阵发性睡眠性血红蛋白尿症患者T细胞亚群及其数量与功能的研究  

Quantity and Function of T Cell Subsets in Patients with Paroxysmal Nocturnal Hemoglobinuria

作　　者：张田[1] 梁勇[1] 付蓉[1] 李丽娟[1] 王珺[1] 刘惠[1] 王红蕾[1] 阮二宝[1] 瞿文[1] 王国锦[1] 吴玉红[1] 刘鸿[1] 王化泉[1] 王晓明[1] 宋嘉[1] 关晶[1] 邢莉民[1] 邵宗鸿[1] 

机构地区：[1]天津医科大学总医院血液肿瘤科,天津300052

出　　处：《中国实验血液学杂志》2010年第3期721-725,共5页Journal of Experimental Hematology

摘　　要：本研究探讨阵发性睡眠性血红蛋白尿症(PNH)患者T细胞免疫状态及GPI+ T细胞、GPI-T细胞的数量与功能。采用流式细胞术检测22例PNH患者及18名正常对照T细胞亚群、Th细胞亚群、GPI+T细胞、GPI- T细胞分别在CD3+ T细胞、CD4+ T细胞和CD8+ T细胞群中的比例及其CD69的表达。结果显示,PNH患者CD4+ T细胞占CD3+ T细胞的比例[(47.7670±13.91139)%]较正常对照组[(54.9592±7.11678)%]降低,CD8+T细胞占CD3+T细胞的比例[(52.2767±13.90395)%]较正常对照组[(45.2418±6.75306)%]升高,差异均有显著性(p<0.05);CD4+/CD8+比值倒置,以PNH-AA患者最为明显(0.77763±0.409153),与正常对照组(1.26356±0.348878)相比,差异有显著性(p<0.05)。PNH患者Th1细胞比例[(16.9136±6.78899)%]较对照组[(4.4600±1.81879)%]升高,差异有显著性(p<0.05),PNH-AA患者Th1细胞比例变化[(22.8000±5.45244)%]较发作性PNH患者[(12.0083±2.20770)%]更为显著,Th2细胞比例[(4.7582±1.98441)%]较正常对照组[(3.7960±1.13810)%]无明显变化。PNH患者体内存在一群GPI- T细胞,其占CD8+T细胞的(14.6797±11.96718)%,占CD4+ T细胞的(3.9241±2.46263)%,其占CD8+ T细胞的比例较占CD4+ T细胞的比例升高更为明显。PNH患者CD8+GPI+ T细胞[(17.67881±8.562493)%]、CD8+GPI-T细胞[(15.86575±7.279743)%]、CD4+GPI+ T细胞[(4.65431±1.984378)%]、CD4+GPI- T细胞[(4.93181±1.730001)%]CD69的表达均高于正常对照组[CD8+T细胞(4.68038±1.216645)%,CD4+ T细胞(1.77339±0.645259)%],差异有显著性(p<0.05),GPI+ T细胞CD69的表达与GPI- T细胞相比,差异并无显著性。结论:PNH患者存在T细胞免疫功能亢进,其可能是造成骨髓衰竭的原因,但与T淋巴细胞组分中含有PNH克隆可能无关。This study was purposed to investigate the immune state of T cells, the quantity and function of GPI ^ ＋T cells and GPI- T cells in patients with paroxysmal nocturnal hemoglobinuria （PNH）. 22 cases of PNH and 18 normal controls were enrolled in this study. Their T lymphocyte subsets, Th lymphocyte subsets were assayed by flow cytometry with the monoclonal antibodies concerned. The proportion of GPI ^＋ T cells or GPI- T cells in CD3 ^＋ T cells, CD4^＋ T cells, CD8 ^＋ T cells and the expressions of CD69 on these T cells were also respectively assayed. The results showed that the proportion of CD4 ^＋ T cells in CD3 ^＋ T cells in PNH [ （47. 7670 ± 13. 91139） % ] was lower than that in controls [ （54.9592 ±7. 11678）% ] （p 〈0.05）. CD8^＋ T cells in CD3^＋ T cells of PNH cases [ （52. 2767 ± 13. 90395）% ] were higher than that of controls [ （45. 2418 ± 6. 75306 ） % ] （p 〈 0.05 ）. The ratio of CD4 ^＋ T cells to CD8 ^＋ T cells was reverse in PNH. Those were more significantly in PNH-AA （0.77763 ±0.409153 ） （p 〈 0, 05 ）. The proportion of Thl cells in PNH [ （ 16. 9136 ± 6. 78899 ） % ], especially in PNH-AA [ （ 22. 8000 ± 5. 45244 ） % ], was significantly higher than that in controls [ （4. 4600 ± 1. 81879）% ] （p 〈0.05）. The proportion of Tb2 cells in PNH [ （4. 7582 ± 1. 98441 ） % ] had no difference from controls [ （3. 7960 ±1. 13810） % ]. The number of GPI - T ceils in CD8 ^＋T ceils and CD4 ^＋ T cells were （14.6797 ±11. 96718） % and （3. 9241 ± 2. 46263 ）% respectively. The expression of CD69 on GPI ^＋ T cells or GPI - T cells in PNH [ CD8 ^＋ GPI ^- T cells （ 17. 67881 ± 8. 562493 ） %, CD8 ^＋ GPI - T cells （ 15. 86575 ± 7. 279743 ） %, CD4 ^＋ GPI ^- T cells （4. 65431 ± 1. 984378 ）%, CD4 ^＋ GPI^- T cells （4.93181 ：~ 1. 730001 ） % ] was significantly higher than that in normal controls [ CD8 ^＋ GPI^- T cells （4. 68038 ± 1. 216645 ）%, CD4 ^＋ GPI^- T cells （1. 77339 ±0. 645259�

关 键 词：阵发性睡眠性血红蛋白尿症 T细胞免疫 GPI^+T细胞 GPI—T细胞 

分 类 号：R556.64[医药卫生—血液循环系统疾病]