阵发性睡眠性血红蛋白尿症患者血细胞表面CD55和CD59的检测及临床意义

目的探讨红细胞和粒细胞膜CD55与CD59抗原表达在阵发性睡眠性血红蛋白尿症(PNH)诊断中的应用。方法采用流式细胞术结合直接免疫荧光法检测25例PNH、20例再生障碍性贫血(AA)、20例健康对照者外周血红细胞和粒细胞膜CD55和CD59抗原的表达,并同时做酸化血清溶血试验(Ham试验)、蔗糖溶血试验和尿含铁血黄素试验(尿Rous试验)。结果与AA组和健康对照组相比,PNH患者外周血红细胞、粒细胞膜CD55、CD59表达缺失率均明显增高(P<0.05);而AA组和健康对照组缺失率均小于5%,且两者之间差异没有统计学意义(P>0.05)。25例PNH患者中,9例Ham试验阴性,6例蔗糖溶血试验阴性,7例尿Rous试验阴性,这些患者的红细胞、粒细胞的CD55、CD59表达缺失率均大于5%。结论利用流式细胞术同时检测患者红细胞和粒细胞膜CD55与CD59抗原对PNH的诊断与鉴别诊断具有重要价值。

Detection and clinical significance of CD55 and CD59 expressed on blood cells surface of patients with PNH

Objective To discuss the application of CD55 and CD59 antigen expressions of the erythrocyte and granulocyte cell membranes in the diagnosis of paroxysmal nocturnal hemoglobinuria （PNH）. Methods Expressions of CD55 and CD59 antigens in the cell membranes of peripheral erythrocytes and granulocytes were detected in 25 ca- ses with PNH,20 cases with aplastic anemia （AA） and a control group of 20 healthy individuals through the use of flow cytometry and direct immunofluorescence. Sucrose hemolysis test, Ham test,and Urine Rous test were simulta- neously done. Results The negative expression rates of CD55 and CD59 antigens in the cell membranes of peripheral erythrocytes and granulocytes in the PNH patients were markedly higher than those in the AA patients and healthy individuals in the control group （P~0. 05） ,whose negative expression rates were both less than 5 %. There was no statistically significant difference （P~0.05）. Six cases of negative sucrose hemolysis, nine cases of negative Ham test and seven cases of negative Urine Rous test were found among the 25 PNH patients,whose negative expression rates of CD55 and CD59 antigens were both greater than 5%. Conclusion The simultaneous detection of patients＇ CD55 and CD59 antigens in the cell membranes of erythrocytes and granulocytes by flow cytometry is significantly valuable in the diagnosis and differential diagnosis of PNH.