重症肌无力患者的外周血CD8~+CD28~-T细胞的变化及意义

目的探讨CD8+CD28-T细胞在重症肌无力(MG)发病中的作用。方法采用流式细胞术对51例MG患者和35例健康对照者外周血中CD8+CD28-T细胞的构成比进行测定。结果 MG患者外周血中CD8+CD28-T细胞明显低于正常对照组,差异有统计学意义(P0.01);病情未能控制的MG患者外周血中CD8+CD28-T淋巴细胞构成比显著低于正常对照组(P0.01);胸腺切除的MG患者CD4/CD8比值均低于胸腺未切除组(P0.05)。胸腺瘤B2型MG患者外周血CD8+CD28-T细胞构成比明显高于胸腺增生的MG患者以及胸腺正常MG患者,其差异有统计学意义(P0.01)。胸腺瘤B2型的MG患者外周血CD4/CD8比值低于胸腺正常的MG患者的(P0.05)。结论提示MG患者外周血中存在异常比例的CD8+CD28-T细胞,可能参与疾病的发生与发展。

Changes of CD8+CD28-T Cell Proportion in the Peripheral Blood of Patients with Myasthenia Gravis

Objective To investigate whether there are differences of CD8^＋CD28^-T cell proportion in peripheral blood between patients with myasthenia Gravis （MG） and normal controls. Methods The contents of the peripheral blood CD8^＋CD28^-T cells of 51 MG patients and 35 normal controls were detected by FACS analysis. Results It was found that there were significant differences between MG patients and normal controls （P〈0.01）; myasthenic patients with symptoms uncontrolled （n=31） showed a lower percentage of CD8^＋CD28^-T cells compared with those of normal controls （P〈0.01）; In addition, thymectomized MG patients （n=30） had significantly lower ratio of CD4/CD8 compared with non-thymectomized MG patients （n=21）（P〈0.05）. The proportion of peripheral blood CD8^＋CD28^-T cells in MG patients with thymoma and type B2 was significantly higher than that in MG patients with thymic hyperplasia and with normal thymus （P〈0.01）, but the ratio of peripheral blood CD4/CD8 in MG patients with thymoma and type B2 showed lower level than that of the MG patients with normal thymus （P〈0.05）. Conclusion These observations indicate the existence of abnormal proportions of CD8^＋CD28^-T cells in MG patients which may correlate with disease occurrence and development.