淋巴细胞亚群在再生障碍性贫血和低增生性骨髓增生异常综合征患者外周血中的表达分析  

Analysis of Lymphocyte Subsets in Peripheral Blood of Patients with Aplastic Anemia or Hypoplastic Myelodysplastic Syndrome

作　　者：吕远飞 闫振宇 陈乃耀 武建辉 刘斌[3] 王国立 王京[4] 

机构地区：[1]华北理工大学公共卫生学院,河北唐山063015 [2]华北理工大学附属医院血液科,河北唐山063000 [3]中国医学科学院血液病医院血液科,天津300020 [4]河北工程大学科信学院,河北邯郸056038

出　　处：《中国实验血液学杂志》2016年第5期1505-1510,共6页Journal of Experimental Hematology

基　　金：河北省省级重大医学科研课题(zd2013088)

摘　　要：目的:观察再生障碍性贫血(AA)和低增生性骨髓增生异常综合征(hypo-MDS)患者外周血淋巴细胞亚群比例的变化并探讨其意义。方法:收集2008年1月-2014年12月中国医学科学院血液病医院的181例AA及111例hypo-MDS患者的临床资料,分析患者外周血淋巴细胞亚群的比例变化及其影响。结果:hypo-MDS组患者外周血CD3^+细胞及其亚群CD3^+CD4^+/CD3^+CD8^+和CD4^+/CD8^+细胞比值与AA组相比均无显著差异(P>0.05)。hypo-M DS组患者的CD3^-CD16/CD56^+NK细胞及CD3^+CD57^+T-LGL细胞比例均显著高于AA组(P<0.05,P<0.01),而CD19^+B淋巴细胞比例明显低于AA组患者(P<0.05)。按CD4^+/CD8^+细胞比值分组后,hypo-MDS组CD3^-CD16/CD56^+NK细胞及CD3^+CD57^+T-LGL细胞比例仅在比值正常组中显著高于AA组(P<0.05);而B淋巴细胞比例仅在CD4^+CD8^+细胞比例倒置组中存在显著性差异。hypo-MDS患者CD19^+B细胞显著低于AA患者(P<0.05)。同样,两组患者外周血红细胞及血小板数仅在比例正常组中存在显著性差异,而白细胞数和网织红细胞比例则分别仅在比例超高组和非比例倒置组中存在显著性差异;骨髓原始细胞及成熟单核细胞比例仅在比例超高组中有明显差异。结论:淋巴细胞亚群的变化可作为AA和hypo-MDS鉴别诊断的参考指标,根据淋巴细胞CD4^+/CD8^+细胞比值将两组患者分为亚组进行比较更有利于鉴别的准确性。Objective：To explore the ratio of lymphocyte subsets in peripheral blood of patients with aplastic anemia（AA） and patients with hypoplastic myelodysplastic syndrome（hypo-MDS） patients and to evaluate their significance.Methods：The clinical data of 181 cases of AA and 111 cases of hypo-MDS from January 2008 to December 2014 were collected from Blood Diseases Hospital of Chinese academy of medical sciences,and then the differences of lymphocyte subsets and its effect in 2 groups were analyzed.Results：CD4＋ /CD8＋ ratio,proportion of CD3＋ cells and its subsets CD3＋ CD4＋/CD3＋ CD8＋ cells in hypo-MDS group were not significant different from AA group（P〉0.05）.the proportion of CD3- CD16/CD56＋ NK cells and CD3＋ CD57＋ T-LGL cells in hypo-MDS group was significantly higher than that in AA group（P〈0.05,P〈0.01）,but CD19＋ B lymphocyte percentage in hypo-MDS patients was lower than that in AA patients（P〈0.05）.After dividing group according to CD4＋ /CD8＋ ratio,the ratios of CD3＋ CD16/CD56＋ NK cells and CD3＋ /CD57＋ T-LGL cells were higher only in normal CD4＋ /CD8＋ ratio group of hypo-MDS patients than those in AA patients,while the ratio of B lymphocytes was significant different in inverted CD4＋ /CD8＋ratio group between hypo-MDS and AA patients.The CD19＋ B lymphocyte ratio in hypo-MDS patients was significantly lower than that in AA patients（P〈0.05）.As well,the levels of erythrocytes and platelets in peripheral blood between hypo-MDS and AA patients only in normal CD4＋ /CD8＋ ratio group were significantly different,while the significant difference of WBC count and reticulocyte ratio were observed in high CD4＋ /CD8＋ ratio and non-inverted CD4＋/CD8＋ratio groups,respectively;the significant difference of bone marrow blast ratio and muture monocyte ratio was found in high CD4＋ /CD8＋ ratio group.Conclusion：The changes of lymphocyte subsets can be used as an reference indicator for differential diagnosis of hypo-MDS and AA.The comparat

关 键 词：再生障碍性贫血 低增生性骨髓增生异常综合征 淋巴细胞亚群 CD4+细胞 CD8+细胞 

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