胸腺切除对重症肌无力患者外周血淋巴细胞Fas表达及T淋巴细胞亚群的影响  

The influences of thymectomy on the fas expression and T Cell subsets in peripheral blood lymphocyte from patients with myasthenia gravis

作　　者：麦卫华[1] 寇丽[1] 周文英[1] 刘汉伟[1] 韩蓉蓉[1] 周武[1] 

机构地区：[1]中山大学附属第五医院神经内科,519000

出　　处：《中国临床实用医学》2010年第6期31-33,共3页China Clinical Practical Medicine

摘　　要：目的研究胸腺切除对重症肌无力（MG）患者外周血淋巴细胞（PBL）中Fas表达及T淋巴细胞亚群的影响，探讨胸腺切除术治疗MG与Fas介导的细胞凋亡的关系。方法采用流式细胞技术检测17例MG患者及13例健康对照组PBL中CD4^＋CD8^＋及Fas表达。结果与对照组相比，无行胸腺切除术组MG患者PBL中CD4^＋CD8^＋细胞比例升高，CD4^＋CD8^＋细胞比例下降，差异有统计学意义（P〈0．05）；行胸腺切除术组CD4^＋CD8^＋细胞比例较无行胸腺切除术组下降，差异有统计学意义（P〈0．05）。无行胸腺切除术组MG患者PBL中Fas^＋、CD4^＋Fas^＋细胞比例以及行胸腺切除术组Fas^＋细胞比例均高于对照组，差异有统计学意义（P〈0．05）。行胸腺切除术组MG患者PBL中Fas^＋、CD4^＋Fas^＋及CD4^＋Fas^＋细胞比例低于无行胸腺切除术组，但差异无统计学意义（P〉0．05）。结论MG患者存在外周血T淋巴细胞亚群分布异常，胸腺切除可减少此异常。MG患者PBL表面Fas表达升高，可能反映体内T淋巴细胞的活化及CD8^＋T淋巴细胞介导的细胞毒性作用增强。胸腺切除可降低PBL中Fas的表达，可能与治疗MG的机制有关。Objective To investigate the influences of thymectomy on the Fas expression and T cell subsets in peripheral blood lymphocyte（PBL） from patients with myasthenia gravis （MG） , so as to make sure whether Fas-mediated apoptosis is involved in the mechanism of thymectomy in MG therapy. Methods We analyzed CD4＋,CD8＋ and Fas expressions in PBL from 17 patients with MG and 13 healthy controls using flow cytometric analysis. Results The percentage of CD4＋,CD8＋ cells in PBL of MG patients without thymectomy was significant higher, while the percentage of CD4＋,CD8＋ cells was significant lower, compared with controls （P 〈 0. 05 ）. The percentage of CD4＋,CD8＋ cells in PBL of MG patients with thymeetomy was significant lower than the ones without thymectomy（ P 〈 0.05 ）. The percentages of Fas ＋ and CD8 ＋ Fas＋ cells in PBL of MG patients without thymectomy, as well as the percentage of Fas＋ cells in PBL of MG patients with thymectomy, were significant higher than that of controls（ P 〈 0.05 ）. The percentages of Fas ~ , CD4 ＋ Fas ＋ and CD8＋ Fas ＋ cells in PBL of MG patients with thymectomy were lower than the ones without thymectomy, but the differences were not significant （ P 〉 0. 05 ）. Conclusion T cell subsets in PBL from patients with MG is abnormal, compared with healthy con- trol. After thymectomy, this abnormality could be revised. Fas expression on PBL of patients with MG is increased, which most likely reflects lymphocyte activation in vivo, as well as increased CD8 ＋T cell-mediated cytotoxic effect. Fas expression on PBL is decreased after thymectomy, which may be involved in the mechanism of thymectomy in MG therapy.

关 键 词：重症肌无力 FAS抗原 T淋巴细胞亚群 胸腺切除 

分 类 号：R746.1[医药卫生—神经病学与精神病学]