贫血患者外周血CD55、CD59检测及对PNH临床意义

发布时间：2018-01-07 11:00

本文关键词：贫血患者外周血CD55、CD59检测及对PNH临床意义　出处：《安徽医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:检测贫血性疾病外周血CD55、CD59表达并行相关实验检查,探讨临床意义。方法:选取2012年6月到2014年2月入院的贫血患者共计129例行流式细胞仪术(flow cytometry,FCM)CD55、CD59检测,同时选取健康人25例作为对照,对贫血性疾病患者以健康对照人群CD55、CD59检出结果进行综合对比与分析,并同时做嗜水气单胞菌毒素变异体(fluorescent aerolysin,FLAER)实验、酸化血清溶血实验(Ham实验)、尿含铁血黄素试验(尿Rous实验)、网织红细胞计数(Ret计数)。结果:与健康组和其他贫血组相比,AA-PNH和PNH患者外周血红细胞与粒细胞CD55、CD59表达明显低下(P0.05),表达均小于95.0%,部分AA与部分MDS患者外周血红细胞与粒细胞CD55、CD59表达也可低下,但表达均大于48.0%,与健康组和其他贫血组(除AA-PNH和PNH组)相比,差异无统计学意义(P0.05)。纯红再障、巨幼细胞贫血、自身免疫性溶血性贫血、缺铁性贫血患者CD55、CD59表达均在正常范围。部分AA-PNH和PNH患者,加做FLAER实验,显示外周血粒细胞及单核细胞PNH克隆明显增加,与对照组比较,差异有统计学意义(P0.05)。对于AA-PNH、PNH患者而言,FLAER实验粒细胞PNH克隆与自身粒细胞及红细胞表面CD55、CD59阴性表达检出结果差异明显(P0.05),FLAER实验单核细胞PNH克隆与自身粒细胞及红细胞表面CD55、CD59阴性表达检出结果差异也比较明显(P0.05)。结论:CD55、CD59检测与FLAER实验在诊断AA-PNH、PNH患者中有重要意义,是目前诊断PNH的最敏感,最可靠的方法,也可作为疗效判断及观察病情变化的手段,与其他贫血性疾病鉴别诊断方面也有重要意义。
[Abstract]:Objective: to detect the expression of CD55 and CD59 in peripheral blood of anemia disease. Methods: a total of 129 patients with anemia admitted to hospital from June 2012 to February 2014 underwent flow cytometry (FCM) with flow cytometry (cytometry). FCM-CD55-CD59 was detected and 25 healthy persons were selected as control. The results of CD55-mCD59 in healthy controls were compared and analyzed. At the same time, the fluorescent aerolysin FLAER-test of Aeromonas hydrophila and the Ham test of acidified serum hemolysis were also done. Urine hemosiderin test (Rous test, reticulocyte count Ret count). Results: compared with healthy group and other anemia group. In patients with AA-PNH and PNH, the expression of CD55 / CD59 in erythrocytes and granulocytes was significantly lower than 95.0%. The expression of CD55 and CD59 in peripheral blood red blood cells and granulocytes of patients with partial AA and partial MDS was also lower, but the expression of CD55-tCD59 was higher than 48.0%. Compared with the healthy group and other anemia group (except AA-PNH and PNH group), there was no significant difference (P 0.05). Pure red aplastic anemia, megaloblastic anemia, autoimmune hemolytic anemia. The expression of CD55 and CD59 in patients with iron deficiency anemia was in normal range. FLAER test was performed in some patients with AA-PNH and PNH. The results showed that the number of PNH clones in peripheral blood granulocytes and monocytes was significantly higher than that in control group (P 0.05). The negative expression of CD55 and CD59 on the surface of autologous granulocytes and erythrocytes was significantly different from that of granulocyte PNH clone in FLAER assay (P0.05). There was also a significant difference in the negative expression of CD55 and CD59 between monocyte PNH clone and autologous granulocyte and erythrocyte surface in FLAER assay. CD59 detection and FLAER test have important significance in the diagnosis of AA-PNH PNH patients. It is the most sensitive and reliable method to diagnose PNH at present. It can also be used as a means to judge the curative effect and observe the changes of the disease, and it is also of great significance in differential diagnosis with other anemia diseases.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R556

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