继发性红细胞增多症患者血清促红细胞生成素水平的变化

Changes of Serum EPO in Patients with Secondary Polycythemia

目的检测继发性红细胞增多症患者血清促红细胞生成素(EPO)的水平,探讨其改变的临床意义。方法选择32例继发性红细胞增多症患者、15例真性红细胞增多症患者和30例健康者,采用夹心酶联免疫法测定其血清EPO。结果继发性红细胞增多症患者EPO水平(中位数41.50mIU/mL)明显高于真性红细胞增多症患者(中位数9.60mIU/mL)和健康对照组(中位数15.30mIU/mL),差异有统计学意义(U值分别为68.5和106.5,P值均<0.01);根据受试者操作特性曲线(ROC曲线)分析,曲线下面积为0.839,EPO检测继发性红细胞增多症的临界值为22.43 mIU/mL时,其敏感度为71.88%、特异性为82.22%;在继发性红细胞增多症患者中,血清EPO水平与RBC呈显著正相关(r=0.825,P<0.01),与Hb呈正相关(r=0.772,P<0.01)。结论 EPO水平增高可能与继发性红细胞增多症的发生发展相关;EPO是直接反映继发性红细胞增多症的一项敏感、特异的指标,可作为继发性红细胞增多症诊断的辅助指标。

Objective To explore the changes and clinical significance of serum erythropoietin （EPO） in patients with secondary polycythemia. Methods The serum EPO levels in 32 secondary polycythemia patients, 15 polycythemia vcra patients and 30 normal controls were determined by enzyme-linked immunosorbent assay. Results The median serum levels of EPO in secondary polycythemia patients were significantly higher than that of in polycythemia vera patients and healthy normal controls （P 〈 O. 01 ）. The receiver operating characteristics curve analysis revealed that EPO had a significantly higher area under the curve, while the cut- off value was set to 22.43 mIU/mL with a sensibility and specificity of 71.88% and 82.22%. The serum EPO level had a positive correlation with RBC in secondary polycythemia patients （ r = 0. 825, P 〈 0.01 ）. There was positive correlation between the serum levels of EPO and Hb concentration （ r = 0. 772, P 〈 0.01 ）. Conclusion The serum EPO is peculiarly present in secondary polycythemia patients, and would be used as a sensitive parameter for the diagnosis of secondary polycythemia.