慢性荨麻疹患者细胞免疫功能检测及其临床意义(附68例报告)

目的：探讨细胞免疫在慢性荨麻疹发病中的作用，阐明慢性荨麻疹发生的免疫学机制。方法：选取慢性荨麻疹患者68例和健康对照者70名作为研究对象，根据不同并发症将慢性荨麻疹患者分为4个不同亚组，分别为自身免疫性疾病组11例（类风湿3例、红斑狼疮2例、甲状腺疾病4例、白癜风2例）、幽门螺旋杆菌感染组13例、乙肝和丙肝感染组10例、肿瘤组6例和无并发症组28例。采用流式细胞术检测各组研究对象外周血T细胞亚群表面标志CD3⁺、CD4⁺和CD8⁺的表达情况，检测不同并发症慢性荨麻疹患者外周血T淋巴细胞亚群。结果：与对照组比较，慢性荨麻疹组患者外周血中CD4⁺T淋巴细胞比例明显降低（P<0.05），CD8⁺比例升高（P<0.05），CD4⁺/CD8⁺比值下降（P<0.05），CD3⁺比例无明显变化（P>0.05）；与病程≤ 12个月慢性荨麻疹患者比较，病程>12个月慢性荨麻疹患者外周血中CD4⁺淋巴细胞比例明显降低（P<0.05），CD8⁺比例升高（P<0.05），CD4⁺/CD8⁺比值下降（P<0.05），CD3⁺比例无明显变化（P>0.05）；与无并发症组患者比较，有并发症慢性荨麻疹组患者外周血中CD4⁺和CD3⁺比例亦降低（P<0.05），CD8⁺比例升高（P<0.05），CD4⁺/CD8⁺比值下降（P<0.05）。结论：慢性荨麻疹患者体内存在细胞免疫功能异常，尤其CD4⁺细胞的比例降低可能是疾病发生发展的机制之一。

Detection of cellular immune function in patients with chronic urticaria and its clinical significance:A report of 68 cases

Objective:To study the effect of cellular immune in the pathogenesis of chronic urticaria, and to clarify the immunological mechanism of chronic urticaria. Methods:A total of 68 patients with chronic urticaria and 70 normal controls were selected as the subjects.The patients with chronic urticaria were divided into four different subgroups according to the different complications; there were 11 patients in autoimmune disease group (3 case of rheumatism, 2 case of lupus erythematosus, 4 cases of thyroid diseases, 2 cases vitiligo), 13 patients in Helicobacter pylori infection group, 10 patients in hepatitis B and hepatitis C group, and 6 patients in tumor group. The expressions of T cell surface markers CD3⁺, CD4⁺, and CD8⁺ in the peripheral blood were detected with flow cytometry. Furthermore,the T cell subsets in the peripheral blood of the patients with chronic urticaria with different complications were detected by flow cytometry. Results:Compared with control group, the ratio of CD4⁺ T cells of the patients in chronic urticaria group was significantly decreased (P<0.05), the ratio of CD8⁺ T cells was increased(P<0.05),and the ratio of CD4⁺ T cells/CD8⁺ T cells was decreased (P<0.05);but the ratio of CD3⁺ T cells had no changes (P>0.05).Compared with the patients with the disease duration less than 12 months, the ratio of CD4⁺ T cells of the patients with the disease duration more than 12 months was significantly decreased (P<0.05), the ratio of CD8⁺ T cells was increased(P<0.05),and the ratio of CD4⁺/CD8⁺ was decreased (P<0.05); but the ratio of CD3⁺ T had no changes (P>0.05).Compared with the patients without complications, the ratios of CD4⁺T cells and CD3⁺ T cells of the patients with complications were decreased (P<0.05), the ratio of CD8⁺ T cells was increased(P<0.05),and the ratio of CD4⁺/CD8⁺ was decreased (P<0.05). Conclusion:The unbalance of cellular immune exists in the patients with chronic urticaria, especially the decreasing of the ratio of CD4⁺ T cells in peripheral blood of the patients might be one of the mechanisms of pathogenesis of chronic urticaria.