铁调素、IFN-γ,TNF-α负调控因子对肿瘤性贫血患者红系增生的影响  

Influence of Negative Regulating Factors （Hepcidin, Interferon-γ and Tumor Necrosis Factor-α） on Ery- throid Hyperplasia in Patients with Cancer Relate Anemia

作　　者：刘东芳[1] 张成侠[1] 冯志刚[1] 闫慧[1] 訾建杰[1] 刘艳芬[1] 赵小亮[1] 刘欣[1] 李素欣 

机构地区：[1]唐山市人民医院血液科,河北唐山063000

出　　处：《医学临床研究》2015年第10期1940-1942,共3页Journal of Clinical Research

摘　　要：【目的】探讨铁调素（hepcidin，Hepc）、干扰素-γ（interferon-γ，INF-γ）、肿瘤坏死因子-α（tumor necrosis factor-α，TNF—α）等调控因子对肿瘤性贫血（cancer relate anemia，CRA）患者红系增生的影响。【方法】检测CRA患者53例（肿瘤贫血组）、肿瘤非贫血患者67例（肿瘤非贫血组）和50例健康者（对照组）白细胞（WBC）、红细胞（RBC）、红细胞平均体积（MCV）、血红蛋白（Hb）、网织红细胞（RET），采用酶联免疫吸附试验检测促红细胞生成素（Erythropoietin，EP0）、铁蛋白（serum ferritin，SF）、TNF—α、INF-γ、Hepc水平；并分析各因子的相关性。【结果】肿瘤贫血组WBC、RBC、MCV、Hb显著低于肿瘤非贫血组和对照组，RET显著高于肿瘤非贫血组和对照组（P〈0．05）；肿瘤贫血组EPO、TNF-α、INF-γ水平均显著高于肿瘤非贫血组和对照纽（P〈0．05），肿瘤非贫血组EPO又显著高于对照组（P〈0．05）；贫血组SF、Hepc表达水平显著低于肿瘤非贫血组和对照组（P〈0．05）。相关性分析显示肿瘤性贫血患者血清TNF-α与Hepc、EPO呈负相关（P〈0．05），INF-γ与Hepc呈负相关（P〈0．05），Hepc与EPO呈负相关（P〈0．05）。【结论】Hepc、TNF-α、INF-γ等负调控因子作用于EPO，导致骨髓红系对EPO的反应性相对偏低，可能是CRA的发病机制之一。[Objective]To explore the effect of regulating factors like hepcidin,interferon-γ and tumor necrosis factor- α on erythroid hyperplasia in cancer relate anemia patients.[Methods]53 cases of malignant anemia （anemia group） 67 cases of tumor in patients with non anemic patients （tumor non anemia group） and 50 healthy people （control group） were detected including their levels of white blood cell （WBC）, red blood cell （RBC）, red blood cell average volume （MCV）, hemoglobin （Hb） and net woven red blood cell （RET）, Enzyme linked immunosorbent assay was used to calculate the correlation of the erythropoietin （Erythropoietin, EPO）, ferritin （serum ferritin, SF） ,TNF- α,INF-γ and hepcidin： And the correlation of each factor were analyzed. [Results] WBC, RBC, MCV, Hb of anemia group were significantly lower than those of non anemia group and the control group, RET was significantly higher than that of the tumor non anemia group and the control group （ P 〈0.05）. EPO, TNF-α, and INF-γ of the anemia group were significantly higher than those of the tumor non anemia group and the control group （ P〈0.05） ; EPO of the tumor non anemia group was signif- icantly higher than that in the control group （ P 〈0.05） ; the expression Of SF and Hepc of the anemia group was obvi ously lower than that of the tumor non anemia group and the control group （ P 〈0.05）. Correlation analysis showed that serum TNF-α of cancer relate anemia patients was negatively correlated with Hepc and EPO （ P 〈0.05）; INF-γ was negatively related with Hepc （ P 〈0.05）, Hepc was negatively correlated with EPO （ P〈0.05）. [Conclusion]The neg ative regulatory factors of Hepe, TNF-α and INF-γ effected on EPO which caused a relatively lower reaction of bone mar row erythroid to EPO . This is likely to be one of the mechanisms of cancer relate anemia.

关 键 词：铁/代谢 干扰素Ⅱ型 肿瘤坏死因子α 贫血/病因学 肿瘤/并发症 红细胞生成素 

分 类 号：R556[医药卫生—血液循环系统疾病]