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目的探讨慢性再生障碍性贫血(chronic aplastic anemia,CAA)患者外周血共刺激分子CD28表达与外周血象的相关性,观察共刺激分子与造血抑制的关系。方法采用流式细胞仪技术,测定45例CAA患者、20例健康对照者外周血T细胞CD4+及CD8+中共刺激分子CD28的表达水平,并对CD28及白细胞、血红蛋白、血小板计数进行相关性分析。结果CD28+、CD4+CD28+、CD8+CD28+与CAA患者外周血血红蛋白含量存在负相关性(r=-0.411,P﹤0.05;r=-0.37,P﹤0.05;r=-0.417,P﹤0.05),共刺激分子的表达与白细胞、血小板无明显相关性(P﹥0.05)。结论CAA的发病机制与T细胞的异常激活相关,共刺激分子可作为选择治疗方案及对预后估计的参考指标。
Objective To investigate the correlation between the expression of costimulatory molecule CD28 and peripheral blood in patients with chronic aplastic anemia (CAA) and to observe the relationship between costimulatory molecules and hematopoietic suppression. Methods Flow cytometry was used to detect the expression of CD4 + and CD28 + costimulatory molecules in peripheral blood of 45 patients with CAA and 20 healthy controls. Correlation analysis of CD28, leucocyte, hemoglobin and platelet count was performed. Results There was a negative correlation between the levels of CD28 +, CD4 + CD28 +, CD8 + CD28 + and peripheral blood hemoglobin in CAA patients (r = -0.411, P <0.05; r = -0.37, P < Costimulatory molecules expression and leukocytes, platelet no significant correlation (P> 0.05). Conclusions The pathogenesis of CAA is related to the abnormal activation of T cells. Costimulatory molecules can be used as a reference for selection of treatment regimen and estimation of prognosis.