论文部分内容阅读
目的研究和评价以外周血T细胞亚群、Th1/Th2、T-bet和GATA-3基因表达及中西医诊断标准为主建立的多变量指标,作为再生障碍性贫血(AA)患者选用免疫抑制剂或雄激素的预测指标。方法采用流式细胞术检测85例AA患者治疗前后外周血T细胞亚群,同时运用实时定量PCR技术检测T-bet和GATA-3基因表达,并以免疫抑制剂和雄激素有效病例做Logistic回归方程及ROC曲线分析。结果(1)按SPSS的ROC曲线模型,设定假阳性率为0.10,取P值为0.832,若P值≥0.832时,判定患者为免疫紊乱状态,应加用免疫抑制疗法(IST)治疗;若P值<0.832时,判定患者为骨髓衰竭状态,应加用雄激素治疗。(2)提出AA在疾病发生发展过程中可大致分为以异常免疫为主和以骨髓衰竭为主两个阶段,以异常免疫为主应加用IST治疗;以骨髓衰竭为主应加用雄激素治疗。结论上述预测方法可判断AA患者处于以异常免疫为主或以骨髓衰竭为主状态,指导免疫抑制剂或雄激素的临床应用。
Objective To study and evaluate the expression of Th1 / Th2, T-bet and GATA-3 genes in peripheral blood and the diagnostic criteria of Chinese and Western medicine based on multivariate analysis. The patients with aplastic anemia (AA) were immunosuppressed Predictors of agents or androgens. Methods Flow cytometry was used to detect T lymphocyte subsets in peripheral blood of 85 patients with AA before and after treatment. Real-time quantitative PCR was used to detect the expression of T-bet and GATA-3. Logistic regression equation was established with immunosuppressive agents and androgen effective cases And ROC curve analysis. Results (1) According to the ROC curve model of SPSS, the false positive rate was set at 0.10 and the P value was set at 0.832. If the P value was more than or equal to 0.832, the immunosuppressive therapy (IST) If P value <0.832, the judgment of patients with bone marrow failure, should be added androgen therapy. (2) It is suggested that AA can be roughly divided into two stages: abnormal immunity and bone marrow failure in the process of disease development. Abnormal immunity should mainly be treated with IST. In the case of bone marrow failure, male Hormone therapy. Conclusions The above prediction method can be used to judge the clinical application of AA patients who are predominantly with abnormal immunity or bone marrow failure, and who guide immunosuppressive agents or androgen.