中文摘要：

目的分析骨髓增生异常综合征（MDS）患者外周血自然杀伤（NK）细胞占淋巴细胞百分比、功能变化及其与造血功能相关性，并对不同危险度进行分析，探讨NK细胞在MDS发病机制中的作用。方法用流式细胞术检测2013年3—11月天津医科大学总医院血液科收治的20例MDS患者（MDS组）、15例急性髓系白血病（AML）患者（AML组）的外周血NK（CD3-CDl6＋CD56＋）细胞占淋巴细胞百分比、NK细胞胞膜活化性受体（NKG2D、NKp44）和抑制性受体（CDl58a、CDl58b）及NK细胞胞质蛋白穿孔素、颗粒酶．13的表达，并与15名健康对照（对照组）比较；分析上述变化与外周血中性粒细胞比例（ANC％）、淋巴细胞比例（Lyre％）、血红蛋白、血小板、网织红细胞百分比（RET％）及骨髓原始细胞百分比（CD34’％）的相关性。结果（1）MDS组NK细胞占淋巴细胞百分比（3．87％±0．97％）显著低于对照组（6．08％．4-1．37％），高于AML组（2．58％±0．78％）（均P〈0．05）。（2）MDS组NK细胞表面NKC2D表达（中位数：52．83％）显著低于对照组（86．36％），高于AML组（42．00％）（均P〈0．05）。NI~p44表达，MDS组高于AML组和对照组（中位数：2．41％比0．92％、0．62％，均P〈0．05）。（3）MDS组和AML组NK细胞表面CDl58a表达（5．46％±2．40％、4．05％±1．89％）均显著低于对照组（7．97％±2．85％）（均P〈0．05）。CDl58b表达3组间差异无统计学意义（P〉0．05）。（4）MDS组NK细胞穿孔素表达（中位数：17．83％）显著低于对照组（59．79％），高于AML组（13．06％）（均P〈0．05）；MDS组、A／VIL组NK细胞颗粒酶-B表达（中位数：21．54％、30．65％）均显著低于对照组（83．42％）（均P〈0．05）。（5）MDS患者低危组NK细胞占淋巴细胞百分比及NKG2D、NKp44表达高于高危组（4．06％±0．56％比3．59％±1．37％、53．

英文摘要：

Objective To analyze the percentage and functional changes of natural kill （NK） cell in peripheral blood of myelodysplastic syndrome （MDS） patients so as to evaluate the relationships between these changes and hematopoietic functions and explore the role of NK cell in the pathogenesis of MDS. Methods By flow cytometry, the percentage of NK cell （ CD3 - CD56 ± CDI6 ± ） in peripheral blood lymphocytes was detected in 20 MDS patients, 15 acute myelogenous leukemics （AML） and 15 normal controls from March 2013 to November 2013 at our hospital. NK cell activation receptors （ NKG2D, NKp44）, inhibitory receptors （ CD 158 a, CD 158 b） , perforin and granzyme-13 of patients and normal controls were also detected. The correlation between these changes and hematopoietic functions, including the percentages of neutrophil granulocyte （ANC%）, lymphocyte （Lyre%）, reticulocyte （RET%） and hemoglobin, thrombocyte in peripheral blood and the hematopoietic function in bone marrow （CD34 % ） were evaluated. Results （ 1 ） The percentage of NK cell （3.87 % ± 0. 97 % ） in MDS patients was significantly lower than that of normal controls （6. 08% ± 1.37%, P 〈 0. 05 ） and higher than that of AML patients （2.58% ± 0.78%, P 〈0.05）. （2） The expression of NKG2D in MDS patients （52.83%） was significantly lower than that of normal controls （86. 36% , P 〈 0. 05） and higher than that of AML patients （42.00%, P 〈0. 05）. The expression of NKp44 in MDS patients （2.41%） was significantly higher than that of normal controls （0. 62% ） and AML patients （0. 92% ） （ both P 〈 0.05 ）. （3） The expression of CD158a in MDS and AML patients （5.46% ± 2.40%, 4. 05% ± 1.89% ） were significantly both lower than those of normal controls （7.97% ± 2. 85% , both P 〈 0.05 ） . The expression of CD158b had no significant difference among the 3 groups. （4） The expression of perforin in MDS patients （ 17. 83% ） was significantly lower than that of no