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本研究探讨阵发性睡眠性血红蛋白尿症(PNH)患者T细胞免疫状态及GPI+ T细胞、GPI-T细胞的数量与功能。采用流式细胞术检测22例PNH患者及18名正常对照T细胞亚群、Th细胞亚群、GPI+T细胞、GPI- T细胞分别在CD3+ T细胞、CD4+ T细胞和CD8+ T细胞群中的比例及其CD69的表达。结果显示,PNH患者CD4+ T细胞占CD3+ T细胞的比例[(47.7670±13.91139)%]较正常对照组[(54.9592±7.11678)%]降低,CD8+T细胞占CD3+T细胞的比例[(52.2767±13.90395)%]较正常对照组[(45.2418±6.75306)%]升高,差异均有显著性(p<0.05);CD4+/CD8+比值倒置,以PNH-AA患者最为明显(0.77763±0.409153),与正常对照组(1.26356±0.348878)相比,差异有显著性(p<0.05)。PNH患者Th1细胞比例[(16.9136±6.78899)%]较对照组[(4.4600±1.81879)%]升高,差异有显著性(p<0.05),PNH-AA患者Th1细胞比例变化[(22.8000±5.45244)%]较发作性PNH患者[(12.0083±2.20770)%]更为显著,Th2细胞比例[(4.7582±1.98441)%]较正常对照组[(3.7960±1.13810)%]无明显变化。PNH患者体内存在一群GPI- T细胞,其占CD8+T细胞的(14.6797±11.96718)%,占CD4+ T细胞的(3.9241±2.46263)%,其占CD8+ T细胞的比例较占CD4+ T细胞的比例升高更为明显。PNH患者CD8+GPI+ T细胞[(17.67881±8.562493)%]、CD8+GPI-T细胞[(15.86575±7.279743)%]、CD4+GPI+ T细胞[(4.65431±1.984378)%]、CD4+GPI- T细胞[(4.93181±1.730001)%]CD69的表达均高于正常对照组[CD8+T细胞(4.68038±1.216645)%,CD4+ T细胞(1.77339±0.645259)%],差异有显著性(p<0.05),GPI+ T细胞CD69的表达与GPI- T细胞相比,差异并无显著性。结论:PNH患者存在T细胞免疫功能亢进,其可能是造成骨髓衰竭的原因,但与T淋巴细胞组分中含有PNH克隆可能无关。
This study was to investigate the T cell immune status and the number and function of GPI + T cells and GPI-T cells in patients with paroxysmal nocturnal hemoglobinuria (PNH). T cell subsets, Th cell subsets, GPI + T cells and GPI-T cells in 22 patients with PNH and 18 normal controls were detected by flow cytometry in CD3 + T cells, CD4 + T cells and CD8 + T cells, respectively Ratio and its CD69 expression. The results showed that the proportion of CD4 + T cells to CD3 + T cells in PNH patients [(47.7670 ± 13.91139)%] was lower than that in normal controls [(54.9592 ± 7.11678)%], and that of CD8 + T cells in CD3 + T cells (P <0.05). The ratio of CD4 + / CD8 + was upside down, and was most significant in patients with PNH-AA (0.77763 ± 0.409153), Compared with the normal control group (1.26356 ± 0.348878), the difference was significant (p <0.05). The proportion of Th1 cells in patients with PNH [(16.9136 ± 6.78899)%] was significantly higher than that in controls [(4.4600 ± 1.81879)%] (p <0.05), while the proportion of Th1 cells in patients with PNH was (22.8000 ± 5.45244 )%] Were more significant than those in patients with episodic PNH [(12.0083 ± 2.20770)%]. There was no significant difference in Th2 cell ratio [(4.7582 ± 1.98441)% vs control group [(3.7960 ± 1.13810)%]. A group of GPI-T cells present in PNH patients accounted for (14.6797 ± 11.96718)% of CD8 + T cells and (3.9241 ± 2.46263)% of CD4 + T cells, accounting for a higher proportion of CD8 + T cells than CD4 + T cells Increased more obvious. CD4 + GPI + T cells [(17.67881 ± 8.562493)%], CD4 + GPI-T cells [(15.86575 ± 7.279743)%], CD4 + GPI + T cells (4.65431 ± 1.984378% (4.93181 ± 1.730001)%], the expression of CD69 was higher than that of the normal control group [(4.68038 ± 1.216645)% and CD4 + T cells (1.77339 ± 0.645259)%], the difference was significant (p <0.05) There was no significant difference in the expression of CD69 between GPI + T cells and GPI-T cells. CONCLUSION: T cell immune function hypersensitivity exists in PNH patients, which may be the cause of bone marrow failure, but may not be related to the inclusion of PNH clones in T lymphocyte components.