再生障碍性贫血患者血清sVCAM-1、IL-18和VEGF水平及其临床意义

Serum Levels of sVCAM-1,IL-18 and VEGF in Patients with Aplastic Anemia and Their Clinical Significance

本研究探讨再生障碍性贫血(AA)患者血清可溶性血管细胞黏附分子-1(sVCAM-1)、白介素18(IL-18)和血管内皮生长因子(VEGF)水平及其临床意义。采用双抗体夹心酶联免疫吸附法(ELISA)检测30例AA患者和25例正常人血清sVCAM-1、IL-18和VEGF水平。结果表明:AA患者血清sVCAM-1和IL-18水平分别为(839.08±173.97)ng/ml和(380.35±47.76)pg/ml,较正常对照组的(538.16±91.21)ng/ml和(256.39±59.52)pg/ml明显升高(p均<0.01);且重型AA的sVCAM-1和IL-18水平[(969.94±182.54)ng/ml、(388.96±46.06)pg/ml]较慢性AA的sVCAM和IL-18水平[(709.26±165.32)ng/ml、(352.21±47.08)pg/ml]升高更为明显(p<0.01;p<0.05);而AA患者血清VEGF水平[(69.63±27.42)pg/ml]较正常对照组[(125.62±32.15)pg/ml]明显降低(p<0.01),且重型AA[(51.30±29.86)pg/ml]较慢性AA[(80.02±25.14)pg/ml]降低更显著(p<0.01)。AA患者治疗后血清sVCAM-1和IL-18水平[(623.84±176.57)ng/ml、(295.25±89.31)pg/ml]较治疗前[(847.33±186.41)ng/ml,(368.50±62.02)pg/ml]明显降低(p<0.01;p<0.05),而VEGF治疗后水平[(90.61±28.76)pg/ml]较治疗前[(63.93±26.04)pg/ml]则明显升高(p<0.05)。结论:高水平的sVCAM-1、IL-18及低水平的VEGF细胞因子,可能与AA的发生、发展及病情进展相关。

This study was purposed to investigate the serum levels of soluble intracellular adhesion molecule （ sVCAM-1 ）, interlenkin 18 （ IL-18 ） and vascular endothelial growth factor （VEGF） in patients with aplastic anemia （AA） and their clinical significance. Enzyme linked immunosorbent assay（ELISA） was used to detect sVCAM-1, IL- 18 and VEGF in serums of 30 patients with AA and 25 normal controls. The results showed that the serum levels of sVCAM-1 and IL-18 in patients with AA [ （839.08±173.97） ng/ml, （380.35±47.76） pg/ml ] were significantly higher than those in normal controls [ （538.16±91.21 ） ng/ml, （256.39±59.52） pg/ml] （p 〈 0.01 ; p 〈 0.01 ）. The levels of sVCAM-1 and IL-18 in severe AA patients [ （969.94 ±182.54） ng/ml, （ 388.96±46.06） pg/ml] were higher than those in chronic AA patients [ （709.26±165.32） ng/ml, /L-18 （352.21±47.08 ） pg/ml ] （p 〈 0. 01; p 〈 0. 05 ）, but the level of VEGF in AA patients[ （69.63±27.42） pg/ml] was lower than that in the normal controls[ （ 125.62±32. 15 ） pg/ml] （p 〈 0.01 ）]. The level of VEGF in severe AA patients [ （ 51.30±29.86 ） pg/ml ] was significantly lower than that in chronic AA patients [ （80.02±25.14） pg/ml] （p 〈 0.01 ）. The levels of sVCAM-1 and IL-18 in AA patients after treatment were lower than those before treatment（p 〈 0.01 ; p 〈 0.05 ）, but the level of VEGF after treatment was significantly higher than that before treatment（p 〈0.05）. It is concluded that the high levels of sVCAM-1, IL- 18 and low level of VEGF in serum may be involved in the pathogenesis and progress of AA.