获得性纯红细胞再生障碍患者淋巴细胞亚群特点及环孢素对其影响的研究

Study on pure red cell aplastic lymphocyte subsets characteristics and the effect of cyclosporin A

目的 检测和分析获得性纯红细胞再生障碍（PRCA）患者T淋巴细胞亚群的分布,评估患者免疫功能状态及环孢素对T淋巴细胞亚群的影响.方法 采用流式细胞术对22例获得性PRCA患者和22名健康对照者外周血标本进行T淋巴细胞亚群检测,检测PRCA患者在应用以环孢素为基础的免疫抑制方案治疗3个月前后的淋巴细胞亚群变化.结果 22例患者治疗后17例血象恢复正常（3例骨髓象也恢复正常）,总有效率95.5％（21/22）（基本治愈3例,缓解14例,进步4例,无效1例）.获得性PRCA患者组的Th细胞（CD3＋ CD4＋）、Th/Ts比值均低于健康对照组,Ts细胞（CD3＋ CD8＋）的表达高于健康对照组,差异有统计学意义（P＜0.05）.治疗3个月后Th细胞、Th/Ts比值较前升高,Ts细胞较前治疗下降,差异均有统计学意义（均P＜ 0.05）.结论 获得性PRCA患者T淋巴细胞亚群失调导致其细胞免疫功能紊乱,环孢素可改善获得性PRCA患者的T淋巴细胞亚群失衡,是治疗该疾病的有效方法之一,疗效显著,且不良反应较轻。

Objective To detect and analyse acquired pure red cell aplasia （PRCA） T lymphocyte subsets distribution and to assess its condition and cyclosporine immune function of T lymphocytes subsets.Methods Flow cytometry was applicated to detect peripheral blood T lymphocyte subsets of acquired PRCA patients before and after 3 months of treatment with cyclosporine-based immunosuppressive regimen and normal controls.Results Among 22 patients,17 cases of blood returning normal （three cases of bone marrow returning normal）,the total effective rate was 95.5 % （3 cases of cure,14 cases of remission,4 cases of improvement,1 case of ineffectiveness）.Th （CD3＋ CD4＋） cells and Th/Ts ratios in acquired PRCA patient group were lower than those in the normal control group,while Ts （CD3＋ CD8＋） cells was higher than that in the normal control group,the differences were statistically significant （P 〈 0.05）.After 3 months of treatment,Th cells and Th/Ts ratio were higher than those before,and Ts cells were decreased compared with the previous （P 〈 0.05）.Conclusion Disorders of T lymphocyte subsets in acquired PRCA patients lead to immune dysfunction,however,cyclosporine can improve T lymphocyte subsets in patients with imbalance,which is an effective way to treat the disease with significant curative effect and mild adverse reactions.