骨髓增殖性肿瘤患者外周血内皮祖细胞数变化及临床意义  

Change and clinical significance of peripheral blood endothelial progenitor cells in patients with myeloproliferative neoplasms

作　　者：韩雪[1] 白贝贝[1] 冯翠翠 赵森[1] 王芳[2] 王春键 陈烨[1] HAN Xue;BAI Beibei;FENG Cuicui;ZHAO Sen;WANG Fang;WANG Chunjian;CHEN Ye(Department of Hematology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;Department of Hematology,Peking University International Hospital,Beijing 102206,China)

机构地区：[1]首都医科大学附属北京安贞医院血液科,北京100029 [2]北京大学国际医院血液科,北京102206

出　　处：《中华实用诊断与治疗杂志》2024年第5期483-487,共5页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的观察骨髓增殖性肿瘤(MPN)患者外周血内皮祖细胞(EPC)数变化,探讨其与血细胞计数、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)和JAK2V617F突变的关系。方法2013年6月—2020年12月北京安贞医院初诊的105例MPN患者为MPN组,45例非MPN血液恶性肿瘤患者为恶性肿瘤组,52例良性血液病患者为对照组。MPN组中真性红细胞增多症(PV)38例,原发性血小板增多症(ET)61例,原发性骨髓纤维化(PMF)6例。比较3组入院时血红蛋白(Hb)、白细胞计数(WBC)、红细胞计数(RBC)、血小板计数(PLT)、红细胞比容(Hct)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、hs-CRP水平及心血管危险因素(CVRF)>1个比率、EPC数;分析不同临床特征MPN患者EPC数差异;Spearman相关法分析MPN患者EPC数与血细胞计数、IL-6、TNF-α、hs-CRP的相关性。结果(1)MPN组入院时Hb[152(57,235)g/L]、WBC[9.14(2.91,30.56)×10^(9)/L]、RBC[5.05(1.68,9.99)×10^(12)/L]、PLT[557(82,2126)×10^(9)/L]、Hct[(45.39±10.60)%]均高于恶性肿瘤组[99(40,165)g/L、6.55(1.50,146.03)×10^(9)/L、3.12(1.24,5.13)×10^(12)/L、137(4,1305)×10^(9)/L、(29.96±13.17)%]和对照组[137(62,237)g/L、5.60(2.27,15.12)×10^(9)/L、4.62(1.62,6.84)×10^(12)/L、208(32,658)×10^(9)/L、(39.31±16.68%)](P<0.05);恶性肿瘤组Hct、PLT均低于对照组(P<0.05);MPN组、恶性肿瘤组CVRF>1个比率(64.76%、62.22%)均高于对照组(38.46%)(P<0.05)。(2)MPN组、恶性肿瘤组外周血EPC数[306(0,4303)、193(0,2920)个/mL]均多于对照组[87(0,2616)个/mL](U=-4.251,P<0.001;U=-2.031,P=0.042),MPN组与恶性肿瘤组比较差异无统计学意义(U=-1.267,P=0.205)。(3)男性[435(0,4303)个/mL]、>60岁伴JAK2V617F突变阳性[363(0,4303)个/mL]、CVRF>1个[375(0,4303)个/mL]、PV[404(0,2622)个/mL]患者外周血EPC数分别多于女性[227(0,3300)个/mL]、>60岁伴JAK2V617F突变阴性[248(0,2639)个/mL]、1个CVRF[165(0,3330)个/Objective To observe the change of peripheral blood endothelial progenitor cells(EPCs)in patients with myeloproliferative neoplasms(MPNs),and to investigate its relationships with blood cell count,interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP)and JAK2V617F mutation.Methods From June 2013 to December 2020,105 patients with MPNs(MPNs group),45 patients with non-MPNs hematologic malignancies(malignancy group)and 52 patients with benign hematologic diseases(control group)were initially diagnosed and treated in Beijing Anzhen Hospital.In MPNs group,there were 38 patients with polycythemia vera(PV),61 patients with essential thrombocythemia(ET)and 6 patients with primary myelofibrosis(PMF).The hemoglobin(Hb),white blood cell count(WBC),red blood cell count(RBC),platelet(PLT),hematocrit(Hct),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),hs-CRP,proportion of>1 cardiovascular risk factors(CVRFs),and EPCs number on admission were compared among three groups.The differences in EPCs number were analyzed in MPN patients with different clinical characteristics.Spearman correlation method was used to analyze the correlations of EPCs number with blood cell count,IL-6,TNF-αand hs-CRP in MPNs patients.Results(1)The Hb,WBC,RBC,PLT and Hct were higher in MPNs group[152(57,235)g/L],WBC[9.14(2.91,30.56)×10^(9)/L],RBC[5.05(1.68,9.99)×10^(12)/L],PLT[557(82,2 126)×10^(9)/L],Hct[(45.39±10.60)%]than those inmalignancygroup[99(40,165)g/L,6.55(1.50,146.03)×10^(9)/L,3.12(1.24,5.13)×10^(12)/L,137(4,1 305)×10^(9)/L,(29.96±13.17)%]and controlgroup[137(62,237)g/L,5.60(2.27,15.12)×10^(9)/L,4.62(1.62,6.84)×10^(12)/L,208(32,658)×10^(9)/L,(39.31±16.68%)](P<0.05).TheHct andPLTwerelower in malignancy group than those in control group(P<0.05).The proportion of>1 CVRFs was higher in MPNs group(64.76%)and malignancy group(62.22%)than that in control group(38.46%)(P<0.05).(2)The peripheral blood EPCs number was grea

关 键 词：骨髓增殖性肿瘤 内皮祖细胞 血细胞计数 白细胞介素-6 肿瘤坏死因子-α 高敏C反应蛋白 

分 类 号：R733.3[医药卫生—肿瘤]