骨髓增殖性肿瘤患者血清血管调控细胞因子水平变化及意义
Journal of Chinese Practical Diagnosis and Therapy(2017)
Abstract
目的 探讨骨髓增殖性肿瘤(myeloproliferative neoplasms,MPN)患者血清血管调控相关细胞因子水平及其临床意义.方法 30例MPN患者为MPN组,20例体检健康者为对照组,2组采用双抗体夹心ELISA法检测血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、血小板衍生生长因子(platelet derived growth factor,PDGF)、内皮抑素(endostatin,ES)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)及基质金属蛋白酶抑制剂-1(tissue inhibitors of metalloproteinase-1,TIMP-1)水平,分析MPN组各血管调控细胞因子间的相关性,及临床因素与血管调控细胞因子间的关系.结果 MPN组血清VEGF[(610.10±295.70) ng/L]、PDGF[(9.50±3.68)μg/L]、ES[(6.80±2.70)μg/L]、MMP-9[(856.32±544.28) μg/L]、TIMP-1[(464.45±216.71)μg/L]水平及MMP-9/TIMP-1比值(2.41±1.77)均高于对照组[(355.82±155.29) ng/L、(6.03±1.07) μg/L、(4.04±0.90) μg/L、(382.90±171.36) μg/L、(202.37±28.35)μg/L、1.88±0.71](P<0.05);MPN组VEGF与PDGF呈正相关(r=0.429,P=0.018),PDGF与ES呈正相关(r=0.418,P=0.022);MPN组白细胞计数≥10×109/L者血清MMP-9水平[(1 059.95±625.22) μg/L]明显高于<10×109/L者[(623.60±316.93) μg/L](P< 0.05),血红蛋白≥160 g/L者血清TIMP-1水平(385.66±178.38)μg/L]明显低于<160 g/L者[(554.49±227.31)μg/L](P<0.05),≥60岁患者血清PDGF[(10.70±4.14)μg/L]、ES[(7.93±2.85)μg/L]、TIMP-1[(533.89±200.88)μg/L]水平高于<60岁患者[(7.71±1.83) μg/L、(5.10±1.19)μg/L、(360.29±204.25)μg/L] (P<0.05),>2项血管危险因素者血清PDGF水平[(14.01±4.99) μg/L]明显高于≤2项危险因素者[(8.38±2.45)μg/L] (P<0.05);多因素logistic回归分析结果显示,高龄和低血红蛋白是TIMP-1水平增高的独立危险因素(OR=1.005,95%CI:1.000~1.010,P=0.049;OR=0.996,95%CI:0.992~1.000,P=0.046);高龄和>2项血管危险因素是PDGF水平增高的独立危险因素(OR=1.462,95%CI:1.008~2.119,P=0.045;OR=1.282,95%CI:0.988~1.663,P=0.041).结论 MPN患者白细胞计数、血红蛋白增多与血管新生调控因子表达增加有关,通过炎症导致血管新生促进和抑制因子的表达失衡,进而参与MPN的发生、发展.
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Key words
Myeloproliferative neoplasms,cytokine,vascular endothelial growth factor,platelet derived growth factor,endostatin,matrix metalloproteinase-9,tissue inhibitors of metalloproteinase-1
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