流式细胞术分析神经系统疾病患者脑脊液T淋巴细胞亚群

检验医学 ›› 2012, Vol. 27 ›› Issue (5): 364-370.

流式细胞术分析神经系统疾病患者脑脊液T淋巴细胞亚群

蔡蓓,冯伟华,李立新,王兰兰

四川大学华西医院实验医学科，四川成都 610041

收稿日期:2012-03-29 修回日期:2012-04-15 出版日期:2012-05-30 发布日期:2012-05-10
通讯作者: 王兰兰，联系电话:028-85422751。
作者简介:蔡　蓓，女，1978年生，博士，主管技师，主要从事细胞免疫调节效应研究。
基金资助:
高等学校博士学科点专项教育部博士点专项科研基金资助项目(20090181110026);新教师基金课题资助项目（20090181120099）

Flow cytometry application in analyzing T lymphocyte subsets of cerebrospinal fluid in patients with neural systemic diseases

Department of Clinical Laboratory, West China Hospital of Sichuan University, Sichuan Chengdu 610041, China

Received:2012-03-29 Revised:2012-04-15 Online:2012-05-30 Published:2012-05-10

摘要/Abstract

摘要： 目的　〖JP2〗用流式细胞术分析脑脊液中T淋巴细胞及其亚群，探讨不同类型神经系统疾病患者脑脊液中T淋巴细胞亚群百分率差异，寻找在疾病诊断和治疗监测中有意义的实验室检测指标。方法　采用流式细胞术测定神经系统疾病患者脑脊液和外周血T淋巴细胞亚群。结果　采用流式细胞术分析脑脊液中T淋巴细胞亚群时，运用侧向散射点（SS） vs.CD45能更准确的确定淋巴细胞群；但流式细胞术只适用于检测神经系统免疫相关疾病患者脑脊液中T淋巴细胞亚群，不适用于分析神经系统变性疾病患者。中枢神经系统炎性疾病和脊髓炎患者脑脊液中CD3⁺T淋巴细胞、CD3⁺CD4⁺T淋巴细胞和CD3⁺CD8⁺T淋巴细胞百分率最高，脱髓鞘疾病患者脑脊液T淋巴细胞亚群百分率最低，但各类神经系统疾病患者脑脊液中T淋巴细胞百分率无明显差异（P>0.05）。细菌性脑膜炎患者脑脊液中CD3⁺T淋巴细胞和CD3⁺CD4⁺T淋巴细胞百分率最高，明显高于脱髓鞘疾病患者（P=0.032），但与病毒性脑膜炎患者比较差异无统计学意义（P>0.05）。各类神经系统疾病患者脑脊液中CD4/CD8比值明显高于外周血，其中细菌性脑膜炎和脊髓炎患者脑脊液中CD4/CD8比值最高，脱髓鞘疾病脑脊液中CD4/CD8比值最低，但差异均无统计学意义（P>0.05）。脑脊液IgG生成指数与脑脊液中CD3⁺CD4⁺T淋巴细胞百分率有一定相关性（r=0.324，P=0.032)。结论　流式细胞术分析神经系统炎性疾病较脑脊液常规检测具有优势，敏感性更高，可同时分析脑脊液免疫状况。流式细胞术分析在神经系统相关炎性疾病具有重要意义， CD3⁺CD4⁺T淋巴细胞高百分率与神经系统炎性疾病密切相关。但流式细胞术对于神经系统变性疾病的临床应用有限。

关键词: T淋巴细胞亚群, 流式细胞术, 神经系统疾病, 脑脊液

Abstract: Objective　To analyze T lymphocyte and its subsets in cerebrospinal fluid (CSF) by flow cytometry (FCM), investigate the difference of T lymphocyte subset percentages in CSF of patients with different neural systemic diseases, and find the significant indicators in diagnosis and treatment monitoring. Methods　The T lymphocyte subsets in peripheral blood and CSF were determined in patients with neural systemic diseases. Results　Making plots based on side scaffer (SS) vs. CD45 was more accurate to define lymphocytes in CSF by FCM. FCM was only suitable for analyzing lymphocyte subsets in neural systemic immune diseases. The percentages of CD3⁺T lymphocytes, CD3⁺CD4⁺T lymphocytes and CD3⁺CD8⁺T lymphocytes in CSF of patients with inflammatory diseases of central nervous system or myelitis were the highest, those in patients with demyelinating diseases were the lowest. There was no significant difference in the percentage of T lymphocyte subsets of CSF among kinds of neural systemic diseases(P>0.05). The percentages of CD3⁺T lymphocytes and CD3⁺CD4⁺T lymphocytes in CSF from patients with bacterial meningitis were higher than those in patients with demyelinating diseases (P=0.032), and there was no statistical significance with those in patients with viral meningitis（P>0.05). The ratios of CD4/CD8 were significantly higher in CSF in all kinds of neural systemic diseases than those in peripheral blood. The ratio in CSF was the highest in patients with bacterial meningitis and myelitis, and was the lowest in demyelinating diseases with no statistical significance（P>0.05）. The correlation coefficient(r) was 0.324 between CSF IgG production index and the percentage of CD3⁺ CD4⁺ T lymphocytes in CSF (P=0.032). ConclusionsFCM for T lymphocyte subset analysis in inflammatory neural systemic diseases is more sensitive and helpful in analyzing the immune status of CSF than CSF routine examination. High percentage of CD3⁺CD4⁺T lymphocytes is closely related with neural systemic inflammatory diseases, but it is limited for FCM application in neurodegenerative diseases.

Key words: T lymphocyte subset, Flow cytometry, Neural systemic disease, Cerebrospinal fluid

蔡　蓓;冯伟华;李立新;王兰兰. 流式细胞术分析神经系统疾病患者脑脊液T淋巴细胞亚群[J]. 检验医学, 2012, 27(5): 364-370.

CAI Bei;FENG Weihua;LI Lixin;WANG Lanlan. Flow cytometry application in analyzing T lymphocyte subsets of cerebrospinal fluid in patients with neural systemic diseases[J]. , 2012, 27(5): 364-370.

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