细胞因子对再生障碍性贫血患者发病的影响

EFFECT OF CYTOKINES ON THE PATIENTS WITH APLASTIC ANEMIA

为探讨ＡＡ的免疫发病机制，阐明细胞因子在ＡＡ患者中变化的基础与临床意义，应用ＥＬＩＳＡ法及ＡＰＡＡＰ法对３８例初治ＡＡ患者及２０名正常人外周血单个核细胞（ＰＢＭＮＣ）培养上清诱生的Ｇ－ＣＳＦ、ＩＬ－６、ＴＮＦα、ＩＦＮα及ＩＬ－８进行检测，同时观察外周血象、Ｔ细胞亚群及ＨＬＡ－ＤＲ表达。结果：ＡＡ患者外周血ＣＤ４减低，ＣＤ８增高，ＣＤ４／ＣＤ８减低或倒置，ＨＬＡ－ＤＲ抗原表达率增高。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。Ｇ－ＣＳＦ与ＣＤ４及ＣＤ４／ＣＤ８呈正相关而与ＩＦＮα呈负相关，ＩＬ－６与白细胞数及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，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,T lymphocte subsets,HLADR antigen and GCSF,IL6,TNFα,IFNα,IL8 in the PBMNC culture supernatants in 38 AA patients and 20 normal persons were examined with APAAP and ELISA methods.CD4 cell,CD4/CD8 and GCSF in AA patients were lower,CD8,HLADR and IL6,TNFα,IL8 were higher than that of normal control.The level of GCSF was positively associated with CD4,CD4/CD8 and negatively associated 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 with CD8 and HLA-DR.The study provide envidence that the cell immune and cytokines anticipate in the pathogenesis of AA.