CD34、CD59在阵发性睡眠性血红蛋白尿中表达及意义.docVIP

CD34、CD59在阵发性睡眠性血红蛋白尿中表达及意义 　 作者：王学霞 孙建荣 高娜 于文征 张化道 【摘要】 目的 研究阵发性睡眠性血红蛋白尿(PNH)患者骨髓CD34+细胞比率及外周血粒、红细胞CD59表达阳性率并探讨其临床意义。方法 采用流式细胞术检测20例PNH患者骨髓单个核细胞(BMMNC)中CD34+细胞比率及外周血中粒、红细胞CD59表达阳性率。 结果 PNH患者CD34+细胞比率显著低于正常人(Plt;0.01);其中增生减低组CD34+细胞比率低于增生活跃、增生明显活跃组(P均lt;0.05)，而后两组之间差异无显著性(Pgt;0.05)。正常人外周血粒、红细胞CD59表达阳性率均gt;95%，其中粒细胞CD59表达稳定性较好;PNH患者外周血粒、红细胞CD59表达阳性率与正常对照组相比均显著减低(Plt;0.01);粒细胞CD59在不发、偶发、频发组中表达逐渐减低且差异均有显著性(Plt;0.05)，红细胞CD59表达则在三组之间差异无显著性(Pgt;0.05)。 结论 CD34+造血干细胞减少可能参与PNH发病;外周血粒、红细胞CD59检测是诊断PNH的特异性及敏感性方法，其中粒细胞CD59缺失程度对判断病情严重与否具参考价值。 【关键词】 阵发性睡眠性血红蛋白尿;CD34;CD59;流式细胞术 　　【Abstract】 Objective To study the bone marrow CD34+ cell ratio and positive expression of CD59 on granulocytes and erythrocytes from peripheral blood in patients with paroxysmal nocturnal hemoglobinuria(PNH) and to explore their clinical significance.Methods 　　The ratio of CD34+ cell in bone marrow mononuclear cells(BMMNC) and expression of CD59 on peripheral granulocytes and erythrocytes in 20 patients with PNH were detected by flow cytometry along with labelled CD34 and CD59 monoclonal antibodies.Results The ratio of CD34+ cell in PNH patients was significantly lower than that in control group (Plt;0.01). There was a significant difference between hypocellular PNH and normo/hypercellular PNH(Plt;0.05)，but no difference was found between the two latter groups(Pgt;0.05). The positive expression ratio of CD59 on peripheral granulocytes and erythrocytes in control group were all more than 95% and the former had a better stability.The expression of CD59 on both granulocytes and erythrocytes in PNH patients remarkably decreased as compared with that in control group (Plt;0.01 ).There was a significant difference of the expression of CD59 on peripheral granulocytes among the frequent，occasional and no hemoglobinuria group(Plt;0.05) while there was no significant difference of the expression of CD59 on erythrocytes among the three groups (Pgt;0.05).Conclusion The reduction of CD34+ hematopoietic stem cell