目的研究骨髓基质细胞(BMSCs)分泌的 IL-6、血管内皮生长因子(VEGF)、胰岛素样生长因子(IGF-1)在多发性骨髓瘤(MM)进展中的变化和意义以及这三种细胞因子之间的相互作用。方法取28例 MM 患者(分为活动组和稳定组)、10例缺铁性贫血患者(对照组)及2例意义未明的单克隆免疫球蛋白血症(MGUS)患者的骨髓,建立 BMSCs 的体外培养体系。用 ELISA 法检测单独培养的 BMSCs,以及 BMSCs 与 U266细胞混合培养后 IL-6、VEGF、IGF-1在培养上清中的浓度;应用外源性IL-6、VEGF、IGF-1作用于 BMSCs 后三种细胞因子的分泌量。结果①单独培养 BMSCs 所分泌的 IL-6和 VEGF 浓度,对照组<稳定组<活动组(P<0.05),IGF-1的浓度在三组之间差异无统计学意义(P>0.05);②U266细胞和 BMSCs 均分泌 IL-6、VEGF 和 IGF-1;U266与 BMSCs 黏附后 IL-6、VEGF、IGF-1的分泌明显升高(P<0.05);混合培养上清中 IL-6、VEGF、IGF-1浓度,对照组<稳定组<活动组(P<0.05);③BMSCs 分别加入外源性 IL-6/VEGF/IGF-1后,诱导 VEGF、IGF-1/IL-6、IGF-1/VEGF、IL-6分泌增加(P<0.05);④MGUS 患者 BMSCs 分泌 IL-6、VEGF、IGF-1 的水平与对照组相似。结论BMSCs 分泌的细胞因子 IL-6、VEGF、1GF-1与 MM 的进展有关;IL-6、VEGF、IGF-1三种细胞因子影响BMSCs 的分泌,三者之间有相互促进分泌的作用。 Objective To study the changes and significance of IL-6, VEGF and IGF-1 secreted by bone marrow stromal cells (BMSCs) in the progression of multiple myeloma (MM) The interaction between factors. Methods The bone marrow of 28 patients with MM (divided into active group and stable group), 10 patients with iron deficiency anemia (control group) and 2 patients with unidentified monoclonal immunoglobulinism (MGUS) were recruited to establish BMSCs In vitro culture system. The concentrations of IL-6, VEGF and IGF-1 in culture supernatant of BMSCs cultured alone and mixed with U266 cells were detected by ELISA. Exogenous IL-6, VEGF and IGF-1 were applied to BMSCs The latter three kinds of cytokine secretion. Results ① The concentrations of IL-6 and VEGF secreted by BMSCs were significantly lower in control group than those in control group (P <0.05). There was no significant difference in IGF-1 concentration among the three groups (P> 0.05). IL-6, VEGF and IGF-1 were secreted by both U266 cells and BMSCs; the secretion of IL-6, VEGF and IGF-1 was significantly increased after adhesion of U266 and BMSCs (P <0.05) The levels of VEGF, IGF-1 in the control group