再生障碍性贫血患者细胞免疫功能的研究

STUDY ON CELL IMMUNE FUNCTION IN PATIENTS WITH APLASTIC ANEMIA

为了探讨细胞免疫功能在再障发病中的作用，对165例再障患者淋巴细胞与全血细胞比值、138例再障患者的T细胞亚群、89例患者的HLA－DR抗原的表达及16例患者PBMNC培养上清的TNFα水平进行了测定。结果表明，再障患者骨髓及外周血中淋巴细胞与全血细胞比值明显高于对照组，T细胞亚群比例失衡，外周血HLA－DR抗原表达明显高于对照组；PBMNC可自发分泌TNFα，PHA刺激后TNFα诱生水平显著增高，免疫抑制治疗可纠正细胞免疫功能紊乱。

In order to probe the effect of cell immune function on the pathogenesis ofaplastic anemia (AA), the percentage of lymphocytes in 165 AA patients, T lymphocytesubsets in 138 cases and the expression rate of HLA-DR antigen in 89 cases as well as thetumor necrosis factor alpha (TNFα) level in 16 patients were analysed as follows: (1)Thelymphocytic percentage in peripheral blood and bone marrow of AA patients wereremarkably higher than that of the normal control, and were well correlated with theseverity of the disorder (2)There were T lymphocyte subsets imbalance in AA patients,including decrease of T4, increase of T8,and reverse of T4/T8 ratio,There was no significantchange of T3. (3) In AA patients, the suppressor T cells were in an activated state. TheirHLA-DR antigen expression rate was significantly higher than that of the control. (4)PBMNC of AA patients could secrete TNFa sporitaneously. TNFa production increasedsignificantly after PHA stimulation. (5)After treated with immune suppressive agents, thedisturbance of cell immune function of AA patients was corrected, that is, T lymphocytesubsets were normalized,production of TNFa decreased,and activated T, cells eliminated.