大骨节病患者淋巴细胞亚群及sIL-2R的检测意义  

Study of lymphocyte subsets in PBMC and serum sIL-2R in children with Kashin-Beck disease

作　　者：王治伦[1] 郭汝宁[1] 陈静宏[1] 杨占田[1] 薛莉[1] 

机构地区：[1]西安交通大学医学院地方病研究所,陕西西安710061

出　　处：《中国地方病学杂志》2003年第3期214-216,共3页Chinese Jouranl of Endemiology

基　　金：国家自然科学基金资助项目 (3 9770 667) ;陕西省自然科学研究计划项目 (2 0 0 1SM82 )

摘　　要：目的　探讨大骨节病患者外周血淋巴细胞分布形式、血清可溶性白细胞介素 - 2受体 (s IL- 2 R)及其与硒的相关性。方法　在大骨节病病区随机选取经 X线和临床检查确诊的大骨节病儿童 ,同时在该病区和非病区分别选取健康儿童作为对照组。采用单克隆抗体 (抗 CD4 ,CD8)免疫细胞组化法检测淋巴细胞亚群。s IL- 2 R的测定采用双抗体夹心 EL ISA法。结果　大骨节病病区儿童外周血单核细胞 (PBMC)中 CD4 +、CD8+率显著低于非病区水平 (P <0 .0 5 ) ,CD4 / CD8各组间没有差异 (P >0 .0 5 )。患儿组血清 s IL- 2 R水平显著高于非病区水平 (P =0 .0 38)。病区健康儿童组较非病区有升高趋势 ,但差异无显著意义。另外 ,病区儿童红细胞硒水平仍显著低于非病区 (P <0 .0 0 1)。相关分析表明 ,红细胞硒水平与 CD4 +率呈典型正相关 (r=0 .6 2 5 ,P <0 .0 5 ) ,与血清 s IL-2 R水平则无明显相关关系。结论　大骨节病病区儿童外周血处于一种免疫抑制状态 ,以 CD4 + 、CD8+ 比例的减少尤为明显。硒通过影响 PBMC中 T淋巴细胞亚群的分布形式从而在这种免疫紊乱中发挥了重要作用。建议把血清 s IL - 2 R的测定作为检出大骨节病儿童的一种参考指标。Objective To investigate the distribution pattern of lymphocyte subsets of peripheral blood nuclear cells (PBMC), serum soluble interleukin-2 receptor (sIL-2R), and erythrocyte selenium in patients with Kashin-Beck disease (KBD).Methods Children with KBD in KBD affected ared (KAA) were randomly selected, as controls, children with similar age range and sex ratio in KAA and KBD non-affected area (KNAA) were also included. Immunohistochemistry analysis with monoclonal antibody anti-CD4, anti-CD8 was used to detect the PBMC lymphocyte subsets. Determination of serum sIL-2R level was measured by double-antibody enzyme-linked immunosorbant test (ELISA), and 2,3-naphthyl fluorescence assay for erythrocyte selenium.Results CD4 + and CD8 + percentages in KAA were significantly lower than those in KNAA ( P <0.05). No difference was found in CD4/CD8 ratio. Children with KBD had a noted higher level of serum sIL-2R compared to that in KNAA ( P =0.038), and those without KBD in KAA also showed an increasing trend, though not statistically significant. In addition, Erythrocyte selenium level in KAA is still much lower than in KNAA ( P <0.001). Correlation analysis showed, erythrocyte selenium level had a strong association with CD4 + percentage ( r = 0.625 , P <0.05), whereas no relationship detected with serum sIL-2R.Conclusions Cellular immunity of peripheral blood in children of KAA was in a state of immune suppression, manifested by the marked depression of CD4 +, and CD8 + percentage. Of this immune disorder, selenium deficiency play a critical part via effecting on the distribution pattern of PBMC lymphocyte subsets. Serum sIL-2R can be implied as a referential marker of KBD patients.

关 键 词：大骨节病 淋巴细胞亚群 SIL-2R 检测意义 外周血 双抗体夹心ELISA法 儿童 

分 类 号：R684.1[医药卫生—骨科学]