十二指肠球部溃疡患者红细胞免疫功能与T细胞亚群的变化

Variation of erythrocyte immunity and T lymphocyte subsets in patients with duodenal ulcer

探讨幽门弯曲菌 (Helicobaclerpylori,Hp)阳性的十二指肠球部溃疡 (DU)患者红细胞免疫和T细胞亚群的变化及其相关关系。应用免疫黏附法和SAP法对 4 0例Hp阳性、6例Hp阴性的DU患者红细胞免疫活性 (RBC C3bRR、RBC ICR和RBC TRR)和外周血T细胞亚群 (CD3+ 、CD4 + 、CD8+ 和CD4 + /CD8+ )进行了检测。结果发现Hp阳性DU患者RBC C3bRR、RBC TRR、CD3+ 、CD4 + 和CD4 + /CD8+ 较Hp阴性患者无明显降低。Hp阳性的DU患者RBC C3bRR、RBC TRR、CD3+ 、CD4 + 和CD4 + /CD8+ 显著低于健康对照组 (P <0.0 1) ,而RBC ICR和CD8+ 显著高于对照组(P <0.0 1)。Hp阳性的DU患者疗程结束后 ,38例Hp被根除 ,根除率为 95 %。Hp根除且溃疡愈合者为 35例 ,愈合率为 86 % ,其红细胞免疫功能和T细胞亚群基本恢复正常。Hp根除但溃疡未愈合者 11例 ,溃疡愈合但Hp未根除者 2例 ,其红细胞免疫功能和T细胞亚群均有所改善。此外 ,红细胞免疫功能 (RBC C3bRR和RBC TRR)与T细胞亚群 (CD4 + /CD8+ )的变化呈明显正相关 (P <0.0 5 )。因此 ,红细胞免疫与T细胞亚群可能均参与了DU的发生、发展和转归。

To research the variation of erythrocyte immunity and T lymphocyte subsets and their relationship in patients with Hp + duodenal ulcer. In 40 cases of Hp + duodenal ulcer,6 cases of Hp - duodenal ulcer, and 32 normal people, RBC-C 3bRR, RBC-ICR and RBC-TRR were tested by immune adherence rosette method. T lymphocyte subsets were tested by SAP assay. The results showed that the percentage of RBC-C 3bRR, RBC-TRR, CD3 +, CD4 + and the CD4 +/CD8 + ratio were slightly lower in the duodenal ulcer with Hp + group than in the duodenal ulcer with Hp - group. The value of RBC-C 3bRR and RBC-TRR, the percentage of CD3 +, CD4 + and the CD4 +/CD8 + ratio were significantly lower in the duodenal ulcer with Hp + group as compared with the control subjects (P<0.01). RBC-ICR and the percentage of CD8 + were significantly increased in the duodenal ulcer with Hp + group(P<0.01). In the duodenal ulcer with Hp + group, Hp of 38 cases of patients was deracinated after treament. The rate of deracinating was 95%. There were 35 cases with neither Hp nor ulcer after treament. The rate of healing was 86%. Their erythrocyte immunity and T lymphocyte subsets resumed nearly normal. There were 11 cases without Hp with ulcer and 2 cases with Hp without ulcer after treament. Their erythrocyte immunity and T lymphocyte subsets resumed in some extent. The CD4 +/CD8 + ratio were significantly correlated with the value of RBC-C 3bRR and RBC-TRR in all groups(P<0.05). It is concluded that erythrocyte immunity and T lymphocyte subsets may play an important role in the occurrence, development and the outcome of the duodenal ulcer. DU and Hp may incur the dysfunction of the cell immune function together.