再生障碍性贫血免疫抑制治疗疗效预测

Prediction on Response of Immunosuppressive Therapy in Patients with Aplastic Anemia

目的 筛选可以预测再生障碍性贫血 (再障 )患者免疫抑制治疗 (IST)疗效的指标。方法 应用RT PCR技术检测 5 2例再障骨髓单个核细胞 (BMMNC)中干扰素γ(IFN γ)基因的表达和外周血单个核细胞 (PBMNC)中Hsp72基因的热诱导性 ,并观察其与IST疗效的关系。结果 初治的特发性再障和继发于苯中毒的重型再障患者两个基因的表达显著高于其它组别 ,且IFN γ基因阳性率及Hsp72基因的热诱导性在IST有效的特发性再障患者显著升高 ,而与继发性患者疗效无关。结论 这两种基因的检测可以作为特发性再障患者IST的疗效预测指标。部分苯中毒导致的再障患者即使无IST的应用 ,造血干细胞的损伤也能逐渐恢复。

Objective To find reliable markers of aplastic anemia (AA) patients responsive to Immunosuppressive therapy(IST).Methods In 52 AA patients,the expression of interferon-γ(IFN-γ)gene in bone marrow mononuclear cells (BMMNC) and the heat inducibility of heat shock protein 72(hsp72)gene in peripheral blood mononuclear cells (PBMNC) were examined by RT-PCR,and their relationship with patients’response to IST was investigated.Results The expression of IFN-γ gene and Hsp72 gene in newly diagnosed idiopathic AA patients and secondary SAA patients were significantly higher than those of others.Among idiopathic AA patients who used IST,positive rate of IFN-γ gene and heat inducibility of Hsp72 gene were significantly higher in the IST responders than the non-responders.And this had no relationship with the treatment effect of secondary patients.Conclusion Examining the expression of these two genes may be helpful in predicting responses to IST in patients with idiopathic AA.The destruction of hematopoietic stem cells induced by benzene can recover gradually in some patients even without IST.