高铝暴露地区再生障碍性贫血患者免疫细胞功能的变化
发布时间：2019-03-08 15:59
【摘要】：目的:研究高铝暴露地区再生障碍性贫血(aplastic anemia,AA)患者免疫细胞功能的变化及其临床特点,分析不同血铝水平与免疫细胞和免疫因子的关系。方法:选取确诊AA病例62例,根据饮用水铝含量及病例来源分为2组,饮用水铝含量300μg/L并长期居住于铝工业地区为高铝暴露地区AA组,共33例;饮用水铝含量300ug/L并长期居住于非铝工业地区为非高铝暴露地区AA组,共29例,同时选取高铝暴露地区及非高铝暴露地区健康人群各30例作为对照组。采用电感藕合等离子体质谱(inductivity coupled plasma mass spectrometry,ICP-MS)方法检测血清铝水平,酶联免疫吸附法(enzyme linked immuno sorbent assay,ELISA)法检测细胞因子IL-10、IL-12、IL-17及INF-γ表达情况,流式细胞术(flow cytometry,FCM)检测淋巴细胞亚群比例,同时收集患者免疫球蛋白、补体C3、C4表达水平数据及临床资料。分析高铝暴露地区AA患者免疫细胞及免疫因子变化特点,探讨血清铝与免疫指标的关系。结果:1、高铝地区人群(高铝AA及高铝健康组)血清铝水平高于非高铝地区人群(非高铝AA及非高铝健康)(P0.05)。高铝暴露地区AA患者血清铝水平增高,显著高于非高铝暴露地区AA组及健康对照组(均P0.01)。2、高铝暴露地区AA患者的贫血程度、骨髓造血组织减少程度明显重于非高铝暴露地区AA组(均P0.05),但两组患者的发病年龄、性别、白细胞、中性粒细胞数目、网织红细胞数量、血小板数量、骨髓增生程度无明显差异。3、高铝暴露地区AA患者CD4+T淋巴细胞比例、CD4+/CD8+高于非高铝暴露地区AA组及健康对照组(均P0.05),CD8+T淋巴细胞比例低于非高铝地区AA组及健康对照组(均P0.05),CD3+、CD+19、NK细胞比例两组比较无明显统计学差异(均P0.05)。CD4+T、CD8+T淋巴细胞比例、CD4+/CD8+与血清铝水平未见相关性(r=0.169,P=0.067;r=0.072,P=0.438;r=-0.039,P=0.679)。4、高铝暴露地区AA患者IL-10、IFN-γ水平高于非高铝暴露地区AA组(均P0.05)。IL-17、IL-12水平两组比较无统计学差异(均P0.05)。血清铝水平与细胞因子IL-10(r=0.072,P=0.4290.05)、IFN-γ(r=0.480,P=0.598)间未见相关性。5、IgG、IgA、IgM、IgE水平在高铝暴露地区AA组与非高铝暴露地区AA组间的表达均无差异(均P0.05)。6、高铝暴露地区AA患者补体C4水平显著低于非高铝暴露AA组(P0.01),补体C3水平在两组间比较无明显统计学差异(P0.05)。血清铝与补体C4水平(r=0.097,P=0.311)未见相关性。结论:高铝暴露地区人群血清铝水平高于非高铝暴露地区人群。高铝暴露可能影响AA患者免疫功能。高铝暴露地区AA免疫细胞功能特点有别于非高铝暴露地区AA,以细胞免疫和免疫因子改变显著,血清铝水平与免疫细胞和免疫因子间未见相关性。
[Abstract]:Aim: to study the changes of immune cell function and its clinical characteristics in patients with aplastic anemia (aplastic anemia,AA) exposed to high aluminum, and to analyze the relationship between serum aluminum levels and immune cells and immune factors. Methods: 62 cases of AA were selected and divided into two groups according to the aluminum content of drinking water and the source of the cases. The drinking water aluminum content was 300 渭 g / L and lived for a long time in the high aluminum exposed area of AA group (33 cases). Drinking water aluminum content 300ug/L and long-term living in non-aluminum industrial areas are non-high aluminum exposed areas of AA group, a total of 29 cases, and high aluminum exposure areas and non-high aluminum exposure areas 30 healthy people as the control group. The serum aluminum level was measured by inductively coupled plasma mass spectrometry (inductivity coupled plasma mass spectrometry,ICP-MS), and the expression of cytokines IL-10,IL-12,IL-17 and INF- 纬 was detected by enzyme-linked immunosorbent assay (enzyme linked immuno sorbent assay,ELISA). Flow cytometry (flow cytometry,FCM) was used to detect the proportion of lymphocyte subsets. The data of immunoglobulin, complement C3, C4 expression and clinical data were collected. To analyze the changes of immune cells and immune factors in AA patients exposed to high aluminum, and to explore the relationship between serum aluminum and immune indexes. Results: 1. The level of serum aluminum in high aluminum area (high aluminum AA and high aluminum healthy group) was higher than that in non high aluminum area population (non high aluminum AA and non high aluminum health group) (P0.05). The level of serum aluminum in AA patients in high aluminum exposure area was significantly higher than that in non high aluminum exposed area AA group and healthy control group (P0.01). 2. The anemia degree of AA patients in high aluminum exposed area was significantly higher than that in non high aluminum exposed area (P < 0 01). The degree of bone marrow hemopoietic tissue decrease was more severe than that in AA group (P0.05), but the age, sex, leukocyte, neutrophil, reticulocyte and platelet count in the two groups were significantly higher than those in the control group (P0.05). There was no significant difference in myeloproliferative degree. 3. The ratio of CD4 T lymphocytes and CD4 / CD8 in AA patients exposed to high aluminum were higher than those in AA group and healthy control group in non-aluminum exposed area (P 0.05). The percentage of CD8 T lymphocyte was lower than that of AA group and healthy control group (all P0.05), and there was no significant difference in CD3, CD 19, NK cell ratio between the two groups (P0.05). CD4 T, CD8 T lymphocyte ratio was not significantly different between the two groups (P 0.05). There was no correlation between CD4 / CD8 and serum aluminum level (r = 0.169, P = 0.067). 0. 072, 0. 438, 0. 072, 0. 438; (4) the level of IL-10,IFN- 纬 in AA patients exposed to high aluminum was higher than that in AA patients without high aluminum exposure (P 0.05). There was no significant difference in IL-17,IL-12 level between the two groups (P 0.05). There was no correlation between serum Al level and cytokines IL-10 (r = 0.072, P = 0.4290.05) and IFN- 纬 (r = 0.480, P = 0.598). There was no significant difference in the expression of IgE between the AA group and the AA group in the high aluminum exposure area (P0.05). 6. The complement C4 level of the AA patients in the high aluminum exposed area was significantly lower than that in the non high aluminum exposed AA group (P0.01). There was no significant difference in complement C3 level between the two groups (P0.05). There was no correlation between serum aluminum and complement C4 (r = 0.097, P = 0.311). Conclusion: the level of serum aluminum in high aluminum exposed area is higher than that in non high aluminum exposed area. High aluminum exposure may affect immune function in patients with AA. The functional characteristics of AA immune cells in high aluminum exposed areas were significantly different from those in non high aluminum exposed areas. The changes of cellular immunity and immune factors were significant in AA, exposed to high aluminum. There was no correlation between serum aluminum levels and immune cells and immune factors.
