摘要
目的探讨血清血红素氧合酶-1(HO-1)升高在获得性噬血细胞综合征(HPS)中的诊断价值及监测其病情变化的临床意义,为临床诊疗工作的进一步开展提供理论依据。方法收集首都医科大学附属北京友谊医院2012年3月至2013年5月期间收治的HPS疑似患者129例,根据HLH-2004诊断标准最终分为原发性HPS患者8例,确诊获得性HPS组65例,排除组56例。并选取健康志愿者27例,采用酶联免疫吸附法检测所有获得性HPS患者确诊时、排除组患者、健康志愿者及部分获得性HPS临床治疗有效患者治疗2周后血清HO-1浓度,比较各组间差异。结果获得性HPS确诊组患者血清HO-1浓度明显高于排除组及正常实验对照组(F=36.835,P=0.000)。自身免疫性疾病相关性HPS血清HO-1浓度高于感染相关性HPS及淋巴瘤相关性HPS患者,组间比较差异具有统计学意义(F=4.579,P=0.014)。监测36例获得性HPS临床治疗有效患者治疗2周后血清HO-1浓度发现,治疗后血清HO-1浓度明显降低,差异有统计学意义(t=2.536,P=0.01)。血清HO-1与NK细胞活性、可溶性白细胞介素-2受体(sCD25)均无明显相关性;与铁蛋白有一定相关,但相关系数较小(r=0.273,P=0.028)。结论血清HO-1在获得性HPS患者中明显升高,尤其在自身免疫性疾病相关性HPS患者中明显高于淋巴瘤相关性HPS及感染相关性HPS,这对于诊断自身免疫性疾病相关性HPS具有重要提示意义,HO-1有可能成为监测获得性HPS病情变化的重要指标。
Objective To explore the diagnostic value and the clinical significance of monitoring the condition changes of serum HO - 1 in acquired hemophagocytic syndrome （ HPS）, so as to provide a theoretical basis for the further development of clinical work. Methods Relevance data of 129 suspected I-IPS patients in Beijing Friendship Hospital, Capital Medical University were collected during the period from March 2012 to May 2013. All these patients were divided into three groups according to HLH -2004 diagnostic criteria, including 8 primary HPS patients, 65 di- agnosed acquired HPS patients and other 56 excluded person. 27 healthy volunteers were included into this study. The level of serum HO - 1 of all the person and some patients with acquired HPS were detected. All these subjects had 2 weeks effective clinical treatment. The serum HO - 1 level of these subjects were compared among the different groups. Results The serum HO - 1 levels of patients with acquired HPS were significantly higher than those of two other groups （ F = 36. 835, P = 0. 000）. The serum HO - 1 levels of autoimmune disease associated hemophagocytic syn- drome were higher than those of infection associated HPS and lymphoma associated hemophagoeytie syndrome, with statistical significance （ F = 4. 579, P = 0. 014）. The serum HO - 1 of 36 patients with acquired HPS who had 2 weeks effective clinical treatment were monitored. The serum HO - 1 levels were significantly lower after treatment . The difference was statistically significant （ t = 2. 536, P = 0.01 ）. There was no correla- tion between Serum HO - 1, NK cell activity and sCD25. Ferritin had some relevance with HO - 1, but the correlation coefficient is small （ r = 0. 273, P = 0. 028 ）. Conclusion The serum HO - 1 in patients with acquired HPS significantly increased, especially in the autoimmune disease associated hemophagoeytic syndrome, which had important signifleance for the diagnosis of autoimmune diseases associated HPS. The serum HO - 1 may be an important indicato
出处
《临床和实验医学杂志》
2013年第20期1609-1611,共3页
Journal of Clinical and Experimental Medicine
基金
国家自然科学基金(81270653)
首都医学发展科研基金(2009-1032)
北京市科技计划首都临床特色应用研究(D101100050010005)
中华医学会关于临床医学科研专项资金(11010020246)
北京友谊医院科研启动基金(YYQDKT2011-6)
