再生障碍性贫血发病机制的探讨

本文对26例再障的发病机制分别用GM-CFU、CFU-F及BFU-E培养方法进行了研究.发现在发病机制上多因素同时存在的复合型明显多于一个因素的单纯型;有干细胞缺损的病例最多,微环境缺陷者亦不少见;有细胞抑制的两例,其抑制可能来自单核巨噬细胞.在CFU-F减低组中循环免疫复合物(CIC)升高的病例不比CFU-F正常组中CIC升高的病例明显增多,未能说明CIC升高和造血微环境缺陷有关.在干细胞缺损型的再障中,同时存在两种祖细胞的异常(GM-CFU;BFU-E),提示其缺陷乃发生在多向造血祖细胞水平或其以上的水平.最后还对现用的4组分型法在再障发病机制研究中的作用进行了评价,并提出进一步研究的意见.

AN APPROACH TO PATHOGENESIS OF APLASTIC ANEMIA

The pathogenesis of 26 cases of aplastic anemia (AA) was studied by GM-GFU.CFU-F and BFU-E cultures.We found that the mixed type was more common than the simple one;most of the cases had hemopoietic stem cell defects,while the hemopoietic micro-envir- onment defect was also common.The GM-GFU yield was inhibited in 2 cases when cocultured by normal and patient marrow cells.The inhibition probably came from monocyte-macrophage.Circulating immune complex (CIC) elevated cases in CFU-F reduced group were not more common than that in CFU-F normal group.Thus the elevation of CIC was not related to micro-environment defect.In AA,there were a part of patients possessed two kinds of abnormal hemopoietic progenitor cells.The result suggested that in stem cell defect AA,the defect occured at the level of pluripotent progenitor cells or earlier.Finally,the four-group method used in this paper was evaluated and further study in pathogenesis of AA suggested.