骨髓单个核细胞Coombs试验阳性血细胞减少症患者NK细胞数量及功能研究  

Quantities and function of NK cells in patients with positive BMMNC-Coombs test and cytopenia

作　　者：袁鑫[1] 付蓉[1] 刘惠[1] 王一浩[1] 李丽娟[1] 刘春燕[1] 王红蕾[1] 邵媛媛[1] 丁凯[1] 陈瑾[1] 阮二宝[1] 王化泉[1] 宋嘉[1] 王国锦[1] 邵宗鸿[1] 

机构地区：[1]天津医科大学总医院血液内科,300052

出　　处：《中华血液学杂志》2016年第5期393-398,共6页Chinese Journal of Hematology

基　　金：国家自然科学基金（81570106、81400088、81400085）;天津市自然科学基金（14JCYB-JC25400、15JCYBJC24300）;天津市抗癌重大专项攻关计划（12ZCDZSY18000）

摘　　要：目的检测骨髓单个核细胞Coombs试验阳性血细胞减少症（CBCPC）患者外周血NK细胞数量和功能，探讨NK细胞在CBCPC发病中的作用机制。方法采用流式细胞术检测20例CBCPC初治患者、22例CBCPC缓解患者和12名健康志愿者外周血NK细胞及其亚群比例，表面激活性受体NKG2D、NKp46、NKp44，抑制性受体CD158a、CD158b及穿孔素、颗粒酶13的表达。结果①初治组、缓解组患者CD3CD56＋NK细胞比例显著低于对照组[分别为（10．04±5．33）％、（11．62±6．80）％、（19．94±7.38）％，P值均〈0．01]。②初治患者NK细胞激活性受体NKG2D比例（74．03±18．24）％显著高于缓解组患者[（45．97±29．45）％]和对照组[（41．89±15．34）％]（P值均〈O．01）。③初治患者NK细胞抑制性受体CD158a中位水平为3．72％（7．88％），显著低于缓解组的16．10％（26．43％）和对照组的11．04％（22．87％）（P值分别为0．015、0．025）。④初治、缓解患者NK细胞穿孔素比例分别为（75．71±10．14）％、（77．88±22．82）％，均显著高于对照组的（60．22±14．58）％（P值分别为0．018、0．008）。⑤初治和缓解患者NK细胞比例与穿孔素比例乘积分别为（7．68±4．54）％、（8．24±5．80）％，均显著低于对照组的（12．13±5．19）％（P值分别为0．011、0．023）；初治和缓解患者NK细胞比例与颗粒酶B比例乘积分别为（7．83±5．26）％、（8．37±6．83）％显著低于对照组的（14．79±8．37）％（P值分别为0．008、0．012）。结论初治CBCPC患者NK细胞比例降低，激活性受体表达增加，抑制性受体表达降低，提示NK细胞在CBCPC发病机制中起保护作用，但代偿不足。Objective To test NK cell quantities and function in patients with positive BMMNC- Coombs test （CBCPC） and cytopenia and to explore how NK cell participate in the progress of this disease. Methods The percentage of CD3-CD56＋ NK cell in peripheral blood lymphocytes, the expression of activating receptor （NKG2D, NKp46, NKp44）, inhibitory receptor （CD158a, CD158b）, perforin and granzyme-β were detected by flow cytometry. All samples were taken from 42 patients （22 newly diagnosed and 20 in remission） and 12 healthy volunteers. The correlation between the above parameters and patients＇ clinical profile were evaluated. Results ①The percentage of CD3-CD56＋ NK cell in new diagnosed and remission CBCPC patients were significantly lower than that in healthy control [ （10.04± 5.33）%vs （19.94± 7.38）%; （11.62± 6.80）% vs （19.94± 7.38）%, all P〈0.01]. ②The expression of activating receptor NKG2D in new diagnosed CBCPC patients was significantly higher than that in remission group and healthy control [ （74.03± 18.24）% vs （45.97± 29.45）%; （74.03± 18.24）% vs （41.89± 15.34）% , P 〈 0.01 ]. ③The expression of inhibitory receptor CD158a in new diagnosed CBCPC patients was significantly lower than that in remission group and healthy control （median： 3.72% vs 16.10%, P= 0.015; 3.72% vs 1 1.04%, P=0,025）. ④The expression of perfor/n in new diagnosed and remitted CBCPC patients were significantly higher than that in healthy controls [ （75.71 ± 10.14） % vs （ 57.20.4.18.85 ） %, P= 0.018; （77.88±22.82） % vs （57.20±18.85 ） %, P=0.008 ]. ⑤The product of NK cell percentage and perforin expression in new diagnosed and remission CBCPC patient were significantly lower than that in healthy control [ （7.68± 4.54）% vs （12.13± 5.19）%, P=0.011; （8.24± 5.80）% vs （12.13± 5.19）%, P=0.023]. The product of NK cell percentage and granzyme-β expression in the new diagnosed and remission CBCPC patient were significantly lower than that in

关 键 词：COOMBS试验 杀伤细胞 天然 穿孔素 颗粒酶类 

分 类 号：R55[医药卫生—血液循环系统疾病]