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[目的]了解燃煤污染型地方性砷中毒患者外周血淋巴细胞亚群的变化,探讨其在砷中毒发生发展中的意义。[方法]中毒组为53名燃煤型砷中毒患者,暴露组为7名砷暴露者,对照组为32名健康者。从中毒组选取22例患者(一般病变组11例,癌前病变和癌变组11例),采用流式细胞分析技术检测其外周血T淋巴细胞(CD3+)、辅助性T淋巴细胞(Th细胞,CD3+CD4+)、抑制性T淋巴细胞(Ts细胞,CD3+CD8+)、Th/Ts比值(CD3+CD4+/CD3+CD8+)、B淋巴细胞(CD3-CD19+)和自然杀伤细胞[NK细胞,CD3-CD(16+56)+]的改变情况,并比较不同临床分度砷中毒患者和不同皮肤病损患者上述指标的差异。[结果]与对照组比较,轻、中、重度中毒组患者外周血CD3+、CD3+CD4+和CD3-CD19+淋巴细胞百分比均降低(P<0.01或P<0.05),暴露组CD3+CD4+和CD3-CD19+淋巴细胞百分比降低(P<0.05);重度中毒组CD3-CD(16+56)+细胞百分比高于对照组和暴露组(P<0.05);与一般病变组比较,癌前病变和癌变组外周血CD3+、CD3+CD4+和CD3-CD19+淋巴细胞百分比均降低(P<0.05);[结论]Th细胞和B淋巴细胞可能是燃煤型砷污染致人体免疫损伤的早期靶点。燃煤型砷中毒患者外周血中Th细胞和B淋巴细胞百分比的降低可能在砷中毒的发生发展过程中起一定作用。
[Objective] To understand the changes of peripheral blood lymphocyte subsets in patients with coal-burning endemic arsenism and its significance in the development of arsenism. [Method] The poisoning group was 53 coal-burning arsenic poisoning patients, exposed group was 7 arsenic-exposed persons, while the control group was 32 healthy persons. Twenty-two patients were selected from the poisoning group (11 in the general lesion, 11 in the precancerous lesions and 11 in the cancerous group). The levels of T lymphocytes (CD3 +), helper T lymphocytes (Th cells, CD3 + CD8 +), CD3 + CD8 +, CD3 + CD8 +, CD3 + CD8 +, NK cells, CD3 + -CD (16 + 56) +], and to compare the differences of the above indexes in patients with arsenic poisoning and different skin lesions with different clinical scores. [Results] Compared with the control group, the percentages of CD3 +, CD3 +, CD4 + and CD3 + CD19 + lymphocytes in peripheral blood of mild, moderate and severe poisoning groups were decreased (P <0.01 or P <0.05) (P <0.05). The percentage of CD3-CD (16 + 56) + cells in severe poisoning group was higher than that in control group and exposure group (P <0.05). Compared with normal group, The percentage of CD3 +, CD3 +, CD4 + and CD3-CD19 + lymphocytes in peripheral blood decreased (P <0.05). [Conclusion] Th cells and B lymphocytes may be the early targets of human immune injury caused by coal- The decrease of the percentage of Th cells and B lymphocytes in peripheral blood of coal-fired arsenism patients may play a role in the development of arsenic poisoning.