慢性再生障碍性贫血CD8~+T细胞CD28表达与中医辨证分型关系的探讨

目的 探讨慢性再生障碍性贫血(chronic aplastic anemia，CAA)患者外周血CD8^+T细胞CD28分子的表达与中医辨证分型的关系、方法采用流式细胞仪技术，测定门诊和住院CAA患者45例、健康对照人群24名的外周血CD8^+T细胞CD28分子的表达水平，从免疫学角度讨论其与中医分型关系一结果(1)CAA患者的CD8、CD28、CD8^+CD28^+表达水平及CD8^+CD28^+／CD8^+CD28均高于健康对照组(P<0．01，P<0．05)。(2)CAA肾阴虚患者CD28、CD8^+CD28^+表达水平及CD8^+CD28^+／CD8^+CD28均高于肾阳虚患者(P<0．01，P<0．05)。结论 (1)CAA患者外周血共刺激分子CD28异常高表达，提示CD28失调可能在CAA免疫发病中起重要作用、(2)CAA患者外周血CD28、CD8^+CD28^+的表达水平及CD8^+CD28^+／CD8^+CD28可以作为CAA辨证分型的参考指标，肾阴虚患者的免疫紊乱较肾阳虚患者严重。

Relationship between CD8~+ T-cell CD28 Expression and TCM Defferenfiation Type in Patients with Chronic Aplastic Anemia

Objective To explore the relationship between CD8 + T cell CD28 molecular expression in peripheral blood and TCM type in patients with chronic aplastic anemia (CAA). Methods Using flow cytometry to detect the CD28 expression in 45 in patients or out patients and 24 healthy subjects for control. And the relation with TCM type was analyzed from the immunological aspect. Results (1) The levels of CD8, CD28, CD8 +CD28 + expression and CD8 +CD28 +/CD8 +CD28 - were all higher in the CAA patients than those in the healthy subjects ( P <0 05 or P <0 01). (2) The levels of CD28, CD8 +CD28 + expression and CD8 +CD28 +/CD8 +CD28 - were all higher in the CAA patients of Shen Yin deficiency type than those in the CAA patients of Shen Yang deficiency type ( P <0 05 or P <0 01). Conclusion (1)The abnormal high expression of peripheral blood co stimulatory molecules CD28 suggested CD28 disorder may play an important role in immuno pathogenesis of CAA. (2) The levels of peripheral CD28, CD8 +CD28 + expression and CD8 +CD28 +/CD8 +CD28 - can be taken as an objective indexes for TCM typing of CAA, which was disordered more severe in patients of Shen Yin deficiency type than in those of Shen Yang deficiency type.