上海交通大学学报（医学版）

›› 2009, Vol. 29 ›› Issue (9): 1081-.

• 论著（临床研究） • 上一篇    下一篇

重组人G-CSF治疗不同白细胞减少症的疗效与机制

马玉杰, 梁 辉   

  1. 上海交通大学 医学院新华医院血液内科, 上海 200092
  • 出版日期:2009-09-25 发布日期:2009-09-29
  • 通讯作者: 梁辉, 电子信箱: lianghui_wu@sina.com。
  • 作者简介:马玉杰（1982—）, 女, 硕士生；电子信箱: myjlwlfe@163.com。

Efficacy and mechanism of rhG-CSF in treatment of different leukopenia

MA Yu-jie, LIANG Hui   

  1. Department of Hematology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China
  • Online:2009-09-25 Published:2009-09-29

PDF (PC)

1443

摘要：

目的 探讨重组人粒细胞集落刺激因子（rhG-CSF）治疗不同白细胞减少症的疗效与机制。方法 临床选取四组患者：再生障碍性贫血组（AA组，n=10）、骨髓增生异常综合征组（MDS组，n=10）、药物性白细胞减少组（药物组，n=20）（根据骨髓粒系增生程度再分为增生活跃组和增生减低组）和缺铁性贫血组（对照组，n=10）。ELISA法测定外周血G-CSF浓度；流式细胞仪检测骨髓单个核细胞（BMMNC）G-CSF受体(G-CSFR)的表达率及CD34+细胞比例；培养BMMNC，比较粒细胞集落形成单位（CFU-G）集落数。比较AA组、MDS组和药物组进行rhG-CSF治疗的效果。结果 AA组和药物组的血清G-CSF浓度均高于对照组和MDS组（P<0.05）。AA组的G-CSFR表达率低于其余各组（P<0.05），但MDS组与药物组和对照组之间差异无统计学意义（P>0.05）；增生减低组G-CSFR表达率低于增生活跃组和对照组（P<0.05），但增生活跃组与对照组差异无统计学意义（P>0.05）。AA组的CD34+细胞比例低于其余各组（P<0.05），但其余各组间差异无统计学意义（P>0.05）。AA组和MDS组的CFU-G集落数均低于对照组和药物组（P<0.05），但AA组与MDS组、药物组与对照组之间差异无统计学意义（P>0.05）。经rhG-CSF治疗后，药物组疗效优于MDS组，MDS组疗效优于AA组（P<0.05）。结论 rhG-CSF疗效与骨髓G-CSFR表达率、CD34+细胞比例、干祖细胞对G-CSF的反应性及内源性G-CSF浓度有关。

关键词: 白细胞减少症, 粒细胞集落刺激因子, 骨髓单个核细胞, 疗效, 机制

Abstract:

Objective To explore efficacy and mechanism of recombinant human granulocyte-colony stimulating factor (rhG-CSF) in treatment of different leukopenia. Methods A total of 50 patients were divided into 4 groups: aplastic anemia (AA) group (n=10), myelodysplastic syndromes (MDS) group (n=10), drug-induced leukopenia group (n=20) (subdivided into hyperplasia group and hypoplasia group by the degree of cellularity) and iron deficiency anemia group (control group, n=10). The concentrations of G-CSF of peripheral blood were measured by ELISA method. The ratio of CD34+ cells and G-CSFR expression in blood marrow mononuclear cells (BMMNC) were measured by flow cytometry. Granulocyte colony-forming units (CFU-G) of MNC were cultured. Clinical efficacy of rhG-CSF to all patients were determined. Results The concentrations of G-CSF were higher in AA and druginduced leukopenia groups than those of MDS and control groups (P<0.05). Expressions of G-CSFR in AA group were lower than those in other groups (P<0.05). There were no significant differences between MDS group and drug-induced leukopenia and control groups (P>0.05). Expressions of G-CSFR were lower in hypoplasia group than those in hyperplasia and control groups (P<0.05). There was no significant difference between hyperplasia group and control group (P>0.05). The ratio of CD34+ cells was lower in AA group than that of other groups (P<0.05), without significant differences between the others groups (P>0.05). Concentrations of CFU-G were lower in AA and MDS groups than those in drug-induced leukopenia and control groups (P<0.05). There were no significant differences between AA group and MDS group, and between drug-induced leukopenia group and control group (P>0.05). The efficacy of rhG-CSF was superior in drug-induced leukopenia group than in MDS group, and superior in MDS group than in AA group (P<0.05). Conclusion The efficacy of rhG-CSF is related to expression ratio of G-CSFR, ratio of CD34+ cells, and response of stem/progenitor cells to G-CSF and endogenous concentration of G-CSF.

Key words: leukopenia, granulocyte-colony stimulating factor, bone marrow mononuclear cell, efficacy, mechanism

中图分类号: