重型再生障碍性贫血和骨髓增生异常综合征骨髓中T辅助细胞亚群的变化

Changes of Th Cell Subsets in Bone Marrow of Patients with Severe Aplastic Anemia and Myelodysplastic Syndrome

为研究SAA和MDS骨髓Th细胞亚群的数量及比例改变情况。用FACS同期对照研究 16例正常对照组、 2 4例发病期SAA、 15例MDS骨髓Th细胞的改变。结果显示 ,正常对照组Th1、Th2细胞及Th1/Th2为 :0 33%、 0 34%、 1 0 0 ,发病期SAA为 :4 4 2 %、 0 4 0 %、 10 5 7,恢复期SAA为 :0 39%、 0 2 0 %、 0 92 % ,MDS为 :0 4 1%、 0 5 7%、 0 75。发病期SAA的Th1、Th2细胞均显著增高 (P <0 0 1、 0 0 5 ) ,Th1/Th2显著向Th1偏移 (P <0 0 1) ;恢复期SAA与正常对照基本相当 (P>0 0 5 )。与正常对照组比较 ,MDS组的Th1细胞未升高 (P >0 0 5 ) ,亦显著低于发病期SAA组 (P <0 0 1) ,虽然Th2细胞升高 ,但无统计学意义 (P >0 0 5 ) ,但Th1/Th2比值降低 (P <0 0 5 ) ,向Th2偏移。SAA的发病可能由于Th1细胞增多 ,Th2细胞代偿不足 ,Th1/Th2向Th1偏移 ;MDS骨髓Th1细胞改变不显著 ,Th2有增多的趋势 。

To investigate the quantity and ratio of Th1 and Th2 cells in bone marrow of patients with severe aplastic anemia(S) and myelodysplastic syndrome(MDS), the Th cells in bone marrow from 16 healthy individuals, 24 cases with S in acute phase, 15 cases of S at recovery phase and 15 cases of MDS were measured by means of FACS. It was found that the percentages of Th1 and Th2 cells and the Th1/Th2 ratios in normal control were 0.33%, 0.34%, and 1.00 respectively, and they were 4.42%, 0.40% and 10.57 in cases of S in acute phase; 0.39%, 0.20% and 0.92 in cases of S at recovery phase; 0.41%, 0.57% and 0.75 in cases of MDS respectively. It indicated the percentages of Th1 and Th2 cells were significantly higher in patients with S at acute phase than those in normal controls and the Th cells shifted to the Th1 phenotype significantly. The values of cases with S at recovery phase were more or less corresponded to those of the normal controls. In case of patients with MDS, there was no increase of Th1 cell percentage, and also the percentages of Th1 cells were significantly lower than those of cases with S at acute phase. Although there was no significant difference in the percentages of Th1 and Th2 cells between patients with MDS and normal controls, the balance of Th1/Th2 shifted to the Th2 phenotype. In conclus ion, the pathogenesis of S might be associated with the increased numbers of Th1 cells with un-sufficient compensation of Th2 cells. The balance of Th cells shifted to Th2 in cases of MDS.