三种细胞因子与造血干细胞移植后GVHD的相关研究  

Study on Relation with 3 Kinds of Cytokines in Leukemia Patients with Post Allo-HSCT GVHD

作　　者：叶丽萍[1] 姚浩[2] 施兵[1] 刘丽辉[1] 金建刚[1] 俞志勇[3] 扈江伟[3] 陈虎[3] 

机构地区：[1]解放军总医院第二附属医院全军器官移植中心血液科,北京100091 [2]解放军总医院第二附属医院核医学科,北京100091 [3]军事医学科学院附属医院造血干细胞移植中心,北京100039

出　　处：《现代检验医学杂志》2007年第5期4-7,共4页Journal of Modern Laboratory Medicine

摘　　要：目的探讨细胞因子TNF-α,IL-4和TGF-α在白血病异基因造血干细胞移植(allogeneic hematopoietic stem celltransplantation,Allo-HSCT)后的变化与发生移植物抗宿主病(GVHD)及轻重程度的关系。方法用放射免疫分析法检测了42例白血病Allo-HSCT患者、30例正常健康人血清TNF-α,IL-4和TGF-α水平,对移植后发生或未发生急性或慢性GVHD及发生的轻重程度进行了比较。结果急、慢性GVHD组较未发生急、慢性GVHD组患者的血清TNF-α,IL-4,TGF-α水平均升高,与正常对照组比P<0.05(除急性GVHD-组的TGF-α及慢性GVHD-组的TNF-α浓度低外);急、慢性GVHD组与未发生急、慢性GVHD组比较,血清TNF-α,IL-4及TGF-α水平均差异显著(P<0.05);发生急或慢性GVHD重度组较轻度组的TNF-α,IL-4及TGF-α水平高,差异显著,P<0.01或<0.05(除慢性GVHD时IL-4差异不显著)。结论Allo-HSCT术后动态监测TNF-α,IL-4和TGF-α水平变化有助于对发生急慢性GVHD的可能性提供另一种检测方法,并对判断GVHD轻重程度有一定的临床意义。Objective To study alterations in the serum levels of TNF-α,IL-4 and TGF-α with allogeneic hematopoietic stem cell transplantation,Allo-HSCT and their relationship with clinical course,the seriousness and mildness of graf vevsus host disease（GVHD）. Methods Radio-immuno-assays of serum TNF-α,IL-4 and TGF-α were applied to analyse 42 cases of leukemia patients having undergone Allo-HSCT and 30 normal controls. Comparison of serum levels of the cytokines was made between patients with aGVHD and those without aGVHD,and between those with cGVHD and those without aGVHD. Comparison of the seriousness and mildness of GVHD was also made. Results The serum levels of TNF-α,IL-4 and TGF-α in the patients with aGVHD,in those with cGVHD and in those without both aGVHD and cGVHD were higher than the serum levels of the above eytokines in the normal controls（P〈0. 05）. Except the low levels of TNF-α in the patients without aGVHD and TGF-α in the patients without cGVHD, comparison between the patients with aGVHD or cGVHD and those without aGVHD or cGVHD showed that the serum levels of TNF-α,IL-4 and TGF-α were all higher （P〈0.05）than the normal controls. Conclusion Dynamically monitoring the serum levels of TNF-α,IL-4 and TGF-α post Allo -HSCT is another method of predicting the possible occurrence of aGVHD or cGVHD as well as the seriousness and mildness of GVHD and it contributes considerably to the clinical course.

关 键 词：细胞因子 造血干细胞移植 移植物抗宿主病 

分 类 号：R392.4[医药卫生—免疫学] R733.7[医药卫生—基础医学]