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探讨骨髓细胞凋亡和MDS患者无效造血的分子机制。采用ELISA法检测血清细胞因子水平。PCR ELISA法测定骨单个核细胞端粒酶活性。流式细胞仪分析Fas和Bcl 2表达水平。结果 :初发各亚型MDS患者的血清TNF α水平均高于正常对照 (P <0 0 5 ) ,MDS患者骨髓单个核细胞或基质细胞分泌TNF α水平均高于正常对照组。血清IL 1α和G CSF升高者分别为10 7% (3/ 2 8)例和 5 3 6 % (15 / 2 8)。MDS患者血清IL 8和IL 6高于正常对照组 ,各亚型之间无明显差别。在MDS向恶性克隆演变的过程 ,端粒酶活性水平随着恶性演变而逐渐升高。随着MDS患者恶性类型的演变 ,Fas基因表达逐渐降低 ,Bcl 2表达则逐渐升高。负性造血因子TNF α升高和抗凋亡Bcl 2的消长与MDS骨髓细胞凋亡有关。
To investigate the molecular mechanism of bone marrow cell apoptosis and ineffective hematopoiesis in MDS patients. Serum cytokine levels were measured by ELISA. PCR ELISA was used to detect telomerase activity in bone mononuclear cells. Flow cytometry analysis of Fas and Bcl 2 expression levels. Results: The levels of serum TNFα in newly diagnosed MDS patients were significantly higher than those in normal controls (P <0.05). The levels of TNFα secreted by bone marrow mononuclear cells or stromal cells in MDS patients were higher than those in normal controls. Elevated serum levels of IL-1α and G CSF were 10 7% (3/28) and 53.6% (15/2 8), respectively. Serum levels of IL-8 and IL-6 in patients with MDS were higher than those in the normal control group, with no significant difference between the subtypes. During the evolution of MDS to malignant clones, the level of telomerase activity gradually increases with malignant evolution. With the evolution of malignant type in patients with MDS, Fas gene expression gradually decreased, Bcl 2 expression gradually increased. Negative hematopoietic factor TNF α increased anti-apoptotic Bcl 2 and MDS bone marrow cell apoptosis.