【摘要】 目的 了解北京地区400例新型甲型H1N1流感患者的流行病学和临床特征，总结规律，进一步指导临床诊治。 方法 2009年5-12月期间，收治400例甲型H1N1流感确诊病例，主要采用描述性流行病学方法对患者资料进行回顾性分析，并运用单因素方差分析的方法对结果进行检验。 结果 患者以青年和儿童人群为主，47.0%的患者有明确甲型H1N1流感接触史，主要症状包括发热（98.8%）、咳嗽（85.8%）、咽痛（58.5%）。咽部充血（94.0%）和扁桃体肿大（49.5%）为主要体征。外周血白细胞正常或偏低，349例（82.3%）患者血清铁降低，268例（72.6%）患者C反应蛋白升高。在发病后不同时间内给予奥司他韦治疗的患者发热持续时间和咽拭子的阴转时间有显著差异（Plt;0.001）。 结论 新型甲型H1N1流感发病多以青年和儿童人群为主，以流感样症状为主，多数症状轻微，预后良好，C反应蛋白和血清铁的变化可能对于早期诊断有指导价值，奥司他韦早期抗病毒治疗可以缩短病程。【Abstract】 Objective To investigate the clinical and epidemiologic characteristics of pandemic influenza A (H1N1) virus infection in Beijing. Methods The epidemiological information and clinical characteristics of 400 patients with pandemic influenza A (H1N1) virus infection hospitalized in Beijing 302 Hospital from May to December, 2009 were analyzed retrospectively by descriptive epidemiology. One-way ANOVA was used to assess the results. Results H1N1 virus infection preferentially affected adolescents and young adults. The mean age of the patients was 23 years. A total of 189 (47.0%) of the patients had an identifiable epidemiologic link to another confirmed patient. The most common symptoms were fever (98.8%), cough (85.8%) and sore throat (58.5%). The main physical signs were pharyngeal portion congestion (94.0%) and antiadoncus (49.5%). The number of leukocytes in the peripheral blood was normal or low. The decreased serum iron and elevated C-reaction protein were found in 82.3% and 72.6% of the patients. There was significant difference in the duration of fever and viral shedding from throat swabs among the patients who accept the antiviral medication within the different time. Conclusion H1N1 virus infection preferentially affects adolescents and young adults, and presents with influenza-like illness. The clinical course of H1N1 virus infection is generally mild. The change of C-reaction protein and serum iron may be favorable for the diagnosis of H1N1. Early antiviral treatment may shorten the duration of fever and viral shedding.
目的:观察急性时相反应指数在成人Still病中的变化规律。方法：以32例成人Still病患者为观察组，以50例门诊体检者为对照组，检测其血清铁蛋白和C反应蛋白水平。结果：观察组检测结果在SF、CRP和APRI三项较对照组均有显著的差异（Plt;0.05），其中APRI最为显著（Plt;0.001）。结论：急性时相反应指数在成人Still病的诊断中有较高的应用价值。
【摘要】 目的 观察急性淋巴细胞白血病（ALL）患儿血清铁蛋白（SF）及β2-微球蛋白（β2-MG）水平变化，探讨SF和β2-MG水平变化对ALL患儿临床治疗效果的应用价值。 方法 对2008年7月-2010年4月期间血液病区住院确诊为ALL的患儿53例，病情得到控制缓解后的ALL患儿28例，分别抽取空腹静脉血进行SF和β2-MG测定，并选取正常健康儿童30例作为对照组。 结果 ALL患儿治疗前血清SF和β2-MG水平均高于正常对照组（Plt;0.01），经治疗缓解后ALL患儿的SF和β2-MG水平显著降低，并随着病情的转归而逐渐恢复至正常水平；与治疗前比较，差异有统计学意义（Plt;0.01）。 结论 SF和β2-MG可作为ALL临床治疗效果的有效监测指标。【Abstract】 Objective To observe the dynamic changes of Serum Ferritin(SF) and β2-MG levels in children with acute lymphoblastic leukemia(ALL) and to investigate its clinical significance on clinical curative effect. Methods Fifty-three in-patients with ALL, 28 relieved patients from July 2008 to April 2010 in our Hematology and 30 normal as control were selected in our study. The venousblood of patients and controls were extract in order to detect SF and β2-MG. Results Before the treatment, the level of SF and β2-MG in ALL group were significantly higher than those in the control group (Plt;0.01). After the treatment, the level of SF and β2-MG in ALL group decreased significantly (Plt;0.01), and they return to normal level gradually with the outcome; compared with before the treatment, the differences were statistically significant(Plt;0.01). Conclusion SF and β2-MG can be used as a helpful indicator to evaluate the therapeutic effect of ALL.
