摘要
目的分析急性白血病(AL)、多发性骨髓瘤(MM)、非霍奇金淋巴瘤(NHL)患者血清促红细胞生成素(sEPO)、可溶性转铁蛋白受体(sTfR)、血液血红蛋白(Hb)及骨髓有核红细胞百分数(Eb)4种指标的相关性,并探讨联合检测的临床意义。方法纳入68例AL、41例MM、33例NHL患者作为研究对象,采用ELISA法测定sEPO、sTfR,使用全自动血液细胞分析仪测定Hb,穿刺采集骨髓进行骨髓细胞学检查,计数Eb。使用SPSS软件对检测结果进行统计分析。结果三种血液肿瘤患者的sEPO均较对照组不同程度的增高,贫血患者的增幅较无贫血患者更大。AL、MM贫血患者的sTfR分别为2.24±0.89mg/L和2.6±0.9mg/L,均低于对照组;AL、MM无贫血患者的sTfR分别为4.50±1.22 mg/L和3.72±1.09 mg/L,均高于对照组;NHL贫血患者与无贫血患者的sTfR分别为2.93±0.48 mg/L和3.28±0.68mg/L,与对照组无差异。AL、MM贫血患者的sEPO与Hb、sTfR及Eb均呈负相关;NHL贫血患者的EPO与Hb、Eb均呈负相关。结论 AL、MM、NHL贫血患者的血清EPO明显增高,主要是因贫血导致的低氧血症引起的反应性增高;AL、MM、NHL血清EPO增高还存在贫血以外的其他机制;sEPO、sTfR、Hb及Eb的联合检测分析将有助于客观全面评价AL、MM、NHL贫血患者内源性EPO的有效含量和促红细胞生成活性。
Objective To investigate the relationship between serum erythropoietin（ sEPO）, serum transferrin receptor （sTfR） ,hemoglobin（Hb） and the percentage of erythroblast in bone marrow nucleated cells in patients with acute leukemia（AL）,multiple myeloma （MM） and Non Hodgkin lymphoma（NHL）, respectively. And to explore the clinical significance of combined determination on above four parameters. Methods 68 of patients with acute leukemia,41 of patients with multiple myeloma and 33 of patients with Non Hodgkin lymphoma were included in study groups. Results The level of sEPO in the three kinds of hematological tumor was higher to the extend than that in control group, and sEPO in those patients with anemia was higher than in those without anemia compared as control group with increase of 33.9 fold in Al, 8.1 fold in MM and 12.4 fold in NHL vs 12.7 fold in Al, 2.2 fold in MM and 5.9fold in NHL,respectively. The concentration of sTfR in patients with anemia undergoing AL and MM were 2.24 ±0. 89 mg/L and 2.6± 0.9 mg/L respectively, it was less than that in control group. The concentration of sTfR in patients without anemia undergoing AL and MM were 4.50 ± 1.22 mg/L and 和 3.72 ±1.09 mg/L respectively,it was higher than that in control group. The concentration of sTiR in NHL were 2.93± 0.48 mg/L and 3.28 ±0.68mg/L （in group without anemia） ,there were no difference compared with control group. There was negative correlation between EPO and Hb, EPO and sTfR, EPO and Eb in patients undergoing AL and MM respectively. There was negative correlation between EPO and Hb, EPO and Eb in patients undergoing NHL. Conclusion Significant increasement in sEPO of patients undergouing AL, MM and NHL with anemia is the result of reaction caused by hypoxymia mainly. There are other mechnism which make the sEPO increase in patients undergoing AL, MM and NHL. Combined determination and analysis would evaluate the effective concentration and erythropoietic activity on endogeneous EPO in AL,MM and NHL.
出处
《中国医刊》
CAS
2010年第7期40-42,共3页
Chinese Journal of Medicine
