自身免疫性溶血性贫血患者外周血CD4^(+)CD69^(+)T细胞及血浆免疫球蛋白水平变化及其临床意义  

Changes of peripheral blood CD4^(+)CD69^(+)T cell and plasma immunoglobulins and their clinical significance in patients with autoimmune hemolytic anemia

作　　者：刘波[1] 张文玲[2] 王猛[1] 金亮[3] 于丹军[1] LIU Bo;ZHANG Wen-ling;WANG Meng;JIN Liang;YU Dan-jun(Department of Blood Transfusion,First Hospital of Qinhuangdao,Qinhuangdao,Hebei 066000,China;Department of Clinical Laboratory,Chinese PLA General Hospital,Beijing 100039,China;Department of Clinical Laboratory,First Hospital of Qinhuangdao,Qinhuangdao,Hebei 066000,China)

机构地区：[1]秦皇岛市第一医院输血科,河北秦皇岛066000 [2]中国人民解放军总医院检验科,北京100039 [3]秦皇岛市第一医院检验科,河北秦皇岛066000

出　　处：《热带医学杂志》2022年第11期1580-1583,共4页Journal of Tropical Medicine

基　　金：秦皇岛市科学技术研究与发展计划(202004A093)

摘　　要：目的分析自身免疫性溶血性贫血(AIHA)患者外周血CD4^(+)CD69^(+)T细胞及血浆免疫球蛋白水平变化及其临床意义。方法收集2014年6月-2019年10月秦皇岛市第一医院收治的60例AIHA患者临床资料,其中28例经临床治疗后部分缓解或完全缓解(缓解组),32例为初发溶血发作(非缓解组),并纳入30名同期入院体检健康者作为对照组。比较三组外周血CD4^(+)CD69^(+)T细胞百分比、免疫球蛋白G(IgG)各亚型及血常规[血红蛋白(Hb)、红细胞计数(RBC)、白细胞计数(WBC)]水平差异,评估AIHA患者CD4^(+)CD69^(+)T细胞百分比、IgG各亚型水平与血常规的相关性。结果三组外周血CD4^(+)CD69^(+)T细胞百分比及IgG1、IgG2、IgG3、IgG4、Hb、RBC、WBC水平整体比较,差异有统计学意义(F=217.312、54.790、18.263、34.122、11.143、166.427、143.034、35.733,P均<0.05)。非缓解组CD4^(+)CD69^(+)T细胞百分比及WBC水平高于缓解组及对照组,缓解组高于对照组,差异均有统计学意义(P均<0.05)。非缓解组及缓解组外周血IgG1、IgG2、IgG3、IgG4水平均显著高于对照组,差异有统计学意义(P均<0.05)。非缓解组外周血Hb、RBC水平显著低于缓解组及对照组,缓解组低于对照组,差异均有统计学意义(P均<0.05)。Pearson相关性分析显示,AIHA患者外周血CD4^(+)CD69^(+)T细胞百分比与Hb及RBC水平呈显著负相关(r=-0.584、-0.557,P均<0.05),与IgG各亚型水平无显著相关性(P>0.05)。结论IgG各亚型水平在AIHA患者中显著升高,CD4^(+)CD69^(+)T细胞可能与AIHA发生及病情发展有关,监测上述指标对AIHA诊疗有积极作用。Objective To analyze the changes in levels of peripheral blood CD4^(+)CD69^(+)T cell and plasma immunoglobulinsand their clinical significance in patients with autoimmune hemolytic anemia(AIHA).MethodsThe clinical data of 60patients with AIHA admitted to First Hospital of Qinhuangdao were collected between June 2014 and October 2019.Amongthe patients,28 cases were in partial or complete remission after clinical treatment(remission group),and 32 cases wereshown as initial hemolytic attack(non-remission group).Another 30 people undergoing physical examination during thesame period were enrolled as control group.The differences in percentage of peripheral blood CD4^(+)CD69^(+)T cell,immunoglobulin G(Ig G)subtypes and blood routine[hemoglobin(Hb),red blood cell count(RBC),white blood cellcount(WBC)]were compared among the three groups,and the correlations between the percentage of CD4^(+)CD69^(+)T cell,the levels of Ig G subtypes and blood routine in patients with AIHA were analyzed.ResultsThere were statisticallysignificant differences in the percentage of peripheral blood CD4^(+)CD69^(+)T cell and the levels of Ig G1,Ig G2,Ig G3,Ig G4,Hb,RBC and WBC among the three groups(F=217.312,54.790,18.263,34.122,11.143,166.427,143.034,35.733,all P<0.05),and the percentage of CD4^(+)CD69^(+)T cell and level of WBC in non-remission group were higher than those in remission group and control group(P<0.05),and the above indicators in remission group were higher than those in controlgroup(P<0.05).The levels of peripheral blood Ig G1,Ig G2,Ig G3 and Ig G4 in non-remission group and remission groupwere significantly higher than those in control group(P<0.05).The levels of peripheral blood Hb and RBC were significantlylower in non-remission group than those in remission group and control group(P<0.05),and were lower in remission groupthan those in control group(P<0.05).Pearson correlation analysis showed that the percentage of CD4^(+)CD69^(+)T cell inperipheral blood of patients with AIHA was significantly negatively correlated with

关 键 词：自身免疫性溶血性贫血 T淋巴细胞 CD4^(+) CD69^(+) IGG 

分 类 号：R556.62[医药卫生—血液循环系统疾病]