骨髓增生异常综合征患者淋巴细胞亚群特点及环孢素对其的影响

Study on myelodysplastic syndrome lymphocyte subsets characteristics and the effects of cyclosporin A

目的 检测和分析骨髓增生异常综合征（MDS）-难治性贫血（RA）及-难治性血细胞减少伴有多系发育异常（RCMD）患者T淋巴细胞亚群的分布,评估MDS患者免疫功能状态及环孢素（CsA）对T淋巴细胞亚群的影响.方法 采用流式细胞术（FCM）对MDS-RA及-RCMD患者和13名健康对照外周血标本进行淋巴细胞亚群检测,检测MDS-RA及-RCMD患者在应用以CsA为基础的免疫抑制方案治疗前、治疗6个月后的淋巴细胞亚群的表达情况.结果 MDS组的Th细胞（CD3＋CD4＋）、Th/Ts（CD1＋CD8＋）比值均低于健康对照组[（35.72±5.02）％比（45.73±2.15）％、（1.89±0.51）％比（2.41±0.39）％],差异有统计学意义（t值分别为13.39、3.64,均P＜0.05）;Ts细胞的表达高于健康对照组[（29.07±3.88）％比（21.80±3.63）％],差异有统计学意义（t=6.47,P＜0.05）;治疗前后Th细胞、Ts细胞、Th/Ts比值差异均有统计学意义（治疗后分别为（38.19±4.98）％、（26.03±3.03）％、（1.96±0.35）％,t值分别为0.39、2.65、3.57,均P＜0.05）.CsA治疗6个月后有效和无效组比较,Th细胞[（42.79±7.74）％与（36.46±1.28）％]、Ts细胞[（22.14±3.91）％与（27.51±2.84）％]、Th/Ts比值[（2.40±0.40）％与（2.08±0.11）％]差异均有统计学意义（t值分别为67.65、3.77、3.57,均P＜0.05）.结论 MDS患者T淋巴细胞亚群免疫失调导致细胞免疫功能紊乱,CsA可改善MDS患者的T淋巴细胞亚群失衡.

Objective To analysis the T lymphocyte subsets distribution of patients with myelodysplastic syndrome （MDS）-RA and-RCMD,assess the immune status of MDS patients,and analysis the effects of cyclosporine on T lymphocyte subsets.Methods Using flow cytometry （FCM） on MDS-RA and -RCMD patients and 13 normal controls peripheral blood samples for T lymphocyte subsets,detection of patients with RA and RCMD lymphocyte subsets before and after 6 months of treatment in the application of cyclosporine-based immunosuppressive regimen.Results The MDS group Th cells （CD; CD;）,Th/Ts ratio were lower than those in normal control group （t =13.39,3.64,all P 〈 0.05）.Ts cells （CD3＋ CD8＋） express higher than that in normal control group [（29.07±3.88） % vs （21.80±3.63） %] （t =6.47,P 〈 0.05）.Before and after treatment of Th cells,Th / Ts ratio,Ts cells of T lymphocyte subset were significant difference [（35.72±5.02） %,（29.07±3.88） %,（1.89±0.51） % vs （38.19±4.98） %,（26.03±3.03） %,（1.96±0.35）%] （t =0.39,2.65,3.57,all P 〈 0.05）.Cyclosporine treatment after 6 months of effective and ineffective group of T cell subsets,Th cells （CD3＋ CD4＋）,Th/Ts ratio of T lymphocyte subsets,there was significant difference in Ts cells [（42.79±7.74） % vs （36.46±.1.28） %,（22.14±.3.91） % vs （27.51±2.84） %,（2.40±0.40） % vs （2.08±0.11） %]（t =67.65,3.77,3.57,all P 〈 0.05）.Conclusion MDS patients with T-lymphocyte subsets immune disorders lead to immune dysfunction,cyclosporine may improve the imbalance of T lymphocyte subsets of MDS patients.