摘要
目的检测正常人及急性白血病和缺铁性贫血中重度贫血患者血清促红细胞生成素(EPO)水平,探讨急性白血病贫血发生机制。方法ELISA法测定急性白血病59例的血清EPO水平,包括伴中重度贫血患者44例(12例初治患者,13例完全缓解伴贫血患者,19例骨髓抑制期患者)和15例完全缓解非贫血患者。另测定中重度缺铁性贫血15例及12例正常人对照血清的EPO水平。结果缺铁性贫血组EPO水平与正常人对照组无显著性差异(P>0.05)。急性白血病初治组、骨髓抑制组、完全缓解伴贫血组EPO水平显著高于正常人对照组和缺铁性贫血组(P<0.05)。初治组、骨髓抑制组、完全缓解伴贫血组之间EPO水平无显著差异(P>0.05)。完全缓解贫血组EPO水平高于完全缓解非贫血组(P<0.05),后者与正常对照组无显著差异(P>0.05)。中重度贫血急性白血病及缺铁性贫血患者血清EPO水平与血红蛋白水平均呈明显负相关(r=-0.697和-0.970,P<0.05)。结论急性白血病贫血患者血清EPO水平显著高于正常对照,中重度贫血急性白血病患者EPO与Hb之间呈显著负相关,说明白血病患者EPO合成机制完整,EPO水平除与Hb水平和缺氧有关外,主要与骨髓红系造血功能相关,骨髓红系造血缺陷是产生贫血主要原因。
Objective To detect serum erythropoietin （EPO） levels in patients with acute leukemia （AL） and iron deficient anemia （IDA） with moderate or severe anemia and explore the mechanism of anemia in these patients. Methods Enzyme-linked immunosorbent assay （ELISA） was used to detect the serum levels of EPO in 59 patients with AL, among whom 15 had complete remission without anemia and 44 had moderate or severe anemia （including 12 receiving the initial treatment, 13 with complete remission and concurrent anemia, and 19 with bone marrow suppression）. Serum EPO was also detected in 15 IDA patients and 12 healthy individuals. Results The IDA patients and healthy individuals had similar serum EPO levels （P〉0.05）, and by comparison, the EPO levels were significantly increased in AL patients upon the initial treatment, those with bone marrow suppression and those with complete remission and anemia, but comparable between the latter 3 groups （P〉0.05）. Among the patients with complete remission, the EPO levels were significantly higher in anemic patients than in those without anemia （P〈0.05）, and the latter patients had similar EPO levels with the healthy individuals （P〉0.05）. In both AL and IDA patients with moderate or severe anemia, the serum EPO level was inversely correlated to the level of hemoglobin （r=-0.697 and -0.970, respectively, P〈0.05）. Conclusion AL patients with anemia have significantly higher serum EPO levels than healthy individuals. In AL and IDA patients with moderate or severe anemia, EPO levels are inversely correlated to the level of hemoglobin, suggesting the integrity of the EPO synthesis mechanism in AL patients. Serum EPO level is also associated with bone marrow function in addition to hypoxia and hemoglobin levels, and hematopoiesis deficit in the early stage may be the main cause of anemia.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2009年第11期2321-2323,共3页
Journal of Southern Medical University
