系统性红斑狼疮血小板减少患者巨核祖细胞分化障碍

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1、维普资讯http://www.cqvip.com上海医学2004年第27卷第lO期739论著·系统性红斑狼疮血小板减少患者巨核祖细胞分化障碍徐亮王元陈顺乐沈南【摘要】目的明确系统性红斑狼疮(SLE)血小板减少患者骨髓巨核祖细胞增殖分化情况，以及患者血清对巨核祖细胞增殖分化的影响。方法分离7例SLE血小板减少患者(SLE血小板减少组)、11例胸外科开胸手术切除肋骨患者(正常对照组)和4例SLE血小板正常但病情活动患者(SLE血小板正常组)的骨髓单个核细胞，体外巨核祖细胞(CFU—MK)无血清半固体培养；并分别加入SLE血小板减少和SLE血小板正常患者的血

2、清，观察血清对CFU—MK集落形成的影响。结果SLE血小板减少组CFU—MK集落数为(27．33±9．30)个／片，明显低于正常对照组的(61．22±29．71)个／片和SLE血小板正常组的(60．00±29．71)个／片(P值均<0．05)；加入SLE血小板减少患者血清后，SLE血小板减少组(n=7)和正常对照组(=7)CFU．MK集落数分别减少为(14．29±6．73)和(29．44±23．35)个／片(P<0．05)。加入SLE血小板正常患者血清后，正常对照组(n=7)CFU—MK增加到(115．60±72．99)个／片，与未加血清者的差异无显著

3、性(P<0．05)；而SLE血小板减少组(=7)无显著增加(P>0．05)。结论SLE血小板减少患者骨髓巨核祖细胞分化障碍，患者血清对骨髓巨核祖细胞的分化具有抑制作用。【关键词】红斑狼疮，系统性；巨核祖细胞；细胞培养Existenceofadifferentiationblockageatthestageofamegakaryocyteprecursorinsystemiclupuserythematosusas-sociatedwiththromhocytopeniaXULiang，WANGYuan，CHENShunle，eta1．Departmen

4、tofRheurnatol—ogy，RenjiHospital，ShanrghaiSecondMedicalUniversity，Shang矗aiInstituteofRheumatology，Shanghai200001．China【Abstract】ObjectiveTostudythedifferentiationofmegakaryocyteprogenitorsinsystemiclupuserythemato—SUS(SLE)associatedwiththrombocytopenia，andtheserumeffectsofthesepa

5、tientsontheproliferationanddifferenti—ationofmegakaryocyteprogenitors．MethodsSevenpatientswithSLE—associatedthrombocytopenia，fourSLEpa—tientswhohadnothrombocytopeniaandelevennormalcontrolswereincludedinthisstudy．Bonemarrowmononuclearcellsfromal1subjectswereculturedinvitroinserum

6、—freefibrinclotsysteminthepresenceofcombinationofthrom—bopoietin(TPO)，interleukin一3(IL一3)andinterleukin一6(IL一6)．Colony—formingunits—megakaryocyte(CFU—MK)werequantifiedbyindirectimmunophosphatasealkalinelabelingtechniqueusinganti—GP1Ib／IllaMoAb．TheeffectsofserumfromSLEassociatedw

7、iththrombocytopeniaontheformationofCFU．MKwerealsostudiedinthesameculturesystemforallsubjects．ResultsAsignificantlyloweringofmegakaryocyteprogenitors(CFUMK)wasobservedinpa—tientswithSLEassociatedwiththrombocytopenia(27．33±9．30CFU—MKper2．2×10bonemarrowmononuclearcells)，comparedtot

8、henormalcontrol(61．22±29．71CFU—MK)andthepatient