自身免疫性血细胞减少症患者骨髓CD_5^+B细胞数量变化及其临床意义

CD^+_5B lymphocytes in the bone morrow of autoimmunic hemocytopenia patients and its clinical significance

目的探讨自身免疫性血细胞减少症患者骨髓CD5+B细胞数量及其临床意义。方法2001-032002-04对中国医学科学院血液病医院的住院患者14例检测自身免疫性溶血性贫血(AIHA)和Evans综合征和22例免疫相关性全血细胞减少症(IRP)及10名正常对照骨髓CD5+B细胞数量并与临床及实验室指标做相关分析。结果AIHA、Evans综合征和IRP患者CD5+B细胞数量[(34·64±9·81)%,(35·81±16·83)%]高于正常人[(12·0±1·97)%],(P<0·05),CD5+B细胞的数量与补体C3呈负相关(P<0·05),与间接胆红素呈正相关(P<0·05);与Evans综合征患者血小板抗体PAIgG(P<0·05)、PAIgM(P<0·05)呈正相关;与临床疗效呈负相关(P<0·05)。结论CD5+B细胞在自身免疫性血细胞减少症的发病机制中可能具有重要意义。

Objective To investigate the quantitative abnormality of CD5^＋ B lymphocytes in the bone morrow of the patients with autoimmunic hemocytopenia and its clinical significance. Methods The patients were referred to the Institute of Hematology ＆ Blood Diseases Hospital, Chinese Academy of Medical Sciences ＆ Peking Union Medical College. Quantities of CD5^＋B lymphocytes in the bone morrow of 14 patients with autoimmune hemolytic anemia （AIHA） or Evans syndrome, 22 immunorelated pancytopenia （IRP） patients and 10 normal controls were assayed by FACS. The correlation between their clinical and laboratory parameters with CD5^＋B lymphocytes was analyzed. Results The qutantity of CD5^＋B lymphocytes were significantly higher in AIHA and Evans and IRP patients than in normal controls; there was no significant difference between AIHA, Evans syndrome and IRP patients. The qutantity of CD5^＋B lymphocytes in the bone morrow of all cytopenic patients showed negative correlation with C3 complement. In AIHA, Evans syndrome patients, the quantity of CD5^＋B lymphocytes in their bone morrow showed positive correlation with IBIL. In Evans syndrome patients, the quantity of CD5^＋B lymphocytes in their bone morrow showed positive correlation with PAIgG and PAIgM. The qutantity of CD5^＋B lymphocytes in the bone marrow of all cytopenic patients showed negative correlation with treatment response, but no correlation with the yields of CFU - E, BFU - E, CFU - F and CFU - GM cultured from their bone marrow mononuclear cells in vitro. Conclusion CD5^＋ B lymphocytes in the bone marrow of the patients with autoimmunic hemocytopenia significantly increase and are related to the disease severity and clinical response. It is suggested that CD5^＋B lymphocytes might have important roles in the pathogenesis of autoimmunic cytopenia.