复方参鹿颗粒对相对低危骨髓增生异常综合征患者骨髓细胞免疫表型的影响

Effect of Compound Shenlu Granules on Immunophenotype of Bone Marrow Cells in Lower-risk Myelodysplastic Syndrome Patients

目的:观察相对低危骨髓增生异常综合征(MDS)患者药物干预前后骨髓细胞免疫表型的变化,以揭示中药复方的可能作用机理。方法:将符合要求的30例病例随机分成采用复方参鹿颗粒治疗的治疗组和采用安特尔胶丸治疗的对照组,观察2组治疗前后骨髓细胞免疫表型变化。另取骨科骨折手术患者(排除影响造血系统疾病与用药史)共10例为正常对照组。结果:MDS患者骨髓造血干/祖细胞存在CD34、CD117、HLA-DR的高表达,与正常对照组比较,差异均有显著性意义(P<0.05)。治疗组与对照组治疗前后HLA-DR的表达比较,差异无显著性意义(P>0.05),但治疗组治疗后CD34、CD117的表达率均降低,与治疗前比较,差异均有显著性意义(P<0.05)。MDS患者髓系细胞存在CD13、CD33的高表达,而CD15表达减少,与正常对照组比较,差异均有显著性意义(P<0.05);治疗组治疗后CD13、CD33的表达率均降低,CD15则增加,与治疗前比较,差异均有显著性意义(P<0.05),而对照组仅对CD15表达的有显著影响(P<0.05)。结论:复方参鹿颗粒可能具有促进骨髓造血干/祖细胞、早期髓系细胞的成熟、分化作用,从而改善MDS患者病态造血。

Objective. To reveal the therapeutic mechanism of TCM compounds by studying the change of immunophenotype of bone marrow cells after medical intervention in lower-risk myelodysplastic syndrome（MDS） patients. Methods. Thirty qualified cases were randomly divide into treatment group （treated with Compound Shenlu Granules） and control group（treated with Andriol）. The change of immuno- logic phenotype of bone marrow cells was observed before and after the treatment in the two groups. Re- sults= MDS patients had higher expression of CD13, CD33, CD34, CDl17 and HLA-DR, and lower ex- pression of CD15 compared to normal control group（P 〈 0.05）. The expression level of HLA-DR remained unchanged before and after the treatment in both groups（P〉0.05）. After treatment, the positive rates of CD33, CD34, CD13, CDl17 were lower while the expression rate for CD15 was higher in the treatment group（P〈 0.05 compared with those before treatment）. In the control group, only expression rate for CD15 was increased after treatment （P 〈0.05）. Conclusion, The therapeutic mechanism of Compound Shenlu Granules for improving dyshaematopoiesis in MDS patients may be related to the function of promoting the maturation and proliferation of hematopoietic stem/progenitor cells.