创伤、急性心肌梗死患者及过敏性猝死者类胰蛋白酶和类糜蛋白酶活性观察

发布时间：2018-09-02 05:48

【摘要】： 目的:通过测定21例急性心肌梗死患者、63例各种机械性损伤患者,及21例对照组血浆中类胰蛋白酶含量,研究急性心肌梗死及各种机械性损伤对血浆类胰蛋白酶含量的影响。为中国免疫正常人群血浆类胰蛋白酶含量的正常值范围做补充,为过敏性疾病和过敏性猝死提供客观、准确的依据;同时测定了上述105例血浆中类糜蛋白酶的活性,研究心肌梗死及各种损伤患者血浆中类糜蛋白酶活性与类胰蛋白酶含量的关系;观察类胰蛋白酶和类糜蛋白酶在过敏猝死者肺组织的表达,为过敏性猝死的法医学鉴定提供可靠的形态学依据。方法:实验分组为:急性心肌梗死组、下肢骨折组、颅脑损伤、胸部损伤、对照组,每组各21例。(1)使用UniCAP 100过敏原自动检测仪,利用荧光免疫酶技术(FEIA)测定105例血浆中类胰蛋白酶的含量。(2)使用Thermo酶标仪测定105例血浆类糜蛋白酶活性。(3)采用荧光免疫双染法对过敏猝死者肺组织内类胰蛋白酶和类糜蛋白酶进行染色,采用OLYMPUSOLS的Image Analyze及Image-pro plus软件对所取图象进行图像分析,计阳性细胞数和荧光表达强度。结果:(1)105例血浆类胰蛋白酶含量测定结果为:急性心梗组为1.59±0.59μg/L、下肢骨折组为3.87±1.62μg/L、颅脑损伤组为3.51±0.85μg/L、胸部损伤组为3.79±1.50μg/L、对照组为2.97±1.05μg/L。对照组、急性心肌梗死组、下肢骨折组、颅脑损伤组、胸部损伤组与健康中国人血浆类胰蛋白酶含量算术平均数3.06μg/L进行单样本t检验。对照组与健康中国人血浆类胰蛋白酶含量算术平均数3.06μg/L差异无统计学意义(P＞0.05)。颅脑损伤组血浆类胰蛋白酶含量与健康中国人血浆类胰蛋白酶含量算术均数3.06μg/L差异无统计学意义(P＞0.05)。急性心肌梗死组、下肢骨折组、胸部损伤组血浆类胰蛋白酶含量与健康中国人血浆类胰蛋白酶含量算术平均数3.06μg/L差异有统计学意义(P＜0.05)。(2)实验组及对照组血浆类胰蛋白酶含量与血浆类糜蛋白酶活性有相关性(P＜0.05)。(3)类胰蛋白酶和类糜蛋白酶荧光免疫双染结果为:阳性细胞数值实验组为28.9±5.78,对照组为1.40±1.07(P＜0.05);荧光强度数值实验组为94.8±2.74,对照组为0.87±0.54(P＜0.05),表明当过敏猝死发生时,类胰蛋白酶与类糜蛋白酶表达增强。结论:(1)急性心肌梗死可影响机体血浆类胰蛋白酶含量。颅脑损伤不会影响机体类胰蛋白酶含量;胸部损伤及下肢骨折可导致类胰蛋白酶含量轻度增高。血浆类胰蛋白酶含量可以作为过敏性猝死法医学鉴定的指标之一。(2)类糜蛋白酶活性与类胰蛋白酶含量有相关性。(3)过敏猝死者肺组织内类胰蛋白酶与类糜蛋白酶表达增高。
[Abstract]:Objective: to study the effect of acute myocardial infarction (AMI) and mechanical injury on plasma trypsin level in 63 patients with mechanical injury and 21 controls. To supplement the normal range of plasma trypsin content in Chinese immune normal population, to provide objective and accurate basis for allergic diseases and sudden anaphylactic death, and to measure the activity of chymotrypsin in the plasma of 105 cases mentioned above. To study the relationship between plasma chymoid activity and trypsin content in patients with myocardial infarction and various kinds of injury, and to observe the expression of trypsin and chymoid in lung tissue of patients with sudden allergic death. To provide a reliable morphological basis for the forensic identification of sudden allergic death. Methods: the experiment was divided into three groups: acute myocardial infarction group, lower extremity fracture group, craniocerebral injury, chest injury, control group, 21 cases in each group. (1) UniCAP 100 allergen automatic detector was used. The content of trypsin in plasma was determined by (FEIA). (2) the activity of chymotrypsin in plasma was measured by Thermo enzyme marker. (3) the trypsin activity in lung tissue of sudden allergic death patients was detected by fluorescence immunoassay. And chymotrypsin, The images were analyzed by Image Analyze and Image-pro plus software of OLYMPUSOLS. The number of positive cells and the intensity of fluorescence expression were calculated. Results: (1) the levels of plasma trypsin were 1.59 卤0.59 渭 g / L in acute myocardial infarction group, 3.87 卤1.62 渭 g / L in lower limb fracture group, 3.51 卤0.85 渭 g / L in craniocerebral injury group, 3.79 卤1.50 渭 g / L in chest injury group and 2.97 卤1.05 渭 g / L in control group. Control group, acute myocardial infarction group, lower extremity fracture group, craniocerebral injury group, chest injury group and healthy Chinese were tested by single sample t test. There was no significant difference in the mean of plasma trypsin levels between the control group and healthy Chinese (3.06 渭 g / L) (P > 0.05). There was no significant difference in the level of plasma trypsin between the brain injury group and the healthy Chinese (3.06 渭 g / L) (P > 0.05). Acute myocardial infarction group, lower extremity fracture group, There was a significant difference in plasma trypsin and chymotrypsin between the chest injury group and the healthy Chinese (P < 0. 05). (2). The results of fluorescent double staining of trypsin and chymotrypsin were as follows: the number of positive cells was 28.9 卤5.78 in the experimental group and 1.40 卤1.07 in the control group, the fluorescence intensity was 94.8 卤2.74 in the experimental group and 0.87 卤0.54 in the control group (P < 0. 05), which indicated that the number of positive cells in the experimental group was 94.8 卤2.74 and that in the control group was 0. 87 卤0. 54 (P < 0. 05). The expression of trypsin and chymotrypsin were increased. Conclusion: (1) Acute myocardial infarction can affect plasma trypsin level. Craniocerebral injury does not affect the content of trypsin, but chest injury and fracture of lower extremity may lead to slight increase of trypsin content. Plasma trypsin content can be used as one of the indicators for forensic identification of sudden anaphylactic death. (2) the activity of chymoid is correlated with the content of trypsin. (3) the expression of trypsin and chymotrypsin in lung tissue is increased in patients with sudden allergic death.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：D919

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