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目的 探讨选择性IgA缺乏症 (SelectiveIgADeficiency ,SIgAD)患者的细胞免疫功能 ,指导临床诊断与治疗。 方法 以激光比浊法测定患者血清IgG、IgA、IgM水平 ,以银染法检测外周血T淋巴细胞增殖活性 ,以单抗花环法检测T淋巴细胞亚群水平 ,以ELISA法检测血清中干扰素 -γ(IFN -γ)、白细胞介素 - 4 (IL - 4 )水平来评价辅助性T细胞亚群活性。结果 ① 2 2例IgA水平低于 0 .1 g/L而IgG、IgM基本正常的患者 ,CD3、CD4、CD8计数与正常对照组之间差异无统计学意义 (P >0 .0 5) ,CD4/CD8比值显著低于正常对照组 ,差异有统计学意义 (P <0 .0 5) ;②T淋巴细胞增殖活性 (I .S % )为 (4.75± 1 .1 7) % ,与对照组比较明显降低 ,差异有统计学意义 (P<0 .0 1 ) ;③SIgAD患者血清IL - 4水平与正常对照组比较显著降低 ,差异有统计学意义 (P <0 .0 5) ,IFN -γ分泌无明显变化。 结论 ①选择性IgA缺乏症患者细胞免疫活性低于正常水平 ;②IL - 4分泌水平降低 ,提示Th2类活性降低 ,在选择性IgA缺乏相关疾病中存在Th1 /Th2的不平衡。
Objective To investigate the cellular immune function in patients with selective IgA deficiency (SIgAD) and to guide clinical diagnosis and treatment. Methods Serum IgG, IgA and IgM levels were measured by laser nephelometry. The proliferation activity of peripheral blood T lymphocytes was detected by silver staining. The level of T lymphocyte subsets was detected by the monoclonal antibody anti - -γ (IFN-γ), interleukin-4 (IL-4) levels were used to assess the activity of helper T cell subsets. Results ① There were no significant differences in the counts of CD3, CD4, CD8 between the two groups (P> 0.05) and the normal control group in 22 patients with IgA level less than 0.1 g / L and IgG, IgM basically normal CD4 / CD8 ratio was significantly lower than the normal control group, the difference was statistically significant (P <0.05); ②T lymphocyte proliferation activity (I .S%) was (4.75 ± 1.17)%, and the control group (P <0.01). ③ The level of serum IL - 4 in patients with SsgAD was significantly lower than that in controls (P <0.05), the level of IFN - γ No significant changes in secretion. Conclusions ① The cellular immunocompetence of patients with selective IgA deficiency is lower than normal; ② The level of IL - 4 secretion is decreased, which indicates that the activity of Th2 is decreased. There is an imbalance of Th1 / Th2 in the diseases associated with selective IgA deficiency.