再生障碍性贫血患者骨髓肾素血管紧张素系统表达探究.docVIP

再生障碍性贫血患者骨髓肾素血管紧张素系统表达探究 　 作者：彭敏源，赵谢兰，高欣，雷瑚仪 【摘要】 肾素血管紧张素系统（RAS）已被证明参与了骨髓造血细胞的生长增殖和分化，而再生障碍性贫血（AA）被认为是与骨髓造血细胞受损和造血微环境缺陷有关的疾病。为了探讨AA的发病机制，运用放射免疫方法检测22例AA患者骨髓和外周血肾素活性及AngⅠ、AngⅡ浓度，并以16例外周血常规和骨髓检查正常的患者为对照组，比较两组之间的差异。结果发现： AA组骨髓AngⅡ浓度低于对照组（Plt;0.01），AA组的骨髓AngⅡ浓度与外周血比较差异无统计学意义（P＞0.05），对照组的骨髓AngⅡ浓度较同组的外周血高（Plt;0.01），两组的肾素活性及AngⅠ浓度差异无统计学意义（Pgt;0.05）。结论： AA患者骨髓AngⅡ浓度降低，AA发病可能与其有关。 【关键词】 再生障碍性贫血 　　Renin Angiotensin System in Bone Marrow of Patients with Aplastic Anemia 　　　Abstract Renin-angiotensin system (RAS) has been shown to be involved in the growth，production，proliferation and differentiation of the bone marrow (BM) hematopoietic cells，while aplastic anemia (AA) is a disease in which proliferation ability of the BM hematopoietic cells is damaged with defective hematopoietic microenvironment. To investigated the pathogenesis of AA，the rennin activity，angiotensinⅠ(AngⅠ) and angiotensin Ⅱ(AngⅡ) concentration in peripheral blood and BM of 22 AA patients were detected by radioimmunnoassay，16 nonhematological disease patients with nomal blood counts and BM picture were used as control，and the differeence between two groups was compared. The results showed that BM AngⅡconcentration in the AA patients was significantly lower than that in the control （Plt;0.01）. In nonhematological disease patients，AngⅡconcentration in BM was significantly higher than that in peripheral blood，the renin activities and AngⅠconcentrations were not significantly different in the two groups（Pgt;0.05）. In conclusion，the decreased BM AngⅡconcentration in AA patients may be involved to the pathogenesis of AA. 　　Key words aplastic anemia; rennin angiotensin system; AngⅠ； AngⅡ; bone marrow hematopoietic cell 肾素血管紧张素系统(renin-angiotensin system，RAS)被认为是调节血压电解质的内分泌系统，然而近年发现，该系统在许多组织中（心脏、血管、肾脏和消化系统）存在旁分泌和自分泌，并参与组织器官的损伤修复。1996年Haznedaroglu等［1］首次提出骨髓中也存在RAS，并认为该系统在病理和生理条件下对骨髓（BM）造血、造血细胞的生成和增殖分化可能产生作用。目前已有研究发现，血管紧张素Ⅱ(AngⅡ)能够促进放射线损伤后小鼠骨髓造血功能的恢复［2］，增强人类脐血CD34+CD38-细胞集落形成的增殖能力［3］。应用免疫组织化学方法也发现，骨髓细胞胞浆内和胞膜上有血管紧张素