慢性再生障碍性贫血患者共刺激分子及Fas表达与中医辨证分型的关系

Relationship between Expression of CD_(28) and Fas and TCM Differenciation Type in Patients with Chronic Aplastic Anemia

目的:探讨慢性再生障碍性贫血(chronic aplastic anemia,CAA)患者外周血共刺激分子CD28及Fas的表达与中医辨证分型的关系。方法:采用流式细胞仪技术,分别测定CAA患者45例、健康对照人群20名的外周血T细胞CD4+及CD8+中共刺激分子CD28及Fas分子表达水平。结果:①CAA组患者与健康对照组相比较,CD2+8、CD8+CD2+8/CD8+CD2+8(P<0.05)及CD4+CD2+8/CD4+CD2-8(P<0.01)、CD8+CD2+8均明显升高(P<0.001),CD9+5、CD3+CD9+5、CD8+CD9+5低于健康对照组(P<0.05)。②肾阴虚与肾阳虚组相比较,肾阴虚组共刺激分子高表达更明显,两组CD2+8、CD3+CD2+8、CD4+CD2+8、CD8+CD2+8比较均具显著差异(P<0.001),两证型CD4+CD2+8/CD4+CD2-8、CD8+CD2+8/CD8+CD2-8相比肾阴虚组数值升高明显(P<0.05);两组CD9+5、CD3+CD9+5指标差异显著(P<0.01),肾阴虚组异常更甚,两证型间CD4+CD9+5、CD8+CD9+5亦有差别(P<0.05)。结论:①CAA患者外周血共刺激分子CD28异常高表达,Fas下降,提示CD28、Fas失调可能在CAA免疫发病中起重要作用。②CAA患者外周血CD28,Fas的表达水平测定可以作为CAA辨证分型的参考指标,肾阴虚患者的免疫紊乱较肾阳虚患者严重。

Objective： To discuss relationship between the Expression of CD28 and Fas and TCM Differenciation Type in Patients with Chronic Aplastic Anemia. Methods ： Using flow cytometry to detect the CD28 and Fas expression in 45 in - patients or out - patients and 20 healthy subjects for control , and to discuss the relationship between TCM Differentiation Type in Patients with Chronic Aplastic Anemia and the Expression of CD28 and Fas. Results ： ① The level of the expressions of CD28^＋, CD8^＋ CD28^＋/ CD8^＋ CD28^-（ P 〈0.05）, CD4^＋CD28^＋/CD4^＋ CD28^- （ P 〈 0.01 ）, CD8^＋ CD28^＋in the CAA patients are higher than the normal contrast group;While CD95^＋ ,CD3^＋ CD95^＋ ,CD8^＋ CD95^＋ is lower（ P 〈0.05）. ②Compared with the yang - deficiency group, the level of the expressions of yin - deficiency group of CD28^＋, CD3^＋ CD28^＋, CD4^＋ CD28^＋, CD8^＋ CD28^＋ （ P 〈 0. 001 ）, CD4^＋ CD28^＋/CD4^＋ CD28^-, CD8^＋ CD28^＋/ CD8^＋; CD28^-（ P 〈0.05）are higher;While CD95^＋ ,CD3^＋ CD95^＋; ,CD4^＋ CD95^＋ ,CD^8 CD95^＋ are lower （ P 〈0.01 ）. Conclusion： The abnormal expression of Co - stimulatory molecule CD28 and Fas in the peripheral blood of CAA patients suggested CD28 and Fas disorder may play an important role in immuno - pathogenesis of CAA , and contribute to the differentiation of syndrome types and serve as the guideline of the effect of treatment and prognosis; The abnormality of the Co -stimulatory molecule and CD95 of kidney yin- deficiency patients are worse, which indicates the seriousness of the disease.