恶性淋巴瘤伴贫血患者红细胞寿命测定意义初步探讨  

Clinical Significance of Detecting the Erythrocyte Life Expectancy in Patients with Malignant Lymphoma Complicated with Anemia

作　　者：裴强[1] 申浩睿 张薇[1] 周道斌[1] PEI Qiang;SHEN Hao-Rui;ZHANG Wei;ZHOU Dao-Bin(Department of Hematology,Peking Union Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院血液科,北京100730

出　　处：《中国实验血液学杂志》2019年第1期80-85,共6页Journal of Experimental Hematology

基　　金：首发基金(首发2016-2-4016);中国医学科学院医学与健康科技创新工程(2016-12M-1-001)

摘　　要：目的:探讨红细胞寿命变化在淋巴瘤伴贫血患者诊疗中的临床价值。方法:收集2017年1月至2017年6月于北京协和医院血液科确诊的45例淋巴瘤患者临床资料,采用肺泡气CO测定法检测患者红细胞寿命。结果:恶性淋巴瘤患者贫血发生率为46. 7%,红细胞寿命缩短患者占40. 0%,存在溶血状态患者占15. 56%,DLBCL患者贫血的发生率为47. 1%;患者合并B症状、骨髓受累、脾大或LDH升高时常发生贫血,但仅有脾大和LDH指标与患者红细胞寿命呈明显负相关。采用CHOP±R化疗方案与其他化疗方案(R+MINE/FC/SMILE/GDP)对患者贫血及红细胞寿命的影响具有明显差异。结论:淋巴瘤患者贫血的发生率较高,红细胞破坏或寿命缩短可能参与了贫血的发生机制;采用强烈的化疗方案可明显缩短患者红细胞寿命而加重贫血。Objective: To investigate the clinical value of erythrocyte life span in the diagnosis and treatment of lymphoma patients w ith anemia. Methods: The clinical data of 45 patients w ith lymphoma diagnosed by Department of Hematology in Beijing Union Hospital from January 2017 to June 2017 w ere collected. The life of erythrocytes w as detected by alveolar gas CO test. Results: The incidence of anemia in patients w ith malignant lymphoma w as 46. 7%,40. 0% of patients displayed the shorting of blood cell life and the hemolytic status existed in 15. 56% of patients. The incidence of anemia w as 47. 1% in patients w ith DLBCL. Patients w ith B symptoms,bone marrow involvement,splenomegaly or LDH increase often accompanied w ith anemia,but only the splenomegaly and LDH level w ere significantly negatively correlated w ith red blood cell life;there w as a significant difference in the effects of CHOP ± R regimen and other chemotherapy regimens( R + M INE/FC/SM ILE/GDP) on patients w ith anemia and erythrocyte life span. Conclusion: The incidence of anemia in patients w ith lymphoma is high,red cell damage or shortened life may be involved in the mechanism of anemia,the use of a strong chemotherapy regimen can significantly shorten the red blood cell life of patients and aggravates anemia.

关 键 词：淋巴瘤 贫血 红细胞寿命 

分 类 号：R733.1[医药卫生—肿瘤] R512.6[医药卫生—临床医学]