免疫相关性全血细胞减少症患者树突状细胞亚群、数量及其临床意义  

Quantity and Subtypes of Dendritic Cells in Patients with Immune Related Pancytopenia and Their Clinical Significance

作　　者：滕广帅[1] 付蓉[1] 刘惠[1] 王红蕾[1] 王一浩[1] 阮二宝[1] 瞿文[1] 梁勇[1] 王国锦[1] 王晓明[1] 刘鸿[1] 吴玉红[1] 宋嘉[1] 王化泉[1] 邢莉民[1] 关晶[1] 王珺[1] 李丽娟[1] 邵宗鸿[1] 

机构地区：[1]天津医科大学总医院血液科,天津300052

出　　处：《中国实验血液学杂志》2012年第3期722-726,共5页Journal of Experimental Hematology

基　　金：国家自然科学基金(编号30971286;30971285);高等学校博士学科点专项科研基金(编号200800620004);天津市自然科学基金(编号08JCYBJC07800;09JCYBJC11200);卫生部卫生行业科研专项基金(编号201002024);天津医科大学重点学科基金(编号2009xk50;2009xk51);天津医科大学基金(编号2010ky20);天津市卫生局科技基金(编号2010KZ105)

摘　　要：本研究旨在检测免疫相关性全血细胞减少症(IRP)患者树突状细胞(DC)亚群和数量,并探讨DC在IRP发病中的作用。应用流式细胞术检测65例IRP(37例初治、28例恢复)患者及17名健康对照者外周血浆细胞样DC(plasmacytoid dendritic cells,pDC)(Lin-HLA-DR+CD123+细胞)、髓系DC(myeloid dendritic cell,mDC)(Lin-HLA-DR+CD11c+细胞)数量、亚群。结果显示,IRP初治组外周血pDC占外周血单个核细胞(PBMNC)的比例为(0.91±0.64)%,明显高于恢复组(0.39±0.11)%和正常对照组(0.29±0.13)%(均P<0.01),恢复组明显高于正常对照组(P<0.05)。初治组、恢复组mDC占PBMNC的比例分别为(0.21±0.20)%、(0.34±0.21)%,与正常对照组(0.29±0.09)%比较均无统计学意义(P>0.05)。初治组pDC/mDC比值为6.75±7.11,明显高于恢复组(1.55±0.93)和正常对照组(1.07±0.43,均P<0.01),恢复组与对照组比较没有明显差别(P>0.05)。IRP组外周血pDC占PBMNC的比例与Th1/Th2呈负相关(r=-0.347,P<0.05),与骨髓单个核细胞膜表面抗体阳性率呈正相关(r=0.606,P<0.05),与CD5+B细胞数量呈正相关(r=0.709,P<0.05),与血红蛋白(r=-0.381,P<0.01)和血小板水平(r=-0.343,P<0.01)均呈负相关;mDC占PBMNC的比例与Th1/Th2呈正相关(r=0.595,P<0.05),与血红蛋白水平呈正相关(r=0.292,P<0.05);pDC/mDC与Th1/Th2水平呈负相关(r=-0.395,P<0.05),与骨髓单个核细胞膜表面抗体阳性率呈正相关(r=0.421,P<0.05),与CD5+B细胞数量呈正相关(r=0.423,P<0.05),与血红蛋白(r=-0.304,P<0.05)和血小板水平(r=-0.287,P<0.05)均呈负相关。结论:IRP患者外周血pDC数量增多,可能与IRP发病有关。This study was aimed to investigate the quantity and subtypes of dendritic cells（DC） in patients with immune related pancytopenia（IRP） and to explore the role of DC in pathogenesis of IRP.The quantity of plasmacytoid dendritic cells（pDC,Lin-HLA-DR＋ CD123＋ cells） and myeloid dendritic cells（mDC,Lin-HLA-DR＋ CD11c＋cells） in peripheral blood of 65 patients with IRP（37 new diagnosed and 28 remitted） and 17 healthy controls were analyzed by flow cytometry.The results indicated that the ratio of pDC in peripheral blood mononuclear cells（PBMNC） was（0.91±064）% in new diagnosed group,which was significantly higher than that in remission group（0.39±0.11）% and control group（0.29±0.13）%（P0.05）.The ratio of pDC to mDC in new diagnosed group was 6.75±7.11,which was significantly higher than that in remission group（1.55±0.93）and control group（1.07±0.43,P0.05）.The ratio of pDC in PBMNC of IRP group negatively correlated to ratio of Th1/Th2（r=-0.347,P〈0.05）,and positively correlated to the ratio of auto-antibody on membrane of BMMNC（r=0.606,P〈0.05）and to the quantity of CD5＋B cells（r=0.709,P〈0.05）,while it negatively correlated to the levels of hemoglobin（r=-0.381,P〈0.01）and platelets（r=-0.343,P〈0.01）.The ratio of mDC in PBMNC positively correlated to the ratio of Th1/Th2（r=0.595,P〈0.05）and the level of hemoglobin（r=0.292,P〈0.05）.The ratio of pDC/mDC negatively correlated to ratio of Th1/Th2（r=-0.395,P〈0.05）,it positively correlated to the level of antibody on membrane of BMMNC（r=0.421,P〈0.05）and the quantity of CD5＋B cells（r=0.423,P〈0.05）,while it negatively correlated to the levels of hemoglobin（r=-0.304,P〈0.05）and platelets（r=-0.287,P〈0.05）.It is concluded that the quantity of pDC in peripheral blood of IRP patients increases,which may be related to the immunopathogenisis of IRP.

关 键 词：免疫相关性全血细胞减少症 树突状细胞 

分 类 号：R551[医药卫生—血液循环系统疾病]