雄激素对再生障碍性贫血患者调节性T细胞的影响  

Effects of androgen on regulatory T cells in patients with aplastic anemia

作　　者：张慧敏[1] 袁炜[1] 白明明 谢清清 陶朝欣 张玉娜[1] 李晓云[1] ZHANG Huimin;YUAN Wei;BAI Mingming(Shijiazhuang Ping’an Hospital,Hebei,Shijiazhuang 050021,China)

机构地区：[1]石家庄平安医院

出　　处：《河北医药》2019年第21期3205-3209,共5页Hebei Medical Journal

基　　金：河北省科学技术研究与发展计划项目(编号:17277768D)

摘　　要：目的探讨CD4+CD25highCD127low调节性T细胞(T-regs)在再生障碍性贫血(AA)病理生理学中的作用以及雄激素对AA患者T-regs的影响。方法依据AA诊断标准收集患者,分为抗胸腺细胞球蛋白(ATG)+环孢素(CsA)、CsA+达那唑(DAN)及DAN 3个治疗组,治疗前后分别采集患者外周血标本,采用多色流式细胞术对标本进行T-regs计数,并计算T-regs/CD4+T淋巴细胞百分率(T-regs%),并与健康对照组进行比较。结果 25例AA患者初诊时平均T-regs%值(3.45±1.33)%与对照组(7.90±0.99)%比较,差异有统计学意义(P<0.01)。治疗3个月后,所有患者平均T-regs%值显著升高(6.70±1.99%)(P<0.01)。其中无反应13例,部分反应11例,完全反应1例,反应组T-regs平均上升率高于无反应组(P=0.613)。治疗3个月后,3组T-regs%值均升高,3组治疗前后差异有统计学意义(P<0.01),但组间比较差异无统计学意义(P=0.585)。单因素分析未发现T-regs%值变化的显著预测因子。结论 T-regs在AA病理生理过程中起重要作用,雄激素对T-regs有调节作用;达那唑作为一种减弱的雄激素可能具有免疫调节潜力。Objective To investigate the role of CD+4CD25 high CD127 low regulatory T cells in the pathophysiology and the effects of androgen on regulatory T cells in patients with aplastic anemia(AA).Methods The 25 patients with AA were enrolled in the study according to the AA clinical diagnostic criteria(case group),who were redivided into three groups:ATG+CsA treatment group,CsA+danazol treatment group and danazol treatment group.The peripheral blood specimens were collected, and T-regs were counted by multi-color flow cytometry,moreover, the percentage of T-regs/CD+4T lymphocytes was calculated before and after treatment.The results were compared with those of healthy subjects(control group).Results The average T-regs values in case group were(3.45±1.33%),which were s(7.90±0.99%) in control group, there were significant differences between the two groups(P<0.01).After 3-month treatment the average T-regs values were significantly increased in case group(P<0.01),of whom, 13 patients showed no response,11 patients had partial response,and 1 patient had a complete response.The mean increase rate of T-regs values in response group was higher than that in no response group(P>0.05),and which was increased in the three treatment group,there was significant difference in the three groups before treatment and after treatment(P<0.01),however,there was no significant difference among the three groups(P>0.05).Moreover no significant predictive factors of T-regs value changes were found by univariate analysis.Conclusion T-regs play an important role in the pathophysiological process of AA,and androgen may have immunoregulation effects on T-regs.Danazol as a weakened androgen may have immunoregulation potential.

关 键 词：再生障碍性贫血 免疫机制 调节性T细胞 雄激素 

分 类 号：R556[医药卫生—血液循环系统疾病]