摘要:
This study was aimed to explore the change charactedtics of cell differentiation antigen (CD) on bone marrow(BM) granulocyts in patients,with megaloblastic anemia(MA).In combination with BM cell morphology,hemogram,level of blood serum folic acid,level of Vit B12,cell genetics and biologocal examination data,the BM granulocytes differentiation antigens in 13 patients with MA were detected by flow cytometery and analyzed retrospectively,in order to summarize the variation characteristics of CD13,CD33 and CD15 expressed on myeloid cells in patient with MA,including forward scatter light (FSC) and side scatter light (SSC) signal intensity,then these findings were compared with that in normal healthy persons.The results showed that the expression rates of CD13,CD15 and CD33 on granulocytics in patients with MA and normal healthy persons were (44.53 ± 16)%,(96.16 ± 2.67)%,(80.81 ±14.71)% and (62.33+11.02)%,(99.53±0.46)%,(70.00±7.81)% respectively,in which the expression rate of CD13 and CD15 in patients with MA decreased(P <0.01),while the expression rate of CD33 increased(P <0.01).The mean fluorescence intensity(MFI) of CD13,CD15,CD33,SSC and FSC in MA patients and normal helthy persons were 3.39 ± 1.41,14.29 ±6.59,1.95 ±0.94,478.78 +70.43,633.46 ±75.53 and 5.12 ± 1.15,20.67 ± 5.13,1.04 ± 0.17,332.00 ± 38.16,537.00 ± 16.70 respectively,in which the MFI of CD13 and CD15 on granulocytes in MA patients decreased(P <0.01),while the MFI of FSC,SSC and CD33 increased(P <0.01 and P < 0.05).It is concluded that not only the morphology of BM granulocytes in patents with MA shows dysmaturity,but the expressing feature of differentiation antigens on BM granulocytes in MA patients also displays dysmaturity.These findings will contrubute to the clinical diagnosis of MA patients.%本研究探讨巨幼细胞性贫血(megaloblastic anemia,MA)患者骨髓(bone marrow,BM)粒细胞的分化抗原(cell differentiation antigen,CD)变化.结合骨髓象、血象、血清叶酸、Vit B12含量、细胞遗传学以及有关分子生物学检查等资料,对13例MA患者骨髓细胞的流式细胞术检测结果进行回顾分析,总结MA患者骨髓粒细胞相关特异性分化抗原CD13、CD33、CD15的表达及粒细胞前向散射光(forward scattering light,FSC)、侧向散射光(side scatter light,ssc)的信号强度变化特点并与正常人群比较.结果表明:MA患者和正常人的粒细胞表面CD13、CD15、CD33的表达率分别为(44.53±16)%、(96.16±2.67)%、(80.81±14.71)%和(62.33±11.02)%、(99.53±0.46)%、(70.00±7.81)%,其中MA粒细胞CD13、CD15表达率下降(P<0.01),CD33表达率增高(P<0.01).MA患者和正常人的粒细胞CD13、CD15、CD33、SSC、FSC的平均荧光强度(mean fluorescence intensity,MFI)分别是3.39±1.41、14.29±6.59、1.95±0.94、478.78±70.43、633.46±75.53和5.12±1.15、20.67±5.13、1.04±0.17、332.00±38.16、537.00±16.70,其中MA粒细胞CD13、CD15的MFI值下降(P<0.01);而FSC、SSC和CD33的MFI值增高(P<0.01和P<0.05).结论:MA患者粒细胞不仅在形态学上表现为成熟障碍,而且其分化抗原的表达也呈现成熟障碍的特征,这对于临床上诊断MA具有一定的意义.