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目的 :探讨人细小病毒B19(HPVB19)感染致骨髓衰竭的机制。方法 :应用ELISA法检测 38例再生障碍性贫血 (AA)患儿血清中造血负调控细胞因子IL - 8,IL - 6 ,TNF -α及IFN -α水平 ,并应用原位末端标记法和免疫组化SABC法检测其中 13例患儿骨髓细胞涂片中凋亡发生情况及HPVB19感染对细胞凋亡调控基因bax ,fas和bcl- 2表达的影响。结果 :从患儿上述 4种细胞因子水平均显著高于正常对照组 (P <0 .0 1或P<0 .0 5 )。其中HPVB19阳性AA组IL - 8水平亦高于HPVB19阴性组 ,而IL - 6 ,TNF -α及IFN -α两组间无差异。对HPVB19AA组作直线相关分析显示 ,IL - 8与TNF -α和IFN -α呈正相关 ,TNF -α与IL -6呈正相关 (r分别为 0 .5 6 5 ,0 .6 0 3及 0 .86 0 ,P <0 .0 1)。 8例HPVB19阳性AA患儿骨髓涂片中均明显见到散在分布的凋亡细胞 ,高倍镜下可见到核边聚、核固缩和核碎裂等特征性凋亡改变 ;5例HPVB19阴性AA患儿骨髓涂片中 3例未见、2例偶见凋亡细胞。除 2例细胞脱片外 ,11例AA患儿骨髓涂片中均未见到bcl- 2表达 ;HPVB19阳性 6例中 3例 (5 0 % )bax和fas同时表达阳性 ,bax主要位于细胞浆中 ,为散在性分布 ,fas主要位于细胞膜上 ,亦位于细胞浆中 ;HPVB19阴性 5例中仅 1例fas表达阳性。结论 :HPVB19所致AA患儿存在明显的
Objective: To explore the mechanism of human parvovirus B19 (HPVB19) infection in bone marrow failure. Methods: The levels of IL - 8, IL - 6, TNF - α and IFN - α in hematopoietic cells of 38 children with aplastic anemia (AA) were detected by ELISA. The expression of IL - The histopathological SABC assay was used to detect the apoptosis of bone marrow cells in 13 children and the effect of HPVB19 infection on the expression of bax, fas and bcl-2. Results: The levels of these four cytokines in children were significantly higher than those in normal controls (P <0.01 or P <0.05). The level of IL - 8 in HPVB19 - positive AA group was also higher than that in HPVB19 - negative group, while no difference was found between IL - 6, TNF - α and IFN - α. Linear correlation analysis of HPV - B19AA group showed that IL - 8 was positively correlated with TNF - α and IFN - α, and TNF - α was positively correlated with IL - 6 (r = 0.565, 0.660 and. 86 0, P <0. 01). Eight apoptotic cells were found in all 8 cases of HPV-B positive AA patients. Apoptotic cells were found scattered in the cytoplasm of the AA-positive AA children. High-power microscope showed the characteristic apoptotic changes such as nuclear condensation, nuclear condensation and nuclear fragmentation. 3 cases of bone marrow smear in children were not seen, 2 cases of occasional apoptotic cells. Bcl-2 expression was not seen in all the bone marrow smears of 11 children with AA except for 2 cases of cell detachment. 3 cases (5%) of 6 cases were positive for bax and fas, and bax was mainly located in cytoplasm In the distribution of scattered, fas mainly located in the cell membrane, also located in the cytoplasm; HPVB19 negative in only 5 cases of fas positive expression. Conclusion: There are obvious AA children with HPVB19