目的：分析再生障碍性贫血（AA）、骨髓增生异常综合征（MDS）和急性髓系白血病（AML）患者外周血 T 淋巴细胞相关细胞因子表达水平的变化，探讨3种疾病的细胞免疫状态是否存在差异。方法采用流式细胞微球芯片捕获术（CBA）检测20例 AA 患者（AA 组）、20例 MDS患者[MDS 组，难治性贫血（RA）与难治性贫血伴原始细胞增多（RAEB）各10例]、20例 AML患者（AML 组）和10名健康体检者（正常对照组）外周血中 IL-4、IL-17、IFN-γ，TNF-α的表达水平，间接评价各组 T 淋巴细胞免疫状态，并作组间比较。结果与正常对照组相比，AA 组 IFN-γ、TNF-α、IL-17表达水平均较高，MDS-RA 组 IFN-γ和 IL-17表达水平均较高（P 均＜0．05），MDS-RAEB 组和 AML 组 IL-4表达水平均较高（P 均＜0．05）。与 AA 组比较，MDS 组 TNF-α表达水平较低（P ＜0．05）。与 AML 组比较，MDS 组 TNF-α、IFN-γ和 IL-17表达水平均较高（P 均＜0．05）。与 AA组比较，MDS-RAEB 组和 AML 组 IFN-γ、IL-17和 TNF-α表达水平均较低（P 均＜0．05），但 IL-4表达水平均较高（P 均＜0．05）；与 MDS-RA 组比较，MDS-RAEB 组和 AML 组 IFN-γ、TNF-α和 IL-17表达水平均较低（P 均＜0．05），而 IL-4表达水平均较高（P 均＜0．05）。结论 AA、不同阶段 MDS和 AML 患者所处的 T 淋巴细胞免疫状态并不相同。%Objective To measure the expression levels of T lymphocyte-related cytokines in the pe-ripheral blood of patients with aplastic anemia (AA),myelodysplastic syndrome (MDS),acute myeloid leuke-mia (AML)for comparing the immune status of T lymphocytes in these diseases.Methods Cytometric bead array (CBA)were used to measure the expression levels of IL-4,IL-1 7,IFN-γand TNF-αin the peripheral blood from 20 patients diagnosed with AA (AA group),20 with MDS (MDS group:1 0 with RA and 1 0 with RAEB),20 with AML (AML group)and 1 0 healthy individuals (normal control group).The immune status of T lymphocytes was evaluated and compared among different groups.Results Compared with the normal control group,the levels of IFN-γ,TNF-αand IL-1 7 in the AA group were significantly up-regulated (all P <0.05).IFN-γand IL-1 7 levels in patients with MDS-RA were considerably up-regulated (both P <0.05). The levels of IL-4 in patients with MDS-RAEB and AML were significantly increased in comparison to normal controls (both P <0.05).Compared with the AA group,the level of TNF-αin the MDS group was considera-bly down-regulated (P <0.05).The expression of TNF-α,IFN-γand IL-1 7 in the MDS group was significant-ly up-regulated compared with those in the AML group (all P <0.05).The expression of TNF-α,IFN-γand IL-1 7 in the MDS-RAEB and AML groups was dramatically lower whereas the level of IL-4 was significantly higher than those in the AA group (all P <0.05).The expression levels of TNF-α,IFN-γand IL-1 7 in the MDS-RAEB and AML groups was significantly lower whereas the level of IL-4 was significantly higher than those in the MDS-RAEB group (all P <0.05).Conclusion The immune status of T lymphocytes were dif-fered among AA,various stages of MDS and AML.
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