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目的评价山东“10·21”辐射事故2例严重放射病患者接受异基因外周血造血干细胞移植(Allo-PBSCT)后的植入状态。方法通过常规染色体畸变(CA)分析、R显带核型分析及微核(MN)法对外周血样本和(或)骨髓样本进行细胞遗传学动态分析。结果所获数据证明2例患者移植成功(为完全嵌合状态),植入状态稳定,骨髓与外周血的细胞遗传学分析结果基本一致。结果与用短串联-聚合酶联反应(STR-PCR)检测的植入情况及临床表现相符。结论对急性放射病患者受照射后动态观察双+环畸变和MN检测可作为Allo-PBSCT后评价植入状态的指标。此外,在外周血淋巴细胞急剧减少的情况下,用骨髓样本进行细胞遗传学分析优于外周血样本。
Objective To evaluate the implantation status of 2 cases of severe radiotherapy in Allo-PBSCT after “10 · 21” radiation accident in Shandong Province. Methods Cytogenetic analysis was performed on peripheral blood samples and / or bone marrow samples by routine chromosome aberration (CA) analysis, R-banding karyotype analysis and micronuclei (MN). Results The data obtained showed that 2 patients were successfully transplanted (completely chimerism) and the implantation status was stable. The results of cytogenetic analysis between bone marrow and peripheral blood were basically the same. The results were consistent with the implantation and clinical manifestations detected by STR-PCR (Short Tandem-Polymerase Chain Reaction). Conclusions The dynamic observation of double-ring distortion and MN detection after irradiation in patients with acute radiation sickness can be used as an index for evaluation of allograft status after Allo-PBSCT. In addition, cytogenetic analysis of bone marrow samples is superior to peripheral blood samples in the case of a sharp decrease in peripheral blood lymphocytes.