吉兰-巴雷综合征患者外周血记忆性T细胞和记忆性B细胞亚群的变化及其临床意义  

Changes and clinical significance of memory T cells and memory B cell subsets in peripheral blood of patients with Guillain-Barrésyndrome

作　　者：刘坛 黄小雨 张勇 LIU Tan;HUANG Xiaoyu;ZHANG Yong(Department of Neurology,the First People’s Hospital of Huzhou,Huzhou 313000,Zhejiang,China;Department of Neurology,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,Jiangsu,China)

机构地区：[1]湖州市第一人民医院神经内科,浙江湖州313000 [2]徐州医科大学附属医院神经内科,江苏徐州2210001

出　　处：《中国现代医生》2024年第6期54-57,66,共5页China Modern Doctor

摘　　要：目的探讨吉兰-巴雷综合征(Guillain-Barrésyndrome,GBS)患者外周血记忆性T细胞和记忆性B细胞亚群的变化及其临床意义。方法选取2018年6月至2020年12月于徐州医科大学附属医院神经内科住院的16例GBS患者作为研究组,并选取同期16名来院的健康体检者作为对照组。流式细胞术检测两组入选者的外周血T细胞亚群,包括CD4^(+)初始T细胞(naive T cells,TN)、CD4^(+)中央记忆性T细胞(central memory T cells,TCM)、CD4^(+)效应记忆性T细胞(effector memory T cells,TEM)和CD4^(+)终末分化效应记忆性T细胞(terminally differentiated effector memory T cells,TEMRA)及记忆性B细胞、浆母细胞的占比并分析其临床价值。结果与对照组相比,研究组患者的CD4^(+)TN及CD8^(+)TN均明显下降(P<0.05),CD4^(+)TEM及CD8^(+)TEM均明显升高(P<0.05),TCM及TEMRA在CD4和CD8上的比例比较,差异无统计学意义(P>0.05)。与对照组相比,研究组记忆性B细胞比例明显升高(P<0.05),两组患者间浆母细胞占比比较,差异无统计学意义(P>0.05)。GBS患者外周血CD4^(+)TEM及CD8^(+)TEM占比与Hughes残疾评分、脑脊液蛋白、脑脊液免疫球蛋白G及记忆性B细胞占比均呈正相关(P<0.05)。结论GBS患者存在记忆性T细胞和记忆性B细胞亚群免疫紊乱,CD4^(+)TEM细胞、CD8^(+)TEM细胞及记忆性B细胞占比升高,这很可能是GBS发病过程中重要的外周免疫机制。Objective To investigate the changes of memory T cells and memory B cells subsets in peripheral blood of patients with Guillain-Barrésyndrome(GBS)and their clinical significance.Methods A total of 16 patients with GBS who were hospitalized in the Department of Neurology,Affiliated Hospital of Xuzhou Medical University from June 2018 to December 2020 were selected as the research group,and 16 healthy people who came to the hospital for physical examination during the same period were selected as the control group.The proportion of CD4^(+)naive T cells(TN),CD4^(+)central memory T cells(TCM),CD4^(+)effector memory T cells(TEM),CD4^(+)terminally differentiated effector memory T cells(TEMRA),memory B cells and plasmacytocytes in peripheral blood of the two groups was detected by flow cytometry and its clinical value was analyzed.Results Compared with the control group,CD4^(+)TN and CD8^(+)TN were significantly decreased in research group(P<0.05),while CD4^(+)TEM and CD8^(+)TEM were significantly increased in research group(P<0.05).There was no significant difference between TCM and TEMRA in the proportion of CD4 and CD8(P>0.05).Compared with the control group,the proportion of memory B cells in the GBS group was significantly increased(P<0.05),while the proportion of plasmabytes was not significantly different.The percentages of CD4^(+)TEM and CD8^(+)TEM in peripheral blood of GBS patients were positively correlated with Hughes disability score,cerebrospinal fluid protein,cerebrospinal fluid immunoglobulin G and memory B cells(P<0.05).Conclusion There are immune disorders of memory T cells and memory B cells subsets in patients with GBS.The increased proportion of CD4^(+)TEM cells,CD8^(+)TEM cells and memory B cells may be a peripheral immune mechanism in the pathogenesis of GBS.

关 键 词：吉兰-巴雷综合征 效应记忆性T细胞 记忆性B细胞 

分 类 号：R743.3[医药卫生—神经病学与精神病学]