HIF-1α表达与含砷中药复方治疗骨髓增生异常综合征的预后生存相关性  

Correlation Between Expression of HIF-1αand Prognosis of Arsenic-containing Chinese Herbal Compound in Treatment of Myelodysplastic Syndrome

作　　者：蒋佩珍 杨秀鹏[1] 王德秀 王文儒 吕妍[1] 刘为易 陈卓 王洪志[1] 郭小青[1] 张姗姗[1] 许勇钢[1] 唐旭东[1] JIANG Peizhen;YANG Xiupeng;WANG Dexiu;WANG Wenru;LYU Yan;LIU Weiyi;CHEN Zhuo;WANG Hongzhi;GUO Xiaoqing;ZHANG Shanshan;XU Yonggang;TANG Xudong(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]中国中医科学院西苑医院,北京100091 [2]北京中医药大学东方医院,北京100078

出　　处：《中国实验方剂学杂志》2024年第9期101-107,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然基金面上项目(82074258,82274502);第二批北京市研究型病房示范建设项目(BCRW202108);中国中医科学院科技创新工程重大攻关项目(CI2021A01701)。

摘　　要：目的:骨髓增生异常综合征(MDS)是一组克隆性造血干细胞疾病,本研究旨在探讨MDS患者骨髓细胞中低氧诱导因子-1α(HIF-1α)表达情况,及其与MDS临床特征、含砷中药复方治疗疗效和生存预后的相关性。方法:根据纳入排除标准,收集2022年1月至2022年9月期间中国中医科学院西苑医院血液科治疗予含砷中药复方的27例MDS患者,行骨髓穿刺术采集骨髓样本,采用实时荧光定量聚合酶链式反应(Real-time PCR)检测骨髓细胞中HIF-1α表达水平,分析其与临床特征的相关性,以Logistic、Cox模型回归分析影响MDS患者疗效及预后生存的危险因素。结果:MDS患者骨髓细胞相比正常人中HIF-1αmRNA水平表达较低;HIF-1α与骨髓增生程度(r=0.384,P<0.05)、骨髓粒细胞系统%(G%)(r=0.560,P<0.01)呈正相关;Logistic回归分析显示HIF-1α在随访疗效中是危险因素(P<0.05);Cox回归分析显示,HIF-1α是影响MDS患者生存预后的独立危险因素[比值比(OR)=398.968,95%置信区间(CI)(1.281,116858.743),P<0.05]。结论:MDS患者骨髓细胞中的HIF-1α表达水平与临床骨髓增生程度和G%密切相关,HIF-1α是MDS疗效和生存预后危险因素。Objective:Myelodysplastic syndromes(MDS)is a group of clonal hematopoietic stem cell disorders,and this study aims to investigate the expression of hypoxia-inducible factor-1α(HIF-1α)in the bone marrow cells of patients with MDS and its correlation with the clinical features of MDS,the therapeutic efficacy of arsenic-containing Chineseherbal compound,and the survival prognosis.M ethod:According to the inclusion and exclusion criteria,27 MDS patients treated with arsenic-containing Chinese herbal compound in the Department of Hematology,Xiyuan Hospital,China Academy of Chinese Medical Sciences from January 2022 to September 2022 were included,and their bone marrow samples were collected by myelotomy. HIF-1α expression level in bone marrow cells was detected by real-time polymerase chain reaction (PCR) to analyze its correlation with clinical features,and logistic and Cox regression was used to analyze the risk factors affecting the efficacy and prognostic survival of MDS patients.Result:The HIF-1α mRNA expression level was lower in bone marrow cells of MDS patients than in healthy subjects. HIF-1α was positively correlated with the degree of myelodysplasia(r=0.384,P<0.05) and bone marrow granulocytic system%(G%)(r=0.560,P<0.01). Logistic regression showed that HIF-1α was a risk factor for the prognosis in the follow-up of the efficacy of treatment(P<0.05)and Cox regression showed that HIF-1α was an independent factor affecting the survival prognosis of MDS patients [odds ratio(OR)=398.968,95% confidence interval(CI)(1.281,116858.743),P<0.05].Conclusion:The level of HIF-1α expression in bone marrow cells of MDS patients was closely related to the degree of clinical myelodysplasia and G%,and HIF-1α was a risk factor for the efficacy for and survival prognosis of MDS patients.

关 键 词：骨髓增生异常综合征 低氧诱导因子-1α(HIF-1α) 含砷中药复方 青黄散 生存预后 

分 类 号：R242[医药卫生—中医临床基础] R2-0[医药卫生—中医学] R2-031R551.3R733.3