获得性纯红细胞再生障碍性贫血患者的T淋巴细胞亚群分析及疗效观察  

Analysis and observation of T lymphocyte subsets and curative effects in patients with acquired pure red cellaplasia

作　　者：朱琳[1] 安利[1] 王增胜[1] 富玲[1] 

机构地区：[1]新疆维吾尔自治区人民医院血液科,乌鲁木齐830001

出　　处：《国际输血及血液学杂志》2016年第4期319-324,共6页International Journal of Blood Transfusion and Hematology

基　　金：新疆维吾尔自治区科技支疆项目（20150213）.

摘　　要：目的探讨获得性纯红细胞再生障碍性贫血（PRCA）患者的T淋巴细胞亚群分布和外周血、骨髓中大颗粒淋巴细胞（LGL）绝对细胞数及比例，评估获得性PRCA患者的免疫功能状态与免疫抑制剂疗效。方法选取2002年1月至2015年11月于新疆维吾尔自治区人民医院血液科住院治疗的25例初诊获得性PRCA患者为研究对象，纳入研究组。其中，5例患者为T细胞型大颗粒淋巴细胞白血病（T-LGLL）继发PRCA，其余20例为原发性PRCA。研究组患者纳入标准：符合《血液病诊断及疗效标准》中有关获得性PRCA的诊断标准；临床资料完整。排除标准：其他具有贫血表现的疾病；临床资料不全者。采用简单随机抽样法选择同期于本院体检中心进行体检的25例健康个体纳入对照组。对照组受试者纳入标准：血常规检查、生化检查结果均在正常参考值范围者。排除标准：血常规检查结果异常及罹患免疫性疾病、肿瘤者。采用流式细胞术对两组受试者进行T淋巴细胞亚群检测；对研究组获得性PRCA患者于治疗前、后进行血常规及骨髓检查；对研究组获得性PRCA患者的骨髓、外周血中LGL绝对细胞数及比例结果和环孢素A等药物治疗疗效进行回顾性分析，并进行统计学比较。本研究遵循的程序符合新疆维吾尔自治区人民医院人体试验委员会所制定的伦理学标准，得到该委员会批准。两组受试者年龄、性别构成比等一般临床资料相比，差异均无统计学意义（P〉0.05）。结果①研究组获得性PRCA患者的辅助性T淋巴细胞（Th）比例、Th/抑制性T淋巴细胞（Ts）值均低于对照组，Th比例：（36.6±3.8）%比（45.1±2.1）%，Th/Ts值：1.2±0.2比2.2±0.4，并且差异均有统计学意义（t＝9.161、12.174，P＝0.032、0.021）。研究组Ts比例高于对照组，分别为（30.5±2.8）%比（20.2±1.9）%，并且差异亦有统计学意义（t＝13.460Objectives To investigate distribution of T lymphocyte subsets, absolute value and proportion of large granular lymphocyte（LGL） in peripheral blood and bone marrow of acquired pure red cell aplasia （PRCA） patients, and to evaluate patients＇ immune function and efficacy of immunosuppressive agents. Methods From January 2002 to November 2015, a total of 25 patients with acquired PRCA who were treated at Department of Hematology, People＇s Hospital of Xinjiang Uygur Autonomous Region at first-visit were enrolled into this study, as study group. Inclusion criteria of study group： patients＇ diagnoses were conformed to the diagnostic criteria of PRCA in Diagnosis and Curative Effect of Hematology （3rd edition） and clinical data were complete. Exclusion criteria： other anemia disease and clinical data were not complete. In 25 cases of PRCA patients, 5 cases were secondary PRCA with T cell- large granular lymphocyte leukemia （T-LGLL）, other 20 cases were primary PRCA. And 25 cases of health people who were receiving physical examination at the People＇s Hospital of Xinjiang Uygur Autonomous Region during the same period were recruited into control group randomly, by simple random method. Inclusion criteria of control group： no abnormality in blood routine examination and biochemical test. Exclusion criteria： abnormality in blood routine examination, and suffering from immune disease, tumor. T lymphocyte subsets of subjects in study group and control group were detected by flow cytometry. Blood routine examination and bone marrow examination were carried out in study group before and after treatment. Then absolute value and proportion of LGL in bone marrow, peripheral blood and curative effect after drug treatment of cyclosporine A and so on of 25 acquired PRCA patients were analyzed retrospectively and compared statistically. The study protocol was approved by the Ethical Review Board of Investigation in Human at People＇s Hospital of Xinjiang Uygur Autonomous Region. There were no statisti

关 键 词：红细胞再生障碍 纯 贫血 再先障碍性 T淋巴细胞亚群 白血病 大颗粒淋巴细胞 环孢菌素 

分 类 号：R556.5[医药卫生—血液循环系统疾病]