再生障碍性贫血患者的T淋巴细胞亚群与病毒感染关系的探究

[摘要] 目的 通过回顾性分析临床资料，探讨再生障碍性贫血患者的T淋巴细胞亚群与病毒感染之间的相互关系。 方法 对50例再生障碍性贫血患儿和50例正常儿童分别进行病毒检测和淋巴细胞亚群CD4、CD8的检测，对结果进行分析。 结果 再生障碍性贫血患者病毒感染阳性率明显高于对照组，且再生障碍性贫血患者外周血中CD4细胞下降，CD8细胞增多，CD4/CD8比例下降。 结论 病毒感染能刺激机体免疫系统并使之对造血干细胞、祖细胞或基质细胞发生异常免疫反应，进而损伤或抑制造血功能；免疫功能的紊乱使病毒容易入侵机体，并难以清除。本研究对治疗再生障碍性贫血有指导意义。

[关键词] 儿童；再生障碍性贫血；病毒感染；免疫功能紊乱

[中图分类号] R556.5 [文献标识码] A [文章编号] 1674-4721（2012）07（b）-0024-02

Study of the relations between the T lymphoblastic subgroup of aplitic anemia patients and virus infection

TIAN Weiping ZHANG Lin

1.Pediatrics Department, Loufeng Hospital of Suzhou Industrial Park in Jiangsu Province, Suzhou 215000, China; 2.Pediatrics Department, Central Hospital of Mudan District in Heze City of Shandong Province, Heze 274000, China

[Abstract] Objective To explore the relations between the T lymphoblastic subgroup of aplitic anemia patients and virus infection, through the analysis of the clinical data were retrospectively. Methods The results concluded through examinations of viruses and lymphoblastic subgroup cells of CD4, CD8 from 50 cases of child patients and 50 cases of normal ones were analyzed. Results Aplitic anemia patients had significant positive infection rate than the reference group, as well as the CD4 cells were decrease, CD8 cells were increase, and the ratio of CD4/CD8 goes down in the outer blood. Conclusion Virus infection can stimulate organic immune system and thus induces unusual immune reactions to stem cells, mesenchymal cells, ending up with damages or restrains on the abilities of blood produce; The immune disorder makes it easy for viruses to invade into the living body that is hard to be cured. This article tries to explain how to prevent virus infections and how to regulate immune system. This study have guiding significance in treatment aplastic anemia.

[Key words] Children; Aplitic anemia; Virus infections; Immune disorder

再生障碍性贫血（aplastic anemia，AA），简称”再障”，是骨髓造血功能衰竭所致的一种全血细胞减少综合征，其发病机制尚不十分清楚。临床表现为贫血、出血、感染；3种血细胞同时减少，无肝脾淋巴结肿大。近年来认为AA的发病与病毒感染后的免疫反应和自身免疫反应有关，尤其与细胞免疫有关。再障是比较多见的造血系统疾病，急性再障多于起病后几个月至1年内死亡；慢性再障可以生存多年，若治疗恰当，病情可能好转甚至缓解。为了探讨病毒感染与再障患者体内免疫变化的相关性及其意义，笔者自2005年以来共检测50例再障患者，全部病例诊断均符合第四届全国再生障碍性贫血学术会议修订的诊断标准[1]。检测内容是患者体内病毒及外周血T淋巴细胞亚群CD4和CD8。

1 资料与方法

1.1 一般资料

再障患者50例，男26例，女24例，年龄3～12岁，其中，急性再障38例，慢性再障10例，纯红再障2例；均为2005年9月1日～2010年9月1日的住院患者。正常对照组50名，男25名，女25名，年龄3～12岁，均为2005年9月1日～2010年9月1日健康检查的幼儿园、小学、中学的儿童。

1.2 方法

标本采集为50例再障患者外周空腹静脉血及正常儿童空腹外周静脉血。检测人类疱疹病毒用间接免疫荧光法（IFA）；EB病毒、巨细胞病毒、肝炎病毒均用酶联免疫法（ELISA）检测；人类微小病毒用筑巢式检测；T细胞亚群用碱性磷酸酶抗碱性磷酸酶（APAAP）法。试剂盒由北京军事医学科学院提供。