噬血细胞综合征患者血清血小板生成素水平的研究

目的 探讨血清血小板生成素(TPO)在噬血细胞综合征(HPS)患者中的表达水平及其临床意义.方法 收集2008年9月至2010年7月经首都医科大学附属北京友谊医院确诊的HPS患者26例,根据不同病因分为感染相关性HPS、肿瘤相关性HPS和风湿免疫病相关性HPS,同时收集26名健康人血清,分别采用酶联免疫吸附(ELISA)方法检测其血清TPO水平,并与各实验室检查指标进行相关性分析.结果 HPS患者组血清TPO水平显著低于健康对照组,差异有统计学意义(P=0.001),对HPS患者组中不同病因人群进行单因素方差分析,差异无统计学意义(P=0.183).检测HPS患者血清TPO水平与采血当日血小板、红细胞、血红蛋白、血肌酐、尿素氮、三酰甘油、纤维蛋白原、铁蛋白、NK细胞活性、sCD25水平的相关性,发现其与血肌酐水平呈正相关关系,与其他各项实验室指标均无相关性.结论 TPO可能与各种细胞因子一起影响了HPS患者血细胞的生成,TPO水平降低可能与HPS患者肝功能损害有关,其深层机制还有待进一步探讨.

Expression of serum thrombopoietin in patients with hemophagocytic syndrome

Objective To investigate the expression of serum thrombopoietin (TPO) in patients with hemophagocytic syndrome (HPS) and to evaluate its clinical significance. Methods The clinical data of HPS patients from Beijing Friendship Hospital,Capital Medical University during the period from September 2008 to July 2010 were collected. They were divided into infection-associated HPS,tumor-associated HPS and rheumatological disease associated HPS according to different causes. The serum concentration of TPO in HPS patients and 26 healthy controls was measured with enzyme-linked immunosorbent assay (ELISA). Then the correlations between TPO and laboratory indicators was analyzed. Results The level of serum TPO in 26 cases of HPS was significantly lower than that of control group (P =0.001) and the variance was not statistically significant in different causes of HPS groups using ANOVA (P =0.183). The TPO levels in HPS patients showed positive correlations with serum creatinine,after we detected their TPO levels and platelets,red blood cells,hemoglobin,serum creatinine,urea nitrogen,triglyceride,fibrinogen,ferritin,NK cell activity and sCD25 levels on the same day. Conclusion TPO together with various cytokines may affect the formation of blood cells in HPS patients,and its reduction may be associated with impaired liver function. The underlying mechanism remains to be further explored.