方法 回顾分析从2007年1月-2009年12月收治的12例成人Still病患者的临床资料，观察其临床特点。 结果 12例患者体温均≥39.0℃，有一过性皮疹、关节疼痛，周围血常规白细胞总数、中性粒细胞增高（白细胞≥15.0×109/L、中性粒细胞≥80%），血沉、C-反应蛋白、血清铁蛋白增高，骨髓涂片为增生性骨髓像，其次有咽痛，肝、脾、淋巴结肿大等临床表现。糖皮质激素是治疗的主要措施。 结论 成人Still病临床表现复杂多样，实验室检查缺乏特异性，血清铁蛋白检测值的明显增高有助于诊断。患者经糖皮质激素治疗后预后效好。【Abstract】 Objective To observe the clinical characteristics of adult onset Still’s disease and enhance the awareness of the disease. Methods The clinical data of 12 patients with Still’s disease from January 2007 to December 2009 were retrospective analyzed. The clinical characteristics of the disease were observed. Results Twelve patients had high fever (body temperature≥39.0℃), evanescent eruption, arthralgia, increase of leucocyte and neutrophilic granulocyte (leucocyte≥15.0×109/L, neutrophilic granulocyte≥80%), blood sedimentation, and C-reactive protein, increase of serum ferritin, bone marrow smear being hyperplasticmyelogram, as well as the tumefaction of angina, liver, spleen, and lymphaden. Glucocorticoid was the main measure of the treatment. Conclusions Clinical presentation of adult Still’s disease is various with involvement of many systems with lack of specificity of the lab inspection. Obvious increase of detected value of serum ferritin attributes greatly to the diagnosis. The prognosis of the patients who have undergone glucocorticoid treatment is very good.
Objective To explore the relationship between the level of serum ferritin (SF) and liver damage in patients with chronic hepatitis B (CHB). Methods The concentration of serum ferritin of 98 patients with CHB from July to October 2014 was measured, and then correlation analysis was performed to analyze the correlation between SF and such indexes as serum tumor marker α-fetoprotein, biochemical markers [alanine amino transferase (ALT), aspartate amino transferase (AST), total protein (TP), albumin and total bilirubin (TBIL)], and hepatitis B serum markers (hepatitis B surface antigen, hepatitis B surface antibody, hepatitis B e antigen, hepatitis B e antibody, and hepatitis B core antigen). Serum hepatitis B virus DNA (HBV-DNA) viral load was also tested, and then the discrepancy of SF levels in the high and low viral load groups was analyzed. Results The average concentration of the abnormally elevated SF was (878.69±837.98) ng/mL. The SF mean difference between low-load HBV-DNA and high-load HBV-DNA was statistically significant (P < 0.05). Serum ferritin levels were independently and positively correlated with ALT, AST, and TBIL (P < 0.01) and inversely correlated with TP and albumin (P < 0.01). Conclusion The rise of SF is associated with liver damage, which can reflect the state of inflammation of patients with CHB.
ObjectiveTo systematically review the accuracy of serum ferritin (SF) for detecting breast cancer. MethodsWe electronically and comprehensively searched databases including CNKI, WanFang Data, CBM, VIP, PubMed, EMbase and The Cochrane Library (Issue 5, 2013) up to April 2013, for diagnostic tests about using SF for detecting breast cancer. Four reviewers independently screened literature according to the exclusion and inclusion criteria, extracted data, and assessed methodological quality of included studies. Then, meta-analysis was performed using Meta-Disc 1.4 software and funnel plots were drawn using Stata 12.0 software. ResultsA total of 19 studies were finally included involving 2 977 patients. The results of meta-analysis showed that:Sen, Spe, +LR, -LR, DOR were 0.51 (95%CI 0.48 to 0.53), 0.91 (95%CI 0.89 to 0.92), 5.32 (95%CI 3.72 to 7.60), 0.45 (95%CI 0.35 to 0.57), and 13.22 (95%CI 7.22 to 24.18); SROC area under the curve (AUC) was 0.920 5 and Q* was 0.853 9. Besides, when cut off value was 101-150 μg/L, Sen, Spe, AUC and Q* were the largest, and the best cut-off value was probably 150 μg/L. ConclusionSF has relatively high Sen and Spe in the diagnosis of breast cancer which could not be used as specific index. Heterogeneities exist among the research results, which are possibly associated with researchers, severity of disease, instrument types, sources of reagents, and cut off values. Due to limited quality and quantity of the included studies, the above conclusion should be treated with caution, and in clinic, combing other tumour markers with SF is recommended in detecting breast cancer to augment accuracy.
ObjectivesTo systematically review the association between pretreatment serum ferritin (SF) concentration and prognosis in lung cancer patients.MethodsDatabases including PubMed, EMbase, Web of Science, CNKI, VIP and WanFang Data were electronically searched to identify cohort studies on the relationship between the pretreatment SF concentration and prognosis of lung cancer patients from inception to January, 2020. Literature screening, data extraction and quality evaluation of included studies were independently performed by two reviewers. Then, meta-analysis was conducted by Stata 12.0 software.ResultsA total of 8 cohort studies involving 1 002 lung cancer patients were included. The results of meta-analysis indicated that patients with higher pretreatment SF concentration had poorer overall survival (HR=1.70, 95%CI 1.06 to 2.73, P=0.029) compared with patients with lower pretreatment SF concentration. Subgroup analysis based on the pathological type manifested showed that pretreatment SF concentration only had high prognostic value in small cell lung cancer patients (HR=4.78, 95%CI 2.83 to 8.05, P<0.001).ConclusionsLung cancer patients with high pretreatment SF level have worse overall survival. Pretreatment SF concentration may serve as an independent prognostic factor in lung cancer, especially in small cell lung cancer. Due to the limited quality and quantity of included studies, more prospective well-designed studies are required to verify above conclusions.