标可作为GDM患者不良妊娠结局的预测因子,可能与GDM的诊断、发展及预后密切相关。

Celly血液分析仪计数时间缩短影响血小板计数结果

目的探讨Celly血液分析计数时间缩短对血液分析检测结果的影响。方法随机选取30名我院体检中心健康体检者,用Celly血液分析仪重复测量10次,分别选取计数时间正常和缩短数据,比较计数时间正常和缩短对血液分析结果的影响。结果计数时间缩短至7.76±1.34s范围内,对白细胞计数(P>0.05)、红细胞计数(P>0.05)、血红蛋白(P>0.05)、白细胞分类均无显著性影响,但计数时间缩短显著降低血小板计数结果(计数时间正常:198.14±54.14×109/Lvs计数时间缩短:185.14±54.71×109/L,P<0.05)。结论计数时间缩短显著降低血小板计数结果,应进行手工校正。

相差镜检联合UF-1000i RBC参数对肾小球性血尿的诊断价值

目的通过分析尿液流式细胞分析仪UF-1000i RBC激光参数与相差镜检对尿红细胞形态判断结果的相关性,探讨RBC激光参数联合相差镜检对肾小球性血尿的诊断价值。方法对120份新鲜尿标本采用日本Sysmex UF-1000i全自动尿沉渣分析仪分析RBC激光参数,同时采用相差显微镜镜检尿红细胞形态,以临床诊疗和病理结果为标准,统计临床诊疗符合率,比较镜检与RBC激光参数的相关性。结果 120例血尿标本中,相差显微镜与尿沉渣分析仪RBC-info对肾小球性血尿诊疗符合率分别是75%和76.7%;ROC曲线分析,RBC参数联合相差显微镜检测对肾小球性血尿诊断效能最高(AUC=0.942)。结论联合应用流式尿沉渣分析仪和相差显微镜检查可提高肾小球性血尿红细胞鉴别能力。

OSAHS患儿血FIB、RBC相关指标变化及其临床意义探讨

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿血纤维蛋白原(FIB)、红细胞计数(RBC)相关指标变化及其临床意义。方法回顾性分析2018年1月~2020年5月医院收治的90例OSAHS患儿的资料,记为A组,另回顾性分析同期在该院体检的84例健康儿童的资料,记为B组。对比A组和B组血FIB、RBC、血红蛋白(HB)、平均红细胞容积(MCV)、平均红细胞血红蛋白量(MCH)和平均红细胞血红蛋白浓度(MCHC)以及呼吸暂停低通气指数(AHI)、氧减指数(ODI)、夜间平均血氧饱和度(MnSaO_(2))和夜间最低血氧饱和度(LOSaO_(2)),对比A组不同病情严重程度患儿血FIB、RBC相关指标,睡眠呼吸参数,采用Pearson相关性检验,分析A组血FIB、RBC相关指标与睡眠呼吸参数的相关性。结果A组血FIB、RBC、HB、MCV、MCH、MCHC水平和睡眠呼吸参数AHI、ODI均高于B组(P<0.05),MnSaO_(2)和LOSaO_(2)均低于B组(P<0.05);A组不同病情严重程度患儿血FIB、RBC、HB、MCV、MCH、MCHC水平对比差异均有统计学意义(P<0.05),与轻度组相比,中度组和重度组均升高(P<0.05),重度组患儿又高于中度组(P<0.05);A组不同病情严重程度患儿AHI、ODI、MnSaO_(2)和LOSaO_(2)对比差异均有统计学意义(P<0.05),与轻度组相比,中度组和重度组AHI、ODI均升高(P<0.05),重度组患儿又高于中度组(P<0.05),MnSaO_(2)、LOSaO_(2)均降低(P<0.05),重度组患儿又低于中度组(P<0.05);A组患儿血FIB、RBC、HB、MCV、MCH、MCHC水平分别与AHI、ODI呈正相关(P<0.05),分别与MnSaO_(2)、LOSaO_(2)呈负相关(P<0.05)。结论OSAHS患儿血FIB、RBC、HB、MCV、MCH、MCHC水平及AHI、ODI均高于健康者,MnSaO_(2)和LOSaO_(2)均低于健康者,且OSAHS患儿血FIB、RBC相关指标与睡眠呼吸参数均相关。

