再生障碍性贫血患者淋巴细胞表型变化

目的：研究再生障碍性贫血（AA）患者骨髓（BM）及外周血（PB）淋巴细胞及其活化相关分子的表达及临床意义。方法：采用单色和双色免疫荧光标记法，流式细胞仪分析AA患者的BM和PB中淋巴细胞膜分子的表达。结果：AA患者BM和BP中CD8^ 细胞增加，CD4／CD8比例下降，BM在CD25^ 细胞和HLA－DR^ 细胞增多，急性AA增加尤为显著（P＜0．01），BM中CD16^ 或CD56^ 细胞也明显增多（P＜0．05），双标记分析提示T细胞主要为CD8^ 细胞：急性AA患者CD8^ -CD25^ 细胞显著增多（P＜0．01），AA患者BM中淋巴细胞活化相关分子表达增多，尤其4－1BB^ ,CD95L^ 和CD40L＋细胞显著增多（P＜0．01），结论：AA患者BM中淋巴细胞活化相关膜分子增多，是AA免疫功能异常及最终导致造血功能衰竭的原因之一。

Abnormal expressed co-stimulating factors and their relationship to activation of T lymphocytes in patients with aplastic anemia

Objective To investigate the phenotypes and expression of activated T cell membrane molecules on lymphocytes in the peripheral blood(PB) and bone marrow(BM) of the patients with aplastic anemia. Mothed Single and double colors immunoflourescence were used to analyze the mononuclear cells from PB and BM of the AA patients by flow cytometry. Results The expression of CD8 increased and ratio of CD4 + to CD8 + cells decreased significantly. The expression of CD25 and HLA-DR increased in the BM, which was more significant in patients with serious AA (P<0.01) and the CD16 or CD56 positive cells also increased in BM. Two-colors analysis showed that the most activated T cells were CD8 + cells. The CD8 +-CD25 + lymphocytes increased significantly in the BM (P<0.01). Co-stimulatory molecules which essential to activation of lymphocytes such as 4-1BB, CD95L and CD40L increased significantly in the BM of AA patients. Conclusion Increase of co-stimulating molecules which were necessary for lymphocytes activation in the BM of AA patients is one of main reason to explain abnormal T cells activation and failure of hematopoiesis.