严重型再生障碍性贫血患者血清集落刺激活性的研究  

Colony stimulating activities of serum from patients with severe aplastic anemia

作　　者：郑以州[1] 储榆林[1] 邵宗鸿[1] 汪永桂[1] 杨萍[1] 田征[1] 汤晓培[1] 张君奎[1] 

机构地区：[1]中国医学科学院中国协和医科大学血液学研究所

出　　处：《中华血液学杂志》1997年第4期173-176,共4页Chinese Journal of Hematology

摘　　要：目的：探讨严重型再生障碍性贫血（ＳＡＡ）患者血清集落刺激活性与免疫抑制治疗（ＩＳＴ）疗效的关系。方法：采用造血祖细胞体外培养技术检测ＳＡＡ患者ＩＳＴ前后和健康献血员血清体外红系爆式集落刺激活性（ＢＰＡ）及粒－巨噬细胞系集落刺激活性（ＧＭ－ＣＳＡ），并用酶联免疫法（ＥＬＩＳＡ）检测了本组患者ＩＳＴ前后和正常对照组血清红细胞生成素（Ｅｐｏ）水平。结果：初诊ＳＡＡ患者血清ＢＰＡ较正常对照显著增强（Ｐ＜０．００１）；２２例ＳＡＡ患者中１３例（５９．０％）血清ＧＭ－ＣＳＡ正常，９例（４１．０％）较正常明显降低；ＩＳＴ后ＳＡＡ患者血清ＢＰＡ及ＧＭ－ＣＳＡ均无明显变化；初诊时ＳＡＡ患者血清ＧＭ－ＣＳＡ水平高低与ＩＳＴ疗效密切相关，血清ＧＭ－ＣＳＡ水平正常者ＩＳＴ疗效显著优于明显降低者（Ｐ＜０．０１）；ＳＡＡ患者ＩＳＴ前血清Ｅｐｏ水平显著高于正常对照（Ｐ＜０．００１），ＩＳＴ后有效者血清Ｅｐｏ水平明显下降，但仍显著高于正常对照者（Ｐ＜０．００１），而无效者血清Ｅｐｏ水平有进一步增高趋势。结论：初诊时ＳＡＡ患者血清ＧＭ－ＣＳＡ个体间差异较大，其血清ＧＭ－ＣＳＡ高低与ＩＳＴ疗效密切相关；初诊ＳＡＡ患者血清ＢＰＡ及Ｅｐｏ水平较正?Objective:To investigate the correlation between colony stimulating activities of serum from patients with severe aplastic anemia (SAA) and their responses to immunosuppressive therapy (IST). Methods: In vitro effects of sera from SAA patients before and after IST and from normal subjects on human marrow colony growth were examined in a semisolid methylcellulose culture system for burst promoting activity (BPA) and granulocyte/macrophage colony stimulating activity (GM CSA).Serum erythropoietin (Epo) level was also measured by ELISA method before and after IST in SAA patients. Results: Serum BPAs in SAA patients at diagnosis were significantly higher than that in normal controls (P<0.001),but serum GM CSAs in 13 of 22 SAA patients were normal,and in 9 of 22 extremely low as compared with normal values.After IST, serum BPA and GM CSA in SAA patients had no changes. Serum Epo levels in SAA patients at diagnosis were significantly higher than that in normal controls (P<0.001).After IST,serum Epo levels declined in responded patients, while further increased in nonresponded . Conclusion: Serum GM CSA of SAA patients was a predictive factor for responsiveness to IST, and a normal value was associated with a good response.

关 键 词：再生障碍性贫血 集落刺激活性 

分 类 号：R556.502[医药卫生—血液循环系统疾病]