外阴硬化性苔藓患者HLA-DR抗原的表达及T细胞亚群变化的研究

目的研究外阴硬化性苔藓患者病变组织中的HLA-DR抗原表达和外周血中T细胞亚群水平的变化,探讨上述因素在其发病中的作用机制。方法应用免疫组化SP法检测30例患者（研究组）及21例其他良性病变患者（对照组）外阴组织HLA-DR抗原的表达情况;另用流式细胞术检测研究组和对照组血清中CD3＋、CD4＋、CD8＋及CD4＋/CD8＋的水平,并进行比较。结果①研究组外阴病变组织中HLA-DR抗原阳性表达率为30%,显著高于对照组正常外阴组织中HLA-DR抗原表达率（4.77%）,差异有统计学意义（P〈0.05）。②研究组血清中CD3＋、CD4＋的水平略低于对照组,CD8＋的水平略高于对照组,差异均无统计学意义（P〉0.05）。③研究组血清CD4＋/CD8＋的比值1.23±0.26,显著低于对照组CD4＋/CD8＋的比值（1.55±0.62）,差异有统计学意义（P〈0.05）。结论以HLA-DR为代表的遗传免疫因素可能与本病患者免疫功能紊乱,导致免疫应答过度,造成机体自身组织的损伤有关。

The Study on Lichen Sclerosus of Vulva Patients HLA-DR Antigen Expressing and T lymphocyte Subpopulation Changing

Objective To study the vulvar lichen sclerosus patients about the HLA - DR antigen expression in vulvar lesion tissue and T lymphocyte subpopulation levels in the peripheral blood and their functions in the vulvar lichen sclerosus pathogenesis. Methods From Dec 2006 to March 2008, Immunohistochemistry study of HLA - DR antigen in biopsy specimen of vulva was performed on 30 cases of VLS patients（ study group） and 21 cases of ob- stetrics and gynecology other benign lesions patients（ contrastive group ）. With Another Flow CytoMetry we detec- ted CD3＋ ,CD4＋ ,CD8＋ and CD4＋/CD8＋ levels in the study group and contrastive group,and the results were compared, Results （1）Study group vulvar lesion specimen, HLA - DR antigen positive level （ 30% ）is very higher than normal vular specimen HLA -DR antigen positive level（4.77% ） ,P 〈 0.05 ;The difference has statistical sig- nification. （2）CD3 ＋ , CD4 ＋ levels of the study group are slightly lower than the contrastive group ; CD8 ＋ level of the study group is slightly higher than the contrastive group, P 〉 0：05 ;The difference has no statistical signification. （3） CD4 ＋/CD8 ＋ level of the study group is 1.23 ± 0.26, significantly lower than CD4＋/CD8 ＋ level （ 1.55 ± 0.62） of the contrastive group, P 〈 0.05 ; The difference is significant statistically. Conclusion We can make a conclusion HLA - DR as a representative of the genetic and immune factors may be related to the incidence of vulvar lichen sclerosus ; At the same time, the incidence of this disease may be related to immune dysfunction in patients with ex- cessive immune response,resulting in the body＇s own injury tissues.