多发性硬化患者淋巴细胞激活的临床意义

目的：探讨多发性硬化(MS)患者淋巴细胞的激活状态及临床意义。方法：流式细胞仪测定28例缓解复发型MS患者(复发期20例，缓解期8例)外周血(PB)、12例复发期脑脊液(CSF)及11例复发期MS患者予糖皮质激素治疗后淋巴细胞CD69和HLA-DR表达的阳性百分率。结果：复发期MS患者阳淋巴细胞HLA-DR 和CD3 ／HAL-DR 的百分率高于对照组和缓解期MS，缓解期MS患者CD3 /HLA-DR 的百分率高于对照组3复发期MS患者CSF中CD69 、HLA-DR 和CD3 ／HLA-DR 的百分率均高于PB；复发期MS患者CSF中CD69 的百分率与血脑屏障受损呈正相关；激素治疗降低复发期MS PB淋巴细胞HLA-DR 的百分率。结论：MS患者淋巴细胞激活涉及MS的发病机制并可作为MS活动期的一个指标。

The clinical significance of lymphocytes activation in patients with multiple sclerosis

Objective:To analyze the lymphocyte activation from patients with different activities of multiple sclerosis (MS) and its clinical signifiance. Methods: The positive percentage of CD69 and HLA-DR were determined on peripheral blood (PB) or cerebrospinal fluid (CSF) lymphocytes by flow cytometry from 28 patients with relapsing-remitting MS (relapses n - 20, remission n = 8) , 12 patients with relapse MS and 11 patients with relapse MS after glucocorticoid treatment. ResultS:The percentage of HLA-DR+ and CD3+ /HLA-DR+ on PB lymphocytes in relapses MS group were higher than in remission MS group and controls. The percentage of CD3+ /HLA-DR+ on PB lymphocytes in remission MS group were higher than in controls. The percentage of CD69+ , HLA-DR+ and CD3+ /HLA-DR+ were higher in CSF than in PB of patients with relapse MS. There was no significant correlation between the levels of CD69+ , HLA-DR+ , CDS+ /HLA-DR+ and the time of onset of clinical relapse, duration, clinical disability scale score(EDSS) . In patients with relapse MS, there was significant positive correlation between CD69+ expression on CSF lymphocytes and blood brain barrier damage, intravenous glucocorticoid treatment caused a significant changes in the positive percentage of HLA-DR on PB lymphocytes. Conclusion:The findings support that lymphocyte activation involvement of MS pathogenesis. Lymphocyte activation may be as a marker of disease activity in MS.