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目的研究系统性红斑狼疮(SLE)合并血小板减少病人的血清对正常人骨髓巨核细胞倍体形成的影响,了解SLE血小板减少病人的血清对正常巨核细胞产生血小板的能力有无抑制作用。方法12例SLE血小板减少病人为研究对象,正常骨髓细胞来源于胸外科手术切除的肋骨(胸外伤或食管裂孔疝患者),骨髓细胞体外培养,并分别加入12例SLE血小板减少病人的血清、灭活补体的病人的血清和SLE血小板正常病情活动病人的血清,流式细胞仪分析检测培养细胞中CD41+细胞(巨核细胞)的倍体分布。结果正常人骨髓细胞培养后,2倍体、4倍体和8倍体的巨核细胞数分别为(37.8±5.4)%、(29.8±3.3)%和(2.61±0.63)%;加入SLE血小板减少病人的血清后4倍体和8倍体细胞明显受到抑制,分别为(15.91±2.65)%和(0.44±0.12)%,P<0.05。灭活血清中的补体后,这种抑制作用仍然存在。与10%浓度的SLE血小板减少病人血清相比,20%的血清则几乎完全抑制了8倍体和4倍体细胞的形成。结论SLE血小板减少病人血清存在某种抑制物,抑制正常人高倍体巨核细胞的形成,这种抑制作用是非补体依赖的,并与剂量相关。
Objective To investigate the effect of serum of patients with systemic lupus erythematosus (SLE) combined with thrombocytopenia on the proliferation of megakaryocytes in normal human bone marrow and to find out whether the serum of patients with SLE thrombocytopenia has an inhibitory effect on the ability of normal megakaryocytes to produce platelets. Methods Twelve SLE patients with thrombocytopenia were studied. Normal bone marrow cells were obtained from thoracotomy patients with thoracic or esophageal hiatal hernia. Bone marrow cells were cultured in vitro and serum of 12 patients with SLE thrombocytopenia were added. Serum from patients with live complement and those with SLE from patients with normal disease activity was analyzed by flow cytometry to detect the ploidy distribution of CD41 + cells (megakaryocytes) in cultured cells. Results After cultured in normal human bone marrow cells, the number of megakaryocytes at 2, 4 and 8-fold was (37.8 ± 5.4)%, (29.8 ± 3.3)% and (2.61 ± 0.63)%, respectively. SLE thrombocytopenia Patients’ serum levels of 4-and 8-somatic cells were significantly inhibited (15.91 ± 2.65)% and (0.44 ± 0.12)%, respectively, P <0.05. This inactivation persisted after inactivating serum complement. 20% of the sera almost completely inhibited the formation of 8-and 4-somatic cells compared to 10% of SLE patients. Conclusions The serum of SLE patients with thrombocytopenia has some inhibitors, which inhibit the formation of normal human high-density megakaryocytes. The inhibitory effect is non-complement dependent and dose-dependent.