白血病及骨髓增生异常综合征患者骨髓细胞凋亡的研究  

Study on Apoptosis in Patients with Leukemia and Myelodysplastic Syndrome

作　　者：徐正慧 窦志勇[1] 句国栋 吕传林[1] 王景明[1] 

机构地区：[1]天津市河西医院血液病研究室,300202

出　　处：《天津医药》2001年第6期330-332,F004,共4页Tianjin Medical Journal

摘　　要：目的:研究白血病及骨髓增生异常综合征(MDS)患者骨髓细胞的凋亡状态。方法:采用流式细胞术DNA含量和(或)膜联蛋白(Annexin V)法检测了48例急性白血病(AL)、14例MDS及16例非白血病、非MDS贫血患者骨髓细胞的凋亡,并对上述两种凋亡的检测方法进行相关性比较。结果:(1)白血病骨髓细胞自发凋亡率为(4.04±2.25)％低于MDS(7.42±6.39)％及贫血组(7.58±5.86)％(P<0.05)。在AL中,急性早幼粒细胞白血病(AML-M3)患者凋亡呈一致性低水平(2.92±1.17)％,低于急性髓性白血病(AML)中的其他亚型(P<0.05)。影响预后的因素及预后本身与自发性凋亡水平无相关性(P>0.05)。全反式维甲酸(ATRA)治疗有效的AML-M3在用药期间以及AL完全缓解(CR)后,凋亡水平明显上升。(2)用流式细胞术DNA含量法及Annexin V法检测凋亡有较好的相关性。结论:细胞凋亡在白血病中减低而在MDS中相对增高;AL中骨髓细胞自发性凋亡水平的高低与预后无直接关联;治疗因素可以影响凋亡。Objective: To explore the status of apoptosis in patients with leukemia and myelodysplastic syndrome (MDS). Motheds: Apoptosis of bone marrow cells were measured using methods of DNA content and Annexin V by flow cytometer (FCM) in 48 acute leukemia, 14 MDS, and 16 non-leukemia and non-MDS anemia patients, and the two methods were compared. Results: The spontaneous apoptosis rate in leukemia (4.04%± 2.05%) was significantly lower than those in MDS(7.42%±6.39%) and anemia (7.58% ±5.86%)(P<0.05). Apoptosis rate in AML-M3(2.92%±1.17%) was significantly lower than that in other subtypes of AML (P< 0.05). There was no significant correlation between prognostic factors, prognosis itself, and spontaneous apoptosis (P>0.05). Apoptosis level in AML-M3 elevated during the administration of ATRA and relieving of leukemia. There was a correlation between methods of DNA content and Annexin V by flow cytometer (FCM). Conclusion: The level of apoptosis decreases in leukemia, and relatively increases in MDS. There is no direct correlation between bone marrow cell spontaneous apoptosis and prognosis. The treatment intervention may affect apoptosis.

关 键 词：白血病 骨髓增生异常综合征 骨髓细胞 细胞凋亡 

分 类 号：R733.7[医药卫生—肿瘤] R551.3[医药卫生—临床医学]