本文關(guān)鍵詞：貧血患者外周血CD55、CD59檢測(cè)及對(duì)PNH臨床意義　出處：《安徽醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 貧血 陣發(fā)性睡眠性血紅蛋白尿癥 CD55 CD59 流式細(xì)胞儀

【摘要】：目的:檢測(cè)貧血性疾病外周血CD55、CD59表達(dá)并行相關(guān)實(shí)驗(yàn)檢查,探討臨床意義。方法:選取2012年6月到2014年2月入院的貧血患者共計(jì)129例行流式細(xì)胞儀術(shù)(flow cytometry,FCM)CD55、CD59檢測(cè),同時(shí)選取健康人25例作為對(duì)照,對(duì)貧血性疾病患者以健康對(duì)照人群CD55、CD59檢出結(jié)果進(jìn)行綜合對(duì)比與分析,并同時(shí)做嗜水氣單胞菌毒素變異體(fluorescent aerolysin,FLAER)實(shí)驗(yàn)、酸化血清溶血實(shí)驗(yàn)(Ham實(shí)驗(yàn))、尿含鐵血黃素試驗(yàn)(尿Rous實(shí)驗(yàn))、網(wǎng)織紅細(xì)胞計(jì)數(shù)(Ret計(jì)數(shù))。結(jié)果:與健康組和其他貧血組相比,AA-PNH和PNH患者外周血紅細(xì)胞與粒細(xì)胞CD55、CD59表達(dá)明顯低下(P0.05),表達(dá)均小于95.0%,部分AA與部分MDS患者外周血紅細(xì)胞與粒細(xì)胞CD55、CD59表達(dá)也可低下,但表達(dá)均大于48.0%,與健康組和其他貧血組(除AA-PNH和PNH組)相比,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。純紅再障、巨幼細(xì)胞貧血、自身免疫性溶血性貧血、缺鐵性貧血患者CD55、CD59表達(dá)均在正常范圍。部分AA-PNH和PNH患者,加做FLAER實(shí)驗(yàn),顯示外周血粒細(xì)胞及單核細(xì)胞PNH克隆明顯增加,與對(duì)照組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。對(duì)于AA-PNH、PNH患者而言,FLAER實(shí)驗(yàn)粒細(xì)胞PNH克隆與自身粒細(xì)胞及紅細(xì)胞表面CD55、CD59陰性表達(dá)檢出結(jié)果差異明顯(P0.05),FLAER實(shí)驗(yàn)單核細(xì)胞PNH克隆與自身粒細(xì)胞及紅細(xì)胞表面CD55、CD59陰性表達(dá)檢出結(jié)果差異也比較明顯(P0.05)。結(jié)論:CD55、CD59檢測(cè)與FLAER實(shí)驗(yàn)在診斷AA-PNH、PNH患者中有重要意義,是目前診斷PNH的最敏感,最可靠的方法,也可作為療效判斷及觀察病情變化的手段,與其他貧血性疾病鑒別診斷方面也有重要意義。
[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.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R556

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本文編號(hào)：1392246