噬血细胞综合征患者红细胞寿命的检测及其对患者贫血的影响分析

Dectection of Erythrocyte Life and Analysis of Its Effect on the Anemia in Patients with Hemophagocytic Syndrome

目的:通过一氧化碳呼气试验测定噬血细胞综合征患者红细胞寿命,分析其对噬血细胞综合征合并贫血患者的影响。方法:对20例初诊HLH患者进行一氧化碳呼气试验并测定红细胞寿命,并以20例健康人的检测作为对照,对比噬血细胞综合征患者与健康人2组间贫血相关指标的差异。结果:噬血细胞综合征患者的平均红细胞寿命为45.3 d,比健康人缩短65%。血红蛋白水平与红细胞寿命呈正相关,sCD25、呼气一氧化碳浓度和骨髓噬血现象与红细胞寿命呈负相关,胆红素、网织红细胞计数与红细胞寿命无相关性。新发噬血细胞综合征患者血清中IL-1β,IL-2,sCD25,IL-6,IL-10,IL-17A,GM-CSF,TNF-α和IFN-γ表达水平较健康人显著升高(P<0.05)。结论:一氧化碳呼气试验是一项快速测定红细胞寿命的方法。红细胞破坏增加是噬血细胞综合征合并贫血的重要发病机制。

Objective:To detect the erythrocyte life by breath carbon monoxide assay and to analyze the effect of erythrocyte life on the anemia in patients with hemophagocytic syndrome.Methods:The breath carbon monoxide test and erythrocyte life assay were performed for 20 cases of hemophagocytic syndrome,at the same time the detection of 20 healthy persons was used as control.The difference of anemia-related indexes was compared between hemophagocytic syndrome patients and healthy persons.Results:The average erythrocyte life of patients with hemophagocytic syndrome was 45.3 days,which was 65%shorter than that of healthy persons.Hemoglobin levels positively correlated with erythrocyte life,while sCD25,breath carbon monoxide concentration and hemophagocytosis negatively correlated with erythrocyte life.Bilirubin level and reticulocyte count showed no correlation with erythrocyte life.Serum level of IL-1β,IL-2,sCD25,IL-6,IL-10,IL-17 A,GM-CSF,TNF-αand IFN-γin patients with newly diagnosed hemophagocytic syndrome were significantly higher than those of healthy persons(P<0.05).Conclusion:Breath carbon monoxide assay is a rapid and efficient method to assess erythrocyte life.Increased erythrocyte destruction may be an important pathogenic factor for anemia in hemophagocytic syndrome.