噬血细胞综合征患者血清sHLA-G表达及其临床意义

Expression of Serum sHLA-G in Patients with Hemophagocytic Syndrome and Its Clinical Significance

本研究旨在探讨血清可溶性人类白细胞抗原G(sHLA-G)在噬血细胞综合征(HPS)患者中的表达水平及临床意义。收集2008年9月至2010年7月经首都医科大学附属北京友谊医院确诊的HPS患者23例,根据不同病因分为感染相关性HPS、肿瘤相关性HPS和风湿免疫病相关性HPS,同时收集25例健康人血清,分别采用酶联免疫吸附(ELISA)法检测患者及健康人血清sHLA-G水平,并与各实验室检查指标进行相关性分析。结果表明,HPS患者组血清sHLA-G水平高于健康对照者,差异有显著统计学意义(p=0.003),对HPS患者组中不同病因人群进行单因素方差分析,差异无统计学意义(p=0.233)。检测HPS患者血清sHLA-G水平与采血当日WBC、Hb、Plt、ALT、AST、LDH、ALB、TBil、DBil、IBil、Cr、BUN、TG、纤维蛋白原、铁蛋白的相关性发现,其与血小板水平呈正相关关系,与其他各项实验室指标均无相关性。结论:血清sHLA-G水平在HPS患者中升高可能有多种原因,包括感染、肿瘤、T淋巴细胞过度活化以及一些细胞因子的刺激等,sHLA-G还可以抑制NK细胞活性,导致异常免疫风暴形成,在HPS的发病机制中可能起到一定作用。

In order to investigate the expression of serum sHLA-G in hemophagocytic syndrome（HPS） patients and to evaluate its clinical significance,the clinical data of HPS patients in Capital Medical University Beijing Friendship Hospital during the period from September 2008 to July 2010 were collected.They were divided into infection-associated HPS,tumor-associated HPS and rheumatological disease-associated HPS according to cause of diseases.The serum concentration of sHLA-G in HPS patients and 25 healthy controls was measured by enzyme-linked immunosorbent assay（ELISA）,the correlations between sHLA-G level and laboratory indicators were analyzed.The results showed that the level of serum sHLA-G in HPS patients was significantly higher than that in healthy controls（p=0.003）,but the difference was not statistically significant between HPS groups of different causes（p=0.233）.The positive correlation of sHLA-G level in HPS patients with platelet count was found,but there was no positive correlation of their sHLA-G levels with WBC,Hb,Plt,ALT,AST,LDH,Alb,TBil,DBil,IBil,Cr,BUN,TG,fibrinogen and ferritin levels detected on same day.It is concluded that the the increase of serum sHLA-G levels in HPS patients may be caused by different factors such as infection,tumor,T cell activation and over-stimulation of several cytokines.sHLA-G can inhibit NK cell activity,resulting in formation of abnormal immune storm,and may be play a role in the pathogenesis of HPS.