再生障碍性贫血患者细胞因子水平观察

DETECTION OF CYTOKINES IN THE PATIENTS WITH APLASTIC ANEMIA

为进一步探讨细胞免疫对ＡＡ发病的影响，阐明细胞因子在ＡＡ患者中变化的基础与临床意义，采用酶联免疫试剂盒ＥＬＩＳＡ法对３８例ＡＡ患者及２０例正常人外周血单个核细胞（ＰＢＭＮＣ）培养上清诱生Ｇ－ＣＳＦ、ＩＬ－６、ＴＮＦα、ＩＦＮα及ＩＬ－８水平进行测定，同时采用改良ＡＰＡＡＰ法观察外周血Ｔ细胞亚群及ＨＬＡ－ＤＲ抗原表达。结果ＡＡ患者ＰＢＭＮＣ培养上清中Ｇ－ＣＳＦ阳性率减低，ＩＬ－６、ＴＮＦα、ＩＦＮα及ＩＬ－８水平增高，而且ＣＤ４细胞减低、ＣＤ８增高、ＣＤ４／ＣＤ８降低或倒置，ＨＬＡ－ＤＲ抗原表达率增高。相关分析发现Ｇ－ＣＳＦ与ＣＤ４及ＣＤ４／ＣＤ８呈正相关而与ＩＮＦα呈负相关，ＩＬ－６与ＷＢＣ及ＣＤ４呈负相关，ＴＮＦα与ＣＤ８呈正相关而与ＣＤ４／ＣＤ８呈负相关，ＩＬ－８与ＣＤ８及ＨＬＡ－ＤＲ呈负相关。证明了细胞免疫功能异常及细胞因子网络失调在ＡＡ发病中起重要作用，激活的ＣＤ８细胞可以抑制造血，且多种因素引起的细胞因子紊乱，最终引发ＡＡ。

To evaluate the effects of cell immune function and cytokines on the pathogenesis of aplastic anemia(AA)and the clinical significance,we examined G CSF,IL 6,TNFα,IFNα,IL 8 levels in the PBMNC culture supernatants and T lymphocyte subsets,HLA DR antigen in 38 AA patients and 20 normal persons,with ELISA and APAAP methods.Result:G CSF and CD 4 cell,CD 4/CD 8 in AA patients were lower,IL 6,TNFα,IFNα,IL 8 and CD 8, HLA DR were higher than that in normal control.The level of G CSF was positively associated with CD 4 CD 4/CD 8 and negatively asscociated with IFNα,IL 6 was negatively associated with WBC and CD 4,TNFα was positively correlated with CD 8 and negatively correlated with CD 4/CD 8.IL 8 was negatively correlated with CD 8 and HLA DR.This study provide evidence that the cell immune and cytokines participate in the pathogenesis of AA.