温抗体型自身免疫性溶血性贫血患者外周血B细胞激活因子的变化及意义

目的 探讨温抗体型自身免疫性溶血性贫血(warm autoimmune hemolytic anemia,WAIHA)患者外周血B细胞激活因子(B cell activating factor,BAFF)的变化及意义.方法 采用ELISA法检测30名健康成人(对照组)和43例WAIHA患者治疗前后血清可溶性BAFF(sBAFF)水平,采用实时定量PCR法榆测外周血单个核细胞(PBMNC)BAFF mRNA表达水平.结果 WAIHA患者治疗前血清sBAFF水平和PBMNC中BAFF mRNA表达水平分别为2311(825-6523)as/L和884(463～2346)ng/L,较治疗后患者组[分别为1201(358～5014)ng/L和486(138～2699)ns/L]和对照组[分别为1128(590～3201)ns/L和341(102～965)ng/L]增高,差异均有统计学意义(P值均<0.01),而治疗后患者组与对照组比较,差异无统计学意义(P>0.05).治疗前有效组和无效组血清sBAFF水平和PBMNC中BAFF mRNA表达水平比较,差异无统计学意义(P>0.05).有效组治疗前后血清sBAFF水平和PBMNC中BAFF mRNA表达水平比较,差异有统计学意义(P<0.01);无效组治疗前后相比,差异无统计学意义(P>0.05).治疗前后患者血清sBAFF水平和PBMNC中BAFF mRNA表达水平呈正相关(均P<0.05).结论 血清sBAFF水平和PBMNC中BAFF mRNA表达水平在WAIHA患者明显增高,其动态变化与病情变化有关.

Detection and of peripheral blood B cell activating factor in warm autoimmune hemolytic anemia pa-tients and its implication

Objective To detect the B cell activating factor(BAFF) and explore its significance in patients with warm autoimmune hemolytic anemia(WAIHA).Methods The levels of serum soluble BAFF (sBAFF) and BAFF mRNA in peripheral blood mononuclear cells( PBMCs) in 30 healthy volunteers (control group) and 43 patients with WAIHA were measured by ELISA and real-time quantitative polymerase chain re-action( RT-qPCR) respectively.Results The levels of serum sBAFF and BAFF mRNA in PBMCs in pre-treatment group [2311(825～6523)ng/L and 884(463～2346)ng/L] was significanly higher than those in posttreatment group[1205(358～5014)ng/L and 446(138～2699)ng/L] and control group[1128(590-3201)ng/L and 341(102～965)ng/L] (both P<0.01) , the difference between the posttreatment group and control group was not statistically significant.There was no significant difference between therapy responsive and nonresponsive groups before treatment.There was a significant difference between the pre-and post-treat-ment resuets in responsive group(P<0.01), but not in nonresponsive group(P>0.05).The serum levels of sBAFF was positively correlated with the levels of the BAFF mRNA in PBMCs both in pre- and post therapy group( both P<0.05).Conclusion The levels of serum sBAFF and BAFF mRNA in PBMCs are increased in patients with WAIHA, their dynamic alterations may contribute to the development of WAIHA.