抗T淋巴细胞单克隆抗体治疗再生障碍性贫血的临床研究

用抗人Ｔ巴细胞单克隆抗体ＳＭＵ３（抗ＣＤ３）ＳＭＵ８（抗ＣＤ８）治疗３２例再生障碍性贫血，基本治愈６例，缓解７例，明显进步１１例，无效８例，有效率７５％（２４／３２）。治疗前Ｔ淋巴细胞亚群ＣＤ４／ＣＤ８比例倒置，淋巴细胞表面ＨＬＡ－ＤＲ抗原表达增高，治疗后ＣＤ４／ＣＤ８比例恢复正常，ＨＬＡ－ＤＲ表达降低，无血清病及血细胞减少等严重毒副作用。     

再生障碍性贫血患者骨髓T细胞亚群与免疫抑制治疗疗效的关系

目的：探讨再生障碍性贫血（再障）患者骨髓T细胞亚群的变化及其与再障免疫抑制治疗疗效之间的关系。方法：48例分别接受常规和常规联合免疫抑制治疗,采用流式细胞术检测骨髓T细胞亚群及CD4＋/CD8＋比值,将患者分为比值正常型和比值倒置型2个免疫亚型,分析和比较各亚型与疗效之间的关系。结果：总有效率为62.5%（29/48）,常规治疗组有效率（43.2%）显著低于免疫抑制剂治疗组（72.2%,P〈0.05）,比值倒置型患者采用免疫抑制治疗时其总有效率（89.3%）显著高于常规治疗组（46.4%,P〈0.05）。结论：再障患者存在CD4＋/CD8＋比值失调,其发病与免疫异常密切相关。     

再生障碍性贫血患者外周血γδT细胞亚群与红细胞生成素、血小板生成素水平关系

目的 探讨再生障碍性贫血(AA)患者外周血γδT细胞亚群与红细胞生成素(EPO)、血小板生成素(TPO)水平的关系。方法 选取自2019年2月至2023年2月于通州区人民医院门诊及住院部治疗的193例AA患者纳入AA组。另选取同期58例健康体检者纳入健康组。比较两组外周血γδT细胞亚群、EPO、TPO水平。采用受试者工作特征(ROC)曲线分析外周血γδT细胞亚群、EPO、TPO水平对AA严重程度的评估价值。采用Logistic回归分析影响AA患者病情的危险因素。比较不同病情严重程度患者外周血γδT细胞亚群、EPO、TPO水平。分析各指标联合检测对AA病情严重程度的评估价值及对患者病情加重的影响。于治疗后3个月将患者分为有效组(n=154)与无效组(n=39),比较两组治疗后γδT细胞亚群、EPO、TPO水平。结果 AA组γδT细胞、CD4⁺γδT细胞、CD8⁺γδT细胞、EPO、TPO水平高于健康组,差异有统计学意义(P<0.05)。AA患者外周血γδT细胞、CD8⁺γδT细胞与EPO、TPO水平呈正相关(P<...     

再生障碍性贫血儿童血清作用下巨噬细胞及T淋巴细胞对BFU—E的影响

作观察了再生障碍性贫血儿童血清作用下正常人骨髓巨噬细胞及T淋巴细胞对BFU-E产率的影响，发现正常人巨噬细胞在再障血清影响下对BFU-E生长有明显刺激作用。T淋巴细胞的作用系双向的，其条件培养液及小量加入混合细胞培养可刺激BFU-E生长。大量加入混合细胞培养则产生抑制效应，据此推断再障患骨髓中网状细胞增多对造血机能衰竭具有代偿作用。而T淋巴细胞增高则对红系造血起抑制作用。     

猪抗淋巴细胞球蛋白联合环孢素治疗重型再生障碍性贫血的疗效观察

目的 评价国产猪抗淋巴细胞球蛋白+环孢素治疗重型再生障碍性贫血的疗效.方法 回顾性分析36例重型再生障碍性贫血应用猪抗淋巴细胞球蛋白联合环孢素治疗临床资料,观察治疗疗效、并发症及转归,并根据患者的年龄、性别、病程长短、重型再生障碍性贫血类型、网织红细胞计数、治疗前中性粒细胞计数、对粒细胞集落刺激因子的治疗有无反应以及免...     

