Graves病伴血细胞减少症患者外周血淋巴细胞探究.docVIP

Graves病伴血细胞减少症患者外周血淋巴细胞探究 　【摘要】 　　为了研究Graves病伴血细胞减少症患者外周血淋巴细胞的变化，探讨Graves病伴血细胞减少症的发病机制，以流式细胞术测定24例患者外周血Th细胞亚群及CD5+B淋巴细胞的数量、B淋巴细胞胞浆内凋亡蛋白Bcl2的表达水平，并与18名正常人作对照。结果表明：正常对照组Th1细胞和Th2细胞百分率、 Th2/Th1 比值、CD5+B细胞百分率、Bcl2表达率分别是(0.39±0.24)%、（0.28±0.15）%、 （0.52±0.12）%、（7.89±0.38）%、（36.49±6.79)%；患者组Th1细胞和Th2细胞百分率、Th2/Th1 比值、CD5+B细胞百分率、Bcl2表达率分别是(0.81±0.45)%、（ 6.83±3.02）%、（20.55 ±6.15）%、（20.89±1.62）%、（80.25±15.56)%，均显著多于正常人对照（ Plt;0.05, Plt;0.01, Plt;0.01,Plt;0.05 ,Plt;0.05）。结论：Graves病伴血细胞减少症发病可能与Th1/Th2 比例失衡，Th2细胞增多，导致CD5+B细胞数量上升及凋亡减低，自身抗体的产生增加有关。 【关键词】 Graves病; 血细胞减少; 淋巴细胞; 免疫; 细胞凋亡 　　 Lymphocyte Changes in Patients with Graves’s Disease Accompanied by Hematocytopenia Abstract The aim of study was to investigate the lymphocyte changes in peripheral blood of patients with Graves’s disease accompanied by hematocytopenia and to explore its pathogenesis. The quantity and ratio of Th2、Th1 、CD5+B 、Bcl2 level in 24 Graves’s disease patients with hematocytopenia were detected by FACS, and 18 adults were selected as normal controls. The results indicaled that the percentages of Th1, Th2, ratio of Th2/Th1, CD5+B, Bcl2 leve in peripheral blood of the patients were( 0.81±0.45)%, (6.83±3.02)%,( 20.55 ±6.15)%, (20.89±1.62)%, (80.25±15.56)%, respectively, and were higher than those of normal controls［(0.39±0.24)% (Plt;0.05),( 0.28±0.15) % (Plt;0.01) , ( 0.52±0.12)% (Plt;0.01) , (7.89±0.38) % (Plt;0.05) ,(36.49±6.79) % (Plt;0.05)］. It is concluded that the pathogenesis of Graves’s disease with hematocytopenia may be related to unbalance of Th1/Th2, increase of Th2 inducing overexpression of CD5+B and Bcl2 on B cell. Key words Graves’s disease; hematocytopenia; lymphocyte; immune; apoptosis Graves病由Parry于1825年首次报告，是甲状腺功能亢进症的最常见病因，主要表现为甲状腺毒症、弥漫性甲状腺肿、眼征和胫前黏液水肿。目前公认Graves病的发生与自身免疫有关，属于自身特异性自身免疫病，即抗体介导的免疫反应性疾病，临床上经常与血细胞减少症并存，说明两者之间可能存在同样的发病机制，或就是一种疾病的不同阶段的不同组织受累的表现。为探讨其发病机制，我们检测24例Graves病伴血细胞减少症患者的外周血淋巴细胞的变化，并与18名正常人进行了对照，兹报告如下。 材料和方法 病例 24 例Graves病患者，均为2004年8月至2005年12月在我院门诊及住院的患者，男5例，女