贫血患者瘦素水平的测定

Measurement of leptin level in anemic patients

目的 通过对贫血患者体内瘦素水平的测定 ,了解在贫血状态下是否存在瘦素分泌的异常。方法 分别抽取正常人、再生障碍性贫血 (再障 )、营养不良性贫血、溶血性贫血患者骨髓液及外周血 ,用放射免疫分析法分别测定其瘦素含量。结果 营养不良性贫血、溶血性贫血患者骨髓瘦素含量和外周血瘦素含量比 (BM/PB)与正常人接近 (P >0 0 5 ) ,而再障患者两者的比值比正常人明显升高 (P <0 0 1 ) ,而贫血程度与瘦素含量无明显相关性 (P >0 0 5 ) ,但骨髓与外周血瘦素含量则高度相关 (P <0 0 1 )。结论 再障患者瘦素水平明显高于正常人及其他类型贫血患者 ,可能与再障骨髓脂肪细胞明显增多、脂肪细胞分泌瘦素明显增多有关。瘦素受体的不完整及造血干 /祖细胞对干细胞因子 (SCF)的反应性降低、破坏了瘦素与SCF协同刺激原始造血祖细胞增殖的作用 ,可能是造成再障瘦素水平高 ,但造血干

Objective To study leptin level in patients with anemia and to find out weather there is abnormality in leptin level in anemia state. Methods Radioimmunoassay (RIA) was used to measure leptin level of bone marrow (BM) and peripheral blood (PB) from normal persons, patients with aplastic anemia, with nutritional anemia and with hemolytic anemia, respectively. The ratio of BM/PB was calculated. Results The ratio of BM/PB had no difference between normal persons and nutritional anemia or hemolytic anemia ( P >0 05), while highly significant difference existed between normal persons and aplastic anemia ( P <0 01). The degree of anemia had no correlation with leptin level ( P >0 05), but leptin level of bone marrow was significantly correlated with that of peripheral blood ( P <0 01). Conclusion The leptin level of bone marrow and peripheral blood from patients with aplastic anemia is significantly higher than those of normal persons or patients with other types anemia, probably be related to the remarkable increase of adipocytes in bone marrow of aplastic anemia. Incomplete leptin receptors and low responsiveness of hematopoietic stem/progenitor cells to stem cell factor may destroy the synergic stimulation effects of leptin and stem cell factor on proliferation of primitive hematopoietic progenitors, which may be one of the reasons of high leptin level and low hematopoietic stem/progenitor cell number in aplastic anemia.