Abstract
目的观察骨髓增生异常综合征(MDS)患者单个核细胞诱导的巨噬细胞的功能,分析其与MDS疾病发展的关系。方法以2014年9月至2015年12月天津医科大学总医院血液科24例MDS患者为病例组,以15名健康志愿者为正常对照组。收集外周血标本并分离单个核细胞,体外以GM-CSF诱导分化形成巨噬细胞。在光学显微镜下观察巨噬细胞的形态;使用流式细胞术检测巨噬细胞的数量及其表面受体CD206、SIRPα的表达水平;分别采用流式细胞术和免疫荧光显微镜检测巨噬细胞的吞噬功能。结果①MDS来源的巨噬细胞形态较正常对照差(形态不规则、细胞体积小、异形明显、无足突、数量减少),MDS外周血单个核细胞转化为巨噬细胞的转化率为(5.17±3.47)%,显著低于正常对照组的(66.18±13.43)%(t=3.529,P=0.001);②MDS来源的巨噬细胞表面识别受体CD206的表达水平[(9.73±2.59)%]显著低于正常对照组[(51.15±10.82)%](t=4.551,P<0.001),SIRPα的表达水平[(0.51±0.09)%]显著低于正常对照组[(0.77±0.06)%](t=2.102,P=0.043);③MDS来源的巨噬细胞吞噬免疫微球的吞噬指数、吞噬百分率分别为0.45±0.08、(23.69±3.22)%,显著低于正常对照组的0.92±0.07、(42.75±2.13)%(P值均<0.05),MDS来源的巨噬细胞吞噬单个核细胞的吞噬指数(0.24±0.04)显著低于正常对照组(0.48±0.96,t=3.464,P=0.001)。结论MDS患者外周血单个核细胞诱导形成巨噬细胞能力下降,吞噬识别受体减少,吞噬能力减弱。
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