GPI锚定蛋白检测诊断阵发性睡眠性血红蛋白尿症的临床价值

doi:吉林省科技厅科研项目资助课题（20050402-3

GPI锚定蛋白检测诊断阵发性睡眠性血红蛋白尿症的临床价值

段秀梅，车媛媛，谭岩，方艳秋，许淑芬,刘磊，孙牧男

吉林大学第一医院中心实验室，吉林长春 130021

收稿日期:2008-04-28 修回日期:1900-01-01 出版日期:2008-11-28 发布日期:2008-11-28
通讯作者: 谭岩

Clinical value of glycosyl-phosphatidyl inositol anchored protein detection on diagnosis of paroxysmal nocturnal hemoglobinuria

DUAN Xiu-mei,CHE Yuan-yuan,TAN Yan,FANG Yan-qiu,XU Shu-fen,LIU Lei,SUN Mu-nan

Central Laboratory, First Hospital,Jilin University,Changchun 130021,China

Received:2008-04-28 Revised:1900-01-01 Online:2008-11-28 Published:2008-11-28
Contact: TAN Yan

摘要/Abstract

摘要： 目的：探讨阵发性睡眠性血红蛋白尿症（PNH）患者不同外周血细胞GPI锚定蛋白的表达情况，为PNH的诊断和鉴别诊断提供依据。方法：采用流式细胞术检测32例PNH患者外周血各类细胞膜上CD55、CD59、 CD16及CD14的表达百分率。结果： PNH患者外周血红细胞、粒细胞膜上CD55、CD59表达均明显减少，与正常对照组比较差异有显著性（P<0.001）,且粒细胞上CD55、CD59表达率低于红细胞（P<0.05）；血小板CD55、CD59表达率也较对照组减少（P<0.05）；有27例PNH患者的淋巴细胞CD55、CD59表达降低，其缺失率达30%，低于粒细胞和红细胞；CD16在粒细胞上表达量差异很大（34%～83%），与对照组比较差异有显著性（P<0.001）；在单核细胞上可见CD14表达缺失的PNH克隆，CD14表达比例明显低于正常对照组（P<0.001）。结论：检测外周各系血细胞CD55和CD59可以使典型PNH的诊断更加可靠，使部分缺乏典型临床表现的PNH明确诊断。检测CD16和CD14对排除PNH具有重要意义。

关键词: 阵发性, 糖基磷脂酰肌醇锚定蛋白, CD55, CD59, CD16, CD14

Abstract: Objective To investigate the expression of glycosyl-phosphatidyl inositol(GPI) anchored protein on peripheral blood cells from patients with paroxysmal nocturnal hemoglobinuria (PNH) and provide a basis for diagnosis and differential diagnosis of PNH.Methods The percentages of CD55,CD59,CD16 and CD14 expression on the peripheral blood cells from 32 patients with PNH were determined by flow cytometry. Results The　 expression levels of CD55 and CD59 were decreased significantly on the erythrocytes and granulocytes from patients with PNH compared with control group (P<0.001),the expression levels of CD55 and CD59 on granulocytes were lower than those on erythrocytes (P<0.05).The expression levels of CD55 and CD59 on the thrombocytes of PNH patients were lower than those in control group（P<0.001）.The expression levels of CD55 and CD59 on the lymphocytes from 27 PNH patients were lower than those on granulocytes and erythrocytes,the deficiency rate was 30%.The percentage of CD16 expression varied greatly from 34% to 83% on the granulocytes,there was significant difference compared with control group (P<0.001). The deficiency of CD14 clones was detected on the monocytes from PNH patients. Conclusion The diagnosis reliability of patients with PNH is increased by the assay of CD55 and CD59 on all kinds of cells of peripheral blood.The detection of CD16 and CD14 is also an optimal and helpful index to diagnose PNH.

Key words: paroxysmal, glycosyl-phosphatidyl inositol anchored protein, CD55, CD59, CD16, CD14

中图分类号:

R696.3

段秀梅，车媛媛，谭岩，方艳秋，许淑芬,刘磊，孙牧男. GPI锚定蛋白检测诊断阵发性睡眠性血红蛋白尿症的临床价值[J]. J4, 2008, 34(6): 1018-1021.

DUAN Xiu-mei,CHE Yuan-yuan,TAN Yan,FANG Yan-qiu,XU Shu-fen,LIU Lei,SUN Mu-nan. Clinical value of glycosyl-phosphatidyl inositol anchored protein detection on diagnosis of paroxysmal nocturnal hemoglobinuria[J]. J4, 2008, 34(6): 1018-1021.

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