血浆单核细胞趋化蛋白-2水平不能作为Allo-HSCT术后早期急性移植物抗宿主疾病与感染的鉴别指标  

Serum level of monocyte chemoattractant protein-2 can’t be used as an indicator for identifying acute graft-versus-host disease or infection at the early stage after Allo-HSCT

作　　者：许多荣[1] 邹外一[1] 许辉茹[1] 杨茂华[1] 

机构地区：[1]中山大学附属第一医院血液科,广州510080

出　　处：《器官移植》2011年第5期253-256,共4页Organ Transplantation

基　　金：国家自然科学基金项目(30670997);教育部归国人员启动基金项目(2005546);中山大学附属第一医院人才支持计划项目(18700108)

摘　　要：目的研究检测血浆单核细胞趋化蛋白-2(monocyte chemoattractant protein-2,MCP-2)水平作为区分白血病患者行异基因造血干细胞移植(allogeneic hematopoietic stem cell transplantation,Allo-HSCT)后出现中性粒细胞缺乏合并感染(感染)或急性移植物抗宿主疾病(aGVHD)的鉴别指标的可行性。方法采用酶联免疫吸附试验检测35例Allo-HSCT患者(Allo-HSCT组)、14例自体造血干细胞移植(autologous hematopoietic stem cell transplantation,Auto-HSCT)患者(Auto-HSCT组)和10名健康人(正常对照组)血浆中MCP-2的水平。比较Allo-HSCT与Auto-HSCT术后感染或aGVHD患者的血浆MCP-2水平变化。结果 14例Auto-HSCT患者和12例Allo-HSCT患者移植后早期发生中性粒细胞缺乏合并感染,其血浆MCP-2水平均明显高于感染前、感染控制后以及正常对照组的血浆MCP-2水平(均为P<0.05),但后3者比较差异均无统计学意义(均为P>0.05)。Allo-HSCT组确诊aGVHD时的血浆MCP-2水平均明显高于发生aGVHD前、经抗aGVHD治疗有效后1d以及正常对照组的血浆MCP-2水平(均为P<0.05),但后3者比较差异均无统计学意义(均为P>0.05)。与正常对照组比较,Auto-HSCT组、Allo-HSCT组患者确诊感染时及Allo-HSCT组患者确诊aGVHD时的血浆MCP-2水平均明显升高(均为P<0.05),但后3者比较差异均无统计学意义(均为P>0.05)。结论 Allo-HSCT术后早期发生aGVHD或中性粒细胞缺乏合并感染时血浆MCP-2水平均明显升高,但比较差异无统计学意义,初步认为MCP-2血浆水平不能作为鉴别Allo-HSCT术后早期aGVHD或感染的指标。Objective To investigate the feasibility of using the serum levels of monocyte chemoattractant protein-2 （MCP-2） as an indicator for identifying acute graft-versus-host disease （aGVHD） or infection with neutropenia （infection） in leukemia patients after allogeneic hematopoietic stem cell transplantation （Allo-HSCT）. Methods The serum levels of MCP-2 were detected using enzyme-linked immune absorbent assay in 35 patients of Allo-HSCT （Allo-HSCT group） , 14 patients of autologous hematopoietic stem cell transplantation （Auto-HSCT group） and 10 healthy volunteers （normal control group）. Then the changes of the serum level of MCP-2 were compared in patients with infection or aGVHD after Allo-HSCT or Auto-HSCT. Resuits Fourteen patients with Auto-HSCT and 12 patients with AIIo-HSCT developed infection with neutropenia at the early stage after transplantation. The serum levels of MCP-2 in these patients were significantly higher than those in patients before infection, after infection control and of normal control group （ all in P 〈 0.05 ）. However, there was no significant difference among the latter three groups （ all in P 〉 0. 05 ）. In Allo-HSCT group, the serum levels of MCP-2 in patients with confirmed aGVHD diagnosis were much higher than those in patients before aGVHD, 1 day after effective treatment and of normal control group （ all in P 〈 0. 05 ） , but there was also no significant difference among the latter three groups （ all in P 〉 O. 05 ）. Compared with normal control group, the serum levels of MCP-2 were obviously elevated in patients suffered from infection after auto- HSCT or allo-HSCT and in patients with aGVHD after allo-HSCT, but there was no significant difference among the latter three groups （ all in P 〉 0. 05）. Conclusions When recipients developed aGVHD or infection with neutropenia at early stage after aIlo-HSCT, the serum levels of MCP-2 increase without significant difference. The serum levels of MCP-2 can＇t be used as an indicator f

关 键 词：单核细胞趋化蛋白-2 造血干细胞移植 急性移植物抗宿主疾病 感染 

分 类 号：R457[医药卫生—治疗学]