低、中危骨髓增生异常综合征和慢性再生障碍性贫血患者外周血淋巴细胞亚群分析及其对早期治疗反应的影响  

Peripheral Blood Lymphocyte Subsets and Their Relation with Early Response to Treatment in Patients with Low or Intermediate Risk Myelodysplastic Syndrome( IPSS score≤1.0) and Chronic Aplastic Anemia

作　　者：张梦颖[1] 马杰[1] 孙慧[1] 谢新生[1] 王冲[1] 刘帅[1] 李涛[1] 

机构地区：[1]郑州大学第一附属医院血液科,河南郑州450052

出　　处：《中国实验血液学杂志》2014年第2期377-381,共5页Journal of Experimental Hematology

基　　金：国家自然科学基金(81000224;81300418);中国博士后科学基金资助项目(2012M511591);中国博士后科学基金资助项目(2013T60708)

摘　　要：本研究回顾性分析低、中危骨髓增生异常综合征(MDS)(IPSS≤1.0)和慢性再生障碍性贫血(CAA)患者外周血淋巴细胞亚群分布情况,并观察治疗后6个月外周血血液学变化,了解两者间差异及与早期治疗反应的关系。运用流式细胞术分析67例低、中危MDS患者、54例CAA患者及73例健康人外周血淋巴细胞亚群。结果显示,低、中危MDS组外周血Th细胞、Th/Ts比率分别为(42.94±10.80)%、(1.80±0.99)%,显著高于正常对照组,CD16+CD56+细胞比率为(11.22±7.97)%,显著低于正常对照组,差异均有统计学意义(P<0.05)。CAA组外周血Ts细胞、CD19+细胞比率分别为(30.87±9.11)、(16.98±7.40)%,显著高于正常对照组;CD16+CD56+细胞比率为(9.81±7.00)%,显著低于正常对照组,差异均有统计学意义(P<0.05);而低、中危MDS组Th细胞、Th/Ts比率均显著高于CAA组,差异有统计学意义(P<0.05)。治疗6个月时低、中危MDS患者CD19+细胞正常组HIE、HI-N有效率分别为18.2%(4/22)、13.6%(3/22),均显著低于增高组和降低组,Ts细胞增高组HI-N有效率为15.4%(2/13),显著低于正常组和降低组,Th/Ts比值降低组HI-N有效率为14.3%(2/14),显著低于增高组和正常组,差异有统计学意义(P<0.05)。治疗6个月时CAA患者CD3+细胞、Th细胞、Th/Ts比值降低组有效率为分别为71.4%(5/7)、56.3%(9/16)、50.0%(10/20),均显著高于增高组和正常组,差异有统计学意义(P<0.05)。结论:低、中危MDS患者及CAA患者外周血淋巴细胞亚群存在异常,且各亚型间与早期治疗后血液学变化存在一定相关性。The purpose of this study was retrospectively to analyze the peripheral blood lymphocyte subset distribution in patients with low or intermediate risk myelodysplastic syndromes （IPSS ≤ 1.0） and chronic aplastic anemia（ CAA）, and their hematological changes of peripheral blood after treatment, so as to understand differences and their relation with early treatment response. The lymphocyte subsets in peripheral blood of 67 patient with low or intermediate risk MDS （IPSS ≤ 1. 0）, 54 patients with CAA and 73 healthy individuals were analyzed by flow cytometry. The results showed that Th cells, Th/Ts ratio in peripheral blood of low or intermediate risk MDS were 42. 94% ± 10. 80% and 1. 80%± 0. 99% respectively, and were significantly higher than those in control group; the CD16＋ CD56＋ cell ratio was 11.22% ± 7. 97%, and was significantly lower than that in control group, the difference was statistically significant （P 〈0. 05） ; Ts cells and CD19 ＋ cell ratio in peripheral blood of CAA patients were 30.87% ±9.11% and 16.98% ± 7.40% respectively, and were significantly higher than those in control group; CD16＋ CD56＋ cell ratio was 9. 81% ±7.00%, and was significantly lower than that in normal control group, and the difference was statistically significant （P 〈 0. 05 ） ; while the Th cells and Th/Ts ratio in low or intermediate risk MDS group were significantly higher than those in CAA group, and the difference was statistically significant （P 〈0.05）. After treatment for 6 mouths, the HI-E and H/-N rates in CD19 ＋cell normal group of low or intermediate risk MDS patients were 18.2% （4/22） and 13.6% （3/22）, and were significantly lower than that in the increased group and decreased group. In Ts cell increased group HI-N rate was 15.4% （2/13）, and was significantly lower than that in normal group and decreased group. In Th/Ts ratio decreased group HI- N rate was 14.3% （2/14）, and was significantly lower than that in the increase group and normal group, th

关 键 词：低、中危骨髓增生异常综合征 慢性再生障碍性贫血 淋巴细胞亚群 血液学变化 

分 类 号：R551.3[医药卫生—血液循环系统疾病] R556.5[医药卫生—内科学]