中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2010年
4期
219-222
,共4页
张丽红%王慧君%张莉%周康%杨栋林%阎嶂松%李洪强%刘庆国%齐军元%刘强%储榆林%张凤奎
張麗紅%王慧君%張莉%週康%楊棟林%閻嶂鬆%李洪彊%劉慶國%齊軍元%劉彊%儲榆林%張鳳奎
장려홍%왕혜군%장리%주강%양동림%염장송%리홍강%류경국%제군원%류강%저유림%장봉규
贫血,再生障碍性%彗星试验%遗传不稳定%免疫抑制治疗
貧血,再生障礙性%彗星試驗%遺傳不穩定%免疫抑製治療
빈혈,재생장애성%혜성시험%유전불은정%면역억제치료
Anemia,aplastic%Comet assay%Genetic instability%Immunosuppressive therapy
目的 评价再生障碍性贫血(AA)患者骨髓造血细胞遗传不稳定性,探讨其对患者免疫抑制治疗(IST)的影响和在晚期克隆性血液学异常发生中的意义.方法 采用彗星试验检测AA患者骨髓造血细胞遗传不稳定性,分析其与反映骨髓造血衰竭参数的相关性,评价遗传不稳定对IST近期疗效的影响及IST对骨髓细胞遗传不稳定性的影响.结果 AA患者骨髓造血细胞彗星参数尾矩(TM)、Olive尾矩(OTM)、彗星细胞率(Comet%)均明显高于对照组(P值均<0.05);患者年龄、性别和外周血细胞计数与骨髓造血细胞各项彗星参数无相关性(P值均>0.05);比较Comet%<21.64%组与Comet%321.64%组、OTM<1.58组与OTM≥1.58组重型从(SAA)患者IST后6个月治疗反应差异无统计学意义(P>0.05);IST治疗对SAA患者彗星参数无明显影响,获得部分治疗反应者Comet%、TM、OTM以及获得完全治疗反应者Comet%均较治疗前明显降低.2例SAA患者在发生克隆性细胞遗传学异常前彗星参数均明显增高.结论 遗传不稳定性增高与骨髓造血衰竭可能是AA同一病理生理机制导致的不同表现形式;治疗前造血细胞遗传不稳定性对SAA患者IST近期疗效无影响;IST可能减轻获得治疗反应者骨髓造血细胞遗传不稳定.
目的 評價再生障礙性貧血(AA)患者骨髓造血細胞遺傳不穩定性,探討其對患者免疫抑製治療(IST)的影響和在晚期剋隆性血液學異常髮生中的意義.方法 採用彗星試驗檢測AA患者骨髓造血細胞遺傳不穩定性,分析其與反映骨髓造血衰竭參數的相關性,評價遺傳不穩定對IST近期療效的影響及IST對骨髓細胞遺傳不穩定性的影響.結果 AA患者骨髓造血細胞彗星參數尾矩(TM)、Olive尾矩(OTM)、彗星細胞率(Comet%)均明顯高于對照組(P值均<0.05);患者年齡、性彆和外週血細胞計數與骨髓造血細胞各項彗星參數無相關性(P值均>0.05);比較Comet%<21.64%組與Comet%321.64%組、OTM<1.58組與OTM≥1.58組重型從(SAA)患者IST後6箇月治療反應差異無統計學意義(P>0.05);IST治療對SAA患者彗星參數無明顯影響,穫得部分治療反應者Comet%、TM、OTM以及穫得完全治療反應者Comet%均較治療前明顯降低.2例SAA患者在髮生剋隆性細胞遺傳學異常前彗星參數均明顯增高.結論 遺傳不穩定性增高與骨髓造血衰竭可能是AA同一病理生理機製導緻的不同錶現形式;治療前造血細胞遺傳不穩定性對SAA患者IST近期療效無影響;IST可能減輕穫得治療反應者骨髓造血細胞遺傳不穩定.
목적 평개재생장애성빈혈(AA)환자골수조혈세포유전불은정성,탐토기대환자면역억제치료(IST)적영향화재만기극륭성혈액학이상발생중적의의.방법 채용혜성시험검측AA환자골수조혈세포유전불은정성,분석기여반영골수조혈쇠갈삼수적상관성,평개유전불은정대IST근기료효적영향급IST대골수세포유전불은정성적영향.결과 AA환자골수조혈세포혜성삼수미구(TM)、Olive미구(OTM)、혜성세포솔(Comet%)균명현고우대조조(P치균<0.05);환자년령、성별화외주혈세포계수여골수조혈세포각항혜성삼수무상관성(P치균>0.05);비교Comet%<21.64%조여Comet%321.64%조、OTM<1.58조여OTM≥1.58조중형종(SAA)환자IST후6개월치료반응차이무통계학의의(P>0.05);IST치료대SAA환자혜성삼수무명현영향,획득부분치료반응자Comet%、TM、OTM이급획득완전치료반응자Comet%균교치료전명현강저.2례SAA환자재발생극륭성세포유전학이상전혜성삼수균명현증고.결론 유전불은정성증고여골수조혈쇠갈가능시AA동일병리생리궤제도치적불동표현형식;치료전조혈세포유전불은정성대SAA환자IST근기료효무영향;IST가능감경획득치료반응자골수조혈세포유전불은정.
Objective To evaluate bone marrow hematopoietic cells genetic instability (BMHCGI) in patients with aplastic anemia(AA) and to explore its influence on immunosupressive therapy for AA and significance on late clonal hematologic disorders.Methods Genetic instability of bone marrow mononuclear cells (BMMNC) was measured by Comet assay.The relationship between bone marrow failure parameters and genetic instability results was evaluated.The reciprocity of genetic instability and treatment responses to im-munosuppressive therapy (IST) was investigated.Results Comet assay parameters [tail moment (TM) , ol-ive TM(OTM), comet % ] of AA patients were significantly higher than that of control group (P<0.05).There was no statistic correlation of comet parameters of severe AA(SAA) BM hematopoietic cells with age, gender and peripheral blood cell count (P>0.05).For the treatment response rate at six months after IST there was no statistical difference between comet cells of<21.64% and of ≥21.64% , and so did between OTM<1.58 and 1.58 in SAA patients.IST had no effect on SAA BMHCGI, whereas,the Comet% , TM and OTM in SAA PR patients and Comet% in CR patients were significantly decreased than those before treat-ment.Comet parameters of two SAA patients were significantly increased before the development of clonal cy-togenetic abnormalities.Conclusions Increased BMHCGI may be one of the elements in the pathogenetic mechanisms in AA.The genetic instability is irrelevant to the SAA patients overall response rate of IST at six months, but IST can alleviate the genetic instabilities in responded SAA patients.
