粒细胞上CD59分子缺失表达在PNH特异性诊断指标的价值分析  

Diagnostic value of CD59 molecule deficient expression on granulocyte in PNH diagnosis

作　　者：乔伟振[1] 李小雯[1] 谢平[1] 殷莹[1] 林军[2] 

机构地区：[1]南京医科大学附属无锡市人民医院中心实验室,江苏无锡214023 [2]上海市第一人民医院病理科,200080

出　　处：《重庆医学》2011年第20期1991-1994,F0002,共5页Chongqing medicine

摘　　要：目的研究膜反应性溶解抑制物(MIRL,CD59)分子在阵发性睡眠性血红蛋白尿症(PNH)患者和其他类型贫血患者粒细胞膜表达情况,分析CD59分子缺失表达的诊断价值。方法使用藻红蛋白(PE)荧光素标记针对CD59分子单克隆抗体,应用流式细胞术检测CD59在16例PNH、7例再生障碍性贫血-阵发性睡眠性血红蛋白尿症(AA-PNH)、33例再生障碍性贫血(AA)、29例骨髓增生异常综合征(MDS)、11例多发性骨髓瘤(MM)、10例系统性红斑狼疮(SLE)、10例急性淋巴细胞白血病(ALL)、11例急性成髓系细胞性白血病(AML)、28例巨幼红细胞性贫血(MA)、66例缺铁性贫血(IDA)和13例自身免疫性溶血性贫血(AIHA)患者粒细胞上表达水平。CD59-表达数据通过一维变量方差分析。结果 CD59-细胞在30例正常对照组粒细胞上表达百分比平均为1.9%,在PNH组和其他贫血组粒细胞上缺失表达百分比平均数分别为43.6%(PNH)、29.3%(AA-PNH)、17.7%(AA)、14.6%(MDS)、12.1%(MM)、12.1%(SLE)、11.7%(ALL)、33.6%(AML)、11.6%(MA)、8.0%(IDA)和11.2%(AIHA)。与正常对照组比较,PNH、AA-PNH、AA、MDS、MM、SLE、ALL、AML、MA、IDA以及AIHA组粒细胞上CD59缺失表达均有增加,差异有统计学意义(P<0.01或P<0.05)。结论 CD59在PNH和其他不同类型贫血患者粒细胞上都有不同程度表达缺失,CD59分子表达降低可能不是PNH特异性诊断指标。Objective To investigate the expression of CD59-on the surface of granulocytic cells in patients with PNH and other type anemia,and to evaluate the diagnostic value of CD59 deficient expression.Methods Using PE fluorescence labeled monoclonal antibodies against CD59,the expression levels of CD59-were detected by flow cytometric analysis on granulocytic cells of 16 patients with PNH,7 with AA-PNH,33 with AA,29 with MDS,11 with MM,10 with SLE,10 with ALL,11 with AML,28 with MA,66 with IDA and 13 with AIHA.One-way analysis of variance test was performed to compare the difference in the frequency of CD59 negative granulocytic populations.Results The average percents of CD59-cells expressed in granulocytes were 1.9% in normal individuals,43.6% in PNH,29.3% in AA-PNH,17.7% in AA,14.6% in MDS,12.1% in MM,12.1% in SLE,11.7% in ALL,33.6% in AML,11.6% in MA,8.0% in IDA and 11.2% in AIHA.Compared to the normal control group,the percentage of CD59-deficency increased apparently in patients with PNH,AA-PNH,AA,MDS,MM,SLE,ALL,AML,MA,IDA and AIHA,and were statistics significant（P0.01 or P0.05）.Conclusion The expression levels of CD59-deficency on granulocytic cells in patients with different type anemia are increase to different extent and the diminished expression of the surface molecular CD59 may not be specific to PNH diagnosis.

关 键 词：贫血 流式细胞术 阵发性睡眠性血红蛋白尿症 CD59 

分 类 号：R556[医药卫生—血液循环系统疾病]