CAJ | 학술논문

目的探讨T、B、NK细胞亚型与慢性荨麻疹发病机制的关系.方法用流式细胞仪检测51例慢性荨麻疹患者和30例健康献血者外周血CD3+、CD4+、CD8+ T细胞、B细胞、NK细胞的构成比,并计算CD4+/CD8+比值,分析其与病情、病程和抗组胺治疗之间的关系.结果慢性荨麻疹患者CD8+T细胞构成比27.20%±8.22%低于正常人对照组29.9%±3.74%(P＜0.05),CD4+/CD8+比值(1.48±0.62)、NK细胞构成比21.20%±10.84%高于正常人对照组(分别为1.24±0.27,17.5%±3.56%,P＜0.05);抗组胺治疗无效组CD3+T细胞61.81%±11.70%、CD8+T细胞24.00%±7.79%、B细胞10.78%±2.07%构成比低于抗组胺治疗显效组(分别为75.74%±2.36%,34.22%±9.30%,15.25%±4.10%;P＜0.05,P＜0.01,P＜0.05),CD4+/CD8+比值(1.67±0.76)、NK细胞构成比28.61%±12.62%均高于抗组胺治疗显效组(分别为1.17±0.41,12.78%±6.02%,P＜0.01).慢性荨麻疹患者的CD3+、CD8+T细胞构成比与症状评分呈负相关性(r=-0.31,-0.28,P＜0.05),B细胞构成比与症状评分、病程呈正相关性(r=0.53,0.55,P＜0.01).结论慢性荨麻疹患者存在T、B、NK细胞亚型构成紊乱,在慢性荨麻疹及其耐抗组胺的发病机制中,可能有体液免疫参与.
목적 탐토T、B、NK세포아형여만성담마진발병궤제적관계.방법 용류식세포의검측51례만성담마진환자화30례건강헌혈자외주혈CD3+、CD4+、CD8+ T세포、B세포、NK세포적구성비,병계산CD4+/CD8+비치,분석기여병정、병정화항조알치료지간적관계.결과 만성담마진환자CD8+T세포구성비27.20%±8.22%저우정상인대조조29.9%±3.74%(P＜0.05),CD4+/CD8+비치(1.48±0.62)、NK세포구성비21.20%±10.84%고우정상인대조조(분별위1.24±0.27,17.5%±3.56%,P＜0.05);항조알치료무효조CD3+T세포61.81%±11.70%、CD8+T세포24.00%±7.79%、B세포10.78%±2.07%구성비저우항조알치료현효조(분별위75.74%±2.36%,34.22%±9.30%,15.25%±4.10%;P＜0.05,P＜0.01,P＜0.05),CD4+/CD8+비치(1.67±0.76)、NK세포구성비28.61%±12.62%균고우항조알치료현효조(분별위1.17±0.41,12.78%±6.02%,P＜0.01).만성담마진환자적CD3+、CD8+T세포구성비여증상평분정부상관성(r=-0.31,-0.28,P＜0.05),B세포구성비여증상평분、병정정정상관성(r=0.53,0.55,P＜0.01).결론 만성담마진환자존재T、B、NK세포아형구성문란,재만성담마진급기내항조알적발병궤제중,가능유체액면역삼여.
Objective To study the relationship of T, B and NK lymphocytes with the pathogenesis of chronic urticaria. Methods Flow cytometry was applied to assess the proportion of T, B and NK lymphocyte subgroups in the peripheral blood of 51 patients with chronic urticaria and 30 sex and age-matched human controls. The CD4:CD8 ratio was calculated. Moreover, the symptoms, disease course and response to antihistamines of these patients were evaluated by one physician. Results The percentage of CD8+ T and NK cells, CD4:CD8 ratio were (27.20±8.22)%, (21.20±10.84)% and 1.48±0.62, respectively, in these patients,(29.9±3.74)%, (17.5±3.56)%, 1.24±0.27, respectively, in the controls; the differences were significant between the two groups (all P＜0.05). Decreased levels of CD3+ T cells, CD8+ T cells and B cells were noted in patients resistant to antihistamines compared with those responsive to antihistamines[(61.81±11.70)% vs (75.74±2.36)%, (24.00±7.79)% vs (34.22±9.30)%, (10.78±2.07)% vs (15.25±4.10)%, P＜0.05, 0.01, 0.05, respectively)], while the CD4:CD8 ratio and percentage of NK cells were increased in antihistamine-resistant patients compared to those in antihistamine-sensitive patients [1.67±0.76 vs 1.17±0.41, (28.61±12.62)% vs (12.78±6.02)%, both P＜0.01 ]. In these patients with chronic urticaria, the percentages of CD3+ T and CD8+ T cells were negatively correlated with the symptom scores (R = -0.31, -0.28, respectively, both P＜0.05 ), while the percentage of B cells was positively correlated with the symptom scores and disease course (R = 0.53, 0.55, respectively, both P＜0.01 ). Conclusions There is an abnormality in the proportion of T, B and NK lymphocyte subgroups in patients with chronic urticaria,which indicates that humoral immunity may be involved in the pathogenesis of chronic urticaria and the mechanism for responsiveness to antihistamine.