格林-巴利综合征急性期外周血T淋巴细胞亚群及NK细胞的检测

Analysis of T lymphocyte subsets and NK cells in peripheral blood at the acute stage of the Guillain-Barré syndrome

目的:检测格林-巴利综合征(Guillain-Barrésyndrome,GBS)患者急性期外周血中T淋巴细胞及其亚群和NK细胞的变化,并探讨GBS发病机制。方法:采集12名健康者及12例GBS急性早期患者的静脉血,肝素抗凝,荧光标记,流式细胞术检测活化性T细胞、CD4+T细胞、CD8+T细胞、活化性CD4+T细胞、调节性T细胞(Treg)、Th1和Th2数量及相对比例。结果:与对照组比较,GBS患者外周血中总的活化性T细胞、活化性CD4+T细胞及Th1细胞显著增高,Treg则明显降低,差异有统计学意义(P<0.01)。4例15天后复查(急性后期),Treg细胞、Th1细胞进一步降低,与急性早期相比差异有统计学意义(P<0.01和P<0.05)。结论:GBS患者急性早期机体免疫功能处于过度激活状态,免疫性病理损伤可能主要由Th1细胞介导。Treg所介导的免疫抑制功能减低,其与GBS发病及神经功能恢复的关系有待进一步探讨。

Objective：To determine the T lymphocyte subsets and natural killer（NK） cells in Guillain-Barr6 syndrome（GBS）, and to explore the pathogenic mechanism of GBS. Methods：Blood samples from 12 patients with GBS at the acute stage of their disease and from 12 healthy subjects were studied by flow cytometry to define the circulating T lymphocyte, CD4^＋T cells, CD8^＋T cells, activated T cells, regulatory T cells （Treg）, quantity of Thl and Th2 and their relative proportion. Results：The proportions of total activated T cells, its subset activated CD4 ＋ T cells and Thl cells were increased（ P 〈 0.01 ） compared with the healthy control, while the proportion of Treg was decreased（P 〈0.01 ）. Four of those 12 patients were detected again（ 15 days later） and the proportion of Treg at the lateacute stage of the disease was decreased（ P 〈 0.01 ） compared to the early-acute stage of the disease. The proportion of Thl cells during the late-acute stage of the disease was decreased （ P 〈 0.05 ） compared to the early acute stage of the disease. Conclusions ： The immune system in patients with GBS may be over-activated during the early acute stage of the disease. Immune injures in GBS may be induced by Thl cells. Treg-cell-induced immune suppression is attenuated, and its correlation with the pathogenic mechanism of GBS and the recovery of nerve function requires further study.