贫血患者外周血CD55^-和CD59^-细胞检测结果及其意义

Clinical detection and implications of CD55^- and CD59^- cell in the peripheral blood of anemia patients

目的 :检测贫血患者外周血中红细胞和中性粒细胞膜糖化磷脂酰肌醇 (GPI)连接的补体调节蛋白CD5 5和CD5 9表达情况 ,探讨其临床意义。方法 :采用荧光素标记的CD5 5和CD5 9单克隆抗体 ,流式细胞术检测 35例正常人、5例阵发性睡眠性血红蛋白尿症 (PNH)、32例再生障碍性贫血、4 7例小细胞低色素性贫血、10例巨幼细胞性贫血、12例自身免疫溶血性贫血和 15例造血系统肿瘤伴有贫血患者外周血中CD5 5 -和CD5 9-红细胞和中性粒细胞的百分率。结果 :正常人CD5 5 -、CD5 9-红细胞和中性粒细胞的百分率均 <5 % ,PNH患者均 >4 0 % ,部分再障患者 >5 % (均 <15 % )。约有 5 0 %的小细胞低色素贫血患者CD5 5 -、CD5 9-红细胞 >5 % (均 <15 % ) ,但中性粒细胞的结果全部正常。巨幼贫、自身免疫溶血性贫血和造血系统肿瘤伴有贫血患者的阴性红细胞和中性粒细胞比率均正常。结论 :利用流式细胞术同时检测外周血中CD5 5 -和CD5 9-红细胞和中性粒细胞是目前诊断PNH的最可靠 ,最敏感的方法 ,也可作为判断疗效的手段。

Objective:To detec the expression of membrane associated complement regulatory proteins (CRP) CD55 and CD59 on the peripheral blood cells cerythrocytes and neutrophils in patients with paroxysmal nocturnal hemoglobinuria (PNH), aplastic anemia, microcytic hypochromic anemia, macrocytic anemia, malignant clisorrtes of hematopoietic system with anemia and autoimmune hemolytic anemia, and analyze its clinical implications.Method:Fluorescence (PE and FITC) labeled anti-CD55 and anti-CD59 monoclonal antibodies are used in half flow cytometry.Result:All the ratios of CD55 -and CD59 - cells in 35 normal persons are less than 5%, but in excess of 40% in the 5 PNH patients. The results of some patients with aplastic anemia are more than 5%, but less than 15%. About half patients with microcytic hypochromic anemia having CD55 -and CD59 - erythrocytes are more than 5% (less than 15%), but their neutrophils are normal. The results of patients with macrocytic anemia; Malignant disorders of hematopoietic system with anemia and autoimmune hemolytic anemia are no more than 5%.Conclusion:Detection of CD55 -and CD59 - erythrocytes and neutrophils in the peripheral blood is a valuable and senstitive test in diagnosis and differential diagnosis of PNH, aplastic anemia and microcytic hypochromic anemia. It can be used to evaluate the curative effect of PNH.