CAJ | 학술논문

目的检测免疫相关性全血细胞减少症(IRP)患者外周血CD3+、CD3+CD4+、CD3+CD8+、CD19+淋巴细胞及骨髓CD34+细胞端粒长度变化并分析其与病情严重程度的关系.方法以40例初治IRP患者为研究对象,应用免疫磁珠方法分选外周血CD3+、CD3+CD4+、CD3+CD8+T淋巴细胞,CD19+B淋巴细胞及骨髓CD34+细胞,以流式细胞术-荧光原位杂交技术检测端粒相对长度,并分析端粒长度与IRP患者病情严重程度的相关性.结果初治IRP患者外周血CD3+、CD3+CD4+、CD3+CD8+T淋巴细胞端粒相对长度分别为(27.754±16.323)％、(7.526±3.745)％、(25.854±14.789)％,与健康志愿者的(54.555± 19.782)％、(12.096±2.805)％、(38.367±4.626)％比较明显缩短(P＜0.05);IRP患者外周血CD19+B淋巴细胞端粒相对长度为(22.136±16.142)％,与健康志愿者的(42.846±16.353)％比较亦明显缩短(P＜0.01);IRP患者骨髓CD34+细胞端粒相对长度为(22.528±21.601)％,与健康志愿者的(23.936±19.822)％比较差异无统计学意义(P＞0.05).B淋巴细胞端粒相对长度与外周血白细胞计数呈正相关(r=0.706,P=0.015),而与临床表现积分呈负相关(r=-0.613,P=0.045),与治疗效果呈正相关(r=0.775,P=0.005).结论初治IRP患者存在CD3+、CD3+CD4+、CD3+CD8+T淋巴细胞及CD19+B淋巴细胞端粒长度的缩短,且与IRP病情严重程度相关;骨髓CD34+细胞端粒长度无明显异常.该结果提示IRP为一种后天获得性自身免疫性疾病.
목적 검측면역상관성전혈세포감소증(IRP)환자외주혈CD3+、CD3+CD4+、CD3+CD8+、CD19+림파세포급골수CD34+세포단립장도변화병분석기여병정엄중정도적관계.방법 이40례초치IRP환자위연구대상,응용면역자주방법분선외주혈CD3+、CD3+CD4+、CD3+CD8+T림파세포,CD19+B림파세포급골수CD34+세포,이류식세포술-형광원위잡교기술검측단립상대장도,병분석단립장도여IRP환자병정엄중정도적상관성.결과 초치IRP환자외주혈CD3+、CD3+CD4+、CD3+CD8+T림파세포단립상대장도분별위(27.754±16.323)％、(7.526±3.745)％、(25.854±14.789)％,여건강지원자적(54.555± 19.782)％、(12.096±2.805)％、(38.367±4.626)％비교명현축단(P＜0.05);IRP환자외주혈CD19+B림파세포단립상대장도위(22.136±16.142)％,여건강지원자적(42.846±16.353)％비교역명현축단(P＜0.01);IRP환자골수CD34+세포단립상대장도위(22.528±21.601)％,여건강지원자적(23.936±19.822)％비교차이무통계학의의(P＞0.05).B림파세포단립상대장도여외주혈백세포계수정정상관(r=0.706,P=0.015),이여림상표현적분정부상관(r=-0.613,P=0.045),여치료효과정정상관(r=0.775,P=0.005).결론 초치IRP환자존재CD3+、CD3+CD4+、CD3+CD8+T림파세포급CD19+B림파세포단립장도적축단,차여IRP병정엄중정도상관;골수CD34+세포단립장도무명현이상.해결과제시IRP위일충후천획득성자신면역성질병.
Objective To investigate the changes of relative telomere length (RTL) of peripheral blood (PB) CD3+,CD3+CD4+,CD3+CD8+T lymphocytes,CD19+B lymphocytes and bone marrow (BM) CD34 + cells and its association with disease severity in untreated patients with immuno-related pancytopenia (IRP).Methods The PB CD3 +,CD3 + CD4+,CD3 + CD8 +T lymphocytes,CD19 +B lymphocytes,and BM CD34+ cells were purified by magnetic activated cell sorting (MACS),and RTL were measured with flow-fluorescence in situ hybridization (FLOW-FISH).Results The RTL of CD3+,CD3+CD4+,and CD3+CD8+T lymphocytes in untreated IRP patients were (27.754± 16.323)％,(7.526± 3.745)％ and (25.854± 14.789)％,respectivly,which were significantly shorter than those in healthy controls (54.555± 19.782)％,(12.096±2.805)％,and (38.367±4.626)％ (P＜0.05).The RTL of CD19+ lymphocytes in untreated IRP patients was (22.136± 16.142)％,which was significantly shorter than that in healthy controls (42.846± 16.353)％ (P＜0.01).There was no significant difference of BM CD34+ cells RTL between the untreated IRP patients (22.528±21.601)％ and the healthy controls (23.936± 19.822)％(P＞0.05).There were significantly positive correlations between the RTL of B lymphocytes and the count of white blood cell (r=0.706,P=0.015).There were negative correlations between RTL of B lymphocytes and the clinical symptoms (r=0.613,P=0.045) and positive correlations with therapeutic effect (r=0.775,P=0.005).Conclusions The shorter RTL of CD3 +,CD3 +CD4+,CD3 +CD8+,CD19+ lymphocytes,and the normal RTL of BM CD34+ cells in untreated IRP patients were identified,which might imply that IRP is a type of acquired autoimmune diseases.