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目的:探讨骨髓增生异常综合征(MDS)患者外周血CD4+、CD8+细胞亚群平衡的改变,以及与活化T细胞之间关系的临床意义。方法;选择14例难治性贫血患者(RA)和1例难治性贫血伴原始细胞增多患者(RAEB)的外周血,在PMA、Ionomycin、Monensin存在的条件下体外培养,进行细胞膜表面抗原和细胞内因子染色,并用流式细胞仪计数外周血表达CD3+CD8-IFN-γ+细胞(Th1)、CD3+CD8-IL-4+细胞(Th2)、CD3+CD8+IFN-γ+细胞(Tc1)、CD3+CD8+IL-4+细胞(Tc2)的百分率。结果与活化T细胞之间关系做相关性分析。结果:MDS组患者Th1细胞高于正常对照组(P<0.05),体内的Th细胞向Th1细胞漂移,产生过多的造血抑制因子如IFN-γ,TNF-β等。Th2,Tc1,Tc2细胞与正常对照组相比无显著差异(P>0.05);CD4+CD45RO+细胞的百分率和Th1细胞的百分率呈正相关,相关系数为r=0.573(P<0.05),CD4+CD45RA+细胞的百分率和Th1细胞的百分率呈负相关,相关系数为r=0.509(P=0.05),而和Th2,Tc1,Tc2的百分率无明显的相关性(P>0.05)。结论:MDS患者存在有Th1/Th2细胞因子网络的失衡以及过多的造血抑制因子,且这些因子主要来源于T淋巴细胞。
Objective: To investigate the changes of the balance of CD4 + and CD8 + subsets in peripheral blood of patients with myelodysplastic syndrome (MDS) and the clinical significance of their relationship with activated T cells. Methods: Peripheral blood from 14 patients with refractory anemia (RA) and 1 patients with refractory anemia (RAEB) were selected and cultured in the presence of PMA, Ionomycin and Monensin. Cell surface antigen and The expression of CD3 + CD8-IFN-γ + cells (Th1), CD3 + CD8-IL-4 + cells (Th2) and CD3 + CD8 + IFN-γ + cells in peripheral blood were measured by flow cytometry Tc1), CD3 + CD8 + IL-4 + cells (Tc2). Correlation analysis between the results and activated T cells. Results: Th1 cells in MDS group were higher than those in normal control group (P <0.05). Th cells in MDS group drifted to Th1 cells and produced excessive hematopoietic inhibitory factors such as IFN-γ, TNF-β and so on. The percentage of CD4 + CD45RO + cells and the percentage of Th1 cells were positively correlated with Th2, Tc1 and Tc2 cells (P 0. 05) The percentage of cells was negatively correlated with the percentage of Th1 cells. The correlation coefficient was r = 0.509 (P = 0.05), but not with the percentage of Th2, Tc1 and Tc2 (P> 0.05). Conclusion: There is imbalance of Th1 / Th2 cytokine network and excessive hematopoietic suppressor in MDS patients, and these factors are mainly derived from T lymphocytes.