再生障碍性贫血患者血清sFasL、SDF-1与免疫抑制疗效的相关性  

Correlation of serum levels of sFasL,SDF-1 and immunosuppressive efficacy in patients with aplastic anemia

作　　者：张玉龙 张静 李树军 马龙 祖建兵 孙丹丹 ZHANG Yulong;ZHANG Jing;LI Shujun;MA Long;ZU Jianbing;SUN Dandan(Department of Laboratory,Hinggan League People's Hospital,Ulanhot 137400,China;Department of Blood Specialty,Hinggan League People's Hospital,Ulanhot 137400,China)

机构地区：[1]兴安盟人民医院检验科,137400 [2]兴安盟人民医院血液科,137400

出　　处：《天津医药》2024年第12期1270-1273,共4页Tianjin Medical Journal

基　　金：兴安盟科技计划项目(MJXM2019MB10)。

摘　　要：目的探究再生障碍性贫血(AA)患者血清可溶性凋亡相关因子配体(sFasL)、基质细胞衍生因子1(SDF-1)水平及其与免疫抑制治疗效果的相关性。方法选择接受半年免疫抑制治疗的AA患者43例为观察组,另择43例同期健康体检者为对照组。观察组患者进行免疫抑制治疗和促造血治疗,并依据疗效分为无效组和有效组。收集患者临床资料,采用酶联免疫吸附试验检测血清sFasL、SDF-1、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平,分析血清sFasL与SDF-1水平的相关性,多因素Logistic回归分析AA患者免疫抑制治疗效果的影响因素,受试者工作特征(ROC)曲线分析血清sFasL、SDF-1对免疫抑制治疗效果的预测价值。结果观察组血清sFasL、SDF-1水平均高于对照组(P<0.05)。无效组血清TNF-α、IL-8、sFasL、SDF-1水平均高于有效组(P<0.05)。AA患者血清sFasL水平与SDF-1水平呈正相关(r=0.534,P<0.001)。血清sFasL、SDF-1水平升高是AA患者免疫抑制治疗无效的独立危险因素(P<0.05)。血清sFasL、SDF-1联合预测AA患者免疫抑制治疗效果的曲线下面积(AUC)为0.973(95%CI:0.872~0.999),优于各自单独预测(P<0.05),其敏感度和特异度分别为94.44%和96.00%。结论AA患者血清sFasL、SDF-1水平均明显升高,二者联合检测对AA免疫抑制治疗效果具有较高的预测价值。Objective To investigate serum levels of soluble apoptosis-related factor ligand(sFasL)and stromal cell derived factor 1(SDF-1)in patients with aplastic anemia(AA)and their correlation with immunosuppressive treatment.Methods Forty-three AA patients who received immunosuppressive therapy for half a year were selected as the observation group,and another 43 healthy subjects at the same period were selected as the control group.Patients in the observation group received immunosuppressive therapy and hematopoietic propoietic therapy,and patients were divided into the ineffective group and the effective group according to the efficacy.Clinical data of patients were collected,and serum levels of sFasL,SDF-1,tumor necrosis factor-α(TNF-α)and interleukin-8(IL-8)were detected by enzyme-linked immunosorbent assay.The correlation between serum sFasL and SDF-1 levels was analyzed.Multivariate Logistic regression analysis was conducted to analyze influencing factors of immunosuppressive treatment in AA patients.The predictive values of serum sFasL and SDF-1 on immunosuppressive treatment were analyzed by receiver operating characteristic(ROC)curve.Results Serum levels of sFasL and SDF-1 were higher in the observation group than those in the control group(P<0.05).Serum levels of TNF-α,IL-8,sFasL and SDF-1 were higher in the ineffective group than those in the effective group(P<0.05).Serum sFasL level was positively correlated with SDF-1 level in AA patients(r=0.534,P<0.001).Increased serum sFasL and SDF-1 levels were independent risk factors for ineffective immunosuppressive therapy in AA patients(P<0.05).The area under the curve(AUC)of serum sFasL and SDF-1 combined to predict the immunosuppressive treatment effect of AA patients was 0.973(95%CI:0.872-0.999),which was better than that of single diagnosis(P<0.05),and its sensitivity and specificity were 94.44%and 96.00%,respectively.Conclusion Serum levels of sFasL and SDF-1 are significantly increased in patients with AA.The combined detection of sFasL and SDF-1 has high

关 键 词：贫血 再生障碍性 免疫耐受 可溶性凋亡相关因子配体 基质细胞衍生因子1 

分 类 号：R556.5[医药卫生—血液循环系统疾病]