甘油果糖对人RBC、大鼠RBC的作用及输液安全性的研究

目的:探讨甘油果糖注射液(Glycerol and Fructose Injection)对人红细胞(Red blood cell,RBC),大鼠RBC的作用及对大鼠输液安全性的研究,以指导临床应用。方法:以40例健康成人RBC、32只sD大鼠RBC为研究对象,进行体外溶血试验;以72只SD大鼠为研究对象,进行输液安全性研究,研究组为甘油果糖注射液,对照组为生理盐水注射液,应用改良酸化甘油溶解实验测定甘油果糖注射液对人RBC和大鼠RBC的溶解程度,应用邻-甲联苯胺氧化显色法测定甘油果糖注射液对上清液游离血红蛋白(Hemoglbin,HB)含量的影响。同时测定研究组和对照组大鼠血浆游离HB、蛋白非结合胆红素(间接胆红素)、尿素氮(Blood urea nitrogen,BUN)、肌酐的含量,以对甘油果糖注射液安全性进行研究。结果:体外试验为甘油果糖注射液对人RBC和大鼠RBC的溶解程度与生理盐水相似,对上清液游离HB含量无明显影响。对大鼠给予甘油果糖注射液和生理盐水,最快输液速度6ml/min和最大输液量30ml/kg/d,24小时后测定大鼠血浆游离HB、蛋白非结合胆红素、BUN、肌酐的含量,两组结果相似。结论:甘油果糖注射液在体外对人RBC和大鼠RBC无明显溶解作用。在大鼠体内也没有发现有溶血作用,对肾脏功能影响与生理盐水相似。

CELL-DYN1700型自动血细胞计数仪临床应用评价

目的 :对CELL DYN 1 70 0型全自动血球计数分析仪的性能进行临床应用评价。方法 :应用临床标本测定该仪器的精密度、准确度、携带污染率、线性范围。结果 :各项目的批内CV值 :白细胞 (WBC) 1 .9% ,红细胞 (RBC) 1 .6 5 % ,血红蛋白 (Hb)1 .35 % ,红细胞比积 (HCT) 2 .0 % ,平均红细胞体积 (MCV) 0 .93% ,血小板计数 (BPC) 3.2 %。批间CV值 :高值WBC 2 .7% ,RBC 2 .2 1 % ,Hb 1 .86 % ,HCT 2 .8% ,MCV 1 .9% ,BPC 6 .0 % ;正常值 :WBC 2 .1 % ,RBC 1 .9% ,Hb 1 .7% ,HCT 2 .3,MCV1 .8% ,BPC 3.6 % ;低值WBC 2 .0 % ,RBC 2 .1 % ,Hb 1 .6 8% ,HCT 2 .4 % ,MCV 1 .92 % ,BPC 6 .8%。线性范围较宽WBC(0 .5～ 90 .0 )× 1 0 9/L ,RBC(1 .0～ 7.0 )× 1 0 1 2 /L ,Hb(2 5 .0～ 2 0 0 .0 ) g/L、BPC(1 0 .0～ 999.0 )× 1 0 9/L ;携带污染率低 :WBC 0 .1 % ,RBC 0 % ,Hb 0 % ,BPC 0 .5 % ;准确度高 ,EDTAK2 抗凝的静脉血仪器法和常规手工法结果比较差异均无显著性 (P >0 .0 5 )。结论 :该仪器结果准确 ,重复性好 ,操作易于掌握 ,检测速度快 ,交叉污染小 ,且易于保养。静脉血、末梢血均能检测 1

