CD34、CD59在阵发性睡眠性血红蛋白尿中的表达及意义  

Expression of CD34 and CD59 in paroxysmal nocturnal hemoglobinuria and their clinical significance

作　　者：王学霞[1] 孙建荣[1] 高娜[1] 于文征[1] 张化道[1] 

机构地区：[1]滨州医学院附属医院血液内科,滨州市256603

出　　处：《滨州医学院学报》2009年第5期346-348,共3页Journal of Binzhou Medical University

摘　　要：目的研究阵发性睡眠性血红蛋白尿(PNH)患者骨髓CD34+细胞比率及外周血粒、红细胞CD59表达阳性率并探讨其临床意义。方法采用流式细胞术检测20例PNH患者骨髓单个核细胞(BMMNC)中CD34+细胞比率及外周血中粒、红细胞CD59表达阳性率。结果PNH患者CD34+细胞比率显著低于正常人(P<0.01);其中增生减低组CD34+细胞比率低于增生活跃、增生明显活跃组(P均<0.05),而后两组之间差异无显著性(P>0.05)。正常人外周血粒、红细胞CD59表达阳性率均>95%,其中粒细胞CD59表达稳定性较好;PNH患者外周血粒、红细胞CD59表达阳性率与正常对照组相比均显著减低(P<0.01);粒细胞CD59在不发、偶发、频发组中表达逐渐减低且差异均有显著性(P<0.05),红细胞CD59表达则在三组之间差异无显著性(P>0.05)。结论CD34+造血干细胞减少可能参与PNH发病;外周血粒、红细胞CD59检测是诊断PNH的特异性及敏感性方法,其中粒细胞CD59缺失程度对判断病情严重与否具参考价值。Objective To study the bone marrow CD34^＋ cell ratio and positive expression of CD59 on granulocytes and erythrocytes from peripheral blood in patients with paroxysmal nocturnal hemoglobinuria（PNH） and to explore their clinical significance. Methods The ratio of CD34^＋ cell in bone marrow mononuclear cells （ BMMNC ） and expression of CD59 on peripheral granulocytes and erythrocytes in 20 patients with PNH were detected by flow cytometry along with labelled CD34 and CD59 monoclonal antibodies. Results The ratio of CD34^＋ cell in PNH patients was significantly lower than that in control group （P 〈0. 01 ）. There was a significant difference between hypocellular PNH and normo/hypercellular PNH（ P 〈0. 05 ） ,but no difference was found between the two latter groups（ P 〉0. 05 ）. The positive expression ratio of CD59 on peripheral granulocytes and erythrocytes in control group were all more than 95% and the former had a better stability. The expression of CD59 on both granulocytes and erythrocytes in PNH patients remarkably decreased as compared with that in control group （ P 〈 0. 01 ）. There was a significant difference of the expression of CD59 on peripheral granulocytes among the frequent, occasional and no hemoglobinuria group （ P 〈 0. 05 ） while there was no significant difference of the expression of CD59 on erythrocytes among the three groups （ P 〉 0. 05 ）. Conclusion The reduction of CD34^＋ hematopoietic stem cells may be involved in the pathogenesis of PNH. Detection of CD59 on granulocytes and erythrocytes from peripheral blood could be considered as a specific and sensitive method for the diagnosis of PNH. The deficiency of CD59 on granulocytes is related to the severity of disease.

关 键 词：阵发性睡眠性血红蛋白尿 CD34 CD59 流式细胞术 

分 类 号：R392.1[医药卫生—免疫学]