干扰素α对慢性粒细胞白血病血清疾病相关细胞因子水平的影响

The Impact of IFN-α on Cytokines of Chronic Myelocytic Leukemia

目的探究干扰素“治疗慢性粒细胞白血病（CML）患者后相关细胞因子水平的改变情况。方法将2012年5月至2014年5月天门市第一人民医院收治的120例CML的患者按照随机数字法分为观察I组和观察Ⅱ组，每组60例。患者均给予羟基脲治疗，每日20—60mg／kg，每周2次，6周为1个疗程，观察Ⅱ组患者在羟基脲治疗的基础上加用重组人干扰素Ot注射液治疗，（3—5）×106U／（m2·d），6周为1个疗程。另随机选取60例正常健康人作为对照组。比较所有研究对象治疗前的血清前列腺素E2（PGE2）、基质金属蛋白酶2（MMP-2）、碱性成纤维细胞生长因子（bFGF）、碱性磷酸酶（ALp）以及白细胞介素6（IL-6）等细胞因子水平的差异以及治疗2周及6周后观察I组和观察Ⅱ组上述细胞因子水平的改变情况。结果治疗前观察组I患者血清中的PGE：、MMP-2、bFGF、ALP以及IL-6水平分别为（93±26）ng／L、（5．8±1．1）哕L、（60±18）ng／L、（105±29）U／L、（20．4±6．1）．g／L，观察Ⅱ组分别为（96±25）ng／L、（5．7±1．2）μg／L、（60±17）ng,／L、（106±26）U／L、（20．2±6．0）ng／L，均显著高于对照组[（51±12）ng／L、（2．7±0．5）μ/L、（33±8）ng／L、（614±13）U／L、（4．8±1．1）ng／L]，差异有统计学意义（均P〈0．01）；而观察I组和观察Ⅱ组患者治疗前上述细胞因子水平的比较差异无统计学意义（均P〉0．05）；观察Ⅱ组患者治疗后PGE2、MMP-2、bFGF、ALP以及IL-6均显著低于观察I组[（52±16）ng／L比（62±20）ng／L，（2．44-0．5）μg／L比（3．9±O．6）μL，（33±7）．g／L比（42±9）ng／L，（62±13）U／L比（76±17）u／L，（5．04μ1．2）ng／L比（8．7±2．4）ng／L]，差异有统计学意义（均P〈0．05），治疗后观察I组、观察Ⅱ组患者上述细胞因子水平均较治疗前显著下降，差异有统计学意义（均P〈O．01）。结论干扰素α能有效降低CML患者血清疾病的相关细胞因子水平，调节CML患者的血清学表现及临床症状，值得在临床上推广应用。

bjective To explore the change of related cytokines levels after the patients with chronic myelocytic leukemia （CML） were treated by interferen-α（IFN-ct）. Methods A total of 120 cases with CML treated in Tianmen First People＇s Hospital from May 2012 to May 2014 were divided into observation I group and observation Ⅱ group according to random number table method, 60 cases in each group. All patients were given hydroxyurea therapy,20-60 mg/kg per day ,2 times a week, six weeks as a course, obser- vation II group on the basis of oral hydroxyurea therapy was given recombinant human interferon ct injection, （3-5） x l0s U/（ m2 ± d） ,6 weeks as a course. Another 60 healthy people were randomly chosen as the con- trol group. Cytokine levels in serum such as prestaglandin E2 （ PGE2 ）, matrix metalloproteinase-2 （ MMP-2）, basic fibroblast growth factor（ bFGF）, alkaline phosphatase（ALP） and interleukin-6 （IL-6） before the treat- ment of all the participants and 2 and 6 weeks after treatment of observation I group and observation I1 group were compared. Results Before treatment, the serum PGE2, MMP-2, bFGF, ALP and IL-6 levels of observation I group were （93 ± 26 ） ng/L, （5.8 ± 1.1 ） μg/L, （60 ± la ） ng/L, （ 105 ± 29 ） U/L, （20.4 ± 6. 1） ng/L,respectively,ef observation II group were （96 ±25） ng/L, （5.7 ± 1.2） p,g/L, （60 ± 17 ） ng/L, （106 ±26） U/L,（20.2 ±6.0） ng/L,both groups were significantly higher than the control group[ （51 ± 12 ） rig/L, （2.7 ± 0. 5 ） Ixg/L, （ 33 ± 8 ）ng/L, （ 61 ± 13 ） U/L, （4.8 ± 1.1 ） ng/L ], the differences were statistically significant（ P 〈 0.01 ）. The above indexes between observation I group and I] group before treatment had no statistically significant difference（P 〉 0.05 ） ; after treatment serum PGE2, MMP-2, bFGF, ALP and IL-6 of observation II group were significantly lower than I group[ （52 ± 16）ng/L vs （62 ±20） ng/L,（2.4 ±0.5） μg/L vs （3.9 ±0.6） p,g/L, （33 ±7）ng/L vs （42 ±9）ng/L, （62 ± 13） U/L vs （76 ± 17 ） U/L, （5.0 ± 1.2 ） ng/L vs （ 8.7 ± 2.4） ng/L ], the differences were statistically significant （ P 〈 0.05 ）. After treatment, the above cytokines levels of the observation groups all decreased than before treatment,with statistically significant difference（ all P 〈 0.01 ）. Conclusion IFN-α can decrease the related cytokines lev- els effectively and adjust the serological manifestations and clinical symptoms of the patients with CML,which is worthy of popularizing in clinic. Key words： Chronic myelocytic leukemia; Interferon-or; Cytokines levels