选择性IgA缺乏症患者细胞免疫活性分析

ANALYSIS OF CELLULAR IMMUNOACTIVITY ON SELECTIVE IgA DEFICIENCY

目的 探讨选择性IgA缺乏症 (SelectiveIgADeficiency ,SIgAD)患者的细胞免疫功能 ,指导临床诊断与治疗。 方法 以激光比浊法测定患者血清IgG、IgA、IgM水平 ,以银染法检测外周血T淋巴细胞增殖活性 ,以单抗花环法检测T淋巴细胞亚群水平 ,以ELISA法检测血清中干扰素 -γ(IFN -γ)、白细胞介素 - 4 (IL - 4 )水平来评价辅助性T细胞亚群活性。结果 ① 2 2例IgA水平低于 0 .1 g/L而IgG、IgM基本正常的患者 ,CD3、CD4、CD8计数与正常对照组之间差异无统计学意义 (P >0 .0 5) ,CD4/CD8比值显著低于正常对照组 ,差异有统计学意义 (P <0 .0 5) ;②T淋巴细胞增殖活性 (I .S % )为 (4.75± 1 .1 7) % ,与对照组比较明显降低 ,差异有统计学意义 (P<0 .0 1 ) ;③SIgAD患者血清IL - 4水平与正常对照组比较显著降低 ,差异有统计学意义 (P <0 .0 5) ,IFN -γ分泌无明显变化。 结论 ①选择性IgA缺乏症患者细胞免疫活性低于正常水平 ;②IL - 4分泌水平降低 ,提示Th2类活性降低 ,在选择性IgA缺乏相关疾病中存在Th1 /Th2的不平衡。

Objective To investigate the cellular immunoactivity in patients with selective IgA deficiency. Methods Laser nephelometery was emploied to detect serum IgG、IgA、IgM, silver staining to the proliferous activity of lymphocyte, rosette formation test to T lymphocytes subsets, and ELISA to IFN-γ、IL-4 serum level for evaluating T cell subsets. Results ①In 22 patients with IgA levels lower than 0.1g/L and IgG、IgM level normal,there had no significant difference in CD3、CD4、CD8 counting between two groups,while CD4/CD8 was significantly lower than normal;②T lymphopoiesis activity was ( 4.75±1.17)%,which was significantly lower than normal control;All of them had normal serum IFN-γlevel and lower serum IL-4 level. Conclusion ①The cellular immunoactivity is lower than normal in selective IgA deficiency patients;②IL-4 level is lower,which shows that there are lower Th2 activity and Th1/Th2 imbalance in patients with selective IgA deficiency and relative diseases.