获得性纯红再障患者外周血T细胞亚群分析

目的　本研究通过分析获得性纯红再障患者外周血T细胞亚群 ,进一步探讨该病的细胞免疫发病机制。方法　用抗人CD3、CD4、CD8、IFN γ及IL 4单抗结合人外周血单个核细胞 ,流式细胞术分析单个核细胞中CD3 +、CD4+、CD8+细胞数Th1、Th2、Tc1、Tc2细胞数以及CD4+/CD8+、Th1/Th2、Tc1/Tc2比值。结果　贫血组患者 ,外周血CD3 +细胞和CD8+细胞明显增加 (P <0 .0 1) ,CD4+/CD8+比例倒置 (P <0 .0 5 ) ;Tc2细胞明显增加 (P <0 .0 5 ) ,Tc1/Tc2比值降低(P <0 .0 5 ) ,治疗后血象恢复的患者各增高的亚群细胞均有所恢复 ,接近正常。结论　在获得性纯红再障患者T细胞明显增高 ,其中主要是CD8+细胞 ,而在CD8+细胞中 ,是Tc2细胞发挥了重要作用。经治疗有效的患者 ,其增高的T细胞亚群降低 ,提示以纠正病人细胞免疫异常为主的治疗方案有益于获得性纯红再障的治疗。

Analysis of peripheral blood T cell subsets in patients with acquired pure red cell aplastic anemia

Objective The purpose of this study was to determine the cellular immuological abnormalities in acquired PRCA.Methods We analyzed CD3+CD4+CD8+ cells percentage,Th1Th2Tc1Tc2 cells percentage and the ratio of CD4+/CD8+Th1/Th2Tc1/Tc2 in peripheral blood of the patients with flowcytometry.Results The results showed that CD3+ and CD8+ cells increased significantly in the patients of anemia group(P<0.05 and P<0.01,respectively)compared with those in control group,but CD4/CD8 ratio was decreased and reversed.Furthermore,our results showed an increased Tc2 cells percentage(P<0.05),and a decreased Tc1/Tc2 ratio(P<0.05).In patients of responding group,however,CD3+ and CD8+ cells,Tc1 and Tc2 cells were decreased,and the ratio of CD4/CD8 and Tc1/Tc2 retured to nearly normal.Conclusion T cells increase in the acquired PPCA patients,and among the increased T cells subsets,CD8+ cell is predominant.Furthermore,in the CD8+ cells,Tc2 cell may play an important role.After treatment,the increased T cells subsets return to neaely normal.It suggests that rectifying the abnormal cellular immunity is an effective way to treat the patients with acquired PRCA.