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目的研究骨髓增生异常综合征(MDS)患者骨髓促红细胞生成素受体(EPOR)的表达以及血清促红细胞生成素(sEPO)水平与临床的关系,为MDS患者贫血采用EPO治疗提供理论依据。方法对45例MDS患者采用RT-PCR法检测EPOR的表达,以夹心酶联免疫法(ELISA)测定sEPO含量,按照WHO分类诊断标准分类,其中低危组20例,包括难治性贫血(RA组)11例、难治性血细胞减少伴多系发育异常(RCMD组)9例;高危组25例,包括难治性贫血伴原始细胞增多-1(RAEB-1组)10例、难治性贫血伴原始细胞增多-2(RAEB-2组)15例。结果 45例MDS患者有25例表达EPOR,低危组患者的EPORmRNA平均表达量为0.686 2±0.372 5,与对照组无显著差异(P>0.05),高危组患者EPORmRNA平均表达量为0.402 3±0.138 5,显著低于对照组0.834 7±0.254 1(P<0.05)。低危组患者sEPO平均含量为(13.91±7.70)IU/L,显著低于对照组(20.57±9.06)IU/L(P<0.05);高危组sEPO平均含量为(30.68±14.08)IU/L,显著高于对照组(20.57±9.06)IU/L(P<0.05)。结论 sEPO水平减低在低危组起重要作用;高危组EPOR表达降低或缺失,但sEPO水平显著升高,表明EPOR表达水平降低为高危MDS患者红系异常的主要原因,对MDS患者临床采用EPO治疗具有指导意义。
Objective To investigate the relationship between the expression of erythropoietin receptor (EPOR) and the level of serum erythropoietin (sEPO) in patients with myelodysplastic syndrome (MDS) and provide a theoretical basis for the treatment of anemia in patients with MDS. Methods The expression of EPOR was detected by RT-PCR in 45 patients with MDS. The content of sEPO was determined by sandwich enzyme-linked immunosorbent assay (ELISA), and classified according to WHO diagnostic criteria. Among them, 20 patients in low risk group including refractory anemia (RA (RCMD group), 9 cases were in refractory cytopenia with multiple lineage dysplasia (RCMD group), and 25 cases in high risk group including 10 cases with refractory anemia and blasts blasts (RAEB-1), refractory Anemia with primitive cells increased -2 (RAEB-2 group) 15 cases. Results EPOR mRNA expression was found in 25 of 45 patients with MDS. The average expression of EPOR mRNA in low risk group was 0.686 2 ± 0.372 5, which was not significantly different from that in control group (P> 0.05). The average EPOR mRNA expression in high risk group was 0.402 3 ± 0.138 5, significantly lower than the control group 0.834 7 ± 0.254 1 (P <0.05). The average level of sEPO in low risk group was (13.91 ± 7.70) IU / L, which was significantly lower than that in control group (20.57 ± 9.06 IU / L, P <0.05). The average level of sEPO in high risk group was (30.68 ± 14.08) IU / L , Significantly higher than that of the control group (20.57 ± 9.06) IU / L (P <0.05). Conclusion The decrease of sEPO plays an important role in low-risk group. The expression of EPOR is decreased or absent in high-risk group, but the level of sEPO is significantly increased, indicating that EPOR expression level is the main reason of erythroid abnormalities in high-risk MDS patients. EPO treatment It is instructive.