骨髓增生异常综合征患者免疫异常90例分析

Analysis of immunological abnormalities in 90 patients with myelodysplastic syndrome

目的 探讨ＭＤＳ患者的免疫异常。方法 对９０ 例ＭＤＳ患者的Ｉｇ、ＲＦ、ＣＩＣ、直接Ｃｏｏｍｂｓ 试验及其它自身抗体（ 包括抗ＳＳＡ、ＳＳＢ、Ｓｍ 、ＲＮＰ、ＡＮＡ、ＤＮＡ 抗体） 的检查结果进行总结分析。结果 发现２９ 例（３２．２ ％） 患者至少有一项免疫异常。其中Ｉｇ 升高者２０ 例（２２．２％ ），降低者９ 例（１０ ％ ）。ＣＩＣ、ＲＦ 或直接Ｃｏｏｍｂｓ 试验阳性者分别有６ 例（６．７％ ） 、２ 例和２ 例（２．２ ％） 。未发现其它自身抗体阳性的患者。免疫异常者的年龄及性别分布有明显的统计学差异（ Ｐ值分别＜０．０５ 和＜０．０１）。但在型别间、有和无感染或染色体异常组间的分布没有统计学差异（ Ｐ值均＞ ０．０５） 。结论 部分ＭＤＳ患者有免疫指标异常，且与性别和年龄有关，而与ＦＡＢ 分型、感染和染色体异常之间的关系不明显。

Objective To explore immunological abnormalities of patients with MDS.Methods It was carried out to analyze the laboratory findings of 90 patients with MDS:serum Ig,RF,CIC,direct Coombs`test and other auto-antibodies,including anti-SSA,SSB,Sm,RNP,ANA,DNA antibodies.Results Twenty nine of 90 patients(32 2%)had an abnormality in at least one immunological laboratory test.There were 20(22 2%)with hypergammaglobulinemia and 9(10%)with hypogammaglobulinemia.Positivities of CIC,RF and direct Coombs test were found in 6(6 7%),2 and 2 patients(2 2%)respectively.None of the 90 was positive with other auto-antibodies.There was significance in the distribution of age(p<0 05),as well as sex(p<0 005).No statistically significant differences were found between groups in terms of FAB types,infection and abnormal genetics(p>0 05).Conclusion Some of the patients with MDS developed immunological abnormalities,which might be associated with sex and age,but not associated with FAB types,infection and chromosome aberration.