^(99m)Tc-RBC的X射线光电子能谱研究

９９ｍＴｃ－标记的红细胞（９９ｍＴｃ－ＲＢＣ）是目前最常用的血池显象剂。木工作用体内标记法制备了９９ｍＴｃ－ＲＢＣ，采用Ｘ－射线光电子能谱（ＸＰＳ）对９９ｍＴｃ－ＲＢＣ中Ｔｃ原子的化学状态及其变化进行了测定。９０ｍＴｃ－ＲＢＣ于标记后１ｈ与标记后２ｈ所测ＸＰＳ能谱显示，表明９９ｍＴｃ－ＲＢＣ的稳定性佳。从ＲＢＣ与９９ｍＴｃ成键的情况看，多肽键上带负电荷的羧酸根氧原子与９９ｍＴｃ配合；半胱氨酸带负电荷的硫原子与９９ｍＴｃ配合。从９９ｍＴｃ－ＲＢＣ９９ｍＴｃ３ｄ５／２的Ｅｂ值（其中ｊ＝５／２，Ｅｂ为原子能级中电子的结合能），可以推测９９ｍＴｃ－ＲＢＣ中９９ｍＴｃ的价态低于３价。与此同时，对含、９９Ｔｃ（Ｖ）、９９Ｔｃ（ＩＶ）及９９Ｔｃ（Ⅲ）的化合物进行ＸＰＳ测定，其结果表明：化学位移随着９９Ｔｃ还原价态的降低而降低。实验结果与理论推测相符。

PCT、WBC联合CRP在ICU呼吸感染中的表达、诊断价值及与CPIS评分的相关性分析

目的分析降钙素原(PCT)、白细胞计数(WBC)联合C反应蛋白(CRP)在重症监护室(ICU)呼吸感染中的表达、诊断价值及与临床肺部感染评分(CPIS)的相关性。方法选取2019年3月至2024年6月涿州市医院ICU呼吸感染患者105例为观察组,另外选取于ICU未发生呼吸感染117例患者为对照组。通过Zybio-Q7型免疫定量分析仪对两组PCT水平进行检测,通过XT-4000i型白细胞分析仪对两组WBC水平进行检测,通过免疫比浊法对两组CRP水平进行检测。分析PCT、WBC、CRP的表达变化与ICU呼吸感染临床特征、CPIS评分的关系及对ICU呼吸感染的诊断价值。结果观察组入住ICU时间(>15 d)和机械通气时间(>7 d)的占比显著高于对照组(P<0.05)。与对照组比较,观察组PCT、WBC、CRP水平和CPIS评分升高,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,入住ICU时间>15 d(OR=4.087)、PCT(OR=6.543)、WBC(OR=2.652)和CRP(OR=8.964)为影响ICU呼吸感染发生的危险因素。PCT、WBC、CRP与CPIS评分之间Pearson相关性分析显示,PCT、CPIS评分之间正相关(r=0.925,P=0.001);WBC、CPIS评分之间正相关(r=0.739,P=0.001);CRP、CPIS评分之间正相关(r=0.948,P=0.001)。ROC曲线显示,三项联合对ICU呼吸感染的诊断价值高于PCT、WBC、CRP单项诊断(P=0.002)。结论PCT、WBC联合CRP对ICU呼吸感染的诊断价值较高,且与CPIS评分呈正相关,因此上述指标可为ICU呼吸感染的早期诊断提供可靠依据。

急性心肌梗死患者入院时RBC和Hb与住院期间死亡的关系

目的探讨急性心肌梗死（AMI）患者人院时红细胞计数（RBC）和血红蛋白（Hb）水平与住院期间死亡的关系。方法以849例初发AMI住院患者为研究对象，收集入院时人口统计学、血RBC计数和Hb等生化指标，收集住院期间死亡资料，采用单因素和多因素分析方法，分析入院时血RBC计数和Hb水平与住院期间死亡的关联关系。结果死亡病例的入院RBC计数和HB水平显著高于存活病例。经单因素Logistic回归分析，RBC计数与住院期间死亡呈显著的关联关系（P〈0．01），但经多因素分析后，这种关联变得无统计学意义。经单因素分析，与Hb120-140g／L组相比，Hb〈100g／L组住院期间发生死亡的危险性为2．716，但经多因素分析后，其OR值无统计学意义。结论人院时血RBC计数和Hb水平可能不是AMI住院患者死亡的重要预示指标。

