儿童再生障碍性贫血骨髓祖细胞的测定和意义

Significance and Detection of Hematopoietic Progenitor Cells in Aplastic Anemia of Childhood

目的通过对再生障碍性贫血 (AA)患儿红系 (BFU E、CFU E)、粒单核系 (CFU GM)及巨核系 (CFU Meg)祖细胞培养 ,了解骨髓祖细胞增殖情况。方法抽取 4 7例AA患儿骨髓分别作四类祖细胞培养 ,在 7、14d测定其集落数。结果 4 7例AA患儿中 ,四类集落数均值与对照组比较均有显著下降 (P <0 .0 5 ,P <0 .0 1) ,且四类集落数均值在AA三种类型中 ,基本上随病情加重均值逐步下降 ,其中四类集落数低于对照组下限的患儿分别为BFU E 36 .17%、CFU E 85 .11%、CFU GM 74 .4 7%、CFU Meg 91.4 9 %。BFU E、CFU GM和CFU Meg随着患儿疾病的加重 ,低于对照组下限的患儿百分比同步上升 ,且三者的表现与外周血三系表现一致 ,而CFU E却未见上述现象。结论在部分AA患儿中存在着四类祖细胞培养集落数的下降 ,且基本上与患儿病情成正比 ;BFU E的变化较CFU E更能代表患儿骨髓红系祖细胞的变化。

Objective To learn hematopoietic progenitor cells (HPC) proliferation though detection of BFU-E,CFU-E,CFU-GM and CFU-Meg by HPC culture of bone marrow (BM) from children with aplastic anemia (AA). Methods To detect clone formation unit (CFU) of BFU-E,CFU-E,CFU-GM and CFU-Meg at 7 d or 14 d after cellular culture from 47 children with AA. Results The mean values of four different colonies in 47 patients were significantly lower than those of the control BM. Meanwhile, the mean decrease of these colonies was positively correlated with the severity of the types of diseases. Among 47 patients, the CFU counts of BFU-E (36.17%),CFU-E (85.11%),CFU-GM(74.47%) and CFU-Meg(91.49%) were lower than those of the control. The CFU number of the patients with their BFU-E,CFU-GM and CFU-Meg lower than the donors were positively correlated with the severity of the disease and the decrease of their peripheral blood cells, but not with CFU-E. Conclusion A portion of children with AA have lower quantities of BFU-E,CFU-E,CFU-GM and CFU-Meg, and the quantitive decrease in these colonies is positively correlated with severity of the disease. The change of BFU-E, compared with the change of CFU-E, could represent erythroid proliferation of BM in children with AA.