52例儿童特发性再生障碍性贫血的淋巴细胞免疫异常分析

本研究评价儿童特发性再生障碍性贫血（IAA）发病时淋巴细胞免疫异常的特点，以探讨儿童特发性再生障碍性贫血的免疫发病机制。应用流式细胞术检测患者发病时外周血中淋巴细胞表型、Th1／Th2和Tc1／Tc2水平，以及CD25^＋及CD4^＋CD25^＋T细胞的水平，并与正常儿童对照组的比较。结果表明：重型再生障碍性贫血（SAA）组40例，轻型再生障碍性贫血（MAA）组12例。SAA组和MAA组患者的CD3^＋CD8^＋水平较正常对照组显著增高（P〈0．05）；MAA组CD3^＋和CD3^＋CD4^＋T细胞水平均明显低于SAA组（P〈0．05）．与正常对照组比较无显著差异．SAA组和MAA组CD3^-CD19^＋水平与正常对照组比较无明显差异。SAA组和MAA组CD3^-CD56^＋水平明显低于正常对照组（P〈0．05）：与正常对照组比较SAA组和MAA组Th1和Tc1水平明显增高（P〈0．05），Th1／Th2和Tc1／Tc2比值也明显增高（P〈0．05）；SAA组伴Th2增高；SAA组Th1和Tc1水平、Th1／Th2和Tc1／Tc2比值明显高于MAA组（P〈0．05）．SAA组、MAA组CD25^＋T细胞表达较正常对照组均显著增高（P〈0．05）。SAA组、MAA组CD4^＋CD25^＋T细胞表达水平和CD4^＋CD25^＋／CD4^＋比值均无明显差异。结论：儿童特发性再生障碍性贫血发病时淋巴细胞免疫异常，Th1／Th2、Tc1／Tc2极化平衡向Th1、Tc1偏移，并且与疾病严重程度相关，以及CD25^＋T细胞表达增高，均提示淋巴细胞免疫异常在儿童特发性再生障碍性贫血患者的发病中起着重要的作用．

Analysis of Lymphocyte Immune Abnormality in 52 Cases of Children Idiopathic Aplastic Anemia

This study was aimed to investigate the characteristics of lymphocyte immune abnormality in children idiopathic aplaetic anemia(IAA) in order to explore the immune pathogenesis of childhood IAA.The phenotypes of lymphocytes,the ratios of Th1/Th2 and Tc1/Tc2,the levels of CD25 and CD4 CD25 T lymphocytes in peripheral blood of IAA patients were measured at the onset of disease by flow cytometry and were compared with that in normal controls.The influences of those immunological indicators on prognosis of IAA were also analyzed.The results showed that there were 40 cases of severe aplastic anemia(SAA) and 12 cases of mild aplastic anemia(MAA).The levels of CD3 CD8 T cells in SAA group and MAA group were significantly higher than those in controls(p<0.05).The levels of CD3 and CD3 CD4 T cells in MAA group were lower than that in SAA group(p<0.05),but there were no difference was compared with control group.No differences of the levels of CD3-CD19 T cells were between the both SAA and MAA groups and the control group.The levels of CD3-CD56 T cells in SAA group and MAA groups were lower significantly than that in control group.As compared to control group,the levels of Th1 and Tc1 in SAA group and MAA groups increased significantly(p<0.05),and the ratios of Th1/Th2 and Tc1/Tc2 in SAA group and MAA groups increased significantly(p<0.05).The level of Th2 increased in SAA group.As compared to MAA group,the levels of Th1 and Tc1 and the ratios of Th1/Th2 and Tc1/Tc2 in SAA group increased significantly(p<0.05).The levels of CD25 T lymphocyte in SAA group and MAA group increased significantly(p<0.05),and were higher than that in normal controls,but levels of CD4 CD25 T lymphocyte and ratio of CD4 CD25 / CD4 in SAA group and MAA group had no significan difference.It is concluded that the abnormal lymphocyte immune function exist in the onset of childhood IAA.The polarization of Th1/Th2 and Tc1/Tc2 shifts to Th1 and Tc1 cells.These changes closely relate to severity of the disease.There is high level of CD25 T lymphocyte in children IAA.These changes reveal that abnormality of immune function plays an important role at the onset of childhood idiopathic aplastic anemia.