淋巴细胞亚群在鉴别低增生性骨髓增生异常综合征和再生障碍性贫血中的价值(英文)  

Deciphering Hypoplastic Myelodysplastic Sy ndrome and Aplastic Anemia via In-Depth A nalysis of Lymphocyte Subsets

作　　者：吴鸿飞 王世充 黄金波 霍佳莉 邵英起 任翔 李星鑫 王敏[1] 聂能 张静[1] 金朋 葛美丽 郑以州 WU Hong-Fei;WANG Shi-Chong;HUANG Jin-Bo;HUO Jia-Li;SHAO Ying-Qi;REN Xiang;LI Xing-Xin;WANG Min;NIE Neng;ZHANG Jing;JIN Peng;GE Mei-Li;ZHENG Yi-Zhou(State Key Laboratory of Experimental Hematology,National Clinical Research Center for Blood Diseases,Haihe Laboratory of Cell Ecosystem,Institute of Hematology&Blood Diseases Hospital,Chinese Academy of Medical Science&Peking Union Medical College,Tianjin 300020,China)

机构地区：[1]中国医学科学院血液病医院,北京协和医学院(中国医学科学院血液学研究所),实验血液学国家重点实验室,国家血液系统疾病临床医学研究中心,细胞生态海河实验室,天津300020

出　　处：《中国实验血液学杂志》2023年第4期1125-1132,共8页Journal of Experimental Hematology

基　　金：国家自然科学基金面上项目(81770119);中国医学科学院基金(2021-RW320-011)。

摘　　要：目的:探讨低增生性骨髓增生异常综合征(hypo-MDS)和再生障碍性贫血(AA)外周血淋巴细胞亚群及其他临床指标的差异。方法:应用流式细胞术检测hypo-MDS(n=25)和AA(n=33)患者的淋巴细胞亚群,同时分析两组间外周血象、生化指标、骨髓各细胞组分以及异常染色体的差异。结果:AA组CD8^(+)T细胞比例明显高于hypo-MDS组(P=0.001),而CD4^(+)T细胞比例和CD4^(+)/CD8^(+)比率明显低于hypo-MDS组(P=0.015;P=0.001)。与hypo-MDS组相比,AA组CD4^(+)、CD8^(+)活化T(TA)细胞及记忆Treg比例均明显下降(P=0.043;P=0.015;P=0.024),而AA组CD8^(+)初始T(TN)细胞比例较高(P=0.044)。与AA组相比,Hypo-MDS组外周血淋巴细胞数明显降低(P=0.025),总胆红素(TBil)、乳酸脱氢酶(LDH)、维生素B12水平及骨髓原始细胞比例均明显升高(P=0.019;P=0.023;P=0.027;P=0.045)。结论:AA组和hypo-MDS组CD4^(+)和CD8^(+)TA细胞、记忆Treg细胞及CD8^(+)TN细胞比例差异明显,可为鉴别这两种疾病提供重要依据。Objective:To explore the difference of lymphocyte subsets in peripheral blood(PB)between aplastic anemia(AA)and hypoplastic myelodysplastic syndrome(hypo-MDS)patients,meanwhile to compare the clinical parameters obtained from PB and bone marrow(BM).Methods:The lymphocyte subsets in hypo-MDS(n=25)and.AA(n=33)patients were investigated by flow cytometry.Meanwhile,the differences in PB cell counts,biochemical indicators,BM cell counts and abnormal chromosomes between the two groups were analyzed.Results:The percentage of CD8^(+)T cells in AA group was significantly higher than that in hypo-MDS group(P=0.001),while the percentage of CD4^(+)T cells and the CD4^(+)/CD8^(+)ratio in AA group were obviously lower than those in hypo-MDS group(P=0.015 and 0.001,respectively).Furthermore,the proportion of CD4^(+)and CD8^(+)activated T(TA)cells,and memory Tregs in AA group was distinctly lower than those in hypo-MDS group(P=0.043,0.015 and 0.024,respectively).Nevertheless,the percentage of CD8^(+)naive T(TN)cells in AA patients was remarkably higher(P=0.044).And hypo-MDS patients had declined lymphocyte counts(P=0.025),increased levels of total bilirubin(TBil),lactate dehydrogenase(LDH),vitamin B12 and proportion of BM blasts than AA patients(P=0.019,0.023,0.027 and.0.045,respectively).Conclusion:In this study it was confirmed that the percentages of CD4^(+)and CD8^(+)TA cells,memory Tregs and CD8^(+)TN cells were significantly different between AA and hypo-MDS patients,which provide an essential basis for the identification of these two diseases.

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 流式细胞术 

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