【学位授予单位】：右江民族医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R556.5
[Abstract]:Aim: to study the changes of immune cell function and its clinical characteristics in patients with aplastic anemia (aplastic anemia,AA) exposed to high aluminum, and to analyze the relationship between serum aluminum levels and immune cells and immune factors. Methods: 62 cases of AA were selected and divided into two groups according to the aluminum content of drinking water and the source of the cases. The drinking water aluminum content was 300 渭 g / L and lived for a long time in the high aluminum exposed area of AA group (33 cases). Drinking water aluminum content 300ug/L and long-term living in non-aluminum industrial areas are non-high aluminum exposed areas of AA group, a total of 29 cases, and high aluminum exposure areas and non-high aluminum exposure areas 30 healthy people as the control group. The serum aluminum level was measured by inductively coupled plasma mass spectrometry (inductivity coupled plasma mass spectrometry,ICP-MS), and the expression of cytokines IL-10,IL-12,IL-17 and INF- 纬 was detected by enzyme-linked immunosorbent assay (enzyme linked immuno sorbent assay,ELISA). Flow cytometry (flow cytometry,FCM) was used to detect the proportion of lymphocyte subsets. The data of immunoglobulin, complement C3, C4 expression and clinical data were collected. To analyze the changes of immune cells and immune factors in AA patients exposed to high aluminum, and to explore the relationship between serum aluminum and immune indexes. Results: 1. The level of serum aluminum in high aluminum area (high aluminum AA and high aluminum healthy group) was higher than that in non high aluminum area population (non high aluminum AA and non high aluminum health group) (P0.05). The level of serum aluminum in AA patients in high aluminum exposure area was significantly higher than that in non high aluminum exposed area AA group and healthy control group (P0.01). 2. The anemia degree of AA patients in high aluminum exposed area was significantly higher than that in non high aluminum exposed area (P < 0 01). The degree of bone marrow hemopoietic tissue decrease was more severe than that in AA group (P0.05), but the age, sex, leukocyte, neutrophil, reticulocyte and platelet count in the two groups were significantly higher than those in the control group (P0.05). There was no significant difference in myeloproliferative degree. 3. The ratio of CD4 T lymphocytes and CD4 / CD8 in AA patients exposed to high aluminum were higher than those in AA group and healthy control group in non-aluminum exposed area (P 0.05). The percentage of CD8 T lymphocyte was lower than that of AA group and healthy control group (all P0.05), and there was no significant difference in CD3, CD 19, NK cell ratio between the two groups (P0.05). CD4 T, CD8 T lymphocyte ratio was not significantly different between the two groups (P 0.05). There was no correlation between CD4 / CD8 and serum aluminum level (r = 0.169, P = 0.067). 0. 072, 0. 438, 0. 072, 0. 438; (4) the level of IL-10,IFN- 纬 in AA patients exposed to high aluminum was higher than that in AA patients without high aluminum exposure (P 0.05). There was no significant difference in IL-17,IL-12 level between the two groups (P 0.05). There was no correlation between serum Al level and cytokines IL-10 (r = 0.072, P = 0.4290.05) and IFN- 纬 (r = 0.480, P = 0.598). There was no significant difference in the expression of IgE between the AA group and the AA group in the high aluminum exposure area (P0.05). 6. The complement C4 level of the AA patients in the high aluminum exposed area was significantly lower than that in the non high aluminum exposed AA group (P0.01). There was no significant difference in complement C3 level between the two groups (P0.05). There was no correlation between serum aluminum and complement C4 (r = 0.097, P = 0.311). Conclusion: the level of serum aluminum in high aluminum exposed area is higher than that in non high aluminum exposed area. High aluminum exposure may affect immune function in patients with AA. The functional characteristics of AA immune cells in high aluminum exposed areas were significantly different from those in non high aluminum exposed areas. The changes of cellular immunity and immune factors were significant in AA, exposed to high aluminum. There was no correlation between serum aluminum levels and immune cells and immune factors.
【学位授予单位】：右江民族医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R556.5
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