白细胞计数、C反应蛋白及降钙素原联合检测对儿童穿孔性阑尾炎的预测价值

目的探讨白细胞计数(WBC)、C反应蛋白(CRP)及降钙素原(PCT)联合检测对儿童穿孔性阑尾炎的预测价值。方法回顾性分析2017年1月至2023年4月吉林省儿童医疗中心收治的427例阑尾炎患儿的临床资料,其中穿孔组113例,非穿孔组314例。采用单因素、多因素分析法分析穿孔性阑尾炎的危险因素,采用受试者工作特征曲线获取最佳截断值并评估各方法的预测效能。结果单因素分析显示,WBC、CRP、PCT可作为阑尾穿孔的影响因素(P<0.05)。多因素分析显示,WBC、CRP、PCT均可作为阑尾穿孔的独立危险因素(OR>1,P<0.05)。WBC、CRP、PCT三项联合预测效能优于两项及单独预测,灵敏度为0.894,特异度为0.764,阳性预测值为74.64%,阴性预测值为81.94%。WBC、CRP、PCT最佳截断值分别为17.42×10^(9)/L、34.09 mg/L、0.355μg/L。结论WBC、CRP、PCT联合检测可以准确地预测儿童穿孔性阑尾炎的发生,能够作为术前早期评估儿童阑尾炎严重程度的方法。

IL-6、PCT、CRP及WBC与老年腹部手术患者术后肺部感染的相关性

目的研究血白细胞介素-6(IL-6)、降钙素原(PCT)、C反应蛋白(CRP)及白细胞计数(WBC)与老年腹部手术后早期肺部感染的相关性。方法收集2023年1月至2023年12月濮阳市中医医院收治的45例老年腹部手术后早期肺部感染患者作为感染组,另按1∶2比例抽取同期行腹部手术但术后早期未出现肺部感染的90例作为未感染组,所有病例术后次日清晨均采集血样完成IL-6、PCT、CRP、WBC检测,比较感染组与未感染组上述指标差异,分析早期肺部感染患者病原菌分布,比较不同感染严重程度患者上述指标的差异,分析以上各指标与肺部感染严重程度的关系,并应用受试者工作曲线(ROC)分析以上参数诊断老年腹部手术后早期肺部感染的效能。结果腹部手术后早期肺部感染病原菌分布主要以革兰阴性菌(77.78%)为主,其中铜绿假单胞菌所占比例最高(53.33%,其次为大肠埃希菌(15.56%);革兰阳性菌(17.78%)中金黄色葡萄球菌所占比例最高(11.11%);真菌占4.44%,均为白假丝酵母菌;感染组术后次日清晨血IL-6、PCT、CRP、WBC水平均高于未感染组,差异均有统计学意义(P<0.05);不同严重程度肺部感染患者术后次日各实验室指标比较差异有统计学意义,随感染严重程度的上升,IL-6、PCT、CRP、WBC水平上升,差异均有统计学意义(P<0.05);IL-6、PCT、CRP、WBC均与临床肺部感染评分(CPIS)呈正相关,差异均有统计学意义(r=0.716、0.765、0.725、0.735,P<0.05);IL-6、PCT、CRP、WBC联合检测诊断腹部手术早期肺部感染的曲线下面积(AUC)值高于单项检测,差异均有统计学意义(P<0.05)。结论IL-6、PCT、WBC及CRP对老年腹部外科术后早期肺部感染皆有一定的诊断价值,且联合检测诊断效能更高,可将其作为腹部外科术后早期肺部感染筛查的重要指标。

单抗HIM_(82)对中性粒细胞ROS损伤RBC的保护作用

目的 研究单抗HIM_(82)(30μg/ml)是否能对PMA激活PMN后产生的ROS进行降调节,进而降低ROS对红细胞的损伤,验证HIM_(82)对RBC损伤有无保护作用。方法 用PMA激活PMN后产生的ROS对无HIM_(82)和加HIM_(82)保护的RBC进行损伤实验。结果 加HIM_(82)保护后的RBC膜蛋白乙酰胆碱酯酶(AchE)活性由损伤时的(71.36±22.15)%恢复到(87.60±14.78)%(n=6 P<0.001),活性提高了16.30%;对RBC膜脂质过氧化损伤的保护作用使损伤率从(52.42±20.63)%减小到(23.81±12.40)%(n=9 P<0.01),脂质过氧化损伤降低了54.57%,RBC膜脆性损伤用溶血率表示,溶血率由(80.76±20.23)%下降到(66.30±7.08)%(n=6 P<0.001),下降了17.90%。结论单抗HIM_(82)不仅能明显地降低PMN的ROS水平也能有效保护周围红细胞,可能对防治多种趋化因子激活PMN引起的ROS损伤提供一种新的有效途径。