期刊文献+

再生障碍性贫血患者T细胞亚群检测的临床意义 被引量:33

Clinical Significance of Detection of T-cell Subgroups in Patients with Aplastic Anemia
下载PDF
导出
摘要 本研究探讨再生障碍性贫血(AA)患者外周血T细胞亚群的变化及其与AA发病、免疫抑制治疗之间的关系;为AA患者合理选择治疗方案提供依据。以88例临床确诊为AA、并分别接受常规和常规联合免疫抑制治疗的患者为对象,采用三色免疫荧光抗体标记法和流式细胞术检测外周血T淋巴细胞亚群及CD4+和CD8+比值,参考正常对照组水平将患者分为比值正常型、比值倒置型和比值超高型3个免疫亚型,分析和比较各亚型与病情、疗效之间的关系。结果表明:CD4+/CD8+比值正常型占39.8%、比值倒置型占44.3%、比值超高型占15.9%。免疫亚型、治疗方法与总有效率的关系为:单独常规治疗时,3个亚型组之间疗效无明显差异;当联合免疫抑制治疗时,比值正常型患者的总有效率与常规治疗相比无显著改变,而比值倒置型及免疫异常型(比值倒置型+比值超高型)患者有效率较同组常规治疗疗效均显著提高(84.2%vs45.5%及82.6%vs42.8%,p值均<0.05),也显著高于比值正常型患者(84.2%及82.6%vs52.6%,p值均<0.05)。结论:大多数AA患者存在严重的CD4+和CD8+比值失调,CD4+/CD8+异常既可表现为降低,也可以是异常增高,AA发病机制与免疫异常有密切相关性;T细胞亚群检测对临床了解病情和发病机制、合理选择治疗方案、提高诊断和治疗水平具有重要价值。 The study was aimed to investigate the changes of T-cell subgroups in the peripheral blood ( PB ) of patients with aplastic anemia (AA) and the relationships between these changes and the pathogenesis of AA and the immunosuppressive therapeutic effects in AA, in order to provide a basis for selecting rational therapy of AA patients. T-cell subtype and the ratio of CD4^+/CD8^+ cell in the PB of 88 AA patients which had been diagnosed clearly and given conventional therapy or conventional therapy combined with immunotherapy were analyzed by tri-colour fluorescence -labeled monoclonal antibody and using multiparameter flow cytometry. The patients with AA were divided into normal type of ratio, inverted type of ratio, hypernormal type of ratio according to the ratio of CD4 ^+/CD8 ^+ cell in normal group, and then the relations of these subtype with patients'conditions and therapeutic effects were investigated. The resuits showed that the percentage of normal type of ratio in all patients was 39, 8%, the percentage of inverted type of ratio in all patients was 44, 3%, The percentage of hypernormal type of ratio in all patients was 15, 9%, In the conventional therapy alone, there was no significant difference on therapeutic effects among these three immunological subtypes. In combined immunotheray, total therapeutic effecacy of AA patients with inverted type of ratio and AA patients with immunologic abnormality ( inverted type + hypernormal type) was 84, 2% and 82.6% respectively, which were more than that in conventional therapy (45, 5% and 42, 8% ) (p 〈0, 05), Total therapeutic effecacy in these patients was better than that in AA patients with normal type, It is concluded that significant abnormal ratios of CD4 ^+/CD8 ^+ exist in the majority of AA patients, abnormal ratios of CD4 ^+/CD8 ^+ both may be showed as increase or decrease, immunologic abnormality may play a role in pathogenesis of the patients with AA, The detection of PB T-cell subtype in patients with aplastic anemia contributes to evaluation of patients'condition and choice of rational treatment prescription, and enhanement of diagnostic level and therapeutic efficacy significantly, which is an important indicator for therapeutic strategy also,
出处 《中国实验血液学杂志》 CAS CSCD 2007年第5期1046-1049,共4页 Journal of Experimental Hematology
基金 安徽省卫生厅科研基金项目 编号2006-2007 06B030
关键词 再生障碍性贫血 免疫异常 T细胞亚群 CD4 CD8 aplastic anemia immunologic abnormality T-cell subgroup CD4, CD8
  • 相关文献

参考文献9

二级参考文献48

  • 1赵春华,蒋本荣.可溶性CD8抗原检测方法建立及其在再生障碍性贫血...[J].中华血液学杂志,1993,14(4):171-173. 被引量:3
  • 2谭柏林,黎盛蓉,李学渊,谢兆霞,陈方平.特发性血小板减少性紫癜患者白介素-2及T细胞亚群[J].临床血液学杂志,1994,7(1):17-19. 被引量:3
  • 3郑以州.抗淋巴细胞球蛋白/抗胸腺细胞球蛋白治疗严重型再生障碍性贫血的现状[J].国外医学(输血及血液学分册),1996,19(2):65-68. 被引量:4
  • 4叶红英.自身免疫性甲状腺疾病的T淋巴细胞亚群异常[J].国外学者来访报告,1996,16(3):46-48. 被引量:5
  • 5Bacigalupo A, Brand R, Oneto R, et al. Treatment of acquired severe aplasic anemia:bone marrow transplantation compared with immunosuppression therapy -the European Group of Blood and Marrow Transplantation experience. Semin Hematol, 2000; 37:69 - 80.
  • 6Frickhofen N, Rosenfeld SJ. Immunosuppressive treatment of aplastic anemia with antithymocyte globulin and cyclosporine. Semin Hematol, 2000; 37:56-68.
  • 7Killick SB, Marsh JC, Gordon-Smith EC, et al. Effects of antithymocyte globulin on bone marrow CD34^+ cells in aplastic anemia andmyelodysplasia. Br J Haematol, 2000; 108:582 - 591.
  • 8Killick SB, Cox CV , Marsh JCW, et al. Mechanisms of bone marrow progenltor cell apoptosis in aplastic anemia and the effect of antithymoeyte globulin: examination of the role of the Fas-Fas-L interaction. Br J Haematol, 2000; 111:1164 - 1169.
  • 9rickhofen N, Kaltwasser JP, Schrezenmeier H, et al. Treatment of aplastic anemia with antilymphocyte globulin and methylprednisolone with or without cyclosporine. N Engl J Med, 1991; 324:1297 -1304.
  • 10Rosenfeld S J, Kimball J, Vining D, et al. Intensive immunosuppression with antithymocyte globulin and cyclosporine as treatment for severe acquired aplastic anemia. Blood, 1995; 85:3058 - 3065.

共引文献51

同被引文献371

引证文献33

二级引证文献215

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部