多发性硬化患者T淋巴细胞亚群与临床研究

目的研究T淋巴细胞亚群(CD4 ,CD8 )比值与多发性硬化患者发病的相关关系。方法采用间接免疫荧光染色及流式细胞仪检测28例多发性硬化(MS)活动期及缓解期外周血和脑脊液的CD4 、CD8 ,MS患者活动期应用糖皮质激素治疗。结果活动期MS的外周血CD4 、CD8 细胞较对照组减少,CD4 /CD8 比值较对照组升高(P<0.01)。脑脊液中CD4 、CD4 /CD8 比值较对照组升高,CD8 细胞降低(P<0.01),且脑脊液中T淋巴细胞亚群均高于自身外周血中相应细胞(P<0.01),而且缓解期与活动期比较外周血和脑脊液CD4 /CD8 比值及脑脊液中CD4 细胞明显降低,脑脊液中CD8 明显升高(P<0.01),但外周血和脑脊液CD8 细胞仍低于对照组。结论MS患者存在T淋巴细胞辅助免疫功能的明显增强,免疫抑制功能的明显减弱;糖皮质激素对活动期MS患者有效,随着病情的缓解T淋巴细胞亚群均有不同程度的改善;部分MS患者活动期与缓解期比较,外周血和脑脊液CD4 、CD8 及CD4 /CD8 比值变化不明显,常提示容易复发。

Clinical research of T lymphocyte subgroup in patients with multiple sclerosis

Objective To explore significance of the T lymphacyte subgroup in cases with multiple sclerosis(MS).Methods Indirect immunofluorescence assay and flow cytometry were used to evaluate the presence of CD_4~ ,CD_8~ and T lymphocyte in the sera and CSF in patients with MS treated with glucocorticoid in the active stage.Results The CD_4~ ,CD_8~ and T lymphocyte in the peripheral blood of the patients in comparison with those of the control group decreased whereas their CD_4~ /CD_8~ increased(P<0.01).Their CD_4~ /CD_8~ in CSF were significantly higher than those in controls.On the other hand,their CD_4~ increased(P<0.01) and the T lymphocyte subgroup in CSF were higher than in the peripheral blood(P<0.01).Moreover,the CD_4~ /CD_8~ in the peripheral blood and the CD_4~ in the CSF were obviously lower and CD_8~ in the CSF were markedly higher in the remission stage than in the active stage.The CD_8~ in their peripheral blood and CSF,however,were lower than those in controls.Conclusion The results suggest that,in the MS,the assist immunological function of the T lymphocyte is considerably reinforced while the immunosuppressive function was weakened.Glucocorticoid is effective in the remission stage.T lymphocytes in some of the MS patients are somewhat ameliorated with the further remission of the condition in some of the MS cases,but in some cases,the CD_4~ ,CD_8~ and the ration of CD_4~ /CD_8~ in the peripheral blood and CSF do not change much and tended to recur.