| Objective: To detect the expression levels ofCD3 +, CD4 +, CD8 +, T-bet gene and IFN-γin aplastic anemia and myelodysplastic syndrome patients, and to study its Clinical differential diagnosis significance.Methods: The study included 14 cases of aplastic anemia(AA),20 cases of myelodysplastic Syndrome (MDS) and 30 cases normal control(NC).There were 14 cases of aplastic anemia (8 males and 6 females,aging form 14 to 66 with a median age of 26),including chronic aplastic anemia(CAA)9cases and 5cases of acute aplastic anemia (SAA). There were 20 cases of myelodysplastic Syndrome (9males and 11 females, aging form 27to 75 with a median age of 58), including refractory anemia(RA) 8cases,refractory anemia with excess blasts (RAEB)12cases.Take 30 normal cases as controls. (15males and 15 females, aging form 20 to 75 with a median age of 55) . the expression levels of CD3 +, CD4 +,CD8+ was detected by the immunofluorescence and flow cytometry. The expression levels of T-bet were measured by the real-time quantitative reverse transcription polymerase chain reaction. and The expression levels of IFN-γwere measured by the ELISE. We studied the expression of these makers in patients who,s post-treatment in 6 months .Finally, collect the clinical date to parallel.Results: 1 1The expression level of CD3 +, CD4 +, CD8 + ,CD4+/ CD8+1.1 The levels of CD3(+)T cells in AA were higher than those in control group(75.338±5.620 VS67.441±12.817,P<0.05),No differences of the levels of CD4 (+)T cells were between the both AA and control group(31.852±6.425VS33.424±8.415, P>0.05), The levels of CD8(+)T cells in AA were higher than those in control group(34.956±6.206 VS27.032±9.046P <0.05), The ratios of CD4+/CD8+ were lower than those of control group (1.177±0.436 VS1.484±0.378 P<0.05)1.2 The levels of CD3(+)T cells in MDS were lower than those in control group(62.241±9.102 VS67.441±12.817, P<0.05),No differences of the levels of CD3 (+)T cells were between the both low-risk group and control group (65.803±13.859 VS67.441±12.817, P>0.05), The levels of CD3(+)T cells in high-risk group were lower than those in control group(52.417±12.585 VS67.441±12.817 P<0.05)。The levels of CD4(+)T cells in MDS and high-risk group were lower than those in control group( 39.283±9.913 VS33.424±8.415, 42.536±10.711 VS33.424±8.415 P <0.05),No differences of the levels of CD4 (+)T cells were between the both low-risk group and control group(33.322±9.603 VS33.424±8.415 P>0.05), The levels of CD8(+)T cells in high-risk group were lower than those in control group(26.634±3.568 VS 27.032±9.046 P>0.05); there no difference between the other groups. and control group, The ratios of CD4+/CD8+ in MDS and high-risk group were higher than those in control group(1.630±1.063 VS1.484±0.378,1.801±1.089 VS1.484±0.378 P<0.05), No differences of the ratios of CD4+/CD8+ were between in low-risk group and control group(1.3313±0.424.MDS VS1.484±0.378 P>0.05);1.3 The levels of CD3(+)T cells in AA group were higher than those in MDS group, low-risk group and high-risk group. The levels of CD4(+)T cells in AA group were lower than those in MDS group and high-risk group, No differences of the levels of CD4(+)T cells were between in AA group and low-risk group. The levels of CD8(+)T cells in AA group were higher than those in MDS group, low-risk group and high-risk group, but there were no differences between AA group and low-risk group. The ratios of CD4+/CD8+ in AA group were lower than those in MDS group and high-risk group, but there were no differences between AA group and low-risk group. 1.4 The patients with AA were serially analyzed before and after treatment, the levels of CD3 + were decreased, The levels of CD4 + were increase, The levels of CD8 + were decreased, The ratios of CD4 + / CD8 +were decreased to close normal. And the changes of CD3 +, CD8 +, CD4 + / CD8 + were statistically significant.2 The expression levels of T-bet gene and IFN-γ2.1 The expression levels of T-bet gene2.1.1 The level of t-bet gene in AA group was significantly higher than that in control group(0.255±0.188 VS0.092±0.058,P<0.05)。2.1.2 The level of T-bet gene in MDS group was lower than those in and control group(0.085±0.041 VS0.092±0.058,P<0.05);The levels of t-bet gene in low-risk group and high-risk group were lower than that in control group, but there were no differences between control group and low-risk group.2.1.3 The level of t-bet gene in AA group was significantly higher than that in MDS group, low-risk group and high-risk group.2.1.4. The patients with AA were serially analyzed before and after treatment, compared with the untreated group ,the level of T-bet gene were decreased(0.153±0.078 VS0.255±0.188 P<0.05)。2.2 The Serum levels of IFN - r2.2.1 The level of IFN-γin AA group was significantly higher than that in control group(9.756±2.537 VS 7.552±0.640 P<0.05)。2.2.2 The level of IFN-γin MDS group was lower than those in control group. (5.365±2.338 VS 7.552±0.640 P<0.05);The levels of IFN-γin low-risk group were higher than that in high-risk group ,but there were no differences between control group and low-risk group.2.2.3 The level of IFN-γin AA group was significantly higher than that in MDS group, low-risk group and high-risk group.2.2.4 The patients with AA were serially analyzed before and after treatment, compared with the untreated group ,the level of IFN-γwere decreased。(9.756±2.537 VS7.6822±2.338 P<0.05)。2.2.5 The levels of t-bet gene in aplastic anemia group and myelodysplastic syndrome group were positively correlated with those of IFN-γ,Pearson respective:o.64,0.7 0(P﹤0.01) Conclusions:1 T lymphocyte immune phenotype testingAlthough there were no differences of the levels of CD3+, CD4 +, CD8 + CD4/CD8 between the low-risk group and the control group. But when AA group was compared with MDS group, low-risk group and high-risk group, all the indicators are statistically significant. And after treatment all the indicators were changed in patients with AA .These changes reveal that abnormality of immune function plays an important role at the onset of AA. and MDS. Immunologic abnormality to promote the advancement of the myelodysplastic syndrome. by flow cytometry Detecting AA and MDS T-lymphocyte immune phenotype helps us to clear the body's immune status, and can better help us both identify and guide clinical treatment.2 The expression levels of t-bet gene and IFN-γ.The expression levels of t-bet gene and IFN-γin AA group was significantly higher than the MDS group and the normal control group, and compared with the untreated group, the levels of t-bet gene and IFN-γin patients with AA were decreased。There exist the closely correlate between the etiopathogenesis of aplastic anemia with the levels of t-bet gene and IFN-γ.the Immunologic abnormality is the main etiological factor to the aplastic anemiathe. Existing the immune state heterogeneity in the MDS group, Immunologic abnormality to promote the advancement of the MDS. But patients in the MDS group have ununiformity in immune state. So identify immunization the factor Precisely effectiveness in the myelodysplastic syndrome, we must the carry out more investigation.3 The multivariable indicators could be used for to guide clinical identification and diagnosis purposes.
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