Rio B, Bauduer F, Arrago J P, Zittoun R
Service d'Hématologie, Hôtel-Dieu, Paris, France.
Bone Marrow Transplant. 1993 Jun;11(6):471-2.
We have studied the kinetics of the N-terminal peptide of type III procollagen (NP3P) after BMT as a marker for the development of hepatic fibrosis in veno-occlusive disease (VOD). Four patients with clinically apparent VOD were retrospectively assayed and demonstrated a very high NP3P level. NP3P was also prospectively monitored at the beginning of conditioning and every week (8 patients) or every other day (14 patients) from the day of BMT (day 0) to day +28. Before conditioning the NP3P level (15.5 +/- 5.5 ng/ml) was twice normal and increased during the course of BMT in patients without VOD (21 ng/ml; range 6-35 ng/ml). In four patients who experienced VOD, the NP3P level exceeded 40 ng/ml by day 0 in two. The early rise of NP3P indicates that it is a valuable marker for the development of VOD before it becomes clinically apparent. These data suggest that VOD develops during preparation for BMT and that prophylaxis should therefore be started at this time.
我们研究了骨髓移植（BMT）后III型前胶原N端肽（NP3P）的动力学，将其作为肝静脉闭塞病（VOD）中肝纤维化发展的标志物。对4例临床表现明显的VOD患者进行回顾性检测，结果显示NP3P水平非常高。从BMT当天（第0天）至第28天，在预处理开始时以及每周（8例患者）或每隔一天（14例患者）对NP3P进行前瞻性监测。预处理前NP3P水平（15.5±5.5 ng/ml）是正常水平的两倍，在无VOD的患者中，BMT过程中NP3P水平升高（21 ng/ml；范围6 - 35 ng/ml）。在4例发生VOD的患者中，2例在第0天NP3P水平超过40 ng/ml。NP3P的早期升高表明，在VOD临床表现出现之前，它是VOD发展的一个有价值的标志物。这些数据表明，VOD在BMT准备过程中就已发生，因此预防应在此时开始。
