T、B、NK细胞亚型与慢性荨麻疹发病机制的关系  

T, B and NK lymphocyte subgroups in the pathogenesis of chronic urticaria

作　　者：朱慧兰[1] 李润祥[1] 郭庆[2] 罗静英[1] 李振洁[1] 李嘉彦[1] 吴志华[3] 

机构地区：[1]广州市皮肤病防治所,510095 [2]中山大学第二附属医院皮肤科 [3]广东医学院附属医院皮肤科

出　　处：《中华皮肤科杂志》2008年第6期391-393,共3页Chinese Journal of Dermatology

基　　金：广东省自然科学基金（5001781）

摘　　要：目的探讨T、B、NK细胞亚型与慢性荨麻疹发病机制的关系。方法用流式细胞仪检测51例慢性荨麻疹患者和30例健康献血者外周血CD3^＋、CD4^＋、CD8^＋T细胞、B细胞、NK细胞的构成比，并计算CD4^＋／CD8^＋比值，分析其与病情、病程和抗组胺治疗之间的关系。结果慢性荨麻疹患者CD8^＋T细胞构成比27．20％±8．22％低于正常人对照组29．9％±3．74％（P〈0．05），CD4＋／CD8^＋比值（1．48±0．62）、NK细胞构成比21．20％±10．84％高于正常人对照组（分别为1．24±0．27，17．5％±3．56％，P〈0．05）；抗组胺治疗无效组CD3^＋T细胞61．81％±11．70％、CD8^＋T细胞24．00％±7．79％、B细胞10．78％±2．07％构成比低于抗组胺治疗显效组（分别为75．74％±2．36％，34．22％±9．30％，15．25％±4．10％；P〈0．05，P〈0．01，P〈0．05）。CD4^＋／CD8^＋比值（1．67±0．76）、NK细胞构成比28．61％±12．62％均高于抗组胺治疗显效组（分别为1．17±0．41，12．78％±6．02％，P〈0．01）。慢性荨麻疹患者的CD3^＋、CD8^＋T细胞构成比与症状评分呈负相关性（r=-0．31，-0．28，P〈0．05），B细胞构成比与症状评分、病程呈正相关性（r=0．53，0．55，P〈0．01）。结论慢性荨麻疹患者存在T、B、NK细胞亚型构成紊乱，在慢性荨麻疹及其耐抗组胺的发病机制中，可能有体液免疫参与。Objective To study the relationship of T, B and NK lymphocytes with the pathogenesis of chronic urticaria. Methods Flow cytometry was applied to assess the proportion of T, B and NK lymphocyte subgroups in the peripheral blood of 51 patients with chronic urticaria and 30 sex and age-matched human controls. The CD4：CD8 ratio was calculated. Moreover, the symptoms, disease course and response to antihistamines of these patients were evaluated by one physician. Results The percentage of CD8^＋ T and NK cells, CD4：CD8 ratio were （27.20± 8.22）%, （21.20 ± 10.84）% and 1.48± 0.62, respectively, in these patients, （29.9 ± 3.74）%, （17.5 ± 3.56）%, 1.24 ± 0.27, respectively, in the controls; the differences were significant between the two groups （all P 〈 0.05）. Decreased levels of CD3^＋ T cells, CD8^＋ T cells and B cells were noted in patients resistant to antihistamines compared with those responsive to antihistamines [（61.81 ± 11.70）% vs （75.74± 2.36）%, （24.00 ± 7.79）% vs （34.22 ± 9.30）%, （10.78 ± 2.07）% vs （15.25±4.10）%, P 〈 0.05, 0.01, 0.05, respectively）], while the CD4 ：CD8 ratio and percentage of NK cells were increased in antihistamine-resistant patients compared to those in antihistamine-sensitive patients [ 1.67 ±0.76 vs 1.17 ±0.41, （28.61 ±12.62）% vs （12.78 ± 6.02）%, both P〈 0.01 ]. In these patients with chronic urticaria, the percentages of CD3^＋ T and CD8^＋ T cells were negatively correlated with the symptom scores （R = -0.31, -0.28, respectively, both P 〈 0.05 ）, while the percentage of B cells was positively correlated with the symptom scores and disease course （R = 0.53, 0.55, respectively, both P 〈 0.01 ）. Conclusions There is an abnormality in the proportion of T, B and NK lymphocyte subgroups in patients with chronic urticaria, which indicates that humoral immunity may be involved in the pathogenesis of chronic urticaria and the mechanism for responsiveness to antihistamine.

关 键 词：荨麻疹 免疫表型分型 流式细胞术 

分 类 号：R758.24[医药卫生—皮肤病学与性病学] R392.12[医药卫生—临床医学]