再生障碍性贫血患者血清中TPO水平变化的临床意义

发布时间：2019-03-21 06:44

【摘要】：目的:评价血清中血小板生成素(TPO)水平在再生障碍性贫血(AA)患者诊疗中的临床意义。方法:以119例健康志愿者和54例AA患者为研究对象。从54例患者中共收集92份样本,其中43份为初诊患者,23份样本为治疗后仍处于骨髓抑制期的患者,10份来源于部分缓解(PR)患者,16份来源于完全缓解(CR)患者。用免疫酶联吸附法(ELISA)检测血清中的TPO水平。用自动血细胞分析仪计数外周血细胞。结合骨髓细胞学及骨髓活检的检查结果对确诊的AA患者进行分型诊断。对不同年龄、性别、不同分型及治疗后血小板计数和TPO水平之间的关系进行了相关分析。结果:健康志愿者血清中TPO水平为95.3±54.0 pg/ml。极重型再生障碍性贫血(vSAA)、重型再生障碍性贫血(SAA)及非重型再生障碍性贫血(nSAA)血清中TPO水平分别为2908±623、2708±623和2684±891 pg/ml,各型AA患者的TPO水平之间无明显差异(P0.05),但显著高于健康对照组(P0.001)。43例初诊患者在治疗前TPO水平最高,为2728±1704 pg/ml,23例在接受免疫抑制治疗(IST)后仍处于骨髓抑制期患者血清TPO水平为1598±1692 pg/ml,PR患者TPO水平为1912±1011 pg/ml,CR患者TPO水平为1009±590 pg/ml,与健康对照相比差异有统计学意义(P0.001)。PR患者的TPO水平高于CR患者(P0.001)。PR和CR患者TPO水平低于初诊及治疗后处于骨髓抑制期的患者(P0.001)。TPO水平与Plt数量呈负相关(r=-0.53,P0.001)。对于AA患者,在收集样本前2周内未输注Plt,其TPO水平与Plt数量呈负相关(r=-0.70,P0.001)。尽管PR患者Plt为117×10~9/L,CR患者Plt计数为167×10~9/L,但二者TPO水平无统计学差异(P0.05)。结论:AA患者无论缓解与否,其TPO水平都显著高于健康对照组,提示TPO通路在AA患者的机制中可能存在异常。
[Abstract]:Objective: to evaluate the clinical significance of serum thrombopoietin (TPO) level in the diagnosis and treatment of (AA) patients with aplastic anemia. Methods: 119 healthy volunteers and 54 AA patients were studied. A total of 92 samples were collected from 54 patients, including 43 newly diagnosed patients, 23 bone marrow suppression patients after treatment, 10 patients with partial remission (PR) and 16 patients with complete remission (CR). The level of TPO in serum was detected by enzyme-linked immunosorbent assay (ELISA). The peripheral blood cells were counted by automatic blood cell analyzer. Combined with the results of bone marrow cytology and bone marrow biopsy, the patients with AA were diagnosed by typing. The relationship between platelet count and TPO level was analyzed in different age, sex, classification and post-treatment. Results: the serum TPO level in healthy volunteers was 95.3 卤54.0 pg/ml.. The serum TPO levels of severe aplastic anemia (vSAA), severe aplastic anemia (SAA) and non-severe aplastic anemia (nSAA) were 2908 卤623,2708 卤623 and 2684 卤891 pg/ml, respectively. There was no significant difference in the level of TPO among all types of AA patients (P0.05), but it was significantly higher than that in the healthy control group (P0.001). The TPO level in 43 newly diagnosed patients was the highest (2728 卤1704 pg/ml,) before treatment. Serum TPO level was 1598 卤1692 pg/ml,PR in 23 patients who were still in myelosuppression stage after immunosuppressive therapy, TPO level was 1912 卤1011 pg/ml,CR in patients with (IST), TPO level was 1009 卤590pg/ml, in patients with immunosuppressive therapy. TPO levels in PR patients were higher than those in CR patients (P0.001). TPO levels in PR and CR patients were lower than those in newly diagnosed and post-treatment patients with myelosuppression (P0.001). The level of .TPO was negatively correlated with the number of Plt (r = 0.53, P < 0.01). P0.001). In patients with AA, the level of TPO was negatively correlated with the number of Plt (r = 0.70, P0.001) without Plt, being infused within 2 weeks before the sample was collected. Although the Plt of PR patients was 117 脳 10 ~ 9 mL, and the Plt count of CR patients was 167 脳 10 ~ 9 mL, there was no significant difference in TPO level between the two groups (P0.05). Conclusion: the level of TPO in AA patients with or without remission is significantly higher than that in healthy controls, suggesting that TPO pathway may be abnormal in the mechanism of AA patients.
【作者单位】：徐州医科大学附属医院血液科;
【基金】：国家自然科学基金青年基金(81500097) 江苏省高校自然科学基金(15KJB320016)
【分类号】：R556.5

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