摘要
目的探讨红细胞和粒细胞膜CD55与CD59抗原表达在阵发性睡眠性血红蛋白尿症(PNH)合并全血细胞减少症(PCP)诊断中的应用。方法采用流式细胞术结合直接免疫荧光法,检测PCP患者病因可疑为PNH的的外周血红细胞和粒细胞膜CD55与CD59抗原的表达。结果 125例中,PNH32例,非PNH 93例(包括再生障碍性贫血80例,病因不明PCP 13例)。外周血红细胞膜CD55和CD59抗原表达缺失诊断PNH合并PCP敏感度和特异度分别为93.75%和82.80%,粒细胞膜CD55和CD59抗原表达缺失诊断的敏感度和特异度分别为100%和81.72%。随访中,非PNH病例中有13例转化为PNH;这些病例的红细胞膜CD55和CD59抗原表达缺失率分别为84.62%和92.31%,粒细胞膜CD55和CD59抗原表达缺失率分别为92.31%和100%。结论利用流式细胞术同时检测患者红细胞和粒细胞膜CD55与CD59抗原对PNH合并PCP的的诊断及鉴别诊断具有重要的价值。
Objective To discuss the application of CD55 and CD59 antigen expressions of the erythrocyte and granulocyte cell membranes in the diagnosis of paroxysmal nocturnal hemoglobinuria（PNH） complicated with pancytopenia.Methods Flow cytometry and direct immuofluorescence staining were used to detect the expressions of CD55 and CD59 antigens in the cell membranes of peripheral erythrocytes and granulocytes in pancytopenia with susceptible etiology of PNH.Results Thirty-two of the 125 cases were PNH,and 93 were non-PNH including 80 cases of aplastic anemia and 13 cases of pancytopenia with unknown etiology.The negative expressions of the CD55 and CD59 antigens of the peripheral erythrocytes have 93.75% sensitivity and 82.80% specificity in the diagnosis of PNH complicated with pancytopenia.There is 100% sensitivity and 81.72% specificity for the diagnosis based on the negative expressions of the CD55 and CD59 antigens of the granulocyte cell membranes.It is known from the subsequent follow-up of the patents that 13 of the non-PNH cases were transformed into PNH.The negative expression rates of these patient cases are 84.62% and 92.31% respectively for the CD55 and CD59 antigens in the erythrocyte cell membrane,and 92.31% and 100% respectively in the granulocyte cell membrane.Conclusion The simultaneous detection of patients＇ CD55 and CD59 antigens in the cell membranes of erythrocytes and granulocytes by flow cytometry is significantly valuable in the diagnosis and differential diagnosis of PNH complicated with pancytopenia.
出处
《福建医科大学学报》
2011年第6期442-444,共3页
Journal of Fujian Medical University
