细胞因子；再生障碍性贫血；免疫治疗；抗淋巴细胞球蛋白；环孢素

两种免疫抑制疗法治疗再生障碍性贫血的细胞因子监测及疗效分析

http://www.100md.com 《东南国防医药》 2006年第5期

细胞因子；再生障碍性贫血；免疫治疗；抗淋巴细胞球蛋白；环孢素A,,],细胞因子；再生障碍性贫血；免疫治疗；抗淋巴细胞球蛋白；环孢素A

     [摘要] 目的观察60例急性和慢性再生障碍性贫血患者两种免疫抑制疗法治疗前后外周血及骨髓中细胞因子的含量变化和临床意义，并探讨细胞因子监测再障疗效的可行性。方法应用ELISA检测外周血和骨髓IL3、IL8和TNFα及IFNγ水平。结果急、慢性再生障碍性贫血患者外周血和骨髓中IL8、TNFα及IFNγ含量均远高于正常对照者，IL3则低于正常对照者。抗淋巴细胞球蛋白(ALG)联合环孢素A(CsA)+雄激素较CsA+雄激素治疗效果明显，总有效率分别为833%和58%。结论细胞因子IL3、IL8和TNFα及IFNγ等可以作为急、慢性再生障碍性贫血的诊断和治疗监测指标。ALG联合CsA治疗急慢性再生障碍性贫血疗效显著。

    [关键词] 细胞因子；再生障碍性贫血；免疫治疗；抗淋巴细胞球蛋白；环孢素A

    Monitor of cytokines and analysis of therapeutic efficacy in two different immunosuppressive treatments of aplastic anemia

    SHEN Hongshi，JIANG Fugao，WU Tianqin，TANG Jieqing，LI Zhengyang，QIN Longmei (Department of Hematology,the 100th Clinical Branch of PLA,Suzhou 215007,Jiangsu,China)

    [Abstract] Objective To investigate the changes of cytokines before and after two different immunosuppressive therapies and their clinical significance in peripheral blood and bone marrow in 60 patients with acute and chronic aplastic anemia and to explore the possibility of therapy efficacy observed by cytokinesMethods The levels of IL3,IL8,TNFα and IFNγ in peripheral blood and bone marrow were measured by enzymelinked immunosorbent assay (ELISA) methodResults The levels of cytokines except IL3 in peripheral blood and bone marrow of the aplastic anemia patients significantly increased than in the normal control ones The antilymphocyte globulin(ALG)+cyclosporine(CsA)+male hormone therapy proved to be more effective than CsA+male hormone therapy with the total efficacy rate of 833% and 58% respectively The ALG+CsA+male hormone therapy treated acute aplastic anemia better than chronic aplastic anemiaConclusion Cytokines changes of IL3,IL8, TNFα and IFNγ et al may be used as indices of diagnosis and treatment for acute and chronic aplastic anemia ALG allied by CsA is more effective than CSA in acute and chronic aplastic anemia therapy ......

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