悬浮去白细胞红细胞输注对骨髓增生异常综合征患者外周血血红素加氧酶-1表达和T淋巴细胞亚群的影响

Effects of suspended leukocyte depleted red blood cell infusion on HO-1 expression and T lymphocyte subsets in peripheral blood of patients with MDS

目的研究悬浮去白细胞红细胞输注对骨髓增生异常综合征(MDS)患者外周血血红素加氧酶-1(HO-1)的表达及T淋巴细胞亚群的影响。方法选取2016年1月至2019年12月山东省血液中心治疗的MDS患者50例作为研究对象,根据血液成分输注不同随机分为观察组和对照组,每组25例,观察组给予悬浮去白细胞红细胞输注治疗,对照组给予洗涤红细胞输注治疗,采用酶联免疫吸附法分别于输血前后测定两组患者血清HO-1、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)的水平,并采用流式细胞术测定T细胞亚群CD3^(+)、CD4^(+)、CD8^(+)和CD4^(+)/CD8^(+)水平。结果两组患者输血前血清HO-1、IL-6及TNF-α水平比较差异无统计学意义(P>0.05);观察组与对照组输血后7 d比较血清IL-6和TNF-α显著降低[(152.10±21.89)ng/L比(201.14±28.90)ng/L、(1.34±0.45)ng/L比(2.89±1.01)ng/L],而HO-1显著升高[(78.91±15.74)μg/L比(58.99±13.33)μg/L],差异有统计学意义(P<0.05);两组患者输血前免疫功能比较差异无统计学意义(P>0.05);经输血后,观察组患者CD3^(+)、CD4^(+)、CD8^(+)和CD4^(+)/CD8^(+)水平与对照组比较均显著升高[(49.11±19.13)%比(47.13±12.84)%、(25.23±10.80)%比(21.09±12.28)%、(24.74±10.84)%比(21.88±11.18)%、1.02±0.25比0.96±0.20],差异有统计学意义(P<0.05)。结论悬浮去白细胞红细胞输注能够提高MDS患者外周血HO-1的表达水平及免疫功能。

Objective To investigate the effect of suspended leukocyte poor red blood cell transfusion on hemeoxygenase-1(HO-1)expression and T lymphocyte subsets in peripheral blood of patients with myelodysplastic syndrome.Methods 50 cases of MDS patients treated in Shandong Blood Center from January 2016 to December 2019 were selected as the research object.According to the different infusion of blood components,they were randomly divided into the observation group and the control group,with 25 cases in each group.The patients in the observation group were treated with s suspended leukocyte poor red blood cell transfusion,and the patients in the control group were treated with washing red blood cell infusion.The level of HO-1,interleukin-6(IL-6)and TNF-αand the T cell subset such as CD_(3)^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)in the serum before and after transfusion were tested by enzyme linked immunosorbent assay and flow cytometry,respectively.Results There was no statistically significantdifference in the level of HO-1,IL-6 and TNF-αin the serum of the two groups before transfusion(P>0.05);After transfusion,TNF-αin the serum of the observation group significantly decreased,compared with that in control group:(152.10±21.89)ng/L vs.(201.14±28.90)ng/L,(1.34±0.45)ng/L vs.(2.89±1.01)ng/L.However,the HO-1 significantly increased:(78.91±15.74)μg/L vs.(58.99±13.33)μg/L,andthe difference was statistically significant(P<0.05).There was nostatistically significantdifference in the immunologic functions of the two groups before transfusion(P>0.05);After transfusion,CD4^(+)/CD8^(+)of the observation group both significantly increased,compared with that inthe control group:(49.11±19.13)%vs.(47.13±12.84)%,(25.23±10.80)%vs.(21.09±12.28)%,(24.74±10.84)%vs.(21.88±11.18)%,1.02±0.25 vs.0.96±0.20,and the difference was statistically significant(P<0.05).Conclusions The expression level of HO-1 in peripheral blood and immune function of patients with myelodysplastic syndrome can be improved by suspended leukocyte poor red blood cell transfusion.