内源性一氧化碳呼气试验检测真性红细胞增多症红细胞寿命  

Red blood cell lifespan detected by endogenous carbon monoxide breath test in patients with polycythemia vera

作　　者：高清妍 朱阳敏 胡靖 郭洁 鲍本霖 赵馨 叶蕾 李园 彭广新 李建平 李洋 樊慧慧 宋琳 井丽萍 张莉 张凤奎 Gao Qingyan;Zhu Yangmin;Hu Jing;Guo Jie;Bao Benlin;Zhao Xin;Ye Lei;Li Yuan;Peng Guangxin;Li Jianping;Li Yang;Fan Huihui;Song Lin;Jing Liping;Zhang Li;Zhang Fengkui(Institute of Hematology and Blood Diseases Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Tianjin 300020,China)

机构地区：[1]中国医学科学院血液病医院北京协和医学院血液学研究所,天津300020

出　　处：《中华内科杂志》2019年第10期777-781,共5页Chinese Journal of Internal Medicine

摘　　要：目的评估真性红细胞增多症(PV)患者的红细胞寿命,探讨其影响因素.方法连续纳入2017年2月至2018年12月中国医学科学院血液病医院确诊的27例PV患者,以同期18例健康志愿者为正常对照,采用内源性一氧化碳呼气试验方法检测红细胞寿命,行相关性分析评估其影响因素.结果 27例PV患者中位红细胞寿命为80(35~120)d,较正常对照组的110.5(69~166)d明显缩短(P<0.05),平均缩短35.3 d.10例初诊PV患者红细胞寿命为98(35~117)d,17例正在行羟基脲和/或干扰素药物治疗者的红细胞寿命为69(45~120)d,两组红细胞寿命均较正常对照缩短(P=0.010, 0.000).相关性分析显示,初诊PV患者的红细胞寿命与JAK2突变基因负荷量呈正相关(r=0.900,P=0.037),与外周血淋巴细胞计数(r=-0.742,P=0.014)及血清维生素B12水平(r=-0.821,P=0.023)呈负相关.结论 PV患者红细胞寿命较健康者缩短约1/3,且与JAK2突变基因负荷量、淋巴细胞计数、血清维生素B12水平相关.Objective To detect the red blood cell lifespan in patients with polycythemia vera (PV), and explore the influencing factors. Methods From February 2017 to December 2018, 27 patients with PV at Blood Diseases Hospital, Chinese Academy of Medical Science and 18 normal controls were recruited. Red blood cell lifespan was detected by endogenous carbon monoxide (CO) breath test. The related factors were analyzed. Results The average red blood cell lifespan of 27 PV patients was 80 (range, 35-120) days (d), which was significantly shorter than that of the normal controls [110.5(69-166) d, P<0.05], namely 35.3 d shorter. The red blood cell lifespan of ten newly diagnosed patients and 17 patients who were treated with hydroxyurea and/or interferon were 98 (35-117) d and 69 (45-120) d, respectively, which were both shorter than that of the normal control (P=0.010, 0.000). Correlation analysis showed that red blood cell lifespan of patients with newly diagnosed PV was associated with JAK2 mutation allele burden (r=0.900, P=0.037), peripheral blood lymphocyte count (r=-0.742, P=0.014) and the level of serum vitamin B12 (r=-0.821, P=0.023). Conclusion The lifespan of red blood cells in patients with PV is about one?third shorter than normal, and is related to JAK2 mutation allele burden, absolute lymphocyte count, and serum vitamin B12 level.

关 键 词：红细胞增多症 真性 红细胞寿命 一氧化碳呼气试验 

分 类 号：R555.1[医药卫生—血液循环系统疾病]