再生障碍性贫血骨髓和外周血FL、SCF测定及临床意义

目的 :测定再生障碍性贫血 (AA)骨髓及外周血FL含量 ,并观察其与临床疗效的相关性。方法 :采用常规Elisa法测定AA骨髓和外周血Flt3 配体 (FL)含量 ,应用单色和双色免疫荧光标记流式细胞仪分析FL的分泌细胞。结果 :AA患者骨髓和外周血FL含量显著升高 ,约为正常的 2 5倍以上 ,外周血和骨髓浓度无区别 ;FL含量变化与疗效密切相关 ,治疗有效者 ,BM及PB中FL水平降低 ,与无效者相比区别显著 (P <0 .0 1)。治疗前后干细胞因子 (SCF)水平则无改变。正常人CD3 + 细胞内贮存有大量FL ,而CD3 + 细胞以膜型FL为主 ,胞内基本无FL存在。结论 :AA患者骨髓和外周血FL水平显著升高 ,主要由CD3 + 细胞产生 ,其含量与临床疗效密切相关。

Significance of changes of FL concentrations in bone marrow an d peripheral blood of patients with aplastic anemia

Objective:To determine the levels of FL in bone marrow and peripheral blood of patients with aplastic anemia(AA) and investigate their relationship with clinical outcome.Method:ELISA assay was employed to determine the levels of Flt 3 ligand(FL) and stem cell factor(SCF) in bone marrow and peripheral blood of AA patients. One and two color immunofluorescence assay and flow cytometry analysis were used to trace the FL producing.Result:The levels of FL in bone marrow and peripheral blood of AA patients increased significantly and were about 25 times as high as the controls. Statistic analysis showed that there was no difference between the levels of bone marrow and the levels of peripheral blood. The levels of FL were parallel to clinical outcome and in those who were effective to the therapy the levels of FL decreased significantly in comparison with that in those fell to the therapy (P< 0.01).There was no changes of the levels of SCF in pre- and post-treatment patients. Flow cytometry analysis showed that there were large quantity of FL inside of CD 3 + cells, otherwise CD 3 + cells from AA patients expressed FL on its membrane and there was almost no FL existed inside the cells.Conclusion:The levels of FL in bone marrow and peripheral blood significantly increased and they mainly secreted from CD 3 positive cells. The changes of FL concentration in bone marrow or peripheral blood were important prognostic factors for AA patients.