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本研究旨在检测免疫相关性全血细胞减少症(IRP)患者树突状细胞(DC)亚群和数量,并探讨DC在IRP发病中的作用。应用流式细胞术检测65例IRP(37例初治、28例恢复)患者及17名健康对照者外周血浆细胞样DC(plasmacytoid dendritic cells,pDC)(Lin-HLA-DR+CD123+细胞)、髓系DC(myeloid dendritic cell,mDC)(Lin-HLA-DR+CD11c+细胞)数量、亚群。结果显示,IRP初治组外周血pDC占外周血单个核细胞(PBMNC)的比例为(0.91±0.64)%,明显高于恢复组(0.39±0.11)%和正常对照组(0.29±0.13)%(均P<0.01),恢复组明显高于正常对照组(P<0.05)。初治组、恢复组mDC占PBMNC的比例分别为(0.21±0.20)%、(0.34±0.21)%,与正常对照组(0.29±0.09)%比较均无统计学意义(P>0.05)。初治组pDC/mDC比值为6.75±7.11,明显高于恢复组(1.55±0.93)和正常对照组(1.07±0.43,均P<0.01),恢复组与对照组比较没有明显差别(P>0.05)。IRP组外周血pDC占PBMNC的比例与Th1/Th2呈负相关(r=-0.347,P<0.05),与骨髓单个核细胞膜表面抗体阳性率呈正相关(r=0.606,P<0.05),与CD5+B细胞数量呈正相关(r=0.709,P<0.05),与血红蛋白(r=-0.381,P<0.01)和血小板水平(r=-0.343,P<0.01)均呈负相关;mDC占PBMNC的比例与Th1/Th2呈正相关(r=0.595,P<0.05),与血红蛋白水平呈正相关(r=0.292,P<0.05);pDC/mDC与Th1/Th2水平呈负相关(r=-0.395,P<0.05),与骨髓单个核细胞膜表面抗体阳性率呈正相关(r=0.421,P<0.05),与CD5+B细胞数量呈正相关(r=0.423,P<0.05),与血红蛋白(r=-0.304,P<0.05)和血小板水平(r=-0.287,P<0.05)均呈负相关。结论:IRP患者外周血pDC数量增多,可能与IRP发病有关。
The aim of this study was to examine the subsets and numbers of dendritic cells (DCs) in patients with immune-associated pancytopenia (IRP) and to explore the role of DCs in the pathogenesis of IRP. Flow cytometry was used to detect plasmacytoid dendritic cells (pDC) (Lin-HLA-DR + CD123 +) in 65 patients with IRP (37 naive and 28 patients) and 17 healthy controls. The number of myeloid dendritic cells (mDC) (Lin-HLA-DR + CD11c + cells), subpopulation. The results showed that the ratio of pDC to peripheral blood mononuclear cells (PBMNC) was significantly higher in IRP-naive group (0.91 ± 0.64) (All P <0.01), the recovery group was significantly higher than the normal control group (P <0.05). The proportions of mDC and PBMNC in the primary and recovery groups were (0.21 ± 0.20)% and (0.34 ± 0.21)%, respectively, which were not significantly different from those in the normal control group (0.29 ± 0.09)% (P> 0.05). The pDC / mDC ratio in the primary treatment group was 6.75 ± 7.11, which was significantly higher than that in the recovery group (1.55 ± 0.93) and the normal control group (1.07 ± 0.43, P <0.01), and there was no significant difference between the recovery group and the control group ). The ratio of pDC to PBMNC in peripheral blood of IRP group was negatively correlated with Th1 / Th2 (r = -0.347, P <0.05), positively correlated with the positive rate of membrane surface mononuclear cell (r = 0.606, + B cells (r = 0.709, P <0.05), and negative correlation with hemoglobin (r = -0.381, P <0.01) and platelet levels There was a positive correlation between Th1 / Th2 ratio and Th1 / Th2 (r = 0.595, P <0.05), and a positive correlation with hemoglobin level (r = 0.292, (R = 0.421, P <0.05), and positively correlated with the positive rate of bone marrow mononuclear cell membrane antibody (r = 0.421, P <0.05), and positively correlated with the number of CD5 + , P <0.05) and platelet level (r = -0.287, P <0.05). Conclusion: The increase of pDC in peripheral blood of patients with IRP may be related to the pathogenesis of IRP.