粒细胞集落刺激因子联合羟基脲对慢性粒细胞白血病患者疗效及Bcl-2、Bax、Smoothened蛋白表达的影响  

Effect of Granulocyte Colony-stimulating Factor Combined with Hydroxyurea in Patients with Chronic Myelogenous Leukemia and Its Effect on Bcl-2,Bax and Smoothened Protein Expression

作　　者：李彦卿 许晓炜 曹宇峰 刘江 王磊 王莉丽 LI Yanqing;XU Xiaowei;CAO Yufeng;LIU Jiang;WANG Lei;WANG Lili(Department of Hematology,the First Hospital of Zhangjiakou City,Zhangjiakou,Hebei 075000,China;Department of Nephrology,the First Hospital of Zhangjiakou City,Zhangjiakou,Hebei 075000,China;Department of General Surgery,the First Hospital of Zhangjiakou City,Zhangjiakou,Hebei 075000,China)

机构地区：[1]张家口市第一医院血液科,河北张家口075000 [2]张家口市第一医院肾内科,河北张家口075000 [3]张家口市第一医院普外科,河北张家口075000

出　　处：《转化医学杂志》2023年第6期314-318,356,共6页Translational Medicine Journal

基　　金：河北省2022年度医学科学研究课题计划项目(20221900);张家口市科学技术研究与发展计划项目(1821112D)。

摘　　要：目的研究粒细胞集落刺激因子联合羟基脲对慢性粒细胞白血病患者疗效及Bcl-2、Bax、Smoothened蛋白表达的影响。方法选取2018年4月—2020年4月收治的慢性粒细胞白血病100例,按照随机数字表法分为粒系组、联合组,每组50例。粒系组给予重组人粒细胞刺激因子注射液治疗,联合组给予重组人粒细胞刺激因子注射液联合羟基脲治疗。比较2组治疗前后血小板参数、白细胞计数(WBC)、血清相关因子[白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、环氧合酶-2(COX-2)、转化生长因子-β1(TGF-β1)]水平,以及Bcl-2、Bax和Smoothened蛋白表达量。比较2组的临床疗效及不良反应发生情况。结果治疗后,与粒系组相比,联合组血小板计数及血清TGF-β1水平较高,血小板分布宽度、血小板平均体积、WBC以及血清IL-10、TNF-α、IL-8、COX-2水平较低(P<0.05)。治疗后,与粒系组相比,联合组Bcl-2及Smoothened蛋白表达量较低,Bax蛋白表达量较高(P<0.05)。与粒系组相比,联合组治疗总有效率较高(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论粒细胞集落刺激因子联合羟基脲治疗慢性粒细胞白血病,能够调节患者造血功能及免疫功能,降低炎症反应及WBC水平,有效抑制白血病细胞增殖症状,从而改善病情。Objective To investigate the effect of granulocyte colony-stimulating factor(G-CSF)combined with Hydroxyurea in patients with chronic myelogenous leukemia(CML)and its impact on Bcl-2,Bax and Smoothened protein expression.Methods A total of 100 patients with CML admitted from April 2018 to April 2020 were selected and divided into G-CSF group(n=50)and combination treatment group(n=50)according to the random number table method.In the G-CSF group,recombinant human granulocyte stimulating factor injection was given,and in the combination treatment group,recombinant human granulocyte stimulating factor injection combined with Hydroxyurea was given.Platelet parameters,white blood count(WBC),serum-related factors[interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),cyclooxygenase-2(COX-2),transforming growth factor-β1(TGF-β1)],and Smoothened protein expression in Bcl-2,Bax and CD34+cells before and after treatment were compared between the two groups.The clinical efficacy and the occurrence of adverse reactions were compared between the two groups.Results After treatment,the platelet count and serum TGFβ1 level in the combination treatment group were higher than those in the G-CSF group,while the platelet distribution width,mean platelet volume,WBC and serum levels of IL-10,TNF-α,IL-8 and COX-2 were lower(P<0.05).After treatment,the Bcl-2 and Smoothened protein expression were lower,while the expression of Bax protein was higher in combination treatment group than in G-CSF group(P<0.05).Compared with G-CSF group,the total effective rate of the combination treatment group was higher(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion G-CSF combined with Hydroxyurea in the treatment of CML can regulate the hematopoietic function and immune function of patients,reduce the inflammatory response and WBC level,and effectively inhibit the symptoms of leukemia cell proliferation,thus improving the condition.

关 键 词：慢性粒细胞白血病 粒细胞集落刺激因子 羟基脲 环氧合酶-2 转化生长因子-β1 白细胞计数 血小板计数 SMOOTHENED 

分 类 号：R733.72[医药卫生—肿瘤]