本研究探讨细胞因子在恶性淋巴瘤贫血的发生中的作用.应用ELISA法检测45例初治淋巴瘤患者和12名正常对照者血清IFN-γ、IL-6、TNF-α、IL-1β和EPO水平；以流式细胞术检测骨髓红系EPOR水平；分离骨髓单个核细胞进行红系集落培养,并在倒置显微镜下检计数CFU-E.结果表明,45例初治淋巴瘤患者中发病时即贫血者25例(55.6％),治疗过程中发生贫血者13例(28.9％),从未发生贫血者7例(15.5％)；血清IFN-γ及TNF-α水平在中、重度贫血组均显著高于轻度贫血组、无贫血组及对照组.血清EPO、IL-6、IFN-γ水平与Hb水平呈显著负相关；淋巴瘤无贫血组EPOR水平明显高于各种程度贫血组及正常对照组.CFU-E与Hb及EPOR水平均呈显著正相关.结论:IFN-γ、TNF-α、IL-6是导致淋巴瘤贫血的造血负调控因子；EPO和EPOR上调是机体对抗红系造血负调控及维持正常造血的重要机制.%This study was purposed to investigate the role of cytokines in pathogenesis of lymphoma-associated anemia. The levels of IFN-γ, IL-1β, IL-6 ,TNF-α and EPO in serum from 45 lymphoma patients and 12 normal controls were detected by using ELISA, the EPOR level on bone marrow cells were detected by flow cytometry, the CFU-E of bone marrow cultured in vitro was counted under inverted microscope. The results showed that 25 (55. 6% ) out of 45 newly diagnosed lymphoma patients had anemia before diagnosis, 13(28.9% ) had anemia during therapy, 7(15.5%) never had anemia. The IFN--γ and TNF-α levels in serum of patients with moderate and severe anemia were significantly higher than those in patients with mild anemia and without anemia as well as normal controls. The EPO, IL-6 and IFN-γ levels correlated negatively with Hb concentration in patients, the EPOR level in patients withont anemia significantly higher than that in patients with anemis and normal controls. The bone marrow CFU-E amount in patients showed positive correlation with Hb and EPOR levels. It is concluded that the increased IFN- γ , TNF-a and IL-6 may contribute to the anemia in lymphoma, and yet the EPO and EPOR levels are elevated to balance negative regulatory effects on hematopoiesis and maintain normal hemotopoiesis.
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