高铝暴露再生障碍性贫血患者临床特征与免疫功能改变特点  

The clinical characteristics and immune function change of aplastic anemia patients with high aluminum exposure

作　　者：陆翔[1,2] 唐乾利[2] 王小超[2] 姜艳[2] 邱丽芳[2] 李萡[1] 李扬秋[1] 

机构地区：[1]暨南大学血液病研究所,广州510632 [2]右江民族医学院附属医院血液科,百色533000

出　　处：《免疫学杂志》2014年第11期987-991,1002,共6页Immunological Journal

基　　金：国家自然科学基金(81370605;81460026);广东省自然科学基金(S2012010008794);中央高校基本科研业务费专项基金(21612425);百色市科技局计划(20122023);广西卫生厅课题(Z2013770)

摘　　要：目的探讨高铝暴露再生障碍性贫血(aplastic anemia,AA)患者临床及T细胞免疫功能特征。方法 37例AA病例,其中高铝暴露组24例,非高铝暴露组13例,流式细胞术检测淋巴细胞亚群,石墨炉原子化分析法检测血清铝,分析高铝暴露AA患者的临床特征及免疫功能。结果高铝暴露组血铝显著增高(P<0.01),临床疗效更佳。高铝暴露组的贫血、血小板下降、骨髓巨核细胞减少及骨髓造血组织减少的程度显著重于非高铝暴露组(P<0.01,P<0.05,P<0.05,P<0.05﹚。高铝暴露组外周血CD4+T细胞和CD19+B细胞、CD4+/CD8+T细胞比值均显著高于非高铝暴露组及对照组(P<0.001,P<0.01,P<0.05),而CD8+T细胞则显著低于非高铝暴露组(P<0.01)。血清铝水平与CD4+T细胞、CD4+/CD8+T细胞比值呈正相关,与CD8+T细胞呈负相关。结论高铝暴露可影响细胞免疫功能,高铝暴露组免疫功能变化和临床疗效均与非高铝暴露组有所不同,提示2组的免疫发病机制可能有所不同。To explore the clinical characteristics and T cell immune function of high aluminum exposure aplastic anemia（AA）, thirty-seven AA patients were selected in this study（24 cases with high aluminum exposure and 13 cases with non-aluminum exposure）. The distribution of lymphocyte subsets was examined by flow cytometry; the serum aluminum level was detected by graphite atomic absorption method; and the clinical characteristiy and the immune function were compared between the high aluminum exposure AA and non-aluminum exposure AA groups. Data showed that the level of serum aluminum of high aluminum exposure group was significant higher（P〈0.01）, and therapeutic effect in high aluminum exposure group was favorable, as compared with non-aluminum exposure group. While the levels of hemoglobin, platelet, bone marrow megakaryocyte number, and bone marrow hematopoietic tissue were significant lower in high aluminum exposure group than those in non-aluminum exposure group（P〈0.01, P〈0.05, P〈0.05, P〈0.05）. The percentage of CD4＋T cells and CD19＋B cells, and the ration of CD4＋/CD8＋T cells in peripheral blood from AA patients with high aluminum exposure were significant higher than that in non-aluminum exposure group and control group（P 0.001, P〈0.01, P〈0.05）, while the percentage of CD8＋T cells was significant lower than that of non aluminum exposure group（P〈0.01）. Positive correlation was found between the percentage of CD4＋T cells or the ration of CD4＋/CD8＋T cells and the level of serum aluminum, while negative correlation was found between the percentage of CD8＋T cells and the level of serum aluminum. In conclusion, the immune function and the clinical outcome in AA patients with high aluminum exposure are different from non-aluminum exposure, suggesting that the immune pathogenesis of AA may be different in the two groups. And high aluminum exposure might impair the immune function.

关 键 词：免疫功能 T细胞 再生障碍性贫血 铝暴露 

分 类 号：R556.5[医药卫生—血液循环系统疾病]