T细胞亚群在再生障碍性贫血外周血的表达及临床意义

目的探讨再生障碍性贫血治疗前后外周血T细胞亚群、肿瘤坏死因子（TNF-α）及HLA-DR抗原的变化。方法选取2008-2010年于我院住院治疗的38例再生障碍性贫血患者为观察组,以同期门诊体检30例健康者做为对照组。采用流式细胞仪检测两组T淋巴细胞亚群及HLA-DR抗原,应用酶联免疫吸附法（ELISA）检测TNF-α。结果与对照组相比,观察组治疗前CD4＋、CD4＋/CD8＋显著降低,差异有统计学意义（P〈0.01）;CD8＋、HLA-DR及TNF-α水平显著高于对照组,差异有统计学意义（P〈0.01）。治疗后观察组CD4＋、CD4＋/CD8＋显著上升,CD8＋、HLA-DR及TNF-α水平显著下降,与治疗前相比差异有统计学意义（P〈0.05）。结论再障患者发病与免疫功能异常密切相关,存在T淋巴细胞亚群的失调及T淋巴细胞异常活化。

Expression of T-lymphocyte subsets and its clinical significance in aplastic anemia

Objective To investigate the changes of T-lymphocyte subsets,tumor necrosis factor(TNF-α) and HLA-DR before and after the treatment of aplastic anemia. Methods 38 cases with aplastic anemia from 2008 to 2010 in our hospital were selected as the study group,while 30 healthy subjects were chosen as the control group. T-lymphocyte subsets and HLA-DR,TNF-α in the two groups were detected by Flow Cytometry(FCM) and ELISA,respectively. Results Before the treatment,the serum CD4+ and CD4+/CD8+ level in the study group were significantly lower than that in the control group(P<0.01) ,and the CD8+,HLA-DR and TNF-α level were significantly higher(P<0.01) . After the treatment,the CD4+ and CD4+/CD8+ level in the study group increased and the CD8+,HLA-DR and TNF-α level decreased,with statistically significant difference compared with that before the treatment(P<0.05) . Conclusion The maladjustment of immune system is closely related to the incidence of aplastic anemia,exibiting disbalance of T-lymphocyte subsets and abnormal activation of T cells.