多发性硬化患者外周血和脑脊液淋巴细胞亚群的观察

Study of lymphocyte subpopulation in peripheral blood and cerebrospinal fluid in patients with multiple sclerosis.

用碱性磷酸酶抗磷酸酶法检测了４６例多发性硬化（ＭＳ）活动期患者外周血和脑脊液（ＣＳＦ）的淋巴细胞亚群。结果显示：活动期ＭＳ者外周血ＣＤ４＋、ＣＤ８＋细胞较对照组减少，ＣＤ２５＋细胞、ＣＤ４＋／ＣＤ８＋比值较对照组升高（Ｐ＜０．００１）。ＣＳＦ中ＣＤ４＋、ＣＤ２５＋细胞、ＣＤ４＋／ＣＤ８＋比值较对照组升高，ＣＤ８＋细胞降低（Ｐ＜０．００１），且ＣＳＦ中淋巴细胞亚群均高于自身外周血中的相应细胞（Ｐ＜０．００１）。此外，外周血、ＣＳＦ中ＣＤ２５＋细胞与患者功能障碍记分相关密切（ｒ＝０．８４，０．８６；Ｐ＜０．００１），而病初ＣＳＦ中ＣＤ４＋／ＣＤ８＋比值与患者病程及发病－缓解所需时间相关（ｒ＝０．７０，０．６４；Ｐ＜０．００１）。肾上腺皮质类固醇激素治疗后，随病情缓解，外周血。

We determined the counts of lymphocyte subpopulation in cerebrospinal fluid (CSF) and peripheral blood by using alkaline phosphatase anti alkaline phosphatase (APAAP) method in 46 patients with active stage multiple sclerosis (MS) and 51 cases control group.The results showed:In cases during exacerbation stage,in peripheral blood,the counts of CD4 +,CD8 + cells decreased, CD25 +cells,the CD4 +:CD8 +ratio increased ( P <0.01).In CSF,the counts of CD4 +,CD25 + cell,the CD4 +:CD8 + ratio was significantly higher than those in controls, CD8 + cells was lower than those in controls( P <0.001),and the counts of lymphocyte subpopulation in CSF was significantly higher than those in peripheral blood( P <0.001).There was significant correlation between the counts of CD25 + cells in peripheral blood and CSF and the disability status scale(DSS) (r=0.84,0.86; P <0.001).It was also found that the CD4 +:CD8 + ratio in CSF correlated with stadium and the duration of MS(r=0.70,0.64; P <0.001).After treatment with corticosteroid,the disease showed recovery,the counts of lymphocyte subpopulation in peripheral blood and CSF tented to normalize.