CD55/CD59缺陷检测及其在阵发性睡眠性血红蛋白尿诊断中的意义  

Significance of CD55/CD59 deficiency analysis in the diagnosis of paroxysmal nocturnal hemoglobinuria

作　　者：曹文俊[1] 王枕亚[1] 石厚荣[1] 陆盈[1] 樊绮诗[1] 

机构地区：[1]上海第二医科大学附属瑞金医院临床实验诊断中心,上海200025

出　　处：《诊断学理论与实践》2004年第6期416-419,共4页Journal of Diagnostics Concepts & Practice

摘　　要：目的:应用外周血红细胞CD55和CD59的检测并结合相关检验,建立有效的诊断和鉴别诊断阵发性睡眠性血红蛋白尿(PNH)的实验体系。方法:运用流式细胞术检测10例PNH患者外周血红细胞和粒细胞的CD55和CD59,并分别对缺陷红细胞作激光散射分析(FS)及FS/CD55和FS/CD59双参数分析,结合溶血性贫血(溶贫)相关其他检验,作出PNH诊断。结果:5例PNH发作期患者酸溶血试验呈阳性,CD55和CD59缺陷红细胞在流式细胞术检测中具有特征性的改变;5例PNH缓解期酸溶血试验等无明显改变,患者外周血CD55和CD59缺陷红细胞的数量较少。运用流式细胞术分别作红细胞FS/CD55和FS/CD59双参数分析,发现CD59缺陷与红细胞FS具有相关性。正常红细胞与缺陷红细胞的FS分布存在明显差异。部分再生障碍性贫血患者外周血也存在PNH样细胞,但FS/CD59检测结果与PNH患者具有不同特征。结论:流式细胞术检测外周血红细胞CD55和CD59缺陷结合溶血性贫血的常规检验可对PNH作出较明确的诊断和鉴别诊断。Objective To establish an efficient way for the diagnosis of paroxysmal nocturnal hemoglobinuria(PNH) through the combination of the hemolytic anemia(HA) associated routine tests with flow cytometry (FCM) of the red cell CD55/CD59 expression. Methods The peripheral erythrocytes and granulocytes were analyzed with flow cytometry for CD55/CD59 expression while the deficient red blood cells were further studied for forward scatter (FS), FS/CD55 and FS/CD59. Other hemolytic anemia associated tests were also employed as routine. Results PNH could be diagnosed based on the results of FCM and routine tests for peripheral erythrocytes and granulocytes, which showed the characteristic defects when the HA broke out. During remission , PNH deficient red blood cells were mainly destroyed and the peripheral blood was negative for Ham's test. FCM analysis revealed those PNH cells with CD55/CD59 deficiency and the changes of FS/CD59, which was helpful in the diagnosis and the differentiation from those PNH patients with aplastic anemia whose PNH cells also exist. Conclusions FCM analysis of the peripheral red blood cells' CD55/CD59 expression in combination with HA-related routine tests was efficient in the diagnosis of PNH.

关 键 词：阵发性睡眠性血红蛋白尿 再生障碍性贫血 CD55 CD59 流式细胞术 外周血 红细胞 

分 类 号：R695.2[医药卫生—泌尿科学] R446.11[医药卫生—外科学]