脐血与再生障碍性贫血

脐血中含有造血干细胞和造血调控因子,具有重建造血和刺激造血的作用。再生障碍性贫血（aplastic anemia,AA）是一种骨髓衰竭性疾病,它的发生涉及骨髓造血干细胞、造血微环境、免疫异常等。笔者将对脐血造血干细胞、间充质干细胞、细胞因子与再生障碍性贫血关系进行综述。     

淋巴细胞、血细胞及骨髓细胞检测在鉴别再生障碍性贫血与低增生性骨髓增生异常综合征中应用价值

目的 探讨淋巴细胞、血细胞及骨髓细胞检测在鉴别再生障碍性贫血(AA)与低增生性骨髓增生异常综合征(hypo-MDS)中的应用价值.方法 将安庆市第一人民医院自2014年1月至2019年12月收治的45例AA患者纳入AA组、48例hypo-MDS患者纳入hypo-MDS组,另将25例健康体检志愿者纳入健康组.比较外周血T...     

苯中毒重型再障免疫细胞及免疫因子变化

目的通过对苯中毒急性再生障碍性食血(AAA)患者的免疫细胞及相关因子动态检测,探索苯中毒AAA发病机制及治疗特点。方法对32例苯中毒AAA患者在治疗前及治疗后4个月作血清白介素-2(sIL-2),及外周血T细胞亚群分类,NK细胞检测,并与同期原发性AAA患者作比较。结果苯中毒AAA患者sIL-2增高,T细胞亚群及NK细胞异常,通过非免疫相关治疗4月后都恢复正常。结论苯中毒AAA患者存在异常免疫,免疫功能在经过非免疫相关治疗可恢复,免疫异常不是苯中毒AAA发病的主要因素,免疫治疗非苯中毒AAA治疗首选。     

Immunosuppressive role of radiotherapy in bone marrow transplant in patients with aplastic anemia

From April 1976 through August 1989, 66 patients with aplastic anemia were treated on either of two immunosuppressive regimens in preparation for allogeneic bone marrow transplantation (BMT) from matched donor. Seventeen patients were treated with cyclophosphamide (50 mg/kg for 3 days) followed by thoracoabdominal irradiation (TAI), 6 Gy/1 fr and 2 patients, receiving marrow graft from partially matched family donors, were treated with cyclophosphamide (50 mg/kg for 3 days), TAI (6 Gy/1 fr) and Ara-C (4 g/mq for 2 days). Forty-seven more patients were treated with cyclophosphamide alone (50 mg/kg for 4 days). All patients received prophylactic treatment with methotrexate (15) or cyclosporine A (51) to avoid graft-versus-host disease. Mean time to engraftment was 12 days after chemotherapy and TAI and 15 days after cyclophosphamide (Cy) alone. No marrow rejections were observed in the TAI group: the two infants that received partially matched marrow allografted and are alive and well. Two patients treated with cyclophosphamide alone rejected allogeneic marrow. Long-term overall survivals are similar: 64% for TAI + Cy group and 56% for Cy alone group. In spite of the immunosuppressive regimen employed, young patients (under 20 years) do better than older ones (survival: 65% vs 45%, respectively). Thus, patient's age seems to be the main factor determining overall survival after allogeneic BMT. We conclude that the use of irradiation does not add significantly to the survival of aplastic patients; given the possible toxic long-term effects of irradiation, it would probably be wise to restrict the combined use of cyclophosphamide and irradiation to the patients sensitized to their donors, to those receiving partially matched marrow from family donors or in programs involving T-cell depletion.     

舟山群岛慢性乙型肝炎外周血T细胞CD80/CD28表达率与病毒载量的关系

目的研究慢性乙型病毒性肝炎(CHB)患者外周血T淋巴细胞CD80／CD28表达率与血清HBV-DNA之间的相关关系。方法应用流式细胞技术检测78例慢性乙型肝炎患者外周血T细胞CD80与CD28表达率,实时荧光PCR法检测患者血清HBV-DNA含量,同时予以肝组织活检,观察病理组织炎症程度。结果(1)CHB患者轻度组、中度组和重度组T细胞CD80表达率分别为(3．06±1．39)％、(4．55±0．68)％、(5．10±0．25)％,3组间差异有显著意义(P<0．05);CD28表达率分别为(51．62±10．30)％、(37．18±4．89)％、(34．58±6．69)％,3组间存在显著性差异(P<0．05)。(2)CHB患者轻、中、重度炎症组血清HBV-DNA定量对数值(logarithm value,lg)分别为6．53±1．52、5．04±1．24与3．86±1．09。(3)CHB患者CD80表达率与HBV-DNA lg值呈负相关(r=-0．57,P<0．01);CD28与HBV-DNA lg值呈正相关(r=0．55,P<0．01)。结论外周血T细胞CD80／CD28表达率同CHB患者HBV血清含量存在一定的相关性,提示可用于检测HBV感染者清除HBV能力。     

