摘要
目的 了解阵发性睡眠性血红蛋白尿症 (PNH)患者体内尿激酶受体 (uPAR)的表达水平 ,并探讨uPAR检测在PNH诊断中的临床意义。方法 用流式细胞仪检测 2 0例PNH患者粒细胞表面uPAR、CD55、CD59的表达水平 ,并与 2 1例正常人、5 9例其他贫血患者 (18例自身免疫溶血性贫血、6例其他溶血性贫血、2 6例慢性再生障碍性贫血、9例缺铁性贫血 )比较 ;同时采用免疫放射分析(IRMA)测定PNH患者与正常人血浆可溶性uPAR(suPAR)的水平。结果 2 0例PNH患者中uPAR、CD55、CD59表达水平显著降低 ,且与正常人uPAR表达下限不重叠。在PNH患者中还存在峰型异常 [双峰和 (或 )峰拖尾 ]。而 5 7例其他贫血患者中粒细胞表面uPAR的表达水平无改变。PNH患者血浆suPAR水平为 (4 0 4± 2 4 7) μg/L ,明显高于正常人的 (1 73± 0 96 ) μg/L水平 (P <0 0 1)。PNH患者血浆suPAR水平与粒细胞表面uPAR的表达呈负相关 (r=- 0 79,P <0 0 1)。结论 PNH患者粒细胞表面uPAR表达水平降低 ,而血浆suPAR水平增高 。
Objective To investigate the expression levels of the receptor for urokinase type plasminogen activator (uPAR) on granulocytes and the soluble uPAR (suPAR) level in plasma from patients with paroxysmal nocturnal hemoglobinuria (PNH) and its clinical application in the diagnosis of this disorder Methods Expression of uPAR, CD 55 and CD 59 was measured on granulocytes by using flow cytometry (FCM) and the level of suPAR in plasma by using immunoradiometric assay (IRMA) in 20 patients with PNH, 59 anemic patients with diagnoses other than PNH (18 with autoimmune hemolytic anemia, 6 with other hemolytic anemias, 26 with aplastic anemia and 9 with iron deficiency anemia) and 21 healthy individuals Results In PNH patients, both the mean fluorescence intensity and percentage of positive fluorescence activated granulocytes of uPAR,CD 55 and CD 59 were remarkably decreased, while in anemic patients with diagnoses other than PNH the results were not different when compared with those of the healthy individuals The expression level of uPAR was reduced to the same extent as that of CD 55 and CD 59 on the PNH affected granulocytes In addition, some peak shape abnormalities (double peaks and/or peak tailing) in the histogram of fluorescence intensity were also found in PNH patients The suPAR concentration of PNH plasma was (4 04±2 47) μg/L, being higher than that of the healthy individuals (1 73±0 96) μg/L ( P <0 01) And the percentage of positive fluorescence activated granulocytes was inversely associated with the plasma suPAR level in PNH patients ( r =-0 79, P <0 01) Conclusion It is suggested that measurement of expression level of uPAR on granulocytes with FCM and suPAR in plasma with IRMA would be alteanative specific techniques for the diagnosis of PNH
出处
《中华内科杂志》
CAS
CSCD
北大核心
2001年第11期740-743,共4页
Chinese Journal of Internal Medicine
基金
国家自然科学基金资助项目 (3 983 0 180 )
