再障生血片对慢性再生障碍性贫血骨髓瘦素与瘦素受体的影响

Effect of Zaizhang Shengxue Tablet on Bone Marrow Leptin,Leptin Receptor of Patients with Chronic Aplastic Anemia

目的观察再障生血片联合环孢素、雄激素治疗慢性再生障碍性贫血(CAA)的临床疗效及其对骨髓瘦素、瘦素受体的影响。方法将58例确诊的CAA患者随机分为2组:治疗组1采用环孢素、雄激素;治疗组2在治疗组1的基础上加用再障生血片,两治疗组于治疗前及治疗后半年检测骨髓瘦素、瘦素受体的表达。选择20例正常骨髓组织作对照组。结果 58例CAA患者治疗前骨髓瘦素表达水平较对照组显著升高(P<0.01),而瘦素受体的表达水平显著低于对照组(P<0.01);治疗组2治愈率、缓解率较治疗组1升高,差异有统计学意义(P<0.05);两治疗组治疗前骨髓瘦素、瘦素受体表达水平无差异,治疗组2治疗后骨髓瘦素表达水平较治疗前降低,且较治疗组1治疗后进一步降低,治疗组2治疗后瘦素受体表达水平较治疗前升高,且较治疗组1治疗后进一步升高。结论再障生血片联合环孢素加雄激素治疗CAA能进一步降低骨髓瘦素水平,升高瘦素受体水平,获得较好临床疗效。

Objective To investigate the clinical efficacy of combined therapy of Zaizhang Shengxue tablets with cy- closporine and androgen in the treatment of patients with chronical aplastic anemia （ CAA）, and its effects on bone marrow leptin and leptin receptor of the CAA patients. Methods A total of 58 CCA patients were randomly divided into group 1 and group 2. Group 1 was treated with cyclosporine and androgen, while the group 2 was treated with a combination of Zaizhang Shengxue tablets with cyclosporine and androgen. Another 20 cases with normal bone marrow were used as the control group. The mean bone marrow leptin and leptin receptor expression levels were detected before and after half a years treatment. Re- suits Compare with the control group, the expression of leptin in the 58 patients with CAA was significantly higher （ P 〈 0. 01 ）, while the expression of leptin receptor was significantly lower （ P 〈 0. 01 ）. The cure rate and remission rate of the treatment in group 1 was significantly higher than those of the treatment in group 2 （ P 〈 0.05 ） ; There was no significant difference in the expression of bone marrow leptin and leptin receptor before treatment between group 1 and group 2. Howev- er, the expression of bone marrow leptin in group 2 after treatment was significantly lower than either before the treatment or the group 1 after treatment. On the contrary, the expression of bone marrow leptin receptor of group 2 was significantly higher than either before the treatment or the group 1 after treatment. Conclusion The combined therapy of Zaizhang Shengxue tab- lets with cyclosporine and androgen can obviously decrease the level of leptin and increase the level of leptin receptor in bone marrow, thus improve the efficacy of treatment in CAA patients.