再生障碍性贫血腰椎骨髓的MRI研究

目的探讨再生障碍性贫血(简称再障)的MRI诊断和在疗效评价上的应用价值。方法选择骨髓穿刺镜检证实的再生障碍性贫血16例及正常组30例,常规行腰椎MRI检查,扫描序列包括T1WI、T2WI和脂肪抑制短时反转恢复(STIR)脉冲序列,层厚5mm,层距1mm,矩阵180×256。对2组腰椎骨髓MRI表现分别总结、测量其T1值,对再生障碍性贫血组,计算椎体异常信号（低信号）区所占面积的百分比。结果本组病例根据腰椎MRI表现分为3种类型1型2例,表现为T1WI呈均匀高信号,T2WI呈均匀等信号,STIR呈均匀低信号,2例均为急性再障;2型7例,表现为3个序列中出现少许灶状不均匀信号,5例为急性再生障碍性贫血;3型7例,表现为明显高低混杂不均匀信号,7例均为慢性再生障碍性贫血。急性再生障碍性贫血患者的腰椎T1WI低信号的面积占椎体的比例明显小于慢性再生障碍性贫血患者（t=30.00,P<0.01）。再生障碍性贫血组的T1值明显低于正常组（q=7.02,P<0.01）。治疗好转后,骨髓又恢复接近正常信号和T1值。结论MRI可作为再生障碍性贫血的一种非创伤性的骨髓检查,对观察病变程度、范围以及治疗后疗效评价有着重要的临床意义。     

Magnetic resonance imaging of the bone marrow in patients with leukemia, aplastic anemia, and lymphoma

Magnetic resonance imaging (MRI) of the bone marrow was performed in 29 patients with leukemia, aplastic anemia, or lymphoma who were scheduled for bone marrow transplantation, and in 12 normals. T1-weighted coronal images (TR600/TE40) of the pelvis and proximal femurs demonstrated marrow pathology in adult patients. A simple MR grading system was developed to classify patterns of marrow involvement, and MR grading of cellularity was correlated with marrow histology. Normal marrow produced a relatively high signal intensity reflecting the predominance of short T1 fat in the marrow space. MRI of pretransplant patients with chronic myelogenous leukemia and acute leukemia in relapse demonstrated a markedly decreased marrow signal, consistent with the replacement of marrow fat by longer T1 neoplastic tissues. Aplastic anemia could not be differentiated from normal with the pulse sequences employed. Marrow involvement by Hodgkin's lymphoma was detected as diffuse marrow infiltration with superimposed focal areas of even lower signal intensity, reflecting the nodular nature of Hodgkin's. These results indicate that infiltrative marrow disorders can be sensitively detected by MRI.     

补肾生血方联合司坦唑醇治疗慢性再生障碍性贫血

目的观察补肾生血方联合司坦唑醇治疗慢性再生障碍性贫血(CAA)的临床疗效及其与外周血T淋巴细胞亚群的关系。方法将60例CAA患者随机分为实验组和对照组、每组各30例,另设空白对照组20例。实验组给予补肾生血方加司坦唑醇口服治疗,对照组给予司坦唑醇口服治疗。检测实验组、对照组治疗前、治疗后9个月以及空白对照组外周血T淋巴细胞亚群。结果 (1)实验组治疗总有效率为86.67%,优于对照组的63.33%,差异有统计学意义(P<0.05);(2)CAA患者治疗前CD4+、CD8+、CD4+/CD8+,CD4+CD45RA+、CD4+CD45RO+、CD8+CD45RO+的表达与空白对照组比较有统计学差异(P<0.05);CD3+、CD8+CD45RA+的表达两者间无差异(P>0.05);(3)实验组治疗前后CD3+、CD4+、CD8+、CD4+/CD8+、CD4+CD45RA+、CD4+CD45RO+、CD8+CD45RO+比较差异有统计学意义(P<0.05);而CD8+CD45RA+差异无统计学意义(P>0.05);(4)实验组与对照组治疗后CD4+、CD8+、CD4+CD45RA+、CD4+CD45RO+比较差异有统计学意义(P<0.05),而CD3+、CD4+、CD8+、CD8+CD45RA+、CD8+CD45RO+比较差异无统计学意义(P>0.05)。结论补肾生血方联合司坦唑醇治疗CAA疗效显著,并且在改善患者外周血淋巴细胞亚群方面能体现出明显优势。     

乙肝患者HBV特异性细胞毒T淋巴细胞的分析

目的 分析急性乙肝患者外周血中HBV特异性细胞毒T淋巴细胞(CTL)的表达特点及其在免疫应答机制中的作用.方法 采集2008年10月-2010年6月于解放军302医院就诊的40例急性乙肝患者血样进行人白细胞抗原-A2( HLA-A2)检测,对其中18例HLA-A2阳性患者取病程极期及恢复期外周血,分离单个核细胞,并以6...