【作者】 孙晓伟；

【导师】 孙伟正；

【作者基本信息】 黑龙江中医药大学 ， 中医内科学， 2006， 硕士

【摘要】 目的:观察补髓生血颗粒加全反式维甲酸(ATRA)治疗骨髓增生异常综合征之难治性贫血(MDS-RA)的临床疗效,检测患者治疗前后VLA-5/CD49e表达的变化,进一步探讨MDS-RA发病机制及补髓生血颗粒治疗MDS-RA的作用机理。 方法:将60例MDS-RA患者开放分为两组,用补髓生血颗粒加全反式维甲酸(实验组)治疗30例,与用全反式维甲酸(对照组)治疗的30例进行比较。并分别在治疗前后采集骨髓标本,采用流式细胞术(FCM)检测患者骨髓造血干/祖细胞相关粘附分子VLA-5/CD49e抗原治疗前后的表达水平。 结果:(1)实验组和对照组的总有效率分别为73.33%和43.33%,两组比较有显著性差异(P<0.05)。(2)实验组可以有效改善MDS-RA的贫血、出血症状及外周血象,降低外周血及骨髓中幼稚细胞百分比,其疗效优于对照组。(3)MDS-RA患者治疗前骨髓造血干/祖细胞VLA-5/CD49e的表达水平明显低于正常,疗后实验组及对照组VLA-5/CD49e的表达水平均有不同程度的提高,且实验组优于对照组。 结论:(1)补髓生血颗粒加ATRA治疗MDS-RA的疗效优于ATRA。(2)MDS-RA患者骨髓造血干/祖细胞相关粘附分子VLA-5/CD49e的表达存在异常。(3)补髓生血颗粒可以提高骨髓造血干/祖细胞相关粘附分子VLA-5/CD49e的表达,提示补髓生血颗粒可以增强MDS-RA骨髓造血干/祖细胞与基质细胞的粘附,改善骨髓病态造血,促进骨髓正常造血,使症状得以缓解。更多还原

【Abstract】 Objective: To observe the clinical effect of Busui Shengxue granule (BSSXG) and All-trans retinotic acid (ATRA) in treating Myelodyplastic Syndrome-Refractory Anemia(MDS-RA), evaluate the expression of related adhesion molecules VLA-5/CD49e on hematopoietic stem and progenitor cell (HSPC) before and after treatment, and reveal the pathogenesis of MDS-RA and and effect mecheanism of supplement BSSXG on MDS-RAMethods: Sixty cases of MDS-RA were divided into two groups-thirty patients of experiment group were treated with BSSXG and ATRA and thirty of control group were treated with ATRA. We observed the clinical effect of these sixty patients treated with two groups. We explored flow cytometry (FCM) to detect sixty patients the expression of related adhesion molecules VLA-5/CD49e on hematopoietic stem and progenitor cell (HSPC) before and after treatment.Results: (l)The total effective rate of the experiment group and the control group were 73.33 % 和 43.33 % , the comparison between the two groups showed significant difference (P< 0.05). (2) The experiment group can effectively improve anemia and hemorrhage symptom and peripheral blood , decrease immature cells in peripheral blood and bone marrow, the degree of which is superior to that in control group.(3)The expression level of VLA-5/CD49e in. MDS-RA patients was lower than that in the normal control group before treatment, but After treatment the expression level in two groups were enhanced to different extend. The enhancement in experimental group was superior to that in control group.Conclusion: ⑴The clinical effect of BSSXG and ATRA in treating MDS-RA is superior to that of ATRA. (2) There wasabnormal expression of VLA-5/CD49e of HSPC in MDS-RA patients. (3)BSSXG could enhance the expression VLA-5/CD49e of HSPC, which cues it could faciliate the adhesion of HSPC to stroma in MDS-RA patients, improves morbid generating blood phenomenon, and faciliates bone marrow haematopoiesiall and eviates sympto*ms. ?更多还原