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["使用“多功能组合皮肤试验(Multitest-CMI)”评估慢性肝病患者对抗原的皮肤迟发型超敏反应"]

[Use of the "Multitest-CMI" in the evaluation of cutaneous delayed hypersensitivity reaction to antigens in patients with chronic diseases of the liver].

作者信息

Juszczyk J, Barałkiewicz G, Bereszyńska I, Adamek J

机构信息

Instytutu Mikrobiologii i Chorób Zakaźnych, Akademii Medycznej im. Karola Marcinkowskiego, Poznaniu.

出版信息

Przegl Epidemiol. 1990;44(4):285-92.

PMID:2100810
Abstract

Delayed cutaneous hypersensitivity was assessed in 120 patients (among them 109 HBsAg positive), with chronic persistent hepatitis, chronic active hepatitis, and compensated as well as decompensated liver cirrhosis by simultaneous application of seven standardized antigens and negative control ("Multitest CMI"). In 21 patients, after 12-24 months the tests were repeated. The sum of indurations of all positive responses ("score") were calculated. Responsiveness measured as results below a normal values was related to the advancing of liver disease (from 13% in chronic persistent hepatitis up to 77% in compensated and 61% in decompensated liver cirrhosis). A comparative analysis (t-Student test) of the arithmetical means of the "scores" revealed statistically significant differences between results obtained in diagnostic groups. It was also dependent from the severity of liver disease. Patients with chronic persistent hepatitis (without specific treatment) and patients with chronic active hepatitis (treated using thymus extract, TFX - "Polfa") has showed an increased "score" values. In contrast to this group, all persons with liver cirrhosis without skin-responsiveness in the first and second tests (anergy) died at the period of 18 months. "Multitest CMI" can be of value in assessing of results of immunotherapy, as well as prognosis of the course of advanced liver disease.

摘要

通过同时应用七种标准化抗原和阴性对照(“多测试细胞介导免疫”),对120例患者(其中109例HBsAg阳性)进行迟发性皮肤超敏反应评估,这些患者患有慢性持续性肝炎、慢性活动性肝炎、代偿期和失代偿期肝硬化。21例患者在12 - 24个月后重复进行测试。计算所有阳性反应硬结的总和(“分数”)。以低于正常值的结果衡量的反应性与肝病进展相关(从慢性持续性肝炎的13%到代偿期肝硬化的77%和失代偿期肝硬化的61%)。对“分数”算术平均值的比较分析(t检验)显示,各诊断组的结果之间存在统计学显著差异。这也取决于肝病的严重程度。慢性持续性肝炎患者(未进行特殊治疗)和慢性活动性肝炎患者(使用胸腺提取物TFX - “Polfa”治疗)的“分数”值有所增加。与该组相反,所有在首次和第二次测试中无皮肤反应性(无反应性)的肝硬化患者在18个月内死亡。“多测试细胞介导免疫”在评估免疫治疗结果以及晚期肝病病程的预后方面可能具有价值。

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