摘要
目的 急性移植物抗宿主病 (aGVHD)是异基因骨髓移植术后的主要合并症之一 ,也是导致死亡的主要原因。其早期诊断及早期治疗具有重要的意义。通过对接受异基因骨髓移植的病人的研究 ,以明确血浆肿瘤坏死因子α(TNFα)在aGVHD的诊断中的作用。方法 选择 40例接受异基因骨髓移植的患者 ,分别检测了在骨髓移植前后血浆TNFα的水平 ,与临床aGVHD相比较 ,使用 χ2 检验检测不同级别aGVHD时的TNFα阳性率 ,采用非参数秩和检验检测感染与非感染患者间TNFα水平。结果 Ⅱ级和Ⅲ Ⅳ级aGVHD时 ,血浆TNFα水平呈持续性升高 :分别为 (0～ 4 90 ) μg/L和 (0 2 5～ 4 2 1 ) μg/L ,显著高于 0～I级aGVHD的患者 ,并具有统计学差异 (P <0 0 0 1 ) ,Ⅱ级和Ⅲ～Ⅳ级患者之间差异无显著性 ;TNFα水平随着病情和治疗效果呈动态变化 ;在感染和无感染的患者相比 ,TNFα水平差异无显著性 ;预处理结束时TNFα水平对于aGVHD的预测无显著意义。结论 TNFα可作为aGVHD发生的辅助诊断指标 ,并可作为aGVHD与感染相鉴别的指标之一。
Objective to ascertain the implication of tumor necrosis factor α (TNFα) in the pathogenesis of acute graft versus host disease (aGVHD) Methods Plasma TNFα levels were assessed by ELISA in 243 sera samples from 40 patients who had undergone allogeneic bone marrow transplantation (BMT) Plasma TNFα levels were measured before BMT and at different time points after BMT The results were correlated with aGVHD, infection and conditioning regimen Results Plasma TNFα levels were significantly higher in patients with grade Ⅱ and grades Ⅲ Ⅳ aGVHD (0～ 4 90) μg/L and (0 25～ 4 21) μg/L, respectively than in those with grade 0 or Ⅰ aGVHD, but there was no clear correlation between plasma TNFα levels in patients with grade Ⅱ and grade Ⅲ Ⅳ aGVHD Plasma TNFα levels in patients with infection were not statistically different from those in patients without infection The conditioning regimen did not cause a significant rise in TNFα levels Conclusion It is indicated that TNFα may be useful for the diagnosis of aGVHD and for differentiation between aGVHD and other BMT related complications such as infection
出处
《中华内科杂志》
CAS
CSCD
北大核心
2001年第9期625-627,共3页
Chinese Journal of Internal Medicine
关键词
移植物抗宿主病
肿瘤坏死因子
骨髓移植
Graft vs host disease
Tumor nerosis factor
Bone marrow transplantation
