CAJ | 학술논문

目的检测和分析获得性纯红细胞再生障碍(PRCA)患者T淋巴细胞亚群的分布,评估患者免疫功能状态及环孢素对T淋巴细胞亚群的影响.方法采用流式细胞术对22例获得性PRCA患者和22名健康对照者外周血标本进行T淋巴细胞亚群检测,检测PRCA患者在应用以环孢素为基础的免疫抑制方案治疗3个月前后的淋巴细胞亚群变化.结果 22例患者治疗后17例血象恢复正常(3例骨髓象也恢复正常),总有效率95.5％(21/22)(基本治愈3例,缓解14例,进步4例,无效1例).获得性PRCA患者组的Th细胞(CD3+ CD4+)、Th/Ts比值均低于健康对照组,Ts细胞(CD3+ CD8+)的表达高于健康对照组,差异有统计学意义(P＜0.05).治疗3个月后Th细胞、Th/Ts比值较前升高,Ts细胞较前治疗下降,差异均有统计学意义(均P＜ 0.05).结论获得性PRCA患者T淋巴细胞亚群失调导致其细胞免疫功能紊乱,环孢素可改善获得性PRCA患者的T淋巴细胞亚群失衡,是治疗该疾病的有效方法之一,疗效显著,且不良反应较轻.
목적 검측화분석획득성순홍세포재생장애(PRCA)환자T림파세포아군적분포,평고환자면역공능상태급배포소대T림파세포아군적영향.방법 채용류식세포술대22례획득성PRCA환자화22명건강대조자외주혈표본진행T림파세포아군검측,검측PRCA환자재응용이배포소위기출적면역억제방안치료3개월전후적림파세포아군변화.결과 22례환자치료후17례혈상회복정상(3례골수상야회복정상),총유효솔95.5％(21/22)(기본치유3례,완해14례,진보4례,무효1례).획득성PRCA환자조적Th세포(CD3+ CD4+)、Th/Ts비치균저우건강대조조,Ts세포(CD3+ CD8+)적표체고우건강대조조,차이유통계학의의(P＜0.05).치료3개월후Th세포、Th/Ts비치교전승고,Ts세포교전치료하강,차이균유통계학의의(균P＜ 0.05).결론 획득성PRCA환자T림파세포아군실조도치기세포면역공능문란,배포소가개선획득성PRCA환자적T림파세포아군실형,시치료해질병적유효방법지일,료효현저,차불량반응교경.
Objective To detect and analyse acquired pure red cell aplasia (PRCA) T lymphocyte subsets distribution and to assess its condition and cyclosporine immune function of T lymphocytes subsets.Methods Flow cytometry was applicated to detect peripheral blood T lymphocyte subsets of acquired PRCA patients before and after 3 months of treatment with cyclosporine-based immunosuppressive regimen and normal controls.Results Among 22 patients,17 cases of blood returning normal (three cases of bone marrow returning normal),the total effective rate was 95.5 ％ (3 cases of cure,14 cases of remission,4 cases of improvement,1 case of ineffectiveness).Th (CD3+ CD4+) cells and Th/Ts ratios in acquired PRCA patient group were lower than those in the normal control group,while Ts (CD3+ CD8+) cells was higher than that in the normal control group,the differences were statistically significant (P ＜ 0.05).After 3 months of treatment,Th cells and Th/Ts ratio were higher than those before,and Ts cells were decreased compared with the previous (P ＜ 0.05).Conclusion Disorders of T lymphocyte subsets in acquired PRCA patients lead to immune dysfunction,however,cyclosporine can improve T lymphocyte subsets in patients with imbalance,which is an effective way to treat the disease with significant curative effect and mild adverse reactions.