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目的 :探讨血管新生及其调控机制在骨髓异常增生综合征 (MDS)发病机制、病情进展及预后判断中的价值。方法 :将 31例 MDS患者根据病情分成两组 ,将难治性贫血 (RA)、环状铁粒幼细胞增多性难治性贫血伴 RAS分为 A组 ,原始细胞增多性难治性贫血 (RAEB)、转化型原始细胞增多性难治性贫血伴有 RAEB- t分为 B组。用 因子相关抗原和 CD34 单抗免疫组化染色的方法 ,观察患者骨髓微血管密度 (MVD)。用 EL ISA的方法测定患者血清血管内皮细胞生长因子 (VEGF)的浓度。结果 :MDS患者的 MVD普遍较正常对照组增高 ,但 A组与对照组相比 ,差异无显著性 (t=0 .37,P>0 .0 5 ) ;而 B组与对照组相比有显著性差异 (t=6 .98,P<0 .0 0 1)而且 A、B组相比亦有显著差异 (t=5 .37,P<0 .0 5 )。MDS患者 VEGF水平显示 :A、B两组均较对照组增高 ,且随着 MDS向急性白血病的转化而逐渐增高 ,A组与对照组相比 ,差异有显著意义 (t=2 .86 ,P<0 .0 2 ) ,而 B组增高更为明显 ,B组与对照组相比差异有非常显著性 (t=6 .4 7,P<0 .0 0 1) ,B组较 A组增高 (t=3.4 86 ,P<0 .0 0 2 )。结论 :血管新生及其调控因素的异常在 MDS的发生、发展及估计预后中有重要作用
Objective: To investigate the value of angiogenesis and its regulatory mechanisms in the pathogenesis, progression and prognosis of myelodysplastic syndrome (MDS). Methods: According to the condition, 31 patients with MDS were divided into two groups according to the disease. The patients with refractory anemia (RA), RBCA with RAS were divided into group A, primary refractory anemia ( RAEB), transformed primitive blastic anemia with RAEB- t divided into B group. The bone marrow microvessel density (MVD) was observed by immunohistochemical staining with factor-related antigen and CD34 monoclonal antibody. Serum levels of vascular endothelial cell growth factor (VEGF) were measured by ELISA. Results: The MVD in patients with MDS was generally higher than that in the control group, but there was no significant difference between group A and control (t = 0.37, P> 0.05) (T = 6 .98, P <0.01). There was also a significant difference between group A and group B (t = 5.37, P <0.05). The level of VEGF in MDS patients showed that both A and B groups were higher than the control group, and gradually increased with the transformation of MDS to acute leukemia. There was significant difference between A group and control group (t = 2.86, P <0. 02), while the increase in group B was more obvious. There was a significant difference between group B and the control group (t = 6.74, P <0.01) (t = 3.4 86, P <0.002). Conclusion: The abnormalities of angiogenesis and its regulatory factors play an important role in the occurrence, development and prognosis of MDS