老年缺铁性贫血患者体液免疫和细胞免疫功能的变化

Changes of Humoral and Cellular Immune Function in Elderly Patients with Iron Deficiency Anemia

目的:探讨老年缺铁性贫血(IDA)患者的体液免疫与细胞免疫功能。方法:选择老年IDA患者60例为IDA组,根据血红蛋白(Hb)值分为轻度(24例)、中度(20例)和重度(16例),选择同期健康体检老年人60例为对照组;检测并比较各组Hb、T淋巴细胞亚群(CD+3、CD+4、CD+8和CD+4/CD+8)、自然杀伤细胞(NK)(CD16+CD56+)、B淋巴细胞(CD19+)、免疫球蛋白(Ig A、Ig G、Ig M)以及铁代谢指标[血清铁(SI)、转铁蛋白(TF)、血清铁蛋白(SF)、总铁结合力(TIBC)和铁调素(Hepc)]水平。结果:IDA组患者的血清Hb、SI、SF和Hepc低于对照组,TF和TIBC高于对照组(P<0.05),且IDA组重度患者的变化较轻、中度IDA更为明显(P<0.05);IDA轻度患者的CD+4和CD+4/CD+8低于对照组(P<0.05),中、重度患者的CD+4和CD+4/CD+8、NK细胞低于IDA轻度和对照组,CD+8高于轻度IDA和对照组(P<0.05);与对照组比较,IDA组轻、中度患者CD+3的差异无统计学意义(P>0.05),重度患者的CD+3降低(P<0.05);IDA组与对照组之间以及IDA组各分级之间的B淋巴细胞比例、Ig A、Ig G和Ig M数量比较,差异无统计学意义(P>0.05)。结论:老年IDA患者存在明显的铁代谢紊乱和细胞免疫功能下降。

Objective： To investigate the changes of humoral and cellular immune function in elderly patients with iron deficiency anemia（ IDA）. Methods： 60 elderly patients with IDA were selected as IDA group. According to the value of HB,the patients were divided into 3 groups： 24 cases with mild degree,20 cases with moderate degree and 16 cases with severe degree. 60 healthy aged people were selected as the control group in the same period. The levels of HB and T lymphocyte subsets（ CD3^＋,CD4^＋,CD8^＋ and CD4^＋/CD8^＋）,natural killer cell（ NK,CD16^＋CD56^＋）,B lymphocytes（ CD19^＋）,immunoglobulin（ Ig A,Ig G and Ig M） and iron metabolism index [serum iron（ SI）,transferrin（ TF）,serum ferritin（ SF）,total iron binding capacity（ TIBC） and hepcidin（ Hepc） ] were detected and compared in each group. Results： Serum Hb,SI,SF and Hepc in IDA group were lower than those in control group,TF and TIBC were higher than those in control group（ P〈0. 05）. In the IDA group,the changes in severe patients were mild,and moderate IDA was more obvious（ P〈0. 05）. CD4^＋ and CD4^＋/CD8^＋ in mild IDA patients were lower than those in control group（ P〈0. 05）,CD4^＋,CD4^＋/CD8^＋ and NK cells in moderate and severe patients were lower than those in IDA mild and control group,and CD8＋was higher than mild IDA and control group（ P〈0. 05）. There was no statistical difference of mild and moderate patients CD3^＋ compared with control group（ P〈0. 05）,and CD3^＋ of severe patients was reduced（ P〈0. 05）. The difference is not statistically significant in the proportion of B lymphocytes,Ig A,Ig G and the number of Ig M in IDA group,control group and the different grades of IDA group（ P〉0. 05）. Conclusion： The elderly IDA patients have obvious iron metabolism disorder and decline of cellular immune function.