【摘要】 目的观察复方参鹿颗粒对较低危骨髓增生异常综合征(MDS)患者钙结合蛋白S100A8、S100A9的影响,探讨其改善无效造血的作用机制。方法采用随机数字表法将60例较低危MDS患者分为治疗组和对照组各30例。治疗组予复方参鹿颗粒,每次1包,每日3次,口服;对照组予十一酸睾酮胶丸,每次40 mg,每日3次,口服。2组均连续治疗3个月。比较2组临床疗效,观察2组治疗前后外周血细胞计数、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、血管内皮生长因子(VEGF),钙结合蛋白S100A9、S100A8、S100A8/A9和p-p38蛋白表达及其相关性。结果治疗组总有效率为85.7%(24/28),对照组为71.4%(20/28),2组比较差异无统计学意义(P>0.05)。与本组治疗前比较,2组治疗后红细胞、血红蛋白、血小板计数明显升高(P<0.05,P<0.01)。与本组治疗前比较,治疗组治疗后TNF-α、IFN-γ、VEGF水平明显下降(P<0.01);2组治疗后比较,治疗组TNF-α、IFN-γ明显低于对照组(P<0.05,P<0.01)。与正常组比较,2组治疗前S100A8、S100A9、S100A8/A9水平明显升高(P<0.01),p-p38蛋白表达明显增加(P<0.05,P<0.01);与本组治疗前比较,治疗组治疗后S100A8、S100A9、S100A8/A9水平明显下降(P<0.01),p-p38蛋白表达明显降低(P<0.01)。2组治疗前S100A8、S100A9、S100A8/A9与TNF-α、IFN-γ、VEGF、p-p38蛋白表达呈正相关(P<0.01)。治疗组治疗后S100A8、S100A9、S100A8/A9与总有效率、红细胞、血红蛋白呈正相关(P<0.01)。结论复方参鹿颗粒可有效改善较低危MDS患者无效造血,其机制可能与下调S100A8、S100A9、S100A8/A9活性,抑制p-p38表达,减少细胞因子分泌有关。更多还原

【Abstract】 Objective To observe the effects of Compound Shenlu Granules on calcium binding protein S100A8 and S100A9 in patients with lower-risk myelodysplastic syndromes(MDS); To explore its mechanism of improving ineffective hematopoiesis. Methods Totally 60 lower-risk MDS patients were divided into treatment group and control group according to random number table method, with 30 cases in each group. Treatment group was given Compound Shenlu Granules, 1 pack each time, three times a day, orally; while control group was given andriol capsule, 40 mg each time, three times a day, orally. The treatment for both groups lasted for 3 months. Clinical efficacy, blood cell counts, changes of cytokines such as TNF-α, IFN-γ, VEGF, calcium-binding proteins S100A8, S100A9, S100A8/A9,and p-p38 protein expression levels before and after treatment in the two groups and their correlation were observed.Results The total effective rate was 85.7%(24/28) in the treatment group and 71.4%(20/28) in the control group,without statistical difference in the two groups(P>0.05). Compared with before treatment, the erythrocyte,hemoglobin and platelet counts of the two groups significantly increased after treatment(P<0.05, P<0.01). Compared with before treatment, the levels of TNF-α, IFN-γ and VEGF in the treatment group decreased significantly(P<0.01);After treatment, the TNF-α and IFN-γ in the treatment group were significantly lower than those in the control group(P<0.05, P<0.01). Compared with the normal group, the concentrations of S100A8, S100A9, and S100A8/A9 significantly increased in the two groups before treatment(P<0.01), and the expression of p-p38 protein significantly increased(P<0.05, P<0.01). The expressions of S100A8, S100A9 and S100A8/A9 were positively correlated with the expressions of TNF-α, IFN-γ, VEGF and p-p38(P<0.01) in both groups before treatment. S100A8, S100 A9 and S100A8/A9 were positively correlated with total effective rate, red blood cells and hemoglobin(P<0.01) in the treatment group after treatment. Conclusion Compound Shenlu Granules can effectively improve the ineffective hematopoiesis in lower-risk MDS patients. The mechanism may be related to down-regulate the activity of S100A8,S100A9 and S100A8/A9, inhibit the expression of p-p38, and reduce the secretion of inflammatory cytokines.更多还原