中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2009年
4期
312-315
,共4页
王昭%王旖旎%冯翠翠%田莉萍%陈皙
王昭%王旖旎%馮翠翠%田莉萍%陳皙
왕소%왕의니%풍취취%전리평%진석
淋巴组织细胞增多症,噬血细胞性%杀伤细胞%天然%受体,白细胞介素2
淋巴組織細胞增多癥,噬血細胞性%殺傷細胞%天然%受體,白細胞介素2
림파조직세포증다증,서혈세포성%살상세포%천연%수체,백세포개소2
Lymphohistiocytosis,hemophagoeytic%Killer cells,natural%Receptors,interleukin-2
目的 探讨NK细胞活性、可溶性白细胞介素-2受体(sCD25)及糖化铁蛋白在继发性噬血细胞性淋巴组织细胞增多症(HLH)早期诊断中的意义.方法 收集2005年6月至2008年5月继发性HLH疑似病例57例,根据HLH-2004诊断标准分为初诊确诊组、复诊确诊组及排除组,另有正常健康人员25例为正常对照组.采用乳酸脱氢酶释放法检测外周血NK细胞活件,酶联免疫吸附试验检测血sCD25的水平,植物血凝素吸附法检测血糖化铁蛋白水平,比较上述指标在各组中的差异,并比较各项诊断指标在疾病确诊前后的阳性发生率情况.结果 NK细胞活性在初诊确诊组(18.3±5.6)%,复诊确诊组(16.7±6.7)%,明显低于排除组(33.4±6.8)%及对照组(36.6±5.0)%.糖化铁蛋白中位百分比在初诊确诊组(15.4±2.0)%及复诊确诊组(16.9±3.4)%明显低于排除组(40.4±3.0)%和对照组(45.2±2.2)%.而sCD25水平在初诊确诊组(12 916±4328)ng/L、复诊确诊组(12 117±5465)ng/L,明显高于排除组(4728±1482)ng/L及对照组(3841±993)ng/L.初诊确诊组及复诊确诊组患者的NK细胞活性、sCD25、糖化铁蛋白比例在疾病早期即100%出现异常.结论 NK细胞活性减低、糖化铁蛋白比例降低及sCD25水平升高在早期诊断继发性HLH中具有重要意义.
目的 探討NK細胞活性、可溶性白細胞介素-2受體(sCD25)及糖化鐵蛋白在繼髮性噬血細胞性淋巴組織細胞增多癥(HLH)早期診斷中的意義.方法 收集2005年6月至2008年5月繼髮性HLH疑似病例57例,根據HLH-2004診斷標準分為初診確診組、複診確診組及排除組,另有正常健康人員25例為正常對照組.採用乳痠脫氫酶釋放法檢測外週血NK細胞活件,酶聯免疫吸附試驗檢測血sCD25的水平,植物血凝素吸附法檢測血糖化鐵蛋白水平,比較上述指標在各組中的差異,併比較各項診斷指標在疾病確診前後的暘性髮生率情況.結果 NK細胞活性在初診確診組(18.3±5.6)%,複診確診組(16.7±6.7)%,明顯低于排除組(33.4±6.8)%及對照組(36.6±5.0)%.糖化鐵蛋白中位百分比在初診確診組(15.4±2.0)%及複診確診組(16.9±3.4)%明顯低于排除組(40.4±3.0)%和對照組(45.2±2.2)%.而sCD25水平在初診確診組(12 916±4328)ng/L、複診確診組(12 117±5465)ng/L,明顯高于排除組(4728±1482)ng/L及對照組(3841±993)ng/L.初診確診組及複診確診組患者的NK細胞活性、sCD25、糖化鐵蛋白比例在疾病早期即100%齣現異常.結論 NK細胞活性減低、糖化鐵蛋白比例降低及sCD25水平升高在早期診斷繼髮性HLH中具有重要意義.
목적 탐토NK세포활성、가용성백세포개소-2수체(sCD25)급당화철단백재계발성서혈세포성림파조직세포증다증(HLH)조기진단중적의의.방법 수집2005년6월지2008년5월계발성HLH의사병례57례,근거HLH-2004진단표준분위초진학진조、복진학진조급배제조,령유정상건강인원25례위정상대조조.채용유산탈경매석방법검측외주혈NK세포활건,매련면역흡부시험검측혈sCD25적수평,식물혈응소흡부법검측혈당화철단백수평,비교상술지표재각조중적차이,병비교각항진단지표재질병학진전후적양성발생솔정황.결과 NK세포활성재초진학진조(18.3±5.6)%,복진학진조(16.7±6.7)%,명현저우배제조(33.4±6.8)%급대조조(36.6±5.0)%.당화철단백중위백분비재초진학진조(15.4±2.0)%급복진학진조(16.9±3.4)%명현저우배제조(40.4±3.0)%화대조조(45.2±2.2)%.이sCD25수평재초진학진조(12 916±4328)ng/L、복진학진조(12 117±5465)ng/L,명현고우배제조(4728±1482)ng/L급대조조(3841±993)ng/L.초진학진조급복진학진조환자적NK세포활성、sCD25、당화철단백비례재질병조기즉100%출현이상.결론 NK세포활성감저、당화철단백비례강저급sCD25수평승고재조기진단계발성HLH중구유중요의의.
Objective To explore the significance of NK cell activity,interleukin-2 receptors (sCD25) and glycosylated ferritin in the early diagnostic of acquired hemophagocytic lymphohistiocytosis (HLH).Methods 57 patients suspected of HLH from June 2005 to May 2008 and 25 healthy subjects were enrolled in the study.The patients suspected of HLH were divided into three groups i.e.(1) a group with diagnosis confirmed at first visit;(2) a group with diagnosis confirmed at subsequent visit and (3) a group with diagnosis unconfirmed according to HLH-2004 diagnostic criteria.Healthy subjects were enrolled as control.NK cell activity was determined with a released LDH assay.The percentage of glycosylated ferritin was determined with phytohemagglutinin adsorption assay,sCD25 was examined with ELISA double antibody sandwich assay.We compared the coincidence of each diagnostic index before and after diagnosis.Results The median percentage of NK cell activity was significantly lower in the first group ( 18.3±5.6) % and the second ( 16.7±6.7)% than that in the third group (33.4±6.8)% or in the controls (36.6±5.0)%.The median percentage of glycosylated ferritin was also significantly lower in the first group ( 15,4 ± 2.0)% and the second group (16.9 ± 3.4)% than that in the third group (40.4 ± 3.0)% or in the controls (45.2±2.2)%.Meanwhile,the median level of sCD25 was significantly higher in the first group (12 916±4328) ng/L and the second group (12 117 ± 5465) ng/L than that in the third group (4728±1482) ng/L or in the controls (3841 ± 993) ng/L.Furthermore,NK cell activity,sCD25 and glycosylated ferritin were abnormal in all the patients in the early stage of HLH.Conclusion NK cell activity,sCD25 and glycosylated ferritin may be helpful markers for the early diagnosis of HLH.
