骨髓增生异常综合征患者骨髓T辅助细胞亚群的研究  

Study of Th cell subsets in bone marrow of myelodysplastic syndromes patients

作　　者：王秀丽[1] 邵宗鸿[1] 姚程[2] 何广胜[1] 刘鸿[1] 施均[1] 白洁[1] 曹燕然[1] 涂梅峰[1] 王化泉[1] 邢莉民[1] 孙娟[1] 贾海蓉[1] 杨崇礼[1] 

机构地区：[1]中国医学科学院,中国协和医科大学血液学研究所,血液病医院,天津300020 [2]吉林大学第一附属医院血液科

出　　处：《中华血液学杂志》2005年第12期743-745,共3页Chinese Journal of Hematology

摘　　要：目的研究骨髓增生异常综合征(MDS)患者骨髓中辅助性T淋巴细胞(Th)亚群数量和比例改变及异常核型细胞与Th1细胞的比例,评价MDS与Th1细胞的相关性。方法用流式细胞术检测21例MDS患者、18名正常对照和13例重型再生障碍性贫血(SAA)患者骨髓Th1细胞和Th2细胞的数量和比例;检测18例MDS患者和15名正常人染色体核型,分析MDS患者肿瘤细胞负荷与Th1细胞的比例关系及MDS患者骨髓原始细胞比例与Th1细胞的相关性。结果正常对照组骨髓Th1细胞、Th2细胞、Th1/Th2比值分别为(0.48±0.10)%、(0.24±0.19)%和2.31±0.76;而MDS患者三指标分别为(0.36±0.11)%、(0.76±0.35)%和0.51±0.13。MDS患者骨髓Th1细胞减少,Th1/Th2比例明显降低(P<0.01)。SAA患者三指标分别为(4.75±0.49)%、(0.40±0.28)%和26.5±8.79,与正常对照组相比,Th1细胞明显增多、Th1/Th2比例明显升高(P<0.01)。MDS患者异常核型细胞占中期细胞的(50.00±0.10)%,而正常对照为0。随着MDS疾病进展及MDS转为AML的患者骨髓Th1细胞数量逐渐下降,原始细胞数量逐渐增多,二者呈负相关(r=-0.563,P<0.01)。结论①MDS患者T细胞免疫异常,Th1细胞与Th2细胞比例失衡,抗肿瘤细胞免疫中起主要作用的Th1细胞减少;②随着骨髓Th1细胞数量下降,MDS逐渐向白血病进展。Objective To study tbe quantity and ratio of Th1, Th2 cells in the bone man＇nw of myelodysplastie syndromes （MDS） patients,and to evaluate the con＇elation between the ratio nf the blast cells and the number of the Th1 cells in the bone marrow of MDS patients. Methods By FACS, the quantity and ratio of IFN-γ/producing CD4^＋ T cell （Th1） and 11,4 producing CD4^＋T cell （Th2） cells in the bone marrow were detected in 21 MDS patients, 18 normal controls and 13 severe aplastic anemia （SAA） patients respectively. The karyotypes of 18 MDS patients and 15 nornial controls were assayed. The con＇elation between the ratio of the blast cells in the bone marrow and the number of the Th1 cells in the MDS patients were analyzed. Results The percentages of Th1 cells, Th2 cells and ratio of Th1/Th2 in the bone marrow of normal controls were （0.48±0. 10）% , （0.24±0. 19）% and 2.31±0, 76 respectively, while those of the MDS patients were （0.36±0. 11 ） %, （ 0.76± 0.35 ） % and 0.51±0. 13. The percentage of Th1 cells of patients with M DS was reduced and the Th1/Th2 ratio was significantly lower than that of normal controls（ P 〈0.01 ）. Those of the patients with SAA were（4.75±0.49 ） %, （ 0.40 ± 0.28 ） % and 26.5 ±8.79 respectively, their Th1 cells and Th1/Th2 ratio were markedly higher than those of nornial controls （ P 〈 0.01 ）. In all of the 15 normal controls the karyotypes were normal, but tbat of M DS patients was （50.00 ± 0. 10）%. The lower ratio of the Th1 cells in the bone marrow of the patients with MDS and the AML which progressed from MDS was negatively correlated with tile higher percentage of the blast cells（ r = - 0. 563,P 〈 0.01 ）. Conclusions （1）The immune function of T lymphocytes in MDS is abuorntal ： the balance between Th1 and Th2 cells is broken.（2）With descending of the number of Th1 cells in the bone marrow of the MDS patients, the disease is progressing to leukemia.

关 键 词：骨髓增生异常综合征 T淋巴细胞 T淋巴细胞亚群 

分 类 号：R55[医药卫生—血液循